NCLEX-RN Comprehensive Review
100% Practice Questions with Detailed Answers and Rationales
Section 1: Management of Care (Questions 1-25)
1. A nurse receives a medication order that seems inappropriate for the
patient's condition. What is the nurse's priority action?
A) Administer the medication as ordered
B) Contact the prescribing provider to clarify the order
C) Document concerns in the medical record
D) Ask another nurse for their opinion
Answer: B - The nurse has a legal and ethical responsibility to question orders that
appear inappropriate. Patient safety is paramount. Contact the provider directly to
clarify before administering.
2. Which task can the RN safely delegate to unlicensed assistive personnel
(UAP)?
A) Initial patient assessment
B) Administering oral medications
C) Measuring vital signs on stable patients
D) Teaching a patient about wound care
Answer: C - UAP can perform routine tasks for stable patients including vital signs,
ADLs, hygiene care. Assessment, medication administration, teaching, and nursing
judgment cannot be delegated.
3. A patient refuses prescribed medication. What should the nurse do first?
A) Document the refusal and notify the provider
B) Explain the consequences and insist the patient take it
, C) Explore the patient's reasons for refusing
D) Ask the family to convince the patient
Answer: C - First explore the patient's concerns and reasons. The patient has the
right to refuse. After understanding concerns, provide education, document, and
notify provider.
4. A nurse witnesses a coworker diverting narcotics. What is the appropriate
action?
A) Confront the coworker privately
B) Report immediately to the nurse manager
C) Continue monitoring before reporting
D) Discuss with other staff members
Answer: B - Patient safety and legal obligations require immediate reporting to
supervisor following chain of command. Do not confront the individual or delay
reporting.
5. Which patient should the nurse assess first after receiving morning report?
A) Post-operative patient requesting pain medication
B) Diabetic patient with blood glucose of 68 mg/dL
C) Patient with chest pain radiating to the left arm
D) Patient scheduled for discharge in 2 hours
Answer: C - Use ABC priority setting. Chest pain radiating to arm suggests possible
MI - life-threatening emergency requiring immediate assessment and
intervention.
6. A nurse floats to an unfamiliar unit. What is the appropriate response?
A) Refuse the assignment completely
B) Accept the assignment and ask for orientation
, C) Accept only if comfortable with all procedures
D) Request to leave work for the day
Answer: B - Nurses are expected to float but should request orientation, inform
charge nurse of limitations, and accept assignments within competency. Refusal
should be last resort.
7. What is the purpose of informed consent?
A) Protect the healthcare provider from liability
B) Ensure patient understands procedure and risks
C) Meet hospital policy requirements
D) Document that procedure was performed
Answer: B - Informed consent ensures patients receive adequate information
about procedures, risks, benefits, and alternatives to make voluntary, informed
decisions.
8. A nurse makes a medication error. What should the nurse do first?
A) Complete an incident report
B) Notify the supervisor immediately
C) Assess the patient and provide necessary care
D) Document the error in the medical record
Answer: C - Patient safety is priority. Assess patient for adverse effects and
intervene as needed. Then notify provider and supervisor, complete incident
report, and document.
9. Which represents a breach of patient confidentiality?
A) Discussing patient care with the healthcare team during rounds
B) Giving report to the oncoming nurse
C) Discussing patient information in the hospital elevator
100% Practice Questions with Detailed Answers and Rationales
Section 1: Management of Care (Questions 1-25)
1. A nurse receives a medication order that seems inappropriate for the
patient's condition. What is the nurse's priority action?
A) Administer the medication as ordered
B) Contact the prescribing provider to clarify the order
C) Document concerns in the medical record
D) Ask another nurse for their opinion
Answer: B - The nurse has a legal and ethical responsibility to question orders that
appear inappropriate. Patient safety is paramount. Contact the provider directly to
clarify before administering.
2. Which task can the RN safely delegate to unlicensed assistive personnel
(UAP)?
A) Initial patient assessment
B) Administering oral medications
C) Measuring vital signs on stable patients
D) Teaching a patient about wound care
Answer: C - UAP can perform routine tasks for stable patients including vital signs,
ADLs, hygiene care. Assessment, medication administration, teaching, and nursing
judgment cannot be delegated.
3. A patient refuses prescribed medication. What should the nurse do first?
A) Document the refusal and notify the provider
B) Explain the consequences and insist the patient take it
, C) Explore the patient's reasons for refusing
D) Ask the family to convince the patient
Answer: C - First explore the patient's concerns and reasons. The patient has the
right to refuse. After understanding concerns, provide education, document, and
notify provider.
4. A nurse witnesses a coworker diverting narcotics. What is the appropriate
action?
A) Confront the coworker privately
B) Report immediately to the nurse manager
C) Continue monitoring before reporting
D) Discuss with other staff members
Answer: B - Patient safety and legal obligations require immediate reporting to
supervisor following chain of command. Do not confront the individual or delay
reporting.
5. Which patient should the nurse assess first after receiving morning report?
A) Post-operative patient requesting pain medication
B) Diabetic patient with blood glucose of 68 mg/dL
C) Patient with chest pain radiating to the left arm
D) Patient scheduled for discharge in 2 hours
Answer: C - Use ABC priority setting. Chest pain radiating to arm suggests possible
MI - life-threatening emergency requiring immediate assessment and
intervention.
6. A nurse floats to an unfamiliar unit. What is the appropriate response?
A) Refuse the assignment completely
B) Accept the assignment and ask for orientation
, C) Accept only if comfortable with all procedures
D) Request to leave work for the day
Answer: B - Nurses are expected to float but should request orientation, inform
charge nurse of limitations, and accept assignments within competency. Refusal
should be last resort.
7. What is the purpose of informed consent?
A) Protect the healthcare provider from liability
B) Ensure patient understands procedure and risks
C) Meet hospital policy requirements
D) Document that procedure was performed
Answer: B - Informed consent ensures patients receive adequate information
about procedures, risks, benefits, and alternatives to make voluntary, informed
decisions.
8. A nurse makes a medication error. What should the nurse do first?
A) Complete an incident report
B) Notify the supervisor immediately
C) Assess the patient and provide necessary care
D) Document the error in the medical record
Answer: C - Patient safety is priority. Assess patient for adverse effects and
intervene as needed. Then notify provider and supervisor, complete incident
report, and document.
9. Which represents a breach of patient confidentiality?
A) Discussing patient care with the healthcare team during rounds
B) Giving report to the oncoming nurse
C) Discussing patient information in the hospital elevator
