NCLEX Reduction of Risk Potential Practice Test

Q: What does Reduction of Risk Potential cover on the NCLEX?

It focuses on preventing complications through monitoring, recognizing changes, and using precautions to reduce harm.

Q: Are these questions mostly about lab values?

Labs show up often, but the bigger skill is knowing what an abnormal result means and what action to take next.

Q: What is the best approach to questions about patient monitoring?

Pick the option that catches deterioration early, follows ordered precautions, and focuses on the most critical system first.

Q: Do post-op complication questions fall under this category?

Yes. Many items involve predictable risks after surgery, like infection, bleeding, respiratory issues, and clots.

Q: How do I handle questions where several actions seem helpful?

Choose the priority action that reduces immediate harm first, then the next steps that support ongoing monitoring and prevention.

Q: What topics should I prioritize when studying this set?

Common complications, key lab trends, neuro checks, respiratory monitoring, fall prevention, and infection risk cues are high value.

Q: How should I use this practice test to improve faster?

Take it once as a baseline, tag misses by theme, review that concept, then retake a short set to confirm improvement.

Q: How do I handle questions about diagnostic tests and procedures?

Focus on the safety steps: prep requirements (like NPO or allergies), what to monitor during and after, and the complications to watch for (bleeding, reaction to prep, airway issues, infection).

Q: What kinds of device and line questions show up in this category?

Expect basics like checking patency and placement, preventing infection, watching output trends, and knowing what changes mean you should report right away.

Q: When choices look similar, how do I avoid picking the ‘nice but useless’ action?

Pick the option that reduces harm first: assess, monitor, protect safety, and report the right finding. Comfort-only actions are rarely correct if the question is about risk and complications.

Question 1

The nurse is assessing the vital signs of a 6-month-old infant. Which of these respiratory rates is cause for concern?

Accepted Answer

63. Expected respiratory rates change based on the age of the child. The neonate and infant expected respiratory range is 30–60 breaths/minute. The toddler respiratory range is 20–40 breaths/minute. For preschool children, the range is 22–30 breaths/minute. School age children have an expected respiratory rate of 20–26 breaths/minute. The adolescent and adult expected respiratory rate is 16–22.

Question 2

A patient with severe renal artery stenosis is under nursing care. Which of the patient’s vital signs would the nurse most likely find to be abnormal as a result of this condition?

Accepted Answer

blood pressure. Renal artery stenosis is usually the result of long-standing (and poorly controlled) hypertension. Conversely, the condition can also trigger the abrupt onset of hypertension. It is also highly correlated with atherosclerosis. However, in this scenario, you’d likely find abnormalities (i.e., elevation) in this patient’s blood pressure.

Question 3

A critical patient with multiple traumas has a Swan-Ganz catheter in place for invasive hemodynamic monitoring. Which of these values requires the brief inflation of a balloon at the distal port of the catheter?

Accepted Answer

pulmonary capillary wedge pressure. A Swan-Ganz catheter is one example of an invasive hemodynamic monitoring system. It has several ports/lumens that allow for specific information/measurements to be taken depending on their location. The distal end of the catheter or the pulmonary artery port will measure the pulmonary artery pressure; however, it also contains a balloon that when inflated measures the pulmonary capillary wedge pressure. Central venous pressure is measured at the proximal port of the catheter, and cardiac output (as measured by a Swan-Ganz) can be determined using a thermistor, which is also located at the distal end of the catheter.

Question 4

A nurse is caring for a 77-year-old, hearing-impaired, client immediately post-operative total hip arthroplasty. The nurse starts discussing post-operative care with the client. The client becomes increasingly agitated with the nurse. Which intervention should the nurse perform?

Accepted Answer

Assist the client in obtaining and wearing her hearing aids. Prior to any operation, a client’s personal belongings and any assistive devices, jewelry, and glasses are removed. The objects are set aside for the patient or family to collect after surgery. A hearing-impaired client will likely struggle to hear without their assistive hearing devices. This increases the client’s agitation due to inability to understand the instructions from the nurse. Promptly returning the hearing-aids to the client will improve communication and reduce agitation. Hearing loss is not a common side effect of anesthesia. The provider does not need to be notified at this time. While the client may be in pain, the priority nursing intervention is to improve communication and reduce agitation in the client.

