WorksheetsNCLEX style practice final exam for RNSG-1413
Total questions: 75
Worksheet time: 43mins
Name
Class
Date
1.
1. Which action best demonstrates professional accountability in nursing practice?
a)
Completing documentation accurately and timely
b)
Delegating all charting to unlicensed personnel
c)
Avoiding feedback from supervisors
d)
Relying solely on experience rather than evidence-based practice
2.
2. The nurse advocates for a patient by ensuring informed consent is obtained before a procedure. This reflects which ethical principle?
a)
Beneficence
b)
Autonomy
c)
Justice
d)
Fidelity
3.
3. Which statement by a nurse demonstrates therapeutic communication?
a)
“I know exactly how you feel.”
b)
“Tell me more about what’s worrying you today.”
c)
“Don’t worry; everything will be fine.”
d)
“Let’s not talk about that now.”
4.
4. When assessing a patient, which data is considered subjective?
a)
Temperature 101°F
b)
“I feel nauseated.”
c)
Blood pressure 140/80
d)
Urine output 400 mL
5.
5. Which documentation entry is most appropriate?
a)
“Patient seems better today.”
b)
“Patient ambulated 30 feet with walker, tolerated well.”
c)
“Patient being lazy, refuses to move.”
d)
“Probably improving, no complaints.”
6.
6. The nurse knows the best position to prevent aspiration during enteral feeding is:
a)
Supine
b)
High Fowler’s
c)
Prone
d)
Trendelenburg
7.
7. A patient on bedrest complains of constipation. The most appropriate nursing action is to:
a)
Encourage high-protein diet
b)
Increase fluid and fiber intake
c)
Limit ambulation
d)
Restrict fluids
8.
8. Which is an example of an independent nursing intervention?
a)
Administering IV antibiotics
b)
Teaching deep breathing exercises
c)
Starting oxygen therapy
d)
Changing IV fluids
9.
9. Which nursing action best prevents pressure injuries in a bed-bound patient?
a)
Reposition every 2 hours
b)
Encourage low-protein diet
c)
Limit fluid intake
d)
Avoid use of pillows
10.
10. A patient becomes upset and refuses care. What is the nurse’s best initial action?
a)
Force the care
b)
Leave the patient alone
c)
Ask the patient to explain their feelings
d)
Call security
11.
11. A patient reports taking both herbal supplements and prescription drugs. The nurse should:
a)
Tell the patient to stop herbs immediately
b)
Document and notify the provider
c)
Ignore since herbs are natural
d)
Administer both as scheduled
12.
12. Which entry follows legal documentation guidelines?
a)
“Error made, fixed it.”
b)
“Medication not given – patient refused, provider notified.”
c)
“Patient is difficult, won’t cooperate.”
d)
“Will do later.”
13.
13. What is the first action if the nurse makes a medication error?
a)
Fill out incident report
b)
Notify the provider after assessing the patient
c)
Document the error in chart
d)
Tell another nurse
14.
14. Which factor most influences drug metabolism in older adults?
a)
Increased renal function
b)
Decreased liver function
c)
Faster gastric emptying
d)
Increased cardiac output
15.
15. The nurse uses SBAR communication primarily to:
a)
Document care
b)
Transfer patients between facilities
c)
Structure communication between providers
d)
Report to insurance
16.
16. Which finding requires intervention when giving enteral feedings?
a)
HOB elevated 30°
b)
Residual volume 400 mL
c)
Tube placement verified
d)
Warmed formula
17.
17. What should the nurse do before giving a feeding through a nasogastric tube?
a)
Check bowel sounds and verify placement
b)
Instill 60 mL air
c)
Measure urine output
d)
Administer medications first
18.
18. Which symptom indicates possible infection?
a)
Normal WBC
b)
Pulse 72
c)
Redness and warmth at wound site
d)
Afebrile and alert
19.
19. The chain of infection can be broken at the portal of exit by:
a)
Hand hygiene
b)
Using sterile gloves
c)
Covering coughs/sneezes
d)
Increasing immunity
20.
20. What lab value supports the presence of acute infection?
a)
Decreased ESR
b)
Elevated CRP
c)
Low WBC
d)
Normal hematocrit
21.
21. The nurse prioritizes which patient for infection control precautions?
a)
Post-op with clean wound
b)
TB patient with coughing
c)
Stable diabetic
d)
Postpartum mother
22.
22. An older adult reports loneliness after spouse’s death. Which intervention is best?
a)
Encourage daily exercise
b)
Encourage joining a support group
c)
Avoid talking about spouse
d)
Prescribe sedatives
23.
23. The nurse recognizes risk for falls in older adults due to:
a)
Improved reaction time
b)
Orthostatic hypotension
c)
Increased bone density
d)
Enhanced night vision
24.
24. Which nursing diagnosis is most appropriate for an elderly client with hearing loss?
a)
Impaired verbal communication
b)
Impaired social interaction
c)
Anxiety
d)
Deficient knowledge
25.
