National Exit Test (NExT) — Questions and Answers

Question 1: What is the relationship between theory and practice?

They are completely separate domains
Theory always takes priority over practical experience
Theory informs practice, and practice tests and refines theory (Correct answer)
Practice is always more important than theory

Correct answer: Theory informs practice, and practice tests and refines theory

Theory and practice have a reciprocal relationship: theory guides practice, and practical experience validates and improves theory.

Question 2: Six Sigma quality improvement methodology aims to reduce defects to fewer than how many per million opportunities?

3.4 (Correct answer)
100
1,000
50

Correct answer: 3.4

Six Sigma targets fewer than 3.4 defects per million opportunities, representing near-perfect process performance at six standard deviations from the mean.

Question 3: The NEXT's objective of measuring 'clinical judgment' specifically refers to which cognitive process?

The ability to recognize cues, analyze information, prioritize hypotheses, and take action for a patient (Correct answer)
The ability to complete nursing documentation in an electronic health record
The ability to perform psychomotor skills such as catheter insertion
The ability to recall pharmacology facts under time pressure

Correct answer: The ability to recognize cues, analyze information, prioritize hypotheses, and take action for a patient

Clinical judgment in the NEXT context encompasses the full cognitive cycle from noticing relevant patient data to evaluating outcomes of nursing interventions.

Question 4: A nurse reviews a patient's chart before the shift assessment. This is an example of which type of data source?

Tertiary source
Secondary source (Correct answer)
Real-time source
Primary source

Correct answer: Secondary source

Secondary data sources include medical records, lab results, and reports from other healthcare providers, as opposed to primary data collected directly from the patient.

Question 5: A patient with COPD is being discharged with home oxygen. Which safety instruction is the highest priority?

Use oxygen continuously regardless of prescribed flow rate
Keep oxygen tubing neatly coiled when not in use
Store oxygen tanks in direct sunlight for easy access
Never smoke or allow smoking near oxygen equipment due to fire hazard (Correct answer)

Correct answer: Never smoke or allow smoking near oxygen equipment due to fire hazard

Oxygen is highly flammable and smoking near oxygen equipment creates a serious fire and explosion hazard, making this the highest-priority safety instruction for home oxygen use.

Question 6: A nurse discovers a small fire in a patient's room. Using the RACE acronym, what is the FIRST action the nurse should take?

Rescue patients in immediate danger (Correct answer)
Extinguish the fire using a fire extinguisher
Confine the fire by closing doors
Activate the fire alarm

Correct answer: Rescue patients in immediate danger

RACE stands for Rescue, Alarm, Confine, Extinguish — rescuing patients from immediate danger is always the first priority.

Question 7: A patient refuses to participate in their own care and states, 'You're the nurse — just tell me what to do.' How should the nurse respond?

Comply fully with the patient's preference and direct all care without discussion
Document that the patient is non-compliant and escalate to the supervisor
Insist the patient take an active role before providing further care
Respect the patient's preference while continuing to provide information and encourage involvement at the patient's comfort level (Correct answer)

Correct answer: Respect the patient's preference while continuing to provide information and encourage involvement at the patient's comfort level

Respecting patient autonomy includes honoring individual preferences while gently encouraging engagement, balancing patient-centered care with advocacy.

Question 8: Which of the following is a nursing-sensitive quality indicator tracked by NDNQI?

Physician response time to emergencies
Pharmacy dispensing errors per admission
Operating room turnover time
Patient falls with injury per 1,000 patient days (Correct answer)

Correct answer: Patient falls with injury per 1,000 patient days

Patient falls with injury is a nursing-sensitive indicator because nursing care practices directly influence fall rates and fall-related injury prevention.

Question 9: Which finding during a neurological assessment would require the nurse to notify the provider immediately?

Patient alert and oriented to person, place, and time
Unilateral pupil dilation and sluggish response (Correct answer)
Pupils equal and reactive to light bilaterally
Glasgow Coma Scale score of 15

Correct answer: Unilateral pupil dilation and sluggish response

Unilateral pupil dilation with sluggish response is a sign of increased intracranial pressure and requires immediate provider notification.

Question 10: A hospital's fall rate is above the national benchmark. Which data is MOST important to collect first when beginning a quality improvement project?

Staff satisfaction scores
Patient satisfaction surveys
Baseline fall rate data and contributing factors (Correct answer)
Budget allocated for fall prevention equipment

Correct answer: Baseline fall rate data and contributing factors

Collecting baseline data and identifying contributing factors is the essential first step in any quality improvement initiative.

Question 11: When evaluating the effectiveness of a pain management intervention, which outcome best indicates goal achievement?

Patient requests additional pain medication after 2 hours
Patient states understanding of the pain scale
Patient's pain rating decreases from 8/10 to 3/10 after medication (Correct answer)
Nurse documents the medication was administered on time

Correct answer: Patient's pain rating decreases from 8/10 to 3/10 after medication

A measurable decrease in the patient's self-reported pain score directly demonstrates the effectiveness of the pain management intervention.

Question 12: A nurse is conducting a head-to-toe assessment and auscultates crackles in the lung bases bilaterally. This finding is MOST consistent with which condition?

Pneumothorax
Pulmonary edema or fluid accumulation (Correct answer)
Asthma exacerbation
Pleural effusion on one side only

Correct answer: Pulmonary edema or fluid accumulation

Bilateral basilar crackles are a classic sign of fluid accumulation in the lungs, commonly seen in pulmonary edema or heart failure.

Question 13: Which adverse effect is MOST associated with aminoglycoside antibiotics (e.g., gentamicin)?

Hepatotoxicity and jaundice
Nephrotoxicity and ototoxicity (Correct answer)
Bone marrow suppression
QT prolongation and dysrhythmias

Correct answer: Nephrotoxicity and ototoxicity

Aminoglycosides accumulate in the renal cortex and cochlea, making nephrotoxicity and ototoxicity their most clinically significant adverse effects requiring monitoring.

Question 14: A nurse is assessing peripheral pulses in a patient with peripheral artery disease. The dorsalis pedis pulse is faint and barely palpable. How should this be documented?

2+ (normal)
0 (absent)
3+ (full/bounding)
1+ (weak/thready) (Correct answer)

Correct answer: 1+ (weak/thready)

A faint, barely palpable pulse is documented as 1+ on the standard 0–4+ pulse scale.

Question 15: A patient with type 2 diabetes asks how often they should check their blood glucose at home. What is the most appropriate response?

You do not need to check it if you are taking oral medications
Only check it when you feel symptoms
Follow the monitoring schedule recommended by your healthcare provider (Correct answer)
Check it once a week at the same time

Correct answer: Follow the monitoring schedule recommended by your healthcare provider

Blood glucose monitoring frequency should be individualized based on the provider's recommendation, medication regimen, and patient's health status.

Question 16: Which medication requires the nurse to assess the apical pulse for one full minute BEFORE administration?

