NCLEX-PN 2026 Next Generation NGN 300-Question Matrix Test Bank: Expected, Unexpected, and Requires Immediate Follow-up Assessment Findings for Cardiovascular, Respiratory, Neurological, Endocrine, Renal, GI, Maternity, Mental Health, and Pharmaco

NCLEX-PN 2026 Next Generation NGN 300-Question Matrix
Test Bank: Expected, Unexpected, and Requires Immediate
Follow-up Assessment Findings for Cardiovascular,
Respiratory, Neurological, Endocrine, Renal, GI, Maternity,
Mental Health, and Pharmacology




SET A — Questions 1–100


Questions 1–10: Cardiovascular

1. Acute Decompensated Heart Failure
Findings: Orthopnea, S3 gallup, SpO₂ 86% on 2L NC, BP 200/110


Finding Expected Unexpected Requires Immediate Follow-up

Orthopnea

S3 gallop

SpO₂ 86%

BP 200/110


2. Cardiac Tamponade
Findings: Muffled heart sounds, Pulsus paradoxus (20 mmHg drop), Distended neck veins, HR 120

,Finding Expected Unexpected Requires Immediate Follow-up

Muffled sounds

Pulsus paradoxus

Distended neck veins

HR 120


3. Atrial Fibrillation with RVR
Findings: Irregularly irregular pulse, HR 160, BP 88/50, Lightheadedness


Finding Expected Unexpected Requires Immediate Follow-up

Irregular pulse

HR 160

BP 88/50

Lightheadedness


4. Acute Limb Ischemia
Findings: Left leg pale/cold, Absent dorsalis pedis pulse, Paresthesia, Cap refill >6 sec


Finding Expected Unexpected Requires Immediate Follow-up

Pale cold leg

Absent pulse

Paresthesia

Cap refill >6 sec

,5. Infective Endocarditis with Septic Emboli
Findings: Fever 102°F, Osler nodes, Splinter hemorrhages, Sudden left arm weakness


Finding Expected Unexpected Requires Immediate Follow-up

Fever

Osler nodes

Splinter hemorrhages

Sudden arm weakness


6. Pulseless Ventricular Tachycardia
Findings: Unresponsive, No palpable pulse, Monomorphic wide QRS, Apneic


Finding Expected Unexpected Requires Immediate Follow-up

Unresponsive

No pulse

Wide QRS

Apneic


7. Dissecting Aortic Aneurysm
Findings: Tearing chest pain to back, BP difference (R arm 180/100, L arm 100/60), Pulse deficit left
femoral, Syncope


Finding Expected Unexpected Requires Immediate Follow-up

Tearing pain

BP difference

, Pulse deficit

Syncope


8. Hypertensive Emergency with Encephalopathy
Findings: BP 240/130, Severe headache, Altered mental status, Nausea/vomiting


Finding Expected Unexpected Requires Immediate Follow-up

BP 240/130

Headache

AMS

N/V


9. Acute Pericarditis with Large Effusion
Findings: Chest pain better leaning forward, Friction rub, Electrical alternans on ECG, BP 85/45


Finding Expected Unexpected Requires Immediate Follow-up

Pain better leaning

Friction rub

Electrical alternans

BP 85/45


10. Heart Transplant Rejection (Acute)
Findings: Fatigue, Shortness of breath, New S3 gallop, Weight gain 5 lbs in 2 days


Finding Expected Unexpected Requires Immediate Follow-up

Fatigue