Kaplan Fundamentals A NGN Questions and Answers Next
Generation NCLEX Nursing Exam Prep
Course Code: NURS 2100
Course Name: Fundamentals of Nursing
Academic Year: 2026/2027
1. Advanced Perioperative Pharmacology
The nurse is reviewing laboratory values for a client starting intermittent heparin
therapy on the medical-surgical unit. Which diagnostic laboratory test is explicitly
used by the healthcare team to monitor the safety and effectiveness of this specific
medication?
,A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT)
C. Bleeding time
D. Protein electrophoresis
CORRECT ANSWER: A. Activated partial thromboplastin time (aPTT)
RATIONALE: Activated partial thromboplastin time (aPTT) measures the
integrity of the intrinsic and common coagulation pathways and is the standard
laboratory test used to monitor the therapeutic effectiveness and dose adjustments
of unfractionated heparin therapy. Prothrombin time (PT) and International
Normalized Ratio (INR) are used to monitor oral warfarin therapy. Bleeding time
evaluates platelet function but is not used for titration. Protein electrophoresis is
used to identify abnormal proteins (such as monoclonal spikes in multiple
myeloma) and has no application in tracking anticoagulant dynamics.
2. Geriatric Physiology
An older adult client asks the nurse about normal age-related changes in the renal
tract. The nurse identifies which physiological alteration in the genitourinary
system is characteristically associated with client aging?
A. Increased frequency
B. Increased sphincter tone
C. Decreased incontinence
D. Increased filtration
CORRECT ANSWER: A. Increased frequency
RATIONALE: As a client ages, changes in the genitourinary system occur.
These include a decreased bladder capacity, weakened pelvic floor muscles, and
decreased bladder elasticity, which culminate in an increased frequency of
urination and nocturia. Sphincter tone typically decreases rather than increases,
contributing to a higher incidence of incontinence, not a decrease. Additionally, the
glomerular filtration rate (GFR) and overall renal blood flow decline with age,
resulting in decreased, rather than increased, filtration capacity.
3. Ethical and Legal Issues in Nursing
,On the morning of a scheduled cholecystectomy, a client signs an operative
consent form. Soon afterward, the client calls the nurse and states, "I do not want
the surgery." Which action must the nurse take first?
A. Encourages the client to discuss reasons for canceling the surgery
B. Notifies the health care provider of the client's decision immediately
C. Informs the client the decision has delayed the operating room schedule
D. Asks the client's family to encourage the client to have the surgery
CORRECT ANSWER: A. Encourages the client to discuss reasons for
canceling the surgery
RATIONALE: The nurse's first action must be to explore the client's feelings
and encourage them to discuss their specific reasons for canceling the surgery.
This therapeutic communication allows the nurse to identify misconceptions,
extreme anxiety, or missing information while respecting client autonomy. While
the healthcare provider must eventually be notified if the client maintains their
refusal, gathering background assessment information takes immediate priority.
Pressuring the client by discussing schedule delays or using family coercion
violates ethical nursing obligations regarding informed refusal and autonomy.
4. Nutritional Assessment
The nurse reviews the chart of an adult client and notes a calculated body mass
index (BMI) of 37.0 kg/m². Which category provides the best clinical description
of the client's body weight status?
A. Obese
B. Normal weight
C. Overweight
D. Underweight
CORRECT ANSWER: A. Obese
RATIONALE: A body mass index (BMI) is categorized as follows:
Underweight is a BMI below 18.5 kg/m²; normal weight ranges from 18.5 to 24.9
kg/m²; overweight is defined as 25.0 to 29.9 kg/m²; and obese is classified as any
BMI 30.0 kg/m² or higher. A BMI of 37.0 kg/m² indicates Class II obesity,
placing the patient at significantly elevated risk for metabolic and cardiovascular
alterations.
, 5. Patient Safety and Ergonomics
The nurse is instructing an unlicensed assistive personnel (UAP) on safe patient
handling guidelines. Which instruction by the nurse regarding correct body
mechanics is most appropriate?
A. "Bend your knees when lifting objects to distribute weight evenly."
B. "Bend at the waist when lifting heavy objects from the floor."
C. "Lift objects with your arms extended away from your center of gravity."
D. "Lean forward aggressively when lifting objects to maximize leverage."
CORRECT ANSWER: A. "Bend your knees when lifting objects to
distribute weight evenly."
RATIONALE: Utilizing correct body mechanics requires the individual to
bend their knees when lifting objects. This maintains a low center of gravity and
shifts the mechanical workload to the large, powerful quadriceps and gluteal
muscles rather than the smaller muscles of the lower back. Bending at the waist,
extending arms away from the body, or leaning forward shifts the center of gravity
away from the base of support, severely increasing shear forces on the lumbar
spine and risking occupational injury.
6. Wellness and Client Education
At discharge, the nurse provides education to a client regarding a calorie-
restricted diet intended for long-term weight reduction. Which evidence-based
guideline should the nurse include in the teaching plan?
A. Losing 1 to 2 pounds per week is safe and effective for long-term
maintenance
B. A highly restrictive, extreme low-calorie diet will be most effective for you
C. Increase the amount of shelf-stable processed foods in your daily diet
D. Decrease whole grain intake while eliminating dietary fiber sources
CORRECT ANSWER: A. Losing 1 to 2 pounds per week is safe and effective
for long-term maintenance
RATIONALE: Healthy and sustainable weight reduction is achieved through
gradual lifestyle changes, where losing 1 to 2 pounds per week is recognized as
Generation NCLEX Nursing Exam Prep
Course Code: NURS 2100
Course Name: Fundamentals of Nursing
Academic Year: 2026/2027
1. Advanced Perioperative Pharmacology
The nurse is reviewing laboratory values for a client starting intermittent heparin
therapy on the medical-surgical unit. Which diagnostic laboratory test is explicitly
used by the healthcare team to monitor the safety and effectiveness of this specific
medication?
