NEW GENERATION (NGN) NCLEX RN EXAM – 2026/2027 EDITION
QUESTIONS AND ANSWERS WITH DETAILED RATIONALES EACH |
CURRENTLY TESTING AND FREQUENTLY TESTED QUESTIONS | EXPERT
VERIFIED FOR GUARANTEED PASS
SECTION 1: MANAGEMENT OF CARE (Q1 - Q50)
Q1. A nurse is caring for a client who has a new prescription for warfarin. Which
of the following client statements indicates a need for further teaching?
A) "I will avoid eating large amounts of leafy green vegetables."
B) "I will take ibuprofen for my headaches instead of acetaminophen."
C) "I will report any unusual bleeding or bruising to my provider."
D) "I will have my blood drawn regularly to check my INR."
Ans: B
Rationale: Ibuprofen is an NSAID that increases the risk of bleeding when taken
with warfarin. Acetaminophen is the preferred analgesic for clients on warfarin
because it does not significantly affect platelet function or increase bleeding risk.
Leafy green vegetables contain vitamin K, which antagonizes warfarin; consistent
intake is more important than avoidance. Regular INR monitoring is essential for
warfarin therapy.
Q2. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which
of the following tasks should the nurse delegate to the UAP?
A) Administering a tube feeding
B) Assessing a client's surgical incision
C) Measuring a client's intake and output
D) Performing a sterile dressing change
Ans: C
Rationale: Measuring intake and output is within the scope of practice for a UAP.
Administering tube feedings, assessing surgical incisions, and performing sterile
dressing changes require licensed nursing judgment and skills. The nurse retains
accountability for delegated tasks and must provide appropriate supervision.
1
,Q3. A nurse is preparing to discharge a client who has a new colostomy. Which of
the following actions is the nurse's priority?
A) Providing a list of ostomy support groups
B) Ensuring the client can independently care for the colostomy
C) Scheduling a follow-up appointment with the wound care nurse
D) Teaching the client about dietary modifications
Ans: B
Rationale: The priority is ensuring the client demonstrates independent self-care
of the colostomy before discharge. This includes cleaning the stoma, applying a
new ostomy bag, and recognizing signs of complications. While support groups,
follow-up appointments, and dietary teaching are important, independent self-
care is essential for safe discharge.
Q4. A client is admitted with a do-not-resuscitate (DNR) order. The client's family
member requests that the DNR order be rescinded. Which of the following
actions should the nurse take?
A) Contact the healthcare provider to discuss the family's request
B) Rescind the DNR order and initiate resuscitation if needed
C) Inform the family that the DNR order cannot be changed
D) Ask the family member to leave the unit
Ans: A
Rationale: A DNR order can be rescinded at the client's or surrogate decision-
maker's request. The nurse should contact the healthcare provider to facilitate a
discussion and document the client's wishes. The nurse should not independently
rescind a DNR order. The healthcare provider must write a new order to rescind
the DNR.
Q5. A nurse is caring for a client who is confused and attempting to pull out the
intravenous (IV) line. Which of the following restraints should the nurse apply?
A) Soft wrist restraints
B) A vest restraint
C) A mitten restraint
D) A waist restraint
Ans: C
2
,Rationale: Mitten restraints are least restrictive and allow the client freedom of
movement while preventing them from grasping the IV line. Soft wrist restraints
should be used only when less restrictive measures are ineffective. Vest and waist
restraints are more restrictive and should be avoided when possible.
Q6. A nurse is preparing to administer a blood transfusion. Which of the following
actions is most important before beginning the transfusion?
A) Obtain the client's baseline vital signs
B) Verify the client's identification with another licensed nurse
C) Ensure the client has signed the informed consent
D) Check the expiration date on the blood product
Ans: B
Rationale: The most important step before a blood transfusion is verifying the
client's identification with another licensed nurse. Two nurses must verify the
client's name, medical record number, blood type, and crossmatch results. This
prevents transfusion reactions due to incompatible blood.
Q7. A client with a new prescription for enoxaparin is being discharged. Which of
the following instructions should the nurse include in the teaching?
A) "Massage the injection site after administration to promote absorption."
B) "Administer the injection in the abdomen at least 2 inches from the umbilicus."
C) "Expel the air bubble from the prefilled syringe before injection."
D) "You will need to have your aPTT monitored regularly."
