2026 Q&A | INSTANT DOWNLOAD PDF.
CORE DOMAINS
Management of Care
Safety and Infection Control
Health Promotion and Maintenance
Psychosocial Integrity
Basic Care and Comfort
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
INTRODUCTION
This comprehensive assessment tool is designed to evaluate readiness for professional nursing licensure and entry-level clinical practice.
Spanning core client need categories, it measures essential clinical reasoning, judgment, and safe nursing care delivery across the lifespan.
The assessment utilizes multiple-choice questions grounded in realistic clinical scenarios to simulate the fast-paced, high-stakes decision-
making required in modern healthcare environments. Candidates are evaluated on their capacity to synthesize foundational theory, apply
legal and ethical principles, prioritize care, and implement evidence-based interventions to optimize patient outcomes. Each scenario
requires critical thinking to ensure the delivery of safe, holistic, and high-quality nursing care.
SECTION ONE: QUESTIONS 1–100
Question 1
A nurse is caring for a client who is 12 hours postoperative following a total hip arthroplasty. Which of the following actions should the nurse
take?
A. Maintain the client's affected hip in a position of adduction.
B. Place a pillow under the client's knees when supine.
🟢 C. Position an abduction wedge between the client's legs while in bed.
D. Encourage the client to flex the affected hip past 90 degrees when sitting.
🔴 RATIONALE: An abduction wedge or pillow prevents adduction and internal rotation of the affected hip, which helps prevent dislocation
of the new prosthetic joint. Flexion beyond 90 degrees, adduction, and internal rotation must be avoided to ensure joint stability.
,Question 2
A nurse is planning care for a client who has a prescription for total parenteral nutrition (TPN) to infuse at 100 mL/hr. Which of the following
interventions should the nurse include in the plan?
A. Change the TPN IV tubing every 72 hours.
B. Check the client's capillary blood glucose levels every 12 hours.
🟢 C. Use an infusion pump to administer the TPN solution.
D. Accelerate the infusion rate if the schedule falls behind.
🔴 RATIONALE: TPN contains high concentrations of dextrose and lipids, requiring precise administration via an electronic infusion pump
to prevent severe fluid and electrolyte shifts or profound hypo/hyperglycemia. Tubing is changed every 24 hours, glucose is checked every 4
to 6 hours, and rates should never be abruptly changed.
Question 3
A nurse in an emergency department is assessing a client who reports a sudden onset of severe right lower quadrant abdominal pain,
nausea, and vomiting. The client's vital signs are: temperature 38.6 C (101.5 F), pulse 112/min, respirations 22/min, and blood pressure
138/84 mm Hg. Which of the following actions should the nurse take first?
A. Administer the prescribed opioid analgesic.
🟢 B. Establish intravenous access and initiate fluid resuscitation.
C. Obtain a clean-catch urine specimen for urinalysis.
D. Auscultate the client's bowel sounds in all four quadrants.
🔴 RATIONALE: The client's clinical presentation is highly suggestive of acute appendicitis. Establishing IV access and beginning fluid
resuscitation takes priority to stabilize hemodynamics and prepare the client for potential emergency surgery, aligning with airway, breathing,
and circulation (ABC) principles.
Question 4
A nurse is preparing to administer digoxin 0.25 mg PO daily to a client who has heart failure. Which of the following findings should cause
the nurse to withhold the medication?
A. Blood pressure 144/88 mm Hg
B. Potassium level 4.8 mEq/L
🟢 C. Apical heart rate 52/min
D. Digoxin level 0.8 ng/mL
🔴 RATIONALE: Digoxin is an inotropic agent that slows the heart rate. The nurse must assess the apical pulse for one full minute prior to
administration and withhold the medication if the rate is less than 60/min in an adult to prevent worsening bradycardia or toxicity.
Question 5
A nurse is caring for a client who is under airborne precautions for suspected active pulmonary tuberculosis. Which of the following
protective equipment must the nurse don before entering the client's room?
🟢 A. N95 respirator mask
B. Surgical mask
, C. Face shield
D. Protective gown
🔴 RATIONALE: Airborne precautions require the use of a fit-tested N95 or higher-level respirator mask to filter out microscopic airborne
droplet nuclei. Standard surgical masks do not provide adequate filtration against Mycobacterium tuberculosis.
Question 6
A nurse is preparing an educational presentation regarding legal issues in nursing for a group of newly licensed nurses. Which of the
following examples should the nurse use to illustrate an intentional tort?
A. Administering the wrong dose of a medication due to a calculation error.
🟢 B. Restraining a competent client against their will to prevent them from leaving.
C. Failing to document a client's response to an antihypertensive medication.
D. Forgetting to recheck a client's blood pressure after administering a vasodilator.
🔴 RATIONALE: False imprisonment, which includes restraining a competent client against their will without legal justification, is an
intentional tort. Negligence and malpractice (such as medication errors or omission of documentation) are examples of unintentional torts.
Question 7
A nurse is providing discharge teaching to a client who has a new prescription for warfarin. Which of the following instructions should the
nurse include?
A. Increase consumption of dark green leafy vegetables.
🟢 B. Use a soft-bristled toothbrush for oral hygiene.
C. Take aspirin for mild headaches or muscle aches.
D. Expect dark, tarry stools as a common side effect.
🔴 RATIONALE: Warfarin is an anticoagulant that increases the risk of bleeding. Using a soft-bristled toothbrush helps minimize the risk of
gingival bleeding. Sudden changes in vitamin K intake (green leafy vegetables) alter warfarin efficacy, aspirin increases bleeding risks, and
tarry stools indicate active gastrointestinal hemorrhage.
Question 8
A nurse is evaluating the electronic fetal monitor tracing of a client who is in active labor. The nurse notes a pattern of uniform decelerations
that begin after the peak of a contraction and return to baseline after the contraction ends. Which of the following actions should the nurse
take first?
A. Administer oxygen via nasal cannula at 2 L/min.
🟢 B. Turn the client onto her left lateral side.
C. Increase the rate of the oxytocin infusion.
D. Prepare the client for an immediate vacuum-assisted delivery.
🔴 RATIONALE: Late decelerations indicate uteroplacental insufficiency. The priority action is to optimize maternal-fetal blood flow by
turning the client onto her side, which relieves vena cava compression and increases uterine perfusion. Oxytocin should be discontinued,
not increased.
Question 9