NCSBN NCLEX-RN TEST PLAN ALIGNED | NGN
MEASUREMENT MODEL
NEW GENERATION
NCLEX QUESTIONS
Real exam-style questions with verified answers. 150 NGN-format items
across all eight client-need categories — including multiple response,
bow-tie, drag-and-drop, fill-in-the-blank, hot spot, and trend items —
each mapped to the Clinical Judgment Measurement Model with
detailed rationales.
Real Exam-Style Questions with Verified Answers
1 00% C ORRE C T | NG N F ORMAT | G RA D E D A +
E D I TI O N · 15 0 Q U E STI O N S · E XTE N D E D C A SE - STU D Y TE STL E TS
,NEW GENERATION NCLEX QUESTIONS | 2026/2027 EDITION
Section 1: Management of Care – NGN Scenarios
Q1: The nurse receives report on four clients at the beginning of the shift. Which client should the nurse
assess first?
A. A client 2 days postoperative appendectomy reporting incisional pain rated 4 out of 10
B. A client with chronic atrial fibrillation whose apical pulse is 78/min and regular
C. A client reporting new-onset chest pressure radiating to the left jaw that began 20 minutes
ago [CORRECT]
D. A client awaiting discharge teaching after an uncomplicated laparoscopic cholecystectomy
Correct Answer: C
Rationale: New chest pressure radiating to the jaw is a classic cue of acute coronary syndrome, an immediate
threat to perfusion and oxygenation; the NGN Clinical Judgment Measurement Model directs the nurse to act
first on cues that threaten life. Clients A, B, and D present stable, expected findings with predictable
outcomes, so they can be assessed after the unstable client. Prioritization frameworks rank actual physiologic
instability above routine, scheduled, or predictable care.
Q2: Which task is appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)?
A. Assessing lung sounds on a client admitted with new pneumonia
B. Ambulating a stable postoperative client in the hallway [CORRECT]
C. Teaching a newly diagnosed client how to draw up insulin
D. Interpreting a client's cardiac rhythm on the telemetry monitor
Correct Answer: B
Rationale: Under NCSBN delegation standards, UAP may perform routine, noninvasive, recurring tasks for
stable clients, and hallway ambulation of a stable postoperative client meets all five rights of delegation.
Assessment, client teaching, and interpretation of clinical data require RN-level judgment and are outside
UAP scope of practice. Delegating assessment or education to UAP constitutes a scope-of-practice violation
even when the UAP volunteers.
Q3: A client scheduled for a colon resection tells the nurse, 'I signed the consent form, but I still do not
understand what a colon resection involves.' Which action should the nurse take first?
A. Explain the surgical technique in detail so the client can proceed with signing
B. Document that the client has been educated about the procedure
C. Notify the surgeon that the client requires further clarification before the consent is
valid [CORRECT]
D. Ask the client's family to explain the procedure to the client
Correct Answer: C
Rationale: Informed consent must be obtained by the provider performing the procedure; the nurse's legal
role is to witness the signature and to advocate when the client's comprehension is incomplete. A consent
signed without understanding is not valid, so notifying the surgeon protects the client's right to autonomy.
Explaining the technique, documenting education, or delegating the explanation to family exceeds the nurse's
scope and does not satisfy consent law.
NCLEX-RN | NGN Format Practice Examination with Verified Answers 1
,NEW GENERATION NCLEX QUESTIONS | 2026/2027 EDITION
Q4: The charge nurse is making assignments for the oncoming shift. Which client is appropriate to assign to
a licensed practical nurse (LPN)?
A. A client 1 hour after cardiac catheterization with a femoral sheath in place
B. A client with newly diagnosed type 1 diabetes requiring intensive insulin teaching
C. A client with stable chronic obstructive pulmonary disease on oxygen at 2 L/min [CORRECT]
D. A client receiving a continuous heparin infusion with titration orders
Correct Answer: C
Rationale: LPNs may be assigned stable clients with predictable outcomes and established plans of care under
most state nurse practice acts. The immediate post-catheterization client, the client needing initial intensive
teaching, and the client on continuous heparin titration are unstable or require complex assessment and
medication titration, which are RN responsibilities. Matching assignments to scope of practice and
competency is a core Management of Care standard.