25. A nurse planning care for a grieving family should prioritize:
a)
Encouraging avoidance of feelings
b)
Supporting open expression of emotions
c)
Providing detailed education
d)
Limiting visits
26.
26. Hospice care primarily focuses on:
a)
Curative treatment
b)
Pain control and comfort
c)
Rehabilitation
d)
Life-prolonging measures
27.
27. What is the first stage of Kübler-Ross’s grief model?
a)
Anger
b)
Denial
c)
Depression
d)
Acceptance
28.
28. Which action best demonstrates cultural sensitivity in end-of-life care?
a)
Applying same rituals to all patients
b)
Asking about the family’s spiritual preferences
c)
Avoiding cultural discussions
d)
Assuming religion guides care
29.
29. A patient states, “I want to die peacefully.” The nurse’s best response is:
a)
“You shouldn’t say that.”
b)
“Tell me more about what that means to you.”
c)
“You’ll feel better tomorrow.”
d)
“Let’s distract you.”
30.
30. The nurse identifies spirituality as:
a)
Membership in a religious group
b)
Personal search for meaning and purpose
c)
Following strict doctrine
d)
Regular church attendance
31.
31. What is the first step in the nursing process?
a)
Assessment
b)
Diagnosis
c)
Planning
d)
Evaluation
32.
32. Which statement is a correctly written nursing diagnosis?
a)
Pain related to surgery
b)
Acute pain related to tissue injury as evidenced by patient stating pain 8/10
c)
Pain from incision
d)
Post-op discomfort
33.
33. Which is an example of an objective finding?
a)
“I feel dizzy.”
b)
Pale skin and clammy hands
c)
“My stomach hurts.”
d)
“I can’t sleep.”
34.
34. What is the correct order of the nursing process?
a)
Planning, Diagnosis, Assessment, Implementation, Evaluation
b)
Assessment, Diagnosis, Planning, Implementation, Evaluation
c)
Diagnosis, Implementation, Planning, Assessment, Evaluation
d)
Implementation, Evaluation, Planning, Assessment, Diagnosis
35.
35. Which is an example of a correctly stated patient outcome?
a)
Patient will feel better soon.
b)
Patient will ambulate 50 feet with assistance by end of shift.
c)
Patient will understand medication.
d)
Patient will be educated.
36.
36. Which type of intervention requires a physician’s order?
a)
Teaching breathing exercises
b)
Providing emotional support
c)
Administering IV medication
d)
Turning patient every 2 hours
37.
37. Which best describes evaluation in the nursing process?
a)
Reviewing progress toward goals
b)
Creating a care plan
c)
Collecting assessment data
d)
Identifying nursing diagnoses
38.
38. What documentation format focuses on patient problems?
a)
Narrative charting
b)
PIE charting
c)
Source-oriented charting
d)
Flow sheet
39.
39. Which is a violation of HIPAA?
a)
Discussing care during handoff
b)
Posting patient info on social media
c)
Sharing info with care team
d)
Documenting in EMR
40.
40. When documenting, which rule is most important?
a)
Use white-out for corrections
b)
Leave blanks between entries
c)
Use black ink and factual statements
d)
Write general impressions
41.
41. What is the main purpose of a patient record?
a)
Billing
b)
Communication among healthcare team
c)
Proof of negligence
d)
Scheduling
42.
42. A nurse notes “BP 90/50, patient dizzy on standing.” Which documentation principle is used?
a)
Subjective charting
b)
Objective and descriptive
c)
Narrative and opinionated
d)
Focus charting
43.
43. The nurse’s primary focus when managing mobility for a post-op patient is to:
a)
Prevent contractures and DVT
b)
Encourage total bed rest
c)
Limit range of motion
d)
Apply heat to incision
44.
44. Which action promotes safety when using mobility aids?
a)
Adjusting walker to patient’s wrist height
b)
Allowing patient to use walker without instruction
c)
Standing behind the patient while walking
d)
Not locking wheelchair brakes
45.
45. Which patient requires use of a mechanical lift?
a)
Independent ambulator
b)
Weak but ambulatory
c)
300-lb patient needing total assistance
d)
Post-op knee replacement walking with crutches
46.
46. Which nursing diagnosis is most appropriate for an immobile patient?
a)
Risk for impaired skin integrity
b)
Acute confusion
c)
Chronic pain
d)
Ineffective coping
47.
47. Which finding indicates a complication of immobility?
a)
Increased appetite
b)
Clear lung sounds
c)
Orthostatic hypotension
d)
Regular bowel movements
48.
48. Which approach helps a patient adapt to stress?
a)
Avoid discussing stressors
b)
Encourage problem-solving and coping strategies
c)
Offer sedatives routinely
d)
Ignore emotional concerns
49.
49. Which statement best defines self-concept?
a)
How others perceive the person
b)
One’s overall view of self
c)
Moral beliefs
d)
Physical appearance
50.
