NLE NURSING PRACTICE TESTS (JUNE 2025)
Situation 1 - Mr. Ibarra is assigned to the triage area and while on duty, he assesses the condition of Mrs. Simon who
came in with asthma. She has difficulty breathing and her respiratory rate is 40 per minute. Mr. Ibarra is asked to inject the
client epinephrine 0.3mg subcutaneously
1. The indication for epinephrine injection for Mrs. Simon is to:
a. Reduce anaphylaxis
b. Relieve hypersensitivity to allergen
c. Relieve respiratory distress due to bronchial spasm
d. Restore client's cardiac rhythm
CORRECT ANSWER: C
RATIONALE: Asthma is a chronic inflammatory disorder of the airways resulting in reversible bronchoconstriction
and air hunger in response to triggers from a variety of sources. When exposed to a trigger, the hyperactivity of
the medium-sized bronchi causes the release of leukotrienes, histamine and other substances from the mast cells
of the lung; these agents intensify the inflammatory process and cause bronchospasm. When inhaled in small
doses, epinephrine causes short-term relief from the symptoms by widening the bronchial tubes allowing air to
pass through. Once again epinephrine is not the best cure, but a temporary relief when an asthma inhaler is not
present.
OPTIONS A & D are incorrect
OPTION B: Epinephrine does have a direct effect to relieve hypersensitivity to allergen
SOURCE: Hogan, Mary Ann and Hill, Karen.Prentice Hall.Reviews and Rationales series for nursing.
Pathophysiology.pp.4-5; http://www.udel.edu/chem/C465/senior/fall00/Performance1/epinephrine.htm.html
2. When preparing the epinephrine injection from an ampule, the nurse initially:
a. Taps the ampule at the top to allow fluid to flow to the base of the ampule
b. Checks expiration date of the medication ampule
c. Removes needle cap of syringe and pulls plunger to expel air
d. Breaks the neck of the ampule with a gauze wrapped around it
CORRECT ANSWER: B
RATIONALE: In preparing medications in ampule or any form of medications, always check first the expiration
date and discard outdated medication. Check the label on the ampule carefully to make sure that the correct
medication is being prepared.
SOURCE: Kozier & Erb. Fundamentals of Nursing. 7th Edition.pp. 816
3. Mrs. Simon is obese. When administering a subcutaneous injection to an obese patient. It is best for the nurse to:
a. Inject needle at a 15 degree angle over the stretched skin of the client
b. Pinch skin at the injection site and use airlock technique
c. Pull skin of patient down to administer the drug in a Z track
d. Spread skin or pinch at the injection site and inject needle at a 45-90 degree angle
CORRECT ANSWER: D
RATIONALE:To determine the angle of insertion , a general rule to follow relates to the amount of tissue that can
be grasped at the site. A 45-degree angle is used when 1 inch of tissue can be grasped at the site; a 90-degree
angle is used when 2 inches of tissue can be grasped.
OPTION A: Skin Test
OPTION C: IM
SOURCE: Kozier & Erb. Fundamentals of Nursing. 7th Edition.pp. 822
4. When preparing for a subcutaneous injection, the proper size of syringe and needle would be:
a. Syringe 3ml and needle gauge 21 to 23
b. Tuberculin syringe 1 ml with needle gauge 26 or 27
c. Syringe 2ml and needle gauge 22
d. Syringe l-3ml and needle gauge 25 to 27
CORRECT ANSWER: D
RATIONALE: The type of syringe used for subcutaneous injections depends on the medication given. Generally a
2-ml syringe is used for most SC injections. However, if insulin is being administered, an insulin syringe is used;
and if heparin is being administered, a tuberculin syringe or prefilled cartridge may be used. Needle sizes and
lengths are selected based on the clients body mass,the intended angle of insertion and the planned site.
Generally a #25-gauge, 5/8-inch needle is used for adults.
OPTIONS A, B & C are incorrect
SOURCE: Kozier & Erb. Fundamentals of Nursing. 7th Edition.pp. 822
5. The rationale for giving medications through the subcutaneous route is;
a. There are many alternative sites for subcutaneous injection
b. Absorption time of the medicine is slower
c. There are less pain receptors in this area
d. The medication can be injected while the client is in any position
CORRECT ANSWER: B
, RATIONALE: Subcutaneous injections are given because there is little blood flow to fatty tissue and the injected
medication is generally absorbed more slowly, sometimes over 24 hours. Some medications injected
subcutaneously are growth hormone, insulin, epinephrine and other substances.
