NCLEX Fundamentals of Nursing MCQs (Part 4: 151–200)
🔹 Introduction:
Are you preparing for the NCLEX Fundamentals of Nursing exam? In this post, we bring you Part 4 of our NCLEX Nursing MCQs series (Questions 151–200). Each question has been carefully designed to test essential nursing knowledge such as patient care, infection control, pharmacology basics, fluid & electrolyte balance, lab values, and emergency interventions.
These NCLEX practice questions come with detailed explanations to strengthen your critical thinking skills and boost your confidence before the exam. Whether you are preparing for NCLEX-RN, NCLEX-PN, or other nursing school exams, this set will help you master the fundamentals.
151. What is the antidote for heparin overdose?
A) Vitamin K
B) Protamine sulfate
C) Atropine
D) Naloxone
Correct Answer: B) Protamine sulfate
Explanation: Protamine sulfate binds with heparin and neutralizes its anticoagulant effect.
152. Which patient position is best for preventing aspiration in an unconscious client?
A) Supine
B) Side-lying (lateral)
C) High Fowler’s
D) Trendelenburg
Correct Answer: B) Side-lying (lateral)
Explanation: Side-lying keeps the airway clear and prevents aspiration of secretions.
153. Which solution is isotonic?
A) 0.45% NaCl
B) 0.9% NaCl
C) 5% dextrose in water (after metabolism)
D) 3% NaCl
Correct Answer: B) 0.9% NaCl
Explanation: Normal saline (0.9% NaCl) is isotonic and maintains fluid balance.
154. Which sign indicates hypocalcemia?
A) Chvostek’s sign
B) Positive Homan’s sign
C) Cullen’s sign
D) Grey-Turner’s sign
Correct Answer: A) Chvostek’s sign
Explanation: Twitching of facial muscles when tapping the facial nerve suggests hypocalcemia.
155. Which nursing action prevents ventilator-associated pneumonia (VAP)?
A) Keep head of bed flat
B) Provide oral care with chlorhexidine
C) Limit suctioning
D) Turn off humidification
Correct Answer: B) Provide oral care with chlorhexidine
Explanation: Frequent oral hygiene reduces bacterial colonization and prevents VAP.
156. Which condition requires airborne precautions?
A) MRSA
B) Tuberculosis
C) Influenza
D) C. difficile
Correct Answer: B) Tuberculosis
Explanation: TB spreads via airborne droplets → requires N95 mask and negative pressure room.
157. Which nursing action helps reduce phantom limb pain?
A) Encourage immobility
B) Apply a tight tourniquet
C) Provide mirror therapy
D) Restrict activity
Correct Answer: C) Provide mirror therapy
Explanation: Mirror therapy and medications help reduce phantom limb pain.
158. Which electrolyte is most associated with muscle weakness and cardiac arrhythmias when low?
A) Sodium
B) Potassium
C) Calcium
D) Chloride
Correct Answer: B) Potassium
Explanation: Hypokalemia causes muscle weakness, cramps, and dangerous arrhythmias.
159. A patient with a chest tube suddenly develops severe shortness of breath. What is the priority?
A) Increase suction pressure
B) Clamp the chest tube
C) Assess for air leaks and check tube patency
D) Remove the chest tube
Correct Answer: C) Assess for air leaks and check tube patency
Explanation: Tube obstruction or dislodgement may cause tension pneumothorax—check function immediately.
160. Which dietary source is rich in folic acid?
A) Red meat
B) Citrus fruits and leafy greens
C) Milk
D) Fish
Correct Answer: B) Citrus fruits and leafy greens
Explanation: Folic acid is found in green vegetables, beans, and citrus fruits—important in pregnancy.
161. Which body system is primarily affected by myasthenia gravis?
A) Respiratory system
B) Nervous system
C) Musculoskeletal system
D) Endocrine system
Correct Answer: C) Musculoskeletal system
Explanation: Myasthenia gravis is an autoimmune disease causing muscle weakness, especially respiratory and ocular muscles.
162. Which is the normal range for serum sodium?
A) 110–120 mEq/L
B) 135–145 mEq/L
C) 150–160 mEq/L
D) 90–100 mEq/L
Correct Answer: B) 135–145 mEq/L
Explanation: Normal sodium range is 135–145 mEq/L; abnormalities cause neuro changes.
163. Which is the first action for a patient with suspected spinal cord injury?
A) Assess pain level
B) Immobilize cervical spine
C) Give oxygen
D) Start IV fluids
Correct Answer: B) Immobilize cervical spine
Explanation: Spinal immobilization is the priority to prevent further injury.
164. What is the best nursing action when a patient refuses a prescribed medication?
A) Hide the medicine in food
B) Document refusal and notify provider
C) Insist the patient must take it
D) Ignore the refusal
Correct Answer: B) Document refusal and notify provider
Explanation: Patients have the right to refuse medications; documentation and communication are essential.
