NSG 4100 EXAMINATION | 250 NCLEX-Style Practice
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1. A nurse manager is planning staff assignments on a medical-surgical unit.
Which patient should be assigned to the most experienced RN?
A. A 45-year-old postoperative cholecystectomy patient with a T-tube
B. A 60-year-old patient with pneumonia requiring IV antibiotics
C. A 70-year-old patient with newly diagnosed diabetes needing teaching
D. A 55-year-old patient with acute pancreatitis and unstable vital signs
D. A 55-year-old patient with acute pancreatitis and unstable vital signs
2. The charge nurse is making patient assignments. Which delegation action
demonstrates appropriate use of the five rights of delegation?
A. Delegating vital signs on a stable patient to an LPN
B. Delegating the initial admission assessment to a new graduate RN
C. Delegating medication titration to a UAP
D. Delegating central line dressing change to an LPN with no IV certification
A. Delegating vital signs on a stable patient to an LPN
3. A staff nurse notices that a colleague frequently omits oral care for unconscious
patients. What is the nurse’s best initial action?
A. Report the colleague to the Board of Nursing
B. Confront the colleague in the break room
C. Discuss the observation with the nurse manager privately
D. Ignore the issue to avoid conflict
C. Discuss the observation with the nurse manager privately
4. Which leadership style is most effective during a code blue emergency?
A. Democratic
B. Laissez-faire
C. Autocratic
D. Transformational
C. Autocratic
5. A nurse is preparing to delegate a task to a UAP. Which task is appropriate?
A. Feeding a patient with dysphagia
B. Measuring intake and output for a patient with heart failure
,C. Suctioning a tracheostomy
D. Administering a tube feeding
B. Measuring intake and output for a patient with heart failure
6. The nurse manager is using the Quality and Safety Education for Nurses (QSEN)
competencies. Which action reflects the "safety" competency?
A. Using evidence-based fall prevention protocols
B. Documenting patient allergies in the EHR
C. Collaborating with PT for mobility
D. Asking the patient about their preferred language
A. Using evidence-based fall prevention protocols
7. A patient tells the nurse, "I don't want that student nurse to start my IV." What
is the nurse’s best response?
A. "The student needs to practice, and I will supervise."
B. "You have the right to refuse care from a student; I will start your IV."
C. "The student is competent; please give them a chance."
D. "If you refuse, I will document it as noncompliance."
B. "You have the right to refuse care from a student; I will start your IV."
8. Which situation represents a sentinel event?
A. A patient falls but is not injured
B. A medication error is caught before administration
C. A patient undergoes surgery on the wrong site
D. A patient develops a stage 2 pressure injury
C. A patient undergoes surgery on the wrong site
9. A nurse is caring for a postoperative patient who refuses to ambulate. Which
action reflects assertive communication?
A. "You must walk now or you will get pneumonia."
B. "I understand you are in pain, but walking will help you recover. Can we try a short
walk with assistance?"
C. "It's your choice; I'll document your refusal."
D. "Why won't you cooperate with your plan of care?"
B. "I understand you are in pain, but walking will help you recover. Can we try a
short walk with assistance?"
10. The nurse manager notices a high rate of catheter-associated UTIs. Which
quality improvement tool is best for tracking infection rates over time?
A. Pareto chart
B. Run chart
,C. Fishbone diagram
D. Histogram
B. Run chart
11. Which action by a nurse leader best promotes a culture of patient safety?
A. Punishing staff for near misses
B. Encouraging incident reporting without fear of blame
C. Discouraging staff from questioning physicians
D. Limiting interdisciplinary rounds to save time
B. Encouraging incident reporting without fear of blame
12. A nurse is assigned to care for four patients. Which patient should the nurse
assess first?
A. A patient with COPD requesting a PRN albuterol treatment
B. A postoperative patient with a pulse of 110 and blood pressure 90/60
C. A patient with diabetes with a breakfast blood glucose of 140 mg/dL
D. A patient with a wound dressing that is saturated with serosanguineous drainage
B. A postoperative patient with a pulse of 110 and blood pressure 90/60
13. The nurse is providing discharge teaching to a patient with heart failure. Which
statement indicates a need for further teaching?
