NCLEX-RN: Clinical Skills practice questions questions 1-25

Answer: C. Age

Topic: Oropharyngeal Suctioning Pressure

Suction pressure limits are determined by the patient's age to prevent mucosal damage and hypoxemia. Standard pressures range from 60-80 mmHg for neonates up to 100-150 mmHg for adults, making age the deciding factor.

Why the others are wrong

• A – Gender does not influence airway mucosal sensitivity or the required suction pressure limits.
• B – Height has no bearing on airway size, tissue fragility, or suction pressure requirements.
• D – Weight does not dictate airway tissue fragility or standard suction pressure ranges.

Remember: Age dictates the gauge for safe suction pressure.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: C. Nasogastric (NG) tube

Topic: Enteral Tube Selection

Nasogastric (NG) tubes are indicated for short-term enteral therapy, typically less than four weeks, because they are non-surgical, easy to insert at the bedside, and carry fewer long-term complications.

Why the others are wrong

• A – PEJ tubes are surgically placed into the jejunum for long-term therapy in high-aspiration-risk patients.
• B – PEG tubes require surgical or endoscopic placement and are utilized for long-term enteral therapy.

Remember: NG is for the short run; PEG and PEJ are long-term.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: C. Adolescents

Topic: Adolescent Communication

Adolescents often fear judgment and value confidentiality, so they are less likely to disclose risky behaviors to providers compared with children, who depend on parents, or older adults, who usually discuss health openly.

Why the others are wrong

• A – Older adults generally discuss health openly and have established trust.
• B – Children rely on parents and usually disclose through caregivers.

Remember: Teens guard secrets; kids and seniors speak up more.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: B. Motor, Eye Opening, and Verbal

Topic: Glasgow Coma Scale

The Glasgow Coma Scale (GCS) is a standardized tool used to assess a patient's level of consciousness by evaluating three specific categories of response: eye opening, verbal response, and motor response.

Why the others are wrong

• A – Cognition is not a distinct category assessed in the Glasgow Coma Scale.
• C – Auditory response is not a category measured by the Glasgow Coma Scale.
• D – Sensory response is not a component evaluated by the Glasgow Coma Scale.

Remember: Remember EVM: Eye opening, Verbal response, Motor response.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: A. rebound tenderness

Topic: Abdominal Assessment Findings

Rebound tenderness is elicited by applying gentle pressure then quickly releasing; pain on release indicates peritoneal irritation, such as appendicitis. The described abrupt hand withdrawal after moderate pressure is classic for this sign.

Why the others are wrong

• B – Guarding is involuntary muscle spasm, evaluated by sustained palpation.
• C – Abdominal rigidity is constant firmness, not assessed by sudden release.
• D – Borborygmus refers to bowel sounds heard with a stethoscope.

Remember: Quick release pain = rebound tenderness.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: D. Cognitive and Perceptual

Topic: Gordon's Functional Health Patterns

Gordon's Functional Health Patterns classify sensory functions—such as vision, hearing, taste, touch, and smell—along with cognitive abilities and pain perception, under the Cognitive and Perceptual pattern. This question directly assesses these sensory capabilities.

Why the others are wrong

• A – Focuses on self-worth, body image, and personal identity rather than physical senses.
• B – Addresses the client's general health awareness, lifestyle choices, and adherence to treatments.
• C – Evaluates social connections, family dynamics, and the client's responsibilities in life.

Remember: Senses and thoughts belong to the cognitive and perceptual pattern.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: D. Patient sitting upright both feet on the floor with arm elevated to the level of the heart

Topic: Blood Pressure Positioning

Accurate BP measurement requires the patient seated, back supported, feet flat, arm supported at heart level; this position eliminates hydrostatic error and stabilizes vascular tone.

Why the others are wrong

• A – Lying supine changes hydrostatic pressure and does not reflect seated normotensive values.
• B – Supine with arms elevated is uncomfortable and can cause muscle fatigue, affecting readings.
• C – Crossed ankles alter venous return; arm on lap may be below heart level.

Remember: Seat, feet flat, arm at heart—BP’s golden rule.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: C. Supine

Topic: Abdominal Assessment Position

The supine position places the abdomen flat on the table, allowing unobstructed visual inspection of all quadrants and preventing gravity from distorting organ contours, which is essential for an accurate assessment.

Why the others are wrong

• A – Fowler's elevates the torso, compressing the abdomen and obscuring landmarks.
• B – Semi‑Fowler's still raises the upper body, limiting full abdominal view.
• D – Prone places the abdomen against the surface, preventing inspection.

Remember: Supine flat, abdomen fully visible.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: A. Pharyngitis

Topic: Causes Of Pharyngitis

Pharyngitis, commonly known as a sore throat, is an inflammation of the pharynx. It is most frequently caused by viral infections like colds and influenza, or bacterial infections such as Streptococcus pyogenes.

