Nclex Rn Fundamentals Of Nursing Practice Actual Questions, Answers And Explanation| Latest Update 2025/2026

1. The nurse is completing the preoperative checklist for a patient scheduled for surgery. In reviewing the chart, the nurse finds the consent has not been signed by the patient. When the patient starts asking questions regarding the surgery, what is the next action the nurse should take? a. Have the patient sign the consent b. Tell the patient all questions will be answered by the surgeon before the anesthesiologist administers anesthetic c. Contact the surgeon to inform them the patient has questions regarding the procedure d. Answer all the patient's questions - ANSWER c. Contact the surgeon to inform them the patient has questions regarding the procedure Before any invasive procedure, the surgeon must inform the patient of what the procedure entails, the purpose for the procedure, and the potential risks associated with that procedure before the consent is signed by the patient. (Hence the term "informed consent.") If the consent has not been signed and the patient has questions, the healthcare provider has not reviewed the procedure and risks involved and needs to do so before the procedure. 2. The nurse is caring for a patient who had an endoscopic total hysterectomy and is now experiencing urinary retention. The nurse is preparing to contact the healthcare provider using SBAR (situation background assessment recommendation). Which of the following questions is a part of SBAR communication? a. "Could you tell me what I need to do?" b. "What do you need to know about the patient?" c. "I believe the patient needs a urinary catheter." d. "Why do you think the patient is unable to urinate?" - ANSWER c. "I believe the patient needs a urinary catheter." Making a recommendation to the healthcare provider is part of SBAR. The following is an example of how the nurse could effectively use SBAR in this patient situation: • Situation: "Mrs. Jones is experiencing urinary retention." • Background: "She had an endoscopic total hysterectomy." • Assessment: "Her vital signs have been stable today. She is taking PO fluids but has had no urine output in the last five hours. Her bladder is distended." • Recommendation: "I recommend that you see her and we insert an indwelling urinary Foley catheter and measure urine output every two hours." 4.A patient is recovering from a total abdominal hysterectomy. When assessed by the nurse eight hours after the procedure, which of the following would the nurse identify as an early sign of shock? a. Restlessness b. Warm, dry skin that is pale c. Heart rate of 115 bpm d. Urine output 50 mL/hr - ANSWER a. Restlessness Early signs of shock include restlessness, anxiousness, nervousness, and irritability. This is due to the sympathetic nervous system release of epinephrine, which also decreases perfusion to the skin causing pallor, coolness, and clamminess. Other signs of shock include hypotension and confusion. 5. A patient is admitted to the emergency room complaining of shortness of breath. The nurse knows the patient will be evaluated for hypoxia and anticipates the healthcare provider ordering which test? a. Complete blood cell count (CBC) b. Sputum culture c. Hemoglobin (Hgb) d. Arterial blood gas (ABG) - ANSWER d. Arterial blood gas (ABG) An ABG evaluates gas exchange in the lungs, which will provide the needed information regarding oxygenation status. An arterial blood gas reveals pH, carbon dioxide and oxygen partial pressures, bicarbonate level (HCO3-), and pH. 6. Emergency medical services brings an unconscious adult in to the emergency room. When the nurse performs a rapid assessment, the location to check the pulse is: a. Radial b. Brachial c. Femoral d. Carotid - ANSWER d. Carotid Rapid assessment of an unconscious adult patient begins with checking circulation, which is checked at the carotid artery. If a patient is hypotensive (decreased blood pressure), the most likely place to be able to feel a pulse is the carotid artery. 7. A patient is admitted to the medical-surgical unit with methicillin-resistant staphylococcus aureus (MRSA) of a wound. The nurse initiates contact precautions, which includes use of which of the following? a. Clean gown and gloves b. N-95 respirator c. Biohazard bin placed in the room d. Negative airflow room - ANSWER a. Clean gown and gloves Contact isolation requires all people entering the room to follow standard precautions in addition to wearing a clean (not sterile) gown and gloves. Other diseases that require contact precautions include the following: norovirus, rotavirus, and Clostridium difficile. Additionally, patients with draining wounds, uncontrolled secretions, pressure ulcers, generalized rash, and ostomy bags/tubes also warrant contact precautions. C is incorrect because linen and trash for this patient are not considered biohazardous. 8. A patient in the medical-surgical unit tells the nurse they haven't had a bowel movement in two days. What is the first intervention the nurse should implement? a. Review the patient's medical record to determine normal bowel pattern b. Offer prune juice with every meal c. Call the healthcare provider to request an order for stool softener d. Increase the patient's oral fluid intake - ANSWER a. Review the patient's medical record to determine normal bowel pattern Bowel patterns can vary greatly in adults: three BMs weekly up to three BMs daily is considered within normal range. Several factors can influence normal bowel patterns, including surgery, stress, and opioid medications. The nurse should review the medical record to determine the patient's normal bowel patterns prior to hospitalization. 9.The nurse encourages a patient with a history of heart failure to reduce energy expenditure by alternating activity and rest. Which nursing process phase is this? a. Diagnosis b. Planning c. Implementation d. Evaluation - ANSWER C. Implementation Teaching a patient about alternating activity and rest is a component of patient education, which falls into the implementation phase. This is an example of putting an individualized plan into action. Other components of implementation include assisting with hygienic care, promoting physical comfort, supporting respiratory and elimination functions, facilitating ingestion of food/fluids, managing the patient's surroundings, promoting a therapeutic relationship, and carrying out other therapeutic nursing activities. 10. The nurse on the medical-surgical unit is interested in implementing evidence-based practice. The nurse knows when evidence-based practice is utilized: a. National health agencies create clinical practice guidelines that must be used. b. Findings from randomized trials are used to plan care. c. Clinical decision-making and nursing judgment are used to find which evidence works for each specific situation in clinical practice. d. Nursing interventions are statistically analyzed by a nurse in relation to patient outcomes to discover evidence for appropriate patient interventions. - ANSWER c. Clinical decision-making and nursing judgment are used to find which evidence works for each specific situation in clinical practice. Evidence-based practice is based on evidence from nurses working with actual patients to find the best interventions for the best outcomes. It is through this evidence that nurses develop and improve their practice to achieve even greater patient outcomes. It is imperative that nurses continue to learn and improve their skills and use updated techniques as technology changes and patients have increasing acuity.