National Council Licensure Examination: Safe Care
Management of care, delegation, and safety and infection control for registered nurses.
Licensing exams are administered by state boards and national councils. FreeExam is not affiliated with those organizations, and these questions are original practice, not an official test.
NCLEX is a registered trademark of the National Council of State Boards of Nursing. FreeExam is not affiliated with the National Council of State Boards of Nursing, and these questions are original practice, not an official test.
1.Twenty minutes after a thyroidectomy, June develops neck swelling and a high-pitched sound on inspiration. Which action is the priority?
2.Andre received a prescribed opioid twenty minutes ago. His respiratory rate is 8, and he does not wake when his shoulder is tapped. Which action is the priority?
3.One hour after a femoral cardiac catheterization, Elena has a growing groin bruise, heart rate 122, and blood pressure 82/50. Which action is the priority?
4.The nurse has just finished shift report on a medical unit. Which client is seen first?
5.Two hours after a tonsillectomy, 7-year-old Mateo swallows often, and bright red blood is on the pillow. Which action is the priority?
6.In the emergency department, 4-year-old Hana sits leaning forward, drools, and will not speak. Her fever began this morning. Which action is the priority?
7.During an intravenous antibiotic, Malik develops hives, wheezing, and swelling of the lips. Which action is the priority?
8.The tubing of Mr. Okonkwo's chest tube pulls apart from the collection system. He is anxious but able to speak. Which action does the nurse take first?
9.Ms. Alvarez coughs, and her new tracheostomy tube comes out. She is gasping. Which action is the priority?
10.On a surgical unit, which client does the nurse assess first?
11.Which client does the nurse see first after receiving report?
12.Mr. Feldman, who has a peptic ulcer, vomits a large amount of bright red blood and says he feels dizzy. Which action is the priority?
13.Which finding requires the nurse's immediate attention?
14.Ms. Cho is receiving packed red blood cells and reports chest tightness. Her blood pressure falls from 128/74 to 86/52. Which action is first?
15.While a central line cap is off, Mr. Dalal suddenly becomes short of breath and says his chest hurts. The nurse suspects air entered the line. Which position is used while help is called?
16.The nurse enters Mr. Brooks's room and sees smoke coming from the bedside monitor outlet. He can walk. Which action is first?
17.Ms. Pereira is receiving oxygen by nasal cannula and asks to smoke one cigarette with the cannula in place. Which action is correct?
18.Mr. Nguyen repeatedly pulls at his nasogastric tube despite reorientation and a sitter. A provider orders a wrist restraint. Which nursing action is correct?
19.Assistive personnel report that Ms. Grant is on the bathroom floor and says her hip hurts. Which action does the nurse take first?
20.Before giving metoprolol to Mr. Silva, how does the nurse confirm identity?
21.During a busy procedure, a provider gives a telephone order for a new medication for Ms. Iqbal. Which nursing action is correct?
22.An order for Mr. Adeyemi is written as digoxin .25 mg by mouth daily. Which action does the nurse take before giving it?
23.A provider orders potassium chloride to be pushed undiluted into Ms. Berg's intravenous line over one minute. Which action is correct?
24.The nurse gives Mr. Patel another client's morning blood-pressure tablet. He remains stable. Which documentation is correct?
25.Ms. Kowalski falls while walking with a staff member. After she is assessed and the provider is notified, what is the correct use of the incident report?
26.A nurse draws up the wrong insulin dose for Mr. Hassan, notices before giving it, and wastes the dose with a witness. Which action is also required?
27.Ms. Laurent is scheduled for a knee replacement and says, 'Nobody told me I could get a clot. What are the real risks?' The consent form is unsigned. Which response is appropriate?
28.The surgeon has explained a cholecystectomy to Mr. Rossi. He says the explanation was clear and he wishes to proceed. Which nursing role is correct?
29.Ms. Abebe is handed a consent form for heart catheterization and says, 'I have no idea what they are going to do.' Which action does the nurse take?
30.Mr. Cohen already signed consent for a colonoscopy and then says, 'I changed my mind. Do not do it.' Which action is correct?
