1
(NGN) NCLEX-RN Exam 2025 –
Actual 200 Questions with Correct
Detailed Answers & Rationales | A+
Grade | Brand New 2025 Release
Safe and Effective Care Environment (50 Questions, 10
NGN)
Question 1
Which action by the nurse ensures a safe environment for a patient with a history of falls?
A) Encourage independence with ambulation
B) Keep the bed in the highest position
C) Place a bed alarm
D) Restrain the patient during sleep
Rationale: A bed alarm alerts staff to patient movement, reducing fall risk without restricting
mobility, per NCSBN safety guidelines.
Question 2
Which drug class is contraindicated for hypertrophic cardiomyopathy?
A) Positive inotropes
B) Vasodilators
C) Diuretics
D) Antidysrhythmics
Rationale: Positive inotropes increase contractility, worsening outflow obstruction in
hypertrophic cardiomyopathy, per NCSBN pharmacology standards.
Question 3
A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
appropriate?
A) Administering oral medications
B) Taking vital signs
C) Developing a care plan
D) Interpreting ECG results
Rationale: UAPs can perform non-invasive tasks like taking vital signs, within their scope, per
NCSBN delegation guidelines.
, 2
Question 4
What is the priority action for a patient with a suspected HIPAA violation?
A) Discuss the issue with colleagues
B) Report to the privacy officer
C) Document in the patient’s chart
D) Notify the patient’s family
Rationale: Reporting to the privacy officer ensures proper handling of HIPAA violations, per
NCSBN ethical standards.
Question 5
A nurse is preparing to administer IV vancomycin. What is the priority assessment?
A) Blood pressure
B) Allergy history
C) Pain level
D) Respiratory rate
Rationale: Vancomycin has a high risk of allergic reactions, making allergy history critical, per
NCSBN pharmacology guidelines.
Question 6 (NGN: Case Study)
Case Study: A 65-year-old patient is admitted with chest pain. The nurse notes a history of
hypertension and smoking. Vital signs: BP 160/90, HR 88, RR 18, SpO₂ 95%.
Question: Which action should the nurse prioritize?
A) Administer oxygen at 2 L/min
B) Notify the provider
C) Place the patient in a supine position
D) Encourage deep breathing exercises
Rationale: Chest pain with hypertension requires immediate provider notification to initiate
diagnostic workup, per NCSBN clinical judgment standards.
Question 7
Which precaution is appropriate for a patient with MRSA?
A) Droplet precautions
B) Contact precautions
C) Airborne precautions
D) Standard precautions
Rationale: MRSA requires contact precautions to prevent skin-to-skin transmission, per NCSBN
infection control guidelines.
Question 8
A nurse is preparing a sterile field. Which action violates sterile technique?
A) Using sterile gloves
, 3
B) Reaching over the sterile field
C) Opening sterile packages away from the body
D) Adding sterile saline to the field
Rationale: Reaching over a sterile field risks contamination, per NCSBN sterile technique
standards.
Question 9
What is the nurse’s role in informed consent?
A) Obtain the patient’s signature
B) Verify the patient understands the procedure
C) Perform the procedure
D) Explain the risks to the family
Rationale: The nurse ensures patient understanding, while the provider explains risks, per
NCSBN ethical guidelines.
Question 10
Which action is appropriate when administering a controlled substance?
A) Discard excess medication without a witness
B) Document administration immediately
C) Leave the medication at the bedside
D) Store the medication in an unlocked cabinet
Rationale: Immediate documentation ensures accountability and prevents diversion, per NCSBN
medication safety standards.
Question 11
A patient refuses a blood transfusion due to religious beliefs. What is the nurse’s priority action?
A) Convince the patient to accept the transfusion
B) Respect the patient’s decision
C) Administer the transfusion regardless
D) Notify the family of the refusal
Rationale: Respecting patient autonomy is a core ethical principle, per NCSBN guidelines.
