Error prevention NCLEX-RN Practice Questions

Error prevention NCLEX-RN Practice Questions help you strengthen critical thinking and clinical decision-making to keep patients safe. This focused set targets common safety pitfalls across medication administration, high-alert protocols, communication, and infection control. You’ll apply strategies like using two identifiers, read-backs, standardized concentrations, sterile technique, and event reporting. Designed for M. Pharma students preparing for NCLEX-RN, these questions mirror real clinical scenarios: pediatric dosing, look-alike/sound-alike drugs, isolation precautions, blood product verification, infusion pump programming, and preventing device-related harm. Work through each case to refine prioritization, recognize red flags, and select actions that break the error chain. Practice now to build safe habits that protect patients and your practice.

Q1. A patient with a red allergy band stating “Penicillin” is ordered piperacillin-tazobactam IV. What is the safest action to prevent a medication error?

• Administer the first dose slowly while monitoring for reaction
• Ask pharmacy to relabel the medication without penicillin listed
• Compare the MAR and wristband, ask the patient to describe past reactions, and hold the dose while clarifying the order with the provider
• Give diphenhydramine and proceed with the antibiotic

Correct Answer: Compare the MAR and wristband, ask the patient to describe past reactions, and hold the dose while clarifying the order with the provider

Q2. To prevent patient identification errors before medication administration, which approach is best?

• Ask the patient to state their room number and last name
• Scan the bar code only if the patient is alert and oriented
• Use two identifiers (full name and date of birth) matched to the ID band and MAR, then scan the bar code
• Confirm identity with a family member if present

Correct Answer: Use two identifiers (full name and date of birth) matched to the ID band and MAR, then scan the bar code

Q3. The provider gives a telephone order: “Give 10 U insulin now.” Which action prevents error?

• Write “10 U” on the order and cosign later
• Read back the order, write “10 units,” avoid abbreviations, and verify using a second nurse per policy
• Administer insulin immediately and document later
• Text the provider a photo of the MAR for confirmation

Correct Answer: Read back the order, write “10 units,” avoid abbreviations, and verify using a second nurse per policy

Q4. A pediatric dose for gentamicin calculates to 8 mg/kg/dose, exceeding the recommended 2.5 mg/kg/dose. What should the nurse do first?

• Split the ordered dose in half and give
• Hold the medication and clarify the order with the prescriber and pharmacist
• Administer and draw a level sooner than usual
• Notify the charge nurse after giving the dose

Correct Answer: Hold the medication and clarify the order with the prescriber and pharmacist

Q5. Which practice best prevents errors with high-alert medications like IV heparin and insulin?

• Double-check dose with any available staff member
• Independent double verification by two licensed nurses using the original order, MAR, and pump settings
• Use verbal confirmation from the provider before each dose
• Rely on the smart pump to catch programming mistakes

Correct Answer: Independent double verification by two licensed nurses using the original order, MAR, and pump settings

Q6. While preparing medications, the nurse draws up an unlabeled syringe for later use. What is the safest immediate action?

• Place it on a clean tray away from other syringes
• Label the syringe immediately with drug name, dose, and time before leaving the preparation area
• Ask another nurse to remember what it contains
• Proceed because the medication will be given within 5 minutes

Correct Answer: Label the syringe immediately with drug name, dose, and time before leaving the preparation area

Q7. Which step is essential to prevent wrong-site surgery during the pre-procedural time-out?

• Verify the room number and surgeon name
• Confirm correct patient, procedure, site/side, and consent with active team participation
• Ask the patient if they are ready for surgery
• Check only the operative permit

Correct Answer: Confirm correct patient, procedure, site/side, and consent with active team participation

Q8. A bar-code scanner alerts “medication not matched to patient.” What is the nurse’s best action?

• Override the alert and administer if the patient confirms the drug name
• Manually document administration and proceed
• Stop, re-verify the patient and medication against the MAR, investigate the discrepancy, and resolve before administration
• Turn the scanner off and rely on visual checks

Correct Answer: Stop, re-verify the patient and medication against the MAR, investigate the discrepancy, and resolve before administration

Q9. To reduce look-alike/sound-alike (LASA) medication errors (e.g., hydrALAzine vs. hydrOXYzine), which is most effective?

