NLN NEX EXAM 200 ACTUAL QUESTIONS AND CORRECT ANSWERS WITH RATIONALE LATEST 2026
ALREADY GRADED A+ ASSURED PASS – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED
ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
CORE DOMAINS
Foundational Nursing Theory and Practice
Health Assessment and Physical Examination
Pharmacology and Medication Administration
Maternal and Newborn Care
Pediatric Nursing Care
Medical-Surgical Nursing
Mental Health Nursing
Community and Public Health Nursing
Ethics, Legal, and Professional Standards
Safety and Infection Control
INTRODUCTION
The NLN NEX Examination is designed to assess the comprehensive knowledge, clinical judgment, and
professional decision-making skills essential for entry-level nursing practice. This assessment evaluates
candidates across foundational theory, applied professional knowledge, technical concepts, regulatory
compliance, and ethical standards. The exam utilizes multiple-choice and scenario-based questions to
simulate real-world clinical situations, emphasizing critical thinking, problem-solving, and practical
application. Successful completion demonstrates readiness to deliver safe, effective, and patient-centered
care in diverse healthcare environments.
SECTION ONE – QUESTIONS 1–100
1. A nurse is preparing to administer a medication via a nasogastric tube. Which action should the
nurse take first?
A. Check the tube placement by aspirating gastric contents.
B. Flush the tube with 30 mL of air.
C. Crush the medication into a fine powder.
D. Position the patient in a supine position.
🟢 Correct answer: A
🔴 Explanation: Verifying tube placement is the priority to prevent aspiration and ensure
medication delivery to the stomach. Auscultating air is no longer considered a reliable method.
Crushing medication and positioning are subsequent steps.
2. A client with a history of heart failure is prescribed furosemide. Which assessment finding requires
immediate intervention?
A. Urine output of 50 mL/hr.
B. Blood pressure of 110/70 mm Hg.
C. Serum potassium level of 2.8 mEq/L.
, D. Weight loss of 1 kg in 24 hours.
🟢 Correct answer: C
🔴 Explanation: Furosemide is a loop diuretic that can cause hypokalemia. A potassium level of 2.8
mEq/L is critically low and can lead to fatal dysrhythmias, requiring immediate notification of the
provider.
3. A nurse is teaching a new mother about newborn safety. Which statement by the mother indicates a
need for further teaching?
A. "I will place my baby on their back to sleep."
B. "I will use a car seat with a five-point harness."
C. "I will keep the crib away from windows and cords."
D. "I will place a soft bumper pad in the crib to prevent injury."
🟢 Correct answer: D
🔴 Explanation: Soft bumper pads are a suffocation hazard and are not recommended in infant
cribs. The other statements reflect safe sleep and injury prevention practices.
4. A nurse is caring for a client who is postoperative following abdominal surgery. The client states, "I
feel like something just popped in my incision." Which action should the nurse take first?
A. Administer the prescribed analgesic.
B. Cover the wound with a sterile saline-soaked dressing.
C. Instruct the client to splint the incision and cough.
D. Auscultate bowel sounds in all four quadrants.
🟢 Correct answer: B
🔴 Explanation: The client's statement suggests wound dehiscence. The immediate priority is to
cover the wound with a sterile, moist dressing to protect the exposed tissue and prevent infection,
then notify the surgeon.
5. A nurse is reviewing the laboratory results of a client with chronic kidney disease. Which finding
should the nurse expect?
A. Hypercalcemia.
B. Hyperphosphatemia.
C. Hyperkalemia.
D. Hypernatremia.
🟢 Correct answer: B
🔴 Explanation: In chronic kidney disease, the kidneys cannot excrete phosphate, leading to
hyperphosphatemia. Calcium levels are typically low due to decreased activation of vitamin D.
6. A nurse is providing discharge teaching to a client prescribed warfarin. Which instruction should the
nurse include?
A. "Increase your intake of green leafy vegetables."
B. "Avoid using a soft-bristled toothbrush."
C. "Use an electric razor for shaving."
D. "Take aspirin for minor headaches."
🟢 Correct answer: C
🔴 Explanation: Warfarin increases bleeding risk. Using an electric razor reduces the risk of cuts and
bleeding. Clients should maintain consistent vitamin K intake, not increase it, and avoid aspirin.
7. A nurse is assessing a client with a suspected pulmonary embolism. Which manifestation is most
common?
A. Bradycardia.
, B. Sudden pleuritic chest pain.
