[NURG 260] COMPLETE EXAM QUESTIONS AND
VERIFIED ANSWERS | 2026–2027 LATEST UPDATE |
GUARANTEED PASS | DETAILED RATIONALES |
FULL STUDY GUIDE | EXAM PREP | PRACTICE TEST |
CERTIFICATION PREPARATION
1. A nurse is caring for a postoperative patient who reports increasing pain despite
receiving prescribed analgesics 30 minutes earlier. What should the nurse do first?
A. Notify the healthcare provider immediately
B. Reassess the patient’s pain characteristics and vital signs
C. Document the patient’s complaint in the chart
D. Encourage the patient to wait longer for medication effects
Correct Answer: B. Reassess the patient’s pain characteristics and vital signs
Rationale: The nurse should first reassess the patient to determine pain severity, location,
associated symptoms, and possible complications. Assessment is the foundation of safe
nursing practice and guides further interventions. Option A may become necessary after
reassessment. Option C is important but not the immediate priority. Option D delays
appropriate patient care and may overlook complications.
2. A nurse preparing medications for administration notices that one tablet appears
discolored and chipped. Which action is most appropriate?
A. Administer the medication because the dose remains intact
B. Replace the medication and report the issue per facility policy
C. Crush the medication and administer it with food
D. Ask another nurse whether the medication is still safe to use
Correct Answer: B. Replace the medication and report the issue per facility policy
Rationale: Medications that appear damaged or altered should never be administered because
potency, sterility, or safety may be compromised. Following medication safety protocols
protects patients from adverse outcomes. Options A and C violate medication administration
standards. Option D does not replace the nurse’s professional responsibility to act
appropriately.
3. A patient with chronic heart failure develops sudden shortness of breath and crackles in
both lungs. Which nursing action takes priority?
A. Elevate the head of the bed
B. Encourage oral fluid intake
C. Obtain the patient’s weight
D. Prepare discharge teaching materials
Correct Answer: A. Elevate the head of the bed
,Rationale: Elevating the head of the bed improves lung expansion and decreases respiratory
distress, making it the priority intervention. The patient is likely experiencing fluid overload or
pulmonary edema. Option B may worsen symptoms. Option C is useful for ongoing
monitoring but is not the immediate priority. Option D is inappropriate during acute
instability.
4. A nurse is educating a newly diagnosed diabetic patient about insulin administration.
Which statement by the patient indicates a need for further teaching?
A. “I will rotate injection sites to prevent tissue damage.”
B. “I should store unopened insulin in the refrigerator.”
C. “Cloudy insulin should always be discarded immediately.”
D. “I need to monitor my blood glucose regularly.”
Correct Answer: C. “Cloudy insulin should always be discarded immediately.”
Rationale: Some insulins, such as NPH insulin, are naturally cloudy and should not be
discarded solely for that reason. The patient requires additional education regarding insulin
types. Options A, B, and D reflect accurate diabetes management principles and support
effective certification preparation knowledge.
5. A nurse enters a patient’s room and discovers the patient lying unconscious on the floor.
What is the nurse’s priority action?
A. Complete an incident report
B. Assess responsiveness and activate emergency support if needed
C. Notify the patient’s family
D. Return the patient to bed immediately
Correct Answer: B. Assess responsiveness and activate emergency support if needed
Rationale: Patient safety and emergency assessment take priority. The nurse should assess
airway, breathing, circulation, and responsiveness before other actions. Option A occurs later
according to facility policy. Option C is not the immediate priority. Option D could worsen
injuries if performed before assessment.
6. Which action best demonstrates therapeutic communication during a patient interview?
A. “You should not worry so much about your condition.”
B. “Everything will be fine after surgery.”
C. “Tell me more about how you are feeling today.”
D. “I understand exactly how you feel.”
Correct Answer: C. “Tell me more about how you are feeling today.”
Rationale: Open-ended questions encourage patient expression and foster therapeutic
communication. Option A minimizes patient concerns. Option B offers false reassurance.
