Incident reporting NCLEX-RN Practice Questions

Incident Reporting NCLEX-RN Practice Questions

Incident reporting is a core component of patient safety and quality improvement in nursing practice. On the NCLEX-RN, you’re expected to recognize when to complete an incident report, what to document (and what to avoid), whom to notify, and how incident reporting protects patients, visitors, and staff. This set of practice questions focuses on safety and infection control through the lens of incident reporting, including medication errors, falls, near misses, sharps injuries, HIPAA breaches, and equipment malfunctions. You’ll apply clinical judgment to prioritize actions, document objectively, and follow institutional policy and regulatory expectations. Use these questions to strengthen your understanding of real-world scenarios and refine decision-making for safe, legally sound nursing care.

Q1. A nurse administers the wrong dose of an antihypertensive. The patient is stable after assessment. Which is the most appropriate action regarding incident reporting?

• Document “incident report completed” in the patient’s chart to ensure transparency
• Complete an incident report as soon as possible after assessing the patient and notifying the provider
• Wait until the end of the shift to complete the incident report to avoid alarming the patient
• Only complete an incident report if the patient experiences adverse effects

Correct Answer: Complete an incident report as soon as possible after assessing the patient and notifying the provider

Q2. Which statement reflects proper documentation in the medical record after a fall?

• “Incident report filed; patient fell due to negligence by staff.”
• “Found patient on floor at 0740; assisted to bed with two staff; vitals obtained; 2 cm laceration to left elbow; provider notified.”
• “Patient fell because he ignored instructions; incident reported.”
• “No injuries observed; no further action required.”

Correct Answer: “Found patient on floor at 0740; assisted to bed with two staff; vitals obtained; 2 cm laceration to left elbow; provider notified.”

Q3. A nurse intercepts a medication labeled for the wrong patient before administration. What is the best action?

• No action is needed because no medication was administered
• File a near-miss incident report according to facility policy
• Tell the pharmacy informally so workflow isn’t disrupted
• Throw away the medication and continue with the shift

Correct Answer: File a near-miss incident report according to facility policy

Q4. A visitor trips over an IV pump cord and sprains an ankle. What should the nurse do regarding incident reporting?

• Complete an incident report for visitors’ injuries per policy
• No report is necessary because the person is not a patient
• Ask security to handle the paperwork; nurses do not report visitor events
• Document only in the unit logbook and move on

Correct Answer: Complete an incident report for visitors’ injuries per policy

Q5. Which information belongs in an incident report for a medication error?

• Objective facts, patient assessment findings, immediate actions taken, and notifications made
• Speculation about why the error happened and who is at fault
• Copies of the nurse’s personal notes for legal protection
• Detailed critique of pharmacy workflow

Correct Answer: Objective facts, patient assessment findings, immediate actions taken, and notifications made

Q6. A nurse finds lab results faxed to the wrong unit, exposing protected health information. What is the appropriate action?

• Shred the paper and move on because no patient was harmed
• Complete a privacy breach incident report and notify the privacy officer per policy
• Call the patient to apologize and avoid reporting
• Document “HIPAA violation” in the patient’s chart

Correct Answer: Complete a privacy breach incident report and notify the privacy officer per policy

Q7. A nurse sustains a needlestick while recapping a needle. What is the priority sequence?

• Finish the current task, then report the injury at the end of shift
• Wash the area, report the exposure, initiate source testing and post-exposure protocol, and complete an incident report
• Apply a bandage and keep working; only report if symptoms occur
• Tell a coworker and write in the unit communication book

Correct Answer: Wash the area, report the exposure, initiate source testing and post-exposure protocol, and complete an incident report

Q8. After an infusion pump malfunctions and delivers an incorrect rate, what is the correct action regarding the device?

• Discard the pump to prevent future errors
• Sequester and tag the pump for investigation, notify biomedical engineering, and file an incident report
• Continue using the pump with closer monitoring
• Return the pump to central supply without reporting

Correct Answer: Sequester and tag the pump for investigation, notify biomedical engineering, and file an incident report

Q9. Which statement about incident reports is true?

