NCLEX Practice Test: Video 1 Answers (25 Questions) — Questions and Answers

Question 1: Which task is most appropriate for an RN to delegate to an unlicensed assistive personnel (UAP)?

Assessing a postoperative client's pain
Measuring vital signs on a stable client (Correct answer)
Teaching a client about a new diet
Administering a scheduled oral medication

Correct answer: Measuring vital signs on a stable client

UAP may obtain vital signs on stable clients. Assessment, teaching, and medication administration require the nurse's licensed judgment and cannot be delegated.

Question 2: The nurse has four clients. Which client should the nurse assess FIRST?

Client with a mild headache after a fall
Client with new onset chest pain and diaphoresis (Correct answer)
Client awaiting discharge teaching
Client with a stable colostomy, day 2

Correct answer: Client with new onset chest pain and diaphoresis

Chest pain with diaphoresis suggests acute coronary syndrome, a life-threatening circulatory problem. The other clients are stable or have lower-acuity needs.

Question 3: A client is scheduled for surgery and is unsure about the procedure. Who is responsible for obtaining informed consent?

The staff nurse who will assist
The surgeon performing the procedure (Correct answer)
The client's family member
The hospital chaplain

Correct answer: The surgeon performing the procedure

The provider performing the procedure must explain risks, benefits, and alternatives and obtain consent. The nurse witnesses the signature and advocates if the client has unresolved questions.

Question 4: A nurse overhears a coworker discussing a client's diagnosis in the hospital elevator. This is a violation of which principle?

Veracity
Autonomy
Beneficence
Confidentiality (Correct answer)

Correct answer: Confidentiality

Discussing client information in a public area violates confidentiality and HIPAA. Autonomy concerns self-determination, and veracity concerns truthfulness.

Question 5: A nurse discovers a medication error that reached the client but caused no harm. What is the nurse's priority action?

Document the error only in the incident report
Wait to see if symptoms develop
Complete an incident report before notifying anyone
Assess the client and notify the health care provider (Correct answer)

Correct answer: Assess the client and notify the health care provider

Assess the client first and notify the provider so care can be adjusted. An incident report is completed afterward, and it is not part of the medical record.

Question 6: A client on contact precautions for Clostridioides difficile needs hand hygiene. Which method is most effective?

Alcohol-based hand rub
Soap and water for at least 20 seconds (Correct answer)
Antiseptic wipes
Wearing gloves without washing

Correct answer: Soap and water for at least 20 seconds

C. difficile forms spores that alcohol-based rubs do not reliably destroy, so soap and water friction is required. Gloves do not replace hand washing.

Question 7: A client with suspected active pulmonary tuberculosis is admitted. Which room and equipment is appropriate?

Private room with droplet precautions
Negative-pressure room with an N95 respirator (Correct answer)
Semi-private room with a surgical mask
Private room with standard precautions

Correct answer: Negative-pressure room with an N95 respirator

TB requires airborne precautions: a negative-pressure room and an N95 or higher respirator for staff. A surgical mask does not filter airborne droplet nuclei.

Question 8: Which intervention is the best first-line approach to prevent falls in a confused older client?

Keep all side rails raised
Apply wrist restraints
Sedate the client at night
Low bed position with call light within reach (Correct answer)

Correct answer: Low bed position with call light within reach

A low bed, call light access, and frequent rounding are least restrictive and effective. Restraints and full rails increase injury risk and need strict justification.

Question 9: A fire starts in a client's room. After removing clients in immediate danger, what should the nurse do NEXT according to RACE?

Evacuate the unit
Extinguish the fire
Activate the alarm (Correct answer)
Close the doors

Correct answer: Activate the alarm

RACE stands for Rescue, Alarm, Contain, Extinguish. After rescue, the nurse activates the alarm, then closes doors to contain the fire, and extinguishes if safe.

Question 10: Which action is required before a nurse applies a physical restraint to a client in a non-emergency?

Obtain a provider's order (Correct answer)
Apply restraints only on the dominant arm
Ask a family member for permission
Restrain the client for at least 8 hours

Correct answer: Obtain a provider's order

Restraints require a provider's order, after less restrictive alternatives fail, with frequent monitoring. In an emergency the nurse may act and then obtain the order promptly.

Question 11: A client is receiving warfarin. Which laboratory value should the nurse monitor to evaluate therapy?

Serum potassium
Platelet count
INR (Correct answer)
aPTT

Correct answer: INR

Warfarin is evaluated by the INR, typically targeting 2 to 3 for most indications. The aPTT monitors unfractionated heparin.

Question 12: A client taking digoxin reports nausea and yellow-green halos in vision. Which action should the nurse take first?

Document and reassess in the morning
Give the next dose as scheduled
Hold the dose and notify the provider (Correct answer)
Encourage a high-potassium meal

Correct answer: Hold the dose and notify the provider

Nausea and visual changes suggest digoxin toxicity. Hold the dose, check the apical pulse and level, and notify the provider. Giving the dose would worsen toxicity.

Question 13: The nurse prepares to give regular insulin and NPH insulin in one syringe. Which step is correct?

Draw up regular first, then NPH (Correct answer)
Draw up each in a separate syringe only
Draw up NPH first, then regular
Inject air only into the regular vial

Correct answer: Draw up regular first, then NPH

Draw up regular (clear) insulin before NPH (cloudy) to avoid contaminating the regular vial with NPH. Air is injected into both vials first.

