2026 RN -LEADERSHIP FINAL ACTUAL EXAM LATEST
VERSION
2026-2027 140 QUESTION AND CORRECT DETAILED ANSWERS
WITH RATIONALES RATED A GRADE.
QUESTION
A nurse is caring for a patient who has diabetes and gangrene of the lower left
extremity. The nurse accompanies the surgeon when he explains that he will
perform a below-the-knee amputation that will remove the infection. He states
that the patient will receive antibiotics, and go home in a few days. After the
surgeon leaves, the nurse brings in the consent forms and asks the patient to
explain what the surgeon said. The patient states, "Oh, he is going to remove
the infection and give me antibiotics and then I can go home. I feel so much
better now because my other doctor told me they were going to cut off my
leg!" What should the nurse do next?
A. Ask the patient to sign the consent form
B. Draw a picture of a below-the-knee amputation for the patient
C. Tell the patient that she did not hear what her doctor told her
D. Call the surgeon and explain the situation to him
CORRECT ANS: D
Expert Rationale
Informed consent requires that the client fully understands the nature of the
procedure, its risks, benefits, and alternatives. The surgeon is legally and
ethically responsible for obtaining informed consent. The patient's statement
indicates a significant misunderstanding; they believe the surgeon will only
"remove the infection" and not perform an amputation. The nurse's role is to
advocate for the patient and ensure they have the information needed to make
an informed decision. The nurse should call the surgeon (Option D) to explain
the patient's misunderstanding and request that the surgeon return to provide
further clarification. Option A is incorrect because asking the patient to sign the
,consent form without ensuring understanding violates the principles of
informed consent. Option B, drawing a picture, is not within the nurse's scope
and does not replace the surgeon's responsibility. Option C, telling the patient
she misheard, is dismissive and does not address the misunderstanding.
Therefore, the nurse must contact the surgeon to ensure proper informed
consent.
DIF: Cognitive Level: Apply (Application) TOP: Informed Consent and Patient
Advocacy MSC: Safe and Effective Care Environment – Management of Care
QUESTION
A healthcare provider orders an injection for a pediatric patient. The patient's
legal guardian refuses to allow the nurse to administer the medication. The
nurse proceeds to administer the injection. Which action has the nurse
committed?
A. Assault
B. Battery
C. Invasion of privacy
D. False imprisonment
CORRECT ANS: B
Expert Rationale
Battery is the intentional and unauthorized touching of another person without
consent. In this scenario, the nurse administered an injection against the legal
guardian's refusal, constituting battery (Option B). Assault (Option A) is the
threat or attempt to touch another person without consent, which creates fear
of imminent harm; the nurse's action was a physical act, not a threat. Invasion
of privacy (Option C) involves the unauthorized disclosure of private
information. False imprisonment (Option D) is the unjustified restraint of a
person's freedom. Therefore, the nurse's act of administering the injection
without consent is battery.
DIF: Cognitive Level: Understand (Comprehension) TOP: Legal Issues – Battery
MSC: Safe and Effective Care Environment – Management of Care
,QUESTION
A nurse on a busy medical-surgical unit reports for a scheduled shift after
working a double shift yesterday. At the end of this day, two nurses call in, and
the nurse manager tells the nurse that he needs to stay and cover the next
shift. The nurse may refuse to accept an assignment if:
A. He is being asked to care for too many difficult clients
B. He believes his assignment is unsafe
C. He is being asked to work overtime
D. He believes there are not enough nurses to work with him
CORRECT ANS: C
Expert Rationale
Nurses have the right to refuse to work overtime if they believe it would
compromise patient safety or their own well-being. Many facilities have policies
that allow nurses to refuse mandatory overtime, especially if it exceeds safe
work limits. Option C, being asked to work overtime, is a valid reason to refuse.
Option A, caring for too many difficult clients, and Option B, believing the
assignment is unsafe, are concerns that should be reported and addressed
through appropriate channels, but they may not be as straightforward as
refusing overtime. Option D, believing there are not enough nurses, is a staffing
concern but does not automatically justify a refusal. Therefore, the nurse may
refuse to work overtime based on the circumstances.
DIF: Cognitive Level: Apply (Application) TOP: Staffing and Overtime MSC: Safe
and Effective Care Environment – Management of Care
QUESTION
What actions should a nurse initiate if named in a lawsuit? (Select all that
apply.)
A. Respond to the complaint.
B. Never sign a document without showing it to an attorney or legal
, representative.
C. Maintain a file of all meetings and conversations.
D. Withhold information that may be incriminating to you.
CORRECT ANS: A, B, C
Expert Rationale
If a nurse is named in a lawsuit, they should take several steps to protect their
legal interests. Responding to the complaint (Option A) is a legal requirement;
failure to respond can result in a default judgment. The nurse should never sign
any document without first showing it to an attorney or legal representative
(Option B) to ensure they understand the implications. Maintaining a file of all
meetings and conversations (Option C) is crucial for documentation and legal
defense. Option D, withholding incriminating information, is not appropriate; it
is essential to be truthful and cooperative within legal boundaries, but the
nurse should consult with legal counsel before providing any statements or
documents.
DIF: Cognitive Level: Apply (Application) TOP: Legal Issues – Lawsuits and
Documentation MSC: Safe and Effective Care Environment – Management of
Care
QUESTION
A high school graduate who wants to be a nurse is looking online at different
programs in the state. The graduate knows that in order to practice nursing it is
necessary to pass the NCLEX-RN. What is the basic qualification required for
licensure?
A. The individual must complete a minimum of 12 months of study from a
program.
B. The individual must graduate from a school located within their state of
residence.