Question 5

A nurse is caring for a patient who must give a sputum culture. The patient has consented for the procedure and the nurse is giving him the proper instructions. Which of these are the proper instructions the nurse should give to the patient for this test?

Accepted Answer

Take a deep breath, cough and expel the sputum into the container while avoiding allowing saliva to enter as well. A sputum culture should be collected with the absence of saliva. The sputum should be cleared from the upper airway with a deep cough that is performed after a deep breath is taken.

Question 6

When preparing for a clean catch urine specimen, what will the nurse need to do differently for female versus male patients?

Accepted Answer

Make sure the female patients have two antiseptic wipes. When preparing and instructing male and female patients on the correct method of performing a clean catch urine specimen, the nurse will need to give females two antiseptic wipes and the males one. Females should use one wipe front to back and the the second to wipe from the inner labia to the outer. Males just use one wipe from the meatus to the peripheral area in a circular motion. Both males and females void a bit of urine without collecting it then void into the specimen container. Both male and female specimen containers should be wiped down with disinfectant, and both male and female specimens should be taken to the lab as quickly as possible.

Question 7

A 44-year-old female patient has recently had her annual physical exam. She calls to inquire about the results of her lipid testing. Her results are as follows: total cholesterol 235 mg/dL, triglycerides 300 mg/dL, LDL 155 mg/dL, and HDL 42 mg/dL. Which of these is the correct way for the nurse to present the results to this patient?

Accepted Answer

Give the patient the values and explain that her lipids are mildly elevated. Discuss some lifestyle modifications that she can use to help improve these values going forward. Based on the normal values for lipid evaluation, this patient has only mildly elevated lipid levels. Regardless of the values, all patients with lipid abnormalities should receive instructions for proper lifestyle modifications (diet, exercise, smoking cessation) as first line therapy. Instructions for pharmacologic therapy and/or further cardiac testing should come from the ordering practitioner and would not be appropriate in this case.

Question 8

The nurse is caring for an acutely ill patient in the ER with a suspected myocardial infarction (MI). His symptoms began about 3 hours ago. The nurse is the first to review his cardiac lab values. Based on his suspected diagnosis, which of these cardiac enzymes would the nurse expect to see elevated?

Accepted Answer

troponin. Of the cardiac enzymes listed, the nurse would expect to see elevations of troponin (both troponin I and T), as it is usually the most sensitive and specific laboratory value to indicate myocardial damage. These cardiac troponins may be elevated as early as 3 hours after the onset of symptoms. LDH and CK-MB are helpful, but may not show changes early in the course of a MI.

Question 9

A 20-year-old female presents to the urgent care with complaints of fever, headache, vomiting, and a rash that has progressed over the past 24 hours. During her physical exam, she has positive Kernig and Brudzinski tests. A lumbar puncture is ordered. Which of these statements is the correct rationale for ordering this test that the nurse should explain to the patient?

Accepted Answer

“Based on your symptoms and exam findings, we need to determine if you have an infection in your cerebrospinal fluid (CSF) called meningitis.”. This patient presents with signs and symptoms that are suggestive of bacterial meningitis. A lumbar puncture is performed in this scenario so that the patient’s cerebrospinal fluid (CSF) can be examined for signs of infection. The nurse must be able to properly explain this rationale to the patient. While the CSF pressure may be elevated, a lumbar puncture is not performed to remove excess CSF or to deliver medication. A computed tomography (CT) exam is the test that would be used to detect a mass or space-occupying lesion in the brain, not a lumbar puncture.

Question 10

A patient has an arterial blood gas (ABG) drawn. The results are as follows: pH 7.3, PCO2 46, and HCO3 29. Based on these findings, what condition does this patient have?

Accepted Answer

respiratory acidosis. This patient’s ABG shows a respiratory acidosis. A pH lower than the normal range of 7.35 to 7.45 indicates an acidosis (higher would be an alkalosis). A respiratory acidosis occurs when the pCO2 raises due to retention of CO2 in the blood (normal range is 35–45). This can be due to either reduced pulmonary function/failure of the lung to excrete CO2, overproduction of CO2 or a combination of both. In any case, the body’s response to this change is to offset it with a slow increase in plasma HCO3, which occurs in the kidney (normal range is 22–28). This compensation occurs slowly over several days. In metabolic acidosis, there will be a low pH, and also a low HCO3 and PCO2.

