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NCLEX-RN / NEXT GENERATION NCLEX (NGN) — 100-
QUESTION COMPREHENSIVE EXAMINATION WITH
DETAILED RATIONALES
Nursing / Health Sciences
Exam coverage:
• Management of Care (Questions 1–20): Prioritization, delegation,
advocacy, legal and ethical responsibilities, and client rights.
• Safety and Infection Prevention and Control (Questions 21–
35): Infection control precautions, needlestick prevention, fall
prevention, and safe medication administration.
• Health Promotion and Maintenance (Questions 36–45): Prenatal
care, newborn assessment, STI prevention, and health screening.
• Psychosocial Integrity (Questions 46–55): Anxiety, mood
disorders, schizophrenia, grief, and substance withdrawal.
• Basic Care and Comfort (Questions 56–65): Mobility, nutrition,
elimination, pain management, and comfort measures.
• Pharmacological and Parenteral Therapies (Questions 66–
80): Medication administration, high-alert medications, IV therapy,
and adverse effects.
• Reduction of Risk Potential (Questions 81–90): DVT prevention,
postoperative complications, chronic disease management, and
fall risk.
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• Physiological Adaptation (Questions 91–100): Sepsis, ARDS,
myocardial infarction, stroke, ICP, DKA, and endocrine disorders.
Section 1: Management of Care (Questions 1–20)
Question 1: A nurse is caring for a client with a new diagnosis of
diabetes mellitus. The client asks, "What is the difference
between type 1 and type 2 diabetes?" Which of the following
responses by the nurse is most appropriate?
A. "Type 1 is caused by obesity, and type 2 is caused by
genetics."
B. "Type 1 is an autoimmune condition where the body does not
produce insulin, while type 2 involves insulin resistance."
C. "Type 1 only affects children, and type 2 only affects adults."
D. "Type 1 is treated with oral medications, and type 2 requires
insulin."
CORRECT ANSWER: B
RATIONALE: Type 1 diabetes is an autoimmune condition
characterized by the destruction of pancreatic beta cells,
leading to little or no insulin production. Type 2 diabetes
involves insulin resistance and relative insulin deficiency.
Option A is incorrect because type 1 is not caused by obesity.
Option C is incorrect because type 2 can affect children, and
type 1 can affect adults. Option D is incorrect because type 1
requires insulin, while type 2 may be managed with oral
medications.
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Question 2: A nurse is delegating tasks to unlicensed assistive
personnel (UAP). Which of the following tasks is most
appropriate for the nurse to delegate?
A. Administering oral medications to a stable client
B. Assisting a client with ambulation
C. Assessing a client's pain level
D. Teaching a client about a new medication
CORRECT ANSWER: B
RATIONALE: Assisting with ambulation is a task that can be
safely delegated to UAP because it does not require nursing
judgment or assessment. Administering medications, assessing
pain, and teaching are nursing responsibilities that require
clinical judgment and cannot be delegated to UAP.
Question 3: A nurse is caring for a client who is scheduled for
surgery. The client states, "I don't want to have this surgery. I
want to go home." Which of the following actions should the
nurse take first?
A. Notify the surgeon immediately
B. Document the client's refusal and respect the client's
decision
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C. Administer a sedative to calm the client
D. Ask the family to convince the client to proceed
CORRECT ANSWER: B
RATIONALE: The client has the right to refuse treatment. The
nurse should document the refusal and respect the client's
decision. Option A is incorrect because the nurse should first
ensure the client understands the procedure. Option C is
incorrect because administering a sedative without consent is
inappropriate. Option D is incorrect because the client's
autonomy must be respected.
Question 4: A nurse is preparing to administer a blood
transfusion. Which of the following actions is the priority before
starting the transfusion?
