Next Gen NCLEX Study Guide Practice Exam
Questions and Correct Answers (Verified Answers)
Plus Rationales 2025
(per the Next Gen format focus – clinical judgment, case-based, prioritization,
and safety):
1. A nurse is caring for a client with COPD who is experiencing shortness of
breath. Which action should the nurse take first?
A. Encourage pursed-lip breathing
B. Elevate the head of the bed
C. Administer albuterol nebulizer
D. Notify the provider
Elevating the head of the bed is a priority to improve ventilation and
oxygenation before initiating other interventions.
2. A client has a potassium level of 2.8 mEq/L. Which food should the nurse
recommend?
A. Apple slices
B. Baked potato
C. White rice
D. Chicken breast
A baked potato is rich in potassium and helps correct hypokalemia.
,3. A nurse receives a new prescription for morphine IV 4 mg every 4 hours PRN
for pain. What is the priority assessment?
A. Respiratory rate
B. Urine output
C. Bowel sounds
D. Temperature
Respiratory depression is the most serious side effect of opioids and
must be assessed first.
4. A client reports severe chest pain and shortness of breath. Which action
should the nurse take first?
A. Administer nitroglycerin
B. Obtain a 12-lead ECG
C. Start an IV line
D. Apply oxygen
Oxygen should be administered immediately to improve perfusion
during a possible myocardial infarction.
5. A client is scheduled for surgery and expresses anxiety. What is the most
therapeutic response by the nurse?
A. "Tell me more about how you're feeling."
B. "You’ll be fine, the doctor is excellent."
C. "There’s nothing to worry about."
D. "I’ll ask the provider to talk with you."
Using open-ended communication helps the client express concerns and
shows empathy.
, 6. A nurse is teaching a client with a new prescription for furosemide. Which
instruction is appropriate?
A. "Increase foods high in potassium."
B. "Avoid foods high in vitamin K."
C. "Take the medication at bedtime."
D. "Take antacids with the medication."
Furosemide is a loop diuretic that causes potassium loss. Increasing
potassium intake is recommended.
7. A nurse receives four client phone messages. Which client should be called
back first?
A. A client with diabetes reporting a glucose of 210
B. A client with hypertension requesting a refill
C. A client on warfarin reporting black stools
D. A client with a cold asking about cough syrup
Black stools may indicate gastrointestinal bleeding, which is a medical
emergency in clients on anticoagulants.
8. Which finding indicates the client with heart failure is responding to
treatment?
A. Weight loss of 2.5 lbs in 24 hours
B. Increased heart rate
C. Decreased urine output
D. Elevated BNP
A decrease in fluid overload (reflected by weight loss) indicates effective
diuresis and improved heart failure status.
Questions and Correct Answers (Verified Answers)
Plus Rationales 2025
(per the Next Gen format focus – clinical judgment, case-based, prioritization,
and safety):
1. A nurse is caring for a client with COPD who is experiencing shortness of
breath. Which action should the nurse take first?
A. Encourage pursed-lip breathing
B. Elevate the head of the bed
C. Administer albuterol nebulizer
D. Notify the provider
Elevating the head of the bed is a priority to improve ventilation and
oxygenation before initiating other interventions.
2. A client has a potassium level of 2.8 mEq/L. Which food should the nurse
recommend?
A. Apple slices
B. Baked potato
C. White rice
D. Chicken breast
A baked potato is rich in potassium and helps correct hypokalemia.
,3. A nurse receives a new prescription for morphine IV 4 mg every 4 hours PRN
for pain. What is the priority assessment?
A. Respiratory rate
B. Urine output
C. Bowel sounds
D. Temperature
Respiratory depression is the most serious side effect of opioids and
must be assessed first.
4. A client reports severe chest pain and shortness of breath. Which action
should the nurse take first?
A. Administer nitroglycerin
B. Obtain a 12-lead ECG
C. Start an IV line
D. Apply oxygen
Oxygen should be administered immediately to improve perfusion
during a possible myocardial infarction.
5. A client is scheduled for surgery and expresses anxiety. What is the most
therapeutic response by the nurse?
A. "Tell me more about how you're feeling."
B. "You’ll be fine, the doctor is excellent."
C. "There’s nothing to worry about."
D. "I’ll ask the provider to talk with you."
Using open-ended communication helps the client express concerns and
shows empathy.
, 6. A nurse is teaching a client with a new prescription for furosemide. Which
instruction is appropriate?
A. "Increase foods high in potassium."
B. "Avoid foods high in vitamin K."
C. "Take the medication at bedtime."
D. "Take antacids with the medication."
Furosemide is a loop diuretic that causes potassium loss. Increasing
potassium intake is recommended.
7. A nurse receives four client phone messages. Which client should be called
back first?
A. A client with diabetes reporting a glucose of 210
B. A client with hypertension requesting a refill
C. A client on warfarin reporting black stools
D. A client with a cold asking about cough syrup
Black stools may indicate gastrointestinal bleeding, which is a medical
emergency in clients on anticoagulants.
8. Which finding indicates the client with heart failure is responding to
treatment?
A. Weight loss of 2.5 lbs in 24 hours
B. Increased heart rate
C. Decreased urine output
D. Elevated BNP
A decrease in fluid overload (reflected by weight loss) indicates effective
diuresis and improved heart failure status.
