LATEST UPDATE 2026/2027 – REX-PN Actual Exam
(210 Questions with Detailed Verified Answers)
Question 1
A client is 1-day post-operative following a total hip arthroplasty. The nurse is planning
care. Which intervention should the nurse delegate to the unlicensed assistive personnel
(UAP)?
A) Assess the client's pain level using a numeric rating scale
B) Apply sequential compression devices (SCDs)
C) Evaluate the client's understanding of hip precautions
D) Assess the surgical incision for signs of infection
Answer: B) Apply sequential compression devices (SCDs)
Rationale: Applying SCDs is a standard, low-risk task that can be delegated to a UAP.
Assessment, evaluation, and teaching require the clinical judgment of a licensed nurse.
This question addresses delegation and assignment according to the client's needs and
staff competencies .
Question 2
A client who is 2 days post-operative after abdominal surgery has developed a cough
with thick, yellow sputum. The client's temperature is 38.5°C (101.3°F). What is the
priority nursing action?
A) Increase the client's oral fluid intake
B) Assist the client to deep breathe and cough
C) Notify the healthcare provider
D) Collect a sputum specimen
Answer: C) Notify the healthcare provider
Rationale: The client is exhibiting signs of a potential respiratory infection (fever,
productive cough with purulent sputum) following surgery. The priority is to notify the
healthcare provider to obtain orders for further assessment and treatment. While deep
,breathing/coughing and increasing fluids are important interventions, the provider must
be informed of this clinical change first.
Question 3
A client with terminal cancer is receiving palliative care. The client's family is concerned
about the client's pain management and requests that the nurse "do everything
possible" to keep the client comfortable. Which ethical principle is the nurse
demonstrating by prioritizing the client's comfort?
A) Beneficence
B) Non-maleficence
C) Autonomy
D) Justice
Answer: A) Beneficence
Rationale: Beneficence is the ethical principle of acting in the patient's best interest and
promoting their well-being. By focusing on comfort and pain management in a palliative
care setting, the nurse is actively working to benefit the client. Non-maleficence is "do
no harm," autonomy respects patient decision-making, and justice is about fair resource
allocation.
Question 4
The nurse is caring for a client with a new diagnosis of diabetes mellitus. Which action
demonstrates the nurse's appropriate use of a standing order?
A) Administering insulin based on the client's daily blood glucose levels
B) Contacting the provider to request an order for pain medication
C) Instructing the UAP on a new procedure
D) Documenting the client's blood pressure
Answer: A) Administering insulin based on the client's daily blood glucose levels
,Rationale: Standing orders are protocols that allow nurses to initiate certain treatments
based on specific clinical parameters, such as a sliding-scale insulin order. This
demonstrates effective use of standardized orders.
Question 5
The nurse is preparing a client for discharge. Which of the following is the most
important factor in ensuring a safe transition home?
A) Confirming that the client has a ride home
B) Evaluating the client's understanding of medication instructions
C) Ensuring the client has a follow-up appointment scheduled
D) Providing a list of community resources
Answer: B) Evaluating the client's understanding of medication instructions
Rationale: Understanding medication instructions is critical for safe self-management at
home. While all options are part of discharge planning, verifying comprehension of the
medication regimen directly impacts safety and adherence.
Question 6
A client with chronic obstructive pulmonary disease (COPD) is being discharged. Which
statement by the client indicates a need for further teaching?
A) "I will use my albuterol inhaler before my fluticasone inhaler."
B) "I should only use my oxygen when I am short of breath."
C) "I will rest my arms on a table when I feel short of breath."
D) "I will take my antibiotics as prescribed, even if I start to feel better."
Answer: B) "I should only use my oxygen when I am short of breath."
Rationale: For clients with COPD requiring supplemental oxygen, the oxygen should be
used continuously as prescribed to maintain adequate saturation levels. Using it only
when short of breath can lead to chronic hypoxia and complications.
Question 7
, The nurse is planning care for a client with a nasogastric (NG) tube to continuous
suction. Which task can the nurse delegate to the LPN?
A) Assessing the client's bowel sounds
B) Irrigating the NG tube per protocol
C) Evaluating the client's fluid and electrolyte balance
D) Teaching the client about the purpose of the NG tube
Answer: B) Irrigating the NG tube per protocol
Rationale: Irrigating an NG tube is a nursing procedure that can be delegated to an LPN
with appropriate competency. Assessment, evaluation, and initial teaching are the
responsibility of the RN.
Question 8
A client with heart failure is experiencing increasing dyspnea and edema. The nurse
should prioritize:
A) Restricting the client's fluid intake
B) Placing the client in a high-Fowler's position
C) Administering a PRN dose of diuretic
D) Notifying the provider of the change in status
Answer: B) Placing the client in a high-Fowler's position
Rationale: The priority is to address the client's dyspnea by positioning them in high-
Fowler's position to maximize lung expansion. This is an immediate, non-
pharmacological intervention. After positioning, the nurse should assess and notify the
provider.
Question 9
The nurse is caring for a client with a prescription for "not for resuscitation" (DNR). The
client begins to manifest signs of impending death. What is the priority action?