C. Hypertension.
D. Warm, flushed skin.
🟢 Correct answer: B
🔴 Explanation: Sudden pleuritic chest pain and dyspnea are classic manifestations of a pulmonary
embolism. Tachycardia, not bradycardia, and hypotension may also occur.
8. A nurse is caring for a client in the manic phase of bipolar disorder. Which intervention is the
priority?
A. Encourage participation in a group activity.
B. Provide a structured, quiet environment.
C. Offer high-calorie finger foods.
D. Set firm limits on manipulative behavior.
🟢 Correct answer: B
🔴 Explanation: A client in the manic phase has heightened sensory awareness and is easily
overstimulated. A structured, quiet, low-stimulus environment is the priority to reduce agitation and
promote safety.
9. A community health nurse is planning a program to prevent the spread of influenza. Which level of
prevention is this?
A. Primary prevention.
B. Secondary prevention.
C. Tertiary prevention.
D. Quaternary prevention.
🟢 Correct answer: A
🔴 Explanation: Primary prevention aims to prevent disease before it occurs. Immunizations and
health education are examples of primary prevention.
10. A nurse is preparing to administer an intramuscular injection to an infant. Which site is preferred?
A. Deltoid.
B. Ventrogluteal.
C. Vastus lateralis.
D. Dorsogluteal.
🟢 Correct answer: C
🔴 Explanation: The vastus lateralis is the preferred IM site for infants because it is well-developed
and has fewer major nerves and blood vessels. The deltoid is not well-developed in infants.
11. A nurse is caring for a client with a new colostomy. Which stoma appearance should the nurse
report to the provider?
A. Beefy red and moist.
B. Pale pink and dry.
C. Dark blue and dusky.
D. Slightly edematous.
🟢 Correct answer: C
🔴 Explanation: A healthy stoma is beefy red and moist. A dark blue, dusky, or black stoma indicates
ischemia and requires immediate notification of the provider.
12. A nurse is administering a blood transfusion. Fifteen minutes into the transfusion, the client reports
chills and flank pain. Which action should the nurse take first?
A. Slow the transfusion rate.
, B. Administer diphenhydramine.
C. Stop the transfusion immediately.
D. Obtain a urine specimen.
🟢 Correct answer: C
🔴 Explanation: Chills and flank pain are signs of an acute hemolytic transfusion reaction. The first
action is to stop the transfusion immediately to prevent further harm, then maintain IV access with
normal saline.
13. A nurse is teaching a client about the use of a metered-dose inhaler (MDI). Which statement
indicates correct understanding?
A. "I will shake the inhaler for 5 seconds before use."
B. "I will inhale slowly and deeply while pressing the canister."
C. "I will hold my breath for 2 seconds after inhaling."
D. "I will use the inhaler 30 minutes before exercising."
🟢 Correct answer: B
🔴 Explanation: The correct technique for MDI use involves shaking the inhaler, exhaling, pressing
the canister while inhaling slowly and deeply, and holding the breath for 10 seconds.
14. A nurse is assessing a client with cirrhosis. Which finding indicates a complication of the disease?
A. Spider angiomas.
B. Blood pressure of 130/80 mm Hg.
C. Respiratory rate of 16/min.
D. Hemoglobin of 14 g/dL.
🟢 Correct answer: A
🔴 Explanation: Spider angiomas are a common sign of cirrhosis due to altered hormone
metabolism. They are a dermatological manifestation of the disease.
15. A nurse is caring for a client who is 1 day postpartum and has a distended, tender bladder. Which
action should the nurse take?
A. Encourage the client to drink fluids.
B. Perform a straight catheterization.
C. Assist the client to the bathroom to void.
D. Apply a warm compress to the suprapubic area.
🟢 Correct answer: C
🔴 Explanation: The first intervention for a distended bladder is to assist the client to void. If this is
unsuccessful, other measures such as catheterization may be considered.
16. A nurse is reviewing the medication orders for a client with asthma. Which medication is a long-
term control agent?
A. Albuterol.
B. Levalbuterol.
C. Fluticasone.
D. Ipratropium.
🟢 Correct answer: C
🔴 Explanation: Fluticasone is an inhaled corticosteroid used for long-term control of asthma by
reducing inflammation. Albuterol and levalbuterol are short-acting beta-agonists for quick relief.
17. A nurse is assessing a client with a head injury. Which finding is an early sign of increased
intracranial pressure (ICP)?
