NUR 254 Exam 1 (Galen College of Nursing) Practice Test 2026 |
100 NCLEX-Style Questions with Answers & Rationales
(Fundamentals of Nursing Study Guide)
1. A nurse is assessing an adult patient in a medical-surgical unit and
obtains the following vital signs. Which finding should be reported
immediately to the healthcare provider?
A. Temperature 98.9°F with mild fatigue
B. Respiratory rate 18 breaths per minute and unlabored
C. Blood pressure 88/54 mmHg with dizziness and weakness
D. Heart rate 76 beats per minute and regular rhythm
✔️ Answer: C
Explanation: A blood pressure of 88/54 mmHg with symptoms such as
dizziness and weakness indicates possible hypotension and impaired tissue
perfusion, which may signal shock or fluid volume deficit requiring immediate
intervention.
2. During patient teaching, a nurse uses therapeutic communication
techniques to encourage expression of feelings. Which statement is the
most appropriate example?
A. “You really should not be feeling that way at all.”
B. “Why didn’t you follow your treatment plan correctly?”
C. “Tell me more about what you are experiencing right now.”
D. “Everything will work out fine, so don’t worry.”
✔️ Answer: C
Explanation: Open-ended statements such as inviting the patient to describe
their experience promote therapeutic communication, trust, and emotional
expression.
,3. A nurse is caring for an elderly patient who has a high risk of falling due
to weakness and confusion. What is the most appropriate safety
intervention to implement first?
A. Apply wrist restraints to prevent movement
B. Keep the bed in the highest position for easier access
C. Place the bed in the lowest position with call light within reach
D. Encourage the patient to ambulate independently to build strength
✔️ Answer: C
Explanation: Lowering the bed reduces injury risk in case of a fall and is a
primary safety intervention for high-risk patients.
4. A nursing student is asked to identify the first step in the nursing
process when caring for a new hospitalized patient. Which action should
the student recognize as correct?
A. Developing a plan of care based on diagnosis
B. Collecting comprehensive patient assessment data
C. Evaluating effectiveness of interventions
D. Implementing prescribed nursing interventions
✔️ Answer: B
Explanation: Assessment is always the first step of the nursing process and
involves gathering subjective and objective data about the patient.
5. A nurse is preparing to perform hand hygiene in a clinical setting. Under
which condition is alcohol-based hand sanitizer considered inappropriate
for use?
,A. Before touching a clean wound dressing
B. After removing gloves following patient care
C. When hands are visibly contaminated with blood or body fluids
D. Before entering a patient’s room for assessment
✔️ Answer: C
Explanation: Alcohol-based sanitizers are not effective when hands are visibly
soiled; soap and water must be used instead.
6. A nurse is identifying patients at risk for pressure injuries during a shift
assessment. Which patient is at highest risk for developing a pressure
ulcer?
A. A fully ambulatory patient with good nutrition
B. A patient who independently repositions every two hours
C. A bedbound patient with limited mobility and poor nutrition
D. A patient recovering from minor surgery who walks daily
✔️ Answer: C
Explanation: Immobility and poor nutrition significantly increase the risk of
skin breakdown and pressure injury formation.
7. Before administering any medication to a patient, a nurse must follow
the “rights” of medication administration. Which action represents the
most critical first step in this process?
A. Confirming the correct medication dose
B. Checking the expiration date of the medication
C. Verifying the patient’s identity using two identifiers
D. Documenting medication administration in the record
, ✔️ Answer: C
Explanation: Patient identification using at least two identifiers is the first and
most critical safety step to prevent medication errors.
8. A nurse is caring for a patient experiencing shortness of breath and
difficulty maintaining oxygen saturation levels. Which position would be
most appropriate to promote breathing efficiency?
A. Supine position with legs elevated
B. Prone position lying flat on abdomen
C. High Fowler’s position with head elevated
D. Trendelenburg position with head lowered
✔️ Answer: C
Explanation: High Fowler’s position maximizes lung expansion and improves
oxygenation in patients with respiratory distress.
9. A patient refuses to take a prescribed medication stating, “I don’t think I
need this medication anymore.” What is the nurse’s priority response?
A. Document the refusal immediately in the chart
B. Notify the healthcare provider right away
C. Provide education about the purpose and benefits of the medication
D. Disregard the refusal and administer the medication anyway
✔️ Answer: C
Explanation: Patient education is the first appropriate response to address
refusal and ensure informed decision-making.
