Nursing Final Exam Practice Pack 2026–2027 |
Family Nursing & Clinical Rationales
Q1. A practical nurse is caring for a child whose divorced parents give conflicting instructions
about the child's diet. Which action should the practical nurse take first?
A. Follow the instructions of the parent who is present at the bedside
B. Tell the parents to settle the disagreement privately
C. Report the conflict to the supervising registered nurse
D. Document only the mother's instructions in the chart
Correct Answer: C. Report the conflict to the supervising registered nurse
Rationale: The practical nurse observes and reports family dynamics that affect care. Conflict
between parents about a child's diet can impact the plan of care, so the PN must report this
to the supervising RN, who coordinates the plan. Following one parent's instructions without
addressing the conflict is unsafe. Telling the parents to settle it privately dismisses the issue.
Documenting only one parent's instructions omits critical data.
Key Takeaway: Report family conflicts that affect care to the RN.
Q2. A practical nurse is assigned to care for a newly immigrated family. Which family-centered
principle should guide the nurse's approach?
A. Assume the family follows a nuclear family model
B. Ask who the patient considers to be family
C. Encourage the family to adopt U.S. customs quickly
D. Avoid asking personal questions about family structure
Correct Answer: B. Ask who the patient considers to be family
Rationale: Family-centered care requires accepting the patient's definition of family. The
nurse should ask who the patient considers family rather than assuming a nuclear model or
imposing cultural expectations. Avoiding personal questions prevents necessary assessment.
,Key Takeaway: Accept the patient's definition of family.
Q3. A practical nurse is caring for a family and notes several findings. Which findings must the
nurse report to the registered nurse because they may alter the family care plan? Select all
that apply.
A. A grandparent states the family uses herbal remedies at home
B. A spouse is crying in the hallway
C. A teenage patient refuses to take prescribed medication
D. A parent speaks a different language than what is documented
E. A father asks when discharge will occur
Correct Answer: A, C, D
Rationale: Herbal remedy use (A) is a safety concern that may interact with prescribed
treatments. Medication refusal (C) indicates nonadherence and requires RN intervention. A
language discrepancy (D) means an interpreter is needed to ensure understanding. A crying
spouse (B) is a normal emotional response; the PN can offer comfort within scope. A
discharge question (E) can be answered within scope or referred appropriately.
Key Takeaway: Report safety concerns, nonadherence, and communication barriers.
Q4. A practical nurse receives a confidential sexually transmitted infection test result for an
adolescent patient. Which action is most appropriate?
A. Give the result only to the adolescent patient
B. Tell the parent after the adolescent leaves
C. Refuse to share the result with anyone
D. Document the result in the family group text
Correct Answer: A. Give the result only to the adolescent patient
Rationale: Minors often have legal confidentiality protection for STI care. The nurse should
give the result directly to the adolescent and follow agency policy regarding disclosure. Telling
the parent without consent may violate confidentiality. Refusing to share with anyone is
, impractical because the patient needs the result. Documenting in a group text is a serious
privacy breach.
Key Takeaway: Respect adolescent confidentiality for STI results.
Q5. During a clinical rotation, a practical nurse overhears a neighbor's name mentioned
during a patient report. What is the most appropriate and legal response?
A. Share the information only with the neighbor
B. Keep all patient information private
C. Document the name on social media to warn others
D. Tell another student in the elevator
Correct Answer: B. Keep all patient information private
Rationale: HIPAA requires strict confidentiality of all patient information. Any release outside
the care team is a violation. Sharing with the neighbor, posting on social media, or telling
another student are all breaches of confidentiality.
Key Takeaway: Protect patient information at all times.
Q6. A practical nurse is assessing a client at 36 weeks gestation who reports a severe
headache and blurred vision. The client's blood pressure is 158/102 mm Hg. Which action
should the nurse take first?
A. Recheck the blood pressure in 30 minutes
B. Notify the provider immediately
C. Administer an antihypertensive as prescribed
D. Encourage the client to rest in a supine position
Correct Answer: B. Notify the provider immediately
Rationale: Severe headache and visual changes at 36 weeks with a blood pressure of 158/102
mm Hg indicate preeclampsia with severe features. The priority is immediate provider
notification. Rechecking in 30 minutes delays care. Antihypertensives require a provider order.
Supine position can worsen vena cava compression.
Key Takeaway: Severe headache in pregnancy means call the provider now.