NGN 2025
Professor-Verified | 180 Questions | All Answers
Graded A+
This examination is a comprehensive simulation designed to predict readiness for the
practical/vocational nursing licensure examination. It incorporates 180 items reflecting
the latest 2025 test plan, including Next Generation NCLEX (NGN) formats that assess
clinical judgment through the NCSBN Clinical Judgment Measurement Model (NCJMM). All
content is validated for accuracy and alignment with current PN/VN scope of practice and
evidence-based standards. Use this exam under timed conditions for the most accurate self-
assessment.
Item #: 1 | Type: MC
Scenario: A 67-year-old client with COPD is receiving oxygen at 2 L/min via nasal
cannula. The PN notes the client’s oxygen saturation is 91%.
Question: Which action should the PN take first?
Options:
A. Increase the oxygen flow to 4 L/min
B. Document the saturation and continue to monitor
C. Notify the RN or provider immediately
D. Encourage the client to take deep breaths
Correct Answer: B. Document the saturation and continue to monitor
Rationale (Professor-Verified): Per 2025 PN/VN scope, 91% saturation is acceptable
for a COPD client due to chronic hypoxemia. Increasing oxygen can suppress hypoxic
drive. The PN should document and monitor unless saturation drops below 88% or the
client shows distress. This aligns with NCJMM Step 2: analyze cues.
Item #: 2 | Type: NGN-EMR (Case Study)
Scenario: A 5-year-old child is admitted with asthma exacerbation. Respiratory rate
38/min, O₂ sat 89%, audible wheeze, unable to speak in full sentences.
Question: Select all nursing actions appropriate for the PN within the first 15 minutes.
Options:
A. Administer prescribed albuterol 2.5 mg nebulizer
B. Obtain capillary blood glucose
C. Start IV access using 24-gauge catheter
D. Place child in high-Fowler position
E. Provide emotional support to parents
pg. 1
,Correct Answer: A, D, E
Rationale (Professor-Verified): PN scope includes administering nebulized
bronchodilators, positioning for optimal ventilation, and psychosocial support. IV starts
and blood glucose are RN or advanced skills in many states. Decision reflects NCJMM
Step 3: prioritize hypotheses.
Item #: 3 | Type: SATA
Scenario: Post-op cholecystectomy client has a Jackson-Pratt drain. The PN observes
sudden serosanguinous output increase from 25 mL to 150 mL in one hour.
Question: Which findings should the PN immediately report?
Options:
A. Blood pressure 88/50 mmHg
B. Heart rate 110/min
C. Drainage color bright red
D. Client reports abdominal fullness
E. Temperature 37.2 °C
Correct Answer: A, C, D
Rationale (Professor-Verified): Acute hypotension, bright-red drainage, and subjective
fullness suggest post-op hemorrhage—PN must escalate under NLN competencies. Mild
tachycardia and low-grade fever are expected. Tests NCJMM Step 4: generate solutions.
Item #: 4 | Type: Drag-and-Drop / Ordered Response
Scenario: PN is assigned to administer a scheduled 0900 dose of digoxin 0.25 mg PO.
Client’s apical pulse is 58 bpm.
Question: Place the PN’s next steps in correct sequence.
Options:
1. Hold the dose
2. Recheck apical pulse in 15 minutes
3. Notify RN or provider
4. Document held dose and notification
Correct Answer: 1, 2, 3, 4
Rationale (Professor-Verified): PN holds digoxin when pulse <60, reassesses to
confirm, escalates, and documents per NLN medication guidelines. Sequence
reflects NCJMM Step 5: take action.
Item #: 5 | Type: MC
Scenario: A client on heparin 5000 units subcutaneous q12h has an aPTT of 90 seconds
(reference 30-40).
pg. 2
,Question: What is the PN’s priority action?
Options:
A. Administer the next scheduled dose
B. Hold the dose and notify the RN
C. Apply ice to injection sites
D. Encourage fluids
Correct Answer: B. Hold the dose and notify the RN
Rationale (Professor-Verified): Elevated aPTT indicates bleeding risk; PN must hold
anticoagulant and escalate. This demonstrates safe practice within PN scope and NCJMM
Step 4: generate solutions.
Item #: 6 | Type: Matrix Multiple Choice
Scenario: PN is caring for four clients. Match each client symptom to the most likely
electrolyte imbalance.
Matrix:
Table
Copy
Client Symptom Hyperkalemia Hypokalemia Hypercalcemia
A. Muscle weakness with
peaked T waves ☐ ☐ ☐
B. Constipation and confusion ☐ ☐ ☐
C. Leg cramps with flattened T
waves ☐ ☐ ☐
Correct Answer:
A → Hyperkalemia
B → Hypercalcemia
C → Hypokalemia
pg. 3
, Client Symptom Hyperkalemia Hypokalemia Hypercalcemia
Rationale (Professor-
Verified): PN must recognize
ECG and clinical correlates to
prevent cardiac complications.
Matrix tests cue analysis
(NCJMM Step 2).
Item #: 7 | Type: Cloze (Drop-Down)
Scenario: A client with heart failure is prescribed furosemide 40 mg PO daily. Morning
weight increased 2 kg in 24 h, and 1+ pedal edema is present.
Question: The PN should monitor the client’s (1) ___ daily and instruct to consume no
more than (2) ___ mL of fluid per day.
Drop-Down Options:
(1) weight / blood pressure / glucose
(2) / 2000
Correct Answer:
(1) weight
(2) 1500
Rationale (Professor-Verified): Daily weight is most sensitive indicator of fluid shifts;
1500 mL balances hydration without overload per HF guidelines. Tests NCJMM Step 3:
prioritize hypotheses.
Item #: 8 | Type: MC
Scenario: A client with DM type 2 is scheduled for a fasting glucose lab draw at 0700.
The PN notes the client drank 240 mL of black coffee 30 minutes ago.
Question: What action should the PN take?
Options:
A. Proceed with the draw and document the coffee
B. Reschedule the lab for the next morning
C. Obtain a random glucose instead
D. Notify dietary to hold breakfast
Correct Answer: B. Reschedule the lab for the next morning
Rationale (Professor-Verified): Even black coffee affects fasting status; PN ensures
accuracy by rescheduling. Reflects NLN diagnostic stewardship and NCJMM Step 1:
recognize cues.
pg. 4