Lisinopril
Metformin
Omeprazole
Digoxin (Correct answer)

Correct answer: Digoxin

Digoxin is withheld and the prescriber notified if the apical pulse is below 60 bpm, as digoxin further slows heart rate and can cause toxicity.

Question 17: Which of the following best describes 'scope of practice' in cosmetology?

The geographic area where a cosmetologist may work
The number of clients a cosmetologist can serve per day
The brands of products a salon is permitted to sell
The services a licensee is legally authorized to perform based on their license type (Correct answer)

Correct answer: The services a licensee is legally authorized to perform based on their license type

Scope of practice defines the specific services a licensee is legally permitted to perform, which varies by license type (e.g., cosmetologist vs. esthetician vs. nail technician).

Question 18: A nurse is caring for a patient with a new colostomy. Which stool characteristic indicates the ostomy is functioning appropriately for a sigmoid colostomy?

No output for the first 24 hours
Bloody, mucoid discharge
Formed or semi-formed stool (Correct answer)
Liquid, green output

Correct answer: Formed or semi-formed stool

A sigmoid colostomy is located near the end of the colon, so output should be formed or semi-formed like normal stool.

Question 19: What is the primary purpose of a comprehensive patient assessment in Next practice?

To establish a baseline for treatment planning (Correct answer)
To avoid clinical documentation
To fulfill insurance requirements only
To replace laboratory testing

Correct answer: To establish a baseline for treatment planning

A comprehensive patient assessment establishes a baseline that guides treatment planning and helps track patient progress over time.

Question 20: Which principle should guide the nurse when selecting educational materials for an older adult patient with low health literacy?

Choose materials with large print, simple language, and visual aids written at a 5th-grade level or below (Correct answer)
Use medical terminology to ensure accuracy
Provide lengthy written materials to ensure complete information
Use materials written at a 10th-grade reading level

Correct answer: Choose materials with large print, simple language, and visual aids written at a 5th-grade level or below

Materials with simple language, large print, and visuals are most effective for patients with low health literacy and older adults, improving comprehension and retention.

Question 21: Which factor most significantly affects the reliability of assessment findings?

The size of the examination room
Standardized procedures and consistent methodology (Correct answer)
The time of day the assessment is performed
The color of assessment forms used

Correct answer: Standardized procedures and consistent methodology

Using standardized procedures and consistent methodology ensures reliable, reproducible assessment findings across different practitioners.

Question 22: When providing patient education about a new medication, which approach is most effective for verifying patient understanding?

Use the teach-back method by having the patient repeat instructions in their own words (Correct answer)
Ask the patient to sign a consent form
Tell the patient to call if they experience any problems
Provide a written pamphlet and ask if they have questions

Correct answer: Use the teach-back method by having the patient repeat instructions in their own words

The teach-back method confirms comprehension by having patients demonstrate or explain information back, identifying gaps in understanding.

Question 23: A patient is allergic to penicillin. Which antibiotic class requires the MOST caution due to cross-reactivity?

Cephalosporins (e.g., cephalexin) (Correct answer)
Macrolides (e.g., azithromycin)
Tetracyclines (e.g., doxycycline)
Fluoroquinolones (e.g., ciprofloxacin)

Correct answer: Cephalosporins (e.g., cephalexin)

Cephalosporins share a similar beta-lactam ring structure with penicillin, and cross-reactivity — while less common than historically thought — still requires caution and careful assessment.

Question 24: A nurse is preparing to administer a medication via a nasogastric tube. Which action should be performed before administration?

Warm the medication to body temperature
Verify tube placement by pH testing or X-ray confirmation (Correct answer)
Flush the tube with 60 mL of sterile water
Clamp the tube for 30 minutes beforehand

Correct answer: Verify tube placement by pH testing or X-ray confirmation

Verifying NG tube placement before each use prevents aspiration from inadvertent tracheal or esophageal positioning.

Question 25: A nurse receives an order for morphine 4 mg IV. The vial reads morphine 10 mg/mL. How many mL should the nurse administer?

2.5 mL
0.4 mL (Correct answer)
0.8 mL
0.2 mL

Correct answer: 0.4 mL

4 mg ÷ 10 mg/mL = 0.4 mL is the correct dose calculation.

Question 26: Which of the following is a correct statement about health literacy?

Health literacy only affects patients with low education levels
High health literacy guarantees patient compliance
Health literacy is the ability to obtain, process, and understand basic health information to make appropriate decisions (Correct answer)
Health literacy is not a concern in acute care settings

Correct answer: Health literacy is the ability to obtain, process, and understand basic health information to make appropriate decisions

Health literacy encompasses the skills needed to navigate the healthcare system and make informed decisions, and it affects people across all education levels.

Question 27: A nurse participates in a structured peer review of a colleague's practice after an adverse event. The PRIMARY goal of this peer review process is to:

Determine liability for the adverse event
Gather evidence to support disciplinary action
Identify practice improvement opportunities and promote professional accountability (Correct answer)
Satisfy mandatory state reporting requirements

Correct answer: Identify practice improvement opportunities and promote professional accountability

Peer review in quality improvement is designed to identify practice improvement opportunities and foster professional accountability in a constructive manner.

Question 28: When the NCSBN updates the NEXT test plan, what objective drives those revisions?

Keeping the exam aligned with evolving nursing practice and healthcare environments (Correct answer)
Reducing the exam length to cut candidate costs
Increasing the exam's difficulty to reduce pass rates
Expanding the exam to cover specialty areas like oncology or pediatrics

Correct answer: Keeping the exam aligned with evolving nursing practice and healthcare environments

Regular test plan updates ensure the NEXT continues to measure competencies that reflect current nursing practice realities.

Question 29: What is the testing window associated with a NEXT ATT?

The ATT validity period is set by the testing center, not the state board
The ATT is valid for exactly one calendar year
Candidates have unlimited time to schedule once an ATT is issued
The ATT is typically valid for 90 days from the date of issue, after which it expires (Correct answer)

Correct answer: The ATT is typically valid for 90 days from the date of issue, after which it expires

ATTs are generally valid for 90 days; candidates must schedule and complete the exam within this window or reapply.

Question 30: Morphine 4 mg IV is ordered. The vial contains 10 mg/mL. How many mL should the nurse draw up?

4 mL
0.4 mL (Correct answer)
0.2 mL
2.5 mL

Correct answer: 0.4 mL

Using the formula: dose desired ÷ dose on hand × volume = 4 mg ÷ 10 mg × 1 mL = 0.4 mL.

Question 31: A cosmetologist who moves to a new state and wants to practice must typically:

Retake all coursework from the beginning
Only renew their original state license online
Begin practicing immediately under federal reciprocity law
Apply for licensure by endorsement or reciprocity in the new state (Correct answer)

Correct answer: Apply for licensure by endorsement or reciprocity in the new state

Most states offer licensure by endorsement or reciprocity, allowing licensed cosmetologists from other states to apply for a license without retaking the full exam.

