50 Fundamentals & Safety Practice Questions & Answers
Every Fundamentals & Safety practice question from the NCLEX-RN Practice Test, with the correct answer and a short explanation.
Start practice test →1. A nurse is caring for a client with active pulmonary tuberculosis (TB). Which type of precaution is required?
- A.Droplet precautions with a surgical mask
- B.Airborne precautions with an N95 respirator✓ Answer
- C.Standard precautions only
- D.Contact precautions with gown and gloves
Pulmonary TB spreads via small airborne droplet nuclei, so airborne precautions with a fit-tested N95 respirator and a negative-pressure room are required.
2. According to the ABC (airway, breathing, circulation) priority framework, which client should the nurse assess first?
- A.A client requesting discharge teaching
- B.A client reporting pain rated 8 out of 10
- C.A client with stridor and audible wheezing✓ Answer
- D.A client who needs help ambulating to the bathroom
Stridor signals a compromised airway, which under the ABC framework takes priority over pain, mobility, or teaching needs.
3. When applying personal protective equipment (PPE), what is the correct order of donning?
- A.Gown, mask, goggles, gloves✓ Answer
- B.Mask, gloves, gown, goggles
- C.Goggles, gloves, gown, mask
- D.Gloves, gown, mask, goggles
CDC guidelines specify donning PPE in the order gown, then mask/respirator, then goggles/face shield, then gloves.
4. A nurse is preparing to administer a medication. Which action best prevents a medication error?
- A.Asking the client to state only their first name
- B.Relying on the client's wristband color
- C.Verifying the client's identity using two identifiers✓ Answer
- D.Confirming the client's identity by room number
Using two client identifiers, such as name and date of birth, is the standard safety practice to ensure the right client receives the medication.
5. Which task is most appropriate for a registered nurse (RN) to delegate to unlicensed assistive personnel (UAP)?
- A.Teaching a client about a new diabetes diagnosis
- B.Evaluating the effectiveness of a pain medication
- C.Recording a stable client's intake and output✓ Answer
- D.Performing the initial admission assessment
Recording intake and output for a stable client is a routine, standardized task within the UAP scope; assessment, teaching, and evaluation require the RN.
6. A client is placed on contact precautions for Clostridioides difficile (C. diff). Which hand hygiene method is required after care?
- A.Applying hand lotion after removing gloves
- B.Washing hands with soap and water✓ Answer
- C.Wiping hands with a dry paper towel
- D.Using alcohol-based hand rub only
C. diff spores resist alcohol, so hands must be washed with soap and water to physically remove them.
7. A nurse is positioning an unconscious client who is not intubated to maintain a patent airway. Which position is best?
- A.Lateral (side-lying) recovery position✓ Answer
- B.Supine (flat on the back)
- C.High Fowler's (sitting upright)
- D.Trendelenburg (head lower than feet)
The lateral recovery position lets secretions drain from the mouth and prevents the tongue from occluding the airway in an unconscious client.
8. Using Maslow's hierarchy of needs to prioritize care, which client need should the nurse address first?
- A.A client's low self-esteem
- B.A client's concern about privacy
- C.A client's fear of being alone
- D.A client's difficulty breathing✓ Answer
Maslow places physiological needs such as breathing at the base of the hierarchy, so they take priority over safety, love/belonging, and esteem needs.
9. To prevent falls in an older adult client at high risk, which intervention is most appropriate?
- A.Keeping the bed in the lowest position with the call light within reach✓ Answer
- B.Applying a vest restraint at night
- C.Keeping the room dimly lit at all times
- D.Raising all four side rails on the bed
Keeping the bed low with the call light in reach is the least restrictive, evidence-based fall precaution; four raised rails are considered a restraint.
10. When transferring a client from bed to a wheelchair, which action by the nurse ensures safe body mechanics?
- A.Keeping the feet close together for balance
- B.Bending at the waist to reach the client
- C.Twisting the spine while lifting the client
- D.Bending at the knees and keeping the back straight✓ Answer
Bending at the knees while keeping the back straight uses the strong leg muscles and protects the nurse's spine during transfers.
11. A nurse notices a coworker did not perform hand hygiene before entering a client's room. What is the nurse's best initial action?
- A.Respectfully remind the coworker to perform hand hygiene✓ Answer
- B.Complete an incident report before speaking to anyone
- C.Report the coworker to the nurse manager immediately
- D.Say nothing to avoid conflict
A respectful, direct reminder promptly corrects the infection-control lapse and protects the client, which is the appropriate first step before escalating.
