NCLEX-RN Practice Questions: Nursing Fundamentals
Single-Best-Answer Questions
Question 1 — Infection control (Airborne vs droplet
precautions)
A 72-year-old man is admitted with a 3-week history of
productive cough, night sweats, and weight loss. Sputum for
acid-fast bacilli is pending. Which personal protective
equipment (PPE) should the nurse don before entering the
patient’s room?
A. Surgical mask (procedure mask)
B. N95 (or equivalent) respirator
C. Gloves and gown only
D. N95 respirator plus full face shield
Correct answer: B. N95 (or equivalent) respirator
CJMM
Recognize cues: Chronic productive cough, night sweats, weight
loss → suspicion for tuberculosis (airborne pathogen). Sputum
pending — patient infectious risk unknown.
Analyze: TB and other airborne pathogens require respiratory
protection that filters small droplet nuclei. Surgical masks do
not provide adequate filtration for airborne particles.
Decide: Use an N95 respirator (fit-tested) before entering. Eye
protection may be used for procedures but is not required for
,routine room entry for suspected TB.
Act: Don a properly fit-tested N95 respirator (or powered air-
purifying respirator if indicated). Place patient in airborne
infection isolation room.
Evaluate: Infection control is optimized and exposure risk
minimized if staff use N95 and patient is in a negative-pressure
room.
Rationales (all options)
A. Surgical mask (procedure mask) — Incorrect. Surgical masks
protect against large droplets and splashes but do not filter
small airborne droplet nuclei. Not adequate for suspected TB.
B. N95 respirator — Correct. Recommended for airborne
pathogens to filter small particles; must be fit-tested and worn
before room entry.
C. Gloves and gown only — Incorrect. Gloves/gown protect
against contact but do not provide respiratory protection from
inhalation of airborne organisms.
D. N95 respirator plus full face shield — Incorrect as best single
answer. While an N95 is correct, routine full face shield is not
necessary for suspected airborne TB unless splashes or
procedures generating aerosols are expected. This option adds
unnecessary PPE as a routine requirement.
Question 2 — Patient safety (Fall prevention)
,A 84-year-old woman with mild dementia has been getting out
of bed at night to use the bathroom and has had two near-falls.
Which initial nursing intervention is the best to reduce fall risk?
A. Apply soft wrist restraints during the night.
B. Keep the bed in the lowest position, place a night light on,
keep the call light within reach, and encourage a scheduled
toileting plan.
C. Encourage the patient to get up unassisted to preserve
independence.
D. Increase continuous hourly rounding to every 4 hours.
Correct answer: B. Keep the bed in the lowest position, place a
night light on, keep the call light within reach, and encourage
a scheduled toileting plan.
CJMM
Recognize cues: Advanced age, dementia, nighttime
wandering/urination, near-falls → increased fall risk.
Analyze: Least-restrictive, evidence-based interventions
(environmental modification, assisted toileting, call light access,
adequate lighting) reduce falls. Restraints increase harms.
Decide: Implement environmental and care-process
interventions first (lowest bed, lighting, call light, scheduled
toileting, non-skid footwear).
Act: Put bed in lowest position with locked brakes, place night
light, ensure call light and personal items are within reach, start
scheduled toileting rounds.
, Evaluate: Monitor for decrease in nighttime ambulation and
near-falls; reassess risk and update plan.
Rationales
A. Apply soft wrist restraints during the night. — Incorrect.
Restraints are a last resort, increase risk of injury and
psychological harm, and do not address underlying causes. Use
only after less restrictive measures and with proper orders.
B. Keep the bed in the lowest position...scheduled toileting
plan. — Correct. These are proven, least-restrictive
interventions that address precipitating factors (nocturia, poor
lighting) and reduce fall risk.
C. Encourage the patient to get up unassisted... — Incorrect.
Encouraging unassisted ambulation in a patient with prior near-
falls increases fall risk. Assistive measures should be in place.
D. Increase continuous hourly rounding to every 4 hours. —
Incorrect. The phrase “increase hourly rounding to every 4
hours” is contradictory; rounding less frequently increases risk.
Rounding intervals should be frequent (e.g., hourly or every 1–2
hours), not every 4 hours.
Question 3 — Documentation (Medication refusal)
A patient refuses a routinely scheduled antihypertensive
medication. What is the most appropriate way for the nurse to
document this event?
