🩺 NCLEX Fundamentals of Nursing MCQs (Part 1: 1–50)
Introduction:
The Fundamentals of Nursing form the backbone of NCLEX preparation. This section covers the essential skills every nurse must master, such as infection control, patient safety, ethical principles, communication, and the nursing process.
We’ve prepared 50 carefully selected multiple-choice questions with correct answers and explanations. These MCQs will help you strengthen your fundamentals and boost your confidence for NCLEX, NCLEX-RN, NCLEX-PN, and other international nursing exams.
1. The primary purpose of hand hygiene in nursing practice is to:
A. Prevent hospital odor
B. Reduce healthcare costs
C. Break the chain of infection ✅
D. Protect the nurse only
💡 Explanation: Hand hygiene prevents transmission of microorganisms, breaking the chain of infection, protecting both patient and healthcare providers.
2. Which step comes first in the nursing process?
A. Assessment ✅
B. Planning
C. Implementation
D. Evaluation
💡 Explanation: The nursing process begins with assessment, collecting patient data before making any diagnosis or interventions.
3. A nurse finds a patient lying on the floor. The nurse’s first action should be:
A. Call the physician
B. Check the patient’s airway, breathing, circulation ✅
C. Document the fall
D. Reassure the family
💡 Explanation: Safety first—always check the patient’s ABC (airway, breathing, circulation) immediately after an accident.
4. Which of the following is considered the most effective method of sterilization?
A. Alcohol rub
B. Boiling water
C. Autoclaving ✅
D. Sunlight
💡 Explanation: Autoclaving (steam under pressure) kills all microorganisms, including spores.
5. When communicating with a patient who speaks a different language, the best nursing action is to:
A. Use medical jargon
B. Use a family member as interpreter
C. Speak loudly and slowly
D. Use a professional medical interpreter ✅
💡 Explanation: Professional interpreters ensure accurate communication and maintain confidentiality.
6. The nurse identifies which of the following as a universal precaution?
A. Wearing gloves for all procedures ✅
B. Using antibiotics for all patients
C. Isolating all patients
D. Using sterile gowns daily
💡 Explanation: Standard/universal precautions require gloves, masks, and protective equipment for potential exposure to blood or body fluids.
7. The main purpose of patient education in nursing is to:
A. Increase hospital revenue
B. Empower patients to manage their health ✅
C. Make patients dependent on nurses
D. Replace physician’s role
💡 Explanation: Education enables patients to take responsibility for self-care and informed decision-making.
8. Which of the following positions is best for a patient with respiratory distress?
A. Supine
B. Trendelenburg
C. High Fowler’s ✅
D. Lithotomy
💡 Explanation: High Fowler’s (90° sitting) position promotes lung expansion and improves oxygenation.
9. A nurse suspects elder abuse. What should be the nurse’s first action?
A. Confront the family
B. Document findings ✅
C. Discharge the patient
D. Ignore if no complaint is made
💡 Explanation: Accurate documentation is the first step before reporting to authorities.
10. Which is an example of a closed-ended question?
A. “Tell me how you feel today.”
B. “What brought you to the hospital?”
C. “Are you in pain right now?” ✅
D. “Can you describe your symptoms in detail?”
💡 Explanation: Closed-ended questions usually result in yes/no answers, useful for quick assessments.
11. The nurse’s legal responsibility when obtaining informed consent is to:
A. Explain all risks and benefits
B. Witness the patient’s signature ✅
C. Decide if the patient should sign
D. Provide detailed surgical procedures
💡 Explanation: Only the physician explains risks/benefits. The nurse’s role is to witness and ensure the patient understands.
12. Which of the following is an example of a subjective data?
A. Patient states, “I feel dizzy.” ✅
B. Patient’s BP is 150/90 mmHg
C. Skin is pale and cool
D. Pulse is 110/min
💡 Explanation: Subjective data = patient’s feelings, symptoms, or perceptions.
13. The nurse is caring for a patient with a fever. Which nursing intervention is priority?
A. Encourage fluids ✅
B. Provide extra blankets
C. Restrict oral intake
D. Apply heating pads
💡 Explanation: Fever leads to dehydration; hydration is priority.
14. Which of the following is the best example of primary prevention?
A. Rehabilitation after surgery
B. Health education on smoking cessation ✅
C. Screening for hypertension
D. Physical therapy after stroke
💡 Explanation: Primary prevention = prevent disease before it occurs (education, vaccination).
15. What is the correct sequence of donning personal protective equipment (PPE)?
A. Gloves → Mask → Gown
B. Gown → Mask → Gloves ✅
C. Mask → Gloves → Gown
D. Gloves → Gown → Mask
💡 Explanation: Correct order: Gown → Mask → Goggles → Gloves.
