, Question 1
A nurse is preparing to administer a high-alert medication via intravenous
push. Which action best reflects the QSEN competency of safety?
A. Verify the medication with a second nurse using an independent
double-check.
B. Administer the medication rapidly to minimize patient discomfort.
C. Document the medication administration before giving the dose.
D. Use a general-purpose syringe to measure the dose.
Correct Answer: A - Verify the medication with a second nurse
using an independent double-check.
RATIONALE
Independent double-check for high-alert medications is a critical
safety practice to prevent errors. Rapid administration,
pre-documentation, and using non-calibrated syringes increase risk.
QSEN safety emphasizes system-wide error prevention.
Question 2
Which statement by a nurse indicates correct understanding of
transmission-based precautions for a patient with Clostridioides difficile
infection?
A. I will wear a gown and gloves and use soap and water for hand
hygiene.
B. I will wear an N95 respirator and place the patient in a
negative-pressure room.
C. I will use alcohol-based hand rub after removing gloves.
D. I will wear a mask and eye protection when within 3 feet of the
patient.
Correct Answer: A - I will wear a gown and gloves and use soap
and water for hand hygiene.
Page 2
, RATIONALE
C. difficile requires contact precautions, and alcohol does not kill
spores; soap and water is essential. N95 and negative pressure are for
airborne precautions. Mask and eye protection are standard
precautions for splash risk, not specific to C. diff.
Question 3
A nurse is teaching a patient about a new prescription for warfarin. Which
statement by the patient indicates a need for further teaching?
A. I will use a soft toothbrush and electric razor.
B. I will increase my intake of leafy green vegetables.
C. I will report any unusual bleeding or bruising.
D. I will keep my appointments for blood tests.
Correct Answer: B - I will increase my intake of leafy green
vegetables.
RATIONALE
Increasing leafy greens (vitamin K) can antagonize warfarin and alter
INR. Soft toothbrush, reporting bleeding, and monitoring INR are
correct. Patient education must emphasize consistent vitamin K intake,
not increased.
Question 4
A nurse is reviewing a patient's chart and notes a discrepancy between the
medication administration record and the provider's order. Which action should
the nurse take first?
A. Administer the medication as transcribed in the MAR.
B. Clarify the order with the prescribing provider.
C. Ask the patient what dose they usually take.
D. Document the discrepancy and proceed with the MAR.
Correct Answer: B - Clarify the order with the prescribing
Page 3
, provider.
RATIONALE
The nurse must clarify any unclear or conflicting order with the
prescriber before administration. Administering based on MAR or
patient recall is unsafe. Documentation does not resolve the
discrepancy.
Question 5
A nurse is assessing a patient for risk of falls. Which factor is most predictive
of increased fall risk?
A. Use of a cane for ambulation
B. History of a fall in the past year
C. Age over 65 years
D. Presence of a urinary catheter
Correct Answer: B - History of a fall in the past year
RATIONALE
A previous fall is the strongest predictor of future falls. While age,
assistive devices, and catheters contribute, the history of a fall is most
significant. Fall risk assessments should prioritize this factor.
Question 6
A nurse is caring for a patient with a new colostomy. Which intervention is
priority to promote skin integrity?
A. Apply a skin barrier around the stoma before attaching the pouch.
B. Cleanse the stoma with alcohol wipes.
C. Change the pouch every day to prevent leakage.
D. Use a pouch with a large opening to allow for swelling.
Correct Answer: A - Apply a skin barrier around the stoma
before attaching the pouch.
Page 4
A nurse is preparing to administer a high-alert medication via intravenous
push. Which action best reflects the QSEN competency of safety?
A. Verify the medication with a second nurse using an independent
double-check.
B. Administer the medication rapidly to minimize patient discomfort.
C. Document the medication administration before giving the dose.
D. Use a general-purpose syringe to measure the dose.
Correct Answer: A - Verify the medication with a second nurse
using an independent double-check.
RATIONALE
Independent double-check for high-alert medications is a critical
safety practice to prevent errors. Rapid administration,
pre-documentation, and using non-calibrated syringes increase risk.
QSEN safety emphasizes system-wide error prevention.
Question 2
Which statement by a nurse indicates correct understanding of
transmission-based precautions for a patient with Clostridioides difficile
infection?
A. I will wear a gown and gloves and use soap and water for hand
hygiene.
B. I will wear an N95 respirator and place the patient in a
negative-pressure room.
C. I will use alcohol-based hand rub after removing gloves.
D. I will wear a mask and eye protection when within 3 feet of the
patient.
Correct Answer: A - I will wear a gown and gloves and use soap
and water for hand hygiene.
Page 2
, RATIONALE
C. difficile requires contact precautions, and alcohol does not kill
spores; soap and water is essential. N95 and negative pressure are for
airborne precautions. Mask and eye protection are standard
precautions for splash risk, not specific to C. diff.
Question 3
A nurse is teaching a patient about a new prescription for warfarin. Which
statement by the patient indicates a need for further teaching?
A. I will use a soft toothbrush and electric razor.
B. I will increase my intake of leafy green vegetables.
C. I will report any unusual bleeding or bruising.
D. I will keep my appointments for blood tests.
Correct Answer: B - I will increase my intake of leafy green
vegetables.
RATIONALE
Increasing leafy greens (vitamin K) can antagonize warfarin and alter
INR. Soft toothbrush, reporting bleeding, and monitoring INR are
correct. Patient education must emphasize consistent vitamin K intake,
not increased.
Question 4
A nurse is reviewing a patient's chart and notes a discrepancy between the
medication administration record and the provider's order. Which action should
the nurse take first?
A. Administer the medication as transcribed in the MAR.
B. Clarify the order with the prescribing provider.
C. Ask the patient what dose they usually take.
D. Document the discrepancy and proceed with the MAR.
Correct Answer: B - Clarify the order with the prescribing
Page 3
, provider.
RATIONALE
The nurse must clarify any unclear or conflicting order with the
prescriber before administration. Administering based on MAR or
patient recall is unsafe. Documentation does not resolve the
discrepancy.
Question 5
A nurse is assessing a patient for risk of falls. Which factor is most predictive
of increased fall risk?
A. Use of a cane for ambulation
B. History of a fall in the past year
C. Age over 65 years
D. Presence of a urinary catheter
Correct Answer: B - History of a fall in the past year
RATIONALE
A previous fall is the strongest predictor of future falls. While age,
assistive devices, and catheters contribute, the history of a fall is most
significant. Fall risk assessments should prioritize this factor.
Question 6
A nurse is caring for a patient with a new colostomy. Which intervention is
priority to promote skin integrity?
A. Apply a skin barrier around the stoma before attaching the pouch.
B. Cleanse the stoma with alcohol wipes.
C. Change the pouch every day to prevent leakage.
D. Use a pouch with a large opening to allow for swelling.
Correct Answer: A - Apply a skin barrier around the stoma
before attaching the pouch.
Page 4
