1|Page
NCLEX-RN (NGN) EXAM 1 UPDATED 2025-2026
WITH ALL NEW QUESTIONS AND EXACTLY
RIGHT ANSWERS | A+ QUALITY GUARANTEE
course name: Advanced Nursing Practice
Subject: Next Generation NCLEX-RN Examination
The 50 multiple-choice and clinical scenario-based questions on the NGN NCLEX-
RN exam are intended to assess critical thinking, clinical judgment, prioritization,
safety, and patient-centered care in order to prepare candidates for registered
nurse licensing. Medical-surgical, pediatric, maternity, pharmacology, mental
health, and emergency nursing scenarios are all covered in the questions. Exam
preparation and comprehension are strengthened by the inclusion of rationales.
Question 1
A client with congestive heart failure reports shortness of breath and edema. Which
assessment finding is the highest priority?
A. Mild ankle swelling
B. Shortness of breath at rest
C. Weight gain of 1 lb
D. Slight fatigue
ANSWER: B
Rationale: Shortness of breath at rest indicates worsening pulmonary congestion
and potential respiratory compromise, which is life-threatening and requires
immediate attention.
Question 2
A client with type 1 diabetes reports feeling shaky, sweaty, and dizzy. Blood
glucose is 48 mg/dL. What is the priority action?
A. Recheck blood sugar in 30 minutes
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B. Administer 15 g of fast-acting carbohydrate
C. Provide a protein-rich snack
D. Notify the provider immediately
ANSWER: B
Rationale: Hypoglycemia is an immediate threat. Fast-acting carbohydrates
quickly raise blood glucose, preventing further deterioration.
Question 3
A client with pneumonia has O₂ saturation of 88%. What is the most appropriate
nursing action?
A. Encourage ambulation
B. Administer prescribed supplemental oxygen
C. Increase oral fluid intake
D. Reassess in 2 hours
ANSWER: B
Rationale: Oxygen saturation below 90% indicates hypoxemia; supplemental
oxygen is necessary to prevent tissue hypoxia.
Question 4
A postoperative client reports sudden calf pain and swelling. What is the priority
intervention?
A. Apply heat to the leg
B. Elevate the leg and continue ambulation
C. Notify the provider immediately
D. Massage the calf
ANSWER: C
Rationale: These are classic signs of deep vein thrombosis (DVT). Immediate
notification is critical to prevent a potentially fatal pulmonary embolism.
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Question 5
A client receiving morphine becomes somnolent and has a respiratory rate of
8/min. What is the priority action?
A. Place the client in high-Fowler position
B. Administer naloxone as prescribed
C. Encourage deep breathing exercises
D. Document the findings
ANSWER: B
Rationale: Respiratory depression is a life-threatening opioid side effect; naloxone
is the antidote.
Question 6
A client with chronic kidney disease has potassium level 6.5 mEq/L. Which action
is most urgent?
A. Encourage high-potassium foods
B. Administer prescribed calcium gluconate
C. Provide fluids only
D. Monitor vital signs
ANSWER: B
Rationale: Hyperkalemia is life-threatening and can cause arrhythmias; calcium
gluconate stabilizes cardiac membranes.
Question 7
A client with asthma reports wheezing and dyspnea. Which medication should the
nurse administer first?
A. Albuterol via nebulizer
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B. Montelukast orally
C. Fluticasone inhaler
D. Prednisone orally
ANSWER: A
Rationale: Albuterol is a short-acting bronchodilator for immediate relief during
acute exacerbations.
Question 8
A client with a new tracheostomy shows increased work of breathing and audible
stridor. What is the priority action?
A. Suction the tracheostomy
B. Assess airway and prepare for potential intubation
C. Encourage deep breathing exercises
D. Apply warm compresses
ANSWER: B
Rationale: Stridor indicates upper airway obstruction. Immediate airway
assessment is critical; intubation may be required.
Question 9
A client on furosemide reports muscle cramps. Which lab value should the nurse
check first?
A. Sodium
B. Potassium
C. Calcium
D. Chloride
ANSWER: B
Rationale: Hypokalemia caused by diuretics commonly leads to muscle cramps;
potassium levels must be assessed and corrected.
