Free practice questions · Nursing school
Free nursing school practice questions.
Ten questions from the Lumen Nursing School bank, written to course objectives rather than the licensure plan, across the courses a program examines. Answer each one and check it; the rationale opens underneath with the key, why each other option is wrong, and the teaching point.
1Select all that applyCommunity and Public Health Nursing
A home health nurse reviews a referral for a Medicare beneficiary to decide whether the client qualifies for the Medicare home health benefit. Which criteria must the client meet?
Is homebound, so leaving home takes a considerable and taxing effort
Is 65 years of age or older at the start of home health care
Is under the care of a physician or other allowed practitioner
Needs intermittent skilled nursing care or therapy services
Was a hospital client within the 30 days before the referral
Answer it, then check it.
Answer and rationale
Answer
- A: Is homebound, so leaving home takes a considerable and taxing effort
- C: Is under the care of a physician or other allowed practitioner
- D: Needs intermittent skilled nursing care or therapy services
The key, and why
To qualify for Medicare home health, a beneficiary must be homebound (A), be under the care of a physician or allowed practitioner such as a nurse practitioner (C), need intermittent skilled nursing, physical therapy or speech-language pathology, or continuing occupational therapy (D), receive care under a plan of care that the provider sets up and reviews, and have had a face-to-face encounter with a provider related to the reason for home care.
Each distractor
B. Age is not a criterion. Medicare covers people 65 and older and also younger people with disabilities or end-stage kidney disease, and any of them can qualify for home health.
E. A recent hospital stay is not required. Clients can be referred from the community.
The teaching point
Medicare home health = homebound, under a provider's care and plan of care, intermittent skilled need, face-to-face encounter.
2Select all that applyLeadership and Management
The nurse manager of a cardiac step-down unit wants to strengthen structural empowerment for the staff nurses. Which of the following interventions should the nurse manager include in the plan?
Offer tuition support and certification review courses for interested nurses
Review and approve each change staff make to unit routines before it starts
Share quality scores and budget figures at monthly staff meetings
Add two required competency checklists to each nurse's annual evaluation
Pair each nurse with a mentor who gives regular feedback and guidance
Answer it, then check it.
Answer and rationale
Answer
- A: Offer tuition support and certification review courses for interested nurses
- C: Share quality scores and budget figures at monthly staff meetings
- E: Pair each nurse with a mentor who gives regular feedback and guidance
The key, and why
Kanter's theory of structural empowerment holds that people are empowered when the workplace gives them access to opportunity, information, support and resources. Behavior at work follows from these structures more than from personality.
Tuition support and certification review (A) give access to opportunity for growth. Sharing quality scores and budget figures (C) gives access to information. Mentoring with regular feedback (E) gives access to support.
Each distractor
B. Approving every change before it starts can look like careful oversight, but it keeps control with the manager and removes staff authority over their own practice.
D. Competency checklists measure performance. They add requirements without adding opportunity, information, support or resources.
The teaching point
Kanter's structural empowerment = access to opportunity, information, support and resources.
3Multiple choice, single answerMicrobiology
A clear broth and a turbid culture are compared in a spectrophotometer. Which relationship is expected?
More cells produce greater light transmission and lower optical density
Optical density identifies the species without additional testing
Turbidity proves every observed cell is viable
More suspended cells scatter more light and increase optical density
Answer it, then check it.
Answer and rationale
Answer
- D: More suspended cells scatter more light and increase optical density
The key, and why
Increasing cell density increases light scattering, decreases transmitted light, and raises measured optical density within the instrument's linear range.
Each distractor
A. Cells scatter light and reduce transmission.
B. Turbidity measures biomass, not identity.
C. Turbidity includes live and dead particles.
The teaching point
More turbidity means higher optical density.
4Multiple choice, single answerFundamentals of Nursing
Three hours after abdominal surgery, a client's blood pressure has dropped from 128/76 to 96/58 mm Hg and the heart rate has risen from 82 to 118 beats per minute. The skin is pale and cool, and the dressing is soaked with bright red blood. How should the nurse interpret these findings?
