National University NSG 240 Exam Bank Questions and (Answers at End of each exam) Updated Fall 2025/26

National University NSG 240 Exam Bank Questions and (Answers at End of each exam) Updated Fall 2025/26. 1. Safety A nurse is teaching fire safety to a group of staff. Which of the following actions should the nurse identify as the priority during a fire? A. Close all doors and windows to contain the fire B. Activate the fire alarm system C. Remove all electrical equipment from the client’s room D. Move clients away from the fire area 2. Infection Control A nurse is caring for a client with C. difficile infection. Which of the following actions is appropriate? A. Wash hands with soap and water before leaving the room B. Use alcohol-based hand sanitizer after glove removal C. Wear a surgical mask while entering the room D. Double-bag all soiled linens before removal 3. Vital Signs While assessing an adult client, the nurse notes a respiratory rate of 28/min. Which of the following actions should the nurse take first? A. Reassess the client in 15 minutes B. Notify the provider immediately C. Assess the client’s oxygen saturation D. Document the findings in the medical record 4. Mobility A nurse is teaching a client who is at risk for orthostatic hypotension. Which instruction should the nurse include? A. “Stand up quickly after sitting to promote circulation.” B. “Sit on the side of the bed for several minutes before standing.” C. “Lie flat for 10 minutes before rising.” D. “Tighten your leg muscles while sitting to prevent dizziness.” 5. Legal/Ethical A nurse is caring for a client who refuses a prescribed treatment. The nurse states, “If you refuse this medication, I will have to place you in restraints and give it to you anyway.” The nurse is at risk for which of the following legal issues? A. Battery B. Assault C. False imprisonment D. Malpractice 6. Nutrition A nurse is reinforcing teaching about a clear liquid diet. Which of the following foods should the nurse include? A. Chicken broth B. Vanilla pudding C. Orange sherbet D. Cream of wheat 7. Delegation The nurse is caring for four clients. Which task should the nurse delegate to an assistive personnel (AP)? A. Measuring output from a chest tube drainage system B. Teaching a client how to use an incentive spirometer C. Ambulating a client who is postoperative after being cleared by the RN D. Assessing a client’s pedal pulses 8. Oxygen Therapy A nurse is caring for a client receiving oxygen at 2 L/min via nasal cannula. The client reports dryness in the nasal passages. Which of the following actions should the nurse take? A. Increase the flow rate to 4 L/min B. Apply a water-soluble lubricant to the nares C. Switch the client to a simple face mask D. Provide humidification with sterile water 9. Communication A client states, “I don’t think I can handle chemotherapy.” Which of the following is an appropriate therapeutic response? A. “You should try to stay positive.” B. “Why do you feel that way?” C. “It sounds like you’re overwhelmed. Tell me more about your concerns.” D. “Most clients experience anxiety before chemotherapy.” 10. Safety The nurse finds a client lying on the floor next to the bed. What action should the nurse take first? A. Call the provider B. Complete an incident report C. Assess the client for injuries D. Notify the charge nurse 11. Elimination A nurse is planning care for a client who is on bed rest and requires a bedpan. Which of the following actions will best promote comfort during elimination? A. Place the client in high-Fowler’s position B. Keep the head of the bed flat C. Position the client in a side-lying position D. Encourage the client to bear down while flat in bed 12. Hygiene The nurse is bathing a client with right-sided paralysis from a stroke. Which of the following actions is appropriate? A. Wash the unaffected side first, then the affected side B. Wash the affected side first to promote circulation C. Ask the client to bathe independently without assistance D. Avoid washing the affected arm to prevent injury 13. Prioritization The nurse is caring for four clients. Which client should the nurse see first? A. A client who is due for routine insulin administration B. A client who has an oxygen saturation of 89% on room air C. A client who requests pain medication for a headache rated 7/10 D. A client with an indwelling urinary catheter requesting emptying 14. Fluid & Electrolytes