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Fundamentals of Nursing · Fundamentals of Nursing NCLEX Practice Quiz

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Showing all 15 practice questions with expert explanatory rationales.

Question 1 of 15

Case excerpt

A patient develops sudden facial droop and unilateral weakness; the family gives a precise time the patient was last normal.

Which nursing action is the priority?

A. Document the finding without intervening
B. Ask the patient to manage the problem independently
C. Activate the stroke response and communicate the last-known-well time.
D. Wait until the next routine round
E. Continue the current plan without reassessment

Expert Explanatory Rationale

Correct Answer: C. Activate the stroke response and communicate the last-known-well time.

The last-known-well time is essential to time-sensitive stroke decisions.

Question 2 of 15

Case excerpt

A bedbound patient has nonblanchable redness over the sacrum.

What is the most appropriate nursing response?

A. Ignore the finding if the patient is alert
B. Offload pressure and implement an individualized pressure-injury prevention plan.
C. Delay escalation until symptoms worsen
D. Perform an intervention outside the prescription
E. Reassure the patient without completing an assessment

Expert Explanatory Rationale

Correct Answer: B. Offload pressure and implement an individualized pressure-injury prevention plan.

Nonblanchable redness may indicate a stage 1 pressure injury; pressure relief is essential.

Question 3 of 15

Case excerpt

A peripheral IV site is cool, swollen, pale, and painful.

Which action should the nurse take first?

A. Repeat the same action without checking the patient's response
B. Postpone follow-up until the next shift
C. Change the treatment without an order
D. Ask an untrained person to make the clinical decision
E. Stop the infusion and assess for infiltration.

Expert Explanatory Rationale

Correct Answer: E. Stop the infusion and assess for infiltration.

These findings are consistent with infiltration and require stopping the infusion.

Question 4 of 15

Case excerpt

A patient coughs repeatedly while drinking thin liquids after a stroke.

Which intervention best addresses the immediate concern?

A. Encourage activity that may worsen the condition
B. Stop oral intake and follow the swallowing-safety plan.
C. Skip the required safety check
D. Discontinue monitoring
E. Give an unrelated medication

Expert Explanatory Rationale

Correct Answer: B. Stop oral intake and follow the swallowing-safety plan.

Coughing with swallowing may indicate aspiration and requires reassessment.

Question 5 of 15

Case excerpt

A urine culture is ordered for a patient with an indwelling urinary catheter.

What should the nurse do next?

A. Proceed without verifying the order
B. Collect the specimen aseptically from the disinfected sampling port.
C. Assume the finding is expected
D. Wait for the next appointment
E. Provide advice unrelated to the clinical problem

Expert Explanatory Rationale

Correct Answer: B. Collect the specimen aseptically from the disinfected sampling port.

Urine from the drainage bag may be stagnant or contaminated.

Question 6 of 15

Case excerpt

A patient taking an anticoagulant reports black stools and dizziness.

Which nursing action is the priority?

A. Assess promptly and notify the provider about possible bleeding.
B. Document the finding without intervening
C. Ask the patient to manage the problem independently
D. Wait until the next routine round
E. Continue the current plan without reassessment

Expert Explanatory Rationale

Correct Answer: A. Assess promptly and notify the provider about possible bleeding.

Melena and dizziness may indicate gastrointestinal hemorrhage.

Question 7 of 15

Case excerpt

A patient becomes lightheaded when standing after several days of bed rest.

What is the most appropriate nursing response?

A. Ignore the finding if the patient is alert
B. Reassure the patient without completing an assessment
C. Delay escalation until symptoms worsen
D. Perform an intervention outside the prescription
E. Assist the patient to sit or lie down and reassess.

Expert Explanatory Rationale

Correct Answer: E. Assist the patient to sit or lie down and reassess.

Orthostatic symptoms increase fall risk and require safe positioning.

Question 8 of 15

Case excerpt

A medication administration record conflicts with the patient's documented severe allergy.

Which action should the nurse take first?

