Exam 2026/2027 | NGN Test Bank | Questions with
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SECTION 1: Fundamentals & Safety (15 Questions)
Q1: A nurse is caring for four patients. Which patient should the nurse assess FIRST?
A. A post-op patient with pain rated 7/10
B. A diabetic patient with blood glucose of 210 mg/dL
C. A patient 2 hours post-thyroidectomy complaining of "tightness" in the neck
D. An elderly patient requesting assistance to the bathroom
Correct Answer: C
Rationale: Clinical Judgment Step: Prioritize Hypotheses using ABCs. Complaint of
"tightness" after thyroidectomy suggests possible hematoma formation, which can
compromise airway - an immediate threat to life. This prioritizes over pain (A),
hyperglycemia (B), and elimination needs (D).
Q2: Which task can the RN delegate to an experienced UAP?
A. Assist a stable patient with ambulation
B. Assess a new post-op patient's pain
C. Teach insulin administration
D. Change a sterile dressing
Correct Answer: A
Rationale: Delegation Principle: UAPs can perform non-invasive, routine tasks for stable
patients. Ambulation assistance is within scope. Pain assessment (B), patient
,education (C), and sterile procedures (D) require nursing judgment and cannot be
delegated.
Q3: A nurse notes a medication error was made on the previous shift. What should the
nurse do FIRST?
A. Complete an incident report immediately
B. Notify the nurse manager
C. Assess the patient for adverse effects
D. Call the pharmacist
Correct Answer: C
Rationale: Clinical Judgment Step: Take Action - Patient safety is priority. Before
documentation or notifications, assess for harm. This follows the principle of
immediate patient assessment before administrative tasks.
Q4: During handoff report, which statement is most appropriate?
A. "The patient is fine, nothing new to report"
B. "The patient has a new onset of confusion and vital signs are stable"
C. "The family is demanding and difficult"
D. "I didn't have time to complete the assessment"
Correct Answer: B
Rationale: SBAR Communication: Objective, relevant clinical data. New confusion is
critical information requiring follow-up. Other options are either vague (A), judgmental
(C), or indicate incomplete care (D).
Q5: A patient is receiving oxygen at 4 L/min via nasal cannula. Which finding requires
immediate intervention?
A. Respiratory rate 20/min
B. SpO₂ 92%
C. Lethargy and decreased respiratory rate to 10/min
D. Productive cough
Correct Answer: C
, Rationale: Clinical Judgment Step: Recognize Cues - Oxygen-induced hypoventilation in
COPD patients. Lethargy and decreased RR indicate suppressed respiratory drive -
requires immediate oxygen reduction and assessment.
Q6: Which action demonstrates proper use of restraints?
A. Apply restraints to prevent patient falls
B. Obtain physician order within 1 hour of application
C. Check restraints every 4 hours
D. Use restraints for staff convenience
Correct Answer: B
Rationale: Regulatory Requirement: Physician order required within 1 hour of restraint
application. Restraints cannot be used for falls prevention (A) or staff convenience (D),
and must be checked every 2 hours (C).
Q7: A nurse is preparing to insert an IV. Which action demonstrates proper infection
control?
A. Clean site with alcohol only
B. Use chlorhexidine for skin antisepsis
C. Palpate vein after cleaning
D. Reuse tourniquet without cleaning
Correct Answer: B
Rationale: Evidence-Based Practice: Chlorhexidine is superior to alcohol alone for skin
antisepsis before IV insertion. Site should not be palpated after cleaning (C), and
tourniquets require cleaning between patients (D).
Q8: During medication administration, the patient states "I don't want that pill." What
should the nurse do FIRST?
A. Explain the medication's importance
B. Document the refusal and notify the provider
C. Crush the pill and hide it in applesauce
D. Give the medication anyway