165. Which vitamin prevents neural tube defects during pregnancy?
A) Vitamin A
B) Vitamin B9 (Folic acid)
C) Vitamin B12
D) Vitamin D
Correct Answer: B) Vitamin B9 (Folic acid)
Explanation: Folic acid supplementation in early pregnancy prevents spina bifida and neural tube defects.
166. Which is the safest injection site for intramuscular injections in adults?
A) Dorsogluteal
B) Deltoid
C) Vastus lateralis
D) Ventrogluteal
Correct Answer: D) Ventrogluteal
Explanation: The ventrogluteal site avoids major nerves and vessels, making it safest for adults.
167. Which is the universal recipient blood type?
A) O negative
B) AB positive
C) B positive
D) A negative
Correct Answer: B) AB positive
Explanation: AB positive individuals can receive blood from any group because they lack anti-A or anti-B antibodies.
168. Which nursing measure prevents atelectasis after surgery?
A) Restrict fluids
B) Encourage deep breathing and incentive spirometry
C) Keep patient in supine position
D) Avoid coughing
Correct Answer: B) Encourage deep breathing and incentive spirometry
Explanation: Breathing exercises expand alveoli and prevent lung collapse.
169. Which is a sign of hypoglycemia?
A) Polyuria
B) Hot and dry skin
C) Sweating and tremors
D) Fruity breath odor
Correct Answer: C) Sweating and tremors
Explanation: Hypoglycemia causes adrenergic symptoms such as sweating, hunger, tremors, confusion.
170. What is the primary purpose of hand hygiene in nursing practice?
A) To remove visible dirt
B) To prevent nosocomial infections
C) To make hands look clean
D) To avoid legal consequences
Correct Answer: B) To prevent nosocomial infections
Explanation: Hand hygiene is the most effective way to reduce hospital-acquired infections.
NCLEX Fundamentals of Nursing MCQs (Part 4: 171–200)
171. Which condition requires contact precautions?
A) Tuberculosis
B) MRSA infection
C) Measles
D) Influenza
Correct Answer: B) MRSA infection
Explanation: MRSA spreads by direct contact → gown and gloves required.
172. Which is the antidote for opioid overdose?
A) Atropine
B) Naloxone
C) Protamine sulfate
D) Flumazenil
Correct Answer: B) Naloxone
Explanation: Naloxone rapidly reverses opioid-induced respiratory depression.
173. Which electrolyte imbalance is common in renal failure?
A) Hypokalemia
B) Hyperkalemia
C) Hypocalcemia
D) Hyponatremia
Correct Answer: B) Hyperkalemia
Explanation: Damaged kidneys cannot excrete potassium → leading to life-threatening arrhythmias.
174. Which lab test monitors warfarin therapy?
A) aPTT
B) PT/INR
C) Platelet count
D) D-dimer
Correct Answer: B) PT/INR
Explanation: Warfarin effectiveness is measured by PT/INR values.
175. Which is the best site for checking pulse in an infant?
A) Radial artery
B) Carotid artery
C) Brachial artery
D) Femoral artery
Correct Answer: C) Brachial artery
Explanation: The brachial pulse is easiest to palpate in infants.
176. Which oxygen delivery device provides the most precise oxygen concentration?
A) Nasal cannula
B) Non-rebreather mask
C) Simple face mask
D) Venturi mask
Correct Answer: D) Venturi mask
Explanation: Venturi masks deliver exact oxygen concentrations, useful in COPD.
177. Which nursing action prevents pressure ulcers?
A) Restricting fluid intake
B) Repositioning every 2 hours
C) Elevating head of bed 90°
D) Using only cotton sheets
Correct Answer: B) Repositioning every 2 hours
Explanation: Frequent repositioning reduces prolonged pressure on skin.
178. What is the normal range for serum potassium?
A) 2.0–3.0 mEq/L
B) 3.5–5.0 mEq/L
C) 6.0–7.0 mEq/L
D) 7.5–9.0 mEq/L
Correct Answer: B) 3.5–5.0 mEq/L
Explanation: Normal potassium range is 3.5–5.0 mEq/L.
179. Which patient is at highest risk for fluid volume deficit?
A) Post-op patient receiving IV fluids
B) Patient with diarrhea and vomiting
C) Patient with controlled diabetes
D) Patient on low-salt diet
Correct Answer: B) Patient with diarrhea and vomiting
Explanation: Excess GI losses cause dehydration and hypovolemia.
180. Which nursing intervention prevents urinary tract infection (UTI) in a catheterized patient?
A) Keep drainage bag above bladder
B) Break the closed drainage system daily
C) Maintain closed system and dependent drainage
D) Irrigate catheter frequently
Correct Answer: C) Maintain closed system and dependent drainage
Explanation: Keeping a closed system reduces infection risk.
181. Which symptom is most associated with left-sided heart failure?
A) Pedal edema
B) Ascites
C) Pulmonary congestion and dyspnea
D) Jugular vein distention
Correct Answer: C) Pulmonary congestion and dyspnea
Explanation: Left-sided heart failure → fluid backs into lungs → breathing difficulty.
182. Which is the universal donor blood type?
A) O negative
B) AB positive
C) B negative
D) A positive
Correct Answer: A) O negative
Explanation: O negative blood can be given to all types in emergencies.
