Comps Exam NSG 4800 - Comprehensive
Practice Examination 2026
SECTION 1: ETHICS AND LEGAL PRINCIPLES
Question 1
The nurse is caring for a 75-year-old client who has just been diagnosed with cancer. The client's spouse
has requested that the client not be told of the diagnosis because it would be devastating to the client.
The client asks the nurse if the diagnosis is cancer. Which of the following responses by the nurse
reflects the ethical principle of veracity?
a. "Let me contact your health care provider (HCP) to talk to you about your diagnosis."
b. "Any serious health care issues will be discussed with you and your family before you are discharged."
c. "At this time, I do not know your diagnosis because the tests were inconclusive."
d. "Your doctor is the only one who can discuss health care issues with you."
Correct ANSWER: A
Rationale for Option A: This is the correct ANSWER. Veracity means truth-telling. The nurse should not
lie to the client but should facilitate honest communication by involving the health care provider who
can discuss the diagnosis appropriately with the client. This respects the client's right to know while
maintaining professional boundaries.
Rationale for Option B: This is incorrect because it avoids ANSWERing the client's direct question and
delays necessary information. It does not uphold veracity as it sidesteps the truth the client is seeking.
Rationale for Option C: This is incorrect because it is a direct lie to the client. The nurse knows the
diagnosis has been made, and providing false information violates the ethical principle of veracity.
Rationale for Option D: This is incorrect because while it is true that physicians typically discuss
diagnoses, this response avoids the ethical obligation of veracity and does not address the client's
immediate concern or facilitate truthful communication.
Question 2
The nurse has attended a conference on informed consent. It indicates a correct understanding of the
conference if the nurse states that informed consent:
a. Is signed by the nurse to indicate that the client understands the procedure.
,b. May not be withdrawn by the client once they have confirmed understanding and signed the consent.
c. Can be signed by a client who has dementia if they are oriented at the time of signing the form.
d. Can be waived, per facility policy, for urgent medical or surgical treatment if the client is unconscious.
Correct ANSWER: D
Rationale for Option A: This is incorrect. The nurse's signature on an informed consent form indicates
that the nurse witnessed the client's signature, not that the client understands the procedure. The
health care provider performing the procedure is responsible for ensuring the client understands.
Rationale for Option B: This is incorrect. A client has the right to withdraw consent at any time, even
after signing the form, as long as they are competent to make that decision. Consent is an ongoing
process, not a one-time event.
Rationale for Option C: This is incorrect. A client with dementia generally lacks the legal capacity to
provide informed consent, even if they appear oriented at a particular moment. Dementia is a
progressive cognitive impairment that affects decision-making capacity.
Rationale for Option D: This is the correct ANSWER. In emergency situations where the client is
unconscious and unable to provide consent, and there is an immediate threat to life or limb, consent
can be waived according to facility policy and legal standards. This is known as implied consent or
emergency exception.
Question 3
The nurse preceptor is teaching a newly hired nurse about legal principles when providing client care.
Which of the following situations should the nurse preceptor use as an example of malpractice?
a. A client who is alert and oriented makes an informed decision to leave the hospital against medical
advice (AMA). The nurse applies restraints to the client to prevent the client from leaving.
b. A client who is competent refuses an antidepressant medication. The nurse dissolves the medication
in food and administers it to the client without the client's knowledge.
c. A nurse is plugging in an IV pump that is alarming with a low battery. The nurse notices the outlet
cover in a client's room is loose and proceeds with plugging in the IV pump.
d. A nurse finds a client who is on a low-sodium diet eating salted potato chips. The nurse tells the client
that wrist restraints will be applied if the client does not stop eating the chips.
Correct ANSWER: B
Rationale for Option A: This is incorrect as an example of malpractice, though it represents false
imprisonment and is illegal. Malpractice specifically refers to professional negligence. While applying
restraints to a competent client refusing care is wrong, it is more accurately classified as a violation of
rights rather than malpractice.
Rationale for Option B: This is the correct ANSWER. Administering medication covertly to a competent
client who has refused it constitutes malpractice and battery. The nurse breached the standard of care
,by violating the client's right to refuse treatment and administering medication without consent, which
is a clear violation of nursing practice standards.