31.Ms. Chen does not speak English and is asked to consent to a hysterectomy. Her bilingual child offers to interpret. Which action is correct?
32.The nurse is asked to witness consent for Mr. Walsh, who received a sedative ten minutes ago and cannot stay awake to talk. Which action is correct?
33.Which task may the registered nurse assign to unlicensed assistive personnel?
34.Which request is appropriate for unlicensed assistive personnel?
35.Assistive personnel are available to help on the unit. Which direction from the nurse is safe?
36.Which client may unlicensed assistive personnel help with a meal?
37.While bathing Mr. Holt, assistive personnel see a new reddened area on the sacrum. Which follow-up is correct?
38.Which task is appropriate to assign to unlicensed assistive personnel for stable Mr. Diaz?
39.Which duty may be assigned to unlicensed assistive personnel?
40.A provider has pronounced Ms. Green's death. The medical examiner is not holding the body, and the family agrees to bathing. Which assignment is appropriate?
41.Which client is appropriate for a practical nurse?
42.A registered nurse taught stable Mr. Brennan a low-sodium diet yesterday. Which follow-up may a practical nurse do?
43.Which task does the registered nurse keep rather than assign to a practical nurse?
44.Four tasks need to be done. Which one does the registered nurse perform?
45.A charge nurse is making assignments. Which client is best for a registered nurse who finished orientation two weeks ago?
46.Which client does the charge nurse assign to the most experienced registered nurse?
47.A nurse floated to an unfamiliar unit is asked to give a medication the nurse has never been trained to give. Which action is correct?
48.Nurse Reed arrives smelling of alcohol, slurring words, and preparing to pass medications. Which action protects clients?
49.Ms. Ortega's blood pressure is 78/42. The nurse has called the provider twice with no response, and she is more drowsy. Which action is next?
50.A handwritten order for Mr. Klein's oral antihypertensive is about ten times the usual daily dose. The provider says, 'Just give it.' Which action is correct?
51.In a crowded elevator, a coworker begins describing Ms. Johnson's diagnosis and room number. Which action is correct?
52.A nurse wants to open the record of a neighbor admitted to another unit, 'just to be supportive.' The neighbor has not asked for contact. Which action is correct?
53.Mr. Ellis has a valid advance directive refusing mechanical ventilation. He is now unconscious and in respiratory failure. His adult child demands intubation. Which action is correct?
54.Ms. Carter has a do-not-resuscitate order. She now has a fever, a productive cough, and oxygen saturation of 89 percent. Which plan is correct?
55.Competent Mr. Goldberg refuses a recommended transfusion. His spouse asks the nurse to give the blood after he falls asleep. Which action is correct?
56.Competent Ms. Duarte wants to leave against medical advice after pulling out her intravenous catheter. Which action is correct?
57.Nonverbal nursing-home resident Mr. Pike has new bruises shaped like fingers and flinches when one aide enters. Which action is required?
58.Three-year-old Lily has a spiral arm fracture. The caregiver first says she rolled off a pillow, then tells a different story. Which action is correct?
59.Before bathing Mr. Owens, who has no known infection, which precaution is required?
60.Ms. Romano has confirmed Clostridioides difficile diarrhea. Which practice is correct?
61.Mr. Bennett is admitted with suspected tuberculosis and coughs blood-streaked sputum. Which room placement is correct?
62.Ms. Farooq is on airborne precautions for suspected tuberculosis and must go to radiology. Which practice is correct?
63.Mr. Sato has confirmed influenza and is coughing. Which precaution is added to standard precautions?
64.Ms. Wright has a draining leg wound that grew methicillin-resistant Staphylococcus aureus. Which practice is correct?
65.Mr. Novak is admitted with suspected meningococcal meningitis. Which precaution is started immediately?
66.Ms. Kapoor is admitted with widespread chickenpox lesions and a cough. Which isolation is correct?
67.Infant Leo is admitted with bronchiolitis caused by respiratory syncytial virus. Which precaution is correct?
68.Mr. Adler has a fever and an absolute neutrophil count of 400. Which placement is safest?