50. Which nursing action supports a patient’s self-esteem?
a)
Ignoring patient choices
b)
Encouraging independence in care
c)
Performing all tasks for the patient
d)
Criticizing mistakes
51.
51. Which communication technique is therapeutic?
a)
Asking “Why” questions
b)
Offering false reassurance
c)
Using silence to allow expression
d)
Changing the topic
52.
52. A nurse notices a patient crying. The best response is:
a)
“Stop crying; everything’s okay.”
b)
“Would you like to talk about what’s making you upset?”
c)
“You shouldn’t be sad.”
d)
“Let’s talk later.”
53.
53. The nurse teaches the patient to read food labels to manage hypertension. This reflects which process?
a)
Evaluation
b)
Patient education
c)
Nursing diagnosis
d)
Delegation
54.
54. Which lab value would support malnutrition?
a)
Albumin 2.8 g/dL
b)
Hemoglobin 14 g/dL
c)
Calcium 9.0 mg/dL
d)
Glucose 98 mg/dL
55.
55. Which patient would require a soft or pureed diet?
a)
Fractured arm
b)
Post-stroke with dysphagia
c)
Diabetes mellitus
d)
Hypertension
56.
56. Which is a sign of poor nutritional status?
a)
Pink mucous membranes
b)
Shiny hair
c)
Delayed wound healing
d)
Good appetite
57.
57. The best position for a patient receiving enteral nutrition is:
a)
Supine
b)
Semi-Fowler’s
c)
Prone
d)
Side-lying
58.
58. Which factor interferes with sleep?
a)
Regular bedtime routine
b)
Excess caffeine intake
c)
Quiet, dark room
d)
Light meal before bed
59.
59. Which nursing diagnosis fits a patient with insomnia?
a)
Risk for injury
b)
Disturbed sleep pattern
c)
Ineffective airway clearance
d)
Anxiety
60.
60. Which intervention promotes sleep hygiene?
a)
Watching TV before bed
b)
Performing relaxation exercises
c)
Drinking coffee late
d)
Taking long daytime naps
61.
61. A nurse teaching a family caregiver about mobility should include:
a)
“Always use proper body mechanics.”
b)
“Pull the patient by arms to move.”
c)
“Avoid using gait belts.”
d)
“Twist at the waist to turn.”
62.
62. In coordinated care, which demonstrates effective delegation?
a)
Assigning tasks based on skill level and supervision
b)
Delegating assessment to CNA
c)
Delegating medication teaching to unlicensed staff
d)
Avoiding follow-up
63.
63. Which learning domain involves developing motor skills?
a)
Affective
b)
Cognitive
c)
Psychomotor
d)
Reflective
64.
64. The nurse teaches a patient newly diagnosed with diabetes. Which factor affects learning most?
a)
Motivation to learn
b)
Time of day
c)
Nurse’s preference
d)
Room temperature
65.
65. The nurse includes family in teaching sessions because:
a)
Families reinforce education at home
b)
It shortens hospitalization
c)
It replaces patient teaching
d)
It’s required by law
66.
66. Which statement by the nurse demonstrates critical thinking?
a)
“I follow the same plan for every patient.”
b)
“I consider all data before making a judgment.”
c)
“I never question physician orders.”
d)
“Experience is more important than evidence.”
67.
67. When teaching about insulin administration, which strategy best supports learning?
a)
Demonstration and return demonstration
b)
Written instructions only
c)
Giving complex information at once
d)
Ignoring cultural factors
68.
68. Which dosage order requires clarification?
a)
Digoxin 0.25 mg PO daily
b)
Insulin 10 units SQ daily
c)
Furosemide 80 mg PO BID
d)
Morphine 10 mg PRN pain
69.
69. The nurse identifies a medication error when:
a)
The drug is given at correct time
b)
The wrong dose is administered
c)
The nurse follows the 8 rights
d)
Patient ID verified before giving
70.
70. Which “right” is part of safe medication administration?
a)
Right nurse
b)
Right provider
c)
Right patient
d)
Right documentation only
71.
71. Which technique prevents infection during an injection?
a)
Reusing needles
b)
Wiping site with alcohol
c)
Touching needle tip
d)
Recapping after use
72.
72. For subcutaneous injection, the nurse should:
a)
Use 90° angle for obese patient
b)
Use 10 mL syringe
c)
Aspirate before injection
d)
Massage site vigorously
73.
73. What is the nurse’s next action after drawing insulin from two vials?
a)
Recap the needle
b)
Verify order and label syringe
c)
Expel both medications
d)
Store syringe uncapped
74.
74. Which of the following indicates inflammation?
a)
Pallor
b)
Edema
c)
Cyanosis
d)
Jaundice
75.
75. What is the safest nursing action when unsure of a medication order?
a)
Ask another nurse
b)
Check with the provider before giving
c)
Give anyway to avoid delay
d)
Look it up online quickly
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