1|Page
NEXUS NCLEX® 2026–2027 EDITION NEW
ADULT HEALTH FINAL EXAM HIGH-YIELD
CONTENT | NEXT GENERATION NCLEX (NGN) |
FIRST-TIME PASS GUARANTEE FRAMEWORK
TABLE OF CONTENTS
| Section | Topic | Questions |
|---------|-------|-----------|
| 1 | Cardiovascular Disorders | 30 |
| 2 | Respiratory Disorders | 30 |
| 3 | Neurological Disorders | 25 |
| 4 | Gastrointestinal & Renal | 25 |
| 5 | Endocrine & Metabolic | 20 |
| 6 | Hematology, Immunology, & Oncology | 20 |
| 7 | Infectious Diseases & Sepsis | 15 |
| 8 | Perioperative & Emergency Nursing | 15 |
| 9 | Pharmacology & Safe Medication Administration | 20 |
| 10 | NGN Case Studies (6 cases × 3 items) | 18 |
| **TOTAL** | | **218** |
---
,2|Page
SECTION 1 – CARDIOVASCULAR (30 Questions)
**1.** A patient with acute decompensated heart failure has severe
dyspnea, crackles, and pink frothy sputum. **First action?**
A) Furosemide IV push
B) High-Fowler’s position
C) CPAP
D) Morphine IV
*Rationale:* Positioning reduces preload immediately, improving
oxygenation before other interventions.
**2.** Post-MI patient has HR 120, BP 90/60, JVD, new murmur at left
sternal border. Suspect?
A) Tamponade
B) Papillary muscle rupture
C) VSD
D) Pericarditis
*Rationale:* Acute MR from papillary rupture → holosystolic murmur,
pulmonary edema, shock.
**3.** Heparin infusion for PE; aPTT 110 sec (control 30). Priority?
A) Increase rate
B) Stop infusion, prepare protamine
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C) Repeat aPTT in 4h
D) Give vitamin K
*Rationale:* Supratherapeutic aPTT → bleeding risk. Protamine
reverses heparin.
**4.** Hyperkalemia ECG finding?
A) Peaked T waves
B) Wide QRS
C) ST elevation
D) Absent P waves
*Rationale:* Peaked T waves are earliest sign.
**5.** A fib (rate 140) on digoxin + metoprolol; reports nausea + yellow
vision. First?
A) Check digoxin level
B) Antiemetic
C) Hold metoprolol
D) Oxygen
*Rationale:* Yellow halos + nausea = digoxin toxicity.
**6.** Patient with unstable angina. IV nitroglycerin started. BP drops
from 140/90 to 85/50. Next?
A) Increase nitroglycerin
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B) Give fluid bolus
C) Start dopamine
D) Trendelenburg
*Rationale:* Hypotension from nitrate → fluid resuscitation first.
**7.** Post-cardiac cath; groin site oozing, expanding hematoma.
Priority?
A) Apply sandbag
B) Mark hematoma edges
C) Hold manual pressure
D) Call provider
*Rationale:* Manual pressure above site to stop bleeding immediately.
**8.** Which beta-blocker is cardioselective (β1)?
A) Propranolol
B) Metoprolol
C) Carvedilol
D) Labetalol
*Rationale:* Metoprolol and atenolol are β1-selective; safer in COPD.
**9.** Patient with aortic stenosis. Triad includes?
A) Syncope, angina, dyspnea
NEXUS NCLEX® 2026–2027 EDITION NEW
ADULT HEALTH FINAL EXAM HIGH-YIELD
CONTENT | NEXT GENERATION NCLEX (NGN) |
FIRST-TIME PASS GUARANTEE FRAMEWORK
TABLE OF CONTENTS
| Section | Topic | Questions |
|---------|-------|-----------|
| 1 | Cardiovascular Disorders | 30 |
| 2 | Respiratory Disorders | 30 |
| 3 | Neurological Disorders | 25 |
| 4 | Gastrointestinal & Renal | 25 |
| 5 | Endocrine & Metabolic | 20 |
| 6 | Hematology, Immunology, & Oncology | 20 |
| 7 | Infectious Diseases & Sepsis | 15 |
| 8 | Perioperative & Emergency Nursing | 15 |
| 9 | Pharmacology & Safe Medication Administration | 20 |
| 10 | NGN Case Studies (6 cases × 3 items) | 18 |
| **TOTAL** | | **218** |
---
,2|Page
SECTION 1 – CARDIOVASCULAR (30 Questions)
**1.** A patient with acute decompensated heart failure has severe
dyspnea, crackles, and pink frothy sputum. **First action?**
A) Furosemide IV push
B) High-Fowler’s position
C) CPAP
D) Morphine IV
*Rationale:* Positioning reduces preload immediately, improving
oxygenation before other interventions.
**2.** Post-MI patient has HR 120, BP 90/60, JVD, new murmur at left
sternal border. Suspect?
A) Tamponade
B) Papillary muscle rupture
C) VSD
D) Pericarditis
*Rationale:* Acute MR from papillary rupture → holosystolic murmur,
pulmonary edema, shock.
**3.** Heparin infusion for PE; aPTT 110 sec (control 30). Priority?
A) Increase rate
B) Stop infusion, prepare protamine
,3|Page
C) Repeat aPTT in 4h
D) Give vitamin K
*Rationale:* Supratherapeutic aPTT → bleeding risk. Protamine
reverses heparin.
**4.** Hyperkalemia ECG finding?
A) Peaked T waves
B) Wide QRS
C) ST elevation
D) Absent P waves
*Rationale:* Peaked T waves are earliest sign.
**5.** A fib (rate 140) on digoxin + metoprolol; reports nausea + yellow
vision. First?
A) Check digoxin level
B) Antiemetic
C) Hold metoprolol
D) Oxygen
*Rationale:* Yellow halos + nausea = digoxin toxicity.
**6.** Patient with unstable angina. IV nitroglycerin started. BP drops
from 140/90 to 85/50. Next?
A) Increase nitroglycerin
, 4|Page
B) Give fluid bolus
C) Start dopamine
D) Trendelenburg
*Rationale:* Hypotension from nitrate → fluid resuscitation first.
**7.** Post-cardiac cath; groin site oozing, expanding hematoma.
Priority?
A) Apply sandbag
B) Mark hematoma edges
C) Hold manual pressure
D) Call provider
*Rationale:* Manual pressure above site to stop bleeding immediately.
**8.** Which beta-blocker is cardioselective (β1)?
A) Propranolol
B) Metoprolol
C) Carvedilol
D) Labetalol
*Rationale:* Metoprolol and atenolol are β1-selective; safer in COPD.
**9.** Patient with aortic stenosis. Triad includes?
A) Syncope, angina, dyspnea
