Fundamentals of Nursing NCLEX Practice Quiz

1 (25 Items)
By Matt Vera - July 3, 2014

Is your knowledge about the foundation of nursing well and sound? This quiz will
question your ability to handle different nursing procedures, and other concepts covered
by Fundamentals of Nursing.

Nurses are a unique kind. They have this insatiable need to care for others, which is both their
biggest strength and fatal flaw.
– Dr. Jean Watson

Topics
Topics or concepts included in this exam are:

• Drug Administration
• Nursing Procedures and Skills
• Various questions about Fundamentals of Nursing

Guidelines
To make the most out of this exam, follow the guidelines below:

• Read each question carefully and choose the best answer.

• You are given one minute per question. Spend your time wisely!
• Answers and rationales (if any) are given below. Be sure to read them.
• If you need more clarifications, please direct them to the comments section.
Questions

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will only be given after you’ve finished the quiz. You are given 1 minute per question.

NCLEX Exam: Fundamentals of Nursing 1 (25 Items)

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shown after you have selected an answer. No time limit for this exam.

NCLEX Exam: Fundamentals of Nursing 1 (25 Items)

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1. The most important nursing intervention to correct skin dryness is:

A. Avoid bathing the patient until the condition is remedied, and notify the physician
B. Ask the physician to refer the patient to a dermatologist, and suggest that the patient
wear home-laundered sleepwear
C. Consult the dietitian about increasing the patient’s fat intake, and take necessary
measures to prevent infection
D. Encourage the patient to increase his fluid intake, use non-irritating soap when
bathing the patient, and apply lotion to the involved areas

2. When bathing a patient’s extremities, the nurse should use long, firm strokes
from the distal to the proximal areas. This technique:

A. Provides an opportunity for skin assessment

B. Avoids undue strain on the nurse
C. Increases venous blood return
D. Causes vasoconstriction and increases circulation

3. Vivid dreaming occurs in which stage of sleep?

A. Stage I non-REM
B. Rapid eye movement (REM) stage
C. Stage II non-REM
D. Delta stage
4. The natural sedative in meat and milk products (especially warm milk) that
can help induce sleep is:

A. Flurazepam
B. Temazepam
C. Tryptophan
D. Methotrimeprazine

5. Nursing interventions that can help the patient to relax and sleep restfully
include all of the following except:

A. Have the patient take a 30- to 60-minute nap in the afternoon

B. Turn on the television in the patient’s room
C. Provide quiet music and interesting reading material
D. Massage the patient’s back with long strokes

6. Restraints can be used for all of the following purposes except to:

A. Prevent a confused patient from removing tubes, such as feeding tubes, I.V. lines, and
urinary catheters
B. Prevent a patient from falling out of bed or a chair
C. Discourage a patient from attempting to ambulate alone when he requires assistance
for his safety
D. Prevent a patient from becoming confused or disoriented

7. Which of the following is the nurse’s legal responsibility when applying

restraints?

A. Document the patient’s behavior

B. Document the type of restraint used
C. Obtain a written order from the physician except in an emergency, when the patient
must be protected from injury to himself or others
D. All of the above

8. Kubler-Ross’s five successive stages of death and dying are:

A. Anger, bargaining, denial, depression, acceptance

B. Denial, anger, depression, bargaining, acceptance
C. Denial, anger, bargaining, depression acceptance
D. Bargaining, denial, anger, depression, acceptance

9. A terminally ill patient usually experiences all of the following feelings during
the anger stage except:

A. Rage
B. Envy
C. Numbness
D. Resentment

10. Nurses and other health care provides often have difficulty helping a
terminally ill patient through the necessary stages leading to acceptance of
death. Which of the following strategies is most helpful to the nurse in
achieving this goal?