16. Which of the following nursing actions ensures patient safety during seizure?
A. Restrain the patient
B. Insert a tongue depressor
C. Place the patient on side-lying position ✅
D. Hold the patient tightly
💡 Explanation: Side-lying prevents aspiration and maintains airway during seizure.
17. Which of the following is considered a sentinel event?
A. A patient refusing medication
B. Wrong-site surgery ✅
C. Patient falling asleep
D. Medication given late
💡 Explanation: Sentinel events = unexpected serious incidents like wrong surgery or patient death.
18. Which method is best to confirm placement of a nasogastric (NG) tube?
A. Air insufflation test
B. Patient’s verbal confirmation
C. X-ray ✅
D. Aspiration of gastric content only
💡 Explanation: X-ray confirmation is the gold standard for NG tube placement.
19. The nurse uses SBAR for hand-off communication. “R” stands for:
A. Report
B. Recommendation ✅
C. Results
D. Record
💡 Explanation: SBAR = Situation, Background, Assessment, Recommendation.
20. Which of the following is the best nursing goal for a patient at risk of falls?
A. Patient will stay in bed at all times
B. Patient will be free of injury ✅
C. Patient will use the call bell only
D. Patient will not walk independently
💡 Explanation: The priority goal is always patient safety and injury prevention.
21. A patient refuses a blood transfusion due to religious beliefs. The nurse should:
A. Force the transfusion
B. Respect the patient’s wishes ✅
C. Call the police
D. Discharge the patient
💡 Explanation: Respecting autonomy is an ethical principle in nursing.
22. Which vitamin deficiency causes rickets?
A. Vitamin C
B. Vitamin D ✅
C. Vitamin K
D. Vitamin B12
💡 Explanation: Vitamin D deficiency leads to weak, soft bones (rickets).
23. The nurse is teaching about deep breathing exercises. This is an example of:
A. Tertiary prevention
B. Primary prevention
C. Secondary prevention
D. Health promotion ✅
💡 Explanation: Teaching lifestyle practices = health promotion activity.
24. What is the normal range of serum potassium?
A. 2–3 mEq/L
B. 3.5–5.0 mEq/L ✅
C. 5.5–7.0 mEq/L
D. 1–2 mEq/L
💡 Explanation: Normal K⁺ = 3.5–5.0 mEq/L.
25. The nurse prepares to give an intramuscular (IM) injection in the deltoid. The maximum volume should not exceed:
A. 1 mL ✅
B. 3 mL
C. 5 mL
D. 10 mL
💡 Explanation: Deltoid muscle safely holds max 1 mL.
26. The best way to check if suctioning of tracheostomy is effective is:
A. Patient’s respiratory rate decreases
B. Breath sounds are clear ✅
C. Patient’s temperature is normal
D. Patient coughs continuously
💡 Explanation: Clear breath sounds indicate airway clearance.
27. What is the primary purpose of incident reporting?
A. To blame the staff
B. To prevent future errors ✅
C. To notify insurance
D. To discipline staff
💡 Explanation: Incident reports are used to improve patient safety and prevent recurrence.
28. Which action best maintains a sterile field?
A. Turning back while working
B. Keeping hands above waist level ✅
C. Touching the sterile field with gloves
D. Reaching across the sterile field
💡 Explanation: Hands must be above waist and within vision to maintain sterility.
29. A nurse is performing CPR on an adult. The correct compression-to-breath ratio is:
A. 30:2 ✅
B. 15:2
C. 10:1
D. 50:5
💡 Explanation: Adult CPR ratio = 30 compressions : 2 breaths.
30. Which type of precaution is used for a patient with tuberculosis?
A. Contact precaution
B. Droplet precaution
C. Airborne precaution ✅
D. Universal precaution
💡 Explanation: Airborne precautions (N95 mask, negative pressure room) are required for TB.
31. The nurse uses the Glasgow Coma Scale (GCS) to assess:
A. Pain level
B. Level of consciousness ✅
C. Depression
D. Blood pressure
💡 Explanation: GCS evaluates eye, verbal, and motor response to measure consciousness.
32. Which electrolyte imbalance is common in renal failure?
A. Hypokalemia
B. Hyperkalemia ✅
C. Hypocalcemia
D. Hyponatremia
💡 Explanation: Kidneys fail to excrete potassium → Hyperkalemia.
33. Which nursing diagnosis is most appropriate for a patient with dyspnea?
A. Risk for infection
B. Impaired gas exchange ✅
C. Constipation
D. Impaired skin integrity
💡 Explanation: Dyspnea = breathing difficulty, so impaired gas exchange is priority.
34. The nurse administers a medication via Z-track method to:
A. Prevent tissue trauma ✅
B. Speed absorption
C. Reduce pain
D. Avoid first-pass metabolism
💡 Explanation: Z-track is used in IM injections to prevent medication leakage and irritation.
