NCLEX-RN Practice Questions: Nursing Fundamentals
Single-Best-Answer Questions
1) Infection control — Contact precautions
Scenario: A 68-year-old male admitted with a draining stage IV
sacral pressure injury is colonized with MRSA. He is on contact
precautions. The nursing assistive personnel (NAP) asks
whether they may remove the soiled dressing at the bedside in
the patient’s room and bring it to the soiled utility closet down
the hall for disposal.
Recognize cues: MRSA, draining wound, contact precautions,
bedside dressing removal, disposal location.
Analyze: Risk of environmental contamination and provider
exposure if dressing is carried through unit.
Decide: Which is the BEST nursing action?
A. Allow NAP to remove the dressing at bedside and carry it to
the soiled utility closet for disposal.
B. Instruct NAP to remove the dressing at bedside, place
dressing in a sealed impermeable bag at bedside, and dispose
in the room’s designated waste receptacle.
C. Have NAP bring the patient to the soiled utility closet to
remove and dispose of dressing there.
D. Ask the NAP to place dressing in a regular trash bag and carry
it to central disposal on the way to their next patient.
Correct answer: B.
,Rationales:
A. Incorrect. Carrying a soiled dressing through hallways
increases risk of environmental contamination and
transmission. This violates contact-precaution practices.
B. Correct. Best practice: remove at bedside, contain infectious
material in a sealed impermeable bag (or leak-proof container)
and dispose in designated waste receptacle in the room or an
enclosed receptacle per facility policy. Minimizes spread.
C. Incorrect. Transporting the patient increases exposure to
others and is unnecessary for a dressing change.
D. Incorrect. Regular trash bags are not appropriate for
biohazardous/soiled items and carrying through the unit
increases transmission risk.
Act: Instruct NAP and ensure proper bagging/disposal and hand
hygiene.
Evaluate: No contamination outside room; staff and
environment protected.
2) Patient safety — Falls risk prioritization
Scenario: Four patients are due for rounding. Which patient
should the nurse assess first?
1. 84-year-old male with Alzheimer’s who is ambulatory and
reports needing to use the restroom.
2. 62-year-old postop hip arthroplasty, awake, OOB (out of
bed) with walker, on opioid PCA.
, 3. 45-year-old ambulatory with stable vitals complaining of
dizziness after taking antihypertensive.
4. 29-year-old s/p appendectomy, stable, wants to ambulate
to prevent ileus.
Recognize cues: Age, cognition, medication effects, dizziness,
mobility assist.
Analyze: Identify highest immediate fall risk.
Decide: Which to assess first?
A. Patient 1
B. Patient 2
C. Patient 3
D. Patient 4
Correct answer: C.
Rationales:
A. Incorrect. Patient with Alzheimer’s is fall risk, but they
reported need to use restroom — important but not as
immediately high risk as sudden dizziness.
B. Incorrect. Postop hip patient on opioids has high fall risk, but
is using walker and is currently awake; still serious but less
urgent than acute dizziness that can cause syncope.
C. Correct. Sudden dizziness after antihypertensive suggests
orthostatic hypotension or syncope risk—immediate potential
for injury and hemodynamic instability. Assess first.
D. Incorrect. Ambulation to prevent ileus is important but lower
immediate risk than acute dizziness or cognitive patient
needing toileting.
, Act: Immediately assess patient 3’s vitals, orthostatic readings,
safety, and intervene.
Evaluate: Stabilization of dizziness/avoidance of fall.
3) Documentation — Accuracy and timeliness
Scenario: The nurse administered PRN morphine to a patient 30
minutes ago for severe pain. The nurse is late documenting the
administration because of an emergency. Which documentation
entry is BEST?
A. Document the morphine administration now and include the
actual time given and the reason for delayed documentation.
B. Document the administration now and enter the current
time as the administration time to avoid confusion.
C. Wait until end of shift and then chart both the administration
and the reason for the delay.
D. Ask another nurse to chart the medication immediately so
the record is up to date.
Recognize cues: Medication given 30 min earlier,
documentation delayed due to emergency, need for accuracy.
Analyze: Legal & safety importance of accurate time & reason
for delay.
Decide: Best action?
Correct answer: A.
