NCLEX NGN RN EXAM 1 (WITH ALL
QUESTIONS FORMART) NEW
ACTUAL EXAM ALL 150 QUESTIONS
AND CORRECT
1. Priority & Post-Procedural Complications
The nurse receives handoff report on four clients. Which client should
the nurse assess FIRST?
A. A client with COPD on 2 L/min oxygen with SpO₂ of 92%
B. A client with type 2 diabetes requesting a bedtime snack
C. A client post-cardiac catheterization whose pedal pulse is diminished
compared to baseline
D. A client with a stage 2 pressure injury requiring a dressing change
✅ Correct Answer: C
🧠 Rationale: A diminished pedal pulse after cardiac catheterization can
indicate an arterial occlusion or a developing hematoma—a vascular
emergency that requires immediate assessment. The other clients have
stable or nonurgent needs.
2. Delegation & Scope of Practice
The charge nurse is making assignments for the oncoming shift. The
team includes an RN, an LPN/LVN, and a UAP. Which client should be
assigned to the LPN/LVN?
A. A client newly admitted with chest pain and dyspnea
B. A client receiving a blood transfusion for the first time
,C. A client with a stable colostomy requiring routine pouch change
D. A client requiring initial admission assessment and care plan
development
✅ Correct Answer: C
🧠 Rationale: Stable clients with predictable outcomes and routine
procedures are appropriate for LPN/LVN assignment. New admissions, first-
time transfusions, and initial assessments must be performed by an RN.
3. Ethical & Legal Responsibilities (DNR)
A nurse is caring for a client who has a DNR order and begins to have a
respiratory arrest. The client's family member says, “Do everything you
can to save him!” Which action should the nurse take?
A. Begin CPR while asking another nurse to contact the HCP
B. Honor the family's request and initiate resuscitation
C. Provide comfort measures and support the family
D. Ask the family if they want the DNR honored
✅ Correct Answer: C
🧠 Rationale: A valid DNR order must be honored. The nurse’s role shifts to
providing comfort, dignity, and family support—not resuscitation.
4. Respiratory Emergencies (COPD)
A nurse finds a client with COPD short of breath and using accessory
muscles. What should the nurse do first?
✅ Correct Answer: Sit the client upright and apply prescribed oxygen.
🧠 Rationale: Proper positioning and oxygen support improve ventilation
immediately. Airway and breathing are always the first priority.
,5. Chest Tube Complications
A client with a chest tube suddenly has no drainage and severe
shortness of breath. What should the nurse suspect?
✅ Correct Answer: Tension pneumothorax.
🧠 Rationale: Sudden absence of drainage with severe shortness of breath
suggests a tube blockage or lung collapse, which can rapidly become life-
threatening.
6. Postoperative Complications (Intra-abdominal)
A client who had abdominal surgery is restless and has a rigid,
distended abdomen. What is the nurse’s priority action?
✅ Correct Answer: Notify the surgeon immediately.
🧠 Rationale: A rigid, distended abdomen with restlessness can signal
internal bleeding or peritonitis, requiring urgent surgical intervention.
7. DVT Recognition
A client reports sudden calf pain and swelling after surgery. What is
the nurse’s priority intervention?
✅ Correct Answer: Assess for signs of deep vein thrombosis and notify the
provider.
🧠 Rationale: Sudden calf pain and swelling suggest DVT, which may
progress to pulmonary embolism, a life-threatening complication.
8. Hypoglycemia Management
A client with diabetes becomes shaky, sweaty, and confused. What
should the nurse do?
, ✅ Correct Answer: Give a fast-acting carbohydrate such as juice.
🧠 Rationale: These are classic signs of hypoglycemia that require rapid
glucose replacement. If the client can swallow safely, oral glucose is the first
line of treatment.
9. Maternity: Naegele’s Rule
A 25-year-old client believes she may be pregnant. Her last menstrual
period began May 20. Using Naegele’s rule, the estimated date of
confinement is:
A. March 27
B. February 1
C. February 27
D. January 3
✅ Correct Answer: C (February 27)
🧠 Rationale: Naegele’s rule: subtract 3 months from the first day of the
LMP and add 7 days. May 20 → February 20 → February 27.
10. First-Trimester Symptoms
The nurse practitioner informs a client at approximately 9 weeks
gestation about symptoms she will experience during the first
trimester, such as:
A. Nausea and vomiting
B. Quickening
C. A 6–8 lb weight gain
D. Abdominal enlargement
✅ Correct Answer: A
🧠 Rationale: Nausea and vomiting affect nearly half of pregnant women in
the first trimester due to elevated hCG and altered carbohydrate
QUESTIONS FORMART) NEW
ACTUAL EXAM ALL 150 QUESTIONS
AND CORRECT
1. Priority & Post-Procedural Complications
The nurse receives handoff report on four clients. Which client should
the nurse assess FIRST?
