VIRTUAL ATI GREEN LIGHT PREDICTOR EXAM 150
Comprehensive NCLEX-Style Practice Questions with
Rationales MASTER EXAMINATION A Complete Review
for NCLEX-RN Readiness
SECTION 1: Safe & Effective Care Environment (Management of Care, Safety, Infection Control)
1. A nurse is preparing to transfer a client from a bed to a stretcher. Which of the following actions
should the nurse take to prevent musculoskeletal injury?
A. Keep feet together while lifting
B. Twist at the waist to reach the client
C. Use a friction-reducing slide sheet
D. Bend at the knees and keep the back straight
*Rationale: Bending at the knees and keeping the back straight uses the strong leg muscles and
maintains proper body mechanics, reducing the risk of back injury. Using a slide sheet also helps,
but proper body mechanics is the foundational principle.
2. A nurse is caring for a client on contact precautions. Which of the following actions is appropriate
when leaving the client's room?
A. Remove gloves and mask at the door
B. Remove gown and gloves in the anteroom
C. Remove PPE in the doorway and perform hand hygiene
D. Leave PPE on until exiting the unit
*Rationale: PPE should be removed at the doorway or in the anteroom to contain contaminants,
and hand hygiene must be performed immediately after removal. Masks are not always required
for contact precautions unless specified.
3. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is appropriate to
delegate?
A. Administering a tube feeding
, B. Assessing a post-operative incision
C. Measuring a client's intake and output
D. Teaching a client about insulin administration
*Rationale: Intake and output measurement is a routine, non-invasive task within the UAP's
scope of practice. Assessment, teaching, and tube feedings require licensed nursing judgment.
4. A client has a living will that declines resuscitation. The client's family member demands CPR. What
should the nurse do?
A. Call a code blue per the family's request
B. Ask the family to sign a consent form
C. Follow the living will and do not resuscitate
D. Call the ethics committee before acting
*Rationale: A living will is a legally binding document. The nurse must follow the client's
documented wishes. The provider should be notified, but the DNR order must be honored.
5. A nurse is caring for a client who is at risk for falls. Which intervention should the nurse implement
first?
A. Place a bed alarm
B. Keep the side rails fully up
C. Complete a fall risk assessment
D. Move the client closer to the nurse's station
*Rationale: Assessment is always the first step of the nursing process. A fall risk assessment
identifies specific risks so interventions can be tailored appropriately.
6. Which of the following clients should the nurse assign to a private room?
A. A client with pneumonia
B. A client with a wound infection
C. A client with active pulmonary tuberculosis
D. A client with a urinary tract infection
*Rationale: Active pulmonary TB requires airborne precautions, which necessitate a private
negative-airflow room. Pneumonia and wound infections (contact/droplet) may not always
require a private room.
7. A nurse is completing an incident report after a client falls. Which statement should the nurse
document in the chart?
A. "Client fell due to staff negligence"
B. "Client was trying to get up alone"
, C. "Client found on floor beside the bed at 0900."
D. "Client fell because the bed alarm was off"
*Rationale: Charting must be objective, factual, and free of blame or assumptions. Documenting
only what was observed (client on floor) is legally correct.
8. A nurse is preparing to administer a blood transfusion. Which action is most important prior to
starting the transfusion?
A. Assess the IV site for patency
B. Warm the blood to body temperature
C. Verify the client's identity and blood compatibility with another nurse
D. Pre-medicate with diphenhydramine
*Rationale: Verifying client identity and blood compatibility (two-nurse check) is the most critical
safety step to prevent fatal hemolytic transfusion reactions.
9. A nurse is caring for a client who is post-op and has a PCA pump. The client is somnolent with a
respiratory rate of 8/min. What should the nurse do first?
A. Increase the IV fluids
B. Encourage the client to take deep breaths
C. Stop the PCA infusion and administer naloxone
D. Notify the provider
*Rationale: A respiratory rate of 8 indicates opioid-induced respiratory depression. The priority is
to stop the opioid infusion and administer naloxone (narcan) to reverse the effects. Notifying the
provider comes after immediate action.
10. A nurse is teaching a client about fire safety. Which statement indicates the client understands
"RACE"?