12. Which client should a charge nurse assign to a newly licensed RN rather than to a more experienced RN?
- A.A client who is rapidly deteriorating
- B.A stable client awaiting routine discharge✓ Answer
- C.A client requiring frequent titration of IV vasopressors
- D.A client with new-onset chest pain
A stable client with predictable, routine needs is the safest assignment for a novice nurse; unstable or complex clients require experienced staff.
13. A nurse is caring for a client with a latex allergy. Which action best protects the client?
- A.Wearing powdered latex gloves for procedures
- B.Using latex-free gloves and supplies✓ Answer
- C.Placing the client in a private negative-pressure room
- D.Limiting the client's visitors
Removing all latex exposure by using latex-free gloves and supplies is the primary intervention to prevent an allergic reaction.
14. A nurse identifies a client at risk for pressure injury. Which intervention is the priority?
- A.Repositioning the client at least every 2 hours✓ Answer
- B.Limiting the client's fluid intake
- C.Keeping the head of the bed elevated above 45 degrees continuously
- D.Massaging reddened bony prominences
Repositioning at least every 2 hours relieves prolonged pressure over bony prominences and is the key measure to prevent pressure injuries.
15. Four clients are waiting to be seen. Applying the ABC and 'unstable first' priority rules, which client should the nurse assess first?
- A.A client with a temperature of 38.1 degrees C (100.6 F)
- B.A client with an oxygen saturation of 84% on room air✓ Answer
- C.A client requesting a warm blanket
- D.A client asking about their discharge time
An oxygen saturation of 84% signals severe hypoxemia, a breathing/oxygenation emergency that takes priority over a low-grade fever or comfort requests.
16. A client scheduled for surgery says, 'I don't really understand what they're going to do to me.' What is the nurse's best action regarding informed consent?
- A.Explain the surgical procedure and its risks to the client
- B.Reassure the client that the surgeon knows best
- C.Ask the client to sign the form and proceed
- D.Notify the surgeon that the client needs further explanation✓ Answer
Obtaining informed consent (informed consent) is the provider's legal responsibility, so the nurse must notify the surgeon to explain the procedure before the client signs.
17. A client newly diagnosed with cancer says, 'I feel like giving up.' Which response by the nurse is most therapeutic?
- A.'You have so much to live for; don't talk that way.'
- B.'It sounds like you're feeling overwhelmed right now.'✓ Answer
- C.'Everyone feels that way at first; it will pass.'
- D.'Why do you feel like giving up?'
Reflecting the client's feelings uses therapeutic communication (therapeutic communication) to acknowledge emotions and encourage the client to express more, unlike responses that dismiss or challenge them.
18. The nurse is delegating tasks. Which task is appropriate to assign to a licensed practical nurse (LPN/LVN) rather than to unlicensed assistive personnel (UAP)?
- A.Feeding a stable client who is not at risk for aspiration
- B.Assisting a client with a bed bath
- C.Taking routine vital signs on a stable client
- D.Administering a scheduled oral medication to a stable client✓ Answer
Administering oral medications is within the LPN/LVN scope (LPN/LVN scope) but outside the UAP scope; feeding, vital signs, and bathing may be delegated to UAP.
19. A nurse is teaching a client about the correct technique for using an alcohol-based hand rub. Which instruction is correct?
- A.Rub hands together until the product is completely dry✓ Answer
- B.Wipe the excess product off with a paper towel
- C.Apply the product to visibly soiled hands
- D.Rinse hands with water after applying the rub
Hands should be rubbed until the alcohol-based rub is fully dry to allow adequate contact time; visibly soiled hands require soap and water instead.
20. A competent adult client refuses a prescribed blood transfusion for religious reasons. What is the nurse's most appropriate action?
- A.Administer the transfusion because it is medically necessary
- B.Have a family member sign consent instead
- C.Respect the client's decision and notify the provider✓ Answer
- D.Tell the client they could die without the transfusion and insist
A competent adult has the right to refuse treatment through client autonomy (autonomy); the nurse must respect the decision and inform the provider.
21. A nurse is inserting an indwelling urinary catheter. Which technique is required to prevent infection?
- A.Clean (medical asepsis) technique
- B.Double-gloving with non-sterile gloves
- C.Standard precautions with clean gloves only
- D.Sterile (surgical asepsis) technique✓ Answer
Urinary catheter insertion requires sterile technique (surgical asepsis) to prevent introducing organisms into the normally sterile bladder.