The nurse is caring for a client receiving IV fluids. Which finding should cause the nurse to suspect fluid overload? A. Flat neck veins when supine B. Bounding pulse and crackles in lungs C. Dry mucous membranes and poor skin turgor D. Decreased blood pressure and weak pulse 15. Infection Control (Select All That Apply) Which of the following are examples of maintaining surgical asepsis? A. Opening a sterile package away from the body B. Keeping sterile items above waist level C. Allowing sterile gloved hands to touch the hair D. Pouring sterile solution onto a field without splashing E. Turning your back briefly on a sterile field 1. Prioritization The nurse is caring for four clients. Which should be assessed first? A. A client 1 day post-op who reports incisional pain 7/10 B. A client with an SpO₂ of 89% on room air C. A client scheduled for discharge who needs instructions on wound care D. A client with blood glucose of 220 mg/dL 2. Infection Control Which of the following situations requires the nurse to wear a gown? A. Performing tracheostomy suctioning for a client on droplet precautions B. Emptying a urinary drainage bag for a client with MRSA in the urine C. Feeding a client with active tuberculosis D. Administering oral meds to a client on contact precautions 3. Safety – Restraints A client becomes agitated and tries to pull out their IV line. Which is the nurse’s priority action? A. Apply bilateral wrist restraints immediately B. Call the provider for a restraint prescription C. Use the least restrictive intervention first D. Document the client’s behavior in the chart 4. Legal/Ethical A nurse accidentally administers a double dose of a client’s antihypertensive medication. Which action should the nurse take first? A. Notify the provider B. Monitor the client’s vital signs C. Complete an incident report D. Inform the charge nurse 5. Delegation Which task is appropriate for an LPN rather than an AP? A. Administering an enteral feeding via gastrostomy tube B. Assisting a client to the bathroom with a walker C. Measuring hourly urine output from an indwelling catheter D. Obtaining vital signs on a stable post-op client 6. Oxygen Therapy A nurse enters a room and finds a client who is short of breath with an SpO₂ of 84% despite being on 6 L/min nasal cannula. Which is the priority action? A. Switch to a non-rebreather mask B. Increase the flow rate to 10 L/min C. Encourage the client to cough and deep breathe D. Notify the provider immediately 7. Hygiene Which action by the nurse requires correction when providing oral care to an unconscious client? A. Placing the client in side-lying position B. Using a padded tongue blade to hold the mouth open C. Rinsing the mouth with large volumes of water using a syringe D. Using a suction device to remove oral secretions 8. Communication (SATA) Which of the following are examples of non-therapeutic communication? A. “Why do you feel so anxious right now?” B. “Let’s talk more about what worries you.” C. “Don’t worry, everything will work out.” D. “I’ll stay here with you until your family arrives.” E. “You should try looking on the bright side.” 9. Safety – Fire Response (Order) The nurse discovers smoke coming from a trash can in a client’s room. List the steps in the correct order: A. Activate the alarm B. Close the room door C. Remove the client from the room D. Extinguish the fire 10. Nutrition A nurse is teaching a client who is prescribed a low-potassium diet. Which food should the client avoid? A. Bananas B. Apples C. Rice D. Green beans 11. Mobility/Immobility Which finding indicates that a client who has been on bed rest for 1 week is developing a complication? A. Increased urinary output B. Non-pitting edema in the ankles C. Crackles at the bases of the lungs D. Increased appetite 12. Documentation Which documentation entry is appropriate? A. “Client seems depressed and angry today.” B. “Client states, ‘I feel like I can’t go on any longer.’” C. “Client is uncooperative with all nursing care.” D. “Client was upset when spouse did not visit.” 