35. Which nursing action prevents catheter-associated urinary tract infection (CAUTI)?
A. Keep the catheter bag above bladder
B. Maintain a closed drainage system ✅
C. Use catheter for convenience
D. Disconnect catheter tubing frequently
💡 Explanation: Best prevention = closed sterile system and perineal hygiene.
36. Which of the following is the safest method to identify a patient?
A. Room number
B. Bed number
C. Patient’s name and ID band ✅
D. Patient’s verbal confirmation only
💡 Explanation: Name + ID band = correct identification method.
37. A nurse is delegating tasks to a nursing assistant. Which task can be delegated?
A. Administering oral medications
B. Inserting Foley catheter
C. Assisting with ambulation ✅
D. Assessing vital signs in unstable patient
💡 Explanation: Ambulation can be safely delegated to trained nursing assistants.
38. What is the first action when a patient’s IV site is swollen and painful?
A. Apply hot compress
B. Continue infusion
C. Stop infusion immediately ✅
D. Flush with saline
💡 Explanation: First step = stop infusion to prevent complications like infiltration.
39. Which nursing intervention reduces the risk of pressure ulcers?
A. Restricting movement
B. Turning the patient every 2 hours ✅
C. Using plastic sheets
D. Encouraging bed rest
💡 Explanation: Repositioning prevents skin breakdown and pressure ulcers.
40. Which is the best indicator of fluid balance in a patient?
A. Skin turgor
B. Blood pressure
C. Daily weight ✅
D. Urine color
💡 Explanation: Daily weight is the most accurate way to assess fluid balance.
41. The nurse teaches a patient about insulin self-injection. This represents which role?
A. Advocate
B. Teacher ✅
C. Researcher
D. Manager
💡 Explanation: Educating patients = nurse as teacher role.
42. Which of the following nursing interventions helps prevent ventilator-associated pneumonia (VAP)?
A. Keep head of bed flat
B. Oral care with chlorhexidine ✅
C. Avoid suctioning
D. Restrict fluids
💡 Explanation: Oral care and elevating head of bed reduce VAP risk.
43. What is the best position for a patient in shock?
A. Supine with head elevated
B. Trendelenburg position ✅
C. High Fowler’s
D. Side-lying
💡 Explanation: Trendelenburg improves blood flow to vital organs in shock.
44. The nurse evaluates understanding of fire safety. The acronym RACE stands for:
A. Run, Alert, Control, Evacuate
B. Rescue, Alarm, Contain, Extinguish ✅
C. React, Alert, Call, Exit
D. Remove, Assess, Control, Evacuate
💡 Explanation: RACE = Rescue, Alarm, Contain, Extinguish.
45. Which of the following patients is at highest risk for hypothermia?
A. Young adult with fever
B. Newborn infant ✅
C. Middle-aged athlete
D. Patient with hypertension
💡 Explanation: Newborns lose heat quickly due to immature thermoregulation.
46. Which pulse site is best to check during CPR in an adult?
A. Radial
B. Carotid ✅
C. Apical
D. Femoral
💡 Explanation: Carotid artery is checked during CPR for circulation.
47. A nurse should wash hands with soap and water instead of alcohol rub when:
A. After removing gloves
B. Before patient contact
C. When hands are visibly soiled ✅
D. After taking vital signs
💡 Explanation: Soap and water required when hands visibly dirty or after C. difficile exposure.
48. Which of the following is the best way to prevent spread of infection?
A. Wearing gloves always
B. Sterilizing all equipment
C. Hand hygiene ✅
D. Using antibiotics
💡 Explanation: Handwashing is the single most effective infection control measure.
49. Which nursing intervention is appropriate for a patient on fall precautions?
A. Keep side rails up on all sides
B. Place call bell within reach ✅
C. Restrict patient to bed
D. Use dim lighting
💡 Explanation: Accessibility and safe environment reduce fall risk.
50. Which is the correct needle size for an adult intramuscular (IM) injection?
A. 16–18 gauge, ½ inch
B. 22–25 gauge, 1–1.5 inch ✅
C. 25–27 gauge, ⅜ inch
D. 18–20 gauge, 2–3 inch
💡 Explanation: IM injections require 22–25 gauge, 1–1.5 inch needle.
You have just completed Part 1 of NCLEX Fundamentals of Nursing MCQs (1–50) with detailed answers and explanations. By solving these questions, you not only test your knowledge but also gain deeper insights into nursing practice, safety, and patient care.
👉 Don’t stop here! Continue to Part 2 (51–100) for more practice and keep strengthening your NCLEX preparation.
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With consistent practice, you’ll be better prepared to pass the NCLEX exam on your first attempt. 🚀