0/1 scoring · 30 questions in 6 sets
NCLEX Trend Practice Questions
Practice NCLEX trend questions: read vital signs and labs across time points and act on the change, with rationales. Sets 1 and 2 are free, with no sign-up.
The format
What is a Trend question on the NCLEX?
Trend items are standalone Next Generation NCLEX items that show client data over several time points: vital signs across a shift, daily weights, or serial lab results.
The question turns on the change over time, not any single value. Trend items can use any response format.
Practice sets
30 Trend questions in 6 sets
Each set covers one clinical topic and opens in the NCLEX-style test interface. Submit each answer to see the correct answer and a rationale for every option. Your progress and score are saved in this browser.
Neuro
Maternity
Pediatrics
Mental Health
Sample question
Try a Trend question
Open the sample to see the format on the exam screen, with the correct answer marked and the reason each option is right or wrong. To answer questions yourself, start a set above.
Sample question: answer and rationaleWhich action should the nurse take first?
The nurse in the medical unit is caring for a 24-year-old male client.
Which action should the nurse take first?
Correct answer and rationale
Trend · 0/1 scoring
The trend decides this item. Between 0200 and 0400 the wheezes went from loud to absent, but the client did not improve: the pulse oximetry reading fell from 96% to 86% on the same oxygen, the pulse rose from 118 to 134/min, and the client became drowsy, unable to speak and dusky. Wheezing can be absent when airflow is badly impaired, so wheezing that fades while the client looks worse signals impending respiratory failure, not recovery. A quiet chest, a drowsy client or a client too breathless to speak needs the rapid response team, because treatment may have to move on to IV magnesium sulfate and ventilation. Two albuterol treatments and a corticosteroid have not reversed the attack, so repeating the treatment or waiting for a prescription by telephone leaves the client without help at the bedside.
Takeaway: in an asthma attack, wheezing that disappears as the client grows drowsy is an emergency; call the rapid response team.
Why each option is right or wrong
- Let the client sleep and reassess in 1 hour.: Incorrect. Fewer wheezes alone are not improvement. Drowsiness with a quiet chest and a pulse oximetry reading of 86% on oxygen is a sign of impending respiratory failure, and waiting an hour delays help.
- Call the rapid response team to the bedside.: Correct. A quiet chest, drowsiness and being too breathless to speak mean that almost no air is moving, so the rapid response team is called now.
- Telephone the PHCP again and await new prescriptions.: Incorrect. The PHCP was told at 0300, and the client has become worse on the treatment prescribed then. Waiting for an answer by telephone does not bring help to the bedside; a quiet chest in a drowsy client needs the rapid response team.
- Give another nebulized albuterol treatment and reassess in 20 minutes.: Incorrect. Two albuterol treatments and a corticosteroid have not reversed the attack. Another 20 minutes without the team delays the next steps of treatment, which may be IV magnesium sulfate and ventilation.
Sources
- StatPearls: Status Asthmaticus
- NHLBI: Asthma Attacks
- NHLBI Expert Panel Report 3, Section 5: Managing Exacerbations of Asthma
- AHRQ PSNet primer: Rapid Response Systems
- StatPearls: Asthma (Nursing)
- Open RN Nursing Skills, 11.2 Basic Concepts of Oxygenation
- Open RN Nursing Skills, 11.4 Nursing Process Related to Oxygen Therapy
Scoring
How Trend questions are scored
Scored by the rule for the format used (0/1, +/- or rationale).
Scoring rules: NCSBN, Next Generation NCLEX. Last reviewed October 13, 2026.
How to answer Trend questions
- Look at the direction and speed of change, not just whether a value is in range.
- A normal value that is falling fast can matter more than a stable abnormal one.
- Connect changes across data sources, such as a rising heart rate alongside falling urine output.
FAQ
Trend questions: FAQ
What is a trend question on the Next Generation NCLEX?
How are NCLEX trend questions scored?
How do you answer a trend question?
Keep practicing
Other NCLEX question types
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Pick up the set you started, or go on to the next question type. Every set opens in the NCLEX-style test interface.
Ordered Response set 1 · Prioritization & Safety