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Free Fundamentals of Nursing Practice Questions

Foundational nursing principles every NCLEX, NMC CBT, and RCSI candidate must master — safety, infection control, hand hygiene, and basic procedures.

Question 1

A nurse is preparing to perform a sterile dressing change. Which action should the nurse take FIRST?

  1. AOpen the sterile dressing kit.
  2. BPerform hand hygiene.
  3. CDon sterile gloves.
  4. DPosition the patient.
Correct answer: B. Perform hand hygiene.

Hand hygiene is the single most important action to prevent the transmission of infection and must be performed before any clean or sterile procedure. The other actions are part of the procedure but follow proper hand hygiene.

Key concept: Infection control — hand hygiene is always step one.
Question 2

Which client is at the GREATEST risk for a fall during hospitalization?

  1. AA 32-year-old postoperative client receiving morphine.
  2. BA 65-year-old client with new orthostatic hypotension on diuretics.
  3. CA 45-year-old client with controlled hypertension.
  4. DA 28-year-old client recovering from an appendectomy.
Correct answer: B. A 65-year-old client with new orthostatic hypotension on diuretics.

Age over 65, new orthostatic hypotension, and diuretic use are all independent risk factors for falls. Combining them produces the highest risk. Implement bed-low, call light within reach, and assisted ambulation.

Key concept: Fall risk stacks — age + orthostatic changes + diuretics is the highest-risk profile.
Question 3

A nurse measures a blood pressure of 86/52 mm Hg on an adult client who is alert and complaining of dizziness when standing. What is the nurse's priority action?

  1. ADocument the finding and recheck in 4 hours.
  2. BLay the client flat, raise the legs, and notify the provider.
  3. CAdminister the next scheduled antihypertensive.
  4. DRestrict oral fluids to prevent fluid overload.
Correct answer: B. Lay the client flat, raise the legs, and notify the provider.

Symptomatic hypotension requires immediate intervention: position the client supine with legs elevated to improve cerebral perfusion, then notify the provider. Withholding antihypertensives and restricting fluids may be appropriate later but are not the priority action.

Key concept: Symptomatic hypotension is an emergency — position first, then escalate.
Question 4

A client in restraints requires assessment every:

  1. A15 minutes for circulation and skin integrity.
  2. BHour for vital signs only.
  3. C4 hours for documentation.
  4. DShift, unless the client reports discomfort.
Correct answer: A. 15 minutes for circulation and skin integrity.

Restrained clients require assessment of circulation, sensation, motion, and skin integrity at minimum every 15 minutes for the first hour and at least every 1–2 hours afterward, per Joint Commission standards. Restraints must be the least restrictive option and discontinued at the earliest opportunity.

Key concept: Restraints: 15-minute checks initially, least restrictive option, time-limited orders.
Question 5

Which personal protective equipment (PPE) is required when caring for a client with active pulmonary tuberculosis?

  1. ASurgical mask, gown, and gloves.
  2. BN95 respirator and gloves only.
  3. CN95 respirator, gown, gloves, and eye protection if splash risk.
  4. DStandard precautions only.
Correct answer: C. N95 respirator, gown, gloves, and eye protection if splash risk.

Active pulmonary TB requires airborne precautions: a fit-tested N95 respirator is essential, plus standard precautions (gown, gloves, eye protection if splashes are anticipated). The client should be in a negative-pressure room.

Key concept: TB = airborne precautions = fit-tested N95 + negative-pressure room.

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