RN Fundamentals Exam NGN Style Questions
Verified Rationales Actual Exam 2026/2027
– Complete Questions and Answers with
Detailed Rationales – Pass Guaranteed – A+
Graded
SECTION 1: STAND-ALONE QUESTIONS (Questions 1-55)
Q1: A nurse is caring for four clients on a medical-surgical unit. Which client should the
nurse assess first?
A. A client who is postoperative day 2 and requests pain medication for a pain level of
4/10
B. A client who is 1 day postoperative and has absent breath sounds on the right side
C. A client who has a new prescription for physical therapy evaluation this afternoon
D. A client who needs discharge teaching reinforced regarding wound care
Correct Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) prioritization framework,
absent breath sounds indicate a potential pneumothorax or respiratory complication
requiring immediate assessment. While pain management is important (option A), it
does not take priority over respiratory compromise. Options C and D are non-urgent
needs that can be addressed after the priority client is stabilized. [CORRECT]
Q2: A nurse is caring for a client who is receiving heparin via continuous IV infusion. The
client's aPTT result is 95 seconds (therapeutic range 60-80 seconds). Which of the
following actions should the nurse take?
A. Continue the current infusion rate and recheck in 4 hours
B. Stop the infusion immediately and notify the provider
,C. Decrease the infusion rate per protocol and reassess aPTT per facility policy
D. Administer protamine sulfate without consulting the provider
Correct Answer: C
Rationale: An aPTT of 95 seconds indicates supratherapeutic anticoagulation. The
nurse should decrease the infusion rate according to the facility's heparin protocol and
recheck the aPTT as directed. Option A is unsafe as it continues an excessive dose.
Option B is inappropriate for this degree of elevation; stopping completely could cause
clot formation. Option D requires a provider prescription. [CORRECT]
Q3: Which of the following tasks is appropriate for the nurse to delegate to an assistive
personnel (AP)? (Select all that apply)
A. Assisting a client with ambulation in the hallway
B. Measuring and recording intake and output for a client with a urinary catheter
C. Administering oral medications to a stable client
D. Performing postmortem care
E. Checking the vital signs of a client who is 2 hours postoperative
F. Teaching a client about diabetic foot care
Correct Answer: A, B, D, E
Rationale: The five rights of delegation guide safe task assignment. Activities within the
AP scope include ambulation assistance (A), measuring I&O (B), postmortem care (D),
and routine vital signs on stable postoperative clients (E). Medication administration (C)
and client teaching (F) require professional nursing judgment and cannot be delegated.
[CORRECT]
Q4: A nurse is preparing to administer digoxin 0.125 mg PO to a client with heart failure.
The nurse checks the apical pulse and finds it to be 52 beats/minute. Which action
should the nurse take?
A. Administer the medication as prescribed
B. Hold the dose and reassess the radial pulse in 1 hour
C. Hold the dose and notify the provider
D. Give the medication with food to slow absorption
,Correct Answer: C
Rationale: Digoxin is contraindicated when the apical heart rate is below 60
beats/minute due to the risk of severe bradycardia or heart block. The nurse must hold
the dose and notify the provider immediately. Options A and B place the client at risk for
cardiac complications. Food does not mitigate the bradycardia risk. [CORRECT]
Q5: A nurse is calculating the intake for an 8-hour shift (0700-1500). The client
consumed: 6 oz of orange juice, 1 cup of coffee (8 oz), 4 oz of gelatin, and 12 oz of
water. The client also received 500 mL of 0.9% NaCl IV and had 100 mL of fluid
remaining in the IV bag at 1500. How many mL of total intake should the nurse
document? (Round to the nearest whole number)
Correct Answer: 960 mL
Rationale: Oral intake: 6 oz (180 mL) + 8 oz (240 mL) + 4 oz (120 mL) + 12 oz (360 mL)
= 900 mL. IV intake: 500 mL started - 100 mL remaining = 400 mL infused. Total intake
= 900 mL + 400 mL = 1,300 mL. [CORRECT] [Correction: 180+240+120+360 = 900;
500-100=400; 900+400=1,300 mL. The correct answer is 1300 mL]
Q6: A nurse is caring for a client who is dying. The client states, "I need to see my son
graduate next month. I can't die yet." The nurse should identify this as which stage of
grief?