Rationale for Option C: This is incorrect. While using an electrical outlet with a loose cover is a safety
concern, it does not rise to the level of malpractice unless harm results from this action. This represents
a potential safety hazard that should be reported and corrected.
Rationale for Option D: This is incorrect. While threatening restraints for dietary noncompliance is
inappropriate and represents poor practice, it does not constitute malpractice unless actual harm
occurs. This is more accurately described as threatening behavior and potential false imprisonment.
Question 4
A competent client refuses a blood transfusion due to religious beliefs. The client's family members are
demanding that the nurse administer the transfusion because they believe it is necessary to save the
client's life. Which of the following actions should the nurse take?
a. Administer the blood transfusion as ordered by the health care provider.
b. Respect the client's refusal and document the client's decision.
c. Ask the ethics committee to override the client's decision.
d. Convince the family to sign the consent form for the transfusion.
Correct ANSWER: B
Rationale for Option A: This is incorrect. Administering a blood transfusion against a competent client's
wishes, even for religious reasons, violates the client's autonomy and right to refuse treatment. This
could constitute battery and is illegal.
Rationale for Option B: This is the correct ANSWER. A competent adult has the legal and ethical right to
refuse any medical treatment, including life-saving treatment, based on personal or religious beliefs. The
nurse must respect this decision and document it appropriately in the medical record.
Rationale for Option C: This is incorrect. The ethics committee cannot override a competent client's
autonomous decision. Ethics committees provide guidance and recommendations but cannot supersede
a competent client's right to make decisions about their own care.
Rationale for Option D: This is incorrect. Family members cannot provide consent for treatment that a
competent client has refused. The client's autonomy takes precedence over family wishes when the
client is competent to make decisions.
Question 5
The nurse witnesses a client sign an informed consent form for surgery. Which of the following
statements by the nurse indicates understanding of the nurse's role in the informed consent process?
a. "I verified that the client understood the risks and benefits of the procedure."
b. "I witnessed the client's signature on the consent form."
, c. "I explained the surgical procedure to the client before they signed."
d. "I ensured the health care provider ANSWERed all the client's questions."
Correct ANSWER: B
Rationale for Option A: This is incorrect. While the nurse should assess understanding, verifying that the
client understands the risks and benefits is primarily the responsibility of the health care provider
performing the procedure, not the nurse witnessing the signature.
Rationale for Option B: This is the correct ANSWER. The nurse's role in the informed consent process is
to witness the client's signature, confirming that the signature is voluntary and that the client appears
competent to sign. The nurse does not verify understanding of the procedure details.
Rationale for Option C: This is incorrect. Explaining the surgical procedure, including risks, benefits, and
alternatives, is the responsibility of the health care provider performing the procedure, not the nurse.
Rationale for Option D: This is incorrect. While the nurse should advocate for the client, ensuring that
the health care provider ANSWERs all questions is the provider's responsibility. The nurse's role is
limited to witnessing the signature.
SECTION 2: PRIORITIZATION AND DELEGATION
Question 6
The nurse is prioritizing client care after receiving the hand-off report. The nurse should first plan to see
the client who:
a. Has cirrhosis, reports several new areas of ecchymosis, and has a partial thromboplastin time (PTT) of
76 seconds.
b. Has pancreatitis and is reporting mid-epigastric discomfort.
c. Had a transesophageal echocardiogram (TEE) 2 hours ago, has a blood pressure (BP) of 106/61 mm
Hg, and reports a sore throat.
d. Had a laparoscopic cholecystectomy 18 hours ago and is reporting bilateral shoulder pain.
Correct ANSWER: A
Rationale for Option A: This is the correct ANSWER. The client with cirrhosis has new ecchymosis and an
elevated PTT of 76 seconds (normal is approximately 25-35 seconds), indicating a significant bleeding
risk. This client requires immediate assessment for active bleeding and potential intervention to prevent
hemorrhage, making this the highest priority.
Rationale for Option B: This is incorrect. Mid-epigastric discomfort is an expected finding in pancreatitis.
While this client needs assessment and pain management, this is not as urgent as a potential bleeding
disorder.
Rationale for Option C: This is incorrect. A sore throat is an expected finding after a transesophageal
echocardiogram due to the scope passing through the throat. The blood pressure is within normal limits.
