NCLEX Mistake Quiz: Can You Avoid The Traps?

1. A patient with pneumonia has oxygen saturation of 88% on room air. What is the error in saying 'oxygen is not needed'?

Normal O2 sat is 95-100%

Patient will develop respiratory acidosis

Supplemental oxygen is indicated to maintain adequate oxygenation

Patient will refuse oxygen anyway

2. After administering an IV medication, the nurse notices extravasation. What is the first action?

Continue infusing slowly

Stop infusion and notify the provider immediately

Apply heat to the area

Massage the area gently

3. A patient with sepsis has a lactate of 4 mmol/L. What does this indicate?

Normal finding in sepsis

Tissue hypoxia and inadequate perfusion

Liver failure

Metabolic alkalosis

4. A patient receiving chemotherapy develops severe nausea. What is the most appropriate intervention?

Withhold the next chemo dose

Give antiemetic prophylactically before next dose

Tell patient nausea is expected and unavoidable

Switch to a different chemotherapy agent

5. A patient's calcium level is 12.5 mg/dL. Which intervention is contraindicated?

Increase fluid intake

Restrict calcium-rich foods

Give calcium supplement

Encourage mobilization

6. When delegating care to unlicensed assistive personnel, which task should NOT be delegated?

Bathing and grooming

Assessing patient's pain level and adjusting medications

Measuring vital signs

Helping with ambulation

7. A patient with heart failure is given IV normal saline 1 L bolus. What complication is most likely?

Improved cardiac output

Pulmonary edema and respiratory distress

Dehydration

Hypokalemia

8. A patient on heparin reports severe back pain. What is the priority assessment?

Assume it is musculoskeletal pain

Assess for signs of epidural hematoma

Give acetaminophen and monitor

Continue heparin and reassess later

9. A diabetic patient's blood glucose is 420 mg/dL. The nurse should NOT do which action?

Give rapid-acting insulin as ordered

Encourage fluid intake

Check for diabetic ketoacidosis

Give orange juice to prevent hypoglycemia

10. Which statement about informed consent is most accurate?

The nurse can obtain consent for surgery

Consent is valid even if the patient is sedated

The provider is responsible for informed consent

Consent forms alone prove understanding

11. A nurse administers 10 units of regular insulin IV instead of subcutaneously. What is the priority action?

Monitor blood glucose every 15 minutes

Notify the provider and monitor for hypoglycemia

Document the error and continue routine care

Give dextrose prophylactically

12. A patient is prescribed lisinopril and potassium supplement together. What should the nurse verify?

Patient's baseline kidney function and potassium level

Patient's blood pressure is above 140 mmHg

Patient is taking a diuretic

Patient has no history of heart disease

13. When assessing pain in a non-verbal patient, which approach is most reliable?

Assume pain is not present if patient is sleeping

Observe behavioral cues and physiologic changes

Wait for patient to verbally report pain

Use only vital signs to guide pain management

14. A patient with COPD has a respiratory rate of 8 breaths/min after receiving morphine. What mistake was made?

Morphine was contraindicated in COPD

Dose was too high for respiratory-compromised patient

Route should have been subcutaneous

Morphine should never be given to COPD patients

15. A nurse notes a patient's potassium is 2.8 mEq/L. What is the priority nursing action?

Administer potassium IV push

Obtain an ECG and notify the provider

Give oral potassium supplement

Encourage banana and orange juice

16. A patient receives vancomycin 1 g IV push over 2 minutes. What complication is most likely?

Red-man syndrome

Acute kidney injury

Anaphylaxis

Ototoxicity

17. Which finding most clearly indicates increased intracranial pressure in a head-injured patient?

Restlessness and mild headache

Widening pulse pressure and bradycardia

Tachycardia and hypertension

Dilated pupils and hyperventilation

18. A post-op patient has absent bowel sounds 2 hours after surgery. What should the nurse do?

Advance diet to clear liquids

Wait; absent sounds are normal early post-op

Insert a nasogastric tube immediately

Notify the provider if absent after 24 hours

19. A patient on warfarin reports taking new over-the-counter ibuprofen. What is the nurse's first response?

Tell the patient it is safe with warfarin

Notify the provider due to increased bleeding risk

Recommend acetaminophen instead

Check PT/INR immediately

20. Which assessment finding indicates a patient is in hypovolemic shock rather than septic shock?

Warm, flushed skin with tachycardia

Cool, clammy skin with weak pulses

Fever with elevated white blood cell count

Hypoxia responding to oxygen therapy

NCLEX Mistake Quiz: Can You Avoid the Traps?