Q5: A client with a valid do-not-resuscitate (DNR) prescription in the medical record experiences cardiac
arrest, and the family urgently tells the nurse to begin resuscitation. Which action should the nurse take?
A. Begin resuscitation because the family's request overrides the DNR order
B. Honor the DNR order and provide compassionate comfort care to the client and
family [CORRECT]
C. Ask the family to locate the client's attorney before taking any action
D. Withhold all care until the health care provider arrives on the unit
Correct Answer: B
Rationale: A valid DNR order is a legal directive that the nurse must honor regardless of family objection;
resuscitating against it constitutes battery and violates client autonomy. The nurse continues comfort measures,
stays with the family, and provides grief support rather than delaying all care. Waiting for the provider or legal
consultation is not required because the directive is already valid and active in the chart.
Q6: A nurse in the emergency department is approached by a neighbor who asks, 'Is it true my coworker was
brought in after a drug overdose?' Which response by the nurse is correct?
A. 'I cannot confirm or deny any information about clients in this facility.' [CORRECT]
B. 'I can share that with you because you are a close neighbor and friend.'
C. 'Ask the admitting office; they are permitted to release that information.'
D. 'I will check the chart and let you know what I find at the end of my shift.'
Correct Answer: A
Rationale: HIPAA prohibits disclosing any client information, including whether a person is even present in
the facility, to individuals not involved in care, so the neutral neither-confirm-nor-deny statement protects
confidentiality. Friendship does not create a right to information, and directing the neighbor to any source or
promising to check the chart is itself an impermissible disclosure. A violation of this type is reportable under
facility policy.
NCLEX-RN | NGN Format Practice Examination with Verified Answers 2
, NEW GENERATION NCLEX QUESTIONS | 2026/2027 EDITION
Q7: A client who practices Islam and has type 1 diabetes tells the nurse she plans to fast from dawn to sunset
during Ramadan. Which action by the nurse best demonstrates culturally competent care?
A. Instruct the client that clients on insulin are never permitted to fast
B. Assess the client's beliefs and collaborate with the provider and dietitian to adjust the insulin and
meal plan [CORRECT]
C. Arrange for the dietitian to revise the diet without involving the client in planning
D. Document the client's refusal to follow the standard diabetic diet in the medical record
Correct Answer: B
Rationale: Culturally competent, patient-centered care begins with assessment of the client's values, followed
by collaborative planning such as shifting insulin doses to nighttime and adjusting glucose monitoring during
fasting. Flatly prohibiting fasting is culturally insensitive and clinically inaccurate because many clients fast
safely with modification. Excluding the client from planning or labeling the client nonadherent undermines
autonomy and the therapeutic relationship.
Q8: The nurse is preparing to obtain a health history from a Vietnamese-speaking client. The client's teenage
son offers to interpret. Which action should the nurse take?
A. Allow the son to interpret because he understands his parent best
B. Request a certified medical interpreter through the facility's language services [CORRECT]
C. Use hand gestures and picture boards instead of an interpreter
D. Ask the son to interpret only the questions the nurse considers noninvasive
Correct Answer: B
Rationale: Accreditation and civil rights standards require the use of qualified medical interpreters; family
members may filter, omit, or add information, and minors should never bear responsibility for interpreting
sensitive health data. Gesture-based communication invites clinical error and disparities in care, which
threatens health equity. Using the son selectively still exposes the nurse to liability and compromised accuracy.
Q9: Following a multi-vehicle crash, the nurse is applying disaster triage principles. Which client should be
placed in the immediate (red) treatment category?
A. A client with a deformed lower leg, strong peripheral pulses, and severe pain
B. A client who is ambulatory with superficial lacerations on both forearms
C. A client with a respiratory rate of 30/min, an absent radial pulse, and confusion [CORRECT]
D. A client with obvious head trauma, fixed dilated pupils, and agonal respirations
Correct Answer: C
Rationale: Under START triage, inability to follow commands plus an absent radial pulse or respiratory rate
above 30/min places the client in the immediate category because intervention offers the greatest survival
benefit. Client A has intact perfusion and is delayed (yellow), client B is minor (green), and client D is
expectant (black) because resuscitation resources would not change the outcome. Disaster triage prioritizes the
greatest good for the greatest number rather than individual client need.