Option D assumes the nurse fully understands the patient’s experience, which may not be
accurate.
,7. A patient prescribed an antibiotic develops a rash and swelling of the lips. Which
complication should the nurse suspect?
A. Mild drug intolerance
B. Expected medication side effect
C. Allergic reaction
D. Dehydration
Correct Answer: C. Allergic reaction
Rationale: Rash and lip swelling may indicate an allergic reaction that could progress to
anaphylaxis. Immediate nursing assessment and intervention are required. Options A and B
underestimate the seriousness of symptoms. Option D does not explain the findings.
8. During shift change, which patient should the nurse assess first?
A. A patient requesting assistance with bathing
B. A patient scheduled for discharge later that day
C. A patient with a blood pressure of 88/54 mmHg and dizziness
D. A patient awaiting routine laboratory testing
Correct Answer: C. A patient with a blood pressure of 88/54 mmHg and dizziness
Rationale: Hypotension with dizziness may indicate hemodynamic instability and requires
priority assessment. The nurse should use clinical judgment to address potentially life-
threatening conditions first. The remaining options are stable situations that can safely wait.
9. A nurse is reinforcing infection prevention measures with nursing assistive personnel.
Which statement is correct?
A. Gloves replace the need for hand hygiene
B. Hand hygiene should occur before and after patient contact
C. Standard precautions are used only for patients with known infections
D. Masks are required for all patient interactions
Correct Answer: B. Hand hygiene should occur before and after patient contact
Rationale: Proper hand hygiene remains the most effective method for preventing healthcare-
associated infections. Gloves do not replace hand hygiene. Standard precautions apply to all
patients. Masks are required only in specific circumstances based on transmission risk.
10. A patient with chronic obstructive pulmonary disease is receiving oxygen therapy.
Which finding requires immediate intervention?
A. Oxygen saturation of 92%
B. Respiratory rate of 20 breaths/minute
C. New onset confusion
D. Mild productive cough
Correct Answer: C. New onset confusion
, Rationale: Sudden confusion may indicate hypoxia or carbon dioxide retention and requires
immediate evaluation. Oxygen saturation of 92% may be acceptable for some COPD patients.
Options B and D are not immediately alarming in this scenario.
11. A nurse accidentally administers the wrong medication dose to a patient. What is the
nurse’s first responsibility?
A. Notify risk management
B. Assess the patient for adverse effects
C. Complete a disciplinary statement
D. Avoid documenting the incident until speaking with the provider
Correct Answer: B. Assess the patient for adverse effects
Rationale: Patient safety is always the priority after a medication error. The nurse must assess
the patient immediately to identify any harmful effects. Reporting and documentation occur
afterward according to facility policy. Option D is unethical and unsafe.
12. Which patient statement indicates effective understanding of hypertension
management?
A. “I can stop taking my medication when I feel better.”
B. “Reducing sodium intake may help control my blood pressure.”
C. “Exercise has little effect on hypertension.”
D. “Hypertension only needs treatment during symptoms.”
Correct Answer: B. “Reducing sodium intake may help control my blood pressure.”
Rationale: Sodium reduction is an evidence-based strategy for hypertension management.
Hypertension often requires lifelong treatment even when symptoms are absent. Exercise is
beneficial, and medications should not be stopped without provider guidance.
13. A nurse observes smoke coming from an electrical outlet in a patient room. What
should the nurse do first?
A. Evacuate the entire building immediately
B. Disconnect the patient from monitoring equipment
C. Activate the fire alarm and follow facility fire procedures
D. Open the windows to release smoke
Correct Answer: C. Activate the fire alarm and follow facility fire procedures
Rationale: The nurse should follow established fire response procedures, including activating
the alarm and ensuring safety. Opening windows may increase oxygen flow and worsen the
fire. Full evacuation depends on facility protocols and fire severity.
14. A patient receiving anticoagulant therapy reports black, tarry stools. Which action is
most appropriate?