,A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT)
C. Bleeding time
D. Protein electrophoresis
CORRECT ANSWER: A. Activated partial thromboplastin time (aPTT)
RATIONALE: Activated partial thromboplastin time (aPTT) measures the
integrity of the intrinsic and common coagulation pathways and is the standard
laboratory test used to monitor the therapeutic effectiveness and dose adjustments
of unfractionated heparin therapy. Prothrombin time (PT) and International
Normalized Ratio (INR) are used to monitor oral warfarin therapy. Bleeding time
evaluates platelet function but is not used for titration. Protein electrophoresis is
used to identify abnormal proteins (such as monoclonal spikes in multiple
myeloma) and has no application in tracking anticoagulant dynamics.
2. Geriatric Physiology
An older adult client asks the nurse about normal age-related changes in the renal
tract. The nurse identifies which physiological alteration in the genitourinary
system is characteristically associated with client aging?
A. Increased frequency
B. Increased sphincter tone
C. Decreased incontinence
D. Increased filtration
CORRECT ANSWER: A. Increased frequency
RATIONALE: As a client ages, changes in the genitourinary system occur.
These include a decreased bladder capacity, weakened pelvic floor muscles, and
decreased bladder elasticity, which culminate in an increased frequency of
urination and nocturia. Sphincter tone typically decreases rather than increases,
contributing to a higher incidence of incontinence, not a decrease. Additionally, the
glomerular filtration rate (GFR) and overall renal blood flow decline with age,
resulting in decreased, rather than increased, filtration capacity.
3. Ethical and Legal Issues in Nursing
,On the morning of a scheduled cholecystectomy, a client signs an operative
consent form. Soon afterward, the client calls the nurse and states, "I do not want
the surgery." Which action must the nurse take first?
A. Encourages the client to discuss reasons for canceling the surgery
B. Notifies the health care provider of the client's decision immediately
C. Informs the client the decision has delayed the operating room schedule
D. Asks the client's family to encourage the client to have the surgery
CORRECT ANSWER: A. Encourages the client to discuss reasons for
canceling the surgery
RATIONALE: The nurse's first action must be to explore the client's feelings
and encourage them to discuss their specific reasons for canceling the surgery.
This therapeutic communication allows the nurse to identify misconceptions,
extreme anxiety, or missing information while respecting client autonomy. While
the healthcare provider must eventually be notified if the client maintains their
refusal, gathering background assessment information takes immediate priority.
Pressuring the client by discussing schedule delays or using family coercion
violates ethical nursing obligations regarding informed refusal and autonomy.
4. Nutritional Assessment
The nurse reviews the chart of an adult client and notes a calculated body mass
index (BMI) of 37.0 kg/m². Which category provides the best clinical description
of the client's body weight status?
A. Obese
B. Normal weight
C. Overweight
D. Underweight
CORRECT ANSWER: A. Obese
RATIONALE: A body mass index (BMI) is categorized as follows:
Underweight is a BMI below 18.5 kg/m²; normal weight ranges from 18.5 to 24.9
kg/m²; overweight is defined as 25.0 to 29.9 kg/m²; and obese is classified as any
BMI 30.0 kg/m² or higher. A BMI of 37.0 kg/m² indicates Class II obesity,
placing the patient at significantly elevated risk for metabolic and cardiovascular
alterations.
, 5. Patient Safety and Ergonomics
The nurse is instructing an unlicensed assistive personnel (UAP) on safe patient
handling guidelines. Which instruction by the nurse regarding correct body
mechanics is most appropriate?
A. "Bend your knees when lifting objects to distribute weight evenly."
B. "Bend at the waist when lifting heavy objects from the floor."
C. "Lift objects with your arms extended away from your center of gravity."
D. "Lean forward aggressively when lifting objects to maximize leverage."
CORRECT ANSWER: A. "Bend your knees when lifting objects to
distribute weight evenly."
RATIONALE: Utilizing correct body mechanics requires the individual to
bend their knees when lifting objects. This maintains a low center of gravity and
shifts the mechanical workload to the large, powerful quadriceps and gluteal
muscles rather than the smaller muscles of the lower back. Bending at the waist,
extending arms away from the body, or leaning forward shifts the center of gravity
away from the base of support, severely increasing shear forces on the lumbar
spine and risking occupational injury.
6. Wellness and Client Education
At discharge, the nurse provides education to a client regarding a calorie-
restricted diet intended for long-term weight reduction. Which evidence-based
guideline should the nurse include in the teaching plan?
A. Losing 1 to 2 pounds per week is safe and effective for long-term
maintenance
B. A highly restrictive, extreme low-calorie diet will be most effective for you
C. Increase the amount of shelf-stable processed foods in your daily diet
D. Decrease whole grain intake while eliminating dietary fiber sources
CORRECT ANSWER: A. Losing 1 to 2 pounds per week is safe and effective
for long-term maintenance
RATIONALE: Healthy and sustainable weight reduction is achieved through
gradual lifestyle changes, where losing 1 to 2 pounds per week is recognized as