Question 12 (NGN: Select-All-That-Apply)
Question: Select all actions that ensure safe medication administration:
A) Verify the patient’s identity
B) Administer medications without checking the order
C) Check for allergies
D) Confirm the right dose
Answers: A, C, D
Rationale: Verifying identity, allergies, and dose are part of the “five rights” of medication
administration, per NCSBN safety standards.
, 4
Question 13
Which patient is at highest risk for a medication error?
A) A 30-year-old with no allergies
B) A 75-year-old on multiple medications
C) A 50-year-old with a single chronic condition
D) A 20-year-old with no chronic conditions
Rationale: Polypharmacy in older adults increases medication error risk, per NCSBN guidelines.
Question 14
What is the priority action for a patient with a latex allergy during surgery?
A) Use standard gloves
B) Ensure a latex-free environment
C) Administer antihistamines preoperatively
D) Monitor for respiratory distress only
Rationale: A latex-free environment prevents anaphylaxis, per NCSBN safety guidelines.
Question 15
A nurse is transferring a patient to another unit. What ensures continuity of care?
A) Verbal report only
B) Complete a handoff report
C) Document after transfer
D) Rely on the receiving nurse’s assessment
Rationale: A standardized handoff report ensures accurate communication, per NCSBN care
coordination standards.
Question 16 (NGN: Fill-in-the-Blank)
Question: A nurse is calculating the infusion rate for 1000 mL of normal saline to be
administered over 8 hours using a 15 drops/mL drip set. What is the drip rate in drops per
minute?
Answer: 31.25
Rationale: Drip rate = (Volume × Drop factor) / Time = (1000 mL × 15 drops/mL) / (8 × 60
min) = 31.25 drops/min, per NCSBN dosage calculation standards.
Question 17
Which action prevents needlestick injuries?
A) Recap used needles
B) Use a sharps container
C) Dispose of needles in regular trash
D) Store used needles in a pocket
Rationale: Sharps containers prevent needlestick injuries, per NCSBN safety standards.
(NGN) NCLEX-RN Exam 2025 –
Actual 200 Questions with Correct
Detailed Answers & Rationales | A+
Grade | Brand New 2025 Release
Safe and Effective Care Environment (50 Questions, 10
NGN)
Question 1
Which action by the nurse ensures a safe environment for a patient with a history of falls?
A) Encourage independence with ambulation
B) Keep the bed in the highest position
C) Place a bed alarm
D) Restrain the patient during sleep
Rationale: A bed alarm alerts staff to patient movement, reducing fall risk without restricting
mobility, per NCSBN safety guidelines.
Question 2
Which drug class is contraindicated for hypertrophic cardiomyopathy?
A) Positive inotropes
B) Vasodilators
C) Diuretics
D) Antidysrhythmics
Rationale: Positive inotropes increase contractility, worsening outflow obstruction in
hypertrophic cardiomyopathy, per NCSBN pharmacology standards.
Question 3
A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
appropriate?
A) Administering oral medications
B) Taking vital signs
C) Developing a care plan
D) Interpreting ECG results
Rationale: UAPs can perform non-invasive tasks like taking vital signs, within their scope, per
NCSBN delegation guidelines.
, 2
Question 4
What is the priority action for a patient with a suspected HIPAA violation?
A) Discuss the issue with colleagues
B) Report to the privacy officer
C) Document in the patient’s chart
D) Notify the patient’s family
Rationale: Reporting to the privacy officer ensures proper handling of HIPAA violations, per
NCSBN ethical standards.
Question 5
A nurse is preparing to administer IV vancomycin. What is the priority assessment?
A) Blood pressure
B) Allergy history
C) Pain level
D) Respiratory rate
Rationale: Vancomycin has a high risk of allergic reactions, making allergy history critical, per
NCSBN pharmacology guidelines.
Question 6 (NGN: Case Study)
Case Study: A 65-year-old patient is admitted with chest pain. The nurse notes a history of
hypertension and smoking. Vital signs: BP 160/90, HR 88, RR 18, SpO₂ 95%.