OPTIONS A, C & D are all secondary reasons.
SOURCE: http://www.cc.nih.gov/ccc/patient_education/pepubs/subq.pdf
Situation 2 - The use of massage and meditation to help decrease stress and pain have been strongly recommended
based on documented testimonials.
6. Martha wants to do a study on the topic. "Effects of massage and meditation on stress and pain." The type of
research that best suits this topic is:
a.Applied research
b.Qualitative research
c. Basic research
d.Quantitative research
CORRECT ANSWER: B
RATIONALE: Qualitative research is the investigation of phenomena, typically in an in depth and holistic fashion,
through the collection of rich narrative materials using a flexible design.
Qualitative research relies on reasons behind various aspects of behavior. Simply put, it investigates the why and
how of decision making, not just what, where, and when. Hence, the need is for smaller but focused samples
rather than large random samples, which qualitative research categorizes data into patterns as the primary basis
for organizing and reporting results. Qualitative researchers typically rely on four methods for gathering
information: (1) participation in the setting, (2) direct observation, (3) in depth interviews, and (4) analysis of
documents and materials
OPTION A: Applied research focuses on finding solutions to existing problems. For example, a study to determine
the effectiveness of a nursing intervention to ease grieving would be applied reaserch.
OPTION C: Basic research is undertaken to extend the base of knowledge in a discipline, or to formulate or refine
theory.
OPTION D: Quantitative research is the investigation of phenomena that lend themselves to precise
measurement and quantification, often involving rigorous and controlled design.
SOURCE: Polit, Denise F and Beck, Cheryl Tatano. Nursing research. Principles and Methods. 7th Edition.pp 18,
729; http://en.wikipedia.org/wiki/Qualitative_research
7. The type of research design that does not manipulate independent variable is:
a. Experimental design
b. Quasi-experimental design
c. Non-experimental design
d. Quantitative design
CORRECT ANSWER: C
RATIONALE: Non-experimental research- studies in which the researcher collects data without introducing an
intervention.
OPTION A: In experiment, the researcher controls the independent variable and randomly assigns subjects to
different conditions.
OPTION B: Quasi-experiment is an intervention study in which subjects are not randomly assigned to treatment
conditions, but the researcher exercises certain controls to enhance the study’s internal validity.
SOURCE: Polit, Denise F and Beck, Cheryl Tatano. Nursing research. Principles and Methods. 7th Edition.pp.
718,725,729
8. This research topic has the potential to contribute to nursing because it seeks to:
a. Include new modalities of care
b. Resolve a clinical problem
c. Clarify an ambiguous modality of care
d. Enhance client care
CORRECT ANSWER: D
Rationale: Nursing research is systematic inquiry designed to develop knowledge about issues of importance to
the nursing profession, including nursing practice, education administration, and informatics. Research designed
to generate knowledge and to improve the health and quality of life of nurse’s clients. Nurses increasingly are
expected to adopt an evidenced-based practice, which is broadly defined as the use of best clinical evidence in
making patient care decisions.
OPTIONS A,B and C are also correct but the best is option D
SOURCE: Polit, Denise F and Beck, Cheryl Tatano. Nursing research. Principles and Methods. 7th Edition.pp. 3-4
9. Martha does review of related literature for the purpose of:
a. Determine statistical treatment of data research
b. Orientation to what is already known or unknown
c. To identify if problem can be replicated
d. Answering the research question
CORRECT ANSWER: D
RATIONALE: All of the choices are correct except D. Answer to the research question may be found after
conducting the study.
, The following are purposes of a literature review:
• Identification of a research problem and development or refinement of research questions or hypothesis
• Orientation to what is known and not known about an area of inquiry, to ascertain what research can best
make a contribution to the existing base of evidence
• Determination of any gaps or inconsistencies in abody of research
• Determination of a need to replicate a prior study in a different setting or with a different study population
• Identification or development of new or reined clinical interventions to test through empirical research
• Identification of relevant theoretical or conceptual frameworks for a research problem
• Identification of suitable designs and data collection methods for a study
• For those developing research proposals for finding, identification of experts in the fields who could be
used as consultants
• Assistance in interpreting study findings and in developing implications and recommendations
SOURCE: Polit, Denise F and Beck, Cheryl Tatano. Nursing research. Principles and Methods. 7th Edition.pp. 5
10. Client's rights should be protected when doing research using human subjects. Martha identifies these rights as
follows EXCEPT:
a. right of self-determination
b. right to compensation
c. right of privacy
d. right not to be harmed
CORRECT ANSWER: B
RATIONALE: All are the client’s rights for being the subject in a research except option B.