13. Safety – Delegation (SATA) Which tasks are appropriate to delegate to assistive personnel (AP)? A. Obtaining vital signs for a stable client B. Educating a client about a low-sodium diet C. Assisting a client with bed-to-chair transfer D. Monitoring for bleeding after a procedure E. Collecting a stool specimen 14. Vital Signs A client’s radial pulse is irregular. Which action should the nurse take? A. Count radial pulse for 1 minute B. Count apical pulse for 1 full minute C. Ask another nurse to verify pulse D. Record radial pulse as irregular and notify provider 15. Legal/Ethical A nurse leaves the bed in its highest position, and the client falls while trying to get up. This is an example of: A. Assault B. Battery C. Malpractice D. Negligence 16. Oxygenation Which of the following outcomes indicates effective use of an incentive spirometer? A. Decreased heart rate B. Increased O₂ saturation C. Decreased urine output D. Increased blood pressure 17. Safety – Falls Which intervention should the nurse implement for a client at high risk for falls? A. Place the bed in the lowest position B. Apply bilateral wrist restraints C. Keep the client’s personal items on the bedside table across the room D. Raise all four side rails at night 18. Infection Control A nurse is caring for a client with chickenpox (varicella). Which precautions should the nurse implement? A. Contact only B. Droplet only C. Airborne and contact D. Protective (reverse isolation) 19. Hygiene – Foot Care Which teaching is appropriate for a client with diabetes regarding foot care? A. Soak feet daily in warm water B. Apply lotion between the toes C. Wear cotton socks and well-fitting shoes D. Trim toenails rounded at the corners 20. Safety – Medication A client refuses to take a prescribed medication. Which action should the nurse take first? A. Notify the provider of the refusal B. Educate the client about the purpose of the medication C. Document the refusal in the client’s chart D. Ask a family member to encourage the client 21. Legal/Ethical Which action requires completion of an incident report? A. A client refuses a prescribed IV antibiotic B. A nurse gives the wrong medication to a client C. A family member complains about visiting hours D. A client refuses to sign an informed consent form 22. Nutrition (SATA) Which of the following foods are appropriate for a client prescribed a high-protein diet? A. Salmon B. Lentils C. Yogurt D. Applesauce E. White bread 23. Safety – Prioritization The nurse is caring for four clients. Which requires immediate intervention? A. A client who reports 9/10 pain after surgery B. A client with a blood glucose of 290 mg/dL C. A client with a respiratory rate of 8/min D. A client with a urinary catheter draining cloudy urine 24. Vital Signs A client has orthostatic hypotension. Which finding supports this diagnosis? A. BP increases 20 mmHg when standing B. HR decreases by 15 bpm when standing C. BP decreases 20 mmHg systolic when standing D. HR remains unchanged when standing 25. Documentation Which entry is correct according to legal documentation standards? A. “Client was uncooperative; refused medication because of stubbornness.” B. “Client refused medication and stated, ‘I don’t like how it makes me feel.’” C. “Client appeared to be angry about treatment plan.” D. “Client is noncompliant with all care.” 1. Safety & Infection Control The nurse is preparing to insert an indwelling urinary catheter for a client. Which action indicates correct sterile technique? A. Hold the catheter 2 inches from the tip when inserting B. Place the sterile kit on a bedside table above waist level C. Don sterile gloves before opening the kit D. Lubricate the entire catheter before insertion 2. Vital Signs The nurse obtains the following vital signs: BP 88/56 mmHg HR 118/min RR 24/min SpO₂ 90% on room air Which action should the nurse take first? A. Increase IV fluids B. Reassess the client’s blood pressure C. Apply oxygen via nasal cannula D. Notify the provider 3. Delegation The nurse is caring for four clients. Which task is appropriate for assistive personnel (AP)? A. Feeding a client who has difficulty swallowing after a stroke B. Ambulating a client 1 day post-op after hip replacement surgery C. Recording oral intake for a client with heart failure D. Educating a client about incentive spirometry use 4. Hygiene The nurse is performing perineal care for a client with an indwelling urinary catheter. Which is the correct technique? A. Clean from the rectum toward the catheter B. Cleanse outward in a circular motion from the catheter insertion site C. Remove the catheter before cleansing D. Apply powder around the catheter site 5. Communication (SATA) Which of the following are examples of therapeutic communication? A. “Tell me more about how this