Question 32: A patient taking lithium reports nausea, tremors, and confusion. The nurse should first:

Administer the next dose as scheduled
Give the patient more fluid and continue monitoring
Reassure the patient these are normal side effects
Check the serum lithium level and notify the prescriber (Correct answer)

Correct answer: Check the serum lithium level and notify the prescriber

Nausea, tremors, and confusion are signs of lithium toxicity; the serum lithium level must be checked immediately and the prescriber notified because the therapeutic window is very narrow.

Question 33: Which statement best describes the therapeutic effect of ACE inhibitors (e.g., lisinopril) in heart failure?

They increase aldosterone levels to promote fluid retention
They cause vasoconstriction to maintain blood pressure
They reduce afterload and preload, decreasing myocardial workload (Correct answer)
They increase heart rate to improve cardiac output

Correct answer: They reduce afterload and preload, decreasing myocardial workload

ACE inhibitors block angiotensin II formation, causing vasodilation that reduces both afterload and preload, thereby decreasing the workload on a failing heart.

Question 34: When performing tracheostomy suctioning, the nurse should apply suction for no longer than:

15 seconds
10 seconds (Correct answer)
20 seconds
5 seconds

Correct answer: 10 seconds

Suction should be applied for no more than 10 seconds to prevent hypoxia and mucosal trauma.

Question 35: A nurse uses the CAGE questionnaire during a patient assessment. What is this tool designed to screen for?

Alcohol use disorder (Correct answer)
Fall risk
Depression and suicidal ideation
Nutritional deficits

Correct answer: Alcohol use disorder

The CAGE questionnaire is a validated four-question screening tool used to identify patients at risk for alcohol use disorder.

Question 36: A patient with a cast on the right arm reports numbness and tingling distal to the cast. Which action should the nurse take first?

Administer the prescribed analgesic
Assess capillary refill and pulse in the right hand (Correct answer)
Elevate the arm above heart level
Apply ice to the arm for 20 minutes

Correct answer: Assess capillary refill and pulse in the right hand

Neurovascular assessment of the extremity distal to the cast is the priority to detect compartment syndrome.

Question 37: Which technique is most important when transferring a patient from bed to wheelchair to prevent injury?

Asking the patient to push themselves up independently
Moving quickly to reduce patient anxiety
Using proper body mechanics with a wide stance and bent knees (Correct answer)
Bending at the waist and pulling the patient

Correct answer: Using proper body mechanics with a wide stance and bent knees

Proper body mechanics—wide stance, bent knees, straight back—protect both the nursing assistant and patient during transfers.

Question 38: The NEXT measures competency across which broad client needs categories?

Diagnosis, treatment, discharge, and documentation
Assessment, planning, implementation, and evaluation only
Medical-surgical, pediatric, obstetric, and psychiatric nursing
Safe and effective care environment, health promotion, psychosocial integrity, and physiological integrity (Correct answer)

Correct answer: Safe and effective care environment, health promotion, psychosocial integrity, and physiological integrity

The NEXT test plan organizes content into four client needs categories that span the full scope of entry-level nursing practice.

Question 39: What is the primary purpose of thorough documentation in professional practice?

To demonstrate writing ability
To create an accurate record for continuity of care and legal protection (Correct answer)
To fill time during slow periods
To satisfy administrative preferences only

Correct answer: To create an accurate record for continuity of care and legal protection

Documentation serves as the legal record of services provided and ensures continuity of care among providers.

Question 40: Which statement about enteric-coated medications is correct?

They are designed to dissolve in the stomach
They must be swallowed whole to protect the stomach lining (Correct answer)
They may be crushed to ease swallowing
They should be opened and sprinkled on food

Correct answer: They must be swallowed whole to protect the stomach lining

Enteric-coated medications must be swallowed whole because crushing destroys the coating designed to prevent gastric irritation and ensure intestinal absorption.

Question 41: A patient is being discharged after a hip replacement. Which instruction is most critical to include in discharge education?

Dietary restrictions for the first week
Instructions for cosmetic wound care
Weight-bearing restrictions and movement precautions (Correct answer)
Recommendations for resuming full physical activity

Correct answer: Weight-bearing restrictions and movement precautions

Weight-bearing restrictions and movement precautions are essential to prevent hip dislocation and ensure proper healing after hip replacement surgery.

Question 42: A nurse is performing discharge teaching for a patient prescribed a metered-dose inhaler (MDI) with a spacer. Which patient statement indicates a need for further teaching?

'I will breathe in slowly after pressing the inhaler.'
'I should breathe out forcefully immediately after inhaling.' (Correct answer)
'I will shake the inhaler before each use.'
'I will wait 1 minute between puffs.'

Correct answer: 'I should breathe out forcefully immediately after inhaling.'

After inhaling the medication, the patient should hold the breath for 10 seconds to allow deposition, not exhale forcefully.

Question 43: A nurse is administering IV potassium chloride. Which action is essential for patient safety?

Warm the bag before administration to speed infusion
Always administer via the fastest available IV site
Infuse no faster than 10 mEq/hr via peripheral IV (Correct answer)
Administer undiluted by IV push for rapid correction

Correct answer: Infuse no faster than 10 mEq/hr via peripheral IV

IV potassium must never be given by IV push; the maximum safe infusion rate via peripheral IV is 10 mEq/hr to prevent fatal cardiac dysrhythmias.

Question 44: A nurse manager reviews data showing an 18% increase in catheter-associated urinary tract infections (CAUTIs). The BEST next step is to:

Convene a QI team to analyze practice patterns and implement evidence-based bundle interventions (Correct answer)
Immediately replace all urinary catheters on the unit
Report the data to administration and await guidance
Increase antibiotic use prophylactically

Correct answer: Convene a QI team to analyze practice patterns and implement evidence-based bundle interventions

Convening a QI team to analyze practice and implement evidence-based CAUTI prevention bundles addresses the root problem systematically.

Question 45: A nurse is educating a non-English-speaking patient about wound care. What is the most appropriate resource to use?

Speak slowly and loudly in English
Use gestures and pictures only
Ask the patient's family member to translate
Request a certified medical interpreter (Correct answer)

Correct answer: Request a certified medical interpreter

A certified medical interpreter ensures accurate, confidential communication and protects both patient rights and safety during clinical education.

Question 46: What kind of questions are included in Part 1 of NEXT?

Multiple-choice questions (MCQs) and theoretical scenarios (Correct answer)
Oral examinations by an examiner
Practical, hands-on clinical tasks
Essays on medical topics

Correct answer: Multiple-choice questions (MCQs) and theoretical scenarios

Part 1 of the National Exit Test (NEXT) is designed to test a candidate's theoretical knowledge and understanding of medical concepts. This is typically achieved through multiple-choice questions (MCQs) and theoretical scenarios that require reasoning and diagnostic interpretation. It focuses on the cognitive aspect of medical education rather than hands-on clinical tasks.