Ans: B
Rationale: Enoxaparin is administered subcutaneously in the abdomen, at least 2
inches from the umbilicus. The injection site should be rotated. The air bubble in
the prefilled syringe should not be expelled; it ensures delivery of the full dose.
Massage after injection can cause bruising and hematoma. Enoxaparin does not
require aPTT monitoring; anti-Xa levels may be monitored if needed.
Q8. A nurse is caring for a client who has a central venous catheter. Which of the
following findings should the nurse report to the provider immediately?
A) Catheter dressing is intact and dry
B) Client reports pain at the insertion site
C) Temperature of 101.2°F (38.4°C)
3
, D) The catheter is flushing easily
Ans: C
Rationale: Fever is a sign of possible catheter-related bloodstream infection
(CRBSI) and should be reported immediately. Pain at the insertion site may
indicate infection or irritation but does not require immediate reporting unless
accompanied by other signs. An intact dressing and easy flushing are expected
findings.
Q9. A nurse is providing education to a client who has a new diagnosis of diabetes
mellitus. Which of the following statements by the client indicates understanding
of the teaching?
A) "I will check my blood glucose before each meal and at bedtime."
B) "I will administer my insulin after I eat my meals."
C) "I can skip my insulin if I am not feeling hungry."
D) "I will rotate my insulin injection sites weekly."
Ans: A
Rationale: Blood glucose monitoring before meals and at bedtime is the
recommended schedule for most clients with diabetes. Insulin should be
administered before meals (rapid-acting) to cover the postprandial glucose rise.
Insulin should never be skipped. Injection sites should be rotated within the same
anatomical area to prevent lipohypertrophy.
Q10. A nurse is caring for a client who has a prescription for a nasogastric (NG)
tube. Which of the following actions should the nurse take to verify placement of
the NG tube?
A) Auscultate for air insufflation over the epigastric area
B) Aspirate gastric contents and check the pH
C) Observe the client for coughing or choking
D) Measure the length of the tube from the nose to the ear
Ans: B
Rationale: The most reliable method to verify NG tube placement is aspirating
gastric contents and checking the pH. Gastric aspirate has a pH of 5 or less.
Auscultation for air insufflation is no longer recommended due to high false-
4
QUESTIONS AND ANSWERS WITH DETAILED RATIONALES EACH |
CURRENTLY TESTING AND FREQUENTLY TESTED QUESTIONS | EXPERT
VERIFIED FOR GUARANTEED PASS
SECTION 1: MANAGEMENT OF CARE (Q1 - Q50)
Q1. A nurse is caring for a client who has a new prescription for warfarin. Which
of the following client statements indicates a need for further teaching?
A) "I will avoid eating large amounts of leafy green vegetables."
B) "I will take ibuprofen for my headaches instead of acetaminophen."
C) "I will report any unusual bleeding or bruising to my provider."
D) "I will have my blood drawn regularly to check my INR."
Ans: B
Rationale: Ibuprofen is an NSAID that increases the risk of bleeding when taken
with warfarin. Acetaminophen is the preferred analgesic for clients on warfarin
because it does not significantly affect platelet function or increase bleeding risk.
Leafy green vegetables contain vitamin K, which antagonizes warfarin; consistent
intake is more important than avoidance. Regular INR monitoring is essential for
warfarin therapy.
Q2. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which
of the following tasks should the nurse delegate to the UAP?
A) Administering a tube feeding
B) Assessing a client's surgical incision
C) Measuring a client's intake and output
D) Performing a sterile dressing change
Ans: C
Rationale: Measuring intake and output is within the scope of practice for a UAP.
Administering tube feedings, assessing surgical incisions, and performing sterile
dressing changes require licensed nursing judgment and skills. The nurse retains
accountability for delegated tasks and must provide appropriate supervision.
1
,Q3. A nurse is preparing to discharge a client who has a new colostomy. Which of
the following actions is the nurse's priority?
A) Providing a list of ostomy support groups
B) Ensuring the client can independently care for the colostomy
C) Scheduling a follow-up appointment with the wound care nurse
D) Teaching the client about dietary modifications
Ans: B
Rationale: The priority is ensuring the client demonstrates independent self-care
of the colostomy before discharge. This includes cleaning the stoma, applying a
new ostomy bag, and recognizing signs of complications. While support groups,
follow-up appointments, and dietary teaching are important, independent self-
care is essential for safe discharge.