has affected you.” B. “Don’t worry, everything will work out fine.” C. “I’ll stay here with you while you wait for your results.” D. “Why didn’t you come in sooner?” E. “That must be difficult for you.” 6. Safety – Fall Risk A nurse is caring for an older adult who is at risk for falls. Which intervention is most appropriate? A. Raise all four side rails while in bed B. Place the call light within reach C. Keep the client’s bed in the highest position D. Apply wrist restraints for safety 7. Legal/Ethical A nurse witnesses another nurse administer the wrong dose of medication but fail to report it. Which action should the observing nurse take? A. Document the error in the client’s record B. Report the error to the charge nurse immediately C. Confront the nurse privately and demand disclosure D. Report the nurse to the state board of nursing 8. Nutrition A client with heart failure is prescribed a low-sodium diet. Which food should the nurse instruct the client to avoid? A. Fresh apple slices B. Steamed broccoli C. Canned vegetable soup D. Plain baked chicken breast 9. Mobility A client has been on prolonged bed rest. Which finding requires immediate intervention? A. Decreased appetite B. Redness over the sacrum C. Decreased bowel sounds D. Muscle weakness 10. Oxygen Therapy A nurse is caring for a client with COPD who is receiving oxygen at 5 L/min via nasal cannula. Which action should the nurse take? A. Continue oxygen therapy as ordered B. Reduce flow rate and notify the provider C. Switch to a non-rebreather mask D. Encourage incentive spirometry every hour 11. Safety – Fire (Priority Order) The nurse discovers a fire in a client’s room. Place the actions in the correct order. A. Activate the fire alarm B. Close doors and windows C. Remove the client from the room D. Use fire extinguisher 12. Documentation Which of the following entries is appropriate for the nurse to record in the medical record? A. “Client is stubborn and refuses to eat.” B. “Client appears to be upset.” C. “Client stated, ‘I don’t feel like eating lunch today.’” D. “Client is uncooperative with staff.” 13. Infection Control (SATA) A client is diagnosed with tuberculosis. Which actions should the nurse take? A. Place the client in a negative-pressure room B. Wear an N95 respirator when entering the room C. Keep the door to the client’s room closed D. Place a surgical mask on the client during transport E. Use soap and water only for hand hygiene 14. Delegation Which task should the nurse assign to an LPN rather than an AP? A. Recording intake and output B. Collecting a routine urine specimen C. Reinforcing teaching about wound care D. Assisting with ambulation to the bathroom 15. Safety – Restraints A nurse is caring for a client in soft wrist restraints. Which action should the nurse take? A. Tie restraints to the side rails of the bed B. Release restraints every 2 hours for range of motion C. Remove restraints only with provider order D. Keep restraints on at all times 16. Vital Signs A client’s blood pressure is 154/94 mmHg. How should the nurse classify this finding? A. Normal B. Elevated C. Stage 1 hypertension D. Stage 2 hypertension 17. Hygiene Which client should the nurse bathe using a chlorhexidine solution? A. A client preparing for surgery B. A client with a fractured femur C. A client admitted for pneumonia D. A client with dehydration 18. Safety – Medication The client states, “This pill looks different than the one I take at home.” What is the nurse’s best action? A. Reassure the client that medications often look different in the hospital B. Verify the medication with the MAR and provider’s prescription C. Notify the pharmacy immediately D. Hold the dose and document the refusal 19. Oxygenation A client is using an incentive spirometer. Which outcome indicates effectiveness? A. Increased heart rate B. Decreased respiratory rate C. Clearer breath sounds D. Increased O₂ flow rate 20. Legal/Ethical A nurse leaves the bed in a high position and the client falls when attempting to get up. The nurse could be charged with: A. Malpractice B. Negligence C. Battery D. Assault 21. Nutrition (SATA) Which foods should the nurse recommend for a client on a high-protein diet? A. Eggs B. Fish C. Broccoli D. Yogurt E. White rice 22. Communication A client states, “I feel like my family doesn’t want me around anymore.” Which is the most therapeutic response? A. “You should focus on the positive