NCLEX-RN 2027 LATEST – NGN PRACTICE EXAM-ALL
QUESTIONS AND ANSWERS PLUS DETAILED RATIONALES |
COMPLETE STUDYGUIDE | DOWNLOAD INSTANT PDF 2027-
2028
1. A nurse is caring for a client 4 hours after a thyroidectomy. The client suddenly develops
stridor and difficulty breathing. Which action should the nurse take FIRST?
A. Administer the prescribed opioid analgesic
B. Assess the surgical dressing for drainage
C. Position the client supine
D. Activate the emergency response system and prepare for airway management
Answer: D
Stridor after thyroidectomy is a medical emergency that may indicate airway obstruction from
edema or a neck hematoma. Immediate airway support and emergency assistance take
priority.
2. A client with heart failure reports a 2.5-kg (5.5-lb) weight gain over the past 3 days.
Which finding is most concerning?
A. Increased appetite
B. Bilateral crackles and worsening dyspnea
C. Dry oral mucosa
D. Heart rate of 72/min
Answer: B
Rapid weight gain accompanied by crackles and dyspnea indicates worsening fluid retention
and pulmonary congestion, requiring prompt intervention.
3. A nurse is preparing to administer insulin lispro to a client with diabetes mellitus. Which
action is most appropriate?
A. Administer it shortly before the meal according to the prescribed timing
B. Give it at bedtime regardless of food intake
C. Hold it for a blood glucose level above the prescribed range
D. Administer it only after the client finishes eating
,Answer: A
Insulin lispro is rapid-acting insulin and is generally administered in close proximity to meals.
Timing should follow the prescription and facility protocol.
4. A client receiving a blood transfusion develops chills, fever, and low back pain 15
minutes after the transfusion begins. What should the nurse do FIRST?
A. Slow the transfusion rate
B. Administer acetaminophen
C. Stop the transfusion and maintain IV access with appropriate solution using new tubing
D. Obtain a urine specimen
Answer: C
Fever, chills, and back pain can indicate an acute hemolytic transfusion reaction. The
transfusion must be stopped immediately while IV access is maintained for emergency
treatment.
5. A nurse is assessing a client with suspected increased intracranial pressure. Which
finding requires immediate intervention?
A. Headache rated 4/10
B. New-onset unequal pupils
C. Mild nausea
D. Photophobia
Answer: B
New anisocoria can indicate neurological deterioration and possible brain herniation. It
requires immediate assessment and intervention.
6. A client with chronic obstructive pulmonary disease is receiving oxygen therapy. Which
nursing action is appropriate?
A. Maintain oxygen at the lowest prescribed level that achieves the desired oxygenation
B. Discontinue oxygen whenever the client becomes dyspneic
C. Apply a nonrebreather mask routinely
D. Increase oxygen to maximum flow whenever respiratory rate rises
,Answer: A
Clients with COPD require individualized oxygen therapy. The nurse should administer the
prescribed oxygen and monitor respiratory status rather than automatically maximizing
oxygen delivery.
7. A client receiving morphine after surgery has a respiratory rate of 8/min and is difficult
to arouse. Which medication should the nurse anticipate administering?
A. Flumazenil
B. Protamine
C. Naloxone
D. Vitamin K
Answer: C
Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression.
Respiratory support and close monitoring are also essential.
8. A nurse is caring for a client with severe hypokalemia. Which ECG change should the
nurse expect?
A. Peaked T waves
B. Widened QRS complexes as the earliest expected change
C. ST-segment elevation
D. Flattened or inverted T waves with prominent U waves
Answer: D
Hypokalemia can produce flattened T waves, ST depression, and prominent U waves. Severe
potassium abnormalities can cause dangerous dysrhythmias.
9. A client with hyperkalemia has a potassium level of 6.8 mEq/L and ECG changes. Which
prescribed medication should the nurse administer to stabilize the myocardium?
A. Calcium gluconate
B. Sodium chloride
C. Furosemide only
D. Regular insulin without glucose
, Answer: A
IV calcium stabilizes the cardiac membrane during significant hyperkalemia with ECG
changes. It does not remove potassium but temporarily reduces the risk of lethal dysrhythmias.
10. A nurse is caring for a client with suspected sepsis. Which finding requires the most
immediate attention?
A. Temperature of 38.1°C (100.6°F)
B. Blood pressure of 82/48 mm Hg with altered mental status
C. Heart rate of 102/min
D. White blood cell count of 13,000/mm³
Answer: B
Hypotension with altered mental status suggests impaired tissue perfusion and possible septic
shock. Immediate sepsis management and hemodynamic support are priorities.
11. A client with diabetes mellitus becomes pale, diaphoretic, shaky, and confused. The
blood glucose level is 48 mg/dL. The client is awake and able to swallow. What should the
nurse do?
A. Administer rapid-acting carbohydrate
B. Administer long-acting insulin
C. Encourage exercise
D. Restrict oral fluids
Answer: A
A conscious client who can safely swallow should receive a rapidly absorbed carbohydrate for
symptomatic hypoglycemia, followed by reassessment.
12. A client taking warfarin has an INR of 5.8 and reports bleeding gums. Which action
should the nurse take?