22. The nurse is caring for four clients. Which one has the greatest need to be seen first based on physiologic instability?
- A.A postoperative client whose dressing has a small amount of dried drainage
- B.A client whose blood pressure dropped from 120/80 to 84/50 mmHg✓ Answer
- C.A client due for scheduled pain medication in 30 minutes
- D.A client asking for assistance to the bathroom
A sudden drop to 84/50 mmHg indicates hypotension (hypotension) and possible circulatory compromise, an unstable finding that takes priority over routine needs.
23. A nurse is teaching an older adult client about age-related changes and health promotion. Which recommendation is appropriate?
- A.Avoid all physical activity to prevent injury
- B.Receive recommended immunizations such as the annual influenza vaccine✓ Answer
- C.Reduce fluid intake to prevent incontinence
- D.Stop all health screenings after age 65
Health promotion (health promotion) for older adults includes recommended immunizations like the annual flu vaccine; activity, adequate hydration, and screenings should continue.
24. A client is admitted with methicillin-resistant Staphylococcus aureus (MRSA) in a wound. Which precautions should the nurse implement?
- A.Airborne precautions
- B.Droplet precautions
- C.Contact precautions✓ Answer
- D.Standard precautions only
MRSA spreads by direct and indirect contact, so contact precautions (contact precautions) with gown and gloves are required.
25. A nurse is planning care for a client on prolonged bed rest. Which intervention best prevents the complication of venous thromboembolism?
- A.Keeping the client's legs crossed while in bed
- B.Massaging the calves to check for tenderness
- C.Restricting the client's oral fluid intake
- D.Encouraging early mobilization and leg exercises✓ Answer
Early mobilization and leg exercises promote venous return and prevent deep vein thrombosis (DVT); leg crossing and massaging a suspected clot are harmful.
26. A nurse discovers a medication error was made on the previous shift. What is the nurse's priority action?
- A.Assess the client for any adverse effects✓ Answer
- B.Complete an incident report first
- C.Notify the nurse who made the error
- D.Document the error in the chart
Client safety comes first: the nurse must assess the client for adverse effects before reporting or documenting the error.
27. A client is angry and shouting about a delay in receiving pain medication. Which response by the nurse is most therapeutic?
- A.'You need to calm down before I can help you.'
- B.'I can see you're frustrated. Let's talk about what's happening.'✓ Answer
- C.'Yelling will not make the medication come any faster.'
- D.'There are other clients who are sicker than you.'
Acknowledging the client's feelings and inviting dialogue de-escalates anger through therapeutic communication (therapeutic communication), while the other responses are dismissive or defensive.
28. A nurse is caring for a client with a documented do-not-resuscitate (DNR) advance directive who stops breathing. What should the nurse do?
- A.Begin cardiopulmonary resuscitation (CPR) immediately
- B.Call a code and start chest compressions
- C.Provide comfort measures and do not initiate resuscitation✓ Answer
- D.Wait for the family to decide what to do
A valid DNR advance directive (advance directive) legally directs the nurse to withhold resuscitation and provide comfort care instead.
29. A nurse is assessing an adult client's vital signs. Which finding should the nurse report as abnormal?
- A.Respiratory rate of 16 breaths per minute
- B.Heart rate of 72 beats per minute
- C.Oral temperature of 37.0 degrees C (98.6 F)
- D.Resting respiratory rate of 8 breaths per minute✓ Answer
A resting respiratory rate of 8 is bradypnea (bradypnea), below the normal adult range of 12 to 20; the other values are all within normal limits.
30. A nurse is caring for a client at risk for aspiration during meals. Which intervention is most appropriate?
- A.Position the client in high Fowler's position while eating✓ Answer
- B.Have the client lie flat while eating
- C.Encourage the client to eat quickly
- D.Offer thin liquids with each bite
Sitting upright in high Fowler's position uses gravity to reduce aspiration (aspiration) risk during meals; lying flat, rushing, and thin liquids increase risk.
31. The nurse is delegating to a UAP. Which instruction is most appropriate when delegating vital sign measurement?
- A.'Take the vital signs and interpret whether they are normal.'
- B.'Take the vital signs and report any reading outside the range I gave you.'✓ Answer
- C.'Adjust the plan of care based on the vital signs.'
- D.'Only tell me if the client complains of symptoms.'
