2026/2027 – Latest NGN Practice
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Rationales/Graded A+/2026
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Total Questions: 85
Format: Multiple Choice, Select All That Apply (SATA), Bow-Tie, Drag-and-
Drop, Enhanced Hot Spot, Case Study (NGN)
Time Limit: 180 minutes
Section 1: Management of Care (Questions 1–15)
1. A nurse is delegating tasks to an LPN/VN. Which task should the nurse
delegate?
A. Initial admission assessment of a patient with pneumonia
B. Administration of enteral tube feeding to a stable patient
C. Evaluation of a patient’s response to pain medication
D. Teaching a diabetic patient about insulin injection
Rationale: LPNs can administer enteral feedings to stable patients. Initial
assessment, evaluation, and teaching are RN responsibilities.
2. A charge nurse is assigning rooms for four clients. Which client should be
placed in a private room?
A. Client with pneumonia
B. Client with active pulmonary tuberculosis
C. Client with MRSA in a wound
D. Client with Clostridium difficile
,Rationale: Active TB requires airborne precautions and a negative pressure private
room. MRSA and C. diff need contact precautions but can share with same
infection.
3-5. NGN Case Study – Disaster Triage
A mass casualty event occurs. The nurse uses START triage.
• Victim 1: Ambulatory with minor abrasions.
• Victim 2: Apneic after opening airway.
• Victim 3: Respirations 30/min, capillary refill >2 seconds, unable to follow
commands.
• Victim 4: Respirations 6/min, pulse present.
3. Victim 1 is tagged:
A. Red
B. Yellow
C. Green
D. Black
4. Victim 2 is tagged:
A. Red
B. Yellow
C. Green
D. Black
5. Victim 3 is tagged:
A. Red
B. Yellow
C. Green
D. Black
Rationale: START triage: Green (minor/walking wounded), Red (immediate life
threat), Yellow (delayed), Black (deceased/expectant). Apneic after airway opening
= black. Respirations >30, perfusion altered, AMS = red.
6. A nurse is planning care for a client who has a living will. Which action
demonstrates appropriate respect for the document?
A. Follow the client’s wishes even if family disagrees
B. Implement advance directive as legally binding
, C. Consult ethics committee before following it
D. Ignore it if client is stable
Rationale: Living wills are legally binding. Nurse advocates for client autonomy.
7. A nurse manager is implementing a new EHR system. Which step best
promotes staff adoption?
A. Mandating overtime for training
B. Involving staff in system selection and workflow design
C. Using only written manuals
D. Implementing without training
Rationale: Participatory change management increases buy-in and reduces
resistance.
8. A nurse is preparing to transfer a client to a long-term care facility. Which
action is legally required?
A. Verbal report to receiving nurse only
B. Written transfer summary within 30 days
C. Client’s family consent for transfer
D. Notarized copy of medical record
Rationale: Medicare/Medicaid require written transfer summary including meds,
diagnoses, functional status, etc.
9. A nurse is planning discharge for a client with a new colostomy. Which
referral is most appropriate?
A. Social worker
B. Wound, Ostomy, and Continence Nurse (WOCN)
C. Physical therapist
D. Respiratory therapist
10. SATA: Which situations require an incident report?
A. Medication given to wrong patient
B. Patient falls but is uninjured
C. IV site infiltration with blistering
D. Patient refuses breakfast
E. Surgical instrument count discrepancy
Rationale: Incident reports for actual/potential harm, errors, deviations from
standard care.