Single-Best-Answer Questions
Question 1 — Infection control (Airborne vs droplet
precautions)
A 72-year-old man is admitted with a 3-week history of
productive cough, night sweats, and weight loss. Sputum for
acid-fast bacilli is pending. Which personal protective
equipment (PPE) should the nurse don before entering the
patient’s room?
A. Surgical mask (procedure mask)
B. N95 (or equivalent) respirator
C. Gloves and gown only
D. N95 respirator plus full face shield
Correct answer: B. N95 (or equivalent) respirator
CJMM
Recognize cues: Chronic productive cough, night sweats, weight
loss → suspicion for tuberculosis (airborne pathogen). Sputum
pending — patient infectious risk unknown.
Analyze: TB and other airborne pathogens require respiratory
protection that filters small droplet nuclei. Surgical masks do
not provide adequate filtration for airborne particles.
Decide: Use an N95 respirator (fit-tested) before entering. Eye
protection may be used for procedures but is not required for
,routine room entry for suspected TB.
Act: Don a properly fit-tested N95 respirator (or powered air-
purifying respirator if indicated). Place patient in airborne
infection isolation room.
Evaluate: Infection control is optimized and exposure risk
minimized if staff use N95 and patient is in a negative-pressure
room.
Rationales (all options)
A. Surgical mask (procedure mask) — Incorrect. Surgical masks
protect against large droplets and splashes but do not filter
small airborne droplet nuclei. Not adequate for suspected TB.
B. N95 respirator — Correct. Recommended for airborne
pathogens to filter small particles; must be fit-tested and worn
before room entry.
C. Gloves and gown only — Incorrect. Gloves/gown protect
against contact but do not provide respiratory protection from
inhalation of airborne organisms.
D. N95 respirator plus full face shield — Incorrect as best single
answer. While an N95 is correct, routine full face shield is not
necessary for suspected airborne TB unless splashes or
procedures generating aerosols are expected. This option adds
unnecessary PPE as a routine requirement.
Question 2 — Patient safety (Fall prevention)
,A 84-year-old woman with mild dementia has been getting out
of bed at night to use the bathroom and has had two near-falls.
Which initial nursing intervention is the best to reduce fall risk?
A. Apply soft wrist restraints during the night.
B. Keep the bed in the lowest position, place a night light on,
keep the call light within reach, and encourage a scheduled
toileting plan.
C. Encourage the patient to get up unassisted to preserve
independence.
D. Increase continuous hourly rounding to every 4 hours.
Correct answer: B. Keep the bed in the lowest position, place a
night light on, keep the call light within reach, and encourage
a scheduled toileting plan.
CJMM
Recognize cues: Advanced age, dementia, nighttime
wandering/urination, near-falls → increased fall risk.
Analyze: Least-restrictive, evidence-based interventions
(environmental modification, assisted toileting, call light access,
adequate lighting) reduce falls. Restraints increase harms.
Decide: Implement environmental and care-process
interventions first (lowest bed, lighting, call light, scheduled
toileting, non-skid footwear).
Act: Put bed in lowest position with locked brakes, place night
light, ensure call light and personal items are within reach, start
scheduled toileting rounds.
, Evaluate: Monitor for decrease in nighttime ambulation and
near-falls; reassess risk and update plan.
Rationales
A. Apply soft wrist restraints during the night. — Incorrect.
Restraints are a last resort, increase risk of injury and
psychological harm, and do not address underlying causes. Use
only after less restrictive measures and with proper orders.
B. Keep the bed in the lowest position...scheduled toileting
plan. — Correct. These are proven, least-restrictive
interventions that address precipitating factors (nocturia, poor
lighting) and reduce fall risk.
C. Encourage the patient to get up unassisted... — Incorrect.
Encouraging unassisted ambulation in a patient with prior near-
falls increases fall risk. Assistive measures should be in place.
D. Increase continuous hourly rounding to every 4 hours. —
Incorrect. The phrase “increase hourly rounding to every 4
hours” is contradictory; rounding less frequently increases risk.
Rounding intervals should be frequent (e.g., hourly or every 1–2
hours), not every 4 hours.
Question 3 — Documentation (Medication refusal)
A patient refuses a routinely scheduled antihypertensive
medication. What is the most appropriate way for the nurse to
document this event?