A. Taking psychology courses related to gerontology

B. Reading books and other literature on the subject of thanatology
C. Reflecting on the significance of death
D. Reviewing varying cultural beliefs and practices related to death

11. Which of the following symptoms is the best indicator of imminent death?

A. A weak, slow pulse

B. Increased muscle tone
C. Fixed, dilated pupils
D. Slow, shallow respirations

12. A nurse caring for a patient with an infectious disease who requires
isolation should refers to guidelines published by the:

A. National League for Nursing (NLN)

B. Centers for Disease Control (CDC)
C. American Medical Association (AMA)
D. American Nurses Association (ANA)

13. To institute appropriate isolation precautions, the nurse must first know
the:

A. Organism’s mode of transmission

B. Organism’s Gram-staining characteristics
C. Organism’s susceptibility to antibiotics
D. Patient’s susceptibility to the organism

14. Which is the correct procedure for collecting a sputum specimen for culture
and sensitivity testing?

A. Have the patient place the specimen in a container and enclose the container in a
plastic bag
B. Have the patient expectorate the sputum while the nurse holds the container
C. Have the patient expectorate the sputum into a sterile container
D. Offer the patient an antiseptic mouthwash just before he expectorate the sputum

15. An autoclave is used to sterilize hospital supplies because:

A. More articles can be sterilized at a time

B. Steam causes less damage to the materials
C. A lower temperature can be obtained
D. Pressurized steam penetrates the supplies better

16. The best way to decrease the risk of transferring pathogens to a patient
when removing contaminated gloves is to:

A. Wash the gloves before removing them

B. Gently pull on the fingers of the gloves when removing them
C. Gently pull just below the cuff and invert the gloves when removing them
D. Remove the gloves and then turn them inside out

17. After having an I.V. line in place for 72 hours, a patient complains of
tenderness, burning, and swelling. Assessment of the I.V. site reveals that it is
warm and erythematous. This usually indicates:

A. Infection
B. Infiltration
C. Phlebitis
D. Bleeding

18. To ensure homogenization when diluting powdered medication in a vial, the

nurse should:

A. Shake the vial vigorously

B. Roll the vial gently between the palms
C. Invert the vial and let it stand for 1 minute
D. Do nothing after adding the solution to the vial

19. The nurse is teaching a patient to prepare a syringe with 40 units of U-100
NPH insulin for self-injection. The patient’s first priority concerning self-
injection in this situation is to:

A. Assess the injection site

B. Select the appropriate injection site
C. Check the syringe to verify that the nurse has removed the prescribed insulin dose
D. Clean the injection site in a circular manner with alcohol sponge

20. The physician’s order reads “Administer 1 g cefazolinsodium (Ancef) in 150

ml of normal saline solution in 60 minutes.” What is the flow rate if the drop
factor is 10 gtt = 1 ml?

A. 25 gtt/minute
B. 37 gtt/minute
C. 50 gtt/minute
D. 60 gtt/minute

21. A patient must receive 50 units of Humulin regular insulin. The label reads
100 units = 1 ml. How many milliliters should the nurse administer?

A. 0.5 ml
B. 0.75 ml
C. 1 ml
D. 2 ml

22. How should the nurse prepare an injection for a patient who takes both
regular and NPH insulin?

A. Draw up the NPH insulin, then the regular insulin, in the same syringe
B. Draw up the regular insulin, then the NPH insulin, in the same syringe
C. Use two separate syringe
D. Check with the physician

23. A patient has just received 30 mg of codeine by mouth for pain. Five
minutes later he vomits. What should the nurse do first?

A. Call the physician

B. Remedicate the patient
C. Observe the emesis
D. Explain to the patient that she can do nothing to help him

24. A patient is characterized with a #16 indwelling urinary (Foley) catheter to

determine if:

A. Trauma has occurred

B. His 24-hour output is adequate
C. He has a urinary tract infection
D. Residual urine remains in the bladder after voiding

25. A staff nurse who is promoted to assistant nurse manager may feel
uncomfortable initially when supervising her former peers. She can best
decrease this discomfort by:

A. Writing down all assignments

B. Making changes after evaluating the situation and having discussions with the staff.
C. Telling the staff nurses that she is making changes to benefit their performance
D. Evaluating the clinical performance of each staff nurse in a private conference

Answers and Rationale

1. Answer: D. Encourage the patient to increase his fluid intake, use non-
irritating soap when bathing the patient, and apply lotion to the involved areas

Dry skin will eventually crack, ranking the patient more prone to infection. To prevent
this, the nurse should provide adequate hydration through fluid intake, use nonirritating
soaps or no soap when bathing the patient, and lubricate the patient’s skin with lotion.
Bathing may be limited but need not be avoided entirely. The attending physician and
dietitian may be consulted for treatment, but home-laundered items usually are not
necessary.

2. Answer: C. Increases venous blood return

Washing from distal to proximal areas stimulates venous blood flow, thereby preventing
venous stasis. It improves circulation but does not result in vasoconstriction. The nurse
can assess the patient’s condition throughout the bath, regardless of washing technique,
and should feel no strain while bathing the patient.

3. Answer: B. Rapid eye movement (REM) stage

Other characteristics of rapid eye movement (REM) sleep are deep sleep (the patient
cannot be awakened easily), depressed muscle tone, and possibly irregular heart and
respiratory rates. Non-REM sleep is a deep, restful sleep without dreaming. Delta stage,
or slow-wave sleep, occurs during non-REM Stages III and IV and is often equated with
quiet sleep.

4. Answer: C. Tryptophan

Tryptophan is a natural sedative; flurazepam (Dalmane), temazepam (Restoril), and

methotrimeprazine (Levoprome) are hypnotic sedatives.

5. Answer: A. Have the patient take a 30- to 60-minute nap in the afternoon

Napping in the afternoon is not conductive to nighttime sleeping. Quiet music, watching
television, reading, and massage usually will relax the patient, helping him to fall asleep.

6. Answer: D. Prevent a patient from becoming confused or disoriented

By restricting a patient’s movements, restraints may increase stress and lead to

confusion, rather than prevent it. The other choices are valid reasons for using restraints.

7. Answer: D. All of the above

When applying restraints, the nurse must document the type of behavior that prompted
her to use them, document the type of restraints used, and obtain a physician’s written
order for the restraints.

8. Answer: C. Denial, anger, bargaining, depression acceptance

Kubler-Ross’s five successive stages of death and dying are denial, anger, bargaining,
depression, and acceptance. The patient may move back and forth through the different
stages as he and his family members react to the process of dying, but he usually goes
through all of these stages to reach acceptance.

9. Answer: C. Numbness

Numbness is typical of the depression stage, when the patient feels a great sense of loss.
The anger stage includes such feelings as rage, envy, resentment, and the patient’s
questioning “Why me?”

10. Answer: C. Reflecting on the significance of death

According to thanatologists, reflecting on the significance of death helps to reduce the

fear of death and enables the health care provider to better understand the terminally ill
patient’s feelings. It also helps to overcome the belief that medical and nursing measures
have failed, when a patient cannot be cured.

11. Answer: C. Fixed, dilated pupils

Fixed, dilated pupils are sign of imminent death. Pulse becomes weak but rapid, muscles
become weak and atonic, and periods of apnea occur during respiration.

12. Answer: B. Centers for Disease Control (CDC)

The Center of Disease Control (CDC) publishes and frequently updates guidelines on
caring for patients who require isolation. The National League of Nursing’s (NLN’s) major
function is accrediting nursing education programs in the United States. The American
Medical Association (AMA) is a national organization of physicians. The American Nurses’
Association (ANA) is a national organization of registered nurses.