• They are part of the patient’s medical record
• They are discoverable by patients upon request
• They are internal quality improvement documents and not charted in the medical record
• They replace chart documentation of the event

Correct Answer: They are internal quality improvement documents and not charted in the medical record

Q10. A nurse discovers a duplicate dose of a beta-blocker was given by a float nurse. What is the first action?

• Complete an incident report before assessing the patient
• Assess the patient’s vital signs and cardiac status immediately
• Call the provider after the end-of-shift handoff
• Write an email to the nurse manager detailing the error

Correct Answer: Assess the patient’s vital signs and cardiac status immediately

Q11. Which wording is most appropriate in an incident report?

• “Patient care assistant intentionally ignored bed alarm.”
• “Patient fell because staff was short-staffed.”
• “Bed alarm did not sound when patient stood; alarm later tested and functioned; charge nurse notified.”
• “Patient acted irresponsibly by attempting to walk.”

Correct Answer: “Bed alarm did not sound when patient stood; alarm later tested and functioned; charge nurse notified.”

Q12. When should an incident report be completed?

• As soon as possible after the event, generally within 24 hours
• Only at the end of the week to ensure accuracy
• Only if requested by the provider
• Only if the patient or family requests one

Correct Answer: As soon as possible after the event, generally within 24 hours

Q13. A nursing student gives a medication to the wrong patient under the RN’s supervision. What should occur?

• No reporting is needed because the RN is responsible
• Complete an incident report per policy; the RN preceptor guides and cosigns as required
• Only the student’s school should be notified; no facility report is needed
• Document the error in the chart and state “incident report completed”

Correct Answer: Complete an incident report per policy; the RN preceptor guides and cosigns as required

Q14. The end-of-shift controlled substance count is incorrect. What is the best action?

• Note it on a sticky note for the next shift to reconcile
• Notify the charge nurse immediately, reconcile per policy, and complete an incident report
• Wait 24 hours to see if the discrepancy resolves
• Call pharmacy but do not file a report to avoid paperwork

Correct Answer: Notify the charge nurse immediately, reconcile per policy, and complete an incident report

Q15. Which chart entry after a fall is appropriate?

• “Patient fell due to weakness and noncompliance.”
• “Found patient sitting on floor at bedside; denies dizziness; BP 128/76, HR 84; no abrasions observed; provider notified.”
• “Incident report completed and sent to risk management.”
• “Staff error caused the fall.”

Correct Answer: “Found patient sitting on floor at bedside; denies dizziness; BP 128/76, HR 84; no abrasions observed; provider notified.”

Q16. A patient refused bed alarm use and later fell. Which action is correct?

• No incident report is needed because the patient refused precautions
• Complete an incident report and document the refusal and fall facts in the chart
• Document the incident report in the chart to show compliance
• Ask the family to sign a waiver instead of reporting

Correct Answer: Complete an incident report and document the refusal and fall facts in the chart

Q17. A staff member is struck by an agitated patient and sustains a minor injury. What should the nurse do?

• Do nothing because the injury is minor
• Complete a workplace violence incident report and follow injury protocols
• Call law enforcement only; no internal report is needed
• Document only in the patient’s chart

Correct Answer: Complete a workplace violence incident report and follow injury protocols

Q18. During chemotherapy administration, extravasation is suspected. Besides clinical management, what is best regarding reporting?

• No report is necessary if antidote is given
• Complete an incident report and notify the provider and charge nurse
• Only chart “extravasation” with no internal report
• Report only if tissue necrosis occurs

Correct Answer: Complete an incident report and notify the provider and charge nurse

Q19. A patient develops a hospital-acquired Stage 2 pressure injury. What is the appropriate action?

