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Quizzes > Health & Medicine > Human Anatomy & Medicine

Take the NCLEX Fundamentals Quiz: Nurse-Initiated Interventions!

Think you know nurse-initiated intervention examples? Dive into our NCLEX fundamentals quiz!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art nurse scene with clipboard and stethoscope on sky blue background promoting free NCLEX interventions quiz

This NCLEX Fundamentals quiz helps you practice nurse-initiated interventions and decide when a nurse acts independently. Answer exam-style items to spot correct actions and check your gaps before test day. For a wider review, visit the Fundamentals of Nursing quiz.

Which action is an example of a nurse-initiated independent intervention?
Ordering a dietary consultation
Administering a prescribed antibiotic
Repositioning the patient every 2 hours to prevent pressure ulcers
Notifying the provider of abnormal lab values
Repositioning a patient every 2 hours is an independent nursing intervention aimed at preventing pressure ulcers. Administering medications and ordering consultations require provider orders, and notifying the provider is a collaborative action. Independent nursing interventions fall within the nurse's scope to promote patient safety. .
A patient's IV infiltration is noted by swelling at the site. What is the nurse's first independent action?
Increase the infusion rate to clear the line
Stop the infusion immediately
Switch to a potassium-containing solution
Administer IV antibiotics through the same line
At the first sign of IV infiltration, the nurse should stop the infusion to prevent further tissue damage. Adjusting rates or administering other solutions without assessment can worsen the infiltration. After stopping, the nurse can assess and follow facility policy for further management. .
Which intervention can the nurse implement without a provider's order to improve oxygenation?
Instruct the patient in deep-breathing and coughing exercises
Administer a nebulized bronchodilator
Order a chest radiograph
Increase the oxygen flow rate via nasal cannula
Teaching and guiding patients through deep-breathing and coughing exercises is an independent nursing action that enhances lung expansion and secretion clearance. Adjusting oxygen flow or administering medication requires a provider order. Ordering diagnostic tests is also a provider-initiated action. .
A patient is at risk for falls. Which nurse-initiated intervention is appropriate?
Place a bed alarm and keep the call light within reach
Notify the provider to admit to a higher-acuity ward
Prescribe a sedative before bedtime
Order a non-slip mattress from pharmacy
Implementing fall precautions such as placing a bed alarm and ensuring the call light is within reach are independent nursing interventions. Ordering equipment or medications and changing the level of care require provider orders or administrative actions. .
Which action is an example of a nurse-initiated teaching intervention?
Adjusting the patient's pain medication dose
Scheduling a surgical consult
Prescribing a high-protein diet
Reinforcing proper wound care techniques with the patient
Reinforcing and providing education on wound care is an independent nursing intervention that empowers patients. Prescribing diets or adjusting medications requires provider authority, and scheduling consults is collaborative. Patient education is a core nursing role. .
Which intervention is a nurse-initiated action to prevent deep vein thrombosis (DVT)?
Encourage the patient to perform active leg exercises routinely
Order a compression ultrasound
Administer low-molecular-weight heparin
Initiate sequential compression device per protocol
Encouraging active leg exercises and ambulation are independent nursing interventions that promote venous return and help prevent DVT. Administering anticoagulants requires a provider's order, as does ordering tests. Use of compression devices may require a protocol or order. .
To reduce aspiration risk in a patient with dysphagia, which nurse-initiated intervention is appropriate?
Order a swallowing study immediately
Administer oral thickening agents
Consult speech therapy before feeding
Elevate the head of the bed to at least 90 degrees during meals
Elevating the head of the bed to 90 degrees during meals is an independent nursing intervention that reduces aspiration risk. Ordering diagnostic studies and consulting specialists require provider orders or referrals. Thickening agents may be part of a provider's dietary order. .
A patient reports increased anxiety. Which nonpharmacologic intervention can the nurse initiate immediately?
Administer an anxiolytic medication
Order laboratory tests
Offer guided imagery and relaxation techniques
Request a psychiatric consult
Guided imagery and relaxation exercises are independent nursing interventions that can reduce anxiety. Administering medications, ordering labs, and psychiatric consults are provider-initiated actions. Nonpharmacologic strategies are first-line and within the nursing scope. .
A patient rates pain as 8 out of 10. Which nurse-initiated intervention is appropriate while awaiting analgesic medication?
Perform a comprehensive pain assessment
Increase the IV opioid infusion rate
Apply a cold pack to the painful area
Administer an ordered benzodiazepine
Applying a cold pack is a nonpharmacologic, nurse-initiated intervention that can help reduce pain while awaiting medication. Adjusting IV rates or administering medications requires provider orders. A focused pain assessment may have already been done; the nonpharmacologic measure provides immediate relief. .
When caring for a patient with an indwelling urinary catheter, which intervention can the nurse perform without an order?
Irrigate the catheter with sterile saline
Perform daily peri-care around the catheter insertion site
Switch to a leg bag for ambulation
Remove the catheter
Performing daily peri-care of the catheter site is an independent nursing intervention that reduces infection risk. Catheter irrigation, changing drainage systems, or removal typically require provider orders or facility protocols. Routine hygiene falls within standard nursing care. .
A patient has thick respiratory secretions. Which nurse-initiated action is most appropriate?
Perform endotracheal suctioning
Provide a cool-mist humidifier in the room
Order a chest physiotherapy session
Administer nebulized mucolytics
Providing humidification is an independent nursing intervention that helps loosen thick secretions. Administering nebulized medications and ordering chest physiotherapy require provider orders. Suctioning, if indicated, may require an order or specific protocol. .
A patient complains of nausea. Which nursing intervention can be initiated immediately without a provider order?
Remove noxious odors from the environment
Administer an antiemetic medication
Insert a nasogastric tube
Order intravenous fluids
Removing unpleasant or strong odors is an independent nursing action that can alleviate nausea. Administering antiemetics, inserting tubes, and ordering fluids require provider orders. Environmental modifications are often first-line in managing mild nausea. .
For a patient experiencing constipation, which nurse-initiated intervention is appropriate?