A. Encourage increased fiber intake
VERIFIED ANSWERS | 2026–2027 LATEST UPDATE |
GUARANTEED PASS | DETAILED RATIONALES |
FULL STUDY GUIDE | EXAM PREP | PRACTICE TEST |
CERTIFICATION PREPARATION
1. A nurse is caring for a postoperative patient who reports increasing pain despite
receiving prescribed analgesics 30 minutes earlier. What should the nurse do first?
A. Notify the healthcare provider immediately
B. Reassess the patient’s pain characteristics and vital signs
C. Document the patient’s complaint in the chart
D. Encourage the patient to wait longer for medication effects
Correct Answer: B. Reassess the patient’s pain characteristics and vital signs
Rationale: The nurse should first reassess the patient to determine pain severity, location,
associated symptoms, and possible complications. Assessment is the foundation of safe
nursing practice and guides further interventions. Option A may become necessary after
reassessment. Option C is important but not the immediate priority. Option D delays
appropriate patient care and may overlook complications.
2. A nurse preparing medications for administration notices that one tablet appears
discolored and chipped. Which action is most appropriate?
A. Administer the medication because the dose remains intact
B. Replace the medication and report the issue per facility policy
C. Crush the medication and administer it with food
D. Ask another nurse whether the medication is still safe to use
Correct Answer: B. Replace the medication and report the issue per facility policy
Rationale: Medications that appear damaged or altered should never be administered because
potency, sterility, or safety may be compromised. Following medication safety protocols
protects patients from adverse outcomes. Options A and C violate medication administration
standards. Option D does not replace the nurse’s professional responsibility to act
appropriately.
3. A patient with chronic heart failure develops sudden shortness of breath and crackles in
both lungs. Which nursing action takes priority?
A. Elevate the head of the bed
B. Encourage oral fluid intake
C. Obtain the patient’s weight
D. Prepare discharge teaching materials
Correct Answer: A. Elevate the head of the bed
,Rationale: Elevating the head of the bed improves lung expansion and decreases respiratory
distress, making it the priority intervention. The patient is likely experiencing fluid overload or
pulmonary edema. Option B may worsen symptoms. Option C is useful for ongoing
monitoring but is not the immediate priority. Option D is inappropriate during acute
instability.
4. A nurse is educating a newly diagnosed diabetic patient about insulin administration.
Which statement by the patient indicates a need for further teaching?
A. “I will rotate injection sites to prevent tissue damage.”
B. “I should store unopened insulin in the refrigerator.”
C. “Cloudy insulin should always be discarded immediately.”
D. “I need to monitor my blood glucose regularly.”
Correct Answer: C. “Cloudy insulin should always be discarded immediately.”
Rationale: Some insulins, such as NPH insulin, are naturally cloudy and should not be
discarded solely for that reason. The patient requires additional education regarding insulin
types. Options A, B, and D reflect accurate diabetes management principles and support
effective certification preparation knowledge.
5. A nurse enters a patient’s room and discovers the patient lying unconscious on the floor.
What is the nurse’s priority action?
A. Complete an incident report
B. Assess responsiveness and activate emergency support if needed
C. Notify the patient’s family
D. Return the patient to bed immediately
Correct Answer: B. Assess responsiveness and activate emergency support if needed
Rationale: Patient safety and emergency assessment take priority. The nurse should assess
airway, breathing, circulation, and responsiveness before other actions. Option A occurs later
according to facility policy. Option C is not the immediate priority. Option D could worsen
injuries if performed before assessment.
6. Which action best demonstrates therapeutic communication during a patient interview?
A. “You should not worry so much about your condition.”
B. “Everything will be fine after surgery.”
C. “Tell me more about how you are feeling today.”
D. “I understand exactly how you feel.”
Correct Answer: C. “Tell me more about how you are feeling today.”
Rationale: Open-ended questions encourage patient expression and foster therapeutic
communication. Option A minimizes patient concerns. Option B offers false reassurance.