things in your life.” B. “That must be a very lonely feeling for you.” C. “Don’t think like that; your family loves you.” D. “Why would you think that?” 23. Safety – Prioritization Which client should the nurse see first? A. A client with temperature of 101°F and chills B. A client with O₂ saturation of 88% on room air C. A client reporting 8/10 abdominal pain D. A client scheduled for discharge later in the day 24. Hygiene Which action is correct when providing foot care to a client with diabetes mellitus? A. Soak the client’s feet for 20 minutes daily B. Cut toenails straight across with nail clippers C. Apply lotion between the toes to prevent dryness D. Trim toenails rounded at the corners 25. Infection Control The nurse is caring for a client with MRSA in a wound. Which type of precautions should the nurse use? A. Droplet B. Airborne C. Contact D. Protective Advanced NCLEX-Style ATI Fundamentals Questions 1. Safety & Prioritization A nurse is caring for four clients. Which client should the nurse assess first? A. A client reporting constipation for 3 days B. A client with a blood glucose of 210 mg/dL C. A client with O₂ saturation of 89% on room air D. A client reporting pain at a level 6/10 2. Delegation A nurse is assigning tasks to an assistive personnel (AP). Which of the following tasks is appropriate for the AP? A. Assisting a client who had a stroke 2 days ago with ambulation to the bathroom B. Educating a client on how to use a walker C. Assessing a client’s skin for signs of breakdown D. Administering oral medications to a stable client 3. Infection Control (Select All That Apply) The nurse is caring for a client with Clostridium difficile infection. Which precautions are appropriate? A. Place client in a private room B. Wear an N95 respirator mask when entering the room C. Wash hands with soap and water after care D. Use disposable equipment whenever possible E. Place a surgical mask on the client during transport 4. Legal/Ethical A nurse suspects another nurse is working while impaired. Which of the following is the priority action by the nurse? A. Document the incident in the impaired nurse’s record B. Report the concern to the charge nurse or supervisor C. Confront the nurse about her suspected impairment D. Remove the nurse from direct client care immediately 5. Sterile Technique A nurse is preparing a sterile field for a dressing change. Which of the following breaks sterile technique? A. Holding sterile forceps with the tips pointed down B. Opening the sterile field on a waist-high table C. Pouring sterile solution 4–6 inches above the sterile field D. Reaching across the sterile field to reposition supplies 6. Vital Signs/Priority A nurse is caring for a client post-op who is restless, has pale skin, and a blood pressure of 86/54 mmHg. Which action should the nurse take first? A. Increase IV fluid rate per protocol B. Apply oxygen at 2 L/min via nasal cannula C. Notify the provider D. Reassess blood pressure in 15 minutes 7. Communication A client states, “I don’t see the point of living anymore.” Which response by the nurse is most therapeutic? A. “You should focus on the positive things in your life.” B. “Are you thinking about harming yourself?” C. “Things will get better soon, don’t worry.” D. “Why would you feel that way?” 8. Documentation Which of the following entries should the nurse document in the client’s medical record? A. “Client appears angry and upset.” B. “Client is uncooperative with staff.” C. “Client states, ‘I feel very anxious today.’” D. “Client is refusing care because she is stubborn.” 9. Hygiene A nurse is providing perineal care to a female client with an indwelling urinary catheter. Which of the following is the correct technique? A. Cleanse from the rectum toward the urethra B. Cleanse in a circular motion around the catheter insertion site, then move outward C. Remove the catheter before performing perineal care D. Apply powder around the catheter site to prevent skin breakdown 10. Priority Safety The nurse is preparing to administer an oral medication to a client. The client states, “This pill looks different than what I usually take at home.” What should the nurse do first? A. Recheck the prescription with the medication administration record (MAR) B. Reassure the client that different brands look different C. Contact the pharmacy to confirm the pill’s identity D. Hold the medication and notify the provider immediatel