A. "I will weigh myself daily."
B. "I should limit my sodium intake."
C. "I can take ibuprofen for joint pain."
D. "I will call my doctor if I gain 2 pounds in one day."
C. "I can take ibuprofen for joint pain."
14. A nurse witnesses a colleague administering a medication to the wrong
patient. What is the nurse's priority action?
A. Report the error to the nursing supervisor
B. Stop the colleague immediately and assess the patient
C. Document the error in the patient's chart
D. File an incident report anonymously
B. Stop the colleague immediately and assess the patient
15. Which of the following is a key element of informed consent?
A. The patient signs the consent form before the procedure is explained
B. The patient understands the risks, benefits, and alternatives
C. The nurse obtains the consent from a family member
D. The physician documents the consent after the procedure
B. The patient understands the risks, benefits, and alternatives
, 16. A nurse manager is implementing a shared governance model. What is the
primary goal?
A. Increasing physician control over nursing practice
B. Reducing nursing staff turnover
C. Empowering nurses to have a voice in practice decisions
D. Decreasing the length of hospital stays
C. Empowering nurses to have a voice in practice decisions
17. A nurse is preparing a handoff report using the SBAR format. Which
component is included in "S"?
A. Current vital signs and pain level
B. The patient's primary diagnosis and reason for admission
C. What the nurse thinks is the underlying problem
D. The patient's code status and allergies
B. The patient's primary diagnosis and reason for admission
18. Which ethical principle is violated when a nurse fails to keep a promise to a
patient?
A. Autonomy
B. Beneficence
C. Fidelity
D. Justice
C. Fidelity
19. The nurse is caring for a patient with a do-not-resuscitate (DNR) order. Which
action is appropriate?
A. Performing CPR if the patient's heart stops
B. Continuing all other life-sustaining treatments as ordered
C. Withholding all medications and feedings
D. Transferring the patient to the ICU for monitoring
B. Continuing all other life-sustaining treatments as ordered
20. A nurse is using the Plan-Do-Study-Act (PDSA) model to improve medication
reconciliation. During the "Study" phase, what should the nurse do?
A. Implement the new reconciliation form
B. Analyze the data collected on reconciliation errors
C. Plan a staff education session
D. Act on the findings by creating a new policy
B. Analyze the data collected on reconciliation errors
Questions & Verified Answers | Complete Exam Prep |
Latest Updated Version | 100% Pass Success Resource |
Instant Download PDF
1. A nurse manager is planning staff assignments on a medical-surgical unit.
Which patient should be assigned to the most experienced RN?
A. A 45-year-old postoperative cholecystectomy patient with a T-tube
B. A 60-year-old patient with pneumonia requiring IV antibiotics
C. A 70-year-old patient with newly diagnosed diabetes needing teaching
D. A 55-year-old patient with acute pancreatitis and unstable vital signs
D. A 55-year-old patient with acute pancreatitis and unstable vital signs
2. The charge nurse is making patient assignments. Which delegation action
demonstrates appropriate use of the five rights of delegation?
A. Delegating vital signs on a stable patient to an LPN
B. Delegating the initial admission assessment to a new graduate RN
C. Delegating medication titration to a UAP
D. Delegating central line dressing change to an LPN with no IV certification
A. Delegating vital signs on a stable patient to an LPN
3. A staff nurse notices that a colleague frequently omits oral care for unconscious
patients. What is the nurse’s best initial action?
A. Report the colleague to the Board of Nursing
B. Confront the colleague in the break room
C. Discuss the observation with the nurse manager privately
D. Ignore the issue to avoid conflict
C. Discuss the observation with the nurse manager privately
4. Which leadership style is most effective during a code blue emergency?
A. Democratic
B. Laissez-faire
C. Autocratic
D. Transformational
C. Autocratic
5. A nurse is preparing to delegate a task to a UAP. Which task is appropriate?
A. Feeding a patient with dysphagia
B. Measuring intake and output for a patient with heart failure
,C. Suctioning a tracheostomy
D. Administering a tube feeding
B. Measuring intake and output for a patient with heart failure
6. The nurse manager is using the Quality and Safety Education for Nurses (QSEN)
competencies. Which action reflects the "safety" competency?
A. Using evidence-based fall prevention protocols
B. Documenting patient allergies in the EHR
C. Collaborating with PT for mobility
D. Asking the patient about their preferred language
A. Using evidence-based fall prevention protocols
7. A patient tells the nurse, "I don't want that student nurse to start my IV." What
is the nurse’s best response?
