Free practice questions
NCLEX-RN / Management of Care
- The nurse receives handoff report on four clients on a surgical unit. Which client should the nurse assess first?
- A client is 3 days postoperative after an open bowel resection and is in stable condition. Which tasks can the registered nurse (RN) delegate to assistive personnel (AP)? Select all that apply.
- The nurse is about to witness a client's signature on the consent form for a laparoscopic cholecystectomy. The client says, "The surgeon said something about maybe needing a bigger cut, but I don't really understand why." Which action should the nurse take?
- A client with advanced amyotrophic lateral sclerosis has decision-making capacity and has named an adult son as health care agent in a durable power of attorney for health care. The client declines placement of a gastrostomy tube. The son tells the nurse, "I'm the health care agent, so the tube is going in." Which response by the nurse is most appropriate?
- Which actions by health care team members require the nurse to intervene to protect client privacy and confidentiality? Select all that apply.
NCLEX-RN / Safety and Infection Prevention and Control
- A client is admitted with diarrhea, and stool testing confirms Clostridioides difficile infection. Which actions should the nurse include in the client's care? Select all that apply.
- A client with suspected pulmonary tuberculosis is in an airborne infection isolation room and must be taken to the radiology department. Which action should the nurse take?
- A client with delirium who is receiving mechanical ventilation keeps reaching for the endotracheal tube despite less restrictive measures. Soft wrist restraints have been prescribed. Which actions by the nurse are appropriate? Select all that apply.
- At the start of a shift, a nurse notices that a colleague has slurred speech, an unsteady gait, and the odor of alcohol on the breath while preparing client medications. Which action should the nurse take first?
NCLEX-RN / Health Promotion and Maintenance
- The nurse is teaching the parents of a healthy 2-week-old infant how to reduce the risk of sleep-related infant death. Which instructions should the nurse include? Select all that apply.
- Eight hours after a vaginal birth, the nurse palpates the client's uterine fundus 2 cm above the umbilicus and displaced to the right. The fundus is firm, and the lochia is moderate rubra. Which action should the nurse take first?
- The nurse is providing anticipatory guidance to the parent of a 7-month-old infant who has no eczema or food allergies and has started eating solid foods. Which statement by the parent indicates a NEED FOR FURTHER TEACHING?
NCLEX-RN / Psychosocial Integrity
- The nurse is caring for a client who is hospitalized for major depressive disorder. Which findings should the nurse recognize as warning signs that require an immediate suicide risk assessment? Select all that apply.
- A client who had surgical repair of a hip fracture 2 days ago drinks about 10 alcoholic drinks a day; the last drink was 52 hours ago. The client is now disoriented to place and time, is picking at the air, and says insects are crawling on the walls. Vital signs: T 38.4°C (101.1°F), HR 126/min, BP 176/102 mm Hg, RR 24/min, SpO2 96% on room air; capillary blood glucose is 112 mg/dL. The client is diaphoretic and tremulous. Which prescription should the nurse implement first?
- A client who has just learned of a diagnosis of pancreatic cancer tells the nurse, "I did everything right. Why is this happening to me?" Which response by the nurse is most therapeutic?
NCLEX-RN / Basic Care and Comfort
- During a skin assessment of a client who is immobile, the nurse finds an open area over the sacrum with full-thickness skin loss. Subcutaneous fat is visible, and yellow slough covers part of the wound bed, but the depth of the wound can be seen. No bone, tendon, or muscle is visible or palpable. How should the nurse document this wound?
- The nurse is caring for an adult client receiving a continuous feeding through a nasogastric tube; tube placement was confirmed by radiograph when the tube was inserted. Which actions are appropriate? Select all that apply.
- A client with advanced dementia who cannot reliably report pain had surgical repair of a hip fracture yesterday. Which approach should the nurse use to assess the client's pain?
NCLEX-RN / Pharmacological and Parenteral Therapies
- A client with a serum potassium level of 3.0 mEq/L has a prescription for potassium chloride 10 mEq in 100 mL to infuse intravenously over 1 hour through a peripheral IV. Which actions should the nurse take? Select all that apply.
- At 0730, the nurse is preparing to give a client with type 1 diabetes the prescribed insulin lispro 6 units subcutaneously with breakfast. The client's capillary blood glucose is 146 mg/dL. The dietary department reports that the breakfast tray will be delayed until 0830. Which action should the nurse take?
- The nurse is teaching a client who has just been prescribed warfarin for atrial fibrillation. Which statements by the client indicate understanding of the teaching? Select all that apply.
- A client receiving IV hydromorphone after surgery was found difficult to arouse with a respiratory rate of 7/min. After naloxone 0.04 mg IV was given and repeated twice as prescribed, the client is arousable and the respiratory rate is 14/min. Which action is most important for the nurse to take next?
- [Case Study 1, Screen 2: 1000 nurses' notes, vital signs, prescriptions, and IV access.] Which action should the nurse take?
NCLEX-RN / Reduction of Risk Potential
- During a colonoscopy with moderate sedation using IV midazolam and fentanyl, the client's oxygen saturation drops from 97% to 86%. The client is snoring loudly, does not respond to voice, and has a respiratory rate of 8/min. Which action should the nurse take first?
- [Case Study 1, Screen 1: 0800 nurses' notes, vital signs, and 0815 laboratory results.] The nurse reviews the client's information. Select the findings that require follow-up. Select all that apply.
- [Case Study 1, Screen 3: 1300 nurses' notes, vital signs, and 1230 laboratory results.] For each finding, indicate whether it shows improvement or requires follow-up. Each row has one answer. Grid columns: Indicates improvement | Requires follow-up.
NCLEX-RN / Physiological Adaptation
- A client with type 1 diabetes is admitted with diabetic ketoacidosis. Initial results: blood glucose 486 mg/dL, arterial pH 7.15, serum bicarbonate 10 mEq/L, and serum potassium 3.1 mEq/L. A 0.9% sodium chloride IV bolus is infusing. Which prescription should the nurse clarify with the provider before implementing it?
- [Case Study 1, Screen 1.] For each finding, indicate whether it localizes the source of infection or indicates sepsis-related organ dysfunction or hypoperfusion. Each row has one answer. Grid columns: Localizes the source of infection | Indicates organ dysfunction or hypoperfusion.
- [Case Study 1, Screen 1.] Complete the sentence by choosing one option for each blank. The client is at highest risk for developing [Blank 1: options A-C] as evidenced by [Blank 2: options D-F].
- [Case Study 1, Screen 1.] The provider diagnoses sepsis with a suspected urinary source. Which interventions should the nurse anticipate in the initial management of this client? Select all that apply.