Option D assumes the nurse fully understands the patient’s experience, which may not be
accurate.
,7. A patient prescribed an antibiotic develops a rash and swelling of the lips. Which
complication should the nurse suspect?
A. Mild drug intolerance
B. Expected medication side effect
C. Allergic reaction
D. Dehydration
Correct Answer: C. Allergic reaction
Rationale: Rash and lip swelling may indicate an allergic reaction that could progress to
anaphylaxis. Immediate nursing assessment and intervention are required. Options A and B
underestimate the seriousness of symptoms. Option D does not explain the findings.
8. During shift change, which patient should the nurse assess first?
A. A patient requesting assistance with bathing
B. A patient scheduled for discharge later that day
C. A patient with a blood pressure of 88/54 mmHg and dizziness
D. A patient awaiting routine laboratory testing
Correct Answer: C. A patient with a blood pressure of 88/54 mmHg and dizziness
Rationale: Hypotension with dizziness may indicate hemodynamic instability and requires
priority assessment. The nurse should use clinical judgment to address potentially life-
threatening conditions first. The remaining options are stable situations that can safely wait.
9. A nurse is reinforcing infection prevention measures with nursing assistive personnel.
Which statement is correct?
A. Gloves replace the need for hand hygiene
B. Hand hygiene should occur before and after patient contact
C. Standard precautions are used only for patients with known infections
D. Masks are required for all patient interactions
Correct Answer: B. Hand hygiene should occur before and after patient contact
Rationale: Proper hand hygiene remains the most effective method for preventing healthcare-
associated infections. Gloves do not replace hand hygiene. Standard precautions apply to all
patients. Masks are required only in specific circumstances based on transmission risk.
10. A patient with chronic obstructive pulmonary disease is receiving oxygen therapy.
Which finding requires immediate intervention?
A. Oxygen saturation of 92%
B. Respiratory rate of 20 breaths/minute
C. New onset confusion
D. Mild productive cough
Correct Answer: C. New onset confusion
, Rationale: Sudden confusion may indicate hypoxia or carbon dioxide retention and requires
immediate evaluation. Oxygen saturation of 92% may be acceptable for some COPD patients.
Options B and D are not immediately alarming in this scenario.
11. A nurse accidentally administers the wrong medication dose to a patient. What is the
nurse’s first responsibility?
A. Notify risk management
B. Assess the patient for adverse effects
C. Complete a disciplinary statement
D. Avoid documenting the incident until speaking with the provider
Correct Answer: B. Assess the patient for adverse effects
Rationale: Patient safety is always the priority after a medication error. The nurse must assess
the patient immediately to identify any harmful effects. Reporting and documentation occur
afterward according to facility policy. Option D is unethical and unsafe.
12. Which patient statement indicates effective understanding of hypertension
management?
A. “I can stop taking my medication when I feel better.”
B. “Reducing sodium intake may help control my blood pressure.”
C. “Exercise has little effect on hypertension.”
D. “Hypertension only needs treatment during symptoms.”
Correct Answer: B. “Reducing sodium intake may help control my blood pressure.”
Rationale: Sodium reduction is an evidence-based strategy for hypertension management.
Hypertension often requires lifelong treatment even when symptoms are absent. Exercise is
beneficial, and medications should not be stopped without provider guidance.
13. A nurse observes smoke coming from an electrical outlet in a patient room. What
should the nurse do first?
A. Evacuate the entire building immediately
B. Disconnect the patient from monitoring equipment
C. Activate the fire alarm and follow facility fire procedures
D. Open the windows to release smoke
Correct Answer: C. Activate the fire alarm and follow facility fire procedures
Rationale: The nurse should follow established fire response procedures, including activating
the alarm and ensuring safety. Opening windows may increase oxygen flow and worsen the
fire. Full evacuation depends on facility protocols and fire severity.
14. A patient receiving anticoagulant therapy reports black, tarry stools. Which action is
most appropriate?
A. Encourage increased fiber intake
