Issues and Trends in Nursing: Essential Knowledge for Today and Tomorrow
Student Elements

NCLEX Review

Please read each question and select your answer from the choices provided. You must complete all of the questions in order to view your results. At the end of each exam, you have the option to e-mail your results to your instructor.

1:  The nurse is caring for a surgical patient who has been placed on a multidisciplinary treatment plan or critical pathway. One outcome identified by the plan is that the patient will ambulate on the first postoperative day. The patient was unable to ambulate on postoperative day 1. Which term is used to describe the deviation from the critical pathway?
A: Incident.
B: Root cause.
C: Variance.
D: Sentinel event.

2:  When is the most appropriate time to begin discharge planning for a patient who is admitted to an acute care facility?
A: 48 hours before discharge.
B: Once the discharge order is written.
C: Upon the patient's admission to the facility.
D: Once the insurance company approves discharge coverage.

3:  The nurse is completing the preoperative teaching for a patient who is to undergo a gastrectomy. Which teaching intervention would have the highest priority to ensure the prevention of postoperative complications?
A: Allowing the patient to tour the post-anesthesia care unit.
B: Appling a sequential compression device so the patient will know how the device will feel.
C: Discussing the visitation policy for the clinical unit.
D: Teaching the patient to splint the incision and to cough and deep breathe.

4:  The nurse has received report and rounded on all assigned patients. It is now 8:00 A.M. Which patient should the nurse plan to care for first?
A: A patient who is ambulatory and going for an x-ray at 10:00 A.M.
B: A patient who is to be discharged at 11:00 A.M.
C: A postoperative patient who has just received pain medication.
D: A patient who is short of breath.

5:  A new nurse asks the preceptor if personal professional liability insurance should be purchased. What is the preceptor's best response?
A: "Personal liability coverage is not needed, as the organization has insurance that will cover any malpractice litigation."
B: "Each nurse should purchase individual professional liability coverage."
C: "Coverage is not needed because liability insurance is very costly and the chance of a malpractice suit is low."
D: "Individual coverage for malpractice is not a good idea, as the hospital can then sue the nurse to recoup costs."

6:  The nurse finds an unopened vial of morphine sulfate lying on the cabinet in a patient's room. What is the most appropriate action for the nurse to take first?
A: Secure the vial and return the medication to stock for future use.
B: Remove the vial from the patient's bedside and notify the nurse supervisor that an unsecured vial of a controlled substance was found.
C: Check with the other nurses to see if their patients have morphine orders and administer the medication to another patient to avoid waste.
D: Contact the organization's security department and have it investigate the crime scene.

7:  On nursing rounds, a patient is found lying on the floor. Which statement would be most appropriate for the nurse to document in the patient's medical record?
A: "It is most likely that the patient attempted to climb over the side rails and fell."
B: "Upon entering the room, the patient was found lying on the floor."
C: "The patient had been restless all evening and was trying to get out of bed."
D: "The presence of a bed alarm could have prevented the fall."

8:  After signing an informed consent form, the patient states, "I have changed my mind and do not want to have the procedure done." Which action would be most appropriate for the nurse to take first?
A: Remind the patient that a signed informed consent form is a legally binding document.
B: Notify the surgeon that the patient wishes to withdraw informed consent for the procedure.
C: Contact the operating room and tell the personnel there the patient's surgery has been cancelled.
D: Proceed with preparation of the patient for the surgical procedure.

9:  Which action by a nurse could jeopardize the confidentiality of computerized medical records available at a nurses' station?
A: Log out and sign off all computer screens before leaving a terminal.
B: Share passwords for computer access with colleagues who have forgotten their own passwords.
C: Periodically change computer access passwords.
D: Prevent an unidentified healthcare worker from viewing computer records.

10:  While at the grocery store, a nurse comes upon a shopper who has fallen. The nurse assists the woman and notices that she has slurred speech, facial drooping, and significant weakness on the right side as compared to the left. The shopper tells the nurse she is 70 years of age, has no allergies, and takes medication for high blood pressure. The woman asks, "What is wrong with me? I was fine just a few minutes ago." What is the priority action the nurse should take?
A: Obtain the number of the patient's primary care physician and offer to contact the physician's office.
B: Find a location where the patient can sit down and rest for a few minutes and offer to stay with the woman until a family member arrives.
C: Call 911 and notify the dispatcher that you have a person exhibiting clinical manifestations of a stroke.
D: Drive the patient to the nearest emergency treatment center for evaluation of her blood pressure.