Perform digital stool removal
Place the patient on a clear-liquid diet
Encourage increased dietary fiber and fluid intake
Administer a stimulant laxative
Encouraging dietary fiber and adequate fluid intake is an independent nursing intervention to prevent and manage constipation. Laxatives and invasive procedures require provider authorization. Nonpharmacologic measures are recommended first. .
Which action is a nurse-initiated intervention for a patient with a new tracheostomy?
Order an immediate CT scan
Change the tracheostomy tube with a smaller size
Clean the stoma site with sterile technique per protocol
Administer systemic corticosteroids
Cleaning around the stoma using sterile technique is an independent nursing intervention to prevent infection. Changing tube size, ordering imaging, and administering medications require provider orders. Routine stoma care follows established nursing protocols. .
Which nurse-initiated intervention helps maintain skin integrity in a patient at risk for moisture-associated skin damage?
Request a specialty mattress
Order frequent linen changes
Apply a moisture-barrier cream to vulnerable areas
Increase the room temperature above 80°F
Applying a moisture-barrier cream to areas exposed to excess moisture is an independent nursing intervention that protects skin integrity. Increasing room temperature and equipment orders require collaboration, and linen changes may follow policy but often involve housekeeping. Barrier creams are a frontline nursing strategy. .
Which independent nursing intervention can aid glycemic control in a newly diagnosed type 2 diabetic patient?
Administer an insulin injection
Refer to an endocrinologist
Encourage regular physical activity and walking
Order a hemoglobin A1c test
Encouraging and educating patients on regular physical activity is an independent nursing intervention that can improve insulin sensitivity. Administering insulin, ordering labs, and making specialty referrals require provider involvement. Lifestyle modification education is key in diabetes management. .
A patient arrives with chest pain. Which nurse-initiated intervention should be performed first while awaiting the provider?
Give sublingual morphine
Administer a chewable 325 mg aspirin per chest pain protocol
Start an IV infusion of nitroglycerin
Obtain a stat chest X-ray
Administering aspirin immediately for chest pain is a nurse-initiated intervention in many chest pain protocols to inhibit platelet aggregation. IV medications and diagnostic imaging require orders. Early aspirin administration improves myocardial salvage. .
A patient meets sepsis screening criteria. Which independent nursing action should be initiated promptly?
Begin broad-spectrum antibiotic therapy
Administer a bolus of vasopressors
Order a CT scan of the abdomen
Obtain blood cultures before starting antibiotics
Obtaining blood cultures prior to antibiotic administration is a nurse-initiated action in sepsis protocols to identify causative organisms. Antibiotic administration, vasopressor use, and imaging orders require provider authorization. Early culture collection is critical for targeted therapy. .
A postoperative patient suddenly develops dyspnea and tachycardia. Which nurse-initiated intervention is the priority?
Elevate the head of the bed to improve oxygenation
Administer a dose of IV furosemide
Obtain an arterial blood gas
Call the rapid response team
Elevating the head of the bed is the immediate independent action to enhance ventilation and reduce work of breathing. Medication administration, diagnostic tests, and escalating care involve provider orders or protocols. Optimizing position is a quick, life-saving nursing intervention. .
A patient's lab results show a serum potassium of 6.2 mEq/L. Which nurse-initiated intervention is most appropriate while awaiting orders?
Administer sodium polystyrene sulfonate
Encourage increased dietary potassium
Begin an IV insulin infusion
Place the patient on continuous cardiac monitoring
Continuous cardiac monitoring is an independent intervention to detect life-threatening arrhythmias associated with hyperkalemia. Medications like insulin or resins require orders, and encouraging dietary potassium is contraindicated. Monitoring is essential until definitive treatment begins. .
A patient with a spinal cord injury exhibits severe headache, flushing, and hypertension. Which nurse-initiated intervention is priority?
Administer an antihypertensive agent
Check the patient's bladder distension
Remove tight clothing and constrictive devices
Elevate the head of the bed to 90 degrees
Elevating the head of the bed quickly reduces blood pressure in autonomic dysreflexia and is an independent nursing action. Antihypertensives and bladder checks require orders or protocols, though removing tight clothing is also important. Positioning should be addressed first to prevent stroke. .
To reduce the risk of central line-associated bloodstream infections, which nurse-initiated action is most effective?
Scrub the catheter hub for at least 15 seconds before access
Apply topical antibiotic ointment to the site
Use sterile gloves only when inserting new tubing
Change the dressing weekly
Scrubbing the hub for at least 15 seconds before accessing the line is a proven independent nursing intervention to reduce CLABSI. Dressing intervals and topical antibiotics follow protocols or orders, and sterile technique must be used consistently - not only during tubing changes. Hub disinfection is critical. .
A patient experiences orthostatic hypotension when standing. Which nurse-initiated intervention should be implemented?
Administer a beta-blocker
Encourage the patient to change positions slowly
Increase IV fluid rate
Order compression stockings
Encouraging slow position changes from lying to standing is an independent intervention that allows the cardiovascular system to adapt and reduces dizziness. Medications, fluid adjustments, and compression stockings require provider orders or protocols. Gradual position change is first-line. .
A postpartum patient exhibits signs of uterine atony and increased lochia. Which nurse-initiated intervention is most effective to reduce hemorrhage?
Perform fundal massage until the uterus is firm
Administer intravenous oxytocin
Encourage the patient to void
Order a complete blood count
Fundal massage is an independent nursing action that stimulates uterine contraction and reduces postpartum hemorrhage. Oxytocin administration and ordering labs require provider orders. Ensuring bladder emptying is important but follows fundal massage. .
A patient's chest tube becomes disconnected from suction and lies open to air. What is the nurse's immediate intervention?
Immerse the end of the chest tube in a container of sterile water to reestablish the seal
Reconnect it to wall suction immediately
Clamp the chest tube near the insertion site
Notify the provider and await further orders
If a chest tube is accidentally disconnected, the nurse should immediately place the open end in sterile water to maintain the water seal and prevent air from entering the pleural space. Clamping can cause tension pneumothorax, and reconnection requires a functional suction source. This is a critical nurse-initiated safety action. .
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Study Outcomes

