NEXT GENERATION NCLEX RN
ACTUAL CASE STUDY BANK
WITH RATIONALES . MORE THAN
10 CASE STUDIES FOR THE NGN
QUESTIONS AND VERIFIED
ANSWERS 2025
A student nurse is preparing blood for an A Positive client who needs to receive a blood
transfusion. The nurse intervenes after which statement?
A. " Since you are A positive, you are considered a "universal recipient", therefore you
can receive any type of blood.
B. "A positive blood types can receive A+, A-, O+ and O-"
C. "Testing your blood type helps us determine what type of blood you need. Not all
blood types are the same and can cause a reaction"
D. "Only certain people who meet a certain criteria can donate blood, but if you have
any types of symptoms during transfusion, let a health care staff member know" - right
CORRECT ANSWER--A. " Since you are A positive, you are considered a "universal
recipient", therefore you can receive any type of blood.
A client has a folic acid deficiency. The nurse tells the client to order foods rich
in Folic Acid. What foods are best for the client to look for when ordering food?
A. Leafy Green Vegetables
B. Citrus Fruits
C.Chicken
D.Dried Beans
E. Hard Candy - right CORRECT ANSWER--A. Leafy Green Vegetables
B. Citrus Fruits
D. Dried Beans
1. A client who was recently diagnosed with Gastroesophageal Reflux Disease (GERD)
was just educated on the importance of nutrition and what foods to avoid. What
statement made by the client, indicates the need for further teaching?
a. " I will avoid foods like French fries and citrus juices to decrease my chances of acid
reflux and heart burn"
,b. "I will continue to drink 2 cups of coffee each morning when I wake up, to make sure I
have enough energy for the day"
c. " I need to find another dessert I can eat each night before bed, because the
chocolate ice cream I eat every night will exacerbate my Gastroesophageal Reflux"
d. " I need to drink more room temperature water to make sure my body has help when
properly digesting my meals" - right CORRECT ANSWER--B. "I will continue to drink 2
cups of coffee each morning when I wake up, to make sure I have enough energy for
the day"
A 76-year old man with chronic anemia arrives at the Emergency department with
increased fatigue and heart palpitations even at rest. The nurse would expect the
clients' laboratory test findings to include: (Select all that apply)
a. Hemoglobin (Hgb) of 6.8 g/dL
b. Hematocrit (Hct) value of 32%
c. An Red Blood Cell count of 4,500,000/L
d. A ferritin level of 8.2 ng/mL
e. A White Blood Cell count of 6.5 x 109/L - right CORRECT
ANSWER--A, B, D a: hemoglobin (Hgb) of 6.8 g/dL
b: hematocrit (Hct) value of 32%
d: a ferritin level of 8.2 ng/mL
A student nurse is explaining the risk factors for metabolic syndrome which statement
by the student would require correction from the nurse?
A. Waist circumference of 41 for a male
B. Body mass index of 30 or higher
C. Triglycerides level of 130
D. Blood Glucose of 168 - right CORRECT ANSWER--C. Triglycerides level of 130
A 68 year-old male suffering from chronic diarrhea is found to have a serum phosphate
level of 0.9 mg/dL. After reviewing this lab value the nurse can expect the client to
exhibit which of the following symptoms? (Select all that apply)
A. Confusion
B. Numbness/tingling in extremities
C. Muscle weakness
D. Cardiac dysrhythmias
E. Dry mucous membranes - right CORRECT ANSWER--A. Confusion
C. Muscle weakness
D. Cardiac dysrhythmias
The physician orders an arterial blood gas who is hyperventilating. The nurse can
anticipate that the blood gas results will most likely reveal that the client is in:
A. Metabolic alkalosis
B. Respiratory acidosis
,C. Metabolic acidosis
D. Respiratory alkalosis - right CORRECT ANSWER--D. Respiratory alkalosis
Thalassemia is a group of diseases that causes an inadequate amount of normal
hemoglobin to be produced in the body. Thalassemia minor is usually asymptomatic
and requires no treatments. There is no cure for thalassemia major, however, there are
therapies available to help manage the disease. These include:
A. Blood transfusions
B. Subcutaneous or IV deferoxamine
C. Iron supplements
D. Zinc supplements
E. Splenectomy - right CORRECT ANSWER--A. Blood transfusions
B. Subcutaneous or IV deferoxamine
D. Zinc supplements
E. Splenectomy
A client diagnosed with Stage II bladder cancer has just received a segmental
cystectomy. What will the nurse correct the client on for postoperative instructions for
discharge?:
A. "I will drink only small amounts of water for the first week."
B. "I will call the doctor if my urine is bright red for the first few days after surgery."
C. "After a week, my urine could have dark red flakes, and that's normal."
D. "I have a follow-up appointment for a cystoscopy in a few weeks." - right CORRECT
ANSWER--A. "I will drink only small amounts of water for the first week."
A client with upper gastrointestinal cancer has been diagnosed with cancer cachexia
which of the following would the nurse expect to see?
A. Weight gain
B. Skeletal muscle atrophy
C. Increase immune function
D. Improvement in metabolic abnormalities - right CORRECT ANSWER--B. Skeletal muscle
atrophy
A female client has just been diagnosed with external hemorrhoids and asks the nurse
what could have contributed to her diagnoses, which of the following will the nurse
mention as probable risk factors?
A. Pregnancy
B. Normal Body Mass Index
C. Prolonged constipation
D. Straining in an effort to defecate
E. Heavy lifting
F. Standing or sitting for a long period of time - right CORRECT ANSWER--A. Pregnancy
B. Normal Body Mass Index
, C. Prolonged constipation
D. Straining in an effort to defecate
E. Heavy lifting
F. Standing or sitting for a long period of time
The most common cause of cobalamin deficiency is pernicious anemia. Which of the
following clients may develop a cobalamin deficiency? (Select all that apply)
A. A 36-year-old morbidity obese client that recently had the Roux-en-Y Gastric
Bypass (RYGB) Surgery
B. A 45-year-old male construction working who has a history of smoking two packs of
cigarettes a day
C. A 23-year-old female nurse apprentice who is having a routine colonoscopy
D. A 50-year-old male yoga instructor who is on a strict vegetarian diet
E. A 28-year-old female nursing student taking Pepcid and Omeprazole to control a
Pepcid ulcer for the past three years - right CORRECT ANSWER--A. A 36-year-old
morbidity obese client that recently had the Roux-en-Y Gastric Bypass (RYGB)
Surgery
B. A 45-year-old male construction working who has a history of smoking two packs of
cigarettes a day
D. A 50-year-old male yoga instructor who is on a strict vegetarian diet
E. A 28-year-old female nursing student taking Pepcid and Omeprazole to control a
Pepcid ulcer for the past three years
A 25 year old female client is diagnosed with viral hepatitis. The provider prescribes
Ribavirin, before administering the nucleoside what test will the nurse give to the
client?
a). Liver function test
b). Pregnancy test
c). Occult blood test
d). Urinalysis - right CORRECT ANSWER--b). Pregnancy test
A Roux-en-Y Gastric Bypass (RYGB) Surgical client is suffering from an early case of
iron deficiency. Which of the following group of clinical manifestations will the client
present?
A. No Symptoms
B. Anorexia, Abdominal Pain, Paresthesia of the hands and feet, Nausea, Red and
Beefy Tongue
C. Pallor, Glossitis, Headache, and Burning Sensation of the Tongue
D. Fever, Swelling, Tachypnea, Hypertension, Tenderness, Nausea, Vomiting - right
CORRECT ANSWER--A. No Symptoms
A 67-year-old male has just been admitted into the Emergency Department late into the
night. He is severely confused, agitated, and complains of severe chest pain. His wife is
present with him and is very concerned about her husband. After receiving some blood
ACTUAL CASE STUDY BANK
WITH RATIONALES . MORE THAN
10 CASE STUDIES FOR THE NGN
QUESTIONS AND VERIFIED
ANSWERS 2025
A student nurse is preparing blood for an A Positive client who needs to receive a blood
transfusion. The nurse intervenes after which statement?