A) Document the client's signs of impending death
B) Notify the family of the client's status
(210 Questions with Detailed Verified Answers)
Question 1
A client is 1-day post-operative following a total hip arthroplasty. The nurse is planning
care. Which intervention should the nurse delegate to the unlicensed assistive personnel
(UAP)?
A) Assess the client's pain level using a numeric rating scale
B) Apply sequential compression devices (SCDs)
C) Evaluate the client's understanding of hip precautions
D) Assess the surgical incision for signs of infection
Answer: B) Apply sequential compression devices (SCDs)
Rationale: Applying SCDs is a standard, low-risk task that can be delegated to a UAP.
Assessment, evaluation, and teaching require the clinical judgment of a licensed nurse.
This question addresses delegation and assignment according to the client's needs and
staff competencies .
Question 2
A client who is 2 days post-operative after abdominal surgery has developed a cough
with thick, yellow sputum. The client's temperature is 38.5°C (101.3°F). What is the
priority nursing action?
A) Increase the client's oral fluid intake
B) Assist the client to deep breathe and cough
C) Notify the healthcare provider
D) Collect a sputum specimen
Answer: C) Notify the healthcare provider
Rationale: The client is exhibiting signs of a potential respiratory infection (fever,
productive cough with purulent sputum) following surgery. The priority is to notify the
healthcare provider to obtain orders for further assessment and treatment. While deep
,breathing/coughing and increasing fluids are important interventions, the provider must
be informed of this clinical change first.
Question 3
A client with terminal cancer is receiving palliative care. The client's family is concerned
about the client's pain management and requests that the nurse "do everything
possible" to keep the client comfortable. Which ethical principle is the nurse
demonstrating by prioritizing the client's comfort?
A) Beneficence
B) Non-maleficence
C) Autonomy
D) Justice
Answer: A) Beneficence
Rationale: Beneficence is the ethical principle of acting in the patient's best interest and
promoting their well-being. By focusing on comfort and pain management in a palliative
care setting, the nurse is actively working to benefit the client. Non-maleficence is "do
no harm," autonomy respects patient decision-making, and justice is about fair resource
allocation.
Question 4
The nurse is caring for a client with a new diagnosis of diabetes mellitus. Which action
demonstrates the nurse's appropriate use of a standing order?
A) Administering insulin based on the client's daily blood glucose levels
B) Contacting the provider to request an order for pain medication
C) Instructing the UAP on a new procedure
D) Documenting the client's blood pressure
Answer: A) Administering insulin based on the client's daily blood glucose levels
,Rationale: Standing orders are protocols that allow nurses to initiate certain treatments
based on specific clinical parameters, such as a sliding-scale insulin order. This
demonstrates effective use of standardized orders.
Question 5
The nurse is preparing a client for discharge. Which of the following is the most
important factor in ensuring a safe transition home?
A) Confirming that the client has a ride home
B) Evaluating the client's understanding of medication instructions
C) Ensuring the client has a follow-up appointment scheduled
D) Providing a list of community resources
Answer: B) Evaluating the client's understanding of medication instructions
Rationale: Understanding medication instructions is critical for safe self-management at
home. While all options are part of discharge planning, verifying comprehension of the
medication regimen directly impacts safety and adherence.
Question 6
A client with chronic obstructive pulmonary disease (COPD) is being discharged. Which
statement by the client indicates a need for further teaching?
A) "I will use my albuterol inhaler before my fluticasone inhaler."
B) "I should only use my oxygen when I am short of breath."
C) "I will rest my arms on a table when I feel short of breath."
D) "I will take my antibiotics as prescribed, even if I start to feel better."
Answer: B) "I should only use my oxygen when I am short of breath."
Rationale: For clients with COPD requiring supplemental oxygen, the oxygen should be
used continuously as prescribed to maintain adequate saturation levels. Using it only
when short of breath can lead to chronic hypoxia and complications.
Question 7
, The nurse is planning care for a client with a nasogastric (NG) tube to continuous
suction. Which task can the nurse delegate to the LPN?
A) Assessing the client's bowel sounds
B) Irrigating the NG tube per protocol
C) Evaluating the client's fluid and electrolyte balance
D) Teaching the client about the purpose of the NG tube
Answer: B) Irrigating the NG tube per protocol
Rationale: Irrigating an NG tube is a nursing procedure that can be delegated to an LPN
with appropriate competency. Assessment, evaluation, and initial teaching are the
responsibility of the RN.
Question 8
A client with heart failure is experiencing increasing dyspnea and edema. The nurse
should prioritize:
A) Restricting the client's fluid intake
B) Placing the client in a high-Fowler's position
C) Administering a PRN dose of diuretic
D) Notifying the provider of the change in status
Answer: B) Placing the client in a high-Fowler's position
Rationale: The priority is to address the client's dyspnea by positioning them in high-
Fowler's position to maximize lung expansion. This is an immediate, non-
pharmacological intervention. After positioning, the nurse should assess and notify the
provider.
Question 9
The nurse is caring for a client with a prescription for "not for resuscitation" (DNR). The
client begins to manifest signs of impending death. What is the priority action?
A) Document the client's signs of impending death
B) Notify the family of the client's status
