NCLEX-RN (NGN) PRACTICE EXAM ACTUAL
QUESTIONS AND ANSWERS - LATEST AND
COMPLETE UPDATE WITH VERIFIED
SOLUTIONS – ASSURED PASS WITH INSTANT
DOWNLOAD PDF.
1. A nurse is caring for a client with community-acquired pneumonia who has
an oxygen saturation of 88% on room air. Which action should the nurse
take first?
A. Obtain a sputum culture
B. Apply supplemental oxygen
C. Administer prescribed antibiotics
D. Encourage incentive spirometry
Rationale: Applying oxygen addresses the immediate physiologic need for
impaired oxygenation. Airway and breathing take priority before diagnostic
tests or medications.
2. A client with heart failure is prescribed furosemide. Which finding requires
immediate follow-up by the nurse?
A. Weight loss of 0.5 kg in 24 hours
B. Increased urine output
C. Serum potassium level of 2.9 mEq/L
D. Decreased peripheral edema
Rationale: Hypokalemia can lead to life-threatening dysrhythmias and
requires prompt intervention.
3. The nurse is assessing a postoperative client who reports sudden shortness of
breath and chest pain. Which complication is most likely?
A. Atelectasis
, B. Pulmonary embolism
C. Pneumonia
D. Pleural effusion
Rationale: Acute onset dyspnea and chest pain after surgery are classic
signs of pulmonary embolism.
4. A nurse is teaching a client with diabetes about insulin administration.
Which statement indicates correct understanding?
A. “I should inject insulin into the same spot each time.”
B. “I can massage the site after injection.”
C. “I will rotate injection sites within the same anatomic area.”
D. “I should store opened insulin in the freezer.”
Rationale: Rotating sites within the same area prevents lipohypertrophy
while maintaining consistent absorption.
5. A client receiving morphine IV reports itching and nausea. Which
interpretation by the nurse is correct?
A. Signs of an allergic reaction
B. Expected side effects of opioid therapy
C. Evidence of toxicity
D. Indication of overdose
Rationale: Pruritus and nausea are common opioid side effects and not
typically allergic reactions.
6. A nurse is caring for a client with acute kidney injury. Which laboratory
value is most concerning?
A. Sodium 138 mEq/L
B. Hemoglobin 12 g/dL
C. Potassium 6.1 mEq/L
D. Calcium 9.0 mg/dL
, Rationale: Hyperkalemia is a critical complication of kidney failure and can
cause fatal cardiac arrhythmias.
7. The nurse is preparing to administer blood to a client. Which action is
required before starting the transfusion?
A. Warm the blood to room temperature
B. Verify the client’s identity with another licensed nurse
C. Prime the tubing with dextrose solution
D. Take vital signs after 30 minutes
Rationale: Two-person verification is required to prevent transfusion errors.
8. A client with COPD is receiving oxygen at 4 L/min via nasal cannula.
Which finding indicates the oxygen flow rate may be too high?
A. Respiratory rate of 22/min
B. Decreased level of consciousness
C. Oxygen saturation of 92%
D. Use of accessory muscles
Rationale: High oxygen levels in COPD clients can suppress respiratory
drive, leading to CO₂ retention and altered mental status.
9. A nurse is delegating tasks to an unlicensed assistive personnel (UAP).
Which task is appropriate to delegate?
A. Assessing pain level
B. Teaching incentive spirometry
C. Obtaining routine vital signs
D. Evaluating response to medication
Rationale: UAPs may collect routine data but not assess, teach, or evaluate.
10.A client is diagnosed with Clostridioides difficile infection. Which isolation
precaution is required?
A. Airborne
, B. Droplet
C. Contact with soap-and-water hand hygiene
D. Protective
Rationale: C. difficile spores require contact precautions and handwashing
with soap and water.
11.A nurse is caring for a client experiencing hypoglycemia. Which
manifestation is expected?
A. Fruity breath
B. Deep, rapid respirations
C. Diaphoresis and tremors
D. Dry, flushed skin
Rationale: Hypoglycemia causes adrenergic symptoms such as sweating and
shakiness.
12.Which client should the nurse see first?
A. Client with chronic back pain requesting medication
B. Client with stable angina reporting mild chest discomfort
C. Client with asthma using accessory muscles to breathe
D. Client awaiting discharge instructions
Rationale: Respiratory distress represents an immediate threat to life.
13.A nurse is teaching a client about hypertension management. Which
statement requires further teaching?
A. “I will stop taking my medication when my blood pressure is
normal.”