A. "I should remove all electrical devices."
B. "I should rescue anyone in immediate danger first."
C. "I should close all the windows first."
D. "I should run to the nearest exit."
*Rationale: RACE stands for Rescue, Alarm, Contain, Extinguish. Rescuing anyone in immediate
danger is the first priority in a fire.
11. A nurse is applying restraints to a confused client. Which action is appropriate?
A. Tie restraints to the side rails
B. Apply restraints for 4 hours without reassessment
C. Obtain a provider's order within 15-30 minutes of application
, D. Secure restraints tightly to prevent movement
*Rationale: Restraints require a provider's order as soon as possible (usually within 15-30
minutes). They must be tied to the bed frame (not side rails), and must be loose enough for 2
fingers to fit under.
12. A nurse is providing shift report. Which information is most important to communicate about a
client with a new tracheostomy?
A. The client's dietary preferences
B. The client's family visiting schedule
C. The client's oxygen saturation and presence of secretions
D. The client's insurance status
*Rationale: Hand-off communication should focus on the client's current airway, breathing, and
circulation status. O2 sat and secretions are critical airway information.
13. A nurse is preparing a sterile field. Which action contaminates the field?
A. Placing sterile items in the center
B. Opening the sterile package away from the body
C. Reaching over the sterile field to grab a supply
D. Keeping the field above waist level
*Rationale: Reaching over a sterile field contaminates it because non-sterile objects (arms) can
shed microorganisms onto the field. The field must stay above waist level and only the edges are
considered contaminated.
14. A nurse is caring for a client with a chest tube. The collection chamber is accidentally knocked
over. What should the nurse do first?
A. Clamp the chest tube immediately
B. Turn the client to the unaffected side
C. Assess the client's respiratory status and vital signs
D. Reconnect the chest tube to a new chamber
*Rationale: Airway and breathing are always the priority. The nurse must first assess the client's
respiratory status to ensure no pneumothorax or distress has occurred before intervening with
the equipment.
15. A nurse is admitting a client who speaks a different language. Which action is appropriate?
A. Use a family member as an interpreter
B. Use hand gestures to explain procedures
C. Request a certified medical interpreter
Comprehensive NCLEX-Style Practice Questions with
Rationales MASTER EXAMINATION A Complete Review
for NCLEX-RN Readiness
SECTION 1: Safe & Effective Care Environment (Management of Care, Safety, Infection Control)
1. A nurse is preparing to transfer a client from a bed to a stretcher. Which of the following actions
should the nurse take to prevent musculoskeletal injury?
A. Keep feet together while lifting
B. Twist at the waist to reach the client
C. Use a friction-reducing slide sheet
D. Bend at the knees and keep the back straight
*Rationale: Bending at the knees and keeping the back straight uses the strong leg muscles and
maintains proper body mechanics, reducing the risk of back injury. Using a slide sheet also helps,
but proper body mechanics is the foundational principle.
2. A nurse is caring for a client on contact precautions. Which of the following actions is appropriate
when leaving the client's room?
A. Remove gloves and mask at the door
B. Remove gown and gloves in the anteroom
C. Remove PPE in the doorway and perform hand hygiene
D. Leave PPE on until exiting the unit
*Rationale: PPE should be removed at the doorway or in the anteroom to contain contaminants,
and hand hygiene must be performed immediately after removal. Masks are not always required
for contact precautions unless specified.
3. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is appropriate to
delegate?
A. Administering a tube feeding
, B. Assessing a post-operative incision
C. Measuring a client's intake and output
D. Teaching a client about insulin administration
*Rationale: Intake and output measurement is a routine, non-invasive task within the UAP's
scope of practice. Assessment, teaching, and tube feedings require licensed nursing judgment.
4. A client has a living will that declines resuscitation. The client's family member demands CPR. What
should the nurse do?
A. Call a code blue per the family's request
B. Ask the family to sign a consent form
C. Follow the living will and do not resuscitate
D. Call the ethics committee before acting
*Rationale: A living will is a legally binding document. The nurse must follow the client's
documented wishes. The provider should be notified, but the DNR order must be honored.
5. A nurse is caring for a client who is at risk for falls. Which intervention should the nurse implement
first?