This is the lowest priority.
Practice Examination 2026
SECTION 1: ETHICS AND LEGAL PRINCIPLES
Question 1
The nurse is caring for a 75-year-old client who has just been diagnosed with cancer. The client's spouse
has requested that the client not be told of the diagnosis because it would be devastating to the client.
The client asks the nurse if the diagnosis is cancer. Which of the following responses by the nurse
reflects the ethical principle of veracity?
a. "Let me contact your health care provider (HCP) to talk to you about your diagnosis."
b. "Any serious health care issues will be discussed with you and your family before you are discharged."
c. "At this time, I do not know your diagnosis because the tests were inconclusive."
d. "Your doctor is the only one who can discuss health care issues with you."
Correct ANSWER: A
Rationale for Option A: This is the correct ANSWER. Veracity means truth-telling. The nurse should not
lie to the client but should facilitate honest communication by involving the health care provider who
can discuss the diagnosis appropriately with the client. This respects the client's right to know while
maintaining professional boundaries.
Rationale for Option B: This is incorrect because it avoids ANSWERing the client's direct question and
delays necessary information. It does not uphold veracity as it sidesteps the truth the client is seeking.
Rationale for Option C: This is incorrect because it is a direct lie to the client. The nurse knows the
diagnosis has been made, and providing false information violates the ethical principle of veracity.
Rationale for Option D: This is incorrect because while it is true that physicians typically discuss
diagnoses, this response avoids the ethical obligation of veracity and does not address the client's
immediate concern or facilitate truthful communication.
Question 2
The nurse has attended a conference on informed consent. It indicates a correct understanding of the
conference if the nurse states that informed consent:
a. Is signed by the nurse to indicate that the client understands the procedure.
,b. May not be withdrawn by the client once they have confirmed understanding and signed the consent.
c. Can be signed by a client who has dementia if they are oriented at the time of signing the form.
d. Can be waived, per facility policy, for urgent medical or surgical treatment if the client is unconscious.
Correct ANSWER: D
Rationale for Option A: This is incorrect. The nurse's signature on an informed consent form indicates
that the nurse witnessed the client's signature, not that the client understands the procedure. The
health care provider performing the procedure is responsible for ensuring the client understands.
Rationale for Option B: This is incorrect. A client has the right to withdraw consent at any time, even
after signing the form, as long as they are competent to make that decision. Consent is an ongoing
process, not a one-time event.
Rationale for Option C: This is incorrect. A client with dementia generally lacks the legal capacity to
provide informed consent, even if they appear oriented at a particular moment. Dementia is a
progressive cognitive impairment that affects decision-making capacity.
Rationale for Option D: This is the correct ANSWER. In emergency situations where the client is
unconscious and unable to provide consent, and there is an immediate threat to life or limb, consent
can be waived according to facility policy and legal standards. This is known as implied consent or
emergency exception.
Question 3
The nurse preceptor is teaching a newly hired nurse about legal principles when providing client care.
Which of the following situations should the nurse preceptor use as an example of malpractice?
a. A client who is alert and oriented makes an informed decision to leave the hospital against medical
advice (AMA). The nurse applies restraints to the client to prevent the client from leaving.
b. A client who is competent refuses an antidepressant medication. The nurse dissolves the medication
in food and administers it to the client without the client's knowledge.
c. A nurse is plugging in an IV pump that is alarming with a low battery. The nurse notices the outlet
cover in a client's room is loose and proceeds with plugging in the IV pump.
d. A nurse finds a client who is on a low-sodium diet eating salted potato chips. The nurse tells the client
that wrist restraints will be applied if the client does not stop eating the chips.
Correct ANSWER: B
Rationale for Option A: This is incorrect as an example of malpractice, though it represents false
imprisonment and is illegal. Malpractice specifically refers to professional negligence. While applying
restraints to a competent client refusing care is wrong, it is more accurately classified as a violation of
rights rather than malpractice.
Rationale for Option B: This is the correct ANSWER. Administering medication covertly to a competent
client who has refused it constitutes malpractice and battery. The nurse breached the standard of care
,by violating the client's right to refuse treatment and administering medication without consent, which
is a clear violation of nursing practice standards.
