NCLEX Practice Test 1

Which of the following situations is an example of negligence?

The charge nurse implements a change in the nursing assistant’s job description. The change increases the nursing assistant’s responsibilities. A nurse with 20 years of service on the unit verbally agrees to the change, but her behaviors indicate otherwise. Which of the following actions by the charge nurse is MOST appropriate?

The nursing team consists of one RN, two LPNs, and one nursing assistant. The nurse determines that assignments are appropriate if the nursing assistant is assigned to which of the following patients?

A nurse’s aide comes to the nurse and expresses concerns about a patient’s T-tube. The aide says, “I’m kind of worried because it’s drained 700mL over the course of our shift. That’s a lot!” Which of the following responses does the nurse give to the aide?

A patient is diagnosed with a DVT. Which of the following, if stated by a UAP (Unlicensed Assistive Personnel), requires intervention by the nurse?

The nurse cares for children at a daycare. On a hot summer day, four children return from recess with various complaints. Which of the following children should the nurse see FIRST?

The charge nurse in the emergency department receives a call that four patients will be arriving immediately with various injuries. Based on the following reports, order the patients from first to last to be seen.

The nurse changes a dressing on a client with an abdominal wound with a Penrose drain in place. What priority information should the nurse chart about this procedure?

An older client is admitted to the cardiac floor for new-onset atrial fibrillation. As the nurse is gathering admission history on the client, the client states, “Did you know that they can keep people alive even after they’re brain dead? I never want to end up on those breathing machines.” Which of the following questions should the nurse ask NEXT?

The nurse on a locked psychiatric unit is administering morning medications to a patient with schizophrenia. The patient refuses and says, “I’m not going to take that!” What is the nurse’s BEST response?

The nurse in an emergency room receives a call from an ambulance alerting that a bomb has gone off in a nearby shopping center and a minimum of forty victims will be arriving shortly for medical care. What action should the nurse take NEXT?

The nurse supervises a UAP (unlicensed assistive personnel) assist a legally blind patient with their meal at dinner time. What action, if performed by the UAP, is correct?

A nursing assistant on the nurse’s unit was injured 4 months ago in a fire. Her right leg was badly burned. She has just been cleared for work by a rehabilitation facility, but she walks with a prominent limp and an extremely unsteady gait. The nursing assistant wants to return to work on her unit, which has a critical care level of acuity. To assist the nursing assistant, the nurse should take which of the following actions?

The nurse cares for four clients in labor on the maternity unit. Which of the following patients should the nurse see FIRST?

The nurse notices a significant increase in the number of patients admitted to the medical/surgical unit who do not have ID bracelets on their wrists. Instead, the ID bracelets are taped to the chart and are often lost in the process. Which of the following actions, if taken by the nurse, is BEST to resolve this issue?

Two days after a coronary artery bypass graft (CABG), a patient is sitting up in a chair by the side of the bed. The nurse walks in and discovers the patient is cold, pale, and responds only to tactile stimulation. Which of the following actions does the nurse take NEXT?

The nurse is caring for a patient with pneumonia using ________ precautions.

The home health nurse visits the home of a client diagnosed with moderate-stage Alzheimer’s disease. The patient is pleasantly confused and lives with his son-in-law and daughter. Which of the following observations, if made by the nurse, is MOST concerning?

The nurse on the surgical unit receives a call from the operating room to administer a preoperative medication to a client scheduled for surgery. After giving the ordered medication, the nurse discovers the consent form for the surgery has not been signed. Which of the following actions should the nurse take NEXT?

The nurse at the daycare center observes children playing on the playground. The nurse is MOST concerned if which of the following is observed?

After a cardiac catheterization, the nurse instructs the patient to lie in which of the following positions?

A patient is scheduled for a cardiac catheterization this afternoon. Which of the following, if noted in the patient’s chart by the nurse, is a contraindication to the test?

The nurse is caring for a client after an ECT treatment. The nurse is MOST concerned if which of the following is observed?

