RN Patient Safety Competency Exam —
Code: RN-PS-COMP | 100-Question
Advanced Practice Exam 2026 |
Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1.
A postoperative patient becomes acutely confused, attempts to climb out of bed,
and has an oxygen saturation of 88% on room air. Which action should the nurse
take first?
A. Apply wrist restraints
B. Administer the prescribed PRN sedative
C. Assess airway and oxygenation and apply oxygen as indicated
D. Ask the family to remain at the bedside
Answer: C. Assess airway and oxygenation and apply oxygen as indicated
,Rationale: Acute confusion may result from hypoxemia. Airway and breathing
take priority under the ABC framework. Restraints or sedation could worsen
respiratory compromise and should not be used before reversible physiologic
causes are addressed.
2.
A nurse receives a medication order that appears to contain an unusually high
dose of an opioid. The electronic system does not flag the order. What is the
nurse's best action?
A. Administer the medication because the electronic system approved it
B. Reduce the dose independently
C. Clarify the prescription with the prescriber before administration
D. Ask another nurse to administer it
Answer: C. Clarify the prescription with the prescriber before administration
Rationale: Nurses remain responsible for identifying potentially unsafe orders
even when electronic safeguards do not generate an alert. The prescription
should be clarified before the medication is administered.
3.
A patient with limited English proficiency is being prepared for a high-risk
procedure. The patient's adult child offers to interpret. What is the safest nursing
action?
A. Use the child because the patient knows the child
B. Use a qualified medical interpreter
C. Proceed if the patient nods appropriately
D. Ask another bilingual patient to interpret
Answer: B. Use a qualified medical interpreter
,Rationale: A qualified interpreter improves accuracy, confidentiality, and
informed decision-making. Family members may unintentionally omit, alter, or
misunderstand clinically important information.
4.
A nurse discovers that a patient's identification band is missing immediately
before medication administration. What should the nurse do?
A. Verify the patient's name verbally and administer the medication
B. Ask another nurse to confirm the patient's identity
C. Stop and obtain a replacement identification band before administering the
medication
D. Compare the room number with the medication administration record
Answer: C. Stop and obtain a replacement identification band before
administering the medication
Rationale: Reliable patient identification requires approved identifiers rather
than room location alone. The nurse should correct the identification problem
before proceeding.
5.
A patient receiving a continuous IV heparin infusion develops a sudden drop in
blood pressure and new flank pain. What is the nurse's priority?
A. Increase the infusion rate
B. Assess for possible hemorrhage and notify the appropriate provider
C. Encourage oral fluids
D. Administer the next scheduled anticoagulant dose
Answer: B. Assess for possible hemorrhage and notify the appropriate provider
, Rationale: Hypotension and flank pain in a patient receiving anticoagulation
may indicate serious internal bleeding. Immediate assessment and escalation
are required.
6.
A nurse is caring for a patient at high risk for falls. Which intervention provides
the strongest safety benefit?
A. Keep all four side rails raised
B. Place the call light within reach and implement individualized fall precautions
C. Tell the patient not to get out of bed
D. Keep the room dark at night
Answer: B. Place the call light within reach and implement individualized fall
precautions
Rationale: Fall prevention should address the patient's specific risks, including
access to assistance, mobility limitations, environmental hazards, and
medication effects. Four side rails may function as a restraint and are not
routinely appropriate.
7.
A nurse finds an unattended syringe labeled only “insulin” on a medication
preparation counter. What should the nurse do?
A. Administer it if the syringe volume appears correct
B. Ask nearby nurses who prepared it and administer it if identified
C. Discard it according to facility policy and obtain a properly prepared, labeled
dose
D. Place it in the medication refrigerator
Code: RN-PS-COMP | 100-Question
Advanced Practice Exam 2026 |
Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1.
A postoperative patient becomes acutely confused, attempts to climb out of bed,
and has an oxygen saturation of 88% on room air. Which action should the nurse
take first?
A. Apply wrist restraints
B. Administer the prescribed PRN sedative
C. Assess airway and oxygenation and apply oxygen as indicated
D. Ask the family to remain at the bedside
Answer: C. Assess airway and oxygenation and apply oxygen as indicated
,Rationale: Acute confusion may result from hypoxemia. Airway and breathing
take priority under the ABC framework. Restraints or sedation could worsen
respiratory compromise and should not be used before reversible physiologic
causes are addressed.
2.
A nurse receives a medication order that appears to contain an unusually high
dose of an opioid. The electronic system does not flag the order. What is the
nurse's best action?
A. Administer the medication because the electronic system approved it
B. Reduce the dose independently
C. Clarify the prescription with the prescriber before administration
D. Ask another nurse to administer it
Answer: C. Clarify the prescription with the prescriber before administration
Rationale: Nurses remain responsible for identifying potentially unsafe orders
even when electronic safeguards do not generate an alert. The prescription
should be clarified before the medication is administered.
3.
A patient with limited English proficiency is being prepared for a high-risk
procedure. The patient's adult child offers to interpret. What is the safest nursing
action?
A. Use the child because the patient knows the child
B. Use a qualified medical interpreter
C. Proceed if the patient nods appropriately
D. Ask another bilingual patient to interpret
Answer: B. Use a qualified medical interpreter
,Rationale: A qualified interpreter improves accuracy, confidentiality, and
informed decision-making. Family members may unintentionally omit, alter, or
misunderstand clinically important information.
4.
A nurse discovers that a patient's identification band is missing immediately
before medication administration. What should the nurse do?
A. Verify the patient's name verbally and administer the medication
B. Ask another nurse to confirm the patient's identity
C. Stop and obtain a replacement identification band before administering the
medication
D. Compare the room number with the medication administration record
Answer: C. Stop and obtain a replacement identification band before
administering the medication
Rationale: Reliable patient identification requires approved identifiers rather
than room location alone. The nurse should correct the identification problem
before proceeding.
5.
A patient receiving a continuous IV heparin infusion develops a sudden drop in
blood pressure and new flank pain. What is the nurse's priority?
A. Increase the infusion rate
B. Assess for possible hemorrhage and notify the appropriate provider
C. Encourage oral fluids
D. Administer the next scheduled anticoagulant dose
Answer: B. Assess for possible hemorrhage and notify the appropriate provider
, Rationale: Hypotension and flank pain in a patient receiving anticoagulation
may indicate serious internal bleeding. Immediate assessment and escalation
are required.
6.
A nurse is caring for a patient at high risk for falls. Which intervention provides
the strongest safety benefit?
A. Keep all four side rails raised
B. Place the call light within reach and implement individualized fall precautions
C. Tell the patient not to get out of bed
D. Keep the room dark at night
Answer: B. Place the call light within reach and implement individualized fall
precautions
Rationale: Fall prevention should address the patient's specific risks, including
access to assistance, mobility limitations, environmental hazards, and
medication effects. Four side rails may function as a restraint and are not
routinely appropriate.
7.
A nurse finds an unattended syringe labeled only “insulin” on a medication
preparation counter. What should the nurse do?
A. Administer it if the syringe volume appears correct
B. Ask nearby nurses who prepared it and administer it if identified
C. Discard it according to facility policy and obtain a properly prepared, labeled
dose
D. Place it in the medication refrigerator
