RN COMPREHENSIVE PREDICTOR 2026/2027 | 180
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Section 1: Safe & Effective Care Environment - Management of
Care (Q1-32)
Q1. A nurse manager on a medical-surgical unit has four patients and three staff
members: one RN, one LPN, and one UAP. Which task is most appropriate to
delegate to the UAP?
A. Administering oral medications to a stable patient
B. Obtaining vital signs on a patient 2 hours post-op
C. Assessing a new admission's lung sounds
D. Teaching a newly diagnosed diabetic about insulin administration
B. Obtaining vital signs on a patient 2 hours post-op [CORRECT]
Rationale: UAPs may perform routine, non-invasive tasks such as vital signs on stable
patients. Medication administration, patient assessment, and patient teaching require
nursing judgment and cannot be delegated to UAPs per state nurse practice acts.
Correct Answer: B
Q2. A patient with terminal cancer expresses a desire to refuse further chemotherapy.
The patient's adult children insist the nurse convince the patient to continue
treatment. What is the nurse's priority action?
A. Arrange a family conference to persuade the patient
B. Honor the patient's autonomous decision and ensure advance directives are
documented
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C. Contact the hospital ethics committee to override the patient's decision
D. Ask the physician to speak with the children without the patient present
B. Honor the patient's autonomous decision and ensure advance directives are
documented [CORRECT]
Rationale: Patient autonomy is a fundamental ethical principle. A competent adult
has the right to refuse treatment. The nurse must support the patient's decision,
verify capacity, and ensure advance directives reflect the patient's wishes.
Correct Answer: B
Q3. During a code blue, the nurse notices a visitor recording the resuscitation on a
smartphone. What is the nurse's appropriate action?
A. Ignore the recording because the visitor is in a public hallway
B. Ask the visitor to stop and contact security if they refuse
C. Allow the recording because HIPAA does not apply to visitors
D. Confiscate the visitor's phone immediately
B. Ask the visitor to stop and contact security if they refuse [CORRECT]
Rationale: Recording medical procedures without consent violates patient privacy
rights and hospital policy. The nurse should calmly request cessation and escalate to
security if needed. Physical confiscation is not within the nurse's authority.
Correct Answer: B
Q4. A nurse receives a telephone order from a physician for a new medication. What
is the correct sequence of actions?
A. Write the order, implement it, then read it back to the physician
B. Write the order, read it back to the physician for verification, then document
C. Implement the order immediately, then document and read it back
D. Document the order first, then read it back and implement
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B. Write the order, read it back to the physician for verification, then document
[CORRECT]
Rationale: The Joint Commission requires read-back verification for all telephone
orders. The nurse must write down the order, read it back verbatim for confirmation,
and then document the order, date, time, and physician name.
Correct Answer: B
Q5. A nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient scheduled for discharge in 2 hours
B. A patient reporting chest pain rated 8/10
C. A patient requesting a PRN sleep medication
D. A patient whose IV infusion is 30 minutes behind schedule
B. A patient reporting chest pain rated 8/10 [CORRECT]
Rationale: Chest pain may indicate a life-threatening cardiac event requiring
immediate assessment and intervention. Using Maslow's hierarchy and ABC priorities,
potential airway/breathing/circulation issues take precedence over comfort or
scheduling concerns.
Correct Answer: B
Q6. An LPN has been working on a unit for 5 years. Which task is within the LPN's
scope of practice?
A. Developing a plan of care for a newly admitted patient
B. Administering IV push morphine to a postoperative patient
C. Performing sterile dressing changes on a stable wound
D. Analyzing blood gas results and adjusting ventilator settings
C. Performing sterile dressing changes on a stable wound [CORRECT]
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Rationale: LPNs may perform sterile procedures on stable patients, administer oral
and some IV medications per facility policy, and provide basic care. Care planning, IV
push medications, and complex analysis requiring nursing judgment remain RN
responsibilities.
Correct Answer: C
Q7. A nurse discovers that a colleague documented a medication administration that
was not actually given. What is the nurse's legal obligation?
A. Confront the colleague privately and request correction
B. Report the incident to the nurse manager as a potential medication error
C. Document the missed dose in the patient's record without mentioning the
colleague
D. Ignore it unless the patient experiences harm
B. Report the incident to the nurse manager as a potential medication error
[CORRECT]
Rationale: Falsifying medical records is fraud and patient endangerment. The nurse
has an ethical and legal duty to report through appropriate channels. Covering up or
ignoring falsification makes the nurse complicit and liable.
Correct Answer: B
Q8. A patient is admitted with a DNR order from a previous hospitalization. The
family demands full resuscitation. What is the nurse's first action?
A. Initiate CPR immediately per family request
B. Verify the DNR order and contact the attending physician to discuss with the
family
C. Honor the DNR and refuse to call the physician
D. Transfer care to another nurse who is comfortable with DNR orders