NCLEX-Style Nursing Comprehensive Review
Complete Study Guide for Nursing Success
Practice Questions with Detailed Rationales
Based on NCLEX-RN Test Plan Categories
1. Safe and Effective Care Environment - Management of Care
Question 1:
The charge nurse is making assignments for the day shift. Which client should be
assigned to the experienced RN rather than a new graduate nurse?
A) A stable post-operative client requiring routine wound care
B) A client with chest pain requiring continuous cardiac monitoring
C) A client admitted for observation after a minor fall
D) A client receiving IV antibiotics for pneumonia
Answer: B) A client with chest pain requiring continuous cardiac monitoring
Clients with chest pain require expert assessment skills, knowledge of cardiac
rhythms, and ability to recognize changes that may indicate myocardial infarction.
This complexity requires an experienced nurse. The other options represent more
stable, routine care situations suitable for new graduates.
Question 2:
A nurse receives a verbal order from a physician over the phone. What is the most
appropriate action?
A) Write the order exactly as heard and implement immediately
B) Read back the order to the physician for verification
C) Ask another nurse to witness the verbal order
D) Refuse to take verbal orders and request written orders only
Answer: B) Read back the order to the physician for verification
Reading back verbal orders helps ensure accuracy and prevents errors. This is a
standard safety practice recommended by The Joint Commission. The nurse should
repeat the order back exactly as written, including spelling medication names and
confirming dosages.
Question 3:
Which task can be safely delegated to unlicensed assistive personnel (UAP)?
A) Teaching a diabetic client about insulin administration
B) Assessing a client's response to pain medication
C) Assisting a stable client with ambulation
D) Developing a care plan for a newly admitted client
Answer: C) Assisting a stable client with ambulation
Delegation follows the Five Rights: right task, right person, right circumstances, right
direction, right supervision. Assisting with ambulation is within the UAP scope of
practice for stable clients. Teaching, assessment, and care planning require RN
licensure and cannot be delegated.
, Question 4:
A nurse discovers that the wrong medication was administered to a client. What is the
priority action?
A) Complete an incident report
B) Assess the client for adverse reactions
C) Notify the nurse manager
D) Call the physician immediately
Answer: B) Assess the client for adverse reactions
Client safety is the priority. The nurse must immediately assess the client for any
adverse reactions to the wrong medication before taking other actions. After ensuring
client safety, the nurse should notify the physician, complete incident reports, and
inform the nurse manager.
SAFETY FIRST: Always prioritize client safety and assessment before
documentation or communication when errors occur.
2. Safe and Effective Care Environment - Safety and Infection Control
Question 5:
A client with Clostridium difficile infection requires which type of precautions?
A) Standard precautions only
B) Droplet precautions
C) Airborne precautions
D) Contact precautions
Answer: D) Contact precautions
C. difficile is transmitted through direct contact with contaminated surfaces and
hands. Contact precautions include gown, gloves, and dedicated equipment. Hand
washing with soap and water (not alcohol-based sanitizer) is required because
alcohol doesn't kill C. difficile spores.
Question 6:
Which client requires airborne precautions?
A) Client with influenza
B) Client with tuberculosis
C) Client with wound infection
D) Client with conjunctivitis
Answer: B) Client with tuberculosis
Tuberculosis requires airborne precautions because it's transmitted through small
airborne particles. This requires negative pressure room, N95 respirator, and limiting
transport. Influenza requires droplet precautions, wound infections require contact
precautions.
Question 7:
A confused client keeps trying to pull out their IV line. What is the most appropriate
initial intervention?
Complete Study Guide for Nursing Success
Practice Questions with Detailed Rationales
Based on NCLEX-RN Test Plan Categories
1. Safe and Effective Care Environment - Management of Care
Question 1:
The charge nurse is making assignments for the day shift. Which client should be
assigned to the experienced RN rather than a new graduate nurse?
A) A stable post-operative client requiring routine wound care
B) A client with chest pain requiring continuous cardiac monitoring
C) A client admitted for observation after a minor fall
D) A client receiving IV antibiotics for pneumonia
Answer: B) A client with chest pain requiring continuous cardiac monitoring
Clients with chest pain require expert assessment skills, knowledge of cardiac
rhythms, and ability to recognize changes that may indicate myocardial infarction.
This complexity requires an experienced nurse. The other options represent more
stable, routine care situations suitable for new graduates.
Question 2:
A nurse receives a verbal order from a physician over the phone. What is the most
appropriate action?
A) Write the order exactly as heard and implement immediately
B) Read back the order to the physician for verification
C) Ask another nurse to witness the verbal order
D) Refuse to take verbal orders and request written orders only
Answer: B) Read back the order to the physician for verification
Reading back verbal orders helps ensure accuracy and prevents errors. This is a
standard safety practice recommended by The Joint Commission. The nurse should
repeat the order back exactly as written, including spelling medication names and
confirming dosages.
Question 3:
Which task can be safely delegated to unlicensed assistive personnel (UAP)?
A) Teaching a diabetic client about insulin administration
B) Assessing a client's response to pain medication
C) Assisting a stable client with ambulation
D) Developing a care plan for a newly admitted client
Answer: C) Assisting a stable client with ambulation
Delegation follows the Five Rights: right task, right person, right circumstances, right
direction, right supervision. Assisting with ambulation is within the UAP scope of
practice for stable clients. Teaching, assessment, and care planning require RN
licensure and cannot be delegated.
, Question 4:
A nurse discovers that the wrong medication was administered to a client. What is the
priority action?
A) Complete an incident report
B) Assess the client for adverse reactions
C) Notify the nurse manager
D) Call the physician immediately
Answer: B) Assess the client for adverse reactions
Client safety is the priority. The nurse must immediately assess the client for any
adverse reactions to the wrong medication before taking other actions. After ensuring
client safety, the nurse should notify the physician, complete incident reports, and
inform the nurse manager.
SAFETY FIRST: Always prioritize client safety and assessment before
documentation or communication when errors occur.
2. Safe and Effective Care Environment - Safety and Infection Control
Question 5:
A client with Clostridium difficile infection requires which type of precautions?
A) Standard precautions only
B) Droplet precautions
C) Airborne precautions
D) Contact precautions
Answer: D) Contact precautions
C. difficile is transmitted through direct contact with contaminated surfaces and
hands. Contact precautions include gown, gloves, and dedicated equipment. Hand
washing with soap and water (not alcohol-based sanitizer) is required because
alcohol doesn't kill C. difficile spores.
Question 6:
Which client requires airborne precautions?
A) Client with influenza
B) Client with tuberculosis
C) Client with wound infection
D) Client with conjunctivitis
Answer: B) Client with tuberculosis
Tuberculosis requires airborne precautions because it's transmitted through small
airborne particles. This requires negative pressure room, N95 respirator, and limiting
transport. Influenza requires droplet precautions, wound infections require contact
precautions.
Question 7:
A confused client keeps trying to pull out their IV line. What is the most appropriate
initial intervention?