Question 14: Before giving morphine IV, which assessment finding requires the nurse to hold the dose and notify the provider?

Respiratory rate of 16 breaths/min
Heart rate of 78 beats/min
Respiratory rate of 10 breaths/min (Correct answer)
Pain rating of 8 out of 10

Correct answer: Respiratory rate of 10 breaths/min

A respiratory rate under 12 suggests respiratory depression, so the nurse holds the opioid and notifies the provider. Severe pain alone is not a reason to withhold it.

Question 15: A client is prescribed furosemide. Which instruction should the nurse include in teaching?

Limit sodium and increase fluids to 4 L
Rise slowly from lying or sitting positions (Correct answer)
Avoid foods high in potassium
Take the dose at bedtime

Correct answer: Rise slowly from lying or sitting positions

Loop diuretics can cause orthostatic hypotension, so clients should change position slowly. They also waste potassium, so potassium-rich foods are encouraged, and the dose is given in the morning.

Question 16: A client in diabetic ketoacidosis (DKA) is admitted. Which finding does the nurse expect?

Fruity breath and deep, rapid respirations (Correct answer)
Slow, shallow respirations
Cool, clammy skin and tremors
Serum glucose of 60 mg/dL

Correct answer: Fruity breath and deep, rapid respirations

DKA causes Kussmaul respirations and fruity acetone breath with hyperglycemia. Cool, clammy skin and tremors with low glucose indicate hypoglycemia instead.

Question 17: A client with left-sided heart failure has crackles and shortness of breath. Which position is best?

Trendelenburg
High Fowler's position (Correct answer)
Supine with legs elevated
Prone

Correct answer: High Fowler's position

High Fowler's position lowers venous return and allows lung expansion, easing dyspnea. Supine and Trendelenburg positions worsen pulmonary congestion.

Question 18: Which finding is an early sign of increased intracranial pressure in an adult client?

Decreased level of consciousness (Correct answer)
Decorticate posturing
Bradycardia
Fixed, dilated pupils

Correct answer: Decreased level of consciousness

A change in level of consciousness is the earliest and most sensitive sign of rising ICP. Bradycardia, fixed pupils, and posturing are late findings.

Question 19: ABGs show pH 7.30, PaCO2 56 mm Hg, HCO3 24 mEq/L. How should the nurse interpret this?

Respiratory alkalosis
Respiratory acidosis (Correct answer)
Metabolic acidosis
Metabolic alkalosis

Correct answer: Respiratory acidosis

The pH is acidic and the PaCO2 is elevated while bicarbonate is normal, so this is uncompensated respiratory acidosis. In metabolic acidosis, HCO3 would be low.

Question 20: A client in hypovolemic shock is most likely to present with which set of findings?

Tachycardia, hypotension, and cool, pale skin (Correct answer)
Fever and wide pulse pressure
Hypertension and bounding pulse
Bradycardia and warm, flushed skin

Correct answer: Tachycardia, hypotension, and cool, pale skin

Hypovolemia triggers sympathetic compensation with rapid heart rate and vasoconstriction, causing cool, pale skin while blood pressure falls. Warm flushed skin suggests distributive shock.

Question 21: At which age should the nurse expect an infant to sit without support and begin transferring objects between hands?

12 months
6 to 7 months (Correct answer)
4 months
2 months

Correct answer: 6 to 7 months

Most infants sit without support and transfer objects by 6 to 7 months. At 2 to 4 months infants are working on head control and rolling.

Question 22: Which statement by a parent indicates a need for further teaching about the MMR vaccine?

"A second dose is given before school age."
"My child will receive it at 12 to 15 months."
"My child cannot have it because of an egg allergy." (Correct answer)
"A mild fever may occur after the shot."

Correct answer: "My child cannot have it because of an egg allergy."

Egg allergy is not a contraindication to MMR, so the statement shows a knowledge gap. The first dose is at 12 to 15 months with a second at 4 to 6 years, and mild fever is common.

Question 23: Which prenatal teaching is most important for a pregnant client at her first visit to reduce neural tube defects?

Take folic acid daily (Correct answer)
Increase vitamin A supplements
Limit fluids to 1 L per day
Avoid all exercise

Correct answer: Take folic acid daily

Folic acid taken before and during early pregnancy lowers the risk of neural tube defects. High-dose vitamin A is teratogenic, and moderate exercise is generally encouraged.

Question 24: A 55-year-old average-risk client asks about colorectal cancer screening. Which recommendation by the nurse is correct?

Screening is not needed without symptoms
Screening should begin at age 45 (Correct answer)
Screening should begin at age 65
Screening is only for those with family history

Correct answer: Screening should begin at age 45

For average-risk adults, screening starts at age 45 and continues through 75, using options like colonoscopy or stool-based tests. This client is already eligible and overdue if never screened.

Question 25: Which developmental task is most characteristic of a toddler according to Erikson?

Industry versus inferiority
Initiative versus guilt
Autonomy versus shame and doubt (Correct answer)
Trust versus mistrust

Correct answer: Autonomy versus shame and doubt

Toddlers, ages 1 to 3, develop autonomy through toilet training and self-feeding. Trust versus mistrust is infancy, and initiative versus guilt is the preschool stage.

NCLEX Practice Test: Video 1 Answers (25 Questions)

Which task is most appropriate for an RN to delegate to an unlicensed assistive personnel (UAP)?

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