Question: Which action should the nurse prioritize?
A) Administer oxygen at 2 L/min
B) Notify the provider
C) Place the patient in a supine position
D) Encourage deep breathing exercises
Rationale: Chest pain with hypertension requires immediate provider notification to initiate
diagnostic workup, per NCSBN clinical judgment standards.
Question 7
Which precaution is appropriate for a patient with MRSA?
A) Droplet precautions
B) Contact precautions
C) Airborne precautions
D) Standard precautions
Rationale: MRSA requires contact precautions to prevent skin-to-skin transmission, per NCSBN
infection control guidelines.
Question 8
A nurse is preparing a sterile field. Which action violates sterile technique?
A) Using sterile gloves
, 3
B) Reaching over the sterile field
C) Opening sterile packages away from the body
D) Adding sterile saline to the field
Rationale: Reaching over a sterile field risks contamination, per NCSBN sterile technique
standards.
Question 9
What is the nurse’s role in informed consent?
A) Obtain the patient’s signature
B) Verify the patient understands the procedure
C) Perform the procedure
D) Explain the risks to the family
Rationale: The nurse ensures patient understanding, while the provider explains risks, per
NCSBN ethical guidelines.
Question 10
Which action is appropriate when administering a controlled substance?
A) Discard excess medication without a witness
B) Document administration immediately
C) Leave the medication at the bedside
D) Store the medication in an unlocked cabinet
Rationale: Immediate documentation ensures accountability and prevents diversion, per NCSBN
medication safety standards.
Question 11
A patient refuses a blood transfusion due to religious beliefs. What is the nurse’s priority action?
A) Convince the patient to accept the transfusion
B) Respect the patient’s decision
C) Administer the transfusion regardless
D) Notify the family of the refusal
Rationale: Respecting patient autonomy is a core ethical principle, per NCSBN guidelines.
Question 12 (NGN: Select-All-That-Apply)
Question: Select all actions that ensure safe medication administration:
A) Verify the patient’s identity
B) Administer medications without checking the order
C) Check for allergies
D) Confirm the right dose
Answers: A, C, D
Rationale: Verifying identity, allergies, and dose are part of the “five rights” of medication
administration, per NCSBN safety standards.
, 4
Question 13
Which patient is at highest risk for a medication error?
A) A 30-year-old with no allergies
B) A 75-year-old on multiple medications
C) A 50-year-old with a single chronic condition
D) A 20-year-old with no chronic conditions
Rationale: Polypharmacy in older adults increases medication error risk, per NCSBN guidelines.
Question 14
What is the priority action for a patient with a latex allergy during surgery?
A) Use standard gloves
B) Ensure a latex-free environment
C) Administer antihistamines preoperatively
D) Monitor for respiratory distress only
Rationale: A latex-free environment prevents anaphylaxis, per NCSBN safety guidelines.
Question 15
A nurse is transferring a patient to another unit. What ensures continuity of care?
A) Verbal report only
B) Complete a handoff report
C) Document after transfer
D) Rely on the receiving nurse’s assessment
Rationale: A standardized handoff report ensures accurate communication, per NCSBN care
coordination standards.
Question 16 (NGN: Fill-in-the-Blank)
Question: A nurse is calculating the infusion rate for 1000 mL of normal saline to be
administered over 8 hours using a 15 drops/mL drip set. What is the drip rate in drops per
minute?
Answer: 31.25
Rationale: Drip rate = (Volume × Drop factor) / Time = (1000 mL × 15 drops/mL) / (8 × 60
min) = 31.25 drops/min, per NCSBN dosage calculation standards.
Question 17
Which action prevents needlestick injuries?
A) Recap used needles
B) Use a sharps container
C) Dispose of needles in regular trash
D) Store used needles in a pocket
Rationale: Sharps containers prevent needlestick injuries, per NCSBN safety standards.