Question 47: A nurse finds a patient attempting to leave the facility against medical advice (AMA). The patient is alert and oriented. The nurse's PRIORITY action is to:

Notify the patient's family to come immediately and persuade the patient to stay
Physically prevent the patient from leaving until the physician arrives
Inform the patient of the risks of leaving and offer to contact the physician, then allow the patient to leave if they still choose to after signing AMA paperwork (Correct answer)
Call security to detain the patient until a psychiatric evaluation is completed

Correct answer: Inform the patient of the risks of leaving and offer to contact the physician, then allow the patient to leave if they still choose to after signing AMA paperwork

A competent patient has the right to leave AMA; the nurse must ensure informed decision-making, complete AMA documentation, and notify the provider.

Question 48: A nurse notes that a patient's nasogastric tube feeding has stopped draining and the patient complains of nausea. What should the nurse check first?

Serum electrolytes
Bowel sounds in all four quadrants
Tube placement via X-ray
Residual gastric volume (Correct answer)

Correct answer: Residual gastric volume

Checking residual gastric volume identifies delayed gastric emptying, which can cause aspiration risk with continued feeding.

Question 49: Which of the following BEST describes benchmarking in healthcare quality improvement?

Comparing performance metrics against top-performing organizations or national standards (Correct answer)
Setting internal goals based solely on last year's performance
Surveying patients about their satisfaction with care
Reviewing staff credentialing files annually

Correct answer: Comparing performance metrics against top-performing organizations or national standards

Benchmarking involves comparing an organization's performance metrics against external top performers or national standards to identify improvement opportunities.

Question 50: Which food should a patient taking an MAO inhibitor (MAOI) antidepressant avoid?

Fresh fruits such as apples and bananas
Aged cheeses, cured meats, and fermented foods (Correct answer)
Dairy products like milk and yogurt
Leafy green vegetables such as spinach

Correct answer: Aged cheeses, cured meats, and fermented foods

Aged cheeses, cured meats, and fermented foods are high in tyramine, which MAOIs prevent from being metabolized, potentially causing a hypertensive crisis.

Question 51: A nurse finds a patient with a blood pressure of 80/50 mmHg and heart rate of 120 bpm. Which priority action should the nurse take first?

Ask the patient about their baseline blood pressure
Administer a scheduled antihypertensive medication
Document findings and reassess in 30 minutes
Place the patient in Trendelenburg position and notify the provider (Correct answer)

Correct answer: Place the patient in Trendelenburg position and notify the provider

Hypotension with tachycardia indicates possible shock; positioning to increase venous return and immediate provider notification is the priority action.

Question 52: A pediatric patient's parent asks about the correct dose of acetaminophen for a child. What is the nurse's best response?

Instruct the parent to follow weight-based dosing per the package insert and confirm with the provider or pharmacist (Correct answer)
Give the same adult dose at half frequency
Recommend avoiding acetaminophen in children entirely
Advise the parent that any dose is safe since acetaminophen is over-the-counter

Correct answer: Instruct the parent to follow weight-based dosing per the package insert and confirm with the provider or pharmacist

Pediatric acetaminophen dosing is weight-based, and directing parents to weight-based package instructions and professional guidance prevents under- or over-dosing.

Question 53: During a handoff from the emergency department to an inpatient unit, a nurse uses the SBAR communication tool. How does this contribute to quality improvement?

It satisfies documentation requirements for billing
It reduces the time nurses spend at the bedside
It standardizes communication to reduce information gaps and handoff errors (Correct answer)
It eliminates the need for written nursing notes

Correct answer: It standardizes communication to reduce information gaps and handoff errors

SBAR (Situation, Background, Assessment, Recommendation) standardizes clinical communication, reducing handoff-related information loss and patient safety risks.

Question 54: Under most state regulations, which of the following services may a cosmetology student perform legally?

Services only on paying clients in licensed salons
Supervised services in a licensed cosmetology school clinic (Correct answer)
Services in any setting once they have completed 500 hours
Any service, as students are exempt from regulations

Correct answer: Supervised services in a licensed cosmetology school clinic

Cosmetology students may legally perform services on clients in a licensed school clinic setting under the supervision of a licensed instructor.

Question 55: A quality improvement team wants to identify all possible causes of medication errors. Which tool is BEST suited for this purpose?

Control chart
Pareto chart
Run chart
Fishbone (Ishikawa) diagram (Correct answer)

Correct answer: Fishbone (Ishikawa) diagram

The fishbone diagram (cause-and-effect diagram) systematically categorizes potential causes of a problem to identify root contributors.

Question 56: Which document must a candidate typically submit to prove graduation eligibility before taking the NEXT?

A reference letter from a supervising physician
A letter of intent from their nursing program
An official transcript or verification of program completion from the nursing school (Correct answer)
A personal statement describing clinical experience

Correct answer: An official transcript or verification of program completion from the nursing school

An official transcript or program completion verification confirms the candidate has met the educational prerequisite.

Question 57: What kind of resources should be prioritized for preparing for Part 2 of NEXT, the practical exam?

Video lectures from medical experts
Medical research papers and articles
Only theoretical knowledge from textbooks
Hands-on clinical practice and mock exams (Correct answer)

Correct answer: Hands-on clinical practice and mock exams

Part 2 of NEXT is a practical examination, making hands-on clinical practice the most critical resource for preparation. This involves actively participating in patient care, performing procedures, and honing diagnostic skills under supervision. Mock practical exams further help by simulating the actual test environment, allowing candidates to refine their clinical approach and time management.

Question 58: A nurse is caring for a patient in traction. Which intervention is essential for skin integrity?

Apply heat to the skin under the traction device
Perform regular skin assessments under and around the device (Correct answer)
Remove the traction every 4 hours for range-of-motion exercises
Keep the traction weights on the bed when repositioning

Correct answer: Perform regular skin assessments under and around the device

Regular skin assessment under and around traction equipment detects pressure injuries before they worsen.

Question 59: A nursing assistant should report which of the following changes in a patient's urine?

Output of 300 mL over 8 hours
Slight ammonia odor after standing
Light yellow color
Dark, cloudy appearance with strong odor (Correct answer)

Correct answer: Dark, cloudy appearance with strong odor

Dark, cloudy urine with a strong odor may indicate dehydration, infection, or other medical issues requiring nursing assessment.

Question 60: A nurse is reassessing a patient 1 hour after administering a diuretic for fluid overload. Which finding best indicates the intervention was effective?

Urine output of 200 mL in the past hour (Correct answer)
Blood pressure increased from 130/80 to 150/90 mmHg
Respiratory rate increased from 16 to 22 breaths/min
Bilateral pitting edema unchanged from baseline

Correct answer: Urine output of 200 mL in the past hour

Increased urine output after diuretic administration indicates the medication is effectively removing excess fluid.

