[Interactive: NGN Practice Question Set — All 6 Item Types with Clinical Judgment Framework Overlay]
NGN Item Type Practice Set
Work through one question from each of the 6 NGN item types. Each includes a strategy tip specific to that format.
Type 1: Extended Multiple Response
Question 1
[Extended Multiple Response] A client is admitted with acute pancreatitis. Select the TWO interventions that are MOST appropriate.
✓ Correct: Administer IV fluids as ordered
NGN Strategy: In Extended Multiple Response, evaluate each option independently. Correct: IV fluids (A — essential for fluid replacement), knee-chest position (C — reduces pain), monitor amylase/lipase (D — monitors disease progression). Incorrect: Oral intake (B — NPO is standard for acute pancreatitis to rest pancreas), warm compresses (E — heat can increase inflammation). Partial credit: choosing A, C, D earns full marks; choosing A, C earns partial.
NGN Strategy: In Extended Multiple Response, evaluate each option independently. Correct: IV fluids (A — essential for fluid replacement), knee-chest position (C — reduces pain), monitor amylase/lipase (D — monitors disease progression). Incorrect: Oral intake (B — NPO is standard for acute pancreatitis to rest pancreas), warm compresses (E — heat can increase inflammation). Partial credit: choosing A, C, D earns full marks; choosing A, C earns partial.
Question 2
[Cloze/Drop-Down] The nurse is completing a nursing note for a client admitted with chest pain. Complete the following note by selecting the most appropriate option. The client reports ___ onset chest pain rated ___ out of 10, with radiation to the ___.
✓ Correct: sudden / 8 / left arm
NGN Strategy: Cloze items require completing clinical documentation accurately. Classic acute MI presentation is sudden onset, high intensity (8/10), radiating to left arm (or jaw). This question tests recognition of textbook vs. atypical MI presentations. Knowing the classic presentation is essential for correctly completing clinical documentation items.
NGN Strategy: Cloze items require completing clinical documentation accurately. Classic acute MI presentation is sudden onset, high intensity (8/10), radiating to left arm (or jaw). This question tests recognition of textbook vs. atypical MI presentations. Knowing the classic presentation is essential for correctly completing clinical documentation items.
Question 3
[Trend Item] Review the following vital sign trend for a post-operative client. 0800: BP 122/78, HR 80, SpO2 98%. 1200: BP 108/70, HR 92, SpO2 96%. 1600: BP 94/62, HR 110, SpO2 94%. Which assessment finding best explains this trend?
✓ Correct: The client is experiencing post-operative haemorrhage
NGN Strategy: Trend items test the ability to interpret sequential data. The trend shows progressively declining BP, rising HR (compensatory tachycardia), and declining SpO2 — classic hypovolaemic shock pattern suggesting post-operative haemorrhage. The timeline (4+ hours post-op) and the pattern of declining BP + rising HR without fever suggests bleeding rather than sepsis (which typically involves fever) or PE (which causes sudden SpO2 drop).
NGN Strategy: Trend items test the ability to interpret sequential data. The trend shows progressively declining BP, rising HR (compensatory tachycardia), and declining SpO2 — classic hypovolaemic shock pattern suggesting post-operative haemorrhage. The timeline (4+ hours post-op) and the pattern of declining BP + rising HR without fever suggests bleeding rather than sepsis (which typically involves fever) or PE (which causes sudden SpO2 drop).
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