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NGN NCLEX Next Gen Exam
Prep: Case-Based Questions
with Step-by-Step Solutions
**1.** A nurse is caring for a client who has a new prescription for a
restraints. Which action is most important?
- A) Obtain a written prescription from the provider every 24 hours
- B) Tie the restraints to the bed frame using a quick-release knot
- C) Remove restraints every 4 hours for range of motion
- D) Document the client’s behavior every shift
**Answer: B**
*Rationale:* Restraints must be secured to the **movable part of the
bed frame** (not side rail) with a **quick-release knot** to allow rapid
removal in an emergency. Option A is incorrect because prescriptions
are needed every 4 hours for adults (not 24h). Option C should be every
2 hours. Option D is too infrequent.
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**2.** A charge nurse is delegating tasks to a licensed practical nurse
(LPN). Which task is appropriate?
- A) Initial admission assessment
- B) Administration of IV push morphine
- C) Reinforcing teaching on insulin self-administration
- D) Creating the nursing care plan
**Answer: C**
*Rationale:* LPNs can **reinforce teaching**, monitor stable clients,
and administer meds (except IV push in many states). Initial assessment
and care plan creation are RN responsibilities. IV push is typically RN-
only.
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**3.** A client falls while attempting to get out of bed. What is the
nurse’s **first** action?
- A) Complete an incident report
- B) Assess the client for injuries
- C) Notify the provider
- D) Check the call light function
, **Answer: B**
*Rationale:* Assessment of the client’s safety and injuries always
comes first. Incident reports are completed after care is provided.
Notifying the provider follows if needed.
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**4.** Which client assignment is most appropriate for an RN to give to
an LPN?
- A) A client 2 hours post-total hip replacement with stable vitals
- B) A client with new-onset chest pain and ECG changes
- C) A client receiving a blood transfusion reaction
- D) A client being admitted with suspected stroke
**Answer: A**
*Rationale:* Stable postoperative clients are appropriate for LPNs.
Unstable, new acute changes, or complex first-time procedures require
RN.
---
**5.** A nurse receives a verbal order over the phone from a provider.
Which action is required?
NGN NCLEX Next Gen Exam
Prep: Case-Based Questions
with Step-by-Step Solutions
**1.** A nurse is caring for a client who has a new prescription for a
restraints. Which action is most important?
- A) Obtain a written prescription from the provider every 24 hours
- B) Tie the restraints to the bed frame using a quick-release knot
- C) Remove restraints every 4 hours for range of motion
- D) Document the client’s behavior every shift
**Answer: B**
*Rationale:* Restraints must be secured to the **movable part of the
bed frame** (not side rail) with a **quick-release knot** to allow rapid
removal in an emergency. Option A is incorrect because prescriptions
are needed every 4 hours for adults (not 24h). Option C should be every
2 hours. Option D is too infrequent.
,---
**2.** A charge nurse is delegating tasks to a licensed practical nurse
(LPN). Which task is appropriate?
- A) Initial admission assessment
- B) Administration of IV push morphine
- C) Reinforcing teaching on insulin self-administration
- D) Creating the nursing care plan
**Answer: C**
*Rationale:* LPNs can **reinforce teaching**, monitor stable clients,
and administer meds (except IV push in many states). Initial assessment
and care plan creation are RN responsibilities. IV push is typically RN-
only.
---
**3.** A client falls while attempting to get out of bed. What is the
nurse’s **first** action?
- A) Complete an incident report
- B) Assess the client for injuries
- C) Notify the provider
- D) Check the call light function
, **Answer: B**
*Rationale:* Assessment of the client’s safety and injuries always
comes first. Incident reports are completed after care is provided.
Notifying the provider follows if needed.
---
**4.** Which client assignment is most appropriate for an RN to give to
an LPN?
- A) A client 2 hours post-total hip replacement with stable vitals
- B) A client with new-onset chest pain and ECG changes
- C) A client receiving a blood transfusion reaction
- D) A client being admitted with suspected stroke
**Answer: A**
*Rationale:* Stable postoperative clients are appropriate for LPNs.
Unstable, new acute changes, or complex first-time procedures require
RN.
---
**5.** A nurse receives a verbal order over the phone from a provider.
Which action is required?