69.Ms. Blake, who is living with HIV and has no other infection, needs a blood draw. Which precaution is sufficient?
70.Mr. Petrova has hepatitis A and is incontinent of stool. Which precaution is correct?
71.The nurse finishes emptying Mr. Cole's urinary drainage bag and removes the gloves. Which action is required before leaving the room?
72.A nurse with long artificial nails is assigned to change Ms. Haddad's central-line dressing. Which action meets infection control?
73.While preparing a sterile field for Mr. Lange's dressing, which observation means the field is contaminated?
74.During catheter insertion for Ms. Vogel, the catheter brushes her thigh before it enters the urethra. Which action is correct?
75.Where does the nurse place Mr. Ibrahim's urinary drainage bag?
76.Mr. Costa needs a blood specimen before a transfusion. Which practice is correct?
77.The team is about to incise Ms. O'Donnell's left knee. The consent and mark say left knee, but the prep was started on the right. Which action is correct?
78.Mr. Bernard is awake and able to take part in marking his surgical site. Who should mark it?
79.The laboratory calls a potassium result of 6.9 mEq/L for Ms. Friedman to the unit secretary. Which action is correct?
80.Nurse Ali is tempted to document Ms. Reyes's dressing change now, although it is planned for later. Which action is correct?
81.A nurse writes the wrong blood pressure in Mr. Clark's paper note. Which correction is proper?
82.The nurse forgot to document a provider notification for Ms. Khan that happened two hours ago. Which entry is correct?
83.Mr. Doyle asks the nurse to leave two blood-pressure tablets on the tray for later. No order allows bedside medication. Which action is correct?
84.Ms. Nowak says, 'This tablet is green. Mine at home is white.' Which action is correct?
85.Mr. Santos cannot swallow an extended-release opioid tablet, and it is not scored. Which action is correct?
86.Ms. Levy had anaphylaxis to penicillin years ago. A new order prescribes amoxicillin. Which action is correct?
87.The prescription changes the rate of Mr. Young's insulin infusion. Which practice is required before the new rate runs?
88.While Mr. Perry sleeps, his adult child keeps pressing the patient-controlled analgesia button so he will not wake in pain. Which action is correct?
89.Nurse Morgan must waste part of a controlled medication drawn for Ms. Adebayo. Which practice is correct?
90.Mr. Bauer brings unnamed white tablets from home and asks for his usual number. Which action is correct?
91.Ms. Ellison is confused and has urinary urgency. Which plan best reduces her risk of falling?
92.Mr. Gallagher, lying in bed, begins a generalized seizure. Which action is correct?
93.Ms. Rahman is going for magnetic resonance imaging. She mentions an old pacemaker and possible metal fragments in one eye from metalwork. Which action is correct?
94.Mr. Solano has a sealed radiation implant in place. Which assignment is appropriate?
95.Ms. Barrett reports anaphylaxis to latex and is on today's surgical list. Which plan is correct?
96.A nurse is stuck by a needle just used on Mr. Mensah. Which action is correct?
97.Which disposal of a needle used for Ms. Ortiz's injection is correct?
98.After a building collapse, few rescuers are present. Which injured adult is tagged for immediate care?
99.Rescuers are overwhelmed after a train collision. Which injured adult is classified as expectant?
100.During mass-casualty triage, which person is tagged minimal?
101.Two clients have the same confirmed influenza strain, and no private room is left. Which placement is best?
102.After changing a soiled dressing for a client on contact precautions, which removal sequence is safest?
103.A student nurse gives a medication to the wrong client. The registered nurse was the preceptor. Which action is correct?
104.Ms. Navarro's urine output is 15 mL in the past hour, and her blood pressure is 86/48. Which report to the provider is best?
105.Mr. Hughes has new heart failure and has never used the prescribed diuretic. He is leaving today. Who gives the initial teaching?
106.The team is dividing work for a new admission. Which statement is correct?
107.Mr. Alam's partner wants to visit while droplet precautions are in place for influenza. Which instruction is correct?
108.Ms. Brennan receives a larger dose of a blood-pressure medication than ordered. Vital signs stay normal, and the provider is informed. What belongs in the medical record?