NCLEX-RN & PN NEXT GEN TEST BANK 2026–2027 | 200+
PRACTICE QUESTIONS, RATIONALES, CASE STUDIES &
CHEAT SHEETS
Q1. (Safety/Priority)
A nurse enters the room and finds a client with COPD short of breath,
oxygen saturation 84% on room air. What is the priority action?
A. Increase client’s activity
B. Place the client in high Fowler’s position
C. Offer oral fluids
D. Notify the provider
Answer: B
Rationale: Positioning improves oxygenation quickly; interventions precede
notification.
Q2. (Pharmacology)
A client with heart failure is prescribed digoxin. Which finding requires
immediate intervention?
A. HR 58 bpm
B. BP 108/70 mmHg
C. Serum potassium 4.0 mEq/L
D. +1 ankle edema
Answer: A
Rationale: Hold digoxin if HR <60 bpm due to risk of toxicity.
Q3. (Maternal – Case Study)
,A 32-week pregnant client presents with painless vaginal bleeding. Which
condition is most likely?
A. Placenta previa
B. Placental abruption
C. Ectopic pregnancy
D. Hyperemesis gravidarum
Answer: A
Rationale: Classic sign of placenta previa = painless, bright red bleeding in
2nd/3rd trimester.
Q4. (Next Gen – SATA)
Which interventions are appropriate for a client with neutropenia? (Select all
that apply.)
A. Place client in a private room
B. Avoid raw fruits and vegetables
C. Restrict visitors with infections
D. Encourage fresh flowers in room
E. Frequent hand hygiene
Answer: A, B, C, E
Rationale: Neutropenia precautions = limit infection exposure; flowers/soil
harbor bacteria.
Q5. (Mental Health)
A client with schizophrenia reports hearing voices. Which response is
therapeutic?
A. “What are the voices telling you?”
B. “I don’t hear any voices.”
,C. “Those voices aren’t real.”
D. “Let’s focus on reality right now.”
Answer: D
Rationale: Acknowledges client’s feelings while reinforcing reality
orientation.
Q6. (Pharm – SATA)
Which are adverse effects of morphine sulfate? (Select all that apply.)
A. Respiratory depression
B. Constipation
C. Hypertension
D. Urinary retention
E. Pupil dilation
Answer: A, B, D
Rationale: Opioids depress respiration, cause constipation, urinary
retention, and miosis (not dilation).
Q7. (Peds)
A toddler with epiglottitis presents to the ED. Which action is priority?
A. Obtain a throat culture
B. Prepare for intubation
C. Administer IV antibiotics
D. Place in a supine position
Answer: B
Rationale: Airway obstruction is imminent; intubation equipment must be
ready. Never manipulate throat.
, Q8. (Med-Surg)
A client with cirrhosis is at risk for hepatic encephalopathy. Which lab
should the nurse monitor?
A. Potassium
B. Ammonia
C. Creatinine
D. Hemoglobin
Answer: B
Rationale: Elevated ammonia levels indicate worsening encephalopathy.
Q9. (Leadership/Priority)
Four clients arrive to the ED after a bus crash. Who should be triaged first?
A. Client with open tibia fracture and controlled bleeding
B. Client with chest pain, RR 10, SpO₂ 82%
C. Client with scalp laceration, bleeding controlled
D. Client with sprained ankle
Answer: B
Rationale: Airway/breathing compromised = immediate priority.
Q10. (OB – SATA)
Which are signs of preeclampsia? (Select all that apply.)
A. Proteinuria
B. Hypertension
C. Headache
D. Hypotension
E. Visual disturbances
PRACTICE QUESTIONS, RATIONALES, CASE STUDIES &
CHEAT SHEETS
Q1. (Safety/Priority)
A nurse enters the room and finds a client with COPD short of breath,
oxygen saturation 84% on room air. What is the priority action?
A. Increase client’s activity
B. Place the client in high Fowler’s position
C. Offer oral fluids
D. Notify the provider
Answer: B
Rationale: Positioning improves oxygenation quickly; interventions precede
notification.
Q2. (Pharmacology)
A client with heart failure is prescribed digoxin. Which finding requires
immediate intervention?
A. HR 58 bpm
B. BP 108/70 mmHg
C. Serum potassium 4.0 mEq/L
D. +1 ankle edema
Answer: A
Rationale: Hold digoxin if HR <60 bpm due to risk of toxicity.
Q3. (Maternal – Case Study)
,A 32-week pregnant client presents with painless vaginal bleeding. Which
condition is most likely?
A. Placenta previa
B. Placental abruption
C. Ectopic pregnancy
D. Hyperemesis gravidarum
Answer: A
Rationale: Classic sign of placenta previa = painless, bright red bleeding in
2nd/3rd trimester.
Q4. (Next Gen – SATA)
Which interventions are appropriate for a client with neutropenia? (Select all
that apply.)
A. Place client in a private room
B. Avoid raw fruits and vegetables
C. Restrict visitors with infections
D. Encourage fresh flowers in room
E. Frequent hand hygiene
Answer: A, B, C, E
Rationale: Neutropenia precautions = limit infection exposure; flowers/soil
harbor bacteria.
Q5. (Mental Health)
A client with schizophrenia reports hearing voices. Which response is
therapeutic?
A. “What are the voices telling you?”
B. “I don’t hear any voices.”
,C. “Those voices aren’t real.”
D. “Let’s focus on reality right now.”
Answer: D
Rationale: Acknowledges client’s feelings while reinforcing reality
orientation.
Q6. (Pharm – SATA)
Which are adverse effects of morphine sulfate? (Select all that apply.)
A. Respiratory depression
B. Constipation
C. Hypertension
D. Urinary retention
E. Pupil dilation
Answer: A, B, D
Rationale: Opioids depress respiration, cause constipation, urinary
retention, and miosis (not dilation).
Q7. (Peds)
A toddler with epiglottitis presents to the ED. Which action is priority?
A. Obtain a throat culture
B. Prepare for intubation
C. Administer IV antibiotics
D. Place in a supine position
Answer: B
Rationale: Airway obstruction is imminent; intubation equipment must be
ready. Never manipulate throat.
, Q8. (Med-Surg)
A client with cirrhosis is at risk for hepatic encephalopathy. Which lab
should the nurse monitor?
A. Potassium
B. Ammonia
C. Creatinine
D. Hemoglobin
Answer: B
Rationale: Elevated ammonia levels indicate worsening encephalopathy.
Q9. (Leadership/Priority)
Four clients arrive to the ED after a bus crash. Who should be triaged first?
A. Client with open tibia fracture and controlled bleeding
B. Client with chest pain, RR 10, SpO₂ 82%
C. Client with scalp laceration, bleeding controlled
D. Client with sprained ankle
Answer: B
Rationale: Airway/breathing compromised = immediate priority.
Q10. (OB – SATA)
Which are signs of preeclampsia? (Select all that apply.)
A. Proteinuria
B. Hypertension
C. Headache
D. Hypotension
E. Visual disturbances