A patient comes into the ER with the complaint of inability to void. The nurse performs a bladder scan and receives a result of 2,000 mL. The nurse prepares to catheterize the patient and knows that the most important part of the procedure relies on:

The nurse is caring for a patient with Meniere’s disease. The nurse knows that the most important consideration in regard for patient safety is to:

The nurse supervises care of a client who is receiving enteral feeding via a nasogastric tube. The nurse determines that care is appropriate if which of the following is observed?

SELECT ALL THAT APPLY:

Which of the following materials would the graduate nurse require to test the function of a patient’s glossopharyngeal nerve?

A patient with rheumatoid arthritis complains to the nurse that exercise is very painful for her. What does the nurse recommend to the patient?

A five-month-old boy is brought to the clinic by his parents for a routine visit. Which of the following observations would require an intervention by the nurse?

The nurse is discharging a patient who had recurrent kidney stones. Which of the following statements, if made by the patient to the nurse, would be considered correct?

SELECT ALL THAT APPLY:

The nurse teaches a 20-year-old female how to perform SBE (self breast exams). Which of the following instructions, if given by the nurse, is INCORRECT?

On a psychiatric unit, the preferred milieu environment is BEST described as:

The nurse cares for a client diagnosed with conversion reaction. The nurse identifies the client is utilizing which of the following defense mechanisms?

A 22-year-old patient and her husband come to the ER after a fall down the stairs. The patient has a black eye, avoids looking at the nurse, and gives yes/no answers to the nurse’s assessment questions. Which of the following actions should the nurse take NEXT?

A client comes to the local clinic complaining that sometimes his heart pounds and he has trouble sleeping. The physical exam is normal. The nurse learns that the client has recently started a new job with expanded responsibilities and is worried about succeeding. Which of the following responses by the nurse is BEST?

The nurse observes that a preschooler who was admitted to the unit three days ago has enuresis. His mother is very upset and says, “But he hasn’t done that in years!” Which of the following responses, if made by the nurse to the mother, is MOST appropriate?

The nurse cares for a ninety-two year-old patient whose wife recently passed away. Which of the following statements, if made by the patient to the nurse, requires further investigation?

Which of the following situations on a psychiatric unit are an example of a trusting patient-nurse relationship?

A patient with Cushing’s disease asks the nurse to help him choose a meal for dinner later. Which of the following meals is the best option?

A 67-year-old client is seen in the outpatient clinic for complaints of perineal irritation due to frequent incontinence. Which of the following measures, if suggested to the client by the nurse, is BEST?

SELECT ALL THAT APPLY:

The nurse on the medical/surgical unit cares for an elderly client two days after hip replacement surgery. The nurse asks the client if she is in pain. The client responds, “I am just fine.” Which of the following responses by the nurse is MOST appropriate?

The nurse performs discharge teaching for a client with a left leg cast who will be using crutches to ambulate. Which of the following statements, if made by the patient to the nurse, would require further teaching?

A nurse assesses the health of a 78 year-old male patient at his annual wellness check-up. Which of the following statements, if spoken by the patient, would be considered normal and EXPECTED?

SELECT ALL THAT APPLY:

A client with baseline decreased mental status is ordered to receive a tube feeding. The nurse knows the best position for the patient once the feeding has finished is:

The nurse receives a call from a patient with type one diabetes. The patient asks for exercise guidelines in regard to eating and insulin administration. Which of the following instructions are MOST appropriate for the nurse to give to the patient?

SELECT ALL THAT APPLY:

A patient with diverticulitis asks the nurse what meal choice in the cafeteria is best for him to eat today. The nurse helps him select which choice of the following:

The nurse gives discharge teaching to a patient going home on Doxycycline. Which of the following patient statements, if made by the patient to the nurse, requires further teaching?

SELECT ALL THAT APPLY:

The nurse notes that a physician new to the hospital’s computer system has input three out of four orders INCORRECTLY for a patient. Which of the following medications is CORRECT for a patient with the following criteria: Diabetes Insipidus, Dehydration, Hypertension.

A graduate nurse prepares a patient to undergo a liver biopsy. The graduate nurse administers what pre-op medication?

The physician has ordered an I.V. of 5% dextose in Lactated Ringers solution at 125mL/hr. The I.V. tubing available delivers 10 drops per mL. At how many drops per minute will the Lactated Ringers infuse?