A. Decerebrate posturing.
ALREADY GRADED A+ ASSURED PASS – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED
ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
CORE DOMAINS
Foundational Nursing Theory and Practice
Health Assessment and Physical Examination
Pharmacology and Medication Administration
Maternal and Newborn Care
Pediatric Nursing Care
Medical-Surgical Nursing
Mental Health Nursing
Community and Public Health Nursing
Ethics, Legal, and Professional Standards
Safety and Infection Control
INTRODUCTION
The NLN NEX Examination is designed to assess the comprehensive knowledge, clinical judgment, and
professional decision-making skills essential for entry-level nursing practice. This assessment evaluates
candidates across foundational theory, applied professional knowledge, technical concepts, regulatory
compliance, and ethical standards. The exam utilizes multiple-choice and scenario-based questions to
simulate real-world clinical situations, emphasizing critical thinking, problem-solving, and practical
application. Successful completion demonstrates readiness to deliver safe, effective, and patient-centered
care in diverse healthcare environments.
SECTION ONE – QUESTIONS 1–100
1. A nurse is preparing to administer a medication via a nasogastric tube. Which action should the
nurse take first?
A. Check the tube placement by aspirating gastric contents.
B. Flush the tube with 30 mL of air.
C. Crush the medication into a fine powder.
D. Position the patient in a supine position.
🟢 Correct answer: A
🔴 Explanation: Verifying tube placement is the priority to prevent aspiration and ensure
medication delivery to the stomach. Auscultating air is no longer considered a reliable method.
Crushing medication and positioning are subsequent steps.
2. A client with a history of heart failure is prescribed furosemide. Which assessment finding requires
immediate intervention?
A. Urine output of 50 mL/hr.
B. Blood pressure of 110/70 mm Hg.
C. Serum potassium level of 2.8 mEq/L.
, D. Weight loss of 1 kg in 24 hours.
🟢 Correct answer: C
🔴 Explanation: Furosemide is a loop diuretic that can cause hypokalemia. A potassium level of 2.8
mEq/L is critically low and can lead to fatal dysrhythmias, requiring immediate notification of the
provider.
3. A nurse is teaching a new mother about newborn safety. Which statement by the mother indicates a
need for further teaching?
A. "I will place my baby on their back to sleep."
B. "I will use a car seat with a five-point harness."
C. "I will keep the crib away from windows and cords."
D. "I will place a soft bumper pad in the crib to prevent injury."
🟢 Correct answer: D
🔴 Explanation: Soft bumper pads are a suffocation hazard and are not recommended in infant
cribs. The other statements reflect safe sleep and injury prevention practices.
4. A nurse is caring for a client who is postoperative following abdominal surgery. The client states, "I
feel like something just popped in my incision." Which action should the nurse take first?
A. Administer the prescribed analgesic.
B. Cover the wound with a sterile saline-soaked dressing.
C. Instruct the client to splint the incision and cough.
D. Auscultate bowel sounds in all four quadrants.
🟢 Correct answer: B
🔴 Explanation: The client's statement suggests wound dehiscence. The immediate priority is to
cover the wound with a sterile, moist dressing to protect the exposed tissue and prevent infection,
then notify the surgeon.
5. A nurse is reviewing the laboratory results of a client with chronic kidney disease. Which finding
should the nurse expect?
A. Hypercalcemia.
B. Hyperphosphatemia.
C. Hyperkalemia.
D. Hypernatremia.
🟢 Correct answer: B
🔴 Explanation: In chronic kidney disease, the kidneys cannot excrete phosphate, leading to
hyperphosphatemia. Calcium levels are typically low due to decreased activation of vitamin D.
6. A nurse is providing discharge teaching to a client prescribed warfarin. Which instruction should the
nurse include?
A. "Increase your intake of green leafy vegetables."
B. "Avoid using a soft-bristled toothbrush."
C. "Use an electric razor for shaving."
D. "Take aspirin for minor headaches."
🟢 Correct answer: C
🔴 Explanation: Warfarin increases bleeding risk. Using an electric razor reduces the risk of cuts and
bleeding. Clients should maintain consistent vitamin K intake, not increase it, and avoid aspirin.
7. A nurse is assessing a client with a suspected pulmonary embolism. Which manifestation is most
common?
A. Bradycardia.
, B. Sudden pleuritic chest pain.