Question 61: A client complains that a cosmetologist caused them a chemical burn during a service. The state board may:

Require the client to file a civil lawsuit first
Transfer the complaint to the FDA for review
Investigate and potentially suspend or revoke the cosmetologist's license (Correct answer)
Only issue a written warning to the salon owner

Correct answer: Investigate and potentially suspend or revoke the cosmetologist's license

State boards have authority to investigate complaints and take disciplinary action including suspension or revocation of a cosmetologist's license.

Question 62: A patient states they do not understand the purpose of their newly prescribed anticoagulant. What is the best initial nursing action?

Document that education was provided and the patient refused
Reassess the patient's current knowledge and provide clear education about the medication's purpose (Correct answer)
Withhold the medication until the patient understands
Contact the prescribing provider to discuss the order

Correct answer: Reassess the patient's current knowledge and provide clear education about the medication's purpose

Reassessing knowledge and providing targeted education addresses the patient's gap in understanding, supporting informed consent and medication adherence.

Question 63: During an initial assessment, what should be documented first?

Insurance information
Discharge planning notes
Chief complaint and history of present illness (Correct answer)
Family social history only

Correct answer: Chief complaint and history of present illness

The chief complaint and history of present illness establish the reason for the visit and provide context for the examination.

Question 64: The sinoatrial (SA) node is located in which chamber of the heart?

Left ventricle
Left atrium
Right atrium (Correct answer)
Right ventricle

Correct answer: Right atrium

The SA node is embedded in the wall of the right atrium near the opening of the superior vena cava.

Question 65: A patient with type 1 diabetes is prescribed regular insulin and NPH insulin. What is the correct mixing sequence?

Draw NPH first, then regular insulin
Draw regular (clear) insulin first, then NPH (cloudy) (Correct answer)
Always use separate syringes for each type
The order does not matter for safety

Correct answer: Draw regular (clear) insulin first, then NPH (cloudy)

The mnemonic 'clear before cloudy' guides drawing regular (clear) insulin first to prevent contaminating the regular insulin vial with NPH, which would alter its action profile.

Question 66: The nurse is assessing a patient's nutritional status. Which laboratory value is the BEST indicator of chronic protein malnutrition?

Total lymphocyte count
Serum prealbumin
Serum transferrin
Serum albumin (Correct answer)

Correct answer: Serum albumin

Serum albumin, with a half-life of 20 days, reflects chronic nutritional status and is a reliable indicator of long-term protein deficiency.

Question 67: A nurse prepares to administer a high-alert medication. Which safety action should ALWAYS be performed for high-alert drugs?

Document administration after the patient has taken the drug
Consult the charge nurse only if the patient appears unstable
Administer the medication independently without delay
Obtain an independent double-check from a second licensed nurse (Correct answer)

Correct answer: Obtain an independent double-check from a second licensed nurse

High-alert medications (e.g., insulin, anticoagulants, concentrated electrolytes) require an independent double-check by a second licensed nurse to verify drug, dose, route, and rate before administration.

Question 68: When teaching a patient about preventing pressure injuries at home, which instruction is most important for a wheelchair-bound patient?

Keep the wheelchair cushion deflated for comfort
Apply lotion to skin only once daily
Perform weight shifts or pressure relief maneuvers every 15–30 minutes (Correct answer)
Stay in the wheelchair all day to avoid fall risk

Correct answer: Perform weight shifts or pressure relief maneuvers every 15–30 minutes

Regular weight shifts relieve sustained pressure on bony prominences, which is the primary cause of pressure injuries in patients with limited mobility.

Question 69: Advertising a cosmetology service in a way that is false or misleading may result in:

Disciplinary action by the state board and possible fines (Correct answer)
No penalty if the ad was posted online
Only a private warning from a competitor
A review by the FCC

Correct answer: Disciplinary action by the state board and possible fines

False or misleading advertising is a regulatory violation that state boards can act upon, in addition to FTC enforcement.

Question 70: When should discharge planning ideally begin for a hospitalized patient?

At the time of admission (Correct answer)
When the physician writes the discharge order
On the day of discharge
After the patient is medically stable

Correct answer: At the time of admission

Discharge planning should begin at admission to allow adequate time to identify needs, coordinate resources, and provide comprehensive patient education before discharge.

Question 71: During evaluation, a nurse determines that a patient's goal was NOT met. What is the most appropriate next action?

Discharge the patient and document goal as met
Revise the plan of care to address barriers to goal achievement (Correct answer)
Transfer the patient to a higher level of care immediately
Continue the same interventions without modification

Correct answer: Revise the plan of care to address barriers to goal achievement

When a goal is not met, the nurse must reassess and revise the plan of care to identify and address the reasons for failure.

Question 72: Which of the following is the BEST example of culturally competent patient education?

Providing the same standard handout to all patients regardless of background
Assessing the patient's cultural beliefs, incorporating them respectfully into the teaching plan, and adapting materials accordingly (Correct answer)
Relying solely on the patient's family to explain health information based on cultural norms
Avoiding any discussion of cultural differences to prevent bias

Correct answer: Assessing the patient's cultural beliefs, incorporating them respectfully into the teaching plan, and adapting materials accordingly

Culturally competent education requires assessing individual cultural contexts and tailoring teaching to align with the patient's values and beliefs, improving engagement and outcomes.

Question 73: What is the correct sequence for a physical assessment?

Inspection, palpation, percussion, auscultation (Correct answer)
Palpation, inspection, auscultation, percussion
Percussion, auscultation, inspection, palpation
Auscultation, percussion, palpation, inspection

Correct answer: Inspection, palpation, percussion, auscultation

The standard physical assessment sequence is inspection (visual), palpation (touch), percussion (tapping), and auscultation (listening).

Question 74: Which of the following best describes patient-centered care?

Focusing primarily on the physician's treatment plan
Prioritizing efficiency over individual patient preferences
Involving patients and families as partners in care decisions (Correct answer)
Standardizing care protocols for all patients equally

Correct answer: Involving patients and families as partners in care decisions

Patient-centered care recognizes patients and their families as active partners in planning and decision-making regarding their health and treatment.

Question 75: Which tool is MOST appropriate for assessing a nonverbal patient's level of pain?

Visual Analog Scale (VAS)
Behavioral Pain Scale (BPS) (Correct answer)
McGill Pain Questionnaire
Numeric Rating Scale (NRS)

Correct answer: Behavioral Pain Scale (BPS)

The Behavioral Pain Scale assesses pain in nonverbal or sedated patients by observing facial expressions, body movements, and ventilator compliance.

Question 76: During assessment of a patient's mental status, the nurse asks the patient to interpret the proverb 'Don't cry over spilled milk.' This tests which cognitive function?