A. Denial
B. Anger
C. Bargaining
D. Depression
Correct Answer: C
Rationale: Bargaining involves attempting to negotiate for more time or postponement
of death, often directed toward a higher power or fate. The client is attempting to make
a deal to survive until a specific event. Denial involves refusal to accept reality. Anger
, involves hostility or resentment. Depression involves withdrawal and sadness.
[CORRECT]
Q7: A nurse is inserting an indwelling urinary catheter for a female client. Place the
following steps in the correct order of performance.
1. Cleanse the perineal area with soap and water
2. Advance the catheter until urine flows, then advance 2.5-5 cm (1-2 inches) further
3. Inflate the balloon with sterile water
4. Don sterile gloves after opening the sterile kit
5. Cleanse the urethral meatus with antiseptic solution using front-to-back motion
Correct Answer: 1, 4, 5, 2, 3
Rationale: The correct sequence is: Perform perineal care with soap and water (1), open
kit and don sterile gloves (4), cleanse urethral meatus with antiseptic (5), insert catheter
and advance after urine flow (2), then inflate balloon (3). This maintains sterile
technique and prevents trauma. [CORRECT]
Q8: A nurse is caring for a client who is on contact precautions for methicillin-resistant
Staphylococcus aureus (MRSA) in a wound. Which PPE is required when entering the
client's room?
A. Gloves and gown
B. N95 respirator and gloves
C. Goggles and gloves
D. Surgical mask and gown
Correct Answer: A
Rationale: Contact precautions require gloves and gown to prevent transmission via
direct contact with the client or contaminated surfaces. N95 respirators are for airborne
precautions. Goggles are for splash protection during procedures. Surgical masks are
for droplet precautions. [CORRECT]
Verified Rationales Actual Exam 2026/2027
– Complete Questions and Answers with
Detailed Rationales – Pass Guaranteed – A+
Graded
SECTION 1: STAND-ALONE QUESTIONS (Questions 1-55)
Q1: A nurse is caring for four clients on a medical-surgical unit. Which client should the
nurse assess first?
A. A client who is postoperative day 2 and requests pain medication for a pain level of
4/10
B. A client who is 1 day postoperative and has absent breath sounds on the right side
C. A client who has a new prescription for physical therapy evaluation this afternoon
D. A client who needs discharge teaching reinforced regarding wound care
Correct Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) prioritization framework,
absent breath sounds indicate a potential pneumothorax or respiratory complication
requiring immediate assessment. While pain management is important (option A), it
does not take priority over respiratory compromise. Options C and D are non-urgent
needs that can be addressed after the priority client is stabilized. [CORRECT]
Q2: A nurse is caring for a client who is receiving heparin via continuous IV infusion. The
client's aPTT result is 95 seconds (therapeutic range 60-80 seconds). Which of the
following actions should the nurse take?
A. Continue the current infusion rate and recheck in 4 hours
B. Stop the infusion immediately and notify the provider
,C. Decrease the infusion rate per protocol and reassess aPTT per facility policy
D. Administer protamine sulfate without consulting the provider
Correct Answer: C
Rationale: An aPTT of 95 seconds indicates supratherapeutic anticoagulation. The
nurse should decrease the infusion rate according to the facility's heparin protocol and
recheck the aPTT as directed. Option A is unsafe as it continues an excessive dose.