The following are the basic human rights of research subjects:
• Right to informed consent
• The right to refuse and/or withdraw from participation
• Right to privacy
• Right to confidentiality or anonymity of data
• Right to be protected from harm
SOURCE: Venzon, Lydia and Venzon, Ronald. Professional Nursing in the Philippines.10th Edition.pp.110-111
Situation 3 - Richard has a nursing diagnosis of ineffective airway clearance related to excessive secretions and is at risk
for infection because of retained secretions. Part of Nurse Mario's nursing care plan is to loosen and remove excessive
secretions in the airway,
11. Mario listens to Richard's bilateral sounds and finds that congestion is in the upper lobes of the lungs. The
appropriate position to drain the anterior and posterior apical segments of the lungs when Mario does percussion
would be:
a. Client lying on his back then flat on his abdomen on Trendelenburg position
b. Client seated upright in bed or on a chair then leaning forward in sitting position
c. Client lying flat on his back and then flat on his abdomen
d. Client lying on his right then left side on Trendelenburg position
CORRECT ANSWER: B
RATIONALE: Postural Drainage involves a patient assuming various positions to facilitate the flow of secretions
from various parts of the lung into the bronchi, trachea and throat so that they can be cleared and expelled from
the lungs more easily. The diagram below shows the correct positions to assume for draining different parts of the
lung.
OPTIONS A and C are inappropriate
OPTION D will drain the lower lobes of the lung
SOURCE: http://www.huff-n-puff.net/posturaldrainage.htm
12. When documenting outcome of Richard's treatment, Mario should include the following in his recording EXCEPT:
a. Color, amount and consistent of sputum
b. Character of breath sounds and respiratory rate before and after procedure
Situation 1 - Mr. Ibarra is assigned to the triage area and while on duty, he assesses the condition of Mrs. Simon who
came in with asthma. She has difficulty breathing and her respiratory rate is 40 per minute. Mr. Ibarra is asked to inject the
client epinephrine 0.3mg subcutaneously
1. The indication for epinephrine injection for Mrs. Simon is to:
a. Reduce anaphylaxis
b. Relieve hypersensitivity to allergen
c. Relieve respiratory distress due to bronchial spasm
d. Restore client's cardiac rhythm
CORRECT ANSWER: C
RATIONALE: Asthma is a chronic inflammatory disorder of the airways resulting in reversible bronchoconstriction
and air hunger in response to triggers from a variety of sources. When exposed to a trigger, the hyperactivity of
the medium-sized bronchi causes the release of leukotrienes, histamine and other substances from the mast cells
of the lung; these agents intensify the inflammatory process and cause bronchospasm. When inhaled in small
doses, epinephrine causes short-term relief from the symptoms by widening the bronchial tubes allowing air to
pass through. Once again epinephrine is not the best cure, but a temporary relief when an asthma inhaler is not
present.
OPTIONS A & D are incorrect
OPTION B: Epinephrine does have a direct effect to relieve hypersensitivity to allergen
SOURCE: Hogan, Mary Ann and Hill, Karen.Prentice Hall.Reviews and Rationales series for nursing.
Pathophysiology.pp.4-5; http://www.udel.edu/chem/C465/senior/fall00/Performance1/epinephrine.htm.html
2. When preparing the epinephrine injection from an ampule, the nurse initially:
a. Taps the ampule at the top to allow fluid to flow to the base of the ampule
b. Checks expiration date of the medication ampule
c. Removes needle cap of syringe and pulls plunger to expel air
d. Breaks the neck of the ampule with a gauze wrapped around it
CORRECT ANSWER: B
RATIONALE: In preparing medications in ampule or any form of medications, always check first the expiration
date and discard outdated medication. Check the label on the ampule carefully to make sure that the correct
medication is being prepared.