A primipara is in the transition phase of labor on the maternity unit. On the fetal heart monitor, the nurse observes a contraction begin. Shortly after a delay, the fetal heart rate dips. It only recovers after the contraction has already been ended for a period of 30 seconds. Please place the following actions in order from first to last.

A nurse is caring for a patient with 2nd degree burns all over her body. The nurse knows that which of the following measures is appropriate when the patient is prescribed application of silver sulfadiazine cream?

SELECT ALL THAT APPLY:

A patient with tuberculosis asks why he must take two drugs for his one disease. The nurse explains that:

A patient on the psychiatric unit has been taking Haldol for three days as ordered by the physician. During the nurse’s shift, she enters the patient’s room to find the patient in a prolonged muscle spasm, with his eyes looking upward, and a fever of 103.5 degrees. Which of the following actions, if performed by the nurse, would be considered CORRECT?

SELECT ALL THAT APPLY:

A patient has the following medication orders: Pantaprozole 40mg PO qAM, Metoprolol 50mg PO bid, Lorazepam 0.5mg PO now, Albuterol 1 puff PRN. The patient’s medical history includes high cholesterol and asthma. Which of the orders should the nurse question?

A patient takes Nardil for depression and is confused by the dietary restrictions and allowances that are required with the medication. Which food on the list below is NOT permitted when taking Nardil?

SELECT ALL THAT APPLY:

A patient comes to the ER complaining of joint pain that began in his great toe. Which of the following risk factors, if seen in the patient’s history, does the nurse suspect triggered the patient’s condition?

The nurse enters a patient’s room and observes via the monitor that their vital signs are as follows: blood pressure 80/42, heart rate 118, respirations 32. The nurse will place the patient in which of the following positions?

The incoming nurse received the day’s endorsement for her assigned clients. One particular client needs to be monitored for signs of thyroid storm. Which of the following are considered signs of thyroid storm?

SELECT ALL THAT APPLY:

A patient with a suspected broken femur begins to experience tachycardia, shortness of breath, and chest pain. Which of the following actions should the nurse take NEXT?

A patient with a crush injury to her right arm calls the nurse and requests pain medicine, which the nurse administers as ordered. An hour later, the patient is still complaining of intense pain. Which of the following actions does the nurse take next?

A six-year-old boy with a casted left leg rings his call bell. Which of the following statements, if made by the nurse, requires an immediate intervention?

Which of the following skin manifestations in an infant MOST concerns the nurse?

A primigravida at term is admitted to the birthing room in active labor. Later, when the client is 8 cm dilated, she tells the nurse that she has the urge to push. The nurse instructs her to pant-blow at this time because pushing could:

A nurse is teaching a patient with type one diabetes about measures to prevent long-term complications of the disease. The nurse should include which of the following instructions?

A patient is admitted to the cardiac intensive care unit following diagnosis of a myocardial infarction. Please order the following actions from first to last.

A patient begins hyperventilating due to a panic attack. The registered nurse knows that the correct intervention is to:

The lab results are now available for a nurse caring for a patient with Addison’s disease. Which of the following results are UNEXPECTED in this patient?

A patient at the outpatient clinic describes leg pain that occurs while walking and is relieved with rest. The patient asks why this happens to him. The nurse knows that the pain is related to:

The nurse in the outpatient clinic reviews the history of a client recently diagnosed with essential hypertension. The nurse is MOST concerned if the client states which of the following?

A patient with Addison’s disease knows to eat foods that are high in sodium but are low in _____.

After a female patient has completed six months of multidisciplinary treatment for anorexia nervosa, the nurse evaluates whether the patient has met the goal of balanced nutrition sufficient to meet metabolic demands. Which of the following is the BEST indicator that the goal has been met?

The nurse cares for a client who suffered a severe eye injury related to an acid splash. The nurse administers proparacaine hydrochloride (Ophthaine) before each eye examination. It is MOST important for the nurse to take which of the following actions?

The nurse cares for a patient with myasthenia gravis. Which of the following is a symptom that is NOT typically part of the disease?

A patient with glaucoma asks the nurse what he can do to improve his vision. The nurse knows that: