1
NCLEX-RN ACTUAL EXAM
QUESTIONS 2025/2026 | 100+ Next Generation
NGN Test Bank with Verified Rationales | Pass
Guarantee | Latest Blueprint
DOMAIN 1 – HEALTH PROMOTION / DISEASE PREVENTION (15)
1. A 16-year-old presents for a sports physical. Which single USPSTF 2025
Grade A intervention should the FNP prioritize today?
A. Lipid screening
B. Depression screening (PHQ-9)
C. Testicular cancer screening
D. Skin cancer counseling
Answer: B
Rationale: USPSTF 2025 reaffirms annual depression screening for
adolescents 12–18 as Grade A; lipid screening is Grade B only if risk factors
exist, and testicular/skin measures are Grade I (insufficient).
2. A 29-year-old cis-woman requests contraception. BMI 34 kg/m², migraine
without aura, BP 118/76, nonsmoker. Which method is CDC MEC Category
1?
A. Combined oral contraceptives
B. Depot medroxyprogesterone
C. Levonorgestrel IUD
D. Copper IUD
Answer: D
Rationale: Copper IUD is Category 1 in every situation; obesity and
migraine without aura are Category 2 for COCs, Category 1 for LNG-IUD,
but D is always safest.
3. A 70-year-old up-to-date on Tdap, PCV-15, influenza. Which 2025 ACIP
vaccine is STILL indicated?
, 2
A. PCV-20 booster
B. RZV (Shingles) 2-dose series
C. MenACWY
D. Hepatitis A series
Answer: B
Rationale: RZV is universally recommended ≥ 50 y regardless of prior ZVL;
PCV-15 + PPSV-23 sequence already complete; MenACWY only for high-
risk groups.
4. A 55-year-old post-menopausal woman has a 20-pack-year history, quit 10 y
ago. Which screening is Grade B?
A. Lung cancer LDCT
B. Carotid US for stroke
C. Thyroid cancer
D. Ovarian cancer (CA-125)
Answer: A
Rationale: USPSTF 2025 continues Grade B annual LDCT for 20-pack-year
quit < 15 y; others are Grade D or I.
5. A 1-week-old exclusively breast-fed newborn has lost 6 % of birth weight.
Mother reports “constant feeding.” Next step?
A. Supplement 30 mL formula after each feed
B. Weigh again in 24 h; if loss ≥ 8 % intervene
C. Check serum bilirubin now
D. Refer to lactation consultant within 2 h
Answer: B
Rationale: < 7 % weight loss in term infant is physiologic; recheck before
formula to avoid disrupting breastfeeding (AAP 2025).
6. A 38-year-old farm worker is HIV-negative, lives in rural Midwest. Which
prophylaxis is indicated?
A. Doxycycline 200 mg weekly for Lyme
B. Ivermectin monthly for Strongyloides
C. PrEP with emtricitabine/tenofovir
, 3
D. None; reinforce condoms
Answer: D
Rationale: No FDA-approved Lyme vaccine; doxy PEP not yet 2025
guideline; no soil-transmitted helminth exposure data; PrEP only if HIV risk
≥ 1 %.
7. A 24-year-old G2P1 at 12 weeks gestation asks about NIPT. Which
statement is accurate?
A. Screens for open neural-tube defects
B. Detects 99 % Trisomy 21 with 0.15 % FPR
C. Replaces NT ultrasound
D. Covered universally for age < 35
Answer: B
Rationale: Cell-free DNA has 99 % sensitivity, 0.15 % FPR for T-21; does
NOT screen NTD (need MSAFP), still requires NT for dating.
8. A 62-year-old man takes warfarin for mechanical valve. INR 3.2. Which
immunization route is contraindicated?
A. IM influenza
B. ID influenza
C. Intranasal live attenuated influenza
D. Sub-Q pneumococcal
Answer: C
Rationale: Live intranasal flu contraindicated in adults ≥ 50 y per ACIP
2025; warfarin not a live-vaccine contraindication.
9. A 17-year-old female is leaving for college. Up -to-date on all vaccines.
Which additional?