Memory
Abstract thinking (Correct answer)
Orientation
Judgment

Correct answer: Abstract thinking

Interpreting proverbs assesses abstract thinking, which requires higher-order cognitive processing beyond literal interpretation.

Question 77: Which action best demonstrates respect for a patient's dignity during personal care?

Completing care as quickly as possible to save time
Exposing only the area being cared for and covering the rest (Correct answer)
Discussing the patient's condition with visitors present
Leaving the room door open for easy access

Correct answer: Exposing only the area being cared for and covering the rest

Covering the patient and exposing only the area being cared for protects modesty and preserves dignity.

Question 78: Which of the following is the correct order for the chain of infection?

Host → Reservoir → Portal of exit → Transmission → Portal of entry → Infectious agent
Reservoir → Susceptible host → Infectious agent → Transmission → Portal of exit → Portal of entry
Infectious agent → Reservoir → Portal of exit → Mode of transmission → Portal of entry → Susceptible host (Correct answer)
Susceptible host → Infectious agent → Reservoir → Portal of exit → Transmission → Portal of entry

Correct answer: Infectious agent → Reservoir → Portal of exit → Mode of transmission → Portal of entry → Susceptible host

The chain of infection follows the sequence: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host.

Question 79: Which element is essential when documenting patient education in the medical record?

The time spent teaching only
Only the signature of the patient confirming they received a pamphlet
The nurse's opinion of the patient's intelligence
The content taught, teaching method used, patient response, and plan for follow-up (Correct answer)

Correct answer: The content taught, teaching method used, patient response, and plan for follow-up

Complete documentation includes what was taught, how it was taught, the patient's demonstrated understanding, and any follow-up plan to ensure continuity of care.

Question 80: Why is root cause analysis important in quality improvement?

It identifies the underlying cause of problems rather than just symptoms (Correct answer)
It replaces the need for corrective actions
It eliminates the need for data collection
It assigns blame to specific individuals

Correct answer: It identifies the underlying cause of problems rather than just symptoms

Root cause analysis goes beyond surface-level symptoms to identify fundamental causes, enabling effective and lasting solutions.

Question 81: A patient is about to undergo a colonoscopy and expresses anxiety about the procedure. What is the priority nursing intervention?

Provide clear, factual information about what to expect during the procedure (Correct answer)
Notify the physician that the patient is refusing the procedure
Tell the patient there is nothing to worry about
Administer a sedative immediately

Correct answer: Provide clear, factual information about what to expect during the procedure

Providing accurate procedural information helps reduce anxiety by giving the patient a sense of control and realistic expectations, which is a foundational nursing responsibility.

Question 82: What is the importance of maintaining professional boundaries?

Clear boundaries protect both the professional and the client relationship (Correct answer)
Boundaries are only important in healthcare settings
Only new professionals need to worry about boundaries
Boundaries reduce effectiveness by creating distance

Correct answer: Clear boundaries protect both the professional and the client relationship

Professional boundaries maintain the integrity of the professional-client relationship and protect all parties.

Question 83: When assessing a patient's abdomen, what is the correct order of techniques?

Inspection, palpation, percussion, auscultation
Inspection, auscultation, percussion, palpation (Correct answer)
Auscultation, inspection, palpation, percussion
Palpation, percussion, inspection, auscultation

Correct answer: Inspection, auscultation, percussion, palpation

For abdominal assessment, auscultation is performed before palpation and percussion to avoid altering bowel sounds.

Question 84: A nurse is teaching a patient with heart failure about a low-sodium diet. The patient says, 'I don't really cook — I eat out every day.' What is the best nursing response?

Provide a list of low-sodium restaurant options and strategies for making healthier choices when dining out (Correct answer)
Document that the patient is non-compliant
Advise the patient to stop eating out entirely
Defer the dietary education to the dietitian only

Correct answer: Provide a list of low-sodium restaurant options and strategies for making healthier choices when dining out

Adapting education to the patient's lifestyle and providing practical, actionable strategies improves adherence and makes the teaching relevant to real-life behavior.

Question 85: A nurse is educating a patient prescribed methotrexate for rheumatoid arthritis. Which supplement is often prescribed concurrently to reduce side effects?

Zinc and magnesium
Vitamin D and calcium
Folic acid (Correct answer)
Iron and B12

Correct answer: Folic acid

Folic acid supplementation is routinely prescribed with methotrexate to reduce the drug's folate-antagonist side effects such as mucositis, nausea, and liver toxicity.

Question 86: Which five rights of medication administration are considered the traditional standard?

Right drug, right dose, right time, right nurse, right order
Right patient, right route, right time, right documentation, right reason
Right patient, right drug, right dose, right form, right documentation
Right patient, right drug, right dose, right route, right time (Correct answer)

Correct answer: Right patient, right drug, right dose, right route, right time

The five traditional rights are right patient, right drug, right dose, right route, and right time — these form the foundational safety check for every medication administration.

Question 87: The NEXT exam's content is derived from what primary source to ensure it reflects real-world nursing practice?

National nursing board policy statements
A panel of nursing school deans' recommendations
Surveys of hospital chief nursing officers
A practice analysis study examining tasks performed by entry-level nurses (Correct answer)

Correct answer: A practice analysis study examining tasks performed by entry-level nurses

NCSBN conducts periodic practice analysis studies to identify what entry-level nurses actually do, ensuring the NEXT remains relevant and valid.

Question 88: Which of the following is NOT a standard component of the NEXT eligibility application?

Passing a preliminary oral examination before receiving an ATT (Correct answer)
Submission of proof of nursing program completion
Payment of examination and registration fees
Background check or disclosure of criminal history

Correct answer: Passing a preliminary oral examination before receiving an ATT

The NEXT does not include a preliminary oral examination; eligibility is determined through documentation, fees, and background review.

Question 89: A nurse is performing a cranial nerve assessment and asks the patient to clench their teeth. Which cranial nerve is being assessed?

Cranial nerve VII (Facial)
Cranial nerve XI (Accessory)
Cranial nerve IX (Glossopharyngeal)
Cranial nerve V (Trigeminal) (Correct answer)

Correct answer: Cranial nerve V (Trigeminal)

The trigeminal nerve (CN V) controls the muscles of mastication; clenching the jaw tests its motor function.

Question 90: What role does data collection play in quality improvement?

It is only needed for regulatory audits
It replaces professional judgment entirely
It is optional if staff agree on the problem
It provides objective evidence for identifying trends and measuring progress (Correct answer)

Correct answer: It provides objective evidence for identifying trends and measuring progress

Data-driven decision making provides objective evidence, helping identify patterns and measure the impact of improvement efforts.

Question 91: A patient with dementia cannot provide verbal feedback. Which documentation strategy is most appropriate for pain assessment?