Rationale for Option C: This is incorrect. While using an electrical outlet with a loose cover is a safety
concern, it does not rise to the level of malpractice unless harm results from this action. This represents
a potential safety hazard that should be reported and corrected.
Rationale for Option D: This is incorrect. While threatening restraints for dietary noncompliance is
inappropriate and represents poor practice, it does not constitute malpractice unless actual harm
occurs. This is more accurately described as threatening behavior and potential false imprisonment.
Question 4
A competent client refuses a blood transfusion due to religious beliefs. The client's family members are
demanding that the nurse administer the transfusion because they believe it is necessary to save the
client's life. Which of the following actions should the nurse take?
a. Administer the blood transfusion as ordered by the health care provider.
b. Respect the client's refusal and document the client's decision.
c. Ask the ethics committee to override the client's decision.
d. Convince the family to sign the consent form for the transfusion.
Correct ANSWER: B
Rationale for Option A: This is incorrect. Administering a blood transfusion against a competent client's
wishes, even for religious reasons, violates the client's autonomy and right to refuse treatment. This
could constitute battery and is illegal.
Rationale for Option B: This is the correct ANSWER. A competent adult has the legal and ethical right to
refuse any medical treatment, including life-saving treatment, based on personal or religious beliefs. The
nurse must respect this decision and document it appropriately in the medical record.
Rationale for Option C: This is incorrect. The ethics committee cannot override a competent client's
autonomous decision. Ethics committees provide guidance and recommendations but cannot supersede
a competent client's right to make decisions about their own care.
Rationale for Option D: This is incorrect. Family members cannot provide consent for treatment that a
competent client has refused. The client's autonomy takes precedence over family wishes when the
client is competent to make decisions.
Question 5
The nurse witnesses a client sign an informed consent form for surgery. Which of the following
statements by the nurse indicates understanding of the nurse's role in the informed consent process?
a. "I verified that the client understood the risks and benefits of the procedure."
b. "I witnessed the client's signature on the consent form."
, c. "I explained the surgical procedure to the client before they signed."
d. "I ensured the health care provider ANSWERed all the client's questions."
Correct ANSWER: B
Rationale for Option A: This is incorrect. While the nurse should assess understanding, verifying that the
client understands the risks and benefits is primarily the responsibility of the health care provider
performing the procedure, not the nurse witnessing the signature.
Rationale for Option B: This is the correct ANSWER. The nurse's role in the informed consent process is
to witness the client's signature, confirming that the signature is voluntary and that the client appears
competent to sign. The nurse does not verify understanding of the procedure details.
Rationale for Option C: This is incorrect. Explaining the surgical procedure, including risks, benefits, and
alternatives, is the responsibility of the health care provider performing the procedure, not the nurse.
Rationale for Option D: This is incorrect. While the nurse should advocate for the client, ensuring that
the health care provider ANSWERs all questions is the provider's responsibility. The nurse's role is
limited to witnessing the signature.
SECTION 2: PRIORITIZATION AND DELEGATION
Question 6
The nurse is prioritizing client care after receiving the hand-off report. The nurse should first plan to see
the client who:
a. Has cirrhosis, reports several new areas of ecchymosis, and has a partial thromboplastin time (PTT) of
76 seconds.
b. Has pancreatitis and is reporting mid-epigastric discomfort.
c. Had a transesophageal echocardiogram (TEE) 2 hours ago, has a blood pressure (BP) of 106/61 mm
Hg, and reports a sore throat.
d. Had a laparoscopic cholecystectomy 18 hours ago and is reporting bilateral shoulder pain.
Correct ANSWER: A
Rationale for Option A: This is the correct ANSWER. The client with cirrhosis has new ecchymosis and an
elevated PTT of 76 seconds (normal is approximately 25-35 seconds), indicating a significant bleeding
risk. This client requires immediate assessment for active bleeding and potential intervention to prevent
hemorrhage, making this the highest priority.
Rationale for Option B: This is incorrect. Mid-epigastric discomfort is an expected finding in pancreatitis.
While this client needs assessment and pain management, this is not as urgent as a potential bleeding
disorder.
Rationale for Option C: This is incorrect. A sore throat is an expected finding after a transesophageal
echocardiogram due to the scope passing through the throat. The blood pressure is within normal limits.
This is the lowest priority.
