1
NSG 4800 Comps Exam ACTUAL EXAM
SIMULATION | 100 Questions with Verified
Answers and Comprehensive Rationales
Section 1: Leadership, Delegation, & Professional Concepts
1. A nurse manager observes that staff morale is low and nurses are leaving the unit at high rates.
Which leadership action would BEST address this situation?
a. Implement strict disciplinary policies to improve performance.
b. Conduct staff surveys and hold regular meetings to identify and address concerns.
c. Increase patient assignments to keep staff busy.
d. Ignore the situation and allow it to resolve naturally.
2. A registered nurse (RN) is preparing to delegate tasks to a licensed practical nurse (LPN) and a UAP.
Which task is MOST appropriate to assign to the LPN?
a. Developing the patient's plan of care.
b. Administering a scheduled oral medication to a stable patient.
c. Performing an admission assessment.
d. Providing discharge education to a newly diagnosed diabetic.
3. A charge nurse is making assignments for the oncoming shift. Which of the following clients should
be assigned to an RN rather than an LPN?
a. A stable client with a new diagnosis of diabetes.
b. A client receiving a continuous tube feeding.
c. A client who is post-op day 2 and requires a sterile dressing change.
d. A client who is post-op day 1 following a Whipple procedure.
4. A nurse is caring for a client who is not behaving and repeatedly tries to get out of bed. The nurse
states, "I will need to put restraints on you if you keep getting up." Legally, this statement is an
example of:
a. Battery
b. Assault
c. False imprisonment
d. Negligence
5. The nurse is evaluating a new graduate's understanding of the 5 rights of delegation. Which
statement by the new graduate indicates a need for further teaching?
a. "I must ensure the task is within the scope of practice for the person I am delegating to."
,2
b. "I need to provide clear direction and communication about the task."
c. "Once I delegate the task, I am no longer accountable for it."
d. "I must provide appropriate supervision and evaluation."
6. A home health nurse is assessing a client for hospice eligibility. The nurse should recommend
hospice care for a client who:
a. Has a chronic condition and needs assistance with meal preparation.
b. Has terminal cancer with a life expectancy of less than 6 months and needs pain management.
c. Is recovering from a hip fracture and needs physical therapy.
d. Has end-stage renal disease and is awaiting a kidney transplant.
7. A nurse is caring for a patient who is scheduled for a procedure. The patient has questions about
the risks. Who is responsible for explaining the procedure's risks, benefits, and alternatives?
a. The registered nurse
b. The healthcare provider performing the procedure
c. The charge nurse
d. The hospital's risk manager
8. Which of the following situations does NOT require informed consent?
a. A scheduled elective cholecystectomy.
b. Administration of a blood transfusion.
c. An unconscious patient requiring emergency surgery to control internal bleeding.
d. A patient undergoing chemotherapy.
9. The nurse is working with an unlicensed assistive personnel (UAP). Which task can the nurse safely
delegate to the UAP?
a. Administering a subcutaneous injection of insulin.
b. Measuring and recording the output from a Foley catheter.
c. Suctioning a tracheostomy that was placed 3 days ago.
d. Performing a focused assessment on a client with new onset of chest pain.
10. A nurse is preparing to administer a medication and notices the dosage is higher than usual. Using
the nursing process, what is the first action the nurse should take?
a. Administer the medication as prescribed, as the provider knows best.
b. Call the pharmacy to verify the dose is correct.
c. Call the healthcare provider to clarify the prescription.
d. Document the concern in the chart after giving the medication.
11. A nurse observes a coworker taking a controlled substance from the medication dispensing system
for a patient but suspects the coworker diverted the medication for personal use. What is the nurse's
priority action?
a. Confront the coworker directly.
b. Report the observation to the nurse manager or supervisor immediately.
c. Document the observation in the patient's medical record.
d. Discuss the suspicion with another coworker to validate the concern.
,3
12. A patient asks the nurse to promise not to tell anyone about a secret. The nurse's BEST response
is:
a. "Of course, everything you tell me is confidential."
b. "I can keep a secret as long as it does not involve harm to yourself or others."
c. "I'm sorry, but as a nurse, I have a duty to report information that may affect your health or the safety
of others."
d. "You can trust me. I won't write anything down."