Question 11

The nurse is working in an oncology clinic caring for a patient currently undergoing treatment for colorectal cancer. Which of these tumor markers would most likely be used to monitor the patient’s disease?

Accepted Answer

carcinoembryonic antigen (CEA). Specific tumor markers have become increasingly standard in the detection and monitoring of certain types of cancers. In the case of colorectal cancer, CEA is frequently used to monitor disease progression (and response to treatment), but it is not used to diagnose the condition. PSA is often elevated in prostate cancer and may be used for both detection and monitoring. HCG levels may be elevated in some cases of testicular cancer along with certain gestational trophoblastic tumors. Alpha fetoprotein is often elevated in hepatocellular carcinoma and other hepatic diseases. It may also be elevated in cases of testicular cancer.

Question 12

Which of these patients would a nurse determine is not at a significant risk for aspiration?

Accepted Answer

a 15-year-old with vomiting from a gastrointestinal illness. Vomiting due to a gastrointestinal illness is not considered to be a condition that places someone at an increased risk for aspiration. However, altered level of consciousness, enteral tube feedings (especially with residual), and oral/facial surgery and trauma are all risk factors. Additional risk factors would be impaired cough and/or gag reflex, the inability to clear respiratory secretions, dysfunction of the esophageal sphincter, impaired gastrointestinal motility and delayed gastric emptying, dysphagia, an endotracheal or tracheostomy tube and sedation.

Question 13

Which of the following are intrinsic risk factors for skin breakdown? Select all that apply.
A. poor nutritional status
B. shearing/mechanical forces
C. urinary and/or fecal incontinence
D. bony prominences
E. wedge or positioning device use

Accepted Answer

A, C, and D. Intrinsic risk factors are factors that are patient-related. Intrinsic risk factors include poor nutritional status, urinary and/or fecal incontinence, bony prominences, unstable joints, and muscle weakness. Extrinsic risk factors are factors that involve external or environmental hazards, such as shearing forces and positioning devices.

Question 14

A nurse is caring for a patient who recently had surgery to set a fracture and now has his extremity casted. Which of these nursing examinations is not typically utilized to assess for compartment syndrome?

Accepted Answer

motor strength exam. Compartment syndrome is a medical emergency that requires early detection and intervention to prevent permanent disability. It can occur for various reasons, but the underlying problem is that there is an increase of pressure within the muscular compartment that occludes blood flow to the extremity. In addition to a patient’s subjective complaints of increasing or excruciating pain, the nursing assessment should include a circulatory, neurologic and passive movement exam of the affected extremity. There will be evidence of diminished circulation (pallor, decreased/absent pulses, coolness, etc.) as well as abnormal neurologic signs (paresthesias, numbness, paralysis, etc.) and passive movement/stretching of the affected limb with increase the patients level of pain. Assessment of motor strength is not typically used to make this diagnosis.

Question 15

Which of these procedures and/or conditions is improperly paired with the preferred patient positioning?

Accepted Answer

A patient post lumbar puncture/spinal tap should be in left or right lateral decubitus. Patient positioning is not only important for patient comfort and tolerance of a procedure, but it can also have therapeutic effect and reduce the risk of unwanted complications. A patient that is post lumbar puncture/spinal tap should be placed in a flat, supine position to help prevent the complication of post-procedural headaches and other complications.

Question 16

A 55-year-old female is 22 hours post-op from a total thyroidectomy. The nurse is reviewing the patient’s most recent laboratory studies and preparing her for discharge. The nurse notes no abnormalities other than a slightly low calcium level. Which of these is the correct course of action for the nurse to take?

Accepted Answer

Notify the surgeon immediately of the abnormal result. The nurse should notify the surgeon immediately of this result, as it may indicate damage to or removal of the parathyroid glands during the patient’s surgery. It is a rare, but potentially serious complication of the procedure that requires immediate intervention to prevent further morbidity and mortality.

Question 17

A nurse is caring for a patient who has orders for assessment of cranial nerves I-VII. Which of these techniques will the nurse use for her assessment?