A. Verify the client's identity and blood product with another
nurse
B. Administer premedication with acetaminophen
C. Obtain the client's vital signs
D. Explain the procedure to the client
CORRECT ANSWER: A
RATIONALE: The priority before starting a blood transfusion is
to verify the client's identity and the blood product with another
NCLEX-RN / NEXT GENERATION NCLEX (NGN) — 100-
QUESTION COMPREHENSIVE EXAMINATION WITH
DETAILED RATIONALES
Nursing / Health Sciences
Exam coverage:
• Management of Care (Questions 1–20): Prioritization, delegation,
advocacy, legal and ethical responsibilities, and client rights.
• Safety and Infection Prevention and Control (Questions 21–
35): Infection control precautions, needlestick prevention, fall
prevention, and safe medication administration.
• Health Promotion and Maintenance (Questions 36–45): Prenatal
care, newborn assessment, STI prevention, and health screening.
• Psychosocial Integrity (Questions 46–55): Anxiety, mood
disorders, schizophrenia, grief, and substance withdrawal.
• Basic Care and Comfort (Questions 56–65): Mobility, nutrition,
elimination, pain management, and comfort measures.
• Pharmacological and Parenteral Therapies (Questions 66–
80): Medication administration, high-alert medications, IV therapy,
and adverse effects.
• Reduction of Risk Potential (Questions 81–90): DVT prevention,
postoperative complications, chronic disease management, and
fall risk.
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• Physiological Adaptation (Questions 91–100): Sepsis, ARDS,
myocardial infarction, stroke, ICP, DKA, and endocrine disorders.
Section 1: Management of Care (Questions 1–20)
Question 1: A nurse is caring for a client with a new diagnosis of
diabetes mellitus. The client asks, "What is the difference
between type 1 and type 2 diabetes?" Which of the following
responses by the nurse is most appropriate?
A. "Type 1 is caused by obesity, and type 2 is caused by
genetics."
B. "Type 1 is an autoimmune condition where the body does not
produce insulin, while type 2 involves insulin resistance."
C. "Type 1 only affects children, and type 2 only affects adults."
D. "Type 1 is treated with oral medications, and type 2 requires
insulin."
CORRECT ANSWER: B
RATIONALE: Type 1 diabetes is an autoimmune condition
characterized by the destruction of pancreatic beta cells,
leading to little or no insulin production. Type 2 diabetes
involves insulin resistance and relative insulin deficiency.
Option A is incorrect because type 1 is not caused by obesity.
Option C is incorrect because type 2 can affect children, and
type 1 can affect adults. Option D is incorrect because type 1
requires insulin, while type 2 may be managed with oral
medications.
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Question 2: A nurse is delegating tasks to unlicensed assistive
personnel (UAP). Which of the following tasks is most
appropriate for the nurse to delegate?
A. Administering oral medications to a stable client
B. Assisting a client with ambulation
C. Assessing a client's pain level
D. Teaching a client about a new medication
CORRECT ANSWER: B
RATIONALE: Assisting with ambulation is a task that can be
safely delegated to UAP because it does not require nursing
judgment or assessment. Administering medications, assessing
pain, and teaching are nursing responsibilities that require
clinical judgment and cannot be delegated to UAP.
Question 3: A nurse is caring for a client who is scheduled for
surgery. The client states, "I don't want to have this surgery. I
want to go home." Which of the following actions should the
nurse take first?
A. Notify the surgeon immediately
B. Document the client's refusal and respect the client's
decision
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C. Administer a sedative to calm the client
D. Ask the family to convince the client to proceed
CORRECT ANSWER: B
RATIONALE: The client has the right to refuse treatment. The
nurse should document the refusal and respect the client's
decision. Option A is incorrect because the nurse should first
ensure the client understands the procedure. Option C is
incorrect because administering a sedative without consent is
inappropriate. Option D is incorrect because the client's
autonomy must be respected.
Question 4: A nurse is preparing to administer a blood
transfusion. Which of the following actions is the priority before
starting the transfusion?
A. Verify the client's identity and blood product with another
nurse
B. Administer premedication with acetaminophen
C. Obtain the client's vital signs
D. Explain the procedure to the client
CORRECT ANSWER: A
RATIONALE: The priority before starting a blood transfusion is
to verify the client's identity and the blood product with another
