NGN NCLEX /NCLEX NGN RN EXAM
QUESTIONS AND VERIFIED ANSWERS
WITH RATIONALES GRADED A+
LATEST
1. A 65-year-old patient with chronic obstructive pulmonary disease (COPD) is
admitted with shortness of breath and oxygen saturation of 88% on room air.
Which intervention should the nurse implement first?
A. Encourage deep breathing exercises
B. Administer prescribed bronchodilator
C. Place the patient on supplemental oxygen
D. Obtain arterial blood gas (ABG)
Answer: C. Place the patient on supplemental oxygen
Rationale: The first priority is to correct hypoxemia to prevent tissue hypoxia.
Administering oxygen stabilizes the patient, after which medications and
diagnostics can be applied.
2. A nurse is caring for a patient on continuous heparin infusion. Which laboratory
value is most important to monitor?
A. PT (Prothrombin Time)
B. INR (International Normalized Ratio)
C. aPTT (Activated Partial Thromboplastin Time)
D. Platelet count
Answer: C. aPTT (Activated Partial Thromboplastin Time)
Rationale: Heparin therapy is monitored with aPTT to ensure therapeutic
anticoagulation and prevent bleeding complications.
,3. A patient with type 1 diabetes presents with nausea, vomiting, and abdominal
pain. Blood glucose is 420 mg/dL. Which complication is most likely occurring?
A. Hyperosmolar hyperglycemic state
B. Diabetic ketoacidosis (DKA)
C. Hypoglycemia
D. Lactic acidosis
Answer: B. Diabetic ketoacidosis (DKA)
Rationale: DKA is characterized by hyperglycemia, ketonuria, metabolic acidosis,
and gastrointestinal symptoms in type 1 diabetes.
4. A patient is prescribed furosemide 40 mg IV for pulmonary edema. Which
electrolyte imbalance should the nurse monitor closely?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B. Hypokalemia
Rationale: Loop diuretics increase renal excretion of potassium, putting patients at
risk for hypokalemia, which can cause cardiac arrhythmias.
5. A nurse is teaching a patient with newly diagnosed hypertension about lifestyle
modifications. Which statement by the patient indicates correct understanding?
A. “I should avoid all types of fat completely.”
B. “I should increase my intake of fruits, vegetables, and whole grains.”
C. “I will stop taking my medication if my blood pressure is normal.”
D. “I don’t need to exercise since medication is enough.”
Answer: B. “I should increase my intake of fruits, vegetables, and whole grains.”
Rationale: A diet rich in fruits, vegetables, and whole grains helps control blood
pressure. Complete avoidance of fat is unnecessary, and medication adherence and
regular exercise are essential.
,6. A nurse is caring for a patient with a newly placed central venous catheter
(CVC). Which action is a priority to prevent infection?
A. Flush the line with heparin only
B. Use sterile technique when changing the dressing
C. Clamp the line when not in use
D. Administer prophylactic antibiotics
Answer: B. Use sterile technique when changing the dressing
Rationale: Strict sterile technique during insertion and dressing changes is the
most effective way to prevent catheter-related bloodstream infections.
7. A patient reports sudden chest pain radiating to the left arm, shortness of breath,
and diaphoresis. Which action should the nurse take first?
A. Administer nitroglycerin
B. Obtain a 12-lead ECG
C. Assess vital signs
D. Notify the healthcare provider
Answer: C. Assess vital signs
Rationale: The nurse must first assess the patient’s stability (airway, breathing,
circulation) before interventions. Vital signs provide critical information to guide
urgent care.
8. A nurse is planning care for a patient receiving a blood transfusion. Which
intervention is most important during the first 15 minutes of the transfusion?
A. Ensure IV patency
B. Monitor for signs of a transfusion reaction
C. Administer premedication
D. Document the start time
Answer: B. Monitor for signs of a transfusion reaction
Rationale: The first 15 minutes carry the highest risk for acute hemolytic
reactions; close monitoring is essential for early detection.
, 9. A patient is prescribed morphine 4 mg IV for postoperative pain. Which
assessment is most critical before administration?
A. Blood pressure
B. Pain score
C. Respiratory rate
D. Heart rate
Answer: C. Respiratory rate
Rationale: Morphine can cause respiratory depression. Assessing the respiratory
rate is essential to prevent life-threatening complications.
10. A nurse is caring for a patient who is experiencing hypovolemic shock. Which
intervention should the nurse implement first?
A. Administer vasopressors
B. Elevate the legs and administer IV fluids
C. Obtain a complete blood count
D. Apply supplemental oxygen
Answer: B. Elevate the legs and administer IV fluids
Rationale: Hypovolemic shock requires rapid volume replacement to restore
perfusion. Elevating legs improves venous return, and IV fluids restore circulating
volume.
11. A patient with chronic kidney disease (CKD) has hyperkalemia (K⁺ 6.8
mEq/L). Which intervention should the nurse implement first?
A. Administer sodium polystyrene sulfonate (Kayexalate)
B. Prepare for hemodialysis
C. Administer IV calcium gluconate
D. Encourage high-potassium foods
Answer: C. Administer IV calcium gluconate
Rationale: IV calcium stabilizes cardiac membranes immediately to prevent life-
threatening arrhythmias. Other interventions reduce potassium but act more slowly.