SOURCE: Kozier & Erb. Fundamentals of Nursing. 7th Edition.pp. 816
3. Mrs. Simon is obese. When administering a subcutaneous injection to an obese patient. It is best for the nurse to:
a. Inject needle at a 15 degree angle over the stretched skin of the client
b. Pinch skin at the injection site and use airlock technique
c. Pull skin of patient down to administer the drug in a Z track
d. Spread skin or pinch at the injection site and inject needle at a 45-90 degree angle
CORRECT ANSWER: D
RATIONALE:To determine the angle of insertion , a general rule to follow relates to the amount of tissue that can
be grasped at the site. A 45-degree angle is used when 1 inch of tissue can be grasped at the site; a 90-degree
angle is used when 2 inches of tissue can be grasped.
OPTION A: Skin Test
OPTION C: IM
SOURCE: Kozier & Erb. Fundamentals of Nursing. 7th Edition.pp. 822
4. When preparing for a subcutaneous injection, the proper size of syringe and needle would be:
a. Syringe 3ml and needle gauge 21 to 23
b. Tuberculin syringe 1 ml with needle gauge 26 or 27
c. Syringe 2ml and needle gauge 22
d. Syringe l-3ml and needle gauge 25 to 27
CORRECT ANSWER: D
RATIONALE: The type of syringe used for subcutaneous injections depends on the medication given. Generally a
2-ml syringe is used for most SC injections. However, if insulin is being administered, an insulin syringe is used;
and if heparin is being administered, a tuberculin syringe or prefilled cartridge may be used. Needle sizes and
lengths are selected based on the clients body mass,the intended angle of insertion and the planned site.
Generally a #25-gauge, 5/8-inch needle is used for adults.
OPTIONS A, B & C are incorrect
SOURCE: Kozier & Erb. Fundamentals of Nursing. 7th Edition.pp. 822
5. The rationale for giving medications through the subcutaneous route is;
a. There are many alternative sites for subcutaneous injection
b. Absorption time of the medicine is slower
c. There are less pain receptors in this area
d. The medication can be injected while the client is in any position
CORRECT ANSWER: B
, RATIONALE: Subcutaneous injections are given because there is little blood flow to fatty tissue and the injected
medication is generally absorbed more slowly, sometimes over 24 hours. Some medications injected
subcutaneously are growth hormone, insulin, epinephrine and other substances.
OPTIONS A, C & D are all secondary reasons.
SOURCE: http://www.cc.nih.gov/ccc/patient_education/pepubs/subq.pdf
Situation 2 - The use of massage and meditation to help decrease stress and pain have been strongly recommended
based on documented testimonials.
6. Martha wants to do a study on the topic. "Effects of massage and meditation on stress and pain." The type of
research that best suits this topic is:
a.Applied research
b.Qualitative research
c. Basic research
d.Quantitative research
CORRECT ANSWER: B
RATIONALE: Qualitative research is the investigation of phenomena, typically in an in depth and holistic fashion,
through the collection of rich narrative materials using a flexible design.
Qualitative research relies on reasons behind various aspects of behavior. Simply put, it investigates the why and
how of decision making, not just what, where, and when. Hence, the need is for smaller but focused samples
rather than large random samples, which qualitative research categorizes data into patterns as the primary basis
for organizing and reporting results. Qualitative researchers typically rely on four methods for gathering
information: (1) participation in the setting, (2) direct observation, (3) in depth interviews, and (4) analysis of
documents and materials
OPTION A: Applied research focuses on finding solutions to existing problems. For example, a study to determine
the effectiveness of a nursing intervention to ease grieving would be applied reaserch.
OPTION C: Basic research is undertaken to extend the base of knowledge in a discipline, or to formulate or refine
theory.
OPTION D: Quantitative research is the investigation of phenomena that lend themselves to precise
measurement and quantification, often involving rigorous and controlled design.
SOURCE: Polit, Denise F and Beck, Cheryl Tatano. Nursing research. Principles and Methods. 7th Edition.pp 18,
729; http://en.wikipedia.org/wiki/Qualitative_research
7. The type of research design that does not manipulate independent variable is:
a. Experimental design
b. Quasi-experimental design
c. Non-experimental design
d. Quantitative design
CORRECT ANSWER: C
RATIONALE: Non-experimental research- studies in which the researcher collects data without introducing an
intervention.