B. “I will limit my sodium intake.”
C. “I will exercise regularly.”
D. “I will check my blood pressure at home.”
QUESTIONS AND ANSWERS - LATEST AND
COMPLETE UPDATE WITH VERIFIED
SOLUTIONS – ASSURED PASS WITH INSTANT
DOWNLOAD PDF.
1. A nurse is caring for a client with community-acquired pneumonia who has
an oxygen saturation of 88% on room air. Which action should the nurse
take first?
A. Obtain a sputum culture
B. Apply supplemental oxygen
C. Administer prescribed antibiotics
D. Encourage incentive spirometry
Rationale: Applying oxygen addresses the immediate physiologic need for
impaired oxygenation. Airway and breathing take priority before diagnostic
tests or medications.
2. A client with heart failure is prescribed furosemide. Which finding requires
immediate follow-up by the nurse?
A. Weight loss of 0.5 kg in 24 hours
B. Increased urine output
C. Serum potassium level of 2.9 mEq/L
D. Decreased peripheral edema
Rationale: Hypokalemia can lead to life-threatening dysrhythmias and
requires prompt intervention.
3. The nurse is assessing a postoperative client who reports sudden shortness of
breath and chest pain. Which complication is most likely?
A. Atelectasis
, B. Pulmonary embolism
C. Pneumonia
D. Pleural effusion
Rationale: Acute onset dyspnea and chest pain after surgery are classic
signs of pulmonary embolism.
4. A nurse is teaching a client with diabetes about insulin administration.
Which statement indicates correct understanding?
A. “I should inject insulin into the same spot each time.”
B. “I can massage the site after injection.”
C. “I will rotate injection sites within the same anatomic area.”
D. “I should store opened insulin in the freezer.”
Rationale: Rotating sites within the same area prevents lipohypertrophy
while maintaining consistent absorption.
5. A client receiving morphine IV reports itching and nausea. Which
interpretation by the nurse is correct?
A. Signs of an allergic reaction
B. Expected side effects of opioid therapy
C. Evidence of toxicity
D. Indication of overdose
Rationale: Pruritus and nausea are common opioid side effects and not
typically allergic reactions.
6. A nurse is caring for a client with acute kidney injury. Which laboratory
value is most concerning?
A. Sodium 138 mEq/L
B. Hemoglobin 12 g/dL
C. Potassium 6.1 mEq/L
D. Calcium 9.0 mg/dL
, Rationale: Hyperkalemia is a critical complication of kidney failure and can
cause fatal cardiac arrhythmias.
7. The nurse is preparing to administer blood to a client. Which action is
required before starting the transfusion?
A. Warm the blood to room temperature
B. Verify the client’s identity with another licensed nurse
C. Prime the tubing with dextrose solution
D. Take vital signs after 30 minutes
Rationale: Two-person verification is required to prevent transfusion errors.
8. A client with COPD is receiving oxygen at 4 L/min via nasal cannula.
Which finding indicates the oxygen flow rate may be too high?
A. Respiratory rate of 22/min
B. Decreased level of consciousness
C. Oxygen saturation of 92%
D. Use of accessory muscles
Rationale: High oxygen levels in COPD clients can suppress respiratory
drive, leading to CO₂ retention and altered mental status.
9. A nurse is delegating tasks to an unlicensed assistive personnel (UAP).
Which task is appropriate to delegate?
A. Assessing pain level
B. Teaching incentive spirometry
C. Obtaining routine vital signs
D. Evaluating response to medication
Rationale: UAPs may collect routine data but not assess, teach, or evaluate.
10.A client is diagnosed with Clostridioides difficile infection. Which isolation
precaution is required?
A. Airborne
, B. Droplet
C. Contact with soap-and-water hand hygiene
D. Protective
Rationale: C. difficile spores require contact precautions and handwashing
with soap and water.
11.A nurse is caring for a client experiencing hypoglycemia. Which
manifestation is expected?
A. Fruity breath
B. Deep, rapid respirations
C. Diaphoresis and tremors
D. Dry, flushed skin
Rationale: Hypoglycemia causes adrenergic symptoms such as sweating and
shakiness.
12.Which client should the nurse see first?
A. Client with chronic back pain requesting medication
B. Client with stable angina reporting mild chest discomfort
C. Client with asthma using accessory muscles to breathe
D. Client awaiting discharge instructions
Rationale: Respiratory distress represents an immediate threat to life.
13.A nurse is teaching a client about hypertension management. Which
statement requires further teaching?
A. “I will stop taking my medication when my blood pressure is
normal.”
B. “I will limit my sodium intake.”
C. “I will exercise regularly.”
D. “I will check my blood pressure at home.”