A. Place a bed alarm
B. Keep the side rails fully up
C. Complete a fall risk assessment
D. Move the client closer to the nurse's station
*Rationale: Assessment is always the first step of the nursing process. A fall risk assessment
identifies specific risks so interventions can be tailored appropriately.
6. Which of the following clients should the nurse assign to a private room?
A. A client with pneumonia
B. A client with a wound infection
C. A client with active pulmonary tuberculosis
D. A client with a urinary tract infection
*Rationale: Active pulmonary TB requires airborne precautions, which necessitate a private
negative-airflow room. Pneumonia and wound infections (contact/droplet) may not always
require a private room.
7. A nurse is completing an incident report after a client falls. Which statement should the nurse
document in the chart?
A. "Client fell due to staff negligence"
B. "Client was trying to get up alone"
, C. "Client found on floor beside the bed at 0900."
D. "Client fell because the bed alarm was off"
*Rationale: Charting must be objective, factual, and free of blame or assumptions. Documenting
only what was observed (client on floor) is legally correct.
8. A nurse is preparing to administer a blood transfusion. Which action is most important prior to
starting the transfusion?
A. Assess the IV site for patency
B. Warm the blood to body temperature
C. Verify the client's identity and blood compatibility with another nurse
D. Pre-medicate with diphenhydramine
*Rationale: Verifying client identity and blood compatibility (two-nurse check) is the most critical
safety step to prevent fatal hemolytic transfusion reactions.
9. A nurse is caring for a client who is post-op and has a PCA pump. The client is somnolent with a
respiratory rate of 8/min. What should the nurse do first?
A. Increase the IV fluids
B. Encourage the client to take deep breaths
C. Stop the PCA infusion and administer naloxone
D. Notify the provider
*Rationale: A respiratory rate of 8 indicates opioid-induced respiratory depression. The priority is
to stop the opioid infusion and administer naloxone (narcan) to reverse the effects. Notifying the
provider comes after immediate action.
10. A nurse is teaching a client about fire safety. Which statement indicates the client understands
"RACE"?
A. "I should remove all electrical devices."
B. "I should rescue anyone in immediate danger first."
C. "I should close all the windows first."
D. "I should run to the nearest exit."
*Rationale: RACE stands for Rescue, Alarm, Contain, Extinguish. Rescuing anyone in immediate
danger is the first priority in a fire.
11. A nurse is applying restraints to a confused client. Which action is appropriate?
A. Tie restraints to the side rails
B. Apply restraints for 4 hours without reassessment
C. Obtain a provider's order within 15-30 minutes of application
, D. Secure restraints tightly to prevent movement
*Rationale: Restraints require a provider's order as soon as possible (usually within 15-30
minutes). They must be tied to the bed frame (not side rails), and must be loose enough for 2
fingers to fit under.
12. A nurse is providing shift report. Which information is most important to communicate about a
client with a new tracheostomy?
A. The client's dietary preferences
B. The client's family visiting schedule
C. The client's oxygen saturation and presence of secretions
D. The client's insurance status
*Rationale: Hand-off communication should focus on the client's current airway, breathing, and
circulation status. O2 sat and secretions are critical airway information.
13. A nurse is preparing a sterile field. Which action contaminates the field?
A. Placing sterile items in the center
B. Opening the sterile package away from the body
C. Reaching over the sterile field to grab a supply
D. Keeping the field above waist level
*Rationale: Reaching over a sterile field contaminates it because non-sterile objects (arms) can
shed microorganisms onto the field. The field must stay above waist level and only the edges are
considered contaminated.
14. A nurse is caring for a client with a chest tube. The collection chamber is accidentally knocked
over. What should the nurse do first?
A. Clamp the chest tube immediately
B. Turn the client to the unaffected side
C. Assess the client's respiratory status and vital signs
D. Reconnect the chest tube to a new chamber
*Rationale: Airway and breathing are always the priority. The nurse must first assess the client's
respiratory status to ensure no pneumothorax or distress has occurred before intervening with
the equipment.
15. A nurse is admitting a client who speaks a different language. Which action is appropriate?
A. Use a family member as an interpreter
B. Use hand gestures to explain procedures
C. Request a certified medical interpreter