C. Hypertension.
D. Warm, flushed skin.
🟢 Correct answer: B
🔴 Explanation: Sudden pleuritic chest pain and dyspnea are classic manifestations of a pulmonary
embolism. Tachycardia, not bradycardia, and hypotension may also occur.
8. A nurse is caring for a client in the manic phase of bipolar disorder. Which intervention is the
priority?
A. Encourage participation in a group activity.
B. Provide a structured, quiet environment.
C. Offer high-calorie finger foods.
D. Set firm limits on manipulative behavior.
🟢 Correct answer: B
🔴 Explanation: A client in the manic phase has heightened sensory awareness and is easily
overstimulated. A structured, quiet, low-stimulus environment is the priority to reduce agitation and
promote safety.
9. A community health nurse is planning a program to prevent the spread of influenza. Which level of
prevention is this?
A. Primary prevention.
B. Secondary prevention.
C. Tertiary prevention.
D. Quaternary prevention.
🟢 Correct answer: A
🔴 Explanation: Primary prevention aims to prevent disease before it occurs. Immunizations and
health education are examples of primary prevention.
10. A nurse is preparing to administer an intramuscular injection to an infant. Which site is preferred?
A. Deltoid.
B. Ventrogluteal.
C. Vastus lateralis.
D. Dorsogluteal.
🟢 Correct answer: C
🔴 Explanation: The vastus lateralis is the preferred IM site for infants because it is well-developed
and has fewer major nerves and blood vessels. The deltoid is not well-developed in infants.
11. A nurse is caring for a client with a new colostomy. Which stoma appearance should the nurse
report to the provider?
A. Beefy red and moist.
B. Pale pink and dry.
C. Dark blue and dusky.
D. Slightly edematous.
🟢 Correct answer: C
🔴 Explanation: A healthy stoma is beefy red and moist. A dark blue, dusky, or black stoma indicates
ischemia and requires immediate notification of the provider.
12. A nurse is administering a blood transfusion. Fifteen minutes into the transfusion, the client reports
chills and flank pain. Which action should the nurse take first?
A. Slow the transfusion rate.
, B. Administer diphenhydramine.
C. Stop the transfusion immediately.
D. Obtain a urine specimen.
🟢 Correct answer: C
🔴 Explanation: Chills and flank pain are signs of an acute hemolytic transfusion reaction. The first
action is to stop the transfusion immediately to prevent further harm, then maintain IV access with
normal saline.
13. A nurse is teaching a client about the use of a metered-dose inhaler (MDI). Which statement
indicates correct understanding?
A. "I will shake the inhaler for 5 seconds before use."
B. "I will inhale slowly and deeply while pressing the canister."
C. "I will hold my breath for 2 seconds after inhaling."
D. "I will use the inhaler 30 minutes before exercising."
🟢 Correct answer: B
🔴 Explanation: The correct technique for MDI use involves shaking the inhaler, exhaling, pressing
the canister while inhaling slowly and deeply, and holding the breath for 10 seconds.
14. A nurse is assessing a client with cirrhosis. Which finding indicates a complication of the disease?
A. Spider angiomas.
B. Blood pressure of 130/80 mm Hg.
C. Respiratory rate of 16/min.
D. Hemoglobin of 14 g/dL.
🟢 Correct answer: A
🔴 Explanation: Spider angiomas are a common sign of cirrhosis due to altered hormone
metabolism. They are a dermatological manifestation of the disease.
15. A nurse is caring for a client who is 1 day postpartum and has a distended, tender bladder. Which
action should the nurse take?
A. Encourage the client to drink fluids.
B. Perform a straight catheterization.
C. Assist the client to the bathroom to void.
D. Apply a warm compress to the suprapubic area.
🟢 Correct answer: C
🔴 Explanation: The first intervention for a distended bladder is to assist the client to void. If this is
unsuccessful, other measures such as catheterization may be considered.
16. A nurse is reviewing the medication orders for a client with asthma. Which medication is a long-
term control agent?
A. Albuterol.
B. Levalbuterol.
C. Fluticasone.
D. Ipratropium.
🟢 Correct answer: C
🔴 Explanation: Fluticasone is an inhaled corticosteroid used for long-term control of asthma by
reducing inflammation. Albuterol and levalbuterol are short-acting beta-agonists for quick relief.
17. A nurse is assessing a client with a head injury. Which finding is an early sign of increased
intracranial pressure (ICP)?
A. Decerebrate posturing.
