NCLEX-PN (NGN) 2026/2027 – EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALE | 2027 Q&A | INSTANT DOWNLOAD PDF
1. A practical nurse is assessing a client admitted with pneumonia. Which finding
requires the most immediate attention?
A. Temperature of 38.2°C (100.8°F)
B. Oxygen saturation of 86% on room air
C. Productive cough with yellow sputum
D. Fatigue after walking to the bathroom
Rationale: An oxygen saturation of 86% indicates significant hypoxemia and requires prompt
intervention. The other findings are clinically relevant but do not represent as immediate a
threat to oxygenation.
2. A client is admitted with dehydration after several days of vomiting and diarrhea.
Which assessment finding is most consistent with fluid volume deficit?
A. Bounding peripheral pulses
B. Bilateral crackles
C. Jugular venous distention
D. Orthostatic hypotension
Rationale: Orthostatic hypotension occurs when circulating volume is insufficient to maintain
blood pressure during position changes. Bounding pulses, crackles, and jugular venous
distention are more consistent with fluid excess.
3. A practical nurse is preparing to administer an oral medication to a client. Which
action is essential before administration?
A. Verify the medication against the prescription and identify the client using approved
identifiers.
B. Ask another client whether the medication looks correct.
C. Document administration before giving the medication.
D. Leave the medication at the bedside for the client to take later.
,Rationale: Medication safety requires verification of the prescription and correct client
identification before administration. Documentation occurs after administration, and
medications should not be left unattended unless specifically permitted.
4. A client taking furosemide reports muscle weakness and palpitations. Which
laboratory result would best explain these symptoms?
A. Sodium 140 mEq/L
B. Calcium 9.2 mg/dL
C. Potassium 2.9 mEq/L
D. Magnesium 2.1 mg/dL
Rationale: Furosemide can increase urinary potassium loss. Hypokalemia can cause muscle
weakness and cardiac dysrhythmias, making a potassium level of 2.9 mEq/L clinically
significant.
5. A client with diabetes mellitus becomes shaky, sweaty, and confused. The blood
glucose level is 54 mg/dL, and the client is awake and able to swallow. What
should the nurse do first?
A. Administer the scheduled insulin.
B. Give a high-protein snack.
C. Encourage the client to rest.
D. Give approximately 15 g of rapid-acting carbohydrate.
Rationale: An alert client who can swallow and has symptomatic hypoglycemia should receive
rapid-acting carbohydrate. Blood glucose should then be reassessed according to the
hypoglycemia protocol.
6. A client is prescribed digoxin. Which assessment finding should cause the nurse
to withhold the medication and notify the provider?
A. Blood pressure of 128/74 mm Hg
B. Apical pulse of 54/min
C. Respiratory rate of 18/min
D. Temperature of 37°C (98.6°F)
,Rationale: Digoxin can slow the heart rate. A significantly low apical pulse may indicate
excessive cardiac effects, so the medication should be withheld and the provider notified
according to the prescription and facility protocol.
7. A client with chronic obstructive pulmonary disease is receiving oxygen therapy.
Which assessment finding requires prompt reassessment?
A. Mild chronic cough
B. Respiratory rate of 20/min
C. Oxygen saturation within the client's prescribed target range
D. Increasing drowsiness and difficulty staying awake
Rationale: Increasing drowsiness may indicate worsening respiratory status or carbon dioxide
retention. The nurse should promptly assess airway, breathing, oxygenation, and other
contributing factors.
8. A client is receiving an IV infusion when the insertion site becomes cool, pale,
swollen, and painful. Which complication is most likely?
A. Infiltration
B. Phlebitis
C. Infection of the bloodstream
D. Arterial embolism
Rationale: Infiltration occurs when nonvesicant IV fluid enters surrounding tissue, producing
swelling, coolness, pallor, and discomfort. Phlebitis more commonly causes warmth, redness,
and tenderness along the vein.
9. A client receiving an opioid analgesic has a respiratory rate of 7/min and is
difficult to arouse. Which action is the priority?
A. Offer oral fluids.
B. Reassess the client in one hour.
C. Support the airway and initiate emergency intervention for respiratory depression.
D. Encourage the client to ambulate.
, Rationale: Severe opioid-induced respiratory depression threatens airway and breathing.
Immediate airway support and emergency management take priority over routine reassessment
or comfort measures.
10. A client with a new prescription for warfarin asks about dietary management.
Which statement demonstrates correct understanding?
A. "I should completely avoid all green vegetables."
B. "I should double my vitamin K intake when I have bruising."
C. "I can change my diet significantly from week to week."
D. "I should keep my intake of vitamin K-containing foods consistent."
Rationale: Vitamin K affects warfarin's anticoagulant effect. Consistency in dietary vitamin K
intake helps maintain a more stable response to therapy.
11. A client with suspected tuberculosis is admitted to the unit. Which type of
precautions should the nurse implement?
A. Contact
B. Droplet
C. Airborne
D. Protective
Rationale: Pulmonary tuberculosis can spread through airborne particles. Appropriate airborne
precautions reduce transmission to healthcare personnel and other clients.
12. A client with a seizure disorder begins having a generalized tonic-clonic seizure.
Which intervention is appropriate?
A. Place a padded object in the client's mouth.
B. Turn the client to the side and protect the head from injury.
C. Hold the client's arms and legs still.
D. Give oral medication immediately.
Rationale: Side-lying positioning promotes airway protection, while protecting the head reduces
injury risk. The nurse should never restrain the client or place objects in the mouth during a
seizure.