A. A client with COPD on 2 L/min oxygen with SpO₂ of 92%
B. A client with type 2 diabetes requesting a bedtime snack
C. A client post-cardiac catheterization whose pedal pulse is diminished
compared to baseline
D. A client with a stage 2 pressure injury requiring a dressing change
✅ Correct Answer: C
🧠 Rationale: A diminished pedal pulse after cardiac catheterization can
indicate an arterial occlusion or a developing hematoma—a vascular
emergency that requires immediate assessment. The other clients have
stable or nonurgent needs.
2. Delegation & Scope of Practice
The charge nurse is making assignments for the oncoming shift. The
team includes an RN, an LPN/LVN, and a UAP. Which client should be
assigned to the LPN/LVN?
A. A client newly admitted with chest pain and dyspnea
B. A client receiving a blood transfusion for the first time
,C. A client with a stable colostomy requiring routine pouch change
D. A client requiring initial admission assessment and care plan
development
✅ Correct Answer: C
🧠 Rationale: Stable clients with predictable outcomes and routine
procedures are appropriate for LPN/LVN assignment. New admissions, first-
time transfusions, and initial assessments must be performed by an RN.
3. Ethical & Legal Responsibilities (DNR)
A nurse is caring for a client who has a DNR order and begins to have a
respiratory arrest. The client's family member says, “Do everything you
can to save him!” Which action should the nurse take?
A. Begin CPR while asking another nurse to contact the HCP
B. Honor the family's request and initiate resuscitation
C. Provide comfort measures and support the family
D. Ask the family if they want the DNR honored
✅ Correct Answer: C
🧠 Rationale: A valid DNR order must be honored. The nurse’s role shifts to
providing comfort, dignity, and family support—not resuscitation.
4. Respiratory Emergencies (COPD)
A nurse finds a client with COPD short of breath and using accessory
muscles. What should the nurse do first?
✅ Correct Answer: Sit the client upright and apply prescribed oxygen.
🧠 Rationale: Proper positioning and oxygen support improve ventilation
immediately. Airway and breathing are always the first priority.
,5. Chest Tube Complications
A client with a chest tube suddenly has no drainage and severe
shortness of breath. What should the nurse suspect?
✅ Correct Answer: Tension pneumothorax.
🧠 Rationale: Sudden absence of drainage with severe shortness of breath
suggests a tube blockage or lung collapse, which can rapidly become life-
threatening.
6. Postoperative Complications (Intra-abdominal)
A client who had abdominal surgery is restless and has a rigid,
distended abdomen. What is the nurse’s priority action?
✅ Correct Answer: Notify the surgeon immediately.
🧠 Rationale: A rigid, distended abdomen with restlessness can signal
internal bleeding or peritonitis, requiring urgent surgical intervention.
7. DVT Recognition
A client reports sudden calf pain and swelling after surgery. What is
the nurse’s priority intervention?
✅ Correct Answer: Assess for signs of deep vein thrombosis and notify the
provider.
🧠 Rationale: Sudden calf pain and swelling suggest DVT, which may
progress to pulmonary embolism, a life-threatening complication.
8. Hypoglycemia Management
A client with diabetes becomes shaky, sweaty, and confused. What
should the nurse do?
, ✅ Correct Answer: Give a fast-acting carbohydrate such as juice.
🧠 Rationale: These are classic signs of hypoglycemia that require rapid
glucose replacement. If the client can swallow safely, oral glucose is the first
line of treatment.
9. Maternity: Naegele’s Rule
A 25-year-old client believes she may be pregnant. Her last menstrual
period began May 20. Using Naegele’s rule, the estimated date of
confinement is:
A. March 27
B. February 1
C. February 27
D. January 3
✅ Correct Answer: C (February 27)
🧠 Rationale: Naegele’s rule: subtract 3 months from the first day of the
LMP and add 7 days. May 20 → February 20 → February 27.
10. First-Trimester Symptoms
The nurse practitioner informs a client at approximately 9 weeks
gestation about symptoms she will experience during the first
trimester, such as:
A. Nausea and vomiting
B. Quickening
C. A 6–8 lb weight gain
D. Abdominal enlargement
✅ Correct Answer: A
🧠 Rationale: Nausea and vomiting affect nearly half of pregnant women in
the first trimester due to elevated hCG and altered carbohydrate