• Chart the finding but do not report internally
• Complete an incident/adverse event report and implement prevention plan
• Wait to see if it worsens before reporting
• Only notify the wound care nurse; reporting is unnecessary

Correct Answer: Complete an incident/adverse event report and implement prevention plan

Q20. A nursing assistant posts a patient’s room photo on social media without identifiers. What should the nurse do?

• Ignore it because there are no visible names
• Report the HIPAA/privacy incident per policy and notify management
• Ask the assistant to delete the post; no further action
• Tell the patient only if they ask

Correct Answer: Report the HIPAA/privacy incident per policy and notify management

Q21. A nurse gives an antibiotic to the wrong patient, who experiences no adverse effects. Which is correct?

• No report is needed if there is no harm
• Complete an incident report and disclose the error to the patient per policy
• Document only in the MAR and move on
• Wait to see if symptoms develop before reporting

Correct Answer: Complete an incident report and disclose the error to the patient per policy

Q22. You witness a colleague administer insulin without verifying the blood glucose per protocol. What is the best action?

• Say nothing to maintain teamwork
• Notify the charge nurse/supervisor and complete an incident report
• Confront the colleague privately and do nothing else
• Document in the patient’s chart that an incident report was filed

Correct Answer: Notify the charge nurse/supervisor and complete an incident report

Q23. Regarding incident report handling, which is correct?

• Keep a personal copy in case of litigation
• Do not photocopy; submit via the designated system to risk management
• Place a copy in the patient’s paper chart
• Email a copy to the provider for review

Correct Answer: Do not photocopy; submit via the designated system to risk management

Q24. An unwitnessed fall is discovered. What is the best immediate action sequence?

• Move the patient to bed immediately; then file a report
• Assess for injury before movement, obtain vitals, notify provider, implement precautions, and complete an incident report
• File the incident report before assessing to preserve evidence
• Ask the patient what happened and rely on their report only

Correct Answer: Assess for injury before movement, obtain vitals, notify provider, implement precautions, and complete an incident report

Q25. Which principle applies to incident report content?

• Include only what you personally observed or assessed; avoid hearsay
• Summarize by quoting multiple staff statements you heard
• Assign responsibility based on your judgment
• Include subjective impressions to provide context

Correct Answer: Include only what you personally observed or assessed; avoid hearsay

Q26. A sentinel event occurs. Whom should the nurse expect to notify as part of the process?

• Only the primary provider
• The charge nurse, nursing supervisor, provider, and risk management/quality department
• Only the patient’s family
• The media relations department first

Correct Answer: The charge nurse, nursing supervisor, provider, and risk management/quality department

Q27. A patient asks to see the incident report after a medication error. What is the best response?

• Provide a copy of the incident report upon request
• Explain the incident report is an internal quality document; offer to review the medical record and discuss the event
• Refuse to discuss anything about the event
• Tell them to ask risk management for a copy

Correct Answer: Explain the incident report is an internal quality document; offer to review the medical record and discuss the event

Q28. A mislabeled blood specimen is discovered after it left the unit and must be recollected. What should the nurse do?

• No report; simply recollect the specimen
• Complete an incident report as a lab error and implement labeling double-checks
• Blame the phlebotomist in the patient chart
• Wait for lab to report it officially before acting

Correct Answer: Complete an incident report as a lab error and implement labeling double-checks

Q29. A diabetic patient receives a regular (non-diabetic) meal tray and later has hyperglycemia. What is the appropriate action?

• Correct the glucose and do not report since food errors are minor
• Complete an incident report and notify dietary services and the provider
• Document only in the diet order notes
• File a complaint against the dietary worker in the chart

Correct Answer: Complete an incident report and notify dietary services and the provider

Q30. You discover a small electrical fire risk from a frayed cord on a warming blanket. After removing it from service and ensuring safety, what should you do?

• Wrap the cord with tape and continue using the device
• Tag the device, notify facilities/biomedical, and file a safety incident report
• Discard the device without notifying anyone
• Wait to report until a fire actually occurs

Correct Answer: Tag the device, notify facilities/biomedical, and file a safety incident report

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