• Store them alphabetically on the same shelf
• Use tall-man lettering, separate storage, bar-code scanning, and three label checks against the MAR
• Rely on color-coded vials only
• Ask patients which one they prefer

Correct Answer: Use tall-man lettering, separate storage, bar-code scanning, and three label checks against the MAR

Q10. The order reads “morphine 2.0 mg IV.” What prevents a dosing error?

• Administer as written; trailing zeros are acceptable
• Clarify the order and transcribe as “morphine 2 mg IV” without a trailing zero
• Convert to 0.2 mg to be safe
• Rewrite as 2 mg/kg for clarity

Correct Answer: Clarify the order and transcribe as “morphine 2 mg IV” without a trailing zero

Q11. A patient with suspected C. difficile infection requires hand hygiene. Which practice prevents transmission most effectively?

• Alcohol-based hand rub before and after care
• Soap and water handwashing after patient contact and glove removal
• Hand lotion before donning gloves
• Double-gloving instead of hand hygiene

Correct Answer: Soap and water handwashing after patient contact and glove removal

Q12. A nurse is about to crush an extended-release nifedipine capsule for a patient with a feeding tube. What action prevents harm?

• Crush and mix with sterile water
• Open the capsule and sprinkle on applesauce
• Hold the medication and request a liquid immediate-release alternative
• Dissolve the capsule in warm water

Correct Answer: Hold the medication and request a liquid immediate-release alternative

Q13. Which action best prevents central line-associated bloodstream infection (CLABSI) during a dressing change?

• Use clean gloves and avoid touching the insertion site
• Perform a full sterile technique with mask, sterile gloves, chlorhexidine scrub, and allow antiseptic to dry
• Change the dressing only if saturated
• Apply antibiotic ointment routinely

Correct Answer: Perform a full sterile technique with mask, sterile gloves, chlorhexidine scrub, and allow antiseptic to dry

Q14. A patient at high risk for falls needs toileting assistance. Which action best prevents a fall-related error?

• Encourage the patient to self-transfer to promote independence
• Keep bed in high position with top side rails up
• Implement scheduled toileting, use a gait belt, keep call light within reach, and ensure nonskid footwear
• Use restraints to prevent getting out of bed

Correct Answer: Implement scheduled toileting, use a gait belt, keep call light within reach, and ensure nonskid footwear

Q15. During sterile catheter insertion, the sterile glove contacts a nonsterile bed sheet. What should the nurse do?

• Continue since only part of the glove touched
• Ask the patient not to move
• Change the contaminated glove and re-establish sterility before proceeding
• Use extra lubricant to reduce infection risk

Correct Answer: Change the contaminated glove and re-establish sterility before proceeding

Q16. Which statement reflects correct prevention of wrong-route errors with neuraxial/IV lines?

• Connect epidural tubing to any available pump channel
• Label all lines at the distal and proximal ends; use yellow-striped tubing and dedicated pumps for epidural infusions
• Run epidural medications through a peripheral IV if epidural access is lost
• Use adapters to standardize all connections

Correct Answer: Label all lines at the distal and proximal ends; use yellow-striped tubing and dedicated pumps for epidural infusions

Q17. Which practice reduces sharps injuries and bloodborne pathogen transmission most effectively?

• Recap needles using a two-handed technique
• Activate needle safety devices immediately and dispose of sharps intact without recapping
• Carry used sharps to the medication room for disposal
• Leave sharps in bed linens for removal by housekeeping

Correct Answer: Activate needle safety devices immediately and dispose of sharps intact without recapping

Q18. When programming a smart pump for a vasoactive infusion, what is the safest strategy?

• Bypass the drug library for faster setup
• Use the drug library with standardized concentration and dose limits, and verify with another nurse
• Estimate the rate based on prior patients
• Start at a high rate then titrate down

Correct Answer: Use the drug library with standardized concentration and dose limits, and verify with another nurse

Q19. Which infection prevention strategy is correct for multi-dose insulin vials in a hospital?

• Use one vial for multiple patients kept in the medication room
• Dedicate a multi-dose vial to a single patient, label with date/time opened, and store per policy
• Keep the vial at bedside uncapped for quick access
• Wipe the rubber stopper only on first use

Correct Answer: Dedicate a multi-dose vial to a single patient, label with date/time opened, and store per policy

Q20. A patient is to receive blood. Which step best prevents transfusion errors?

