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OpenExam.NCLEX-RN FOUNDATIONS · FOUNDATION PRACTICE

Mixed skills

Name: __________________________Date: __________________

10 original practice questions · Untimed · Follow each question’s response instructions

1. A client's observations are progressively changing from baseline. Which nursing response best fits the stated findings and professional responsibility?

A. Compare the trend with baseline and symptoms, verify measurement quality, and escalate a concerning change.B. Ignore a worsening trend and new symptoms because one reading remains inside the laboratory's stated reference range.C. Use a single number as a complete diagnosis without considering measurement quality, baseline or current clinical findings.D. Substitute the typical baseline for the unusual result so that the record no longer shows a concerning trend.

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2. A used syringe appears clean and someone suggests saving it for another patient. Which nursing response best fits the stated findings and professional responsibility?

A. Discard the used syringe and needle and obtain a new sterile set for the next patient.B. Reuse the syringe through another length of IV tubing because the tubing prevents direct contact with the patient.C. Save a used syringe for another patient when it still looks clean and no visible blood is present.D. Change the needle but reuse the syringe for a second patient because the barrel did not visibly contact blood.

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3. Two active nonurgent instructions specify incompatible preparation for a procedure. Which nursing response best fits the stated findings and professional responsibility?

A. Use the quicker instruction because both active documents are signed and the intervention is already scheduled.B. Follow the familiar instruction and leave the discrepancy for the next shift to resolve after the intervention.C. Combine the conflicting instructions into a new method without checking which current authorized plan should apply.D. Resolve the conflicting instructions with the responsible clinician before performing the affected nonurgent intervention.

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4. A mobility change increases the time a client remains in one position. Which nursing response best fits the stated findings and professional responsibility?

A. Massage a newly reddened pressure area as the only intervention and postpone assessment until the next routine review.B. Ignore the new skin observation because a small area cannot represent an important pressure-related concern.C. Choose one fixed repositioning schedule for every client without considering mobility, devices or assessed clinical needs.D. Assess the new skin observation and use the client's individualized pressure-relief and mobility plan to address the assessed risk.

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5. A fictional oral-solution calculation uses an order of 75 mg and a labeled concentration of 15 mg/mL. What volume in mL corresponds to the order?

Answer: __________________

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6. A client wants to know why monitoring matters when the daily routine changes. Which nursing response best fits the stated findings and professional responsibility?

A. Choose high-fat food as the fastest oral correction because it contains more total calories than juice.B. Teach that confusion rules out hypoglycemia and means the glucose value does not need further attention.C. Advise independently changing all medicines after a low reading instead of reviewing the pattern with the treating team.D. Teach the individualized monitoring and response plan, including recognition of impaired self-treatment and emergency escalation.

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7. A hypothetical one-dose training protocol specifies 4 mg/kg for a fictional client weighing 50 kg. What total amount in mg results? Do not interpret this as a real drug recommendation.

Answer: __________________

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8. A clean device is accidentally placed beside contaminated equipment. Which nursing response best fits the stated findings and professional responsibility?

A. Use the item for another client without reprocessing because no visible soil remains on the external surface.B. Clean and disinfect the shared device according to its manufacturer and product instructions before reuse.C. Give a brief dry wipe and assume that all required cleaning and disinfection steps have been completed.D. Apply the nearest chemical without checking device compatibility or the product's required contact and application instructions.

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9. An RN touches the immediate environment before preparing an invasive-device task. Which nursing response best fits the stated findings and professional responsibility?

A. Postpone hand hygiene until the entire assignment is complete because care is being delivered during one round.B. Rely on intact gloves instead of completing the hygiene indication before starting the next aseptic task.C. Continue with the same hygiene status because the clean and soiled tasks concern one client during one episode.D. Perform the indicated hand hygiene at this care transition before starting the next clean or aseptic task.

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10. An RN plans storage of a permitted shared multidose vial. Which nursing response best fits the stated findings and professional responsibility?

A. If the vial enters an immediate patient-treatment area, dedicate it to that patient; permitted shared vials stay in a clean preparation area.B. Assume the preservative eliminates every viral risk and permits access with previously used injection equipment.C. Re-enter a shared medication vial with a syringe previously used for a patient to reduce supply waste.D. Share the vial after taking it into an immediate patient-treatment area because it is labeled multidose.