NCLEX-RN | NGN Format Practice Examination with Verified Answers 3
MEASUREMENT MODEL
NEW GENERATION
NCLEX QUESTIONS
Real exam-style questions with verified answers. 150 NGN-format items
across all eight client-need categories — including multiple response,
bow-tie, drag-and-drop, fill-in-the-blank, hot spot, and trend items —
each mapped to the Clinical Judgment Measurement Model with
detailed rationales.
Real Exam-Style Questions with Verified Answers
1 00% C ORRE C T | NG N F ORMAT | G RA D E D A +
E D I TI O N · 15 0 Q U E STI O N S · E XTE N D E D C A SE - STU D Y TE STL E TS
,NEW GENERATION NCLEX QUESTIONS | 2026/2027 EDITION
Section 1: Management of Care – NGN Scenarios
Q1: The nurse receives report on four clients at the beginning of the shift. Which client should the nurse
assess first?
A. A client 2 days postoperative appendectomy reporting incisional pain rated 4 out of 10
B. A client with chronic atrial fibrillation whose apical pulse is 78/min and regular
C. A client reporting new-onset chest pressure radiating to the left jaw that began 20 minutes
ago [CORRECT]
D. A client awaiting discharge teaching after an uncomplicated laparoscopic cholecystectomy
Correct Answer: C
Rationale: New chest pressure radiating to the jaw is a classic cue of acute coronary syndrome, an immediate
threat to perfusion and oxygenation; the NGN Clinical Judgment Measurement Model directs the nurse to act
first on cues that threaten life. Clients A, B, and D present stable, expected findings with predictable
outcomes, so they can be assessed after the unstable client. Prioritization frameworks rank actual physiologic
instability above routine, scheduled, or predictable care.
Q2: Which task is appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)?
A. Assessing lung sounds on a client admitted with new pneumonia
B. Ambulating a stable postoperative client in the hallway [CORRECT]
C. Teaching a newly diagnosed client how to draw up insulin
D. Interpreting a client's cardiac rhythm on the telemetry monitor
Correct Answer: B
Rationale: Under NCSBN delegation standards, UAP may perform routine, noninvasive, recurring tasks for
stable clients, and hallway ambulation of a stable postoperative client meets all five rights of delegation.
Assessment, client teaching, and interpretation of clinical data require RN-level judgment and are outside
UAP scope of practice. Delegating assessment or education to UAP constitutes a scope-of-practice violation
even when the UAP volunteers.
Q3: A client scheduled for a colon resection tells the nurse, 'I signed the consent form, but I still do not
understand what a colon resection involves.' Which action should the nurse take first?
A. Explain the surgical technique in detail so the client can proceed with signing
B. Document that the client has been educated about the procedure
C. Notify the surgeon that the client requires further clarification before the consent is
valid [CORRECT]
D. Ask the client's family to explain the procedure to the client
Correct Answer: C
Rationale: Informed consent must be obtained by the provider performing the procedure; the nurse's legal
role is to witness the signature and to advocate when the client's comprehension is incomplete. A consent
signed without understanding is not valid, so notifying the surgeon protects the client's right to autonomy.
Explaining the technique, documenting education, or delegating the explanation to family exceeds the nurse's
scope and does not satisfy consent law.
NCLEX-RN | NGN Format Practice Examination with Verified Answers 1
,NEW GENERATION NCLEX QUESTIONS | 2026/2027 EDITION
Q4: The charge nurse is making assignments for the oncoming shift. Which client is appropriate to assign to
a licensed practical nurse (LPN)?
A. A client 1 hour after cardiac catheterization with a femoral sheath in place
B. A client with newly diagnosed type 1 diabetes requiring intensive insulin teaching
C. A client with stable chronic obstructive pulmonary disease on oxygen at 2 L/min [CORRECT]
D. A client receiving a continuous heparin infusion with titration orders
Correct Answer: C
Rationale: LPNs may be assigned stable clients with predictable outcomes and established plans of care under
most state nurse practice acts. The immediate post-catheterization client, the client needing initial intensive
teaching, and the client on continuous heparin titration are unstable or require complex assessment and
medication titration, which are RN responsibilities. Matching assignments to scope of practice and
competency is a core Management of Care standard.