• Verify patient identity against the blood unit using one nurse
• Scan the blood bag bar code and begin
• Two licensed personnel verify patient identifiers, blood type, unit number, expiration, and crossmatch at bedside
• Start transfusion if the vital signs are stable

Correct Answer: Two licensed personnel verify patient identifiers, blood type, unit number, expiration, and crossmatch at bedside

Q21. A provider orders potassium chloride 40 mEq IV push. What prevents harm?

• Administer as a slow IV push over 10 minutes
• Clarify the order; potassium chloride must be diluted and infused via pump per protocol
• Give orally instead without notifying the provider
• Split the dose into two 20 mEq pushes

Correct Answer: Clarify the order; potassium chloride must be diluted and infused via pump per protocol

Q22. Which action prevents latex-related errors in a patient with documented latex allergy?

• Use latex gloves with cotton liners
• Apply a latex-free armband, use non-latex gloves/equipment, and schedule as first case of the day if surgery is planned
• Proceed normally and premedicate with steroids
• Allow balloons in the room if kept away from the bed

Correct Answer: Apply a latex-free armband, use non-latex gloves/equipment, and schedule as first case of the day if surgery is planned

Q23. For a patient on contact precautions, which sequence prevents contamination when removing PPE?

• Gown, gloves, goggles, mask
• Gloves, gown, goggles/face shield, mask, hand hygiene
• Mask, gloves, gown, hand hygiene
• Goggles, mask, gloves, gown

Correct Answer: Gloves, gown, goggles/face shield, mask, hand hygiene

Q24. A near-miss is caught before medication reaches the patient. What is the best next action?

• Ignore since no harm occurred
• Complete a non-punitive incident report and analyze contributing factors
• Document “incident report completed” in the medical record
• Confront the provider publicly

Correct Answer: Complete a non-punitive incident report and analyze contributing factors

Q25. Which insulin safety practice prevents errors during preparation and administration?

• Mix insulin glargine with regular insulin to reduce injections
• Use an insulin-only syringe, verify dose independently with another nurse, and never mix long-acting analogs
• Round the dose to the nearest whole number for convenience
• Draw up insulin using a tuberculin syringe

Correct Answer: Use an insulin-only syringe, verify dose independently with another nurse, and never mix long-acting analogs

Q26. During bedside shift report, which practice most reduces communication-related errors?

• Discuss sensitive information away from the patient and omit high-alert meds
• Use SBAR, verify critical labs, review pending tests, line/drain status, and involve the patient in clarifying goals and allergies
• Limit to room number and diagnosis
• Rely on printed summaries only

Correct Answer: Use SBAR, verify critical labs, review pending tests, line/drain status, and involve the patient in clarifying goals and allergies

Q27. Which action prevents oxygen-related fire hazards?

• Apply petroleum-based lip balm
• Post “No Smoking” signs, avoid petroleum products, and keep oxygen away from heat sources
• Use heating pads with oxygen at bedside
• Store oxygen tanks under linens

Correct Answer: Post “No Smoking” signs, avoid petroleum products, and keep oxygen away from heat sources

Q28. Before administering vancomycin via peripheral IV, which step prevents extravasation and dosing errors?

• Use any available IV site regardless of patency
• Verify patency with a saline flush, confirm the dose/infusion rate with the drug library, and assess the site every 15–30 minutes
• Infuse as a rapid IV push for efficiency
• Dilute in minimal volume to reduce time

Correct Answer: Verify patency with a saline flush, confirm the dose/infusion rate with the drug library, and assess the site every 15–30 minutes

Q29. Which practice best prevents wrong-dose errors when converting between mg and mL for liquid medications?

• Estimate volume by eye level in a cup
• Use an oral syringe calibrated in mL, perform an independent calculation check, and compare the concentration on the label with the MAR
• Use household spoons for small doses
• Round to the nearest whole mL for simplicity

Correct Answer: Use an oral syringe calibrated in mL, perform an independent calculation check, and compare the concentration on the label with the MAR

Q30. In the operating room, what is the most effective way to prevent retained surgical items?

• Rely on the surgeon’s memory
• Perform standardized counts of sponges, sharps, and instruments at key times with two staff, use adjunct technology (e.g., radiofrequency tags), and reconcile discrepancies before closure
• Count only at the end of the case
• Use larger sponges to make them visible

Correct Answer: Perform standardized counts of sponges, sharps, and instruments at key times with two staff, use adjunct technology (e.g., radiofrequency tags), and reconcile discrepancies before closure

Download