A. " Since you are A positive, you are considered a "universal recipient", therefore you
can receive any type of blood.
B. "A positive blood types can receive A+, A-, O+ and O-"
C. "Testing your blood type helps us determine what type of blood you need. Not all
blood types are the same and can cause a reaction"
D. "Only certain people who meet a certain criteria can donate blood, but if you have
any types of symptoms during transfusion, let a health care staff member know" - right
CORRECT ANSWER--A. " Since you are A positive, you are considered a "universal
recipient", therefore you can receive any type of blood.
A client has a folic acid deficiency. The nurse tells the client to order foods rich
in Folic Acid. What foods are best for the client to look for when ordering food?
A. Leafy Green Vegetables
B. Citrus Fruits
C.Chicken
D.Dried Beans
E. Hard Candy - right CORRECT ANSWER--A. Leafy Green Vegetables
B. Citrus Fruits
D. Dried Beans
1. A client who was recently diagnosed with Gastroesophageal Reflux Disease (GERD)
was just educated on the importance of nutrition and what foods to avoid. What
statement made by the client, indicates the need for further teaching?
a. " I will avoid foods like French fries and citrus juices to decrease my chances of acid
reflux and heart burn"
,b. "I will continue to drink 2 cups of coffee each morning when I wake up, to make sure I
have enough energy for the day"
c. " I need to find another dessert I can eat each night before bed, because the
chocolate ice cream I eat every night will exacerbate my Gastroesophageal Reflux"
d. " I need to drink more room temperature water to make sure my body has help when
properly digesting my meals" - right CORRECT ANSWER--B. "I will continue to drink 2
cups of coffee each morning when I wake up, to make sure I have enough energy for
the day"
A 76-year old man with chronic anemia arrives at the Emergency department with
increased fatigue and heart palpitations even at rest. The nurse would expect the
clients' laboratory test findings to include: (Select all that apply)
a. Hemoglobin (Hgb) of 6.8 g/dL
b. Hematocrit (Hct) value of 32%
c. An Red Blood Cell count of 4,500,000/L
d. A ferritin level of 8.2 ng/mL
e. A White Blood Cell count of 6.5 x 109/L - right CORRECT
ANSWER--A, B, D a: hemoglobin (Hgb) of 6.8 g/dL
b: hematocrit (Hct) value of 32%
d: a ferritin level of 8.2 ng/mL
A student nurse is explaining the risk factors for metabolic syndrome which statement
by the student would require correction from the nurse?
A. Waist circumference of 41 for a male
B. Body mass index of 30 or higher
C. Triglycerides level of 130
D. Blood Glucose of 168 - right CORRECT ANSWER--C. Triglycerides level of 130
A 68 year-old male suffering from chronic diarrhea is found to have a serum phosphate
level of 0.9 mg/dL. After reviewing this lab value the nurse can expect the client to
exhibit which of the following symptoms? (Select all that apply)
A. Confusion
B. Numbness/tingling in extremities
C. Muscle weakness
D. Cardiac dysrhythmias
E. Dry mucous membranes - right CORRECT ANSWER--A. Confusion
C. Muscle weakness
D. Cardiac dysrhythmias
The physician orders an arterial blood gas who is hyperventilating. The nurse can
anticipate that the blood gas results will most likely reveal that the client is in:
A. Metabolic alkalosis
B. Respiratory acidosis
,C. Metabolic acidosis
D. Respiratory alkalosis - right CORRECT ANSWER--D. Respiratory alkalosis
Thalassemia is a group of diseases that causes an inadequate amount of normal
hemoglobin to be produced in the body. Thalassemia minor is usually asymptomatic
and requires no treatments. There is no cure for thalassemia major, however, there are
therapies available to help manage the disease. These include:
A. Blood transfusions
B. Subcutaneous or IV deferoxamine
C. Iron supplements
D. Zinc supplements
E. Splenectomy - right CORRECT ANSWER--A. Blood transfusions
B. Subcutaneous or IV deferoxamine
D. Zinc supplements
E. Splenectomy
A client diagnosed with Stage II bladder cancer has just received a segmental
cystectomy. What will the nurse correct the client on for postoperative instructions for
discharge?:
