In April 2023, the NCSBN released a revamped NCLEX to the world—the Next Generation NCLEX (NGN)—compelling nursing students/grads just like you to rethink your studying strategies! (To learn more about the way NGN questions differ from the previous generation exam, check out: What to expect from Next Generation NCLEX.)

So, to help you adapt and prepare, the team here at Brainscape joined forces with NCLEX prep expert Justine Buick ( who has crafted from scratch a collection of Next Gen NCLEX practice questions, which you'll see shortly.

Combined with our digital flashcards for the NCLEX-RN and NCLEX-PN licensing exams, these constitute a powerful resource you can lean on to take your NCLEX prep to the next level!

Brainscape's NCLEX Nursing course dashboard, flashcard question and answer, and progress meter
Through its engaging and colorful user interface, Brainscape’s flashcards deliver facts in short question-and-answer pairs. These are neatly organized into decks, which you can study anytime, anywhere, online or off.

These flashcards have been carefully curated and vetted to offer nurse students a hyper-efficient way to drill the enormous amounts of content they need to learn and remember in order to answer the more complex questions posed by Next Generation NCLEX questions.

And if you're still in nursing school, check out our flashcards for all the topics you'll be learning: Pediatrics flashcards, Adult Health flashcards, Pharmacology flashcards, Management of Care flashcards, Maternity flashcards, Mental Health flashcards, and Safety & Infection flashcards.

Now, let’s dive into some Next Generation NCLEX practice questions with, first, a brief aside on the difference between standalone and case study questions...

Standalone vs case study NGN questions

The NCLEX poses questions either as “stand-alone” questions or as “case studies”. In the case of the former, they are—as their name suggests—one-off, discrete questions. Once you finish answering them, you move on to the next question, which isn’t at all related. 

Case studies, on the other hand, ask a series of questions based on the same patient/case and so it serves you to bear in mind your previous answers and maintain a degree of cohesiveness as you work through them.

The first Next Generation NCLEX practice question we’ll be tackling, however, is a standalone bowtie. This is one of the more common types of standalone questions on the NCLEX, which very simply gives you a patient scenario and then you have one question that you have to answer.

Let’s go!

NGN Practice Question:
Standalone Bowtie

The nurse is caring for a 67-year-old client in the cardiac care unit. The nurse documents the following data in the Nurses’ Notes.

Nurses' Notes

1530: Client was admitted 2 days ago for a scheduled coronary artery bypass graft (CABG) x 2 vessels. No complications during surgery and recovered in the ICU overnight. Client transferred out of the ICU this morning to the cardiac care unit. History of coronary artery disease, hypertension, hyperlipidemia, and osteoporosis. Assessment findings are as follows: alert and oriented x 3; denies shortness of breath, sore throat or cough, lungs clear bilaterally; irregular heart rhythm auscultated, denies chest pain, skin is warm to touch, cap refill < 3 seconds, no edema and peripheral pulses 2+ and equal bilaterally; denies nausea/vomiting, bowel sounds active x 4 quadrants, reports passing flatus and last bowel movement was the morning of surgery; indwelling foley catheter was discontinued this morning and has been voiding clear, yellow urine without complications; up to bathroom 2 times with assistance; gait steady. Client is currently sitting at bedside and reporting a "racing heartbeat" and "feeling faint". Vital signs are HR 142 beats/min, BP 116/78, RR 18 breaths/min, pulse oximetry 96% on room air, and temperature 98.4 F (36.9 C).

Complete the diagram by selecting from the choices below to specify which potential condition the client is most likely experiencing, 2 actions the nurse takes to address that condition, and 2 parameters the nurse monitors to assess the client's progress.

For the answers...

Simply sign up for Brainscape's nursing flashcard collections (below) and we'll send the detailed answer and rationale to your inbox! These flashcards are FREE to sign up for; and you can study a certain number of them before being asked to subscribe. But for full access to the Brainscape study experience, which will help you prepare for the NCLEX so much more efficiently, sign up for pro.

NGN Practice Question: Case Study

Now, let's try another type of NGN question: the case study, which, if you remember what we previously explained, poses a series of questions based on the same patient/case. So remember to bear in mind your previous answers and maintain a degree of cohesiveness as you work through them!

The nurse is caring for an older adult in the intermediate care unit.

Nurses' Notes

1000: Client admitted with an exacerbation of chronic obstructive pulmonary disease (COPD). Client has used home oxygen at 3 L/minute by nasal cannula for 4 years but reports increased dyspnea over the last several days. Client increased portable oxygen to 5 L/minute. Currently, the client is fatigued but alert and oriented x 3. Client reports shortness of breath at rest, increased coughing and large amounts of thick, tan sputum. Client has labored breathing and is in the tripod position. Lung sounds with wheezes bilaterally. S1 and S2 heart sounds heard, no murmur or gallop noted. Vital signs obtained. Healthcare provider in to see client and admission laboratory tests completed. Respiratory therapist was in to obtain ABGs.

Vital Signs

Lab Results

The nurse assesses the client, obtains the vital signs and reviews the laboratory results. 1. Which laboratory findings require follow-up? Select all that apply.

2. The nurse reviews the assessment findings and laboratory results. For each client finding, click to select the finding that is most consistent with the condition of hypercapnia or hypoxemia. Each finding may support more than one condition.

3. Complete the following sentence by choosing from the list of options.The client is at highest risk for developing [Option 1] as evidenced by the client's [Option 2].

4. For each finding below, choose the potential nursing intervention that is appropriate for the nurse to include in the plan of care. Each finding may support more than one intervention.

The nurse reviews the healthcare provider's orders.


  • Continuous pulse oximetry monitoring
  • Oxygen via venturi face mask, titrate to maintain pulse ox >88% • collect sputum culture for culture and sensitivity
  • Repeat ABGs at 1800 today
  • X-ray of chest today
  • Medications
    • albuterol 2.5 mg via inhaler three times a day
    • fluticasone 88 mcg via inhaler three a day guaifenesin 400 mg PO every 4 hours

5. What teaching points does the nurse provide regarding the inhaled medications? Select 3 teaching points.

The nurse assesses the client after implementing the healthcare provider's orders. 

6. Check whether the assessment findings indicate that the client’s condition is either Improved/Stable or Not Improved.

NGN Case Study Answers

For the full answers and rationale, include video explanations, simply sign up for Brainscape’s Nursing Fundamentals flashcards (for nursing school) or our certified NCLEX-RN or NCLEX-PN flashcards, which offer you a hyper-efficient way to drill the enormous amounts of content you need to learn in order to answer the more complex questions posed by Next Generation NCLEX questions. (And YES, they’re fully Next Generation NCLEX aligned.)

Brainscape's NCLEX Flashcards Dashboard (Web)
Brainscape's web dashboard for our certified NCLEX flashcards, which cover everything you need to know in each of the 8 major NCLEX subject areas.

Once you've signed up, we'll email you the answers. (By the way, these flashcards are FREE to sign up for; and you can study a certain number of them before being asked to subscribe.)

Finally, for truly excellent advice on excelling in nursing school, taking the NCLEX, and beyond, make sure you follow Brainscape Nursing on YouTube and check out our free Academy of articles and nursing guides!