Accepted Answer

Ask the patient to follow an object through the six cardinal fields of gaze. Examination of cranial nerves I-VII will include assessment of each of the following cranial nerves: olfactory (I), ocular (II), oculomotor (III), trochlear (IV), trigeminal (V), abducens (VI), and the facial (VII) nerves. Asking the patient to follow an object through the six cardinal fields of gaze is the proper technique to test CN VI, the abducens, as it is responsible for side to side movement of the eyes. Testing for hearing assesses the vestibulocochlear nerve (VIII), assessing for the symmetrical rise of the uvula and vocal cord function (“Ahh”) is a test for the function of the glossopharyngeal (IX) and vagus nerves (X), and asking the patient to shrug the shoulders upward against resistance assesses the function of the trapezius muscle, which is controlled by cranial nerve XI, the spinal accessory nerve.

Question 18

Which of these is not considered to be an important risk factor for delayed and/or impaired wound healing?

Accepted Answer

sun exposure. Important risk factors to consider with regard to delayed or impaired wound healing are advanced age, poor nutritional status (alcoholism, obesity, lack of proper protein, carbohydrates and nutrients), lifestyle choices (cigarette smoking, poor diet, etc.), medications (anti-neoplastic, corticosteroids, etc.), and diseases and disorders such as diabetes, circulatory and respiratory problems must all be taken into consideration when considering risk for delayed and/or impaired wound healing. Sun exposure, while not considered safe in excessive amounts for the skin, typically is not a risk factor for poor healing.

Question 19

A nurse is educating the parents of a newborn that has been diagnosed with phenylketonuria (PKU). Which of these statements indicates that the nurse needs to do further education on the nature and management of this disorder?

Accepted Answer

“Our child will be able to eat more protein once he reaches adolescence.”. Phenylketonuria (PKU) is a rare autosomal recessive disease that inhibits the metabolism of the protein phenylalanine. Phenylalanine is normally metabolized to the amino acid tyrosine, which is critical to a child’s normal growth and development. Likewise, the inability to metabolize phenylalanine can lead to harmful accumulation of it and it’s metabolites in the central nervous system leading to movement disorders and mental retardation if not diagnosed by age 3. The disease is managed with a strict low protein diet and tyrosine supplementation for life. Infants with PKU may be breastfed (low levels of phenylalanine) or receive special formula. The statement, “our child will be able to eat more protein once he reaches adolescence” demonstrates that further education on the nature and management of PKU is needed by the parents.

Question 20

A 67-year-old postmenopausal female presents for a general health screening. She has not had a physical in the past 5 years. She states she is in good health and takes no medications. She is concerned about having osteoporosis. She asks if she can have a test to see if she has it. Which of these is the correct response from the nurse to this patient?

Accepted Answer

“A dual-energy x-ray absorptiometry or DEXA scan is the best test to check for osteoporosis. Given your health history and age, you should discuss having this test with our practitioner.”. Osteoporosis is a common condition that affects postmenopausal women who’ve lost the protective effect of estrogen on bone density. The best screening exam to check for decreased bone density is a dual-energy x-ray absorptiometry or DEXA scan. It is recommended for all postmenopausal women over the age of 65; postmenopausal women who present with fractures; all women considering therapy for other conditions where bone mineral density will affect that decision; women who’ve been on hormone replacement therapy for prolonged periods of time; postmenopausal women who have one or more additional risk factors (alcoholism, smoking, low body weight, sedentary lifestyle, low calcium and vitamin D intake, corticosteroid use, recurrent falls); and patients who experience fractures after minimal trauma, with evidence of osteopenia on radiography, with rheumatoid arthritis, or with a disease known to increase the risk of osteoporosis.

NCLEX Reduction of Risk Potential Practice Test

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Common NCLEX Risk Reduction Questions Answered

What does Reduction of Risk Potential cover on the NCLEX?

Are these questions mostly about lab values?

What is the best approach to questions about patient monitoring?

Do post-op complication questions fall under this category?

How do I handle questions where several actions seem helpful?

What topics should I prioritize when studying this set?

How should I use this practice test to improve faster?

How do I handle questions about diagnostic tests and procedures?

What kinds of device and line questions show up in this category?

When choices look similar, how do I avoid picking the ‘nice but useless’ action?

Can I review only the questions I got wrong after I finish?

Can I pause the quiz and come back later where I left off?

After I finish this set, does the page guide me to what to practice next?