Option B is inappropriate for this degree of elevation; stopping completely could cause
clot formation. Option D requires a provider prescription. [CORRECT]
Q3: Which of the following tasks is appropriate for the nurse to delegate to an assistive
personnel (AP)? (Select all that apply)
A. Assisting a client with ambulation in the hallway
B. Measuring and recording intake and output for a client with a urinary catheter
C. Administering oral medications to a stable client
D. Performing postmortem care
E. Checking the vital signs of a client who is 2 hours postoperative
F. Teaching a client about diabetic foot care
Correct Answer: A, B, D, E
Rationale: The five rights of delegation guide safe task assignment. Activities within the
AP scope include ambulation assistance (A), measuring I&O (B), postmortem care (D),
and routine vital signs on stable postoperative clients (E). Medication administration (C)
and client teaching (F) require professional nursing judgment and cannot be delegated.
[CORRECT]
Q4: A nurse is preparing to administer digoxin 0.125 mg PO to a client with heart failure.
The nurse checks the apical pulse and finds it to be 52 beats/minute. Which action
should the nurse take?
A. Administer the medication as prescribed
B. Hold the dose and reassess the radial pulse in 1 hour
C. Hold the dose and notify the provider
D. Give the medication with food to slow absorption
,Correct Answer: C
Rationale: Digoxin is contraindicated when the apical heart rate is below 60
beats/minute due to the risk of severe bradycardia or heart block. The nurse must hold
the dose and notify the provider immediately. Options A and B place the client at risk for
cardiac complications. Food does not mitigate the bradycardia risk. [CORRECT]
Q5: A nurse is calculating the intake for an 8-hour shift (0700-1500). The client
consumed: 6 oz of orange juice, 1 cup of coffee (8 oz), 4 oz of gelatin, and 12 oz of
water. The client also received 500 mL of 0.9% NaCl IV and had 100 mL of fluid
remaining in the IV bag at 1500. How many mL of total intake should the nurse
document? (Round to the nearest whole number)
Correct Answer: 960 mL
Rationale: Oral intake: 6 oz (180 mL) + 8 oz (240 mL) + 4 oz (120 mL) + 12 oz (360 mL)
= 900 mL. IV intake: 500 mL started - 100 mL remaining = 400 mL infused. Total intake
= 900 mL + 400 mL = 1,300 mL. [CORRECT] [Correction: 180+240+120+360 = 900;
500-100=400; 900+400=1,300 mL. The correct answer is 1300 mL]
Q6: A nurse is caring for a client who is dying. The client states, "I need to see my son
graduate next month. I can't die yet." The nurse should identify this as which stage of
grief?
A. Denial
B. Anger
C. Bargaining
D. Depression
Correct Answer: C
Rationale: Bargaining involves attempting to negotiate for more time or postponement
of death, often directed toward a higher power or fate. The client is attempting to make
a deal to survive until a specific event. Denial involves refusal to accept reality. Anger
, involves hostility or resentment. Depression involves withdrawal and sadness.
[CORRECT]
Q7: A nurse is inserting an indwelling urinary catheter for a female client. Place the
following steps in the correct order of performance.
1. Cleanse the perineal area with soap and water
2. Advance the catheter until urine flows, then advance 2.5-5 cm (1-2 inches) further
3. Inflate the balloon with sterile water
4. Don sterile gloves after opening the sterile kit
5. Cleanse the urethral meatus with antiseptic solution using front-to-back motion
Correct Answer: 1, 4, 5, 2, 3
Rationale: The correct sequence is: Perform perineal care with soap and water (1), open
kit and don sterile gloves (4), cleanse urethral meatus with antiseptic (5), insert catheter
and advance after urine flow (2), then inflate balloon (3). This maintains sterile
technique and prevents trauma. [CORRECT]
Q8: A nurse is caring for a client who is on contact precautions for methicillin-resistant
Staphylococcus aureus (MRSA) in a wound. Which PPE is required when entering the
client's room?
A. Gloves and gown
B. N95 respirator and gloves
C. Goggles and gloves
D. Surgical mask and gown
Correct Answer: A
Rationale: Contact precautions require gloves and gown to prevent transmission via
direct contact with the client or contaminated surfaces. N95 respirators are for airborne
precautions. Goggles are for splash protection during procedures. Surgical masks are
for droplet precautions. [CORRECT]
