NUR 138 – TRANSITION TO PROFESSIONAL PRACTICE] QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Professional Role Transition and Identity
- Legal and Regulatory Compliance in Nursing
- Ethical Decision-Making and Moral Distress
- Patient Safety and Quality Improvement
- Interprofessional Communication and Collaboration
- Leadership and Delegation in Nursing Practice
- Evidence-Based Practice and Clinical Reasoning
- Healthcare Policy, Finance, and Systems
Introduction
*This comprehensive examination is designed to assess the essential knowledge, critical thinking, and clinical
judgment required for successful transition from student to professional practice nurse. Candidates will
demonstrate mastery of foundational theory, regulatory and legal standards, ethical principles, and real-world
decision-making in diverse healthcare settings. The exam consists of 200 multiple-choice questions divided into
two sections, each including scenario-based items that emphasize safe, patient-centered care, interdisciplinary
collaboration, and professional accountability. Correct answers are verified with clear rationales to reinforce
learning. Prepare to apply evidence-based reasoning to complex clinical situations encountered in
contemporary nursing practice.*
,SECTION ONE: QUESTIONS 1–100
Question 1
A newly licensed nurse is reviewing the Nurse Practice Act of their state before starting a new position. Which
action is most consistent with legal compliance under this act?
A. Performing advanced procedures taught in continuing education without verified competency
B. Delegating medication administration to an unlicensed assistive personnel (UAP) during a staffing shortage
C. Refusing an assignment that exceeds the nurse’s scope of practice as defined by the act
D. Practicing independently as a nurse practitioner without a collaborative agreement
🟢C
🔴 RATIONALE: The Nurse Practice Act defines the legal scope of practice for each nursing level. Refusing an
assignment outside that scope is legally protected and professionally required. Options A, B, and D violate
statutory boundaries regarding competency, delegation, and advanced practice requirements.
Question 2
A nurse notices a colleague diverting opioids from patient medication dispensing. What is the nurse’s initial
legal and ethical responsibility?
A. Confront the colleague privately in the break room
B. Report the observation to the nurse manager or compliance officer
C. Ignore the incident because it is not personally witnessed
D. Call the Board of Nursing anonymously without internal reporting
🟢B
,🔴 RATIONALE: Mandatory reporting laws require nurses to report suspected diversion to appropriate internal
authorities first (nurse manager/ compliance). Internal reporting initiates investigation and supports patient
safety. Confrontation (A) is unsafe; ignoring (C) violates duty; bypassing internal channels (D) may be premature.
Question 3
A patient refuses a life-saving blood transfusion due to religious beliefs. The nurse understands that the priority
action is to:
A. Administer the transfusion under implied consent because the situation is emergent
B. Notify the healthcare provider and respect the patient’s informed refusal
C. Contact hospital ethics committee without involving the patient
D. Ask the patient’s family to override the refusal
🟢B
🔴 RATIONALE: Respect for autonomy and informed refusal are foundational ethical principles. The nurse must
notify the provider and honor the patient’s decision. Administering against refusal (A) constitutes battery; ethics
committee may be consulted but not without patient involvement (C); family cannot override a competent
adult’s refusal (D).
Question 4
A nurse delegates a stable patient’s vital signs to an unlicensed assistive personnel (UAP). The UAP reports an
unusually high blood pressure. What is the nurse’s best action?
A. Re-delegate the re-check to another UAP to save time
B. Ignore the finding because UAPs are not trained to interpret vitals
, C. Assess the patient personally and compare with prior readings
D. Document the finding as reported without verification
🟢C
🔴 RATIONALE: The nurse retains accountability for delegation and must personally assess abnormal findings.
Delegation does not transfer clinical judgment. Options A, B, and D violate the five rights of delegation and
compromise patient safety.
Question 5
A nurse working on a medical-surgical unit is assigned five patients. One patient’s family member requests
extensive teaching about post-discharge care. Which action demonstrates appropriate time management and
professional boundaries?
A. Complete all other tasks first, then provide teaching if time permits
B. Provide brief teaching and refer the family to written discharge materials
C. Schedule a dedicated time for teaching and inform the charge nurse of other needs
D. Delegate the teaching entirely to the nursing student on the unit
🟢C
🔴 RATIONALE: Effective transition to practice requires prioritization and collaboration. Scheduling teaching
and communicating with charge nurse ensures patient education without neglecting other responsibilities.
Delegating teaching entirely (D) is inappropriate without supervision; option A delays education; option B may
not meet learning needs.