QUESTIONS AND VERIFIED ANSWERS
WITH RATIONALES GRADED A+
LATEST
1. A 65-year-old patient with chronic obstructive pulmonary disease (COPD) is
admitted with shortness of breath and oxygen saturation of 88% on room air.
Which intervention should the nurse implement first?
A. Encourage deep breathing exercises
B. Administer prescribed bronchodilator
C. Place the patient on supplemental oxygen
D. Obtain arterial blood gas (ABG)
Answer: C. Place the patient on supplemental oxygen
Rationale: The first priority is to correct hypoxemia to prevent tissue hypoxia.
Administering oxygen stabilizes the patient, after which medications and
diagnostics can be applied.
2. A nurse is caring for a patient on continuous heparin infusion. Which laboratory
value is most important to monitor?
A. PT (Prothrombin Time)
B. INR (International Normalized Ratio)
C. aPTT (Activated Partial Thromboplastin Time)
D. Platelet count
Answer: C. aPTT (Activated Partial Thromboplastin Time)
Rationale: Heparin therapy is monitored with aPTT to ensure therapeutic
anticoagulation and prevent bleeding complications.
,3. A patient with type 1 diabetes presents with nausea, vomiting, and abdominal
pain. Blood glucose is 420 mg/dL. Which complication is most likely occurring?
A. Hyperosmolar hyperglycemic state
B. Diabetic ketoacidosis (DKA)
C. Hypoglycemia
D. Lactic acidosis
Answer: B. Diabetic ketoacidosis (DKA)
Rationale: DKA is characterized by hyperglycemia, ketonuria, metabolic acidosis,
and gastrointestinal symptoms in type 1 diabetes.
4. A patient is prescribed furosemide 40 mg IV for pulmonary edema. Which
electrolyte imbalance should the nurse monitor closely?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B. Hypokalemia
Rationale: Loop diuretics increase renal excretion of potassium, putting patients at
risk for hypokalemia, which can cause cardiac arrhythmias.
5. A nurse is teaching a patient with newly diagnosed hypertension about lifestyle
modifications. Which statement by the patient indicates correct understanding?
A. “I should avoid all types of fat completely.”
B. “I should increase my intake of fruits, vegetables, and whole grains.”
C. “I will stop taking my medication if my blood pressure is normal.”
D. “I don’t need to exercise since medication is enough.”
Answer: B. “I should increase my intake of fruits, vegetables, and whole grains.”
Rationale: A diet rich in fruits, vegetables, and whole grains helps control blood
pressure. Complete avoidance of fat is unnecessary, and medication adherence and
regular exercise are essential.
,6. A nurse is caring for a patient with a newly placed central venous catheter
(CVC). Which action is a priority to prevent infection?
A. Flush the line with heparin only
B. Use sterile technique when changing the dressing
C. Clamp the line when not in use
D. Administer prophylactic antibiotics
Answer: B. Use sterile technique when changing the dressing
Rationale: Strict sterile technique during insertion and dressing changes is the
most effective way to prevent catheter-related bloodstream infections.
7. A patient reports sudden chest pain radiating to the left arm, shortness of breath,
and diaphoresis. Which action should the nurse take first?
A. Administer nitroglycerin
B. Obtain a 12-lead ECG
C. Assess vital signs
D. Notify the healthcare provider
Answer: C. Assess vital signs
Rationale: The nurse must first assess the patient’s stability (airway, breathing,
circulation) before interventions. Vital signs provide critical information to guide
urgent care.
8. A nurse is planning care for a patient receiving a blood transfusion. Which
intervention is most important during the first 15 minutes of the transfusion?
A. Ensure IV patency
B. Monitor for signs of a transfusion reaction
C. Administer premedication
D. Document the start time
Answer: B. Monitor for signs of a transfusion reaction
Rationale: The first 15 minutes carry the highest risk for acute hemolytic
reactions; close monitoring is essential for early detection.
, 9. A patient is prescribed morphine 4 mg IV for postoperative pain. Which
assessment is most critical before administration?
A. Blood pressure
B. Pain score
C. Respiratory rate
D. Heart rate
Answer: C. Respiratory rate
Rationale: Morphine can cause respiratory depression. Assessing the respiratory
rate is essential to prevent life-threatening complications.
10. A nurse is caring for a patient who is experiencing hypovolemic shock. Which
intervention should the nurse implement first?
A. Administer vasopressors
B. Elevate the legs and administer IV fluids
C. Obtain a complete blood count
D. Apply supplemental oxygen
Answer: B. Elevate the legs and administer IV fluids
Rationale: Hypovolemic shock requires rapid volume replacement to restore
perfusion. Elevating legs improves venous return, and IV fluids restore circulating
volume.
11. A patient with chronic kidney disease (CKD) has hyperkalemia (K⁺ 6.8
mEq/L). Which intervention should the nurse implement first?
A. Administer sodium polystyrene sulfonate (Kayexalate)
B. Prepare for hemodialysis
C. Administer IV calcium gluconate
D. Encourage high-potassium foods
Answer: C. Administer IV calcium gluconate
Rationale: IV calcium stabilizes cardiac membranes immediately to prevent life-
threatening arrhythmias. Other interventions reduce potassium but act more slowly.