Effective delegation (delegation) gives the UAP clear parameters and directs them to report values back to the RN, who retains responsibility for interpretation and care decisions.
32. A nurse is caring for a client who is Muslim and observing dietary practices. Which nursing action demonstrates culturally competent care?
- A.Ask the client about food preferences and arrange appropriate meals✓ Answer
- B.Assume the client will eat whatever is on the standard tray
- C.Encourage the client to set aside beliefs during hospitalization
- D.Provide a pork-based meal to increase protein intake
Culturally competent care (cultural competence) means asking about and accommodating the client's dietary practices rather than assuming or overriding them.
33. A nurse is providing care to promote rest and sleep for a hospitalized client. Which intervention is best?
- A.Cluster nursing care to minimize nighttime interruptions✓ Answer
- B.Offer the client a large caffeinated drink in the evening
- C.Keep the overhead lights on for safety all night
- D.Schedule routine vital signs every hour overnight
Clustering care reduces sleep interruptions and supports the client's rest and sleep (rest and sleep); caffeine, bright lights, and hourly checks disrupt sleep.
34. A nurse is caring for a client with an nasogastric (NG) tube for feeding. Before administering a tube feeding, which action is the priority?
- A.Flush the tube with 500 mL of water
- B.Warm the feeding to body temperature in a microwave
- C.Verify correct tube placement✓ Answer
- D.Position the client flat in bed
Verifying NG tube placement (tube placement) before feeding prevents instilling formula into the lungs; the client should be upright, not flat.
35. A nurse is caring for a client experiencing acute pain and wants to add a non-pharmacologic comfort measure. Which intervention is appropriate?
- A.Doubling the prescribed opioid dose
- B.Guided imagery and relaxation breathing✓ Answer
- C.Withholding all pain medication
- D.Restricting the client to bed rest
Guided imagery and relaxation breathing are safe non-pharmacologic comfort measures (non-pharmacologic comfort) that complement, but do not replace, prescribed analgesia; changing doses requires a provider order.
36. The charge nurse must assign four clients. Which client is most appropriate to assign to a UAP for basic hygiene care?
- A.A client who just returned from surgery and is unstable
- B.A client receiving a blood transfusion
- C.A client with a new tracheostomy requiring suctioning
- D.A stable client on bed rest who needs a bath and linen change✓ Answer
Basic hygiene for a stable client is within the UAP scope (UAP scope); suctioning a new tracheostomy, transfusions, and unstable post-op clients require licensed nurses.
37. A nurse is teaching parents about safety for a 9-month-old infant. Which statement indicates a need for further teaching?
- A.'We keep small objects out of the baby's reach.'
- B.'We place the baby on the back to sleep.'
- C.'We prop the bottle so the baby can feed alone in the crib.'✓ Answer
- D.'We lower the crib mattress as the baby grows.'
Propping a bottle is unsafe because it increases the risk of choking (aspiration) and ear infections; the other statements reflect correct infant safety.
38. A nurse enters a room and finds a small electrical fire in a waste bin. Using the RACE framework, what is the nurse's first action?
- A.Rescue and remove any clients in immediate danger✓ Answer
- B.Activate the fire alarm before doing anything else
- C.Attempt to extinguish the fire with water
- D.Open the windows to let smoke escape
In the RACE fire-response sequence, Rescue (rescue) clients from immediate danger comes first, followed by Alarm, Contain, and Extinguish; water is never used on an electrical fire.
39. A nurse is caring for a client who is grieving the recent death of a spouse. Which nursing action best supports the client's coping?
- A.Encourage the client to express feelings and listen actively✓ Answer
- B.Tell the client it is time to move on
- C.Change the subject to avoid upsetting the client
- D.Reassure the client that the spouse is in a better place
Encouraging expression and using active listening supports healthy grieving and coping (coping); the other responses block or dismiss the client's emotions.
40. A nurse is removing personal protective equipment (PPE) after caring for a client on contact precautions. Which item should be removed first?
- A.The N95 respirator or mask
- B.The gloves✓ Answer
- C.The goggles or face shield
- D.The gown, before anything else
During doffing, the most contaminated item, the gloves, is removed first, followed by goggles, gown, and finally the mask/respirator.
41. A nurse is caring for a client with constipation and no contraindications. Which intervention should the nurse implement first?