C. The individual must provide documentation of citizenship.
D. The individual must graduate from an approved nursing program.
CORRECT ANS: D
VERSION
2026-2027 140 QUESTION AND CORRECT DETAILED ANSWERS
WITH RATIONALES RATED A GRADE.
QUESTION
A nurse is caring for a patient who has diabetes and gangrene of the lower left
extremity. The nurse accompanies the surgeon when he explains that he will
perform a below-the-knee amputation that will remove the infection. He states
that the patient will receive antibiotics, and go home in a few days. After the
surgeon leaves, the nurse brings in the consent forms and asks the patient to
explain what the surgeon said. The patient states, "Oh, he is going to remove
the infection and give me antibiotics and then I can go home. I feel so much
better now because my other doctor told me they were going to cut off my
leg!" What should the nurse do next?
A. Ask the patient to sign the consent form
B. Draw a picture of a below-the-knee amputation for the patient
C. Tell the patient that she did not hear what her doctor told her
D. Call the surgeon and explain the situation to him
CORRECT ANS: D
Expert Rationale
Informed consent requires that the client fully understands the nature of the
procedure, its risks, benefits, and alternatives. The surgeon is legally and
ethically responsible for obtaining informed consent. The patient's statement
indicates a significant misunderstanding; they believe the surgeon will only
"remove the infection" and not perform an amputation. The nurse's role is to
advocate for the patient and ensure they have the information needed to make
an informed decision. The nurse should call the surgeon (Option D) to explain
the patient's misunderstanding and request that the surgeon return to provide
further clarification. Option A is incorrect because asking the patient to sign the
,consent form without ensuring understanding violates the principles of
informed consent. Option B, drawing a picture, is not within the nurse's scope
and does not replace the surgeon's responsibility. Option C, telling the patient
she misheard, is dismissive and does not address the misunderstanding.
Therefore, the nurse must contact the surgeon to ensure proper informed
consent.
DIF: Cognitive Level: Apply (Application) TOP: Informed Consent and Patient
Advocacy MSC: Safe and Effective Care Environment – Management of Care
QUESTION
A healthcare provider orders an injection for a pediatric patient. The patient's
legal guardian refuses to allow the nurse to administer the medication. The
nurse proceeds to administer the injection. Which action has the nurse
committed?
A. Assault
B. Battery
C. Invasion of privacy
D. False imprisonment
CORRECT ANS: B
Expert Rationale
Battery is the intentional and unauthorized touching of another person without
consent. In this scenario, the nurse administered an injection against the legal
guardian's refusal, constituting battery (Option B). Assault (Option A) is the
threat or attempt to touch another person without consent, which creates fear
of imminent harm; the nurse's action was a physical act, not a threat. Invasion
of privacy (Option C) involves the unauthorized disclosure of private
information. False imprisonment (Option D) is the unjustified restraint of a
person's freedom. Therefore, the nurse's act of administering the injection
without consent is battery.
DIF: Cognitive Level: Understand (Comprehension) TOP: Legal Issues – Battery
MSC: Safe and Effective Care Environment – Management of Care
,QUESTION
A nurse on a busy medical-surgical unit reports for a scheduled shift after
working a double shift yesterday. At the end of this day, two nurses call in, and
the nurse manager tells the nurse that he needs to stay and cover the next
shift. The nurse may refuse to accept an assignment if:
A. He is being asked to care for too many difficult clients
B. He believes his assignment is unsafe
C. He is being asked to work overtime
D. He believes there are not enough nurses to work with him
CORRECT ANS: C
Expert Rationale
Nurses have the right to refuse to work overtime if they believe it would
compromise patient safety or their own well-being. Many facilities have policies
that allow nurses to refuse mandatory overtime, especially if it exceeds safe
work limits. Option C, being asked to work overtime, is a valid reason to refuse.
Option A, caring for too many difficult clients, and Option B, believing the
assignment is unsafe, are concerns that should be reported and addressed
through appropriate channels, but they may not be as straightforward as
refusing overtime. Option D, believing there are not enough nurses, is a staffing
concern but does not automatically justify a refusal. Therefore, the nurse may
refuse to work overtime based on the circumstances.
DIF: Cognitive Level: Apply (Application) TOP: Staffing and Overtime MSC: Safe
and Effective Care Environment – Management of Care
QUESTION
What actions should a nurse initiate if named in a lawsuit? (Select all that
apply.)
A. Respond to the complaint.
B. Never sign a document without showing it to an attorney or legal
, representative.
C. Maintain a file of all meetings and conversations.
D. Withhold information that may be incriminating to you.
CORRECT ANS: A, B, C
Expert Rationale
If a nurse is named in a lawsuit, they should take several steps to protect their
legal interests. Responding to the complaint (Option A) is a legal requirement;
failure to respond can result in a default judgment. The nurse should never sign
any document without first showing it to an attorney or legal representative
(Option B) to ensure they understand the implications. Maintaining a file of all
meetings and conversations (Option C) is crucial for documentation and legal
defense. Option D, withholding incriminating information, is not appropriate; it
is essential to be truthful and cooperative within legal boundaries, but the
nurse should consult with legal counsel before providing any statements or
documents.
DIF: Cognitive Level: Apply (Application) TOP: Legal Issues – Lawsuits and
Documentation MSC: Safe and Effective Care Environment – Management of
Care
QUESTION
A high school graduate who wants to be a nurse is looking online at different
programs in the state. The graduate knows that in order to practice nursing it is
necessary to pass the NCLEX-RN. What is the basic qualification required for
licensure?
A. The individual must complete a minimum of 12 months of study from a
program.
B. The individual must graduate from a school located within their state of
residence.
C. The individual must provide documentation of citizenship.
D. The individual must graduate from an approved nursing program.
CORRECT ANS: D
