NCLEX-RN Prep
Clinical judgment, NGN-style
Prepare for the Next Generation NCLEX-RN with prioritization, pharmacology, safety, delegation and full NGN case studies: matrix, cloze, highlight, ordering and bowtie items.
- Topics
- 25
- Questions
- 4046
- Case studies
- 5
What you'll cover
Open a topic to preview its key ideas, the Learn step of the Sharp method.
Clinical judgment
5 Q · 3 cardsRecognizing and analyzing cues, early warning signs.
5 questions with answers →Test this topic →Key ideas
- NGN items follow the Clinical Judgment Measurement Model: recognize cues → analyze cues → prioritize hypotheses → generate solutions → take action → evaluate outcomes.
- A finding matters most when it's new, changing, or outside the client's baseline.
- Early hypoxia: restlessness, anxiety, tachycardia, tachypnea. Late: cyanosis, bradycardia, decreased level of consciousness.
- Poor perfusion: new confusion, delayed capillary refill, low urine output (under 0.5 mL/kg/hr, about 30 mL/hr in adults).
Prioritization
4 Q · 3 cardsABCs, Maslow, acute vs chronic, who to see first.
4 questions with answers →Test this topic →Key ideas
- ABCs: airway, breathing, circulation. Then Maslow: physiological before safety before psychosocial.
- Acute beats chronic, unstable beats stable, actual beats potential.
- Unexpected findings (new chest pain, sudden dyspnea, acute confusion) come before expected ones (post-op pain, chronic baseline values).
- Hypoglycemia rule of 15: 15 g fast-acting carbohydrate, recheck in 15 minutes.
Pharmacology
206 Q · 205 cardsHigh-alert drugs, monitoring, antidotes, dosage calculation.
206 questions with answers →Test this topic →Key ideas
- Digoxin: check the apical pulse for a full minute; hold for HR under 60 in adults and report. Hypokalemia increases toxicity risk.
- Warfarin: monitor INR (commonly 2–3); keep vitamin K intake consistent; antidote vitamin K. Heparin: monitor aPTT; antidote protamine sulfate.
- Loop diuretics (furosemide): watch potassium, weight, intake and output, and orthostatic BP.
- Dosage calculation: desired ÷ have × quantity. Always check units.
Safety & infection control
4 Q · 5 cardsTransmission-based precautions, PPE, falls, restraints.
4 questions with answers →Test this topic →Key ideas
- Airborne (TB, measles, varicella): N95 respirator and an airborne infection isolation room (negative pressure).
- Droplet (influenza, pertussis, meningococcal disease): surgical mask within close range.
- Contact (MRSA, VRE, *C. difficile*): gown and gloves; for *C. diff*, soap-and-water hand hygiene and a sporicidal (bleach) cleaner.
- PPE on: gown → mask/respirator → goggles/face shield → gloves.
Delegation & assignment
3 Q · 3 cardsRN, LPN/LVN and AP roles, the five rights.
3 questions with answers →Test this topic →Key ideas
- Five rights: right task, right circumstance, right person, right directions and communication, right supervision and evaluation.
- RNs keep assessment, care planning, teaching and evaluation, and care of unstable clients.
- LPN/LVNs: stable clients with predictable outcomes, within state scope.
- Assistive personnel (AP/UAP): routine tasks such as vital signs on stable clients, hygiene, ambulation and intake and output.
NGN case studies
24 Q · 2 cardsUnfolding cases with a client record and six linked questions.
24 questions with answers →Test this topic →Key ideas
- Each case gives a client record (nurse's notes, vital signs, labs, orders) and six linked items, one per clinical judgment step.
- Read every tab first. Note what's abnormal and what's changing.
- Item types include highlight, matrix, drop-down cloze, select all that apply, drag-and-drop and bowtie.
- Partial credit: many NGN items score each correct choice, and some subtract for wrong choices (+/− scoring).