Signs of hemorrhage and hypovolemic shock, to be reported at once
Expected effects of anesthesia wearing off after surgery
A sign of severe pain, which will settle once the client receives an analgesic
Signs of a wound infection beginning at the surgical site
Answer it, then check it.
Answer and rationale
Answer
- A: Signs of hemorrhage and hypovolemic shock, to be reported at once
The key, and why
When the body loses blood, the volume in the vessels falls and blood pressure starts to drop. The body tries to make up for it: the heart speeds up to keep blood moving, and blood vessels in the skin narrow to send blood to the vital organs, which makes the skin pale and cool. A falling pressure, a rising pulse and cool, pale skin together, with a dressing soaked in bright red blood, point to hemorrhage with hypovolemic shock.
The nurse reinforces the dressing, stays with the client, checks vital signs often, and notifies the surgeon at once.
Each distractor
B. Anesthesia can lower blood pressure a little, but it does not soak a dressing with fresh blood or cause a rising pulse with cool skin.
C. Pain raises heart rate and blood pressure. It does not drop the pressure and cause pallor and bleeding.
D. Infection usually appears days after surgery, with fever, redness and purulent drainage, not hours after with bright red bleeding.
The teaching point
A falling blood pressure, rising pulse, pale cool skin and fresh bleeding after surgery suggest hemorrhage and shock; report at once.
5Matrix gridCommunity and Public Health Nursing
A public health nurse is reviewing family intake notes at a shelter to plan services using the Healthy People 2030 social determinants of health. For each finding below, click to specify the social determinant domain it belongs to.
Finding
Economic stability
Education access and quality
Health care access and quality
Neighborhood and built environment
Social and community context
Father lost his warehouse job and could not pay rent
Mother left high school in tenth grade and reads at a fifth-grade level
Family has no health insurance and no regular source of care
Previous apartment had mold, broken heat and frequent nearby shootings
Family has no relatives nearby and says neighbors treated them with suspicion
Answer it, then check it.
Answer and rationale
Answer
- Father lost his warehouse job and could not pay rent: Economic stability
- Mother left high school in tenth grade and reads at a fifth-grade level: Education access and quality
- Family has no health insurance and no regular source of care: Health care access and quality
- Previous apartment had mold, broken heat and frequent nearby shootings: Neighborhood and built environment
- Family has no relatives nearby and says neighbors treated them with suspicion: Social and community context
The key, and why
Healthy People 2030 groups the social determinants of health into five domains. Economic stability covers employment, income and poverty. Education access and quality covers schooling and literacy. Health care access and quality covers insurance and having a usual source of care. Neighborhood and built environment covers housing quality, safety and environmental conditions. Social and community context covers relationships, social support, discrimination and civic participation.
Sorting family problems by domain shows the nurse which upstream partners to bring in: employers, schools, health centers, housing and code enforcement, and community groups.
The teaching point
Five domains = economic stability, education, health care, neighborhood and built environment, social and community context.
6Cloze, drop downAnatomy and Physiology I
Choose an option from each list to complete the sentence.
In the stratum basale, melanin is made by . The pigment is then passed to neighboring , where it gathers over the nucleus and absorbs UV light.
Answer it, then check it.
Answer and rationale
Answer
- Blank 1: melanocytes
- Blank 2: keratinocytes
The key, and why
Melanocytes are spider-shaped cells scattered in the stratum basale. They make melanin, a brown to black pigment, and pack it into small sacs called melanosomes. Their long branches reach between nearby keratinocytes, which take in the melanosomes. Inside each keratinocyte, the melanin gathers on the sun-facing side of the nucleus like an umbrella. It absorbs ultraviolet light before it can damage the cell's DNA.
Each distractor
Choosing keratinocytes for the first blank reverses who makes and who receives; keratinocytes make keratin, not melanin.
Choosing dendritic cells for the first blank picks the immune cells of the stratum spinosum, which ingest microbes rather than make pigment.
Choosing melanocytes for the second blank has the cell passing pigment to itself; the pigment is handed to other cells.
Choosing fibroblasts for the second blank puts the receiving cells in the dermis, where melanin is not needed to shield the dividing epidermis.