Why the others are wrong

• B – Epistaxis refers to nosebleeds, commonly caused by local trauma, dry air, or mucosal irritation.
• C – Candidiasis is a fungal infection, not caused by these viral or bacterial pathogens.
• D – Sinusitis is inflammation of the nasal sinuses, typically presenting with facial pressure and congestion.

Remember: Pharyngitis is a sore throat; think 'pharynx' for the throat.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: B. Phrenic

Topic: Phrenic Nerve and Respiration

The phrenic nerve arises from the cervical spinal levels C3 through C5 and provides the essential motor innervation to the diaphragm, which is the primary muscle used for respiration.

Why the others are wrong

• A – Lumbar nerves innervate the lower abdomen and legs, not the diaphragm.
• C – Motor is a general functional classification, not a specific named spinal nerve.
• D – Sacral nerves control the pelvis, buttocks, and lower limbs, not respiration.

Remember: C3, 4, 5 keep the diaphragm alive!

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: D. Comatose

Topic: Glasgow Coma Scale Classification

The Glasgow Coma Scale (GCS) measures level of consciousness based on eye, verbal, and motor responses. A GCS score of 8 or less indicates severe brain injury, which clinically classifies the patient as comatose and typically requires intubation.

Why the others are wrong

• A – Alert and Oriented X 2 indicates mild cognitive impairment, not a severe GCS score under 8.
• B – Lethargic describes a patient who is drowsy but easily aroused, corresponding to a higher GCS.
• C – Obtunded describes a patient with dulled senses who is difficult to arouse, scoring above 8.

Remember: GCS of eight or less, intubate the comatose.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: A. Sleep and Rest

Topic: Functional Health Patterns

Asking about daytime napping directly assesses a patient's daily sleep-wake cycle, rest patterns, and sleep quality. This information is categorized under Gordon's functional health pattern of sleep and rest.

Why the others are wrong

• B – Coping-stress evaluates stress management, defense mechanisms, and support systems.
• C – Mobility and exercise assess physical activity levels, energy expenditure, and movement capabilities.
• D – Nutrition focuses on food and fluid consumption patterns, not sleep habits.

Remember: Naps and nighttime slumber belong to sleep and rest.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: C. 4 to 6

Topic: Post-Catheter Removal Voiding

Following indwelling urinary catheter removal, patients are expected to void spontaneously within 4 to 6 hours. If they are unable to void, a bladder scan is indicated to assess for urinary retention and determine the need for intervention.

Why the others are wrong

• A – Two to three hours does not allow sufficient time for the bladder to fill normally.
• B – Waiting six to eight hours increases the risk of painful bladder distension and injury.
• D – One to two hours is too soon to expect spontaneous voiding after catheter removal.

Remember: Four to six hours to pee, or a bladder scan you'll see.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: A. Allow the collection to rest dependently on the floor

Topic: Indwelling Catheter Care

The urinary drainage bag must never touch the floor to prevent contamination and catheter-associated urinary tract infections (CAUTIs). It should always be secured to the bed frame below the level of the patient's bladder.

Why the others are wrong

• B – Monitoring for kinks ensures continuous urine flow and prevents bladder distension.
• C – Securing the catheter prevents urethral traction, trauma, and accidental dislodgement.
• D – Keeping the bag below the bladder prevents urine backflow and infection.

Remember: Keep the catheter bag off the floor to prevent CAUTIs.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: B. Health Perception - Health Management

Topic: Functional Health Patterns

The Health Perception - Health Management pattern focuses on how a client perceives and manages their health. Assessing financial resources to purchase food, medications, and essential items directly evaluates their ability to manage and maintain their health.

Why the others are wrong

• A – Self-perception and self-concept focuses on identity, body image, and self-esteem, not financial resources.
• C – Cognitive and perceptual focuses on sensory patterns, language, memory, and decision-making abilities.
• D – Values-belief focuses on goals, beliefs, and spiritual values that influence life choices.

Remember: Managing health requires wealth; finances fit under Health Perception-Health Management.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: C. 3

Topic: Glasgow Coma Scale Scoring

The Glasgow Coma Scale measures eye-opening, verbal, and motor responses. Each category has a minimum score of 1, making the lowest possible total score 3, which indicates severe neurological impairment or brain death.

Why the others are wrong

• A – A score of zero is impossible because the lowest score in each category is one.
• B – Five is not the minimum score; the lowest possible score is three.
• D – Fifteen is the maximum possible score on the scale, indicating full alertness.

Remember: GCS: 3 is the floor, 15 is the score.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: B. Mild cognitive impairment

Topic: MMSE Scoring Interpretation

The Mini-Mental State Examination (MMSE) scores range from 0 to 30. A score of 18 to 23 indicates mild cognitive impairment, whereas a score of 24 or higher is normal, and 0 to 17 indicates severe impairment.