A. "I will drink only small amounts of water for the first week."
B. "I will call the doctor if my urine is bright red for the first few days after surgery."
C. "After a week, my urine could have dark red flakes, and that's normal."
D. "I have a follow-up appointment for a cystoscopy in a few weeks." - right CORRECT
ANSWER--A. "I will drink only small amounts of water for the first week."
A client with upper gastrointestinal cancer has been diagnosed with cancer cachexia
which of the following would the nurse expect to see?
A. Weight gain
B. Skeletal muscle atrophy
C. Increase immune function
D. Improvement in metabolic abnormalities - right CORRECT ANSWER--B. Skeletal muscle
atrophy
A female client has just been diagnosed with external hemorrhoids and asks the nurse
what could have contributed to her diagnoses, which of the following will the nurse
mention as probable risk factors?
A. Pregnancy
B. Normal Body Mass Index
C. Prolonged constipation
D. Straining in an effort to defecate
E. Heavy lifting
F. Standing or sitting for a long period of time - right CORRECT ANSWER--A. Pregnancy
B. Normal Body Mass Index
, C. Prolonged constipation
D. Straining in an effort to defecate
E. Heavy lifting
F. Standing or sitting for a long period of time
The most common cause of cobalamin deficiency is pernicious anemia. Which of the
following clients may develop a cobalamin deficiency? (Select all that apply)
A. A 36-year-old morbidity obese client that recently had the Roux-en-Y Gastric
Bypass (RYGB) Surgery
B. A 45-year-old male construction working who has a history of smoking two packs of
cigarettes a day
C. A 23-year-old female nurse apprentice who is having a routine colonoscopy
D. A 50-year-old male yoga instructor who is on a strict vegetarian diet
E. A 28-year-old female nursing student taking Pepcid and Omeprazole to control a
Pepcid ulcer for the past three years - right CORRECT ANSWER--A. A 36-year-old
morbidity obese client that recently had the Roux-en-Y Gastric Bypass (RYGB)
Surgery
B. A 45-year-old male construction working who has a history of smoking two packs of
cigarettes a day
D. A 50-year-old male yoga instructor who is on a strict vegetarian diet
E. A 28-year-old female nursing student taking Pepcid and Omeprazole to control a
Pepcid ulcer for the past three years
A 25 year old female client is diagnosed with viral hepatitis. The provider prescribes
Ribavirin, before administering the nucleoside what test will the nurse give to the
client?
a). Liver function test
b). Pregnancy test
c). Occult blood test
d). Urinalysis - right CORRECT ANSWER--b). Pregnancy test
A Roux-en-Y Gastric Bypass (RYGB) Surgical client is suffering from an early case of
iron deficiency. Which of the following group of clinical manifestations will the client
present?
A. No Symptoms
B. Anorexia, Abdominal Pain, Paresthesia of the hands and feet, Nausea, Red and
Beefy Tongue
C. Pallor, Glossitis, Headache, and Burning Sensation of the Tongue
D. Fever, Swelling, Tachypnea, Hypertension, Tenderness, Nausea, Vomiting - right
CORRECT ANSWER--A. No Symptoms
A 67-year-old male has just been admitted into the Emergency Department late into the
night. He is severely confused, agitated, and complains of severe chest pain. His wife is
present with him and is very concerned about her husband. After receiving some blood