The teaching point
Melanocytes in the stratum basale make melanin and hand it to keratinocytes, where it shields the nucleus from UV.
7Cloze, drop downLeadership and Management
While reviewing the quarterly report for a medical-surgical unit, the nurse manager sees that the rate of falls with injury is above the national benchmark and that the report is posted on a public website comparing hospitals. Complete the following sentence by choosing from the lists of options.
Choose an option from each list to complete the sentence.
Public posting of this data reflects the trend toward , and measures such as falls with injury are increasingly tied to .
Answer it, then check it.
Answer and rationale
Answer
- Blank 1: transparency and accountability for quality
- Blank 2: the hospital's payment and public reputation
The key, and why
New quality imperatives are a major force in health care. Hospitals are expected to measure quality, report it publicly and improve it. Falls with injury, pressure injuries, infections, readmissions and client experience are tracked, compared across hospitals and often linked to payment.
Public reporting makes performance transparent. Clients and payers can compare hospitals, and the hospital has to answer for its results. Value-based programs reduce payment for poor performance on some measures, and public scores shape a hospital's reputation. For a nurse manager, nurse-sensitive measures like falls with injury are the unit's own report card.
Each distractor
B. Price transparency is a separate trend. Posting fall rates compares quality, not price.
C. Public reporting makes results visible; it does not hand daily practice decisions to regulators.
D. Only a few states mandate staffing ratios, and public fall data are not tied to ratio laws.
F. Hospital quality data do not affect individual license renewal, which is handled by the board of nursing.
The teaching point
Quality imperative = measure, report publicly, compare and improve. Nurse-sensitive measures affect payment and reputation.
8Matrix gridHuman Growth and Development
Classify each newborn ability by the sense it belongs to.
Finding
Vision
Hearing
Taste and smell
The least developed sense at birth, with limited acuity and difficulty telling colors apart
Prefers complex sounds, such as noises and voices, to pure tones
Relaxes the face to sweet solutions and purses the lips to sour ones
Can detect the speech sounds of any human language
Scans the environment and tracks slowly moving bright objects
A breastfed baby turns toward the odor of its own mother's breast pad
Answer it, then check it.
Answer and rationale
Answer
- The least developed sense at birth, with limited acuity and difficulty telling colors apart: Vision
- Prefers complex sounds, such as noises and voices, to pure tones: Hearing
- Relaxes the face to sweet solutions and purses the lips to sour ones: Taste and smell
- Can detect the speech sounds of any human language: Hearing
- Scans the environment and tracks slowly moving bright objects: Vision
- A breastfed baby turns toward the odor of its own mother's breast pad: Taste and smell
The key, and why
Newborns arrive with most senses working. Touch is well developed, especially around the mouth and on the palms and soles. Taste and smell work at birth: babies prefer sweet tastes and smells, dislike sour and bitter, and breastfed babies soon recognize their mother's odor. Hearing is good at birth; newborns prefer complex sounds, especially voices, and can tell apart the sounds of every language. Vision is the least developed sense: newborns focus poorly, see far less sharply than adults, and cannot tell colors apart well. They still scan the environment and track moving, bright objects.
Each distractor
Students who place "least developed" under hearing forget that the fetus hears voices for months before birth, so hearing is quite well developed at birth, while vision had nothing to practice on.
Placing "any human language" under vision misreads speech sounds as lip reading; the ability is auditory and narrows to native-language sounds in the second half of the first year.
Students who put the color row anywhere but vision may think newborns see in full color like adults and are simply slow to name it; poor color discrimination and focus are limits of the newborn visual system that improve over the first months.
The teaching point
At birth touch, taste, smell and hearing are well developed; vision is the least developed sense.
9Ordered responseDosage Calculation
The nurse is starting a gravity infusion that has no pump. Place the steps in the order the nurse performs them.
Drag the responses into the order you want. Drag one back to the list to remove it.
Your order
1Drag a response here
2Drag a response here
3Drag a response here
4Drag a response here
5Drag a response here
Responses
Open the roller clamp and adjust while watching the drip chamber
Calculate the drops per minute
Compare the bag and the prescription for the right fluid, volume and time
Count the drops for a full minute and adjust until the count matches
Read the drop factor printed on the tubing package
Answer it, then check it.
