NCLEX Practice Quiz
Questions: 16 · 10 minutes
1. Which measurement is generally the most useful for evaluating short-term fluid loss or gain in a child being treated for acute dehydration?
Body weight measured consistently over time
A single urine specific-gravity result
Skin color under room lighting
The child's stated preference for fluids
2. A nurse realizes that a patient received the wrong dose of an antihypertensive medication. What should the nurse do first?
Assess the patient's condition, including relevant vital signs
Complete the incident report before returning to the bedside
Ask the next-shift nurse to monitor for adverse effects
Document only the dose that was originally prescribed
3. Before administering prescribed digoxin to an adult, the nurse measures an apical pulse of 54 beats per minute. What is the most appropriate action?
Give the medication because the pulse is regular
Hold the dose and notify the prescribing clinician
Administer the dose and repeat the pulse measurement in one hour
Give half of the prescribed dose to reduce the risk of adverse effects
4. After providing care to a patient with Clostridioides difficile infection, which hand-hygiene action is most appropriate?
Use an alcohol-based hand rub until the hands feel dry
Wash thoroughly with soap and water
Wear a new pair of gloves instead of cleaning the hands
Use a surgical hand scrub for several minutes after every interaction
5. Which task is most appropriate for the registered nurse to delegate to trained unlicensed assistive personnel?
Teach a patient how to use a newly prescribed inhaler
Ambulate a stable patient who has already been assessed and has walked safely before
Evaluate whether pain medication relieved a patient's pain
Perform the initial assessment of a patient newly admitted with pneumonia
6. A competent patient is preparing to sign a surgical consent form but asks the nurse for more information about the procedure's risks. What is the nurse's appropriate role?
Provide the complete risk-benefit explanation and obtain the signature independently
Recommend whether the patient should proceed based on the nurse's personal judgment
Ask a family member to explain the procedure before the patient signs
Pause the signing, notify the responsible clinician, and witness the signature after the patient's questions are addressed
7. Fifteen minutes after a blood transfusion begins, a patient develops chills, back pain, and shortness of breath. What is the nurse's first action?
Slow the transfusion and reassess the patient in five minutes
Administer an antipyretic and continue the transfusion
Stop the transfusion immediately
Flush the existing blood tubing rapidly with dextrose solution
8. One hour after a vaginal birth, a patient has heavy lochia and a boggy, enlarged uterus. Which action should the nurse take first?
Place the patient in a warm bath to promote comfort
Prepare the patient for immediate surgical exploration
Massage the uterine fundus until it becomes firm
Delay intervention while weighing the next perineal pad
9. Which electrocardiogram finding is most consistent with hypokalemia?
Flattened T waves with prominent U waves
A consistently shortened QT interval
Tall, sharply peaked T waves
ST-segment elevation localized to neighboring leads
10. Which respiratory protection should a nurse wear when entering the room of a patient with suspected active pulmonary tuberculosis?
A standard surgical mask
A face shield without a mask
A positive-pressure respirator designed to direct room air toward the wearer
A fit-tested N95 or higher-level respirator
11. A patient several hours after a thyroidectomy suddenly develops loud inspiratory stridor and increasing restlessness. What should the nurse do first?
Place the patient flat and reassess the respiratory sounds in 15 minutes
Inspect the surgical dressing for a small amount of expected drainage
Administer the prescribed opioid because pain may be causing the restlessness
Support oxygenation, activate the rapid-response process, and prepare for emergency airway management
12. A nurse must mix regular insulin and NPH insulin in one syringe. Which sequence is correct?
Withdraw NPH insulin, inject air into regular insulin, and then withdraw regular insulin
Inject air into regular insulin, withdraw NPH insulin, and then withdraw regular insulin
Inject air into NPH, inject air into regular, withdraw regular, and then withdraw NPH
Inject air into NPH insulin, withdraw NPH insulin, and then withdraw regular insulin
13. An arterial blood gas shows pH 7.30, PaCO2 36 mm Hg, and bicarbonate 18 mEq/L. Which acid-base imbalance is indicated?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
14. A patient's chest tube becomes disconnected from the drainage system, but the tube remains in the patient's chest. What immediate action should the nurse take while obtaining a replacement system?
Clamp the chest tube and leave it clamped until the clinician arrives
Remove the chest tube and apply a loose dressing over the insertion site
Cover the open end of the chest tube with dry gauze and tape it closed
Place the patient-side end of the tube in sterile water to create a temporary water seal
15. A hospitalized patient begins having a generalized tonic-clonic seizure while in bed. Which action is most appropriate?
Turn the patient to the side when possible, protect the head, and clear nearby hazards
Restrain the patient's arms and legs to prevent injury
Offer water as soon as the jerking movements begin to slow
Insert a padded object between the patient's teeth
16. A patient newly diagnosed with cancer says, “I cannot stop thinking about what might happen to my family.” Which response best demonstrates therapeutic communication?
“Try not to think about the worst possibilities right now.”
“Tell me more about what concerns you most regarding your family.”
“You should discuss financial planning with your family immediately.”
“Everything will probably work out once treatment starts.”