NCLEX-RN Next Gen Practice Questions (2026)practice questions with
answers and rationales
1. Priority Nursing Action
A patient with chest pain is admitted to the ER. What is the nurse’s first action?
A. Obtain ECG
B. Administer oxygen
C. Draw blood samples
D. Start IV fluids
Answer: B
Rationale: Oxygen improves myocardial oxygenation and is the first priority in suspected
acute coronary syndrome.
2. Infection Control
Which isolation precaution is required for MRSA?
A. Airborne
B. Droplet
C. Contact
D. Reverse isolation
Answer: C
Rationale: MRSA spreads through direct contact; contact precautions are required.
3. Medication Safety
Before administering digoxin, the nurse should check:
A. Blood pressure
B. Apical pulse
C. Respiratory rate
D. Temperature
Answer: B
,Rationale: Digoxin is held if apical pulse is <60 bpm in adults.
4. Fluid Balance
Which finding indicates dehydration?
A. Bradycardia
B. Hypotension
C. Moist mucous membranes
D. Weight gain
Answer: B
Rationale: Fluid loss leads to decreased circulating volume and hypotension.
5. Diabetes Care
A patient with hypoglycemia should be given:
A. Insulin
B. Orange juice
C. Water
D. Protein snack only
Answer: B
Rationale: Rapid glucose source like juice corrects hypoglycemia quickly.
6. Post-Operative Care
Which position is best after abdominal surgery?
A. Supine
B. Prone
C. Semi-Fowler’s
D. Trendelenburg
Answer: C
Rationale: Semi-Fowler’s reduces strain on incision and improves breathing.
7. Respiratory Care
Which sign indicates respiratory distress?
A. RR 16
, B. Use of accessory muscles
C. Pink skin
D. Normal breath sounds
Answer: B
Rationale: Accessory muscle use indicates increased work of breathing.
8. Pediatrics
A child with dehydration shows:
A. Tearful crying
B. Sunken fontanel
C. Increased urine output
D. Moist lips
Answer: B
Rationale: Sunken fontanel indicates fluid loss in infants.
9. ECG Interpretation
Which rhythm is life-threatening?
A. Sinus bradycardia
B. Ventricular fibrillation
C. Sinus rhythm
D. Atrial flutter
Answer: B
Rationale: Ventricular fibrillation causes no cardiac output and requires immediate
defibrillation.
10. Ethics
A patient refuses treatment. Nurse should:
A. Force treatment
B. Notify family
C. Respect refusal
D. Ignore decision
answers and rationales
1. Priority Nursing Action
A patient with chest pain is admitted to the ER. What is the nurse’s first action?
A. Obtain ECG
B. Administer oxygen
C. Draw blood samples
D. Start IV fluids
Answer: B
Rationale: Oxygen improves myocardial oxygenation and is the first priority in suspected
acute coronary syndrome.
2. Infection Control
Which isolation precaution is required for MRSA?
A. Airborne
B. Droplet
C. Contact
D. Reverse isolation
Answer: C
Rationale: MRSA spreads through direct contact; contact precautions are required.
3. Medication Safety
Before administering digoxin, the nurse should check:
A. Blood pressure
B. Apical pulse
C. Respiratory rate
D. Temperature
Answer: B
,Rationale: Digoxin is held if apical pulse is <60 bpm in adults.
4. Fluid Balance
Which finding indicates dehydration?
A. Bradycardia
B. Hypotension
C. Moist mucous membranes
D. Weight gain
Answer: B
Rationale: Fluid loss leads to decreased circulating volume and hypotension.
5. Diabetes Care
A patient with hypoglycemia should be given:
A. Insulin
B. Orange juice
C. Water
D. Protein snack only
Answer: B
Rationale: Rapid glucose source like juice corrects hypoglycemia quickly.
6. Post-Operative Care
Which position is best after abdominal surgery?
A. Supine
B. Prone
C. Semi-Fowler’s
D. Trendelenburg
Answer: C
Rationale: Semi-Fowler’s reduces strain on incision and improves breathing.
7. Respiratory Care
Which sign indicates respiratory distress?
A. RR 16
, B. Use of accessory muscles
C. Pink skin
D. Normal breath sounds
Answer: B
Rationale: Accessory muscle use indicates increased work of breathing.
8. Pediatrics
A child with dehydration shows:
A. Tearful crying
B. Sunken fontanel
C. Increased urine output
D. Moist lips
Answer: B
Rationale: Sunken fontanel indicates fluid loss in infants.
9. ECG Interpretation
Which rhythm is life-threatening?
A. Sinus bradycardia
B. Ventricular fibrillation
C. Sinus rhythm
D. Atrial flutter
Answer: B
Rationale: Ventricular fibrillation causes no cardiac output and requires immediate
defibrillation.
10. Ethics
A patient refuses treatment. Nurse should:
A. Force treatment
B. Notify family
C. Respect refusal
D. Ignore decision