13. A nurse is documenting in a patient's electronic health record (EHR). Which action is appropriate?
a. Documenting for a coworker who is busy with another patient.
b. Sharing her personal password with a new orientee to help them log in.
c. Leaving the computer screen open with the patient's chart visible while answering a call light.
d. Recording the assessment findings immediately after completing the assessment.
14. A charge nurse is observing a newly licensed nurse perform a sterile dressing change. Which action
by the new nurse indicates a break in sterile technique?
a. Holding the sterile field below waist level.
b. Pouring sterile solution from a bottle with the label facing up.
c. Opening the sterile package away from the body.
d. Keeping hands above the waist and away from the sterile field.
15. A nurse is caring for a client who is a Jehovah's Witness and has a severe anemia. The client
refuses a blood transfusion. What is the nurse's priority action?
a. Respect the client's decision and explore alternative treatments with the healthcare team.
b. Explain to the client that without the transfusion, they will likely die.
c. Ask the client's family to convince them to accept the blood.
d. Administer the blood transfusion because it is a life-saving measure.
16. The nurse is participating in a performance improvement project to reduce hospital-acquired
pressure injuries. This activity is an example of:
a. Quality improvement (QI)
b. Nursing research
c. Evidence-based practice (EBP)
d. A randomized controlled trial
17. A nurse receives a phone call from a patient's neighbor who is asking for an update on the
patient's condition. What is the nurse's best response?
a. "The patient is stable and resting comfortably."
b. "I cannot provide any information about a patient to anyone without the patient's explicit consent."
c. "Let me get the chart and I will give you a brief update."
d. "You should call the patient's family for that information."
18. A patient with terminal cancer tells the nurse, "I've lived a good life. I'm ready to go, but I'm
worried my family isn't ready." The nurse's most therapeutic response is:
a. "Don't worry, your family will be fine."
b. "Tell me more about your concerns for your family."
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c. "You should focus on yourself right now, not your family."
d. "It's common for families to have a hard time with this."
19. A nurse is educating a patient about advance directives. Which statement by the patient indicates
a correct understanding?
a. "An advance directive allows my family to make all medical decisions for me."
b. "A living will outlines my wishes for medical treatment if I become incapacitated."
c. "Once I sign a living will, I cannot change my mind."
d. "A durable power of attorney for healthcare is only for financial matters."
20. A nurse is caring for a patient who speaks a different language. The patient's family member offers
to interpret. What is the nurse's BEST action?
a. Allow the family member to interpret to facilitate communication.
b. Use a facility-approved medical interpreter service.
c. Use a phone app to translate the conversation.
d. Speak slowly and loudly in English, using gestures.
21. A nurse is reviewing the medical record of a client. The client has designated a durable power of
attorney for healthcare. The nurse understands that this person:
a. Manages the client's finances.
b. Makes healthcare decisions for the client when the client is unable to do so.
c. Is automatically the executor of the client's will.
d. Can only make decisions if the client is in a coma.
22. A nurse is caring for a client who has a history of falls and dementia. The nurse places the client in
a chair with a safety alarm. After the alarm sounds, the family hears the nurse say, "I will need to put
restraints on you if you keep sounding the alarm." The nurse's statement is an example of:
a. Battery
b. Assault
c. False imprisonment
d. Libel
23. The nurse is caring for a client who is 2 days post-op from a bowel resection. The client reports
feeling "something pop" when they coughed. The nurse assesses the incision and notes a loop of
bowel protruding. What is the priority nursing action?
a. Notify the surgeon immediately.
b. Gently push the bowel back into the wound.
c. Cover the wound with a sterile, saline-moistened dressing.
d. Place the client in a high-Fowler's position.
24. A nurse is preparing to administer a unit of packed red blood cells to a client. What is the most
important nursing action?
a. Warm the blood in a microwave for 30 seconds before infusion.
b. Verify the blood product with another licensed nurse at the bedside.
c. Start the blood transfusion with lactated Ringer's (LR) solution.
d. Obtain the patient's blood pressure every hour during the transfusion.