Rationales:
A. Correct. Chart the actual time of administration and explain
Single-Best-Answer Questions
1) Infection control — Contact precautions
Scenario: A 68-year-old male admitted with a draining stage IV
sacral pressure injury is colonized with MRSA. He is on contact
precautions. The nursing assistive personnel (NAP) asks
whether they may remove the soiled dressing at the bedside in
the patient’s room and bring it to the soiled utility closet down
the hall for disposal.
Recognize cues: MRSA, draining wound, contact precautions,
bedside dressing removal, disposal location.
Analyze: Risk of environmental contamination and provider
exposure if dressing is carried through unit.
Decide: Which is the BEST nursing action?
A. Allow NAP to remove the dressing at bedside and carry it to
the soiled utility closet for disposal.
B. Instruct NAP to remove the dressing at bedside, place
dressing in a sealed impermeable bag at bedside, and dispose
in the room’s designated waste receptacle.
C. Have NAP bring the patient to the soiled utility closet to
remove and dispose of dressing there.
D. Ask the NAP to place dressing in a regular trash bag and carry
it to central disposal on the way to their next patient.
Correct answer: B.
,Rationales:
A. Incorrect. Carrying a soiled dressing through hallways
increases risk of environmental contamination and
transmission. This violates contact-precaution practices.
B. Correct. Best practice: remove at bedside, contain infectious
material in a sealed impermeable bag (or leak-proof container)
and dispose in designated waste receptacle in the room or an
enclosed receptacle per facility policy. Minimizes spread.
C. Incorrect. Transporting the patient increases exposure to
others and is unnecessary for a dressing change.
D. Incorrect. Regular trash bags are not appropriate for
biohazardous/soiled items and carrying through the unit
increases transmission risk.
Act: Instruct NAP and ensure proper bagging/disposal and hand
hygiene.
Evaluate: No contamination outside room; staff and
environment protected.
2) Patient safety — Falls risk prioritization
Scenario: Four patients are due for rounding. Which patient
should the nurse assess first?
1. 84-year-old male with Alzheimer’s who is ambulatory and
reports needing to use the restroom.
2. 62-year-old postop hip arthroplasty, awake, OOB (out of
bed) with walker, on opioid PCA.
, 3. 45-year-old ambulatory with stable vitals complaining of
dizziness after taking antihypertensive.
4. 29-year-old s/p appendectomy, stable, wants to ambulate
to prevent ileus.
Recognize cues: Age, cognition, medication effects, dizziness,
mobility assist.
Analyze: Identify highest immediate fall risk.
Decide: Which to assess first?
A. Patient 1
B. Patient 2
C. Patient 3
D. Patient 4
Correct answer: C.
Rationales:
A. Incorrect. Patient with Alzheimer’s is fall risk, but they
reported need to use restroom — important but not as
immediately high risk as sudden dizziness.
B. Incorrect. Postop hip patient on opioids has high fall risk, but
is using walker and is currently awake; still serious but less
urgent than acute dizziness that can cause syncope.
C. Correct. Sudden dizziness after antihypertensive suggests
orthostatic hypotension or syncope risk—immediate potential
for injury and hemodynamic instability. Assess first.
D. Incorrect. Ambulation to prevent ileus is important but lower
immediate risk than acute dizziness or cognitive patient
needing toileting.
, Act: Immediately assess patient 3’s vitals, orthostatic readings,
safety, and intervene.
Evaluate: Stabilization of dizziness/avoidance of fall.
3) Documentation — Accuracy and timeliness
Scenario: The nurse administered PRN morphine to a patient 30
minutes ago for severe pain. The nurse is late documenting the
administration because of an emergency. Which documentation
entry is BEST?
A. Document the morphine administration now and include the
actual time given and the reason for delayed documentation.
B. Document the administration now and enter the current
time as the administration time to avoid confusion.
C. Wait until end of shift and then chart both the administration
and the reason for the delay.
D. Ask another nurse to chart the medication immediately so
the record is up to date.
Recognize cues: Medication given 30 min earlier,
documentation delayed due to emergency, need for accuracy.
Analyze: Legal & safety importance of accurate time & reason
for delay.
Decide: Best action?
Correct answer: A.
Rationales:
A. Correct. Chart the actual time of administration and explain