  1. Understand Nurse-Initiated Intervention Fundamentals -

    Grasp the definition, scope, and purpose of nurse-initiated interventions within the fundamentals of nursing practice quiz.

  2. Differentiate Intervention Categories -

    Distinguish nurse-initiated interventions from provider-initiated and collaborative actions through realistic NCLEX fundamentals quiz scenarios.

  3. Apply Interventions in Clinical Scenarios -

    Implement appropriate nurse-initiated intervention examples when presented with patient care situations to build exam-ready skills.

  4. Analyze Correct Descriptions -

    Evaluate various statements to determine which statement correctly describes a nurse initiated intervention, reinforcing key concepts before exam day.

  5. Assess Performance on Practice Questions -

    Review and reflect on your answers to NCLEX practice questions fundamentals to identify strengths and areas for improvement.

Cheat Sheet

  1. Definition and Scope -

    Nurse-initiated interventions are independent actions based on clinical judgment and evidence-based practice that a registered nurse initiates without a provider's direct order. According to the American Nurses Association (ANA), these interventions promote patient safety and self-care by addressing immediate needs. A handy mnemonic is ADPIE - Assessment, Diagnosis, Planning, Implementation, Evaluation - to remember the nursing process framework.

  2. Independent vs. Dependent Interventions -

    Independent interventions, such as repositioning or comfort measures, rely solely on nursing knowledge and licensure, whereas dependent interventions require a physician's order. This distinction is reinforced by state Nurse Practice Acts and National Council of State Boards of Nursing (NCSBN) standards to ensure scope-of-practice compliance. Remember: "I" for independent actions you initiate and "D" for those directed by a doctor.

  3. Common Nurse-Initiated Intervention Examples -

    Examples include teaching deep-breathing exercises, providing dietary teaching, and applying nonpharmacologic pain management like ice packs. These nurse initiated intervention examples align with QSEN (Quality and Safety Education for Nurses) competencies to enhance patient outcomes. Practice recalling three go-to interventions: educate, comfort, and monitor.

  4. Legal and Ethical Considerations -

    Nurses must stay within their scope of practice and adhere to state Nurse Practice Acts, which define the boundaries for independent actions. Ethical principles such as autonomy, beneficence, and accountability guide decision-making when initiating care without a provider's order. Use the ACE mnemonic - Autonomy, Confidentiality, Ethics - to recall key considerations before implementing any independent intervention.

  5. NCLEX-Style Question Strategies -

    When tackling NCLEX practice questions fundamentals or the NCLEX fundamentals quiz, focus on keywords like "independent" or "without a provider order" to answer which statement correctly describes a nurse initiated intervention. Eliminate options that involve medication administration or diagnostics, which are dependent or collaborative tasks. This process-of-elimination approach boosts confidence and accuracy on your fundamentals of nursing practice quiz.

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