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Next Gen NCLEX-RN® Board Practice Questions | Verified & Updated for 2025/2026 | 100% Correct | A+ Graded
Section 1: Introduction
This document provides a fully updated and verified collection of board-style practice questions for the Next Generation NCLEX-RN®, designed to meet 2025/2026 NCSBN testing standards. It features realistic clinical case scenarios across core content areas—adult health, pediatrics, maternal-newborn, pharmacology, mental health, safety, and delegation— formatted in Next Gen NCLEX item types: case studies, bowtie, matrix, cloze, and multiple- response. Every answer is 100% correct and A+ graded, with rationales grounded in evidence-based practice and the Clinical Judgment Measurement Model (CJMM) to ensure readiness for board licensure.
Section 2: Practice Questions and Answers
Format: NGN-style questions
Clinical case-based questions and item sets Correct answer highlighted Includes rationales to support clinical decision-making and reasoning
1. Case Study: Adult Health - Chest Pain
A 55-year-old male presents with sudden chest pain, diaphoresis, and shortness of
breath. Vital signs: BP 160/90 mmHg, HR 110 bpm, RR 24/min, SpO2 92%. What is
the nurse’s first action?(a) Administer oxygen via nasal cannula (b) Obtain an electrocardiogram (ECG) (c) Provide a nitroglycerin tablet (d) Assess pain level using a scale Rationale: CJMM prioritizes recognizing cues (chest pain, vital signs) to obtain an ECG for potential myocardial infarction diagnosis.
2. Bowtie: Pediatrics - Post-Op Care
A 7-year-old is 2 hours post-tonsillectomy with a temp of 38.1°C and throat pain.Priority action (left side) and complication (right side)?(a) Administer analgesics | Dehydration (b) Monitor for bleeding | Hemorrhage (c) Encourage fluids | Infection (d) Apply ice pack | Swelling
Rationale: CJMM focuses on monitoring for post-tonsillectomy bleeding based on
temperature and pain cues.
3. Matrix: Pharmacology - Medication Use
Match the medication to its primary use:
(a) Furosemide | Diuretic 1 / 3
(b) Morphine | Pain relief (c) Warfarin | Anticoagulant (d) Insulin | Blood glucose control
Rationale: CJMM supports analyzing medication purpose for safe administration.
4. Cloze: Maternal-Newborn - Postpartum Care
A postpartum patient has a BP of 88/50 mmHg and heavy lochia. The nurse should initiate ____ (a) IV fluids, (b) oral iron, (c) ambulation, (d) IV fluids.
Rationale: CJMM prioritizes IV fluids for suspected postpartum hemorrhage to
stabilize hemodynamics.
5. Multiple-Response: Safety - Fall Prevention
Select all actions to prevent falls in an elderly patient:
(a) Keep bed in low position (b) Ensure call bell within reach (c) Use restraints (d) Use non-slip footwear Rationale: CJMM supports multiple safety interventions without using restraints.
6. Case Study: Mental Health - Anxiety
A 30-year-old with generalized anxiety disorder reports palpitations and restlessness.What is the nurse’s priority?(a) Administer sedatives immediately (b) Assess anxiety level and vital signs (c) Encourage physical activity (d) Provide a detailed treatment plan
Rationale: CJMM emphasizes assessing cues to guide anxiety management.
7. Bowtie: Adult Health - Sepsis
A 65-year-old with a fever of 39°C and WBC 18,000/mm³ needs intervention. Priority action (left side) and complication (right side)?(a) Administer antipyretics | Dehydration (b) Obtain blood cultures | Septic shock (c) Increase oxygen | Hypoxia (d) Encourage fluids | Renal failure Rationale: CJMM prioritizes identifying infection source to prevent septic shock.
8. Matrix: Delegation - Task Assignment
Match the task to the appropriate team member:
(a) Insert Foley catheter | Registered Nurse (b) Take vital signs | Licensed Practical Nurse (c) Administer IV medication | Registered Nurse (d) Assist with bathing | Nursing Assistant
Rationale: CJMM aligns delegation with scope of practice.
9. Cloze: Pharmacology - Asthma Management
A patient with wheezing and SpO2 89% needs ____ (a) IV antibiotics, (b) oral corticosteroids, (c) nebulized albuterol, (d) nebulized albuterol.Rationale: CJMM prioritizes bronchodilation for acute asthma relief. 2 / 3
10. Multiple-Response: Maternal-Newborn - Labor Support
Select all actions for a patient in active labor:
(a) Monitor fetal heart rate (b) Encourage position changes (c) Administer epidural without assessment (d) Provide emotional support
Rationale: CJMM supports comprehensive labor care.
11. Case Study: Pediatrics - Dehydration
A 4-year-old with vomiting has dry mucous membranes and no tears. What is the nurse’s first action?(a) Offer oral rehydration solution (b) Initiate IV fluid therapy (c) Administer antiemetics (d) Encourage solid food intake
Rationale: CJMM prioritizes IV fluids for severe pediatric dehydration.
12. Bowtie: Adult Health - Hypoglycemia
A 60-year-old diabetic is diaphoretic with a glucose of 45 mg/dL. Priority action (left side) and complication (right side)?(a) Administer IV fluids | Hyperglycemia (b) Provide oral glucose | Seizure (c) Monitor vital signs | Dehydration (d) Encourage ambulation | Coma
Rationale: CJMM corrects hypoglycemia to prevent seizures.
13. Matrix: Pharmacology - Side Effects
Match the medication to its side effect:
(a) Furosemide | Hypokalemia (b) Morphine | Respiratory depression (c) Warfarin | Bleeding (d) Insulin | Hypoglycemia
Rationale: CJMM guides monitoring for adverse effects.
14. Cloze: Mental Health - Depression
A patient with depression reports suicidal thoughts. The nurse should initiate ____ (a) group therapy, (b) safety precautions, (c) antidepressant therapy, (d) family counseling.
Rationale: CJMM prioritizes immediate safety measures for suicidal ideation.
15. Multiple-Response: Safety - Infection Control
Select all measures to prevent hospital-acquired infections:
(a) Hand hygiene (b) Use of personal protective equipment (c) Sharing needles (d) Sterile technique
Rationale: CJMM emphasizes multiple infection control strategies.
16. Case Study: Adult Health - Stroke
A 70-year-old exhibits facial droop and slurred speech, with onset 1 hour ago. What is
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