A. Hold the medication and clarify the order before administration.
B. Ask an untrained person to make the clinical decision
C. Change the treatment without an order
D. Repeat the same action without checking the patient's response
E. Postpone follow-up until the next shift

Expert Explanatory Rationale

Correct Answer: A. Hold the medication and clarify the order before administration.

Potential allergy conflicts must be resolved before exposure.

Question 9 of 15

Case excerpt

A new colostomy stoma appears dusky and nearly black.

Which intervention best addresses the immediate concern?

A. Discontinue monitoring
B. Report the color change promptly for urgent evaluation.
C. Skip the required safety check
D. Give an unrelated medication
E. Encourage activity that may worsen the condition

Expert Explanatory Rationale

Correct Answer: B. Report the color change promptly for urgent evaluation.

A healthy stoma is moist and pink to red; dusky or black tissue may indicate impaired perfusion.

Question 10 of 15

Case excerpt

A patient on contact precautions needs assistance with personal care.

What should the nurse do next (Select all that apply)?

A. Ignore a new warning sign
B. Assess the patient and relevant clinical findings
C. Follow the prescribed plan or facility protocol
D. Change a prescription independently
E. Communicate the concern to the appropriate clinician

Expert Explanatory Rationale

Correct Answer: B. Assess the patient and relevant clinical findings; C. Follow the prescribed plan or facility protocol; E. Communicate the concern to the appropriate clinician

Correct PPE and hand hygiene reduce transmission.

Question 11 of 15

Case excerpt

A patient with diabetes is alert, shaky, and has a glucose of 58 mg/dL.

Which nursing action is the priority (Select all that apply)?

A. Clarify an unclear order before proceeding
B. Ignore a new warning sign
C. Change a prescription independently
D. Reassess the patient's response
E. Use appropriate safety precautions

Expert Explanatory Rationale

Correct Answer: A. Clarify an unclear order before proceeding; D. Reassess the patient's response; E. Use appropriate safety precautions

An alert patient who can swallow can usually receive oral rapid-acting carbohydrate.

Question 12 of 15

Case excerpt

A patient with a nasogastric tube has a changed external tube marking and new nausea.

What is the most appropriate nursing response (Select all that apply)?

A. Provide patient or caregiver teaching
B. Monitor for complications
C. Change a prescription independently
D. Ignore a new warning sign
E. Use the correct equipment and technique

Expert Explanatory Rationale

Correct Answer: A. Provide patient or caregiver teaching; B. Monitor for complications; E. Use the correct equipment and technique

A changed marking may indicate displacement; blind advancement is unsafe.

Question 13 of 15

Case excerpt

A patient with oxygen prescribed by nasal cannula reports increased breathlessness.

Which action should the nurse take first (Select all that apply)?

A. Change a prescription independently
B. Communicate the concern to the appropriate clinician
C. Follow the prescribed plan or facility protocol
D. Assess the patient and relevant clinical findings
E. Ignore a new warning sign

Expert Explanatory Rationale

Correct Answer: B. Communicate the concern to the appropriate clinician; C. Follow the prescribed plan or facility protocol; D. Assess the patient and relevant clinical findings

Oxygen is a medication and should be adjusted within prescribed parameters.

Question 14 of 15

Case excerpt

A patient receiving an opioid is difficult to arouse and has slow respirations.

Which intervention best addresses the immediate concern (Select all that apply)?

A. Ignore a new warning sign
B. Reassess the patient's response
C. Clarify an unclear order before proceeding
D. Change a prescription independently
E. Use appropriate safety precautions

Expert Explanatory Rationale

Correct Answer: B. Reassess the patient's response; C. Clarify an unclear order before proceeding; E. Use appropriate safety precautions

Opioid-related respiratory depression is a medical emergency.

Question 15 of 15

Case excerpt

A patient is prescribed 1,000 mL of IV fluid over 8 hours.

What should the nurse do next?

Expert Explanatory Rationale

Correct Answer: 125

1,000 mL divided by 8 hours equals 125 mL/hr.

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