11:  The nurse is caring for a patient who has a traumatic brain injury. To promote continuity of care and a positive patient outcome, which finding would be most important for the nurse to report to the oncoming shift nurse?
A: Neurological assessment.
B: Patient complaints.
C: History of the injury.
D: Findings of a CT scan.

12:  When transcribing medical orders, the nurse is unable to read a written order. What is the best action by the nurse?
A: Clarify the type of medication with the family.
B: Interpret the order based on the patient's history.
C: Ask the pharmacist for clarification.
D: Contact the prescriber to clarify the order.

13:  Which nursing diagnosis has the highest priority for a patient with an open abdominal wound during the acute phase of care?
A: Altered body image.
B: Risk for infection.
C: Delayed surgical recovery.
D: Knowledge deficit about wound care.

14:  Which patient would be most appropriate to assign to a private room?
A: A patient who is admitted with fever of unknown origin.
B: A patient who is expected to die within the next 24 hours.
C: A patient who has been diagnosed as HIV positive.
D: A patient with a stage II sacral pressure ulcer.

15:  Which part of a research study would tell the nurse about the predicted relationship of the variables being tested?
A: Abstract.
B: Research question.
C: Hypothesis.
D: Review of the literature.

16:  Who has the authority to revoke a professional nurse's license?
A: A court of law.
B: The chief nursing officer of a hospital.
C: The state board of nursing.
D: The state arm of the American Nurses Association.

17:  The nurse arrives for her shift at 7:00 A.M. and receives her assignment. Which patient should the nurse assess first?
A: A diabetic patient whose blood sugar at 6:50 A.M. was 40 and who just received 50% dextrose for a hypoglycemic episode.
B: A patient who was admitted with chest pain; whose troponin I results were 0.6 ng/mL and 0.8 ng/mL at 24 and 48 hours after admission, respectively; and who is now complaining of indigestion.
C: A patient who was treated for a temperature of 102 °F at 4:00 A.M. and who has pneumonia and an SpO2 of 94% on 2 L nasal cannula.
D: A patient with peptic ulcer disease who has pulled out the peripheral IV catheter and is scheduled to receive a dose of famotidine (Pepcid) at 8:00 A.M.

18:  An ethical conflict about a patient's care has developed, and the nurse is unable to resolve the conflict. Which hospital resource would be most appropriate for the nurse to consult about the ethical dilemma?
A: Hospital ethics committee.
B: Quality improvement committee.
C: Chaplain.
D: Nursing supervisor.

19:  The nurse is unable to find coverage to leave the floor for a personal appointment outside the hospital. The nurse decides to leave her scheduled shift an hour early without permission and notification of the charge nurse. The patients assigned to the nurse are in stable condition. What type of legal tort could apply to the situation?
A: Patient abandonment.
B: Intentional infliction of emotional distress.
C: Battery.
D: Slander.

20:  Two nurses are arguing over which one will go to lunch first. The charge nurse tells the pair of nurses that she is tired of hearing them argue and that she will cover patient care so both nurses can go to lunch together. Which type of conflict management style did the charge nurse use?
A: Avoiding or withdrawing.
B: Competing or forcing.
C: Compromising or negotiating.
D: Accommodating or smoothing.

21:  The cardiac catheterization lab has established a procedure for achieving hemostasis of the cardiac catheter insertion site. Which type of standard does this exemplify?
A: Structure.
B: Process.
C: Outcome.
D: Performance.

22:  A nurse works a full-time equivalent (1.0 FTE). How many hours per year are equal to 1.0 FTE?
A: 2,080 hours.
B: 2,000 hours.
C: 1,872 hours.
D: 1,040 hours.

23:  A patient with sleep apnea is being prepared for discharge from the hospital on bilevel positive airway pressure (BiPAP) at night. Which healthcare team member would be helpful in educating the patient on the use of the home continuous positive airway pressure (CPAP) equipment?
A: Occupational therapist.
B: Physical therapist.
C: Respiratory therapist.
D: Case manager.

24:  A nurse researcher is conducting a study. A notice is posted asking for volunteers to participate in the study. What type of a sample would be obtained with this technique?
A: Random.
B: Convenience.
C: Quota.
D: Network.