NCLEX-RN (NGN) EXAM 1 UPDATED 2025-2026
WITH ALL NEW QUESTIONS AND EXACTLY
RIGHT ANSWERS | A+ QUALITY GUARANTEE
course name: Advanced Nursing Practice
Subject: Next Generation NCLEX-RN Examination
The 50 multiple-choice and clinical scenario-based questions on the NGN NCLEX-
RN exam are intended to assess critical thinking, clinical judgment, prioritization,
safety, and patient-centered care in order to prepare candidates for registered
nurse licensing. Medical-surgical, pediatric, maternity, pharmacology, mental
health, and emergency nursing scenarios are all covered in the questions. Exam
preparation and comprehension are strengthened by the inclusion of rationales.
Question 1
A client with congestive heart failure reports shortness of breath and edema. Which
assessment finding is the highest priority?
A. Mild ankle swelling
B. Shortness of breath at rest
C. Weight gain of 1 lb
D. Slight fatigue
ANSWER: B
Rationale: Shortness of breath at rest indicates worsening pulmonary congestion
and potential respiratory compromise, which is life-threatening and requires
immediate attention.
Question 2
A client with type 1 diabetes reports feeling shaky, sweaty, and dizzy. Blood
glucose is 48 mg/dL. What is the priority action?
A. Recheck blood sugar in 30 minutes
,2|Page
B. Administer 15 g of fast-acting carbohydrate
C. Provide a protein-rich snack
D. Notify the provider immediately
ANSWER: B
Rationale: Hypoglycemia is an immediate threat. Fast-acting carbohydrates
quickly raise blood glucose, preventing further deterioration.
Question 3
A client with pneumonia has O₂ saturation of 88%. What is the most appropriate
nursing action?
A. Encourage ambulation
B. Administer prescribed supplemental oxygen
C. Increase oral fluid intake
D. Reassess in 2 hours
ANSWER: B
Rationale: Oxygen saturation below 90% indicates hypoxemia; supplemental
oxygen is necessary to prevent tissue hypoxia.
Question 4
A postoperative client reports sudden calf pain and swelling. What is the priority
intervention?
A. Apply heat to the leg
B. Elevate the leg and continue ambulation
C. Notify the provider immediately
D. Massage the calf
ANSWER: C
Rationale: These are classic signs of deep vein thrombosis (DVT). Immediate
notification is critical to prevent a potentially fatal pulmonary embolism.
,3|Page
Question 5
A client receiving morphine becomes somnolent and has a respiratory rate of
8/min. What is the priority action?
A. Place the client in high-Fowler position
B. Administer naloxone as prescribed
C. Encourage deep breathing exercises
D. Document the findings
ANSWER: B
Rationale: Respiratory depression is a life-threatening opioid side effect; naloxone
is the antidote.
Question 6
A client with chronic kidney disease has potassium level 6.5 mEq/L. Which action
is most urgent?
A. Encourage high-potassium foods
B. Administer prescribed calcium gluconate
C. Provide fluids only
D. Monitor vital signs
ANSWER: B
Rationale: Hyperkalemia is life-threatening and can cause arrhythmias; calcium
gluconate stabilizes cardiac membranes.
Question 7
A client with asthma reports wheezing and dyspnea. Which medication should the
nurse administer first?
A. Albuterol via nebulizer
, 4|Page
B. Montelukast orally
C. Fluticasone inhaler
D. Prednisone orally
ANSWER: A
Rationale: Albuterol is a short-acting bronchodilator for immediate relief during
acute exacerbations.
Question 8
A client with a new tracheostomy shows increased work of breathing and audible
stridor. What is the priority action?
A. Suction the tracheostomy
B. Assess airway and prepare for potential intubation
C. Encourage deep breathing exercises
D. Apply warm compresses
ANSWER: B
Rationale: Stridor indicates upper airway obstruction. Immediate airway
assessment is critical; intubation may be required.
Question 9
A client on furosemide reports muscle cramps. Which lab value should the nurse
check first?
A. Sodium
B. Potassium
C. Calcium
D. Chloride
ANSWER: B
Rationale: Hypokalemia caused by diuretics commonly leads to muscle cramps;
potassium levels must be assessed and corrected.