- A.Administer an enema immediately
- B.Increase dietary fiber, fluids, and activity✓ Answer
- C.Request an order for a daily stimulant laxative
- D.Restrict the client's fluid intake
The least invasive, first-line intervention for constipation (constipation) is increasing fiber, fluids, and activity; enemas and laxatives are used only if these measures fail.
42. A nurse is planning morning care for four clients. Which client should the nurse see first?
- A.A client requesting help with morning hygiene
- B.A client whose IV pump is alarming for occlusion
- C.A client reporting new shortness of breath and chest tightness✓ Answer
- D.A client who wants to discuss their menu choices
New shortness of breath with chest tightness is a possible cardiac or respiratory emergency (ABC priority) and takes precedence over an IV alarm or routine requests.
43. A client asks the nurse to serve as a witness for their advance directive. What is the nurse's best response?
- A.'I cannot discuss advance directives with you.'
- B.'You should not worry about that while you are ill.'
- C.'Let me provide information and connect you with resources to complete it.'✓ Answer
- D.'Only your family can help you with those decisions.'
The nurse acts as a client advocate (advocacy) by providing information and resources about the advance directive; dismissing or blocking the request violates the client's rights.
44. A nurse is preparing to move a client up in bed. To use safe body mechanics and reduce injury, what should the nurse do?
- A.Lift the client alone to save time
- B.Raise the bed to waist height and use a friction-reducing device with assistance✓ Answer
- C.Keep the bed low and bend over the client
- D.Pull the client up by grasping under the arms
Raising the bed to waist height and using a friction-reducing device with help applies safe body mechanics (body mechanics) and prevents injury to nurse and client.
45. A nurse notes a client's skin over the sacrum is intact but shows nonblanchable redness. This is characteristic of which stage of pressure injury?
- A.Stage 1✓ Answer
- B.Stage 2
- C.Stage 3
- D.Stage 4
Intact skin with nonblanchable redness defines a stage 1 pressure injury (pressure injury); later stages involve partial- or full-thickness skin loss.
46. A nurse is caring for a client with dysphagia after a stroke. Which nursing intervention promotes safe nutrition?
- A.Offer thin liquids to make swallowing easier
- B.Encourage the client to talk while eating
- C.Provide thickened liquids and have the client sit upright✓ Answer
- D.Give large bites to speed up the meal
For dysphagia (dysphagia), thickened liquids and an upright position reduce aspiration risk; thin liquids, talking while eating, and large bites increase it.
47. A nurse must prioritize care for four clients based on physiologic and Maslow needs. Which client should the nurse attend to first?
- A.A client who is anxious about going home
- B.A client with a blood glucose of 45 mg/dL and confusion✓ Answer
- C.A client who wants to call a family member
- D.A client asking to change rooms
A glucose of 45 mg/dL with confusion is symptomatic hypoglycemia (hypoglycemia), a physiologic emergency that takes priority over psychosocial or comfort needs.
48. A nurse suspects a client is being physically abused by a caregiver. What is the nurse's legal and ethical obligation?
- A.Keep the suspicion confidential to protect the client
- B.Confront the caregiver directly and demand an explanation
- C.Report the suspected abuse according to mandatory reporting laws✓ Answer
- D.Wait until there is definitive proof before acting
Nurses are mandatory reporters (mandatory reporting) and must report suspected abuse to the proper authorities; definitive proof is not required to report.
49. A nurse is teaching a client with a new colostomy about self-care. Which statement by the client indicates correct understanding?
- A.'A healthy stoma should look pale and dry.'
- B.'Some bleeding of the stoma when I clean it means infection.'
- C.'I will only change the appliance once a month.'
- D.'I should empty the pouch when it is about one-third to one-half full.'✓ Answer
Emptying the pouch when one-third to one-half full prevents leakage and detachment; a healthy stoma (stoma) is pink/red and moist, and slight bleeding with cleaning is normal.
50. A nurse is caring for a client on airborne precautions in a negative-pressure room. Which action by the nurse is correct?
- A.Keep the room door open for easier access
- B.Wear only a standard surgical mask
- C.Wear a fit-tested N95 respirator and keep the door closed✓ Answer
- D.Turn off the negative-pressure ventilation during care
Airborne precautions (airborne precautions) require a fit-tested N95 respirator and a closed door to maintain negative pressure; the ventilation must stay on.
Practice questions based on the NCSBN NCLEX-RN test plan. Not affiliated with NCSBN and not medical advice — always follow your program and current clinical guidelines. About the NCLEX →