A. MenB 2-dose Trumenba
B. HPV catch-up 3-dose
C. Tdap again
D. None
Answer: A
NCLEX-RN ACTUAL EXAM
QUESTIONS 2025/2026 | 100+ Next Generation
NGN Test Bank with Verified Rationales | Pass
Guarantee | Latest Blueprint
DOMAIN 1 – HEALTH PROMOTION / DISEASE PREVENTION (15)
1. A 16-year-old presents for a sports physical. Which single USPSTF 2025
Grade A intervention should the FNP prioritize today?
A. Lipid screening
B. Depression screening (PHQ-9)
C. Testicular cancer screening
D. Skin cancer counseling
Answer: B
Rationale: USPSTF 2025 reaffirms annual depression screening for
adolescents 12–18 as Grade A; lipid screening is Grade B only if risk factors
exist, and testicular/skin measures are Grade I (insufficient).
2. A 29-year-old cis-woman requests contraception. BMI 34 kg/m², migraine
without aura, BP 118/76, nonsmoker. Which method is CDC MEC Category
1?
A. Combined oral contraceptives
B. Depot medroxyprogesterone
C. Levonorgestrel IUD
D. Copper IUD
Answer: D
Rationale: Copper IUD is Category 1 in every situation; obesity and
migraine without aura are Category 2 for COCs, Category 1 for LNG-IUD,
but D is always safest.
3. A 70-year-old up-to-date on Tdap, PCV-15, influenza. Which 2025 ACIP
vaccine is STILL indicated?
, 2
A. PCV-20 booster
B. RZV (Shingles) 2-dose series
C. MenACWY
D. Hepatitis A series
Answer: B
Rationale: RZV is universally recommended ≥ 50 y regardless of prior ZVL;
PCV-15 + PPSV-23 sequence already complete; MenACWY only for high-
risk groups.
4. A 55-year-old post-menopausal woman has a 20-pack-year history, quit 10 y
ago. Which screening is Grade B?
A. Lung cancer LDCT
B. Carotid US for stroke
C. Thyroid cancer
D. Ovarian cancer (CA-125)
Answer: A
Rationale: USPSTF 2025 continues Grade B annual LDCT for 20-pack-year
quit < 15 y; others are Grade D or I.
5. A 1-week-old exclusively breast-fed newborn has lost 6 % of birth weight.
Mother reports “constant feeding.” Next step?
A. Supplement 30 mL formula after each feed
B. Weigh again in 24 h; if loss ≥ 8 % intervene
C. Check serum bilirubin now
D. Refer to lactation consultant within 2 h
Answer: B
Rationale: < 7 % weight loss in term infant is physiologic; recheck before
formula to avoid disrupting breastfeeding (AAP 2025).
6. A 38-year-old farm worker is HIV-negative, lives in rural Midwest. Which
prophylaxis is indicated?
A. Doxycycline 200 mg weekly for Lyme
B. Ivermectin monthly for Strongyloides
C. PrEP with emtricitabine/tenofovir
, 3
D. None; reinforce condoms
Answer: D
Rationale: No FDA-approved Lyme vaccine; doxy PEP not yet 2025
guideline; no soil-transmitted helminth exposure data; PrEP only if HIV risk
≥ 1 %.
7. A 24-year-old G2P1 at 12 weeks gestation asks about NIPT. Which
statement is accurate?
A. Screens for open neural-tube defects
B. Detects 99 % Trisomy 21 with 0.15 % FPR
C. Replaces NT ultrasound
D. Covered universally for age < 35
Answer: B
Rationale: Cell-free DNA has 99 % sensitivity, 0.15 % FPR for T-21; does
NOT screen NTD (need MSAFP), still requires NT for dating.
8. A 62-year-old man takes warfarin for mechanical valve. INR 3.2. Which
immunization route is contraindicated?
A. IM influenza
B. ID influenza
C. Intranasal live attenuated influenza
D. Sub-Q pneumococcal
Answer: C
Rationale: Live intranasal flu contraindicated in adults ≥ 50 y per ACIP
2025; warfarin not a live-vaccine contraindication.
9. A 17-year-old female is leaving for college. Up -to-date on all vaccines.
Which additional?
A. MenB 2-dose Trumenba
B. HPV catch-up 3-dose
C. Tdap again
D. None
Answer: A