25:  A patient requests that a nurse who was working on a previous shift not be allowed to provide the patient's care again. What is the most appropriate action by the nurse?
A: Document the issue on an incident report.
B: Address the patient's concern with the charge nurse.
C: Explain to the patient that the nurse was just having a bad day.
D: Notify the human resources department.

26:  A new type of infusion pump is introduced to the nursing unit. In which type of educational setting would the nurse most likely learn about the operation and use of this equipment?
A: In-service education.
B: Continuing education.
C: Online education.
D: Undergraduate education.

27:  The nurse determines that a patient's pain score is 8 on a scale of 0 to 10 (where 10 is the highest level of pain). The nurse administers pain medication to the patient. Based on this scenario, which parts of the nursing process did the nurse use?
A: Assessment and intervention.
B: Planning and evaluation.
C: Evaluation and analysis.
D: Intervention and evaluation.

28:  Which statement gives an example of intrapersonal conflict?
A: Nurses on the day shift contend that nurses on the night shift should be responsible for daily weights, but nurses on the night shift argue that nurses on the day shift should do it, so they don't have to wake the patients so early.
B: Some members of the unit staff want 8-hour shifts, but others want 12-hour shifts.
C: Nurse Jones is torn between going to a professional meeting or attending the last night of a play.
D: Nurse Lee is professionally threatened by Nurse Doe, the new clinical nurse specialist, and refutes everything Nurse Doe says.

29:  Which nursing action would contribute to the cost of care for a patient?
A: Delaying discharge from an inpatient care unit for 1 hour until the patient's transportation becomes available.
B: Encouraging a postoperative patient to turn cough and deep breathe every 2 hours.
C: Opening a dressing change kit to obtain a sterile gauze.
D: Encouraging an elderly patient to obtain an annual flu vaccine.

30:  A patient is newly diagnosed with type 1 diabetes. What would the nurse expect the most common disease management plan to include?
A: Oral hypoglycemic agents, dietary counseling, and an exercise plan.
B: Insulin replacement, nutrition management, and self-monitoring of blood glucose.
C: Insulin replacement, oral hypoglycemic agents, and a 1,200-calorie diet.
D: Pancreatic transplant, implantation of an insulin pump, and monitoring of glycated hemoglobin (HbA1c).

31:  Which patient would benefit most from a nurse advocate?
A: A patient who has previously undergone a procedure that is about to be performed for a second time.
B: A patient who has been educated on treatment options and chooses alternative treatments.
C: A cancer patient who makes an informed decision not to participate in chemotherapy treatment.
D: A geriatric patient with no family members who is uncertain about a decision of whether to have a gastrostomy tube inserted.

32:  The nurse is looking for evidence on a practice-based question. Which tool would the nurse use to obtain the highest level of evidence?
A: Randomized controlled trial research study.
B: Descriptive research study.
C: Quasi-experimental study.
D: Case study.

33:  The nurse has made a decision to resign from a staff nurse position because of dissatisfaction with the present working conditions. Which action should the nurse take first?
A: Write a letter of resignation.
B: Review the organizational policies for resignation.
C: Notify the charge nurse that the nurse has accepted another position and is leaving.
D: Constructively share concerns about the working environment in an exit interview.

34:  A charge nurse hears a physician say to the staff nurse in a loud voice, "You are incompetent. You were expected to have everything ready for the procedure when I arrived on the unit." Which action should the charge nurse take?
A: Change the staff nurse's assignment.
B: Discuss appropriate alternative responses to the situation with the staff nurse.
C: Report the staff nurse to the nursing supervisor.
D: Discuss the inappropriate behavior with the physician.

35:  A 42-year-old patient who is scheduled to have an elective surgical procedure tells the nurse that she wants to be designated as a "do not resuscitate" (DNR) case. Which response would be appropriate for the nurse to give?
A: "You're having a simple procedure. You need to discuss this issue with your anesthesiologist."
B: "There can be complications with any type of surgery but the surgery you are having is minor."
C: "I'll ask your family and the hospital lawyer to speak with you about this decision."
D: "Explain to me what you think DNR means."

Optional: Enter your name and your instructor's E-mail address to have your results E-mailed to him or her.
Your Name:
Instructor's E-mail Address:
Your E-mail Address:

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