Answer and rationale
Answer
- 1: Compare the bag and the prescription for the right fluid, volume and time
- 2: Read the drop factor printed on the tubing package
- 3: Calculate the drops per minute
- 4: Open the roller clamp and adjust while watching the drip chamber
- 5: Count the drops for a full minute and adjust until the count matches
The key, and why
You cannot calculate a drip rate without knowing both the order and the tubing, so those come first. Check the order first, because it decides which fluid and tubing you set up. Once you have the number, you open the clamp and set a rough rate while watching the chamber.
The last step is a full-minute count. Counting for 15 seconds and multiplying by 4 is common, but a full minute is more accurate for slow rates.
Each distractor
Calculating before reading the drop factor means guessing it. The package tells you whether the tubing is 10, 15, 20 or 60 gtt/mL.
Counting before adjusting the clamp gives the rate of a line that has not been set yet.
Checking the order last means the fluid may already be running into the client before you know it is the right one.
The teaching point
Order, drop factor, calculate, set the clamp, then count a full minute and fine-tune.
10Matrix multiple responseGerontological Nursing
A 76-year-old fair-skinned client who worked outdoors for 40 years is scheduled for a biopsy of a skin lesion on the face. For each finding below, click to specify if the finding is consistent with the disease process of basal cell carcinoma or melanoma. Each finding may support more than one disease process.
Finding
Basal cell carcinoma
Melanoma
Pearly, dome-shaped papule with small blood vessels on the surface
Flat lesion with an irregular, notched border and mixed colors
Slow growth over several years with rare spread to other organs
Early spread through lymph and blood, so lymph nodes are examined
Prognosis that depends mainly on the depth of the tumor at excision
Risk that increases with age and years of sun exposure
Answer it, then check it.
Answer and rationale
Answer
- Pearly, dome-shaped papule with small blood vessels on the surface: Basal cell carcinoma
- Flat lesion with an irregular, notched border and mixed colors: Melanoma
- Slow growth over several years with rare spread to other organs: Basal cell carcinoma
- Early spread through lymph and blood, so lymph nodes are examined: Melanoma
- Prognosis that depends mainly on the depth of the tumor at excision: Melanoma
- Risk that increases with age and years of sun exposure: Basal cell carcinoma, Melanoma
The key, and why
Basal cell carcinoma arises from the basal cells at the bottom of the epidermis. It is the most common skin cancer, and its risk rises with age, sun exposure and past radiation. It usually appears on the face as a small, pearly, dome-shaped papule with tiny visible blood vessels, sometimes with a central ulcer. It grows slowly and almost never metastasizes, although left untreated it can destroy local tissue. Melanoma arises from melanocytes, the pigment cells. Its risk also rises with sun exposure, fair skin and age. It is less common but far more dangerous because it spreads readily through the lymph and blood, so enlarged lymph nodes may be removed. Its prognosis depends on the depth of invasion more than on its subtype, which is why early detection changes the outcome.
Each distractor
Pearly, dome-shaped papule with small blood vessels on the surface → students sometimes place any raised lesion with melanoma, but the pearly surface with tiny vessels is the hallmark of basal cell carcinoma.
Slow growth over several years with rare spread to other organs → students who think all cancers spread may put this with melanoma, but slow growth and rare metastasis define basal cell carcinoma.
Prognosis that depends mainly on the depth of the tumor at excision → this belongs to melanoma, because depth predicts how likely the tumor has reached lymph and blood vessels.
Risk that increases with age and years of sun exposure → students often link sun exposure with only one cancer, but ultraviolet damage and age raise the risk of both.
The teaching point
Basal cell = most common, pearly, slow, rarely spreads. Melanoma = pigmented, irregular, spreads early, depth decides prognosis. Sun and age raise the risk of both.
Begin with the course that is costing you the most.
Lumen Nursing School is a separate bank written to course objectives: twenty courses, every subsection published, in Study, Test and Adaptive modes. The first 30 questions are free. Licensed separately from NCLEX preparation.