Q4. A client is admitted with a do-not-resuscitate (DNR) order. The client's family
member requests that the DNR order be rescinded. Which of the following
actions should the nurse take?
A) Contact the healthcare provider to discuss the family's request
B) Rescind the DNR order and initiate resuscitation if needed
C) Inform the family that the DNR order cannot be changed
D) Ask the family member to leave the unit
Ans: A
Rationale: A DNR order can be rescinded at the client's or surrogate decision-
maker's request. The nurse should contact the healthcare provider to facilitate a
discussion and document the client's wishes. The nurse should not independently
rescind a DNR order. The healthcare provider must write a new order to rescind
the DNR.
Q5. A nurse is caring for a client who is confused and attempting to pull out the
intravenous (IV) line. Which of the following restraints should the nurse apply?
A) Soft wrist restraints
B) A vest restraint
C) A mitten restraint
D) A waist restraint
Ans: C
2
,Rationale: Mitten restraints are least restrictive and allow the client freedom of
movement while preventing them from grasping the IV line. Soft wrist restraints
should be used only when less restrictive measures are ineffective. Vest and waist
restraints are more restrictive and should be avoided when possible.
Q6. A nurse is preparing to administer a blood transfusion. Which of the following
actions is most important before beginning the transfusion?
A) Obtain the client's baseline vital signs
B) Verify the client's identification with another licensed nurse
C) Ensure the client has signed the informed consent
D) Check the expiration date on the blood product
Ans: B
Rationale: The most important step before a blood transfusion is verifying the
client's identification with another licensed nurse. Two nurses must verify the
client's name, medical record number, blood type, and crossmatch results. This
prevents transfusion reactions due to incompatible blood.
Q7. A client with a new prescription for enoxaparin is being discharged. Which of
the following instructions should the nurse include in the teaching?
A) "Massage the injection site after administration to promote absorption."
B) "Administer the injection in the abdomen at least 2 inches from the umbilicus."
C) "Expel the air bubble from the prefilled syringe before injection."
D) "You will need to have your aPTT monitored regularly."
Ans: B
Rationale: Enoxaparin is administered subcutaneously in the abdomen, at least 2
inches from the umbilicus. The injection site should be rotated. The air bubble in
the prefilled syringe should not be expelled; it ensures delivery of the full dose.
Massage after injection can cause bruising and hematoma. Enoxaparin does not
require aPTT monitoring; anti-Xa levels may be monitored if needed.
Q8. A nurse is caring for a client who has a central venous catheter. Which of the
following findings should the nurse report to the provider immediately?
A) Catheter dressing is intact and dry
B) Client reports pain at the insertion site
C) Temperature of 101.2°F (38.4°C)
3
, D) The catheter is flushing easily
Ans: C
Rationale: Fever is a sign of possible catheter-related bloodstream infection
(CRBSI) and should be reported immediately. Pain at the insertion site may
indicate infection or irritation but does not require immediate reporting unless
accompanied by other signs. An intact dressing and easy flushing are expected
findings.
Q9. A nurse is providing education to a client who has a new diagnosis of diabetes
mellitus. Which of the following statements by the client indicates understanding
of the teaching?
A) "I will check my blood glucose before each meal and at bedtime."
B) "I will administer my insulin after I eat my meals."
C) "I can skip my insulin if I am not feeling hungry."
D) "I will rotate my insulin injection sites weekly."
Ans: A
Rationale: Blood glucose monitoring before meals and at bedtime is the
recommended schedule for most clients with diabetes. Insulin should be
administered before meals (rapid-acting) to cover the postprandial glucose rise.
Insulin should never be skipped. Injection sites should be rotated within the same
anatomical area to prevent lipohypertrophy.
Q10. A nurse is caring for a client who has a prescription for a nasogastric (NG)
tube. Which of the following actions should the nurse take to verify placement of
the NG tube?
A) Auscultate for air insufflation over the epigastric area
B) Aspirate gastric contents and check the pH
C) Observe the client for coughing or choking
D) Measure the length of the tube from the nose to the ear
Ans: B
Rationale: The most reliable method to verify NG tube placement is aspirating
gastric contents and checking the pH. Gastric aspirate has a pH of 5 or less.
Auscultation for air insufflation is no longer recommended due to high false-
4
