REx-PN ACTUAL EXAM 2026 NEWEST EXAM PREP
COMPLETE QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES | ALREADY GRADED A+|
|BRAND NEW VERSION!!
SECTION 1: MANAGEMENT OF CARE (Questions 1-52)
Question 1
The nurse is prioritizing care for four clients. Which client should the nurse
assess first?
A) A client with diabetes mellitus requesting pain medication
B) A client with pneumonia who has an oxygen saturation of 88% on room air
C) A client who needs assistance with ambulation
D) A client requesting discharge instructions
Answer: B
Rationale: The client with an oxygen saturation of 88% is experiencing hypoxia
and requires immediate assessment and intervention. Airway and breathing are
always the priority using the ABC framework. Pain management, ambulation
assistance, and discharge teaching can be addressed after the client with
respiratory compromise is stabilized.
Question 2
The practical nurse is delegating tasks to unregulated care providers (UCPs).
Which task is appropriate to delegate?
A) Administering oral medications
B) Performing a sterile wound dressing change
C) Assisting a client with bathing and grooming
D) Assessing a client's lung sounds
Answer: C
Rationale: Assisting with bathing and grooming is within the scope of practice
for unregulated care providers. Administration of medications, sterile
procedures, and assessments are nursing responsibilities that require clinical
judgment and cannot be delegated to UCPs. The nurse retains accountability for
1
,delegated tasks.
Question 3
The nurse is caring for a client who has an advance directive. Which action by
the nurse demonstrates appropriate integration of this directive into the care
plan?
A) Placing the advance directive in the client's chart without further action
B) Discussing the advance directive with the client's family only
C) Ensuring the care team is aware of the client's wishes regarding
life-sustaining treatment
D) Following the advance directive only if the client becomes unconscious
Answer: C
Rationale: The nurse should ensure that the entire healthcare team is aware of
the client's advance directive and that the client's wishes are respected in the
care plan. Advance directives should be incorporated into ongoing care
discussions, not just placed in the chart or discussed only with family.
Question 4
A client states, "I want to leave the hospital against medical advice." Which
action should the nurse take first?
A) Inform the client that they cannot leave without a physician's order
B) Notify the healthcare provider immediately
C) Ask the client to sign an Against Medical Advice (AMA) form
D) Discuss the client's concerns and reasons for wanting to leave
Answer: D
Rationale: The nurse should first explore the client's reasons for wanting to
leave. Understanding the client's concerns allows the nurse to address issues,
provide education, and potentially prevent AMA discharge. Clients have the right
to leave, but the nurse must ensure they understand the risks and document the
discussion.
2
,Question 5
The nurse is participating in a quality improvement initiative. Which action is
appropriate?
A) Reporting a medication error that occurred on the unit
B) Ignoring a near-miss event because no harm occurred
C) Failing to document an incident
D) Discouraging staff from reporting errors
Answer: A
Rationale: Reporting errors and near-misses is essential for quality improvement
and patient safety. The nurse should report identified client care issues to
appropriate personnel and participate in performance improvement projects.
Ignoring errors or near-misses prevents learning and system improvements.
Question 6
The nurse is caring for a client who has a "Do Not Resuscitate" (DNR) order.
Which action by the nurse is correct?
A) Ignore the DNR order if the client's family requests resuscitation
B) Follow the DNR order if the client experiences cardiac arrest
C) Resuscitate the client regardless of the DNR order
D) Ask the family to sign a new DNR order each day
Answer: B
Rationale: The nurse must follow the DNR order as documented in the client's
chart. A DNR order is a legal directive that should be respected unless there is
a new order. The family cannot override a valid DNR order without a
physician's order.
Question 7
The nurse is providing care to a client who is confused and attempting to remove
their IV line. Which intervention should the nurse implement first?
A) Apply wrist restraints
B) Request a sitter from the nursing supervisor
3
, C) Assess the client's need for alternative interventions (e.g., mitts,
distraction, reorientation)
D) Notify the healthcare provider for an order for chemical restraints
Answer: C
Rationale: The nurse should first assess the client's behavior and attempt less
restrictive interventions such as reorientation, distraction, or padded mitts.
Restraints should be used only as a last resort when other interventions have
failed and the client is at risk for harm. Restraint use requires a physician's
order and frequent monitoring.
Question 8
The nurse is caring for a client who is scheduled for surgery. The client
states, "I'm not sure I want to go through with this surgery." What is the
nurse's best response?
A) "You need to make a decision quickly; the OR is waiting."
B) "I understand you have concerns. Would you like to discuss them?"
C) "Your doctor knows what's best for you."
D) "You signed the consent form already."
Answer: B
Rationale: The nurse should acknowledge the client's concerns and provide an
opportunity for discussion. Informed consent is an ongoing process, and the
client has the right to change their mind. The nurse should explore the client's
concerns and notify the healthcare provider if the client is unsure.
Question 9
The nurse is responsible for supervising a student nurse. Which action is
appropriate?
A) Allowing the student to perform procedures without supervision
B) Assigning the student to care for a critically ill client independently
C) Providing appropriate supervision and feedback
D) Delegating medication administration to the student without checking
4
COMPLETE QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES | ALREADY GRADED A+|
|BRAND NEW VERSION!!