NSG 4800 Comps Exam ACTUAL EXAM
SIMULATION | 100 Questions with Verified
Answers and Comprehensive Rationales
Section 1: Leadership, Delegation, & Professional Concepts
1. A nurse manager observes that staff morale is low and nurses are leaving the unit at high rates.
Which leadership action would BEST address this situation?
a. Implement strict disciplinary policies to improve performance.
b. Conduct staff surveys and hold regular meetings to identify and address concerns.
c. Increase patient assignments to keep staff busy.
d. Ignore the situation and allow it to resolve naturally.
2. A registered nurse (RN) is preparing to delegate tasks to a licensed practical nurse (LPN) and a UAP.
Which task is MOST appropriate to assign to the LPN?
a. Developing the patient's plan of care.
b. Administering a scheduled oral medication to a stable patient.
c. Performing an admission assessment.
d. Providing discharge education to a newly diagnosed diabetic.
3. A charge nurse is making assignments for the oncoming shift. Which of the following clients should
be assigned to an RN rather than an LPN?
a. A stable client with a new diagnosis of diabetes.
b. A client receiving a continuous tube feeding.
c. A client who is post-op day 2 and requires a sterile dressing change.
d. A client who is post-op day 1 following a Whipple procedure.
4. A nurse is caring for a client who is not behaving and repeatedly tries to get out of bed. The nurse
states, "I will need to put restraints on you if you keep getting up." Legally, this statement is an
example of:
a. Battery
b. Assault
c. False imprisonment
d. Negligence
5. The nurse is evaluating a new graduate's understanding of the 5 rights of delegation. Which
statement by the new graduate indicates a need for further teaching?
a. "I must ensure the task is within the scope of practice for the person I am delegating to."
,2
b. "I need to provide clear direction and communication about the task."
c. "Once I delegate the task, I am no longer accountable for it."
d. "I must provide appropriate supervision and evaluation."
6. A home health nurse is assessing a client for hospice eligibility. The nurse should recommend
hospice care for a client who:
a. Has a chronic condition and needs assistance with meal preparation.
b. Has terminal cancer with a life expectancy of less than 6 months and needs pain management.
c. Is recovering from a hip fracture and needs physical therapy.
d. Has end-stage renal disease and is awaiting a kidney transplant.
7. A nurse is caring for a patient who is scheduled for a procedure. The patient has questions about
the risks. Who is responsible for explaining the procedure's risks, benefits, and alternatives?
a. The registered nurse
b. The healthcare provider performing the procedure
c. The charge nurse
d. The hospital's risk manager
8. Which of the following situations does NOT require informed consent?
a. A scheduled elective cholecystectomy.
b. Administration of a blood transfusion.
c. An unconscious patient requiring emergency surgery to control internal bleeding.
d. A patient undergoing chemotherapy.
9. The nurse is working with an unlicensed assistive personnel (UAP). Which task can the nurse safely
delegate to the UAP?
a. Administering a subcutaneous injection of insulin.
b. Measuring and recording the output from a Foley catheter.
c. Suctioning a tracheostomy that was placed 3 days ago.
d. Performing a focused assessment on a client with new onset of chest pain.
10. A nurse is preparing to administer a medication and notices the dosage is higher than usual. Using
the nursing process, what is the first action the nurse should take?
a. Administer the medication as prescribed, as the provider knows best.
b. Call the pharmacy to verify the dose is correct.
c. Call the healthcare provider to clarify the prescription.
d. Document the concern in the chart after giving the medication.
11. A nurse observes a coworker taking a controlled substance from the medication dispensing system
for a patient but suspects the coworker diverted the medication for personal use. What is the nurse's
priority action?
a. Confront the coworker directly.
b. Report the observation to the nurse manager or supervisor immediately.
c. Document the observation in the patient's medical record.
d. Discuss the suspicion with another coworker to validate the concern.
,3
12. A patient asks the nurse to promise not to tell anyone about a secret. The nurse's BEST response
is:
a. "Of course, everything you tell me is confidential."
b. "I can keep a secret as long as it does not involve harm to yourself or others."
c. "I'm sorry, but as a nurse, I have a duty to report information that may affect your health or the safety
of others."
d. "You can trust me. I won't write anything down."
