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Free NCLEX Practice Test Questions For: “Safe and Effective Care Environment – Management of Care”

Your NCLEX practice should cover all tested NCSBN competencies in detail and at the same level of difficulty as the real exam.

One of the two subsections of the Safe and Effective Care Environment category is “Management of Care.” This subsection consists of 17-23% of your RN test score. Make sure your NCLEX review questions cover this information. Below are some Management of Care NCLEX practice questions.

1.) An RN on a busy med-surge unit has administered the wrong medication to her patient. Her first response should be to:

A. Assist the patient to vomit
B. Report to the physician
C. Fill out a variance report
D. Call the nurse supervisor

2.) A patient who reports being allergic to bananas is at risk for an allergy to:

A. Latex
B. Saline
C. Iodine
D. Potassium

3.) You must maintain a sterile field for a medical procedure. All of the following will contaminate the field except:

A. A sterile kit that has become damp
B. A sterile kit that has a broken seal
C. Sterilized instruments taken from the sterilizer to the sterile field while wearing sterile gloves
D. A sterile kit that was found in an area that is contaminated

4.) The nurse finds smells smoke and finds a trash can on fire. What is her immediate action?

A. Alert the staff
B. Use the facility alarm policy.
C. Remove patients that are in the most immediate danger
D. Retrieve the nearest fire extinguisher and put out the fire

5.) Your patient is a member of the Jehovah Witnesses. This group does not allow:

A. Blood transfusions
B. Surgical procedures
C. Psychiatric treatment
D. Hospital births

6.) An unlicensed nursing assistant may perform which delegated task for a patient with an NG tube?

A. Tubal irrigation
B. Monitoring and reporting of complications
C. Administer tube feedings
D. Perform oral care

7.) Which of the following patients should be seen first by the oncoming nurse?

A. A 60 year old female requesting an antacid and feeling sweaty
B. A 59 yo male post cardiac cath by 8 hours
C. A 28 yo female diagnosed with asthma, who has just received a treatment by respiratory therapy
D. A diabetic whose blood glucose was 120 one hour ago

8.) The patient has had abdominal surgery. The nurse is teaching her about deep vein thrombosis (DVT). The nurse will include positive conversation and instruction on all of the following factors except:

A. Exercise can decrease the risk for developing DVT
B. Briskly massage any red, tender areas in the calf
C. Frequent lab work will be necessary
D. Report any leg discomfort immediately

9.) The assigned nurse must administer her patient’s regularly scheduled medications within what time period?

A. 30 minutes before to 30 minutes after the scheduled time
B. Within 5 minutes of the scheduled time
C. One hour before to one hour after the scheduled time
D. The 5 minute rule only applies to oral medications

10.) Patient ambulation as soon as possible after injury or surgery helps prevent:

A. Aneurisms
B. Gall stones
C. Seizures
D. Pneumonia

11.) The nurse has an unusually heavy patient load due to a staff shortage. She can best meet her usual standard of good patient care by:

A. Skipping her meal break
B. Asking for assistance
C. Prioritizing patient care needs early in her shift
D. Skipping unnecessary tasks like baths

Answers and Rational

Use the answers to the NCLEX RN questions below to see how many you got correct.

1. Correct answer: B
Reporting the error to the physician and receiving orders that will correct the error or prevent patient harm is the first priority for a medication error.

A – Vomiting is contraindicated for many types of medication, and may harm the patient further.
C – The variance report should include the procedure followed to correct the situation, therefore the physician should be contacted first.
D – The supervisor cannot give the order for a potential emergency situation that may result from a medication error. The physician should be contacted first with the results reported to the supervisor.

2. Correct answer: A
An allergy to bananas can be a warning sign for an allergic reaction to latex products.

B – Banana allergy does not indicate an allergy to saline
C – Banana allergy does not indicate an allergy to iodine
D – Banana allergy does not indicate an allergy to potassium

3. Correct answer: C
This procedure maintains the sterile field.

A – Germs move readily through a damp or wet package and contaminate the sterile field.
B – A broken seal can indicate that the sterile package has been contaminated.
D – Sterile kits must be kept in a clean environment to decrease the possibility of contamination.

4. Correct answer: C
Moving patients to safety is the nurses first priority.

A – Alerting the staff ASAP is necessary; however, patients in eminent danger are attended to first.
B – The facility alarm policy should be instigated to alert the staff once the nearest patients are moved.
D – Nearest patients should be moved before attempting to extinguish the fire. Certain objects in the trash could increase the intensity of the fire if the wrong method or extinguisher is used.

5. Correct answer: A
The religious group known as Jehovah’s Witnesses does not allow blood transfusions, or any blood derivative.

B – This group allows surgical procedures.
C – This group allows psychiatric treatment.
D – This group allows hospital births.

6. Correct answer: D
An unlicensed nursing assistant can perform oral care if a licensed nurse has documented that they were taught and have performed the task successfully with supervision.

A – Only licensed personnel may perform tubal irrigation.
B – Only licensed personnel may perform complication monitoring.
C – Only licensed personnel may administer tube feedings.

7. Correct answer: A
Feelings of indigestion and sweating can be signs of an impending myocardial infarction.

B – This patient has no signs / symptoms that take priority.
C – This patient has no signs / symptoms that take priority.
D – This patient has no signs / symptoms that take priority.

8. Correct answer: B
Massaging the thrombotic area can dislodge all or part of the clot and cause severe complications and death.

A – Exercise before a DVT develops increases circulation and decreases the risk of DVT.
C – Frequent labs may be necessary to test clotting time and the potential risk for DVT.
D – Leg pain, swelling, redness, or hot spots are signs of DVT.

9. Correct answer: A
If the medication is not administered within one hour (30 minutes before or 30 minutes after) the scheduled time a variance report, incident report, or medication error report must be completed. The type of report and procedure depends on the state and facility policies.

B – There is no 5-minute rule.
C – One hour early or one hour late constitutes a medication error. Medications are scheduled so that the therapeutic dose remains constant in the body.
D – Oral medications fall under the 30-minute rule guidelines.

10. Correct answer: D
A major complication of prolonged bed rest, even with regular turning, is pneumonia.

A – A lack of ambulation has not been shown to cause aneurisms.
B – Ambulation after surgery or injury has no relationship to gallstones.
C – Seizures are not caused by prolonged bed rest.

11. Correct answer: C
Prioritizing and scheduling tasks for each patient early in the shift will decrease chaos, make sure nothing is missed, and allow the nurse to be organized. This also helps ensure the safety of her patients.

A – Skipping meals will add to the nurse’s frustration, and increase the likelihood of mistakes.
B – Assistance may be hard to acquire on a unit that is already short staffed.
D – Baths are important to the patient’s sense of well-being and to their health. Bathing patients keeps bacteria under control that can spread quickly through a facility.

Want more NCLEX practice exam questions and help to succeed in the Management of Care subsection of the Safe and Effective Care Environment?…

Then go to: NCLEX Study Guide Book And Test Prep Plan right now.


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