Free National Council Licensure Examination for Registered Nurses Practice Questions

Sample Practice Questions

Try these 10 sample questions from the National Council Licensure Examination for Registered Nurses practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1An RN has delegated a routine activity for a stable patient. Before it begins, the patient's condition changes unexpectedly. Which of the Five Rights of Delegation most directly requires the RN to reassess this decision?

   1. A. Right person
   2. B. Right circumstance
   3. C. Right task
   4. D. Right directions and communication

   Answer: B

   Explanation: The delegation guideline states, "If the patient’s condition changes, the delegatee must communicate this to the licensed nurse, and the licensed nurse must reassess the situation and the appropriateness of the delegation." That rule appears under right circumstance, which addresses this changed patient condition.

   Reference: National Guidelines for Nursing Delegation — Table 1, Five Rights of Delegation, Right circumstance

2. 2An RN reviews prevention needs with an asymptomatic adult at average risk for colorectal cancer who has never been screened. At what minimum age does the USPSTF recommend beginning screening?

   1. A. 40 years
   2. B. 45 years
   3. C. 50 years
   4. D. 55 years

   Answer: B

   Explanation: The USPSTF says, "Screen adults aged 45 to 49 years for colorectal cancer. Grade B" and limits this recommendation to average-risk, asymptomatic adults. Forty-five is the starting age in this patient's risk group.

   Reference: Colorectal Cancer: Screening — Summary of Recommendations, adults aged 45 to 49 years

3. 3A hospitalized patient says, 'My family would be better off without me.' Which opening question should the RN ask to assess whether the patient is currently contemplating suicide?

   1. A. Are you thinking about suicide?
   2. B. Have you made a plan to kill yourself?
   3. C. Do you have access to potentially lethal items?
   4. D. Who could you contact for support today?

   Answer: A

   Explanation: NIMH's first action is to ask directly, "Are you thinking about suicide?" It separately recommends asking about a plan and reducing access to lethal means to help keep someone safe. The patient's statement calls first for the direct question about current suicidal thinking.

   Reference: 5 Action Steps to Help Someone Having Thoughts of Suicide — 5 Action Steps, ASK

4. 4An RN is starting an enteral feeding for a patient at high risk of aspiration. There is no contraindication to head-of-bed elevation. Which elevation range does the CDC guideline recommend during care?

   1. A. 0–15 degrees
   2. B. 16–29 degrees
   3. C. 30–45 degrees
   4. D. 46–60 degrees

   Answer: C

   Explanation: The CDC guideline says, "In the absence of medical contraindication(s), elevate at an angle of 30--45 degrees of the head of the bed of a patient at high risk for aspiration" and explicitly includes a person with an enteral tube. This range applies to the patient receiving the feeding.

   Reference: Guidelines for Preventing Health-Care-Associated Pneumonia, 2003 — Part II, Prevention of aspiration associated with enteral feeding, item 2.a

5. 5An RN delegates a permitted care activity to a competent assistive worker and confirms its completion. Who remains accountable for the patient's overall care?

   1. A. The nurse leader overseeing the unit
   2. B. The assistive worker performing the activity
   3. C. The RN who delegated the activity
   4. D. The employer authorizing delegation

   Answer: C

   Explanation: The guideline states, "The licensed nurse maintains accountability for the patient, while the delegatee is responsible for the delegated activity, skill, or procedure." The worker's responsibility for the task does not transfer the RN's accountability for overall patient care.

   Reference: National Guidelines for Nursing Delegation — Licensed Nurse Responsibilities, introductory paragraph

6. 6An RN prepares colorectal-cancer screening counseling for asymptomatic adults at average risk. For which age band does the USPSTF recommend a selective decision based on overall health, screening history, and patient preferences?

   1. A. Ages 45 to 49 years
   2. B. Ages 50 to 75 years
   3. C. Ages 76 to 85 years
   4. D. Ages 86 to 95 years

   Answer: C

   Explanation: USPSTF says, "Selectively screen adults aged 76 to 85 years for colorectal cancer, considering the patient’s overall health, prior screening history, and patient’s preferences. Grade C" The selective decision applies to the 76–85 age band in this average-risk counseling scenario.

   Reference: Colorectal Cancer: Screening — Summary of Recommendations, adults aged 76 to 85 years

7. 7A patient tells an RN of an intention to kill themself soon. While urgent assistance is arranged, which observation plan should the nurse institute?

   1. A. Maintain continuous in-person presence with the patient
   2. B. Use continuous video viewing from the nurses' station
   3. C. Check the patient in person at fifteen-minute intervals
   4. D. Place the patient near the nurses' station with the door open

   Answer: A

   Explanation: NIMH directs, "If someone tells you that they are going to kill themselves, do not leave them alone." Continuous in-person presence meets that immediate safety instruction; video viewing, intermittent checks, and location near the station still leave the patient alone between contacts.

   Reference: Frequently Asked Questions About Suicide — What should I do if I am struggling or someone I know is having thoughts of suicide?

8. 8During skin assessment, an RN finds a shallow pressure injury with partial-thickness skin loss and exposed, moist pink dermis. Which stage describes this finding?

   1. A. Stage 1
   2. B. Stage 2
   3. C. Stage 3
   4. D. Stage 4

   Answer: B

   Explanation: AHRQ states, "A Stage 2 injury is a partial-thickness skin loss with exposed dermis." Its description of a moist pink wound bed matches the assessment, while the other stages describe different tissue depth.

   Reference: Module 5: How To Measure Pressure Injury Rates and Prevention Practices — Slide 9, Stage 2

9. 9During an I-PASS handoff, an incoming nurse summarizes what was heard and repeats the pending tasks to the outgoing nurse. Which I-PASS component is the incoming nurse performing?

   1. A. Patient Summary
   2. B. Action List
   3. C. Synthesis by Receiver
   4. D. Situation Awareness & Contingency Planning

   Answer: C

   Explanation: AHRQ lists "Receiver summarizes what was heard" and "Restates key actions/to-do items" under Synthesis by Receiver. The incoming nurse's readback matches that component; the other components describe information conveyed by the sender.

   Reference: Tool: I-PASS — How To Use I-PASS Effectively, Synthesis by Receiver

10. 10During a wellness visit, an RN helps a generally healthy adult set a weekly moderate-intensity aerobic activity goal. What minimum number of minutes per week should the RN teach?

    1. A. 75 minutes
    2. B. 120 minutes
    3. C. 150 minutes
    4. D. 300 minutes

    Answer: C

    Explanation: CDC states, "Adults need at least 150 minutes of moderate-intensity physical activity a week". The question asks for the minimum moderate-intensity goal; more activity can meet or exceed that threshold.

    Reference: Adult Activity: An Overview — Recommendations for adults