A. Administer the next warfarin dose
B. Encourage foods high in sodium
C. Hold the medication and notify the provider promptly
D. Give aspirin for pain
QUESTIONS AND ANSWERS PLUS DETAILED RATIONALES |
COMPLETE STUDYGUIDE | DOWNLOAD INSTANT PDF 2027-
2028
1. A nurse is caring for a client 4 hours after a thyroidectomy. The client suddenly develops
stridor and difficulty breathing. Which action should the nurse take FIRST?
A. Administer the prescribed opioid analgesic
B. Assess the surgical dressing for drainage
C. Position the client supine
D. Activate the emergency response system and prepare for airway management
Answer: D
Stridor after thyroidectomy is a medical emergency that may indicate airway obstruction from
edema or a neck hematoma. Immediate airway support and emergency assistance take
priority.
2. A client with heart failure reports a 2.5-kg (5.5-lb) weight gain over the past 3 days.
Which finding is most concerning?
A. Increased appetite
B. Bilateral crackles and worsening dyspnea
C. Dry oral mucosa
D. Heart rate of 72/min
Answer: B
Rapid weight gain accompanied by crackles and dyspnea indicates worsening fluid retention
and pulmonary congestion, requiring prompt intervention.
3. A nurse is preparing to administer insulin lispro to a client with diabetes mellitus. Which
action is most appropriate?
A. Administer it shortly before the meal according to the prescribed timing
B. Give it at bedtime regardless of food intake
C. Hold it for a blood glucose level above the prescribed range
D. Administer it only after the client finishes eating
,Answer: A
Insulin lispro is rapid-acting insulin and is generally administered in close proximity to meals.
Timing should follow the prescription and facility protocol.
4. A client receiving a blood transfusion develops chills, fever, and low back pain 15
minutes after the transfusion begins. What should the nurse do FIRST?
A. Slow the transfusion rate
B. Administer acetaminophen
C. Stop the transfusion and maintain IV access with appropriate solution using new tubing
D. Obtain a urine specimen
Answer: C
Fever, chills, and back pain can indicate an acute hemolytic transfusion reaction. The
transfusion must be stopped immediately while IV access is maintained for emergency
treatment.
5. A nurse is assessing a client with suspected increased intracranial pressure. Which
finding requires immediate intervention?
A. Headache rated 4/10
B. New-onset unequal pupils
C. Mild nausea
D. Photophobia
Answer: B
New anisocoria can indicate neurological deterioration and possible brain herniation. It
requires immediate assessment and intervention.
6. A client with chronic obstructive pulmonary disease is receiving oxygen therapy. Which
nursing action is appropriate?
A. Maintain oxygen at the lowest prescribed level that achieves the desired oxygenation
B. Discontinue oxygen whenever the client becomes dyspneic
C. Apply a nonrebreather mask routinely
D. Increase oxygen to maximum flow whenever respiratory rate rises
,Answer: A
Clients with COPD require individualized oxygen therapy. The nurse should administer the
prescribed oxygen and monitor respiratory status rather than automatically maximizing
oxygen delivery.
7. A client receiving morphine after surgery has a respiratory rate of 8/min and is difficult
to arouse. Which medication should the nurse anticipate administering?
A. Flumazenil
B. Protamine
C. Naloxone
D. Vitamin K
Answer: C
Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression.
Respiratory support and close monitoring are also essential.
8. A nurse is caring for a client with severe hypokalemia. Which ECG change should the
nurse expect?
A. Peaked T waves
B. Widened QRS complexes as the earliest expected change
C. ST-segment elevation
D. Flattened or inverted T waves with prominent U waves
Answer: D
Hypokalemia can produce flattened T waves, ST depression, and prominent U waves. Severe
potassium abnormalities can cause dangerous dysrhythmias.
9. A client with hyperkalemia has a potassium level of 6.8 mEq/L and ECG changes. Which
prescribed medication should the nurse administer to stabilize the myocardium?
A. Calcium gluconate
B. Sodium chloride
C. Furosemide only
D. Regular insulin without glucose
, Answer: A
IV calcium stabilizes the cardiac membrane during significant hyperkalemia with ECG
changes. It does not remove potassium but temporarily reduces the risk of lethal dysrhythmias.
10. A nurse is caring for a client with suspected sepsis. Which finding requires the most
immediate attention?
A. Temperature of 38.1°C (100.6°F)
B. Blood pressure of 82/48 mm Hg with altered mental status
C. Heart rate of 102/min
D. White blood cell count of 13,000/mm³
Answer: B
Hypotension with altered mental status suggests impaired tissue perfusion and possible septic
shock. Immediate sepsis management and hemodynamic support are priorities.
11. A client with diabetes mellitus becomes pale, diaphoretic, shaky, and confused. The
blood glucose level is 48 mg/dL. The client is awake and able to swallow. What should the
nurse do?
A. Administer rapid-acting carbohydrate
B. Administer long-acting insulin
C. Encourage exercise
D. Restrict oral fluids
Answer: A
A conscious client who can safely swallow should receive a rapidly absorbed carbohydrate for
symptomatic hypoglycemia, followed by reassessment.
12. A client taking warfarin has an INR of 5.8 and reports bleeding gums. Which action
should the nurse take?
A. Administer the next warfarin dose
B. Encourage foods high in sodium
C. Hold the medication and notify the provider promptly
D. Give aspirin for pain