13. A nurse is documenting in a patient's electronic health record (EHR). Which action is appropriate?
a. Documenting for a coworker who is busy with another patient.
b. Sharing her personal password with a new orientee to help them log in.
c. Leaving the computer screen open with the patient's chart visible while answering a call light.
d. Recording the assessment findings immediately after completing the assessment.
14. A charge nurse is observing a newly licensed nurse perform a sterile dressing change. Which action
by the new nurse indicates a break in sterile technique?
a. Holding the sterile field below waist level.
b. Pouring sterile solution from a bottle with the label facing up.
c. Opening the sterile package away from the body.
d. Keeping hands above the waist and away from the sterile field.
15. A nurse is caring for a client who is a Jehovah's Witness and has a severe anemia. The client
refuses a blood transfusion. What is the nurse's priority action?
a. Respect the client's decision and explore alternative treatments with the healthcare team.
b. Explain to the client that without the transfusion, they will likely die.
c. Ask the client's family to convince them to accept the blood.
d. Administer the blood transfusion because it is a life-saving measure.
16. The nurse is participating in a performance improvement project to reduce hospital-acquired
pressure injuries. This activity is an example of:
a. Quality improvement (QI)
b. Nursing research
c. Evidence-based practice (EBP)
d. A randomized controlled trial
17. A nurse receives a phone call from a patient's neighbor who is asking for an update on the
patient's condition. What is the nurse's best response?
a. "The patient is stable and resting comfortably."
b. "I cannot provide any information about a patient to anyone without the patient's explicit consent."
c. "Let me get the chart and I will give you a brief update."
d. "You should call the patient's family for that information."
18. A patient with terminal cancer tells the nurse, "I've lived a good life. I'm ready to go, but I'm
worried my family isn't ready." The nurse's most therapeutic response is:
a. "Don't worry, your family will be fine."
b. "Tell me more about your concerns for your family."
, 4
c. "You should focus on yourself right now, not your family."
d. "It's common for families to have a hard time with this."
19. A nurse is educating a patient about advance directives. Which statement by the patient indicates
a correct understanding?
a. "An advance directive allows my family to make all medical decisions for me."
b. "A living will outlines my wishes for medical treatment if I become incapacitated."
c. "Once I sign a living will, I cannot change my mind."
d. "A durable power of attorney for healthcare is only for financial matters."
20. A nurse is caring for a patient who speaks a different language. The patient's family member offers
to interpret. What is the nurse's BEST action?
a. Allow the family member to interpret to facilitate communication.
b. Use a facility-approved medical interpreter service.
c. Use a phone app to translate the conversation.
d. Speak slowly and loudly in English, using gestures.
21. A nurse is reviewing the medical record of a client. The client has designated a durable power of
attorney for healthcare. The nurse understands that this person:
a. Manages the client's finances.
b. Makes healthcare decisions for the client when the client is unable to do so.
c. Is automatically the executor of the client's will.
d. Can only make decisions if the client is in a coma.
22. A nurse is caring for a client who has a history of falls and dementia. The nurse places the client in
a chair with a safety alarm. After the alarm sounds, the family hears the nurse say, "I will need to put
restraints on you if you keep sounding the alarm." The nurse's statement is an example of:
a. Battery
b. Assault
c. False imprisonment
d. Libel
23. The nurse is caring for a client who is 2 days post-op from a bowel resection. The client reports
feeling "something pop" when they coughed. The nurse assesses the incision and notes a loop of
bowel protruding. What is the priority nursing action?
a. Notify the surgeon immediately.
b. Gently push the bowel back into the wound.
c. Cover the wound with a sterile, saline-moistened dressing.
d. Place the client in a high-Fowler's position.
24. A nurse is preparing to administer a unit of packed red blood cells to a client. What is the most
important nursing action?
a. Warm the blood in a microwave for 30 seconds before infusion.
b. Verify the blood product with another licensed nurse at the bedside.
c. Start the blood transfusion with lactated Ringer's (LR) solution.
d. Obtain the patient's blood pressure every hour during the transfusion.