Why the others are wrong

• A – Severe cognitive impairment is indicated by scores of 17 or lower.
• C – Scores of 24 to 30 indicate no cognitive impairment.

Remember: MMSE: 24+ is fine, 18 to 23 is mild, under 18 is severe.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: B. 0.5 inch

Topic: Ophthalmic Ointment Administration

The recommended dose of ophthalmic ointment is a ribbon approximately 0.5 inch (1 cm) long placed in the lower conjunctival sac, providing enough medication without overflow or patient discomfort.

Why the others are wrong

• A – One inch is excessive and will overflow the sac, causing blur.
• C – Ointments are not measured in drops; drops apply to liquid solutions.
• D – No specific measurement leads to over‑filling; dosage must be precise.

Remember: Half‑inch ribbon, not a drop, fills the eye safely.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: D. 60 mL

Topic: Enteral Tube Irrigation

A 60 mL syringe is the standard size for enteral tube irrigation because it provides adequate volume and generates lower pressure, minimizing the risk of tube rupture or damage to the gastrointestinal mucosa.

Why the others are wrong

• A – Smaller syringes generate excessively high pressure that can rupture the enteral tube.
• B – This size still generates too much pressure and holds insufficient volume for standard irrigation.
• C – This size is too small, risking tube damage from high pressure and requiring multiple refills.

Remember: Sixty for safety: large syringe, low pressure.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: B. Primary Survey

Topic: Primary Survey Assessment

The primary survey, using the ABCs, is performed at the start of each shift or patient encounter to quickly assess airway, breathing, and circulation, confirming the patient is medically stable.

Why the others are wrong

• A – A mental status exam checks cognition, not airway, breathing, or circulation.
• C – Pain assessment measures discomfort, not the ABCs of stability.
• D – A focused exam evaluates specific systems, not overall immediate stability.

Remember: Start with ABCs: primary survey ensures stability.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: C. 3+

Topic: Peripheral Pulse Grading

Pulse grading uses a 0‑4 scale; 3+ denotes a strong, brisk pulse that fills the artery completely, which is described as full and bounding. Therefore documentation of 3+ correctly reflects the observed pulses.

Why the others are wrong

• A – 2+ is moderate strength, not bounding.
• B – 1+ is faint, barely perceptible.
• D – 0 indicates no palpable pulse.

Remember: 3+ equals a full, bounding pulse on the 0‑4 scale.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: C. faster

Topic: Pediatric Respiratory Rates

Infants have higher metabolic demands and smaller airways, resulting in naturally higher respiratory rates than adults; therefore children under one year breathe faster than grown‑up patients.

Why the others are wrong

• A – Infants' rates are not equal to adult rates.
• B – Infants do not breathe slower than adults.

Remember: Babies breathe fast because tiny lungs need more oxygen.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: A. diarrhea

Diarrhea causes rapid loss of water and essential electrolytes, such as potassium and sodium, from the gastrointestinal tract. This rapid depletion significantly increases the patient's risk for dehydration, hypokalemia, and metabolic acidosis.

Why the others are wrong

• B – These indicate decreased peristalsis but do not directly cause active fluid and electrolyte loss.
• C – Constipation involves increased water reabsorption, which does not cause acute fluid or electrolyte depletion.
• D – While they can accompany diarrhea, hyperactive sounds alone do not cause fluid or electrolyte loss.

Remember: Diarrhea flows out, taking fluids and electrolytes with it.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: B. Instill warm water into the tube and apply gentle back and forth motion

Topic: Feeding Tube Clog Management

Instilling warm water and using a gentle back-and-forth motion with a syringe is the safest, most effective first-line method to dissolve enteral tube clogs. Warm water helps dissolve formula, while gentle pressure avoids tube rupture.

Why the others are wrong

• A – Cranberry juice is acidic and can cause enteral formula proteins to coagulate and clog further.
• C – Carbonated beverages are acidic and can precipitate proteins, worsening the tube obstruction.
• D – Cold water is ineffective; aggressive plunger agitation can rupture or damage the feeding tube.

Remember: Warm water and gentle motion clear the clog without commotion.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.

Answer: B. 1 cm

Topic: Abdominal Assessment Technique

Light palpation is performed with gentle pressure, depressing the abdominal wall only about one centimeter; this depth is sufficient to detect surface tenderness without compressing deeper structures.

Why the others are wrong

• A – Two centimeters is too deep for light palpation.
• C – Three centimeters exceeds the gentle pressure intended.
• D – Four centimeters compresses deeper organs, not light touch.

Remember: Light palpation = fingertip depth, roughly 1 cm.

Question adapted from Nursing Skills 2e, by Open Resources for Nursing (Open RN); K. Ernstmeyer and E. Christman, editors (WisTech Open), licensed CC BY 4.0; wording and option order may differ from the book. The explanation is ours, checked against the book's answer.