Page 1 of 69
NCLEX-RN FUNDAMENTALS PRACTICE EXAM
QUESTIONS (100) WITH RATIONAL-
RATIONALE
Nursing
Exam coverage:
I. Section 1: Q1-20 – Safety, Infection Control & Standard
Precautions (hand hygiene, PPE, fall prevention, seizure
precautions, restraints, fire safety, client identification)
II. Section 2: Q21-40 – Vital Signs, Assessment & Physical
Examination (ABCs, normal ranges, pain assessment, neurological
assessment, skin assessment, respiratory assessment, pressure
injury risk)
III. Section 3: Q41-60 – Hygiene, Mobility & Comfort (oral care,
ambulation, pressure injury prevention, perineal care, range of
motion, catheter care, enteral feeding, ostomy care, positioning)
IV. Section 4: Q61-80 – Medication Administration & Calculations
(routes of administration, dosage calculations, IV infusion rates,
PCA pumps, blood transfusion safety, NG tube medications)
V. Section 5: Q81-100 – Documentation, Communication &
Professional Issues (objective documentation, delegation,
therapeutic communication, cultural competence, informed
consent, discharge teaching, critical thinking, professional
responsibility)
SECTION 1: SAFETY, INFECTION CONTROL & STANDARD
PRECAUTIONS (Questions 1–20)
, Page 2 of 69
Question 1
A nurse is preparing to enter the room of a client on contact
precautions for a Clostridioides difficile infection. The nurse has
just completed a wound dressing change on another client and
has alcohol-based hand rub available at the door. Which hand
hygiene action should the nurse take before entering the C.
difficile client's room?
A) Use alcohol-based hand rub for 20 seconds before entering
the room
B) ✓ Wash hands with soap and water at the sink for at least
20 seconds
C) Put on gloves immediately without performing hand hygiene
first
D) Use an antiseptic towelette followed by alcohol-based hand
rub
CORRECT: B
RATIONALE: C. difficile spores are resistant to alcohol-based
hand sanitizers and require mechanical removal through soap-
and-water handwashing. Alcohol-based hand rub does not
reliably remove C. difficile spores. Standard precautions require
appropriate hand hygiene based on the anticipated exposure,
and spore-forming organisms necessitate soap and water.
Question 2
A nurse is caring for a client on contact precautions for
methicillin-resistant Staphylococcus aureus (MRSA). Which
, Page 3 of 69
personal protective equipment (PPE) should the nurse wear
when entering the client's room?
A) Mask only
B) ✓ Gown and gloves
C) Face shield and gown
D) Gloves only
CORRECT: B
RATIONALE: Contact precautions for MRSA require the use of
both a gown and gloves to prevent transmission of the organism
through direct contact. The gown provides barrier protection for
the nurse's clothing, and gloves prevent hand contamination.
Question 3
A nurse is performing hand hygiene. Which situation specifically
requires the use of soap and water rather than an alcohol-based
hand rub?
A) Before touching a client who is immunocompromised
B) After removing gloves following a wound dressing change
C) ✓ When hands are visibly soiled with dirt or body fluids
D) Before performing a sterile procedure
CORRECT: C
RATIONALE: Alcohol-based hand rubs are not effective when
hands are visibly soiled. Soap and water must be used when
hands are visibly dirty or contaminated with blood or body
, Page 4 of 69
fluids. Alcohol-based hand rubs are appropriate for routine
decontamination when hands are not visibly soiled.
Question 4
A nurse has finished caring for a client on contact precautions
and is preparing to remove personal protective equipment
(PPE). Which item should the nurse remove first to prevent self-
contamination?
A) Remove mask first
B) Remove gown first
C) Remove goggles first
D) ✓ Remove gloves first
CORRECT: D
RATIONALE: The correct doffing sequence begins with
removing the most contaminated items first—gloves are the
most contaminated. After removing gloves, the nurse should
perform hand hygiene, then remove the gown, followed by
goggles or face shield, and finally the mask.
Question 5
A nurse is caring for a client who is at risk for falls. Which priority
nursing intervention should the nurse implement to reduce fall
risk?