OPTION A: In experiment, the researcher controls the independent variable and randomly assigns subjects to
different conditions.
OPTION B: Quasi-experiment is an intervention study in which subjects are not randomly assigned to treatment
conditions, but the researcher exercises certain controls to enhance the study’s internal validity.
SOURCE: Polit, Denise F and Beck, Cheryl Tatano. Nursing research. Principles and Methods. 7th Edition.pp.
718,725,729
8. This research topic has the potential to contribute to nursing because it seeks to:
a. Include new modalities of care
b. Resolve a clinical problem
c. Clarify an ambiguous modality of care
d. Enhance client care
CORRECT ANSWER: D
Rationale: Nursing research is systematic inquiry designed to develop knowledge about issues of importance to
the nursing profession, including nursing practice, education administration, and informatics. Research designed
to generate knowledge and to improve the health and quality of life of nurse’s clients. Nurses increasingly are
expected to adopt an evidenced-based practice, which is broadly defined as the use of best clinical evidence in
making patient care decisions.
OPTIONS A,B and C are also correct but the best is option D
SOURCE: Polit, Denise F and Beck, Cheryl Tatano. Nursing research. Principles and Methods. 7th Edition.pp. 3-4
9. Martha does review of related literature for the purpose of:
a. Determine statistical treatment of data research
b. Orientation to what is already known or unknown
c. To identify if problem can be replicated
d. Answering the research question
CORRECT ANSWER: D
RATIONALE: All of the choices are correct except D. Answer to the research question may be found after
conducting the study.
, The following are purposes of a literature review:
• Identification of a research problem and development or refinement of research questions or hypothesis
• Orientation to what is known and not known about an area of inquiry, to ascertain what research can best
make a contribution to the existing base of evidence
• Determination of any gaps or inconsistencies in abody of research
• Determination of a need to replicate a prior study in a different setting or with a different study population
• Identification or development of new or reined clinical interventions to test through empirical research
• Identification of relevant theoretical or conceptual frameworks for a research problem
• Identification of suitable designs and data collection methods for a study
• For those developing research proposals for finding, identification of experts in the fields who could be
used as consultants
• Assistance in interpreting study findings and in developing implications and recommendations
SOURCE: Polit, Denise F and Beck, Cheryl Tatano. Nursing research. Principles and Methods. 7th Edition.pp. 5
10. Client's rights should be protected when doing research using human subjects. Martha identifies these rights as
follows EXCEPT:
a. right of self-determination
b. right to compensation
c. right of privacy
d. right not to be harmed
CORRECT ANSWER: B
RATIONALE: All are the client’s rights for being the subject in a research except option B.
The following are the basic human rights of research subjects:
• Right to informed consent
• The right to refuse and/or withdraw from participation
• Right to privacy
• Right to confidentiality or anonymity of data
• Right to be protected from harm
SOURCE: Venzon, Lydia and Venzon, Ronald. Professional Nursing in the Philippines.10th Edition.pp.110-111
Situation 3 - Richard has a nursing diagnosis of ineffective airway clearance related to excessive secretions and is at risk
for infection because of retained secretions. Part of Nurse Mario's nursing care plan is to loosen and remove excessive
secretions in the airway,
11. Mario listens to Richard's bilateral sounds and finds that congestion is in the upper lobes of the lungs. The
appropriate position to drain the anterior and posterior apical segments of the lungs when Mario does percussion
would be:
a. Client lying on his back then flat on his abdomen on Trendelenburg position
b. Client seated upright in bed or on a chair then leaning forward in sitting position
c. Client lying flat on his back and then flat on his abdomen
d. Client lying on his right then left side on Trendelenburg position
CORRECT ANSWER: B
RATIONALE: Postural Drainage involves a patient assuming various positions to facilitate the flow of secretions
from various parts of the lung into the bronchi, trachea and throat so that they can be cleared and expelled from
the lungs more easily. The diagram below shows the correct positions to assume for draining different parts of the
lung.
OPTIONS A and C are inappropriate
OPTION D will drain the lower lobes of the lung
SOURCE: http://www.huff-n-puff.net/posturaldrainage.htm
12. When documenting outcome of Richard's treatment, Mario should include the following in his recording EXCEPT:
a. Color, amount and consistent of sputum
b. Character of breath sounds and respiratory rate before and after procedure