Adult health / medical-surgical nursing
200 Q · 200 cardsCardiac disorders, Emergency deterioration, Endocrine disorders, Gastrointestinal disorders, Hematologic disorders, Neurologic disorders
200 questions with answers →Test this topic →Anatomy & Physiology I/II
200 Q · 200 cardsCardiac conduction and perfusion, Endocrine regulation, Gastrointestinal digestion and absorption, Homeostasis and feedback loops, Immune and inflammatory response, Musculoskeletal structure and mobility
200 questions with answers →Test this topic →Chemistry or biochemistry basics
200 Q · 200 cardsAcids, bases, and pH, Buffers and bicarbonate, Drug solubility and absorption, Electrolyte charge and movement, Enzymes and metabolic pathways, Glucose metabolism
200 questions with answers →Test this topic →Clinical judgment / Next Gen NCLEX case studies
200 Q · 200 cardsAnalyze cues, Case study unfolding data, Evaluate outcomes, Generate solutions, Matrix and bow-tie item reasoning, Prioritize hypotheses
200 questions with answers →Test this topic →Community / public health nursing
200 Q · 200 cardsCommunicable disease reporting, Disaster preparedness, Environmental health, Epidemiology basics, Health disparities, Home health safety
200 questions with answers →Test this topic →Ethics, legal nursing, delegation, prioritization
200 Q · 200 cardsAdvance directives, Autonomy and informed consent, Beneficence and nonmaleficence, Confidentiality and HIPAA, Delegation rules, Justice and fairness
200 questions with answers →Test this topic →Health assessment
200 Q · 200 cardsAbdominal assessment, Cardiovascular assessment, Focused reassessment, General survey, Head and neck assessment, Musculoskeletal assessment
200 questions with answers →Test this topic →Informatics and healthcare technology
200 Q · 200 cardsAlarm safety, Barcode medication administration, Clinical decision support, Data accuracy, Electronic health record documentation, Informatics ethics
200 questions with answers →Test this topic →Leadership and management
200 Q · 200 cardsAssignment to LPN or RN, Change management, Conflict management, Delegation to assistive personnel, Incident reporting, Interprofessional communication
200 questions with answers →Test this topic →Maternal-newborn nursing
200 Q · 200 cardsBreastfeeding support, Fetal monitoring, Labor stages, Maternal emergencies, Newborn safety, Newborn transition
200 questions with answers →Test this topic →Microbiology
200 Q · 200 cardsAntimicrobial resistance, Bacteria, viruses, fungi, and parasites, Normal flora and opportunistic infection, Reservoirs and modes of transmission, Sepsis pathophysiology basics, Specimen collection and culture sensitivity
200 questions with answers →Test this topic →Nursing fundamentals
200 Q · 200 cardsDocumentation fundamentals, Elimination, Falls prevention, Hygiene and comfort, Mobility and positioning, Nursing process
200 questions with answers →Test this topic →Nutrition
200 Q · 200 cardsDiabetes nutrition teaching, Dysphagia and aspiration risk, Enteral nutrition, Hydration and fluid balance, Macronutrients, Malnutrition screening
200 questions with answers →Test this topic →Pathophysiology
200 Q · 200 cardsAcid-base imbalance, Clotting and bleeding disorders, Electrolyte imbalance, Endocrine dysfunction, Fluid volume excess and deficit, Hypoxia and impaired gas exchange
200 questions with answers →Test this topic →Pediatric nursing
200 Q · 200 cardsChild safety, Congenital disorders, Dehydration, Family-centered care, Growth and development, Immunizations
200 questions with answers →Test this topic →Professional nursing practice (clinical transition)
200 Q · 200 cardsCapstone transition, Clinical communication, Medication pass safety, Pre-clinical preparation, Preceptorship feedback, Professional behavior
200 questions with answers →Test this topic →Psychiatric / mental health nursing
200 Q · 200 cardsAnxiety disorders, Crisis intervention, Legal and ethical mental health care, Milieu safety, Mood disorders, Psychosis
200 questions with answers →Test this topic →Psychology / lifespan development
200 Q · 200 cardsAdolescent development, Family systems, Grief and coping, Infant development, Middle adult development, Older adult changes
200 questions with answers →Test this topic →Statistics or evidence-based practice
200 Q · 200 cardsBias and confounding, Clinical practice guidelines, Descriptive statistics, Levels of evidence, Outcome evaluation, Quality improvement indicators
200 questions with answers →Test this topic →
Question formats
Practice the formats you'll actually see. Clinical cases included.
- Fill in the blank · 2
- Select all that apply · 9
- Drop-down cloze · 5
- Ordering · 2
- Bowtie · 4
- Matrix / grid · 7
- Interview answer · 1
- Highlight text · 2
- Multiple choice · 4014
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