NCLEX-RN Practice Questions: Nursing Fundamentals
Single-Best-Answer Questions
Question 1: Infection Control & Safety
A nurse is preparing to insert a sterile indwelling urinary
catheter for a patient. After donning sterile gloves and placing
the sterile drape, the nurse accidentally touches the inside of
the catheterization kit with a non-sterile glove. What is the
nurse's priority action?
A. Inform the patient that there will be a short delay and
proceed, as the risk is low.
B. Apply an additional pair of sterile gloves over the current
ones.
C. Discard the entire kit and prepare a new one with a new pair
of sterile gloves.
D. Clean the contaminated area of the kit with an alcohol swab
for 30 seconds.
• Correct Answer: C. Discard the entire kit and prepare a
new one with a new pair of sterile gloves.
• Clinical Judgment Steps:
o Recognize Cues: The inside of the sterile kit was
touched by a non-sterile glove.
o Analyze Cues: This action breaks the chain of asepsis,
contaminating the entire sterile field and introducing
a risk of infection.
, o Take Action: The only way to ensure sterility is to start
the procedure over with all new, uncontaminated
supplies. Patient safety is the priority.
• Rationale for Incorrect Answers:
o A. Proceeding despite a known break in sterile
technique is negligent and violates core infection
control principles.
o B. Adding another layer of gloves does not
decontaminate the already-touched kit and
equipment.
o D. Alcohol swabs are not sufficient to re-sterilize
equipment intended for single, sterile use.
Question 2: Delegation & Prioritization
A charge nurse is assigning care for the following patients.
Which patient should be assigned to the most experienced
registered nurse?
A. A 45-year-old patient admitted for observation after a
concussion, who is now alert and oriented.
B. A 60-year-old patient with heart failure who is scheduled for
a stress echocardiogram in two hours.
C. A 70-year-old patient with pneumonia on IV antibiotics,
whose oxygen saturation has dropped from 95% to 89% on 2L
nasal cannula.
D. A 55-year-old patient who is post-operative day 1 from a
,laparoscopic cholecystectomy and requires teaching for
discharge.
• Correct Answer: C. A 70-year-old patient with pneumonia
on IV antibiotics, whose oxygen saturation has dropped
from 95% to 89% on 2L nasal cannula.
• Clinical Judgment Steps:
o Recognize Cues: A significant drop in oxygen
saturation indicates acute respiratory compromise.
o Analyze Cues & Prioritize Hypotheses: This patient is
unstable and requires immediate assessment, critical
thinking, and potential intervention (e.g., increasing
oxygen, notifying the provider). This is a high-acuity
situation.
o Decide: The most experienced RN is needed to
manage this potentially rapid decline.
• Rationale for Incorrect Answers:
o A & D: These patients are stable and require routine
care and teaching, which can be managed by a less
experienced RN or team.
o B: While this patient has a chronic illness, they are
stable for a scheduled procedure. The task is more
procedural than critical.
, Question 3: Vital Signs & Communication
A nurse obtains a blood pressure of 190/100 mm Hg for a
patient who was admitted with a headache. The patient has no
other symptoms and states, "My BP is always high when I'm
nervous." What is the nurse's best initial action?
A. Document the reading as an isolated incident related to
anxiety.
B. Instruct the unlicensed assistive personnel (UAP) to recheck
the blood pressure in 30 minutes.
C. Stay with the patient, reassure them, and recheck the blood
pressure in 15-30 minutes using the correct technique.
D. Notify the healthcare provider immediately of the
hypertensive crisis.
• correct Answer: C. Stay with the patient, reassure them,
and recheck the blood pressure in 15-30 minutes using
the correct technique.
• Clinical Judgment Steps:
o Recognize Cues: A single high BP reading; patient's
report of anxiety-related elevations.
o Analyze Cues: This could be situational (white-coat
syndrome) or a true reading. Further data is needed
before making a clinical conclusion.
o Take Action: The nurse's own assessment is required.