Q5: A client with a valid do-not-resuscitate (DNR) prescription in the medical record experiences cardiac
arrest, and the family urgently tells the nurse to begin resuscitation. Which action should the nurse take?
A. Begin resuscitation because the family's request overrides the DNR order
B. Honor the DNR order and provide compassionate comfort care to the client and
family [CORRECT]
C. Ask the family to locate the client's attorney before taking any action
D. Withhold all care until the health care provider arrives on the unit
Correct Answer: B
Rationale: A valid DNR order is a legal directive that the nurse must honor regardless of family objection;
resuscitating against it constitutes battery and violates client autonomy. The nurse continues comfort measures,
stays with the family, and provides grief support rather than delaying all care. Waiting for the provider or legal
consultation is not required because the directive is already valid and active in the chart.
Q6: A nurse in the emergency department is approached by a neighbor who asks, 'Is it true my coworker was
brought in after a drug overdose?' Which response by the nurse is correct?
A. 'I cannot confirm or deny any information about clients in this facility.' [CORRECT]
B. 'I can share that with you because you are a close neighbor and friend.'
C. 'Ask the admitting office; they are permitted to release that information.'
D. 'I will check the chart and let you know what I find at the end of my shift.'
Correct Answer: A
Rationale: HIPAA prohibits disclosing any client information, including whether a person is even present in
the facility, to individuals not involved in care, so the neutral neither-confirm-nor-deny statement protects
confidentiality. Friendship does not create a right to information, and directing the neighbor to any source or
promising to check the chart is itself an impermissible disclosure. A violation of this type is reportable under
facility policy.
NCLEX-RN | NGN Format Practice Examination with Verified Answers 2
, NEW GENERATION NCLEX QUESTIONS | 2026/2027 EDITION
Q7: A client who practices Islam and has type 1 diabetes tells the nurse she plans to fast from dawn to sunset
during Ramadan. Which action by the nurse best demonstrates culturally competent care?
A. Instruct the client that clients on insulin are never permitted to fast
B. Assess the client's beliefs and collaborate with the provider and dietitian to adjust the insulin and
meal plan [CORRECT]
C. Arrange for the dietitian to revise the diet without involving the client in planning
D. Document the client's refusal to follow the standard diabetic diet in the medical record
Correct Answer: B
Rationale: Culturally competent, patient-centered care begins with assessment of the client's values, followed
by collaborative planning such as shifting insulin doses to nighttime and adjusting glucose monitoring during
fasting. Flatly prohibiting fasting is culturally insensitive and clinically inaccurate because many clients fast
safely with modification. Excluding the client from planning or labeling the client nonadherent undermines
autonomy and the therapeutic relationship.
Q8: The nurse is preparing to obtain a health history from a Vietnamese-speaking client. The client's teenage
son offers to interpret. Which action should the nurse take?
A. Allow the son to interpret because he understands his parent best
B. Request a certified medical interpreter through the facility's language services [CORRECT]
C. Use hand gestures and picture boards instead of an interpreter
D. Ask the son to interpret only the questions the nurse considers noninvasive
Correct Answer: B
Rationale: Accreditation and civil rights standards require the use of qualified medical interpreters; family
members may filter, omit, or add information, and minors should never bear responsibility for interpreting
sensitive health data. Gesture-based communication invites clinical error and disparities in care, which
threatens health equity. Using the son selectively still exposes the nurse to liability and compromised accuracy.
Q9: Following a multi-vehicle crash, the nurse is applying disaster triage principles. Which client should be
placed in the immediate (red) treatment category?
A. A client with a deformed lower leg, strong peripheral pulses, and severe pain
B. A client who is ambulatory with superficial lacerations on both forearms
C. A client with a respiratory rate of 30/min, an absent radial pulse, and confusion [CORRECT]
D. A client with obvious head trauma, fixed dilated pupils, and agonal respirations
Correct Answer: C
Rationale: Under START triage, inability to follow commands plus an absent radial pulse or respiratory rate
above 30/min places the client in the immediate category because intervention offers the greatest survival
benefit. Client A has intact perfusion and is delayed (yellow), client B is minor (green), and client D is
expectant (black) because resuscitation resources would not change the outcome. Disaster triage prioritizes the
greatest good for the greatest number rather than individual client need.
NCLEX-RN | NGN Format Practice Examination with Verified Answers 3