Question 6
A nurse is mentoring a newly hired graduate nurse. Which statement by the graduate indicates correct
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Professional Role Transition and Identity
- Legal and Regulatory Compliance in Nursing
- Ethical Decision-Making and Moral Distress
- Patient Safety and Quality Improvement
- Interprofessional Communication and Collaboration
- Leadership and Delegation in Nursing Practice
- Evidence-Based Practice and Clinical Reasoning
- Healthcare Policy, Finance, and Systems
Introduction
*This comprehensive examination is designed to assess the essential knowledge, critical thinking, and clinical
judgment required for successful transition from student to professional practice nurse. Candidates will
demonstrate mastery of foundational theory, regulatory and legal standards, ethical principles, and real-world
decision-making in diverse healthcare settings. The exam consists of 200 multiple-choice questions divided into
two sections, each including scenario-based items that emphasize safe, patient-centered care, interdisciplinary
collaboration, and professional accountability. Correct answers are verified with clear rationales to reinforce
learning. Prepare to apply evidence-based reasoning to complex clinical situations encountered in
contemporary nursing practice.*
,SECTION ONE: QUESTIONS 1–100
Question 1
A newly licensed nurse is reviewing the Nurse Practice Act of their state before starting a new position. Which
action is most consistent with legal compliance under this act?
A. Performing advanced procedures taught in continuing education without verified competency
B. Delegating medication administration to an unlicensed assistive personnel (UAP) during a staffing shortage
C. Refusing an assignment that exceeds the nurse’s scope of practice as defined by the act
D. Practicing independently as a nurse practitioner without a collaborative agreement
🟢C
🔴 RATIONALE: The Nurse Practice Act defines the legal scope of practice for each nursing level. Refusing an
assignment outside that scope is legally protected and professionally required. Options A, B, and D violate
statutory boundaries regarding competency, delegation, and advanced practice requirements.
Question 2
A nurse notices a colleague diverting opioids from patient medication dispensing. What is the nurse’s initial
legal and ethical responsibility?
A. Confront the colleague privately in the break room
B. Report the observation to the nurse manager or compliance officer
C. Ignore the incident because it is not personally witnessed
D. Call the Board of Nursing anonymously without internal reporting
🟢B
,🔴 RATIONALE: Mandatory reporting laws require nurses to report suspected diversion to appropriate internal
authorities first (nurse manager/ compliance). Internal reporting initiates investigation and supports patient
safety. Confrontation (A) is unsafe; ignoring (C) violates duty; bypassing internal channels (D) may be premature.
Question 3
A patient refuses a life-saving blood transfusion due to religious beliefs. The nurse understands that the priority
action is to:
A. Administer the transfusion under implied consent because the situation is emergent
B. Notify the healthcare provider and respect the patient’s informed refusal
C. Contact hospital ethics committee without involving the patient
D. Ask the patient’s family to override the refusal
🟢B
🔴 RATIONALE: Respect for autonomy and informed refusal are foundational ethical principles. The nurse must
notify the provider and honor the patient’s decision. Administering against refusal (A) constitutes battery; ethics
committee may be consulted but not without patient involvement (C); family cannot override a competent
adult’s refusal (D).
Question 4
A nurse delegates a stable patient’s vital signs to an unlicensed assistive personnel (UAP). The UAP reports an
unusually high blood pressure. What is the nurse’s best action?
A. Re-delegate the re-check to another UAP to save time
B. Ignore the finding because UAPs are not trained to interpret vitals
, C. Assess the patient personally and compare with prior readings
D. Document the finding as reported without verification
🟢C
🔴 RATIONALE: The nurse retains accountability for delegation and must personally assess abnormal findings.
Delegation does not transfer clinical judgment. Options A, B, and D violate the five rights of delegation and
compromise patient safety.
Question 5
A nurse working on a medical-surgical unit is assigned five patients. One patient’s family member requests
extensive teaching about post-discharge care. Which action demonstrates appropriate time management and
professional boundaries?
A. Complete all other tasks first, then provide teaching if time permits
B. Provide brief teaching and refer the family to written discharge materials
C. Schedule a dedicated time for teaching and inform the charge nurse of other needs
D. Delegate the teaching entirely to the nursing student on the unit
🟢C
🔴 RATIONALE: Effective transition to practice requires prioritization and collaboration. Scheduling teaching
and communicating with charge nurse ensures patient education without neglecting other responsibilities.
Delegating teaching entirely (D) is inappropriate without supervision; option A delays education; option B may
not meet learning needs.
Question 6
A nurse is mentoring a newly hired graduate nurse. Which statement by the graduate indicates correct