100 NCLEX-Style Questions with Answers & Rationales
(Fundamentals of Nursing Study Guide)
1. A nurse is assessing an adult patient in a medical-surgical unit and
obtains the following vital signs. Which finding should be reported
immediately to the healthcare provider?
A. Temperature 98.9°F with mild fatigue
B. Respiratory rate 18 breaths per minute and unlabored
C. Blood pressure 88/54 mmHg with dizziness and weakness
D. Heart rate 76 beats per minute and regular rhythm
✔️ Answer: C
Explanation: A blood pressure of 88/54 mmHg with symptoms such as
dizziness and weakness indicates possible hypotension and impaired tissue
perfusion, which may signal shock or fluid volume deficit requiring immediate
intervention.
2. During patient teaching, a nurse uses therapeutic communication
techniques to encourage expression of feelings. Which statement is the
most appropriate example?
A. “You really should not be feeling that way at all.”
B. “Why didn’t you follow your treatment plan correctly?”
C. “Tell me more about what you are experiencing right now.”
D. “Everything will work out fine, so don’t worry.”
✔️ Answer: C
Explanation: Open-ended statements such as inviting the patient to describe
their experience promote therapeutic communication, trust, and emotional
expression.
,3. A nurse is caring for an elderly patient who has a high risk of falling due
to weakness and confusion. What is the most appropriate safety
intervention to implement first?
A. Apply wrist restraints to prevent movement
B. Keep the bed in the highest position for easier access
C. Place the bed in the lowest position with call light within reach
D. Encourage the patient to ambulate independently to build strength
✔️ Answer: C
Explanation: Lowering the bed reduces injury risk in case of a fall and is a
primary safety intervention for high-risk patients.
4. A nursing student is asked to identify the first step in the nursing
process when caring for a new hospitalized patient. Which action should
the student recognize as correct?
A. Developing a plan of care based on diagnosis
B. Collecting comprehensive patient assessment data
C. Evaluating effectiveness of interventions
D. Implementing prescribed nursing interventions
✔️ Answer: B
Explanation: Assessment is always the first step of the nursing process and
involves gathering subjective and objective data about the patient.
5. A nurse is preparing to perform hand hygiene in a clinical setting. Under
which condition is alcohol-based hand sanitizer considered inappropriate
for use?
,A. Before touching a clean wound dressing
B. After removing gloves following patient care
C. When hands are visibly contaminated with blood or body fluids
D. Before entering a patient’s room for assessment
✔️ Answer: C
Explanation: Alcohol-based sanitizers are not effective when hands are visibly
soiled; soap and water must be used instead.
6. A nurse is identifying patients at risk for pressure injuries during a shift
assessment. Which patient is at highest risk for developing a pressure
ulcer?
A. A fully ambulatory patient with good nutrition
B. A patient who independently repositions every two hours
C. A bedbound patient with limited mobility and poor nutrition
D. A patient recovering from minor surgery who walks daily
✔️ Answer: C
Explanation: Immobility and poor nutrition significantly increase the risk of
skin breakdown and pressure injury formation.
7. Before administering any medication to a patient, a nurse must follow
the “rights” of medication administration. Which action represents the
most critical first step in this process?
A. Confirming the correct medication dose
B. Checking the expiration date of the medication
C. Verifying the patient’s identity using two identifiers
D. Documenting medication administration in the record
, ✔️ Answer: C
Explanation: Patient identification using at least two identifiers is the first and
most critical safety step to prevent medication errors.
8. A nurse is caring for a patient experiencing shortness of breath and
difficulty maintaining oxygen saturation levels. Which position would be
most appropriate to promote breathing efficiency?
A. Supine position with legs elevated
B. Prone position lying flat on abdomen
C. High Fowler’s position with head elevated
D. Trendelenburg position with head lowered
✔️ Answer: C
Explanation: High Fowler’s position maximizes lung expansion and improves
oxygenation in patients with respiratory distress.
9. A patient refuses to take a prescribed medication stating, “I don’t think I
need this medication anymore.” What is the nurse’s priority response?
A. Document the refusal immediately in the chart
B. Notify the healthcare provider right away
C. Provide education about the purpose and benefits of the medication
D. Disregard the refusal and administer the medication anyway
✔️ Answer: C
Explanation: Patient education is the first appropriate response to address
refusal and ensure informed decision-making.