A. "The student needs to practice, and I will supervise."
B. "You have the right to refuse care from a student; I will start your IV."
C. "The student is competent; please give them a chance."
D. "If you refuse, I will document it as noncompliance."
B. "You have the right to refuse care from a student; I will start your IV."
8. Which situation represents a sentinel event?
A. A patient falls but is not injured
B. A medication error is caught before administration
C. A patient undergoes surgery on the wrong site
D. A patient develops a stage 2 pressure injury
C. A patient undergoes surgery on the wrong site
9. A nurse is caring for a postoperative patient who refuses to ambulate. Which
action reflects assertive communication?
A. "You must walk now or you will get pneumonia."
B. "I understand you are in pain, but walking will help you recover. Can we try a short
walk with assistance?"
C. "It's your choice; I'll document your refusal."
D. "Why won't you cooperate with your plan of care?"
B. "I understand you are in pain, but walking will help you recover. Can we try a
short walk with assistance?"
10. The nurse manager notices a high rate of catheter-associated UTIs. Which
quality improvement tool is best for tracking infection rates over time?
A. Pareto chart
B. Run chart
,C. Fishbone diagram
D. Histogram
B. Run chart
11. Which action by a nurse leader best promotes a culture of patient safety?
A. Punishing staff for near misses
B. Encouraging incident reporting without fear of blame
C. Discouraging staff from questioning physicians
D. Limiting interdisciplinary rounds to save time
B. Encouraging incident reporting without fear of blame
12. A nurse is assigned to care for four patients. Which patient should the nurse
assess first?
A. A patient with COPD requesting a PRN albuterol treatment
B. A postoperative patient with a pulse of 110 and blood pressure 90/60
C. A patient with diabetes with a breakfast blood glucose of 140 mg/dL
D. A patient with a wound dressing that is saturated with serosanguineous drainage
B. A postoperative patient with a pulse of 110 and blood pressure 90/60
13. The nurse is providing discharge teaching to a patient with heart failure. Which
statement indicates a need for further teaching?
A. "I will weigh myself daily."
B. "I should limit my sodium intake."
C. "I can take ibuprofen for joint pain."
D. "I will call my doctor if I gain 2 pounds in one day."
C. "I can take ibuprofen for joint pain."
14. A nurse witnesses a colleague administering a medication to the wrong
patient. What is the nurse's priority action?
A. Report the error to the nursing supervisor
B. Stop the colleague immediately and assess the patient
C. Document the error in the patient's chart
D. File an incident report anonymously
B. Stop the colleague immediately and assess the patient
15. Which of the following is a key element of informed consent?
A. The patient signs the consent form before the procedure is explained
B. The patient understands the risks, benefits, and alternatives
C. The nurse obtains the consent from a family member
D. The physician documents the consent after the procedure
B. The patient understands the risks, benefits, and alternatives
, 16. A nurse manager is implementing a shared governance model. What is the
primary goal?
A. Increasing physician control over nursing practice
B. Reducing nursing staff turnover
C. Empowering nurses to have a voice in practice decisions
D. Decreasing the length of hospital stays
C. Empowering nurses to have a voice in practice decisions
17. A nurse is preparing a handoff report using the SBAR format. Which
component is included in "S"?
A. Current vital signs and pain level
B. The patient's primary diagnosis and reason for admission
C. What the nurse thinks is the underlying problem
D. The patient's code status and allergies
B. The patient's primary diagnosis and reason for admission
18. Which ethical principle is violated when a nurse fails to keep a promise to a
patient?
A. Autonomy
B. Beneficence
C. Fidelity
D. Justice
C. Fidelity
19. The nurse is caring for a patient with a do-not-resuscitate (DNR) order. Which
action is appropriate?
A. Performing CPR if the patient's heart stops
B. Continuing all other life-sustaining treatments as ordered
C. Withholding all medications and feedings
D. Transferring the patient to the ICU for monitoring
B. Continuing all other life-sustaining treatments as ordered
20. A nurse is using the Plan-Do-Study-Act (PDSA) model to improve medication
reconciliation. During the "Study" phase, what should the nurse do?
A. Implement the new reconciliation form
B. Analyze the data collected on reconciliation errors
C. Plan a staff education session
D. Act on the findings by creating a new policy
B. Analyze the data collected on reconciliation errors