Assume the patient is not in pain if they are not crying
Use the numeric pain scale and estimate the patient's pain level
Use a behavioral pain scale and document observed cues such as facial grimacing and guarding (Correct answer)
Document 'patient unable to report pain' and make no further entry

Correct answer: Use a behavioral pain scale and document observed cues such as facial grimacing and guarding

Behavioral pain assessment tools capture non-verbal pain indicators in patients unable to self-report, ensuring accurate documentation.

Question 92: When assessing a patient's readiness to learn, which barrier should the nurse prioritize addressing FIRST?

Lack of family support
Low health literacy
Cultural differences
Uncontrolled pain (Correct answer)

Correct answer: Uncontrolled pain

Uncontrolled pain is a physiological barrier that significantly impairs concentration and the ability to learn, and must be addressed before teaching can be effective.

Question 93: The large intestine absorbs primarily which substance from digestive contents?

Proteins
Carbohydrates
Lipids
Water and electrolytes (Correct answer)

Correct answer: Water and electrolytes

The main function of the large intestine is to reabsorb water and electrolytes, concentrating waste into feces.

Question 94: Which muscle layer of the gastrointestinal tract is responsible for peristalsis?

Submucosa
Muscularis externa (Correct answer)
Mucosa
Serosa

Correct answer: Muscularis externa

The muscularis externa, with its inner circular and outer longitudinal smooth muscle layers, generates peristaltic waves.

Question 95: A nurse is evaluating a patient's plan of care. Which step in the nursing process does this represent?

Diagnosis
Assessment
Planning
Evaluation (Correct answer)

Correct answer: Evaluation

Evaluation is the step in the nursing process where the nurse determines whether patient outcomes and goals have been met.

Question 96: A patient on heparin infusion has an aPTT of 180 seconds. The normal range is 30–40 seconds and the therapeutic range is 60–80 seconds. The nurse should:

Continue the current infusion and recheck in 6 hours
Increase the heparin infusion rate
Administer protamine sulfate without waiting for orders
Stop the infusion and notify the prescriber immediately (Correct answer)

Correct answer: Stop the infusion and notify the prescriber immediately

An aPTT of 180 seconds is far above the therapeutic range, indicating excessive anticoagulation and high bleeding risk; the infusion must be stopped and the prescriber notified immediately.

Question 97: A nurse is caring for a patient who is a Jehovah's Witness and refuses a blood transfusion despite a life-threatening hemoglobin level. The nurse's BEST response is to:

Ask the patient's family to convince the patient to accept the transfusion
Administer the transfusion anyway to preserve the patient's life
Contact the ethics committee to override the patient's decision
Document the refusal, inform the physician, and ensure the patient has signed an informed refusal form (Correct answer)

Correct answer: Document the refusal, inform the physician, and ensure the patient has signed an informed refusal form

Competent adult patients have the legal and ethical right to refuse treatment; the nurse must document informed refusal and notify the care team.

Question 98: Which assessment finding is MOST consistent with opioid toxicity?

Pinpoint pupils, respiratory rate of 6 breaths/min, and decreased consciousness (Correct answer)
Fever, muscle rigidity, and diaphoresis
Dilated pupils, tachycardia, and agitation
Hypertension, bradycardia, and widened pulse pressure

Correct answer: Pinpoint pupils, respiratory rate of 6 breaths/min, and decreased consciousness

The classic triad of opioid toxicity is miosis (pinpoint pupils), respiratory depression, and decreased level of consciousness.

Question 99: A nurse is writing a nursing progress note using the DAR (Data, Action, Response) format. Which entry belongs under 'Data'?

Administered ibuprofen 400 mg PO as ordered
Encouraged patient to use prescribed analgesic prior to therapy
Patient reports pain of 7/10 in the right knee with ambulation (Correct answer)
Patient ambulated 50 feet with decreased pain after intervention

Correct answer: Patient reports pain of 7/10 in the right knee with ambulation

In the DAR format, 'Data' captures objective and subjective information gathered during the assessment.

Question 100: A patient is being discharged with a new ostomy. Which educational outcome best indicates the patient is ready for self-care at home?

The patient asks appropriate questions about diet restrictions
The patient can describe the function of the ostomy verbally
The patient independently demonstrates proper ostomy pouch change and skin care without prompting (Correct answer)
The patient has reviewed the written materials provided by the nurse

Correct answer: The patient independently demonstrates proper ostomy pouch change and skin care without prompting

Independent demonstration of a skill without prompting is the strongest indicator of readiness for self-care, confirming both knowledge and psychomotor competency.

Question 101: Which data collection method would best help the nurse assess a patient's skin turgor?

Auscultation over the abdomen
Inspection of mucous membrane color
Percussion over the thoracic cavity
Palpation by gently pinching the skin on the forearm (Correct answer)

Correct answer: Palpation by gently pinching the skin on the forearm

Skin turgor is assessed by gently pinching the skin; slow return to normal position indicates decreased turgor and possible dehydration.

Question 102: A nurse is evaluating a diabetic patient's understanding of insulin administration. Which response by the patient indicates teaching was effective?

'I should inject insulin only into my abdomen for best absorption.'
'I will rotate injection sites within the same anatomical region.' (Correct answer)
'I will reuse my insulin syringe until it becomes dull.'
'I should skip my insulin dose if my blood sugar is below 150.'

Correct answer: 'I will rotate injection sites within the same anatomical region.'

Rotating injection sites within the same anatomical region prevents lipodystrophy and ensures consistent insulin absorption.

Question 103: What role does data collection play in quality improvement?

It replaces professional judgment entirely
It provides objective evidence for identifying trends and measuring progress (Correct answer)
It is optional if staff agree on the problem
It is only needed for regulatory audits

Correct answer: It provides objective evidence for identifying trends and measuring progress

Data-driven decision making provides objective evidence, helping identify patterns and measure the impact of improvement efforts.

Question 104: Which assessment tool is most commonly used to evaluate cognitive function?

Glasgow Coma Scale only
Body Mass Index (BMI)
Visual Analog Scale (VAS)
Mini-Mental State Examination (MMSE) (Correct answer)

Correct answer: Mini-Mental State Examination (MMSE)

The MMSE is widely used to screen for cognitive impairment and track changes in cognitive function over time.

Question 105: A patient receiving chemotherapy develops a platelet count of 18,000/mm³. Which nursing action is the HIGHEST priority?

Administer acetaminophen for anticipated discomfort
Encourage increased oral fluid intake
Obtain cultures to assess for infection
Implement bleeding precautions and fall prevention measures (Correct answer)

Correct answer: Implement bleeding precautions and fall prevention measures

A platelet count below 20,000/mm³ carries a high risk of spontaneous bleeding; implementing bleeding precautions (soft toothbrush, avoiding NSAIDs, fall prevention) is the immediate priority.

Question 106: The term 'supine position' refers to a patient lying:

At a 45-degree angle with head elevated
Flat on their back facing upward (Correct answer)
On their side with knees bent
Face down on their abdomen

Correct answer: Flat on their back facing upward

Supine position means lying flat on the back with the face upward.