A) Restrain the client to prevent movement
NCLEX-RN FUNDAMENTALS PRACTICE EXAM
QUESTIONS (100) WITH RATIONAL-
RATIONALE
Nursing
Exam coverage:
I. Section 1: Q1-20 – Safety, Infection Control & Standard
Precautions (hand hygiene, PPE, fall prevention, seizure
precautions, restraints, fire safety, client identification)
II. Section 2: Q21-40 – Vital Signs, Assessment & Physical
Examination (ABCs, normal ranges, pain assessment, neurological
assessment, skin assessment, respiratory assessment, pressure
injury risk)
III. Section 3: Q41-60 – Hygiene, Mobility & Comfort (oral care,
ambulation, pressure injury prevention, perineal care, range of
motion, catheter care, enteral feeding, ostomy care, positioning)
IV. Section 4: Q61-80 – Medication Administration & Calculations
(routes of administration, dosage calculations, IV infusion rates,
PCA pumps, blood transfusion safety, NG tube medications)
V. Section 5: Q81-100 – Documentation, Communication &
Professional Issues (objective documentation, delegation,
therapeutic communication, cultural competence, informed
consent, discharge teaching, critical thinking, professional
responsibility)
SECTION 1: SAFETY, INFECTION CONTROL & STANDARD
PRECAUTIONS (Questions 1–20)
, Page 2 of 69
Question 1
A nurse is preparing to enter the room of a client on contact
precautions for a Clostridioides difficile infection. The nurse has
just completed a wound dressing change on another client and
has alcohol-based hand rub available at the door. Which hand
hygiene action should the nurse take before entering the C.
difficile client's room?
A) Use alcohol-based hand rub for 20 seconds before entering
the room
B) ✓ Wash hands with soap and water at the sink for at least
20 seconds
C) Put on gloves immediately without performing hand hygiene
first
D) Use an antiseptic towelette followed by alcohol-based hand
rub
CORRECT: B
RATIONALE: C. difficile spores are resistant to alcohol-based
hand sanitizers and require mechanical removal through soap-
and-water handwashing. Alcohol-based hand rub does not
reliably remove C. difficile spores. Standard precautions require
appropriate hand hygiene based on the anticipated exposure,
and spore-forming organisms necessitate soap and water.
Question 2
A nurse is caring for a client on contact precautions for
methicillin-resistant Staphylococcus aureus (MRSA). Which
, Page 3 of 69
personal protective equipment (PPE) should the nurse wear
when entering the client's room?
A) Mask only
B) ✓ Gown and gloves
C) Face shield and gown
D) Gloves only
CORRECT: B
RATIONALE: Contact precautions for MRSA require the use of
both a gown and gloves to prevent transmission of the organism
through direct contact. The gown provides barrier protection for
the nurse's clothing, and gloves prevent hand contamination.
Question 3
A nurse is performing hand hygiene. Which situation specifically
requires the use of soap and water rather than an alcohol-based
hand rub?
A) Before touching a client who is immunocompromised
B) After removing gloves following a wound dressing change
C) ✓ When hands are visibly soiled with dirt or body fluids
D) Before performing a sterile procedure
CORRECT: C
RATIONALE: Alcohol-based hand rubs are not effective when
hands are visibly soiled. Soap and water must be used when
hands are visibly dirty or contaminated with blood or body
, Page 4 of 69
fluids. Alcohol-based hand rubs are appropriate for routine
decontamination when hands are not visibly soiled.
Question 4
A nurse has finished caring for a client on contact precautions
and is preparing to remove personal protective equipment
(PPE). Which item should the nurse remove first to prevent self-
contamination?
A) Remove mask first
B) Remove gown first
C) Remove goggles first
D) ✓ Remove gloves first
CORRECT: D
RATIONALE: The correct doffing sequence begins with
removing the most contaminated items first—gloves are the
most contaminated. After removing gloves, the nurse should
perform hand hygiene, then remove the gown, followed by
goggles or face shield, and finally the mask.
Question 5
A nurse is caring for a client who is at risk for falls. Which priority
nursing intervention should the nurse implement to reduce fall
risk?
A) Restrain the client to prevent movement