Rechecking after a rest period, ensuring proper cuff
size and positioning, and providing a calming
Single-Best-Answer Questions
Question 1: Infection Control & Safety
A nurse is preparing to insert a sterile indwelling urinary
catheter for a patient. After donning sterile gloves and placing
the sterile drape, the nurse accidentally touches the inside of
the catheterization kit with a non-sterile glove. What is the
nurse's priority action?
A. Inform the patient that there will be a short delay and
proceed, as the risk is low.
B. Apply an additional pair of sterile gloves over the current
ones.
C. Discard the entire kit and prepare a new one with a new pair
of sterile gloves.
D. Clean the contaminated area of the kit with an alcohol swab
for 30 seconds.
• Correct Answer: C. Discard the entire kit and prepare a
new one with a new pair of sterile gloves.
• Clinical Judgment Steps:
o Recognize Cues: The inside of the sterile kit was
touched by a non-sterile glove.
o Analyze Cues: This action breaks the chain of asepsis,
contaminating the entire sterile field and introducing
a risk of infection.
, o Take Action: The only way to ensure sterility is to start
the procedure over with all new, uncontaminated
supplies. Patient safety is the priority.
• Rationale for Incorrect Answers:
o A. Proceeding despite a known break in sterile
technique is negligent and violates core infection
control principles.
o B. Adding another layer of gloves does not
decontaminate the already-touched kit and
equipment.
o D. Alcohol swabs are not sufficient to re-sterilize
equipment intended for single, sterile use.
Question 2: Delegation & Prioritization
A charge nurse is assigning care for the following patients.
Which patient should be assigned to the most experienced
registered nurse?
A. A 45-year-old patient admitted for observation after a
concussion, who is now alert and oriented.
B. A 60-year-old patient with heart failure who is scheduled for
a stress echocardiogram in two hours.
C. A 70-year-old patient with pneumonia on IV antibiotics,
whose oxygen saturation has dropped from 95% to 89% on 2L
nasal cannula.
D. A 55-year-old patient who is post-operative day 1 from a
,laparoscopic cholecystectomy and requires teaching for
discharge.
• Correct Answer: C. A 70-year-old patient with pneumonia
on IV antibiotics, whose oxygen saturation has dropped
from 95% to 89% on 2L nasal cannula.
• Clinical Judgment Steps:
o Recognize Cues: A significant drop in oxygen
saturation indicates acute respiratory compromise.
o Analyze Cues & Prioritize Hypotheses: This patient is
unstable and requires immediate assessment, critical
thinking, and potential intervention (e.g., increasing
oxygen, notifying the provider). This is a high-acuity
situation.
o Decide: The most experienced RN is needed to
manage this potentially rapid decline.
• Rationale for Incorrect Answers:
o A & D: These patients are stable and require routine
care and teaching, which can be managed by a less
experienced RN or team.
o B: While this patient has a chronic illness, they are
stable for a scheduled procedure. The task is more
procedural than critical.
, Question 3: Vital Signs & Communication
A nurse obtains a blood pressure of 190/100 mm Hg for a
patient who was admitted with a headache. The patient has no
other symptoms and states, "My BP is always high when I'm
nervous." What is the nurse's best initial action?
A. Document the reading as an isolated incident related to
anxiety.
B. Instruct the unlicensed assistive personnel (UAP) to recheck
the blood pressure in 30 minutes.
C. Stay with the patient, reassure them, and recheck the blood
pressure in 15-30 minutes using the correct technique.
D. Notify the healthcare provider immediately of the
hypertensive crisis.
• correct Answer: C. Stay with the patient, reassure them,
and recheck the blood pressure in 15-30 minutes using
the correct technique.
• Clinical Judgment Steps:
o Recognize Cues: A single high BP reading; patient's
report of anxiety-related elevations.
o Analyze Cues: This could be situational (white-coat
syndrome) or a true reading. Further data is needed
before making a clinical conclusion.
o Take Action: The nurse's own assessment is required.
Rechecking after a rest period, ensuring proper cuff
size and positioning, and providing a calming