Question 107: How does practical experience complement theoretical knowledge in the Next field?

It develops judgment, skills, and the ability to handle real-world complexity (Correct answer)
Theory and practice are completely separate
Practical experience replaces the need for any theoretical study
Practice is unnecessary if you have strong theoretical knowledge

Correct answer: It develops judgment, skills, and the ability to handle real-world complexity

Practical experience develops professional judgment and the ability to apply theoretical knowledge to complex real-world situations.

Question 108: A patient with COPD has an SpO2 of 88% on room air. How should the nurse interpret this finding?

Slightly below normal but not significant
Below the acceptable range; notify the provider and apply supplemental oxygen (Correct answer)
Critically low; prepare for immediate intubation
Normal for a patient with COPD; no action needed

Correct answer: Below the acceptable range; notify the provider and apply supplemental oxygen

SpO2 of 88% is below the acceptable threshold and requires supplemental oxygen and provider notification, though COPD patients may tolerate slightly lower levels than others.

Question 109: Which instruction is MOST important to give a patient who is prescribed a bisphosphonate (e.g., alendronate) for osteoporosis?

Take the medication with a full glass of water and remain upright for 30–60 minutes (Correct answer)
Take the medication with a high-calcium meal for better absorption
Take the medication at bedtime with a full glass of milk
Crush the tablet and mix it with juice if swallowing is difficult

Correct answer: Take the medication with a full glass of water and remain upright for 30–60 minutes

Bisphosphonates must be taken with plain water and the patient must remain upright for 30–60 minutes to prevent severe esophageal ulceration.

Question 110: What is the purpose of reassessment in ongoing patient care?

To complete regulatory paperwork only
To satisfy accreditation requirements exclusively
To monitor treatment effectiveness and adjust the care plan (Correct answer)
To generate additional billing codes

Correct answer: To monitor treatment effectiveness and adjust the care plan

Reassessment monitors how well the treatment plan is working and identifies needed adjustments to optimize patient outcomes.

Question 111: A patient is prescribed warfarin. Which laboratory value is the PRIMARY indicator used to monitor therapeutic dosing?

Platelet count
International Normalized Ratio (INR) (Correct answer)
Complete blood count (CBC)
Partial thromboplastin time (PTT)

Correct answer: International Normalized Ratio (INR)

The INR is the standardized test used to monitor warfarin anticoagulation therapy, with a target range of 2.0–3.0 for most indications.

Question 112: Which factor is most important to assess FIRST when planning patient education?

The time allocated for discharge
The availability of educational pamphlets
The patient's literacy level and learning preferences (Correct answer)
The patient's insurance coverage

Correct answer: The patient's literacy level and learning preferences

Assessing literacy level and learning preferences ensures educational materials and methods are appropriate and effective for that individual patient.

Question 113: A nurse is preparing to administer a medication via IV push. The label reads '10 mg/mL' and the order is for 25 mg. How many mL should be administered?

2.5 mL (Correct answer)
4 mL
25 mL
0.4 mL

Correct answer: 2.5 mL

Using the formula: dose desired ÷ dose on hand = 25 mg ÷ 10 mg/mL = 2.5 mL.

Question 114: A client with COPD is receiving oxygen therapy. Which oxygen delivery method is most appropriate to maintain a controlled FiO2?

Venturi mask (Correct answer)
Simple face mask
Nasal cannula at 6 L/min
Nonrebreather mask

Correct answer: Venturi mask

The Venturi mask delivers a precise, controlled FiO2, which is critical for COPD patients who rely on a hypoxic drive.

Question 115: What is mandatory reporting?

A policy that only applies to government employees
A requirement to report all client information to authorities
A legal obligation to report certain situations such as abuse or neglect (Correct answer)
An optional recommendation for best practice

Correct answer: A legal obligation to report certain situations such as abuse or neglect

Mandatory reporting laws require professionals to report suspected abuse, neglect, or other specified situations to appropriate authorities.

Question 116: A patient newly diagnosed with hypertension asks why lifestyle changes are recommended in addition to medication. What is the most appropriate explanation?

Lifestyle changes are only necessary if the medication causes side effects
Lifestyle modifications such as diet, exercise, and smoking cessation can significantly lower blood pressure and reduce cardiovascular risk (Correct answer)
Lifestyle changes replace the need for medication over time
Medications alone are sufficient and lifestyle changes are optional

Correct answer: Lifestyle modifications such as diet, exercise, and smoking cessation can significantly lower blood pressure and reduce cardiovascular risk

Evidence-based guidelines support combining lifestyle modifications with pharmacotherapy because together they produce greater blood pressure reduction and cardiovascular risk reduction than either alone.

Question 117: A nurse is assessing a patient 2 hours after a right-sided total hip replacement. Which finding requires immediate intervention?

Hip pain rated 5/10
Serosanguineous drainage on the dressing
Right foot capillary refill of 2 seconds
Right leg externally rotated and shortened (Correct answer)

Correct answer: Right leg externally rotated and shortened

External rotation and shortening of the operative leg are signs of hip dislocation, a surgical emergency.

Question 118: Which finding in a patient receiving IV potassium chloride requires the nurse to stop the infusion immediately?

Serum potassium of 3.8 mEq/L
Burning at the IV site (Correct answer)
Heart rate of 78 bpm
Urine output of 35 mL/hour

Correct answer: Burning at the IV site

Burning at the IV site indicates phlebitis or infiltration, requiring the infusion to be stopped and the site changed.

Question 119: Which vital sign finding in an adult patient should be reported to the healthcare provider immediately?

Blood pressure 118/76 mmHg
Pulse 72 bpm
Temperature 37.2°C (99°F)
Respiratory rate 28 breaths/min (Correct answer)

Correct answer: Respiratory rate 28 breaths/min

A respiratory rate of 28 breaths/min in an adult is significantly above the normal range of 12–20 breaths/min and indicates respiratory distress requiring immediate attention.

Question 120: A nurse notes that a postoperative patient has become increasingly confused since the last assessment. Using SBAR, what belongs in the 'A' (Assessment) section?

The surgeon's last documented note
The nurse's clinical interpretation that the patient may be experiencing hypoxia or delirium (Correct answer)
The patient's vital signs from the morning
The patient's history of dementia

Correct answer: The nurse's clinical interpretation that the patient may be experiencing hypoxia or delirium

The Assessment component of SBAR contains the nurse's clinical judgment about what is happening with the patient.

National Exit Test (NExT)

The National Exit Test (NExT) is a standardized licensing examination mandated for all MBBS graduates in India, replacing NEET-PG and FMGE. It assesses clinical knowledge, patient care competency, and medical skills required to obtain a license to practice medicine in India.

120

Questions

180 min

Time Limit

50%

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