13. Answer: A. Organism’s mode of transmission

Before instituting isolation precaution, the nurse must first determine the organism’s
mode of transmission. For example, an organism transmitted through nasal secretions
requires that the patient be kept in respiratory isolation, which involves keeping the
patient in a private room with the door closed and wearing a mask, a gown, and gloves
when coming in direct contact with the patient. The organism’s Gram-straining
characteristics reveal whether the organism is gram-negative or gram-positive, an
important criterion in the physician’s choice for drug therapy and the nurse’s
development of an effective plan of care. The nurse also needs to know whether the
organism is susceptible to antibiotics, but this could take several days to determine; if
she waits for the results before instituting isolation precautions, the organism could be
transmitted in the meantime. The patient’s susceptibility to the organism has already
been established. The nurse would not be instituting isolation precautions for a non-
infected patient.

14. Answer: C. Have the patient expectorate the sputum into a sterile container

Placing the specimen in a sterile container ensures that it will not become contaminated.
The other answers are incorrect because they do not mention sterility and because
antiseptic mouthwash could destroy the organism to be cultured (before sputum
collection, the patient may use only tap water for nursing the mouth).

15. Answer: D. Pressurized steam penetrates the supplies better

An autoclave, an apparatus that sterilizes equipment by means of high-temperature

pressurized steam, is used because it can destroy all forms of microorganisms, including
spores.

16. Answer: C. Gently pull just below the cuff and invert the gloves when
removing them

Turning the gloves inside out while removing them keeps all contaminants inside the
gloves. They should then be placed in a plastic bag with soiled dressings and discarded in
a soiled utility room garbage pail (double bagged). The other choices can spread
pathogens within the environment.

17. Answer: C. Phlebitis

Tenderness, warmth, swelling, and, in some instances, a burning sensation are signs and
symptoms of phlebitis. Infection is less likely because no drainage or fever is present.
Infiltration would result in swelling and pallor, not erythema, near the insertion site. The
patient has no evidence of bleeding.

18. Answer: B. Roll the vial gently between the palms

Gently rolling a sealed vial between the palms produces sufficient heat to enhance
dissolution of a powdered medication. Shaking the vial vigorously can break down the
medication and alter its pharmacologic action. Inverting the vial or leaving it alone does
not ensure thorough homogenization of the powder and the solvent.

19. Answer: C. Check the syringe to verify that the nurse has removed the
prescribed insulin dose

When the nurse teaches the patient to prepare an insulin injection, the patient’s first
priority is to validate the dose accuracy. The next steps are to select the site, assess the
site, and clean the site with alcohol before injecting the insulin.

20. Answer: A. 25 gtt/minute

21. Answer: A. 0.5 ml

22. Answer: B. Draw up the regular insulin, then the NPH insulin, in the same
syringe

Drugs that are compatible may be mixed together in one syringe. In the case of insulin,
the shorter-acting, clear insulin (regular) should be drawn up before the longer-acting,
cloudy insulin (NPH) to ensure accurate measurements.

23. Answer: C. Observe the emesis

After a patient has vomited, the nurse must inspect the emesis to document color,
consistency, and amount. In this situation, the patient recently ingested medication, so
the nurse needs to check for remnants of the medication to help determine whether the
patient retained enough of it to be effective. The nurse must then notify the physician,
who will decide whether to repeat the dose or prescribe an antiemetic.

24. Answer: B. His 24-hour output is adequate

A 24-hour urine output of less than 500 ml in an adult is considered inadequate and may
indicate kidney failure. This must be corrected while the patient is in the acute state so
that appropriate fluids, electrolytes, and medications can be administered and excreted.
Indwelling catheterization is not needed to diagnose trauma, urinary tract infection, or
residual urine.

25. Answer: B. Making changes after evaluating the situation and having
discussions with the staff.

A new assistant nurse manager should not make changes until she has had a chance to
evaluate staff members, patients, and physicians. Changes must be planned thoroughly
and should be based on a need to improve conditions, not just for the sake of change.
Written assignments allow all staff members to know their own and others responsibilities
and serve as a checklist for the manager, enabling her to gauge whether the unit is being
run effectively and whether patients are receiving appropriate care. Telling the staff
nurses that she is making changes to benefit their performance should occur only after
the nurse has made a thorough evaluation. Evaluations are usually done on a yearly
basis or as needed.
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