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NCLEX Fundamentals Practice Questions

Review safety, basic care, infection prevention and core nursing fundamentals. The goal is not to memorize a letter pattern. Read the stem, identify the clinical problem, decide what matters most for safety, and compare every option against that priority.

These questions are original Free NCLEX Prep educational items, not official NCSBN questions. Use each rationale to review why the best option fits and why the alternatives are less appropriate. For stronger learning, answer before opening the explanation, then write one short takeaway from any item you miss.

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Do not chase perfect scores. Chase better reasoning.

Every reviewed mistake can become a safer decision on the next question.

Question 1 · moderate · Safety and Infection Prevention and Control

What is the usual sequence for donning PPE before entering an isolation room?

  1. Gloves, goggles, gown, mask
  2. Gown, mask/respirator, goggles/face shield, gloves
  3. Mask, gloves, gown, goggles
  4. Goggles, gloves, mask, gown
Show answer & rationale
Best answer: B — Gown, mask/respirator, goggles/face shield, gloves

Standard donning is gown → mask/respirator → eye protection → gloves so gloves go on last over gown cuffs.

Question 2 · moderate · Safety and Infection Prevention and Control

A client has Clostridioides difficile diarrhea. Which hygiene practice is correct?

  1. Alcohol gel is sufficient after glove removal
  2. Wash hands with soap and water; use contact precautions
  3. No gloves are needed if a gown is worn
  4. Place the client in negative-pressure airborne isolation only
Show answer & rationale
Best answer: B — Wash hands with soap and water; use contact precautions

Spores are not reliably killed by alcohol rub. Soap and water plus contact precautions are required. Airborne isolation is not the C. diff category.

Question 3 · moderate · Safety and Infection Prevention and Control

Which event contaminates a sterile field?

  1. Keeping sterile gloves above the waist
  2. Turning the back to the field to reach a chart
  3. Opening a sterile kit away from the body first
  4. Pouring sterile solution without splashing
Show answer & rationale
Best answer: B — Turning the back to the field to reach a chart

The back is not sterile. Turning away contaminates the field. Below-waist and wet fields are also contaminated.

Question 4 · moderate · Safety and Infection Prevention and Control

A confused client is pulling at a newly placed central line. What is the first approach?

  1. Apply a vest restraint immediately without an order
  2. Use the least restrictive effective option (reorientation, sitter, concealment) and obtain an order if a restraint becomes necessary
  3. Tie both wrists to the side rails tightly
  4. Sedate without assessment
Show answer & rationale
Best answer: B — Use the least restrictive effective option (reorientation, sitter, concealment) and obtain an order if a restraint becomes necessary

Least-restrictive measures come first. Restraints require an order, frequent assessment, and never attachment to moving side rails.

Question 5 · moderate · Safety and Infection Prevention and Control

Smoke is coming from a microwave in a client lounge. Using RACE, what is the first action if a client is in that lounge?

  1. Rescue the client from the immediate area
  2. Start charting the incident
  3. Look for an extinguisher before moving anyone
  4. Close the door and leave the client to get coffee
Show answer & rationale
Best answer: A — Rescue the client from the immediate area

RACE: Rescue those in danger, Alarm, Contain, Extinguish/Evacuate. People before property.

Question 6 · moderate · Basic Care and Comfort

A sacral area is non-blanchable redness over a bony prominence. What should the nurse do?

  1. Massage the redness vigorously to restore flow
  2. Offload the area, keep skin clean/dry, and document a stage 1 pressure injury
  3. Ignore it because color will return
  4. Place a donut ring so the client sits only on the rim
Show answer & rationale
Best answer: B — Offload the area, keep skin clean/dry, and document a stage 1 pressure injury

Non-blanchable erythema is stage 1. Do not massage reddened prominences. Donut rings concentrate pressure.

Question 7 · moderate · Basic Care and Comfort

Before administering a bolus gastric tube feeding, which action best reduces aspiration risk?

  1. Place the client flat to relax the stomach
  2. Verify placement per protocol and keep the head of bed elevated
  3. Instill the entire bag in 30 seconds
  4. Disconnect suction and leave the client supine for an hour
Show answer & rationale
Best answer: B — Verify placement per protocol and keep the head of bed elevated

Placement check plus HOB elevation are foundational aspiration precautions.

Question 8 · moderate · Basic Care and Comfort

Which stoma finding must be reported immediately?

  1. Pink-red, moist stoma on day 1
  2. Dusky, purple-black stoma
  3. Mild swelling in the first 48 hours
  4. Mucous threads in an ileostomy pouch
Show answer & rationale
Best answer: B — Dusky, purple-black stoma

A dusky or black stoma suggests ischemia. Expected early stomas are pink-red and moist.

Question 9 · moderate · Basic Care and Comfort

A client reports pain at 8/10 after surgery. The last opioid was 4 hours ago and vital signs are stable. What is the best next action?

  1. Tell the client that some pain is character-building
  2. Assess the pain, give the prescribed analgesic, and reassess
  3. Wait until the next vital-sign block in 4 hours
  4. Document that the client is drug-seeking
Show answer & rationale
Best answer: B — Assess the pain, give the prescribed analgesic, and reassess

Pain is what the client says. Assess, treat per order, reassess. Labeling as drug-seeking without data is unsafe.

Question 10 · moderate · Management of Care

A client scheduled for surgery cannot teach-back the procedure or name the risks. What should the nurse do?

  1. Have the client sign anyway to keep the OR on time
  2. Stop and notify the provider; the nurse does not obtain the primary informed consent
  3. Explain the entire operation and then sign as surgeon
  4. Ask a roommate to sign
Show answer & rationale
Best answer: B — Stop and notify the provider; the nurse does not obtain the primary informed consent

The provider discloses risks/benefits. The nurse witnesses and advocates. If understanding is absent, stop the process.

How to use this practice well

Start with one pass without notes. On review, separate a knowledge gap from a decision-making gap. If you did not know a fact, review that concept. If you knew the facts but chose the wrong action, identify the cue or priority rule you overlooked. This keeps practice focused on clinical reasoning instead of raw question volume.

Build a repeatable NCLEX routine

Mix focused practice with broader daily sets. Focused pages help repair a specific weakness; mixed sets test whether you can recognize the problem when the category is not announced. As your exam approaches, add timed work and longer sessions, but keep rationale review central. Accuracy, reasoning and consistency matter more than rushing through a large bank.

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