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OpenExam.ANSWER KEY · KEEP SEPARATE

Answers & reasoning

1. Compare the trend with baseline and symptoms, verify measurement quality, and escalate a concerning change. · Choice A

Identify the current cue and relevant uncertainty: A client's observations are progressively changing from baseline. Risk recognition uses current symptoms, measurement quality, baseline and direction of change. A single reassuring detail does not erase a concerning pattern. Select the response that addresses that cue without an unsupported assumption: Compare the trend with baseline and symptoms, verify measurement quality, and escalate a concerning change.

nclex-rn-trend-context-1

2. Discard the used syringe and needle and obtain a new sterile set for the next patient. · Choice A

Identify the current cue and relevant uncertainty: A used syringe appears clean and someone suggests saving it for another patient. Safe injection practice prohibits using the same syringe for different patients. The one-time rule applies to the syringe and needle, not merely to the part that visibly contacted the person. Select the response that addresses that cue without an unsupported assumption: Discard the used syringe and needle and obtain a new sterile set for the next patient.

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3. Resolve the conflicting instructions with the responsible clinician before performing the affected nonurgent intervention. · Choice D

Identify the current cue and relevant uncertainty: Two active nonurgent instructions specify incompatible preparation for a procedure. A discrepancy must be made explicit and reconciled through the appropriate team member. Check the current authorized plan and communicate the resolution rather than silently choosing an interpretation. Select the response that addresses that cue without an unsupported assumption: Resolve the conflicting instructions with the responsible clinician before performing the affected nonurgent intervention.

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4. Assess the new skin observation and use the client's individualized pressure-relief and mobility plan to address the assessed risk. · Choice D

Identify the current cue and relevant uncertainty: A mobility change increases the time a client remains in one position. Skin risk relates to mobility, pressure, devices and other clinical factors. Identify changes and use an assessed prevention plan rather than equating a completed turning task with prevention success. Select the response that addresses that cue without an unsupported assumption: Assess the new skin observation and use the client's individualized pressure-relief and mobility plan to address the assessed risk.

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5. 5

The concentration is 15 mg in each mL. Volume = 75 mg / (15 mg/mL). The exact result is 5 mL; verify the label and order separately in actual practice.

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6. Teach the individualized monitoring and response plan, including recognition of impaired self-treatment and emergency escalation. · Choice D

Identify the current cue and relevant uncertainty: A client wants to know why monitoring matters when the daily routine changes. A person at risk for hypoglycemia needs a response plan, available supplies and support people who know when to seek help. Recurrent lows require review of medicines, food patterns and activity with the healthcare team. Select the response that addresses that cue without an unsupported assumption: Teach the individualized monitoring and response plan, including recognition of impaired self-treatment and emergency escalation.

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7. 200

The supplied classroom rate is 4 mg per kg and weight is 50 kg. Multiply weight by the amount per kilogram; kg units cancel. The product is 200 mg for this fictional one-dose exercise, not a real prescribing recommendation.

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8. Clean and disinfect the shared device according to its manufacturer and product instructions before reuse. · Choice B

Identify the current cue and relevant uncertainty: A clean device is accidentally placed beside contaminated equipment. Equipment used across clients can transfer contamination. Follow the appropriate cleaning and disinfection process rather than treating appearance or convenience as a sterility test. Select the response that addresses that cue without an unsupported assumption: Clean and disinfect the shared device according to its manufacturer and product instructions before reuse.

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9. Perform the indicated hand hygiene at this care transition before starting the next clean or aseptic task. · Choice D

Identify the current cue and relevant uncertainty: An RN touches the immediate environment before preparing an invasive-device task. Hands can transfer organisms between sites, people, equipment and the environment. Apply the specific hygiene indication before clean or aseptic work, after contamination and after glove removal. Select the response that addresses that cue without an unsupported assumption: Perform the indicated hand hygiene at this care transition before starting the next clean or aseptic task.

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10. If the vial enters an immediate patient-treatment area, dedicate it to that patient; permitted shared vials stay in a clean preparation area. · Choice A

Identify the current cue and relevant uncertainty: An RN plans storage of a permitted shared multidose vial. A multidose vial that enters an immediate patient-treatment area must be dedicated to that patient only; moving it back does not restore shared-use eligibility. Permitted shared vials stay in a designated clean preparation area, and no vial is re-entered with used injection equipment. Select the response that addresses that cue without an unsupported assumption: If the vial enters an immediate patient-treatment area, dedicate it to that patient; permitted shared vials stay in a clean preparation area.

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Original source-grounded practice. Content and reasoning checks are separate from professional educator review, which remains pending. Not an official exam paper.