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALE | 2027 Q&A | INSTANT DOWNLOAD PDF
1. A practical nurse is assessing a client admitted with pneumonia. Which finding
requires the most immediate attention?
A. Temperature of 38.2°C (100.8°F)
B. Oxygen saturation of 86% on room air
C. Productive cough with yellow sputum
D. Fatigue after walking to the bathroom
Rationale: An oxygen saturation of 86% indicates significant hypoxemia and requires prompt
intervention. The other findings are clinically relevant but do not represent as immediate a
threat to oxygenation.
2. A client is admitted with dehydration after several days of vomiting and diarrhea.
Which assessment finding is most consistent with fluid volume deficit?
A. Bounding peripheral pulses
B. Bilateral crackles
C. Jugular venous distention
D. Orthostatic hypotension
Rationale: Orthostatic hypotension occurs when circulating volume is insufficient to maintain
blood pressure during position changes. Bounding pulses, crackles, and jugular venous
distention are more consistent with fluid excess.
3. A practical nurse is preparing to administer an oral medication to a client. Which
action is essential before administration?
A. Verify the medication against the prescription and identify the client using approved
identifiers.
B. Ask another client whether the medication looks correct.
C. Document administration before giving the medication.
D. Leave the medication at the bedside for the client to take later.
,Rationale: Medication safety requires verification of the prescription and correct client
identification before administration. Documentation occurs after administration, and
medications should not be left unattended unless specifically permitted.
4. A client taking furosemide reports muscle weakness and palpitations. Which
laboratory result would best explain these symptoms?
A. Sodium 140 mEq/L
B. Calcium 9.2 mg/dL
C. Potassium 2.9 mEq/L
D. Magnesium 2.1 mg/dL
Rationale: Furosemide can increase urinary potassium loss. Hypokalemia can cause muscle
weakness and cardiac dysrhythmias, making a potassium level of 2.9 mEq/L clinically
significant.
5. A client with diabetes mellitus becomes shaky, sweaty, and confused. The blood
glucose level is 54 mg/dL, and the client is awake and able to swallow. What
should the nurse do first?
A. Administer the scheduled insulin.
B. Give a high-protein snack.
C. Encourage the client to rest.
D. Give approximately 15 g of rapid-acting carbohydrate.
Rationale: An alert client who can swallow and has symptomatic hypoglycemia should receive
rapid-acting carbohydrate. Blood glucose should then be reassessed according to the
hypoglycemia protocol.
6. A client is prescribed digoxin. Which assessment finding should cause the nurse
to withhold the medication and notify the provider?
A. Blood pressure of 128/74 mm Hg
B. Apical pulse of 54/min
C. Respiratory rate of 18/min
D. Temperature of 37°C (98.6°F)
,Rationale: Digoxin can slow the heart rate. A significantly low apical pulse may indicate
excessive cardiac effects, so the medication should be withheld and the provider notified
according to the prescription and facility protocol.
7. A client with chronic obstructive pulmonary disease is receiving oxygen therapy.
Which assessment finding requires prompt reassessment?
A. Mild chronic cough
B. Respiratory rate of 20/min
C. Oxygen saturation within the client's prescribed target range
D. Increasing drowsiness and difficulty staying awake
Rationale: Increasing drowsiness may indicate worsening respiratory status or carbon dioxide
retention. The nurse should promptly assess airway, breathing, oxygenation, and other
contributing factors.
8. A client is receiving an IV infusion when the insertion site becomes cool, pale,
swollen, and painful. Which complication is most likely?
A. Infiltration
B. Phlebitis
C. Infection of the bloodstream
D. Arterial embolism
Rationale: Infiltration occurs when nonvesicant IV fluid enters surrounding tissue, producing
swelling, coolness, pallor, and discomfort. Phlebitis more commonly causes warmth, redness,
and tenderness along the vein.
9. A client receiving an opioid analgesic has a respiratory rate of 7/min and is
difficult to arouse. Which action is the priority?
A. Offer oral fluids.
B. Reassess the client in one hour.
C. Support the airway and initiate emergency intervention for respiratory depression.
D. Encourage the client to ambulate.
, Rationale: Severe opioid-induced respiratory depression threatens airway and breathing.
Immediate airway support and emergency management take priority over routine reassessment
or comfort measures.
10. A client with a new prescription for warfarin asks about dietary management.
Which statement demonstrates correct understanding?
A. "I should completely avoid all green vegetables."
B. "I should double my vitamin K intake when I have bruising."
C. "I can change my diet significantly from week to week."
D. "I should keep my intake of vitamin K-containing foods consistent."
Rationale: Vitamin K affects warfarin's anticoagulant effect. Consistency in dietary vitamin K
intake helps maintain a more stable response to therapy.
11. A client with suspected tuberculosis is admitted to the unit. Which type of
precautions should the nurse implement?
A. Contact
B. Droplet
C. Airborne
D. Protective
Rationale: Pulmonary tuberculosis can spread through airborne particles. Appropriate airborne
precautions reduce transmission to healthcare personnel and other clients.
12. A client with a seizure disorder begins having a generalized tonic-clonic seizure.
Which intervention is appropriate?
A. Place a padded object in the client's mouth.
B. Turn the client to the side and protect the head from injury.
C. Hold the client's arms and legs still.
D. Give oral medication immediately.
Rationale: Side-lying positioning promotes airway protection, while protecting the head reduces
injury risk. The nurse should never restrain the client or place objects in the mouth during a
seizure.