SECTION 1: MANAGEMENT OF CARE (Questions 1-52)
Question 1
The nurse is prioritizing care for four clients. Which client should the nurse
assess first?
A) A client with diabetes mellitus requesting pain medication
B) A client with pneumonia who has an oxygen saturation of 88% on room air
C) A client who needs assistance with ambulation
D) A client requesting discharge instructions
Answer: B
Rationale: The client with an oxygen saturation of 88% is experiencing hypoxia
and requires immediate assessment and intervention. Airway and breathing are
always the priority using the ABC framework. Pain management, ambulation
assistance, and discharge teaching can be addressed after the client with
respiratory compromise is stabilized.
Question 2
The practical nurse is delegating tasks to unregulated care providers (UCPs).
Which task is appropriate to delegate?
A) Administering oral medications
B) Performing a sterile wound dressing change
C) Assisting a client with bathing and grooming
D) Assessing a client's lung sounds
Answer: C
Rationale: Assisting with bathing and grooming is within the scope of practice
for unregulated care providers. Administration of medications, sterile
procedures, and assessments are nursing responsibilities that require clinical
judgment and cannot be delegated to UCPs. The nurse retains accountability for
1
,delegated tasks.
Question 3
The nurse is caring for a client who has an advance directive. Which action by
the nurse demonstrates appropriate integration of this directive into the care
plan?
A) Placing the advance directive in the client's chart without further action
B) Discussing the advance directive with the client's family only
C) Ensuring the care team is aware of the client's wishes regarding
life-sustaining treatment
D) Following the advance directive only if the client becomes unconscious
Answer: C
Rationale: The nurse should ensure that the entire healthcare team is aware of
the client's advance directive and that the client's wishes are respected in the
care plan. Advance directives should be incorporated into ongoing care
discussions, not just placed in the chart or discussed only with family.
Question 4
A client states, "I want to leave the hospital against medical advice." Which
action should the nurse take first?
A) Inform the client that they cannot leave without a physician's order
B) Notify the healthcare provider immediately
C) Ask the client to sign an Against Medical Advice (AMA) form
D) Discuss the client's concerns and reasons for wanting to leave
Answer: D
Rationale: The nurse should first explore the client's reasons for wanting to
leave. Understanding the client's concerns allows the nurse to address issues,
provide education, and potentially prevent AMA discharge. Clients have the right
to leave, but the nurse must ensure they understand the risks and document the
discussion.
2
,Question 5
The nurse is participating in a quality improvement initiative. Which action is
appropriate?
A) Reporting a medication error that occurred on the unit
B) Ignoring a near-miss event because no harm occurred
C) Failing to document an incident
D) Discouraging staff from reporting errors
Answer: A
Rationale: Reporting errors and near-misses is essential for quality improvement
and patient safety. The nurse should report identified client care issues to
appropriate personnel and participate in performance improvement projects.
Ignoring errors or near-misses prevents learning and system improvements.
Question 6
The nurse is caring for a client who has a "Do Not Resuscitate" (DNR) order.
Which action by the nurse is correct?
A) Ignore the DNR order if the client's family requests resuscitation
B) Follow the DNR order if the client experiences cardiac arrest
C) Resuscitate the client regardless of the DNR order
D) Ask the family to sign a new DNR order each day
Answer: B
Rationale: The nurse must follow the DNR order as documented in the client's
chart. A DNR order is a legal directive that should be respected unless there is
a new order. The family cannot override a valid DNR order without a
physician's order.
Question 7
The nurse is providing care to a client who is confused and attempting to remove
their IV line. Which intervention should the nurse implement first?
A) Apply wrist restraints
B) Request a sitter from the nursing supervisor
3
, C) Assess the client's need for alternative interventions (e.g., mitts,
distraction, reorientation)
D) Notify the healthcare provider for an order for chemical restraints
Answer: C
Rationale: The nurse should first assess the client's behavior and attempt less
restrictive interventions such as reorientation, distraction, or padded mitts.
Restraints should be used only as a last resort when other interventions have
failed and the client is at risk for harm. Restraint use requires a physician's
order and frequent monitoring.
Question 8
The nurse is caring for a client who is scheduled for surgery. The client
states, "I'm not sure I want to go through with this surgery." What is the
nurse's best response?
A) "You need to make a decision quickly; the OR is waiting."
B) "I understand you have concerns. Would you like to discuss them?"
C) "Your doctor knows what's best for you."
D) "You signed the consent form already."
Answer: B
Rationale: The nurse should acknowledge the client's concerns and provide an
opportunity for discussion. Informed consent is an ongoing process, and the
client has the right to change their mind. The nurse should explore the client's
concerns and notify the healthcare provider if the client is unsure.
Question 9
The nurse is responsible for supervising a student nurse. Which action is
appropriate?
A) Allowing the student to perform procedures without supervision
B) Assigning the student to care for a critically ill client independently
C) Providing appropriate supervision and feedback
D) Delegating medication administration to the student without checking
4