183. Which precaution prevents infection during Foley catheter insertion?
A) Wearing clean gloves
B) Using sterile technique
C) Keeping catheter below bladder level
D) Frequent irrigation
Correct Answer: B) Using sterile technique
Explanation: Sterile technique is essential to prevent catheter-associated infections.
184. Which sign indicates hypomagnesemia?
A) Hypertension
B) Muscle twitching and seizures
C) Constipation
D) Bradycardia
Correct Answer: B) Muscle twitching and seizures
Explanation: Low magnesium increases neuromuscular excitability.
185. Which is the first nursing action during a blood transfusion reaction?
A) Continue infusion at slower rate
B) Stop transfusion immediately
C) Administer antihistamines
D) Collect urine sample
Correct Answer: B) Stop transfusion immediately
Explanation: Transfusion reaction → stop infusion at once, then notify provider.
186. Which electrolyte imbalance is seen in Addison’s disease?
A) Hypernatremia
B) Hyponatremia and hyperkalemia
C) Hypokalemia
D) Hypercalcemia
Correct Answer: B) Hyponatremia and hyperkalemia
Explanation: Adrenal insufficiency causes sodium loss and potassium retention.
187. Which pulse is checked before giving digoxin?
A) Radial
B) Apical
C) Carotid
D) Femoral
Correct Answer: B) Apical
Explanation: Apical pulse for 1 minute must be assessed before digoxin; hold if <60 bpm.
188. Which patient requires droplet precautions?
A) Tuberculosis
B) Chickenpox
C) Influenza
D) C. difficile
Correct Answer: C) Influenza
Explanation: Influenza spreads via droplets → surgical mask required.
189. Which vitamin deficiency causes rickets?
A) Vitamin A
B) Vitamin B12
C) Vitamin C
D) Vitamin D
Correct Answer: D) Vitamin D
Explanation: Vitamin D deficiency → poor bone mineralization → rickets in children.
190. Which position improves oxygenation in ARDS patients?
A) Supine
B) High Fowler’s
C) Prone
D) Trendelenburg
Correct Answer: C) Prone
Explanation: Prone positioning improves ventilation-perfusion in ARDS.
191. Which IV solution is best for severe dehydration?
A) 0.9% NaCl (Normal saline)
B) 0.45% NaCl
C) 3% NaCl
D) D5W
Correct Answer: A) 0.9% NaCl (Normal saline)
Explanation: Isotonic saline replaces extracellular fluid losses effectively.
192. Which is the normal range of hemoglobin in adult females?
A) 7–10 g/dL
B) 10–12 g/dL
C) 12–16 g/dL
D) 16–20 g/dL
Correct Answer: C) 12–16 g/dL
Explanation: Normal Hb: women 12–16 g/dL, men 13–17 g/dL.
193. Which is the priority action in anaphylaxis?
A) Give antihistamine
B) Secure airway and give epinephrine
C) Start IV fluids
D) Monitor blood pressure
Correct Answer: B) Secure airway and give epinephrine
Explanation: Airway and epinephrine are life-saving in anaphylaxis.
194. Which finding indicates fluid overload?
A) Hypotension
B) Dry mucous membranes
C) Crackles in lungs and edema
D) Weight loss
Correct Answer: C) Crackles in lungs and edema
Explanation: Fluid overload causes pulmonary edema and peripheral swelling.
195. Which injection is given at 45° angle?
A) Intramuscular
B) Intradermal
C) Subcutaneous
D) Intravenous
Correct Answer: C) Subcutaneous
Explanation: Subcutaneous injections are given at 45° or 90° depending on patient size.
196. Which is a normal INR for a patient on warfarin therapy?
A) 1.0
B) 2.0–3.0
C) 4.5–6.0
D) 0.5
Correct Answer: B) 2.0–3.0
Explanation: Therapeutic INR for anticoagulation = 2.0–3.0.
197. Which electrolyte imbalance causes Trousseau’s sign?
A) Hyperkalemia
B) Hypocalcemia
C) Hyponatremia
D) Hypermagnesemia
Correct Answer: B) Hypocalcemia
Explanation: Trousseau’s sign (carpal spasm after BP cuff inflation) → hypocalcemia.
198. Which drug is used in status epilepticus?
A) Diazepam (IV)
B) Atropine
C) Naloxone
D) Furosemide
Correct Answer: A) Diazepam (IV)
Explanation: IV diazepam or lorazepam is first-line in status epilepticus.
199. Which patient position is used for lumbar puncture?
A) Supine with head elevated
B) Side-lying fetal position
C) Prone
D) Trendelenburg
Correct Answer: B) Side-lying fetal position
Explanation: Flexed side-lying opens spaces between vertebrae for lumbar puncture.
200. Which infection is prevented by wearing an N95 mask?
A) MRSA
B) Influenza
C) Tuberculosis
D) Hepatitis B
Correct Answer: C) Tuberculosis
Explanation: TB spreads via airborne route → N95 respirator required.
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