Nursing Acceleration Challenge Exam (NACE) I: Foundations of Nursing –
Study Guide (2026/2027)
1. Which action should the nurse take when a medication order is unclear or appears to contain an error?
A. Administer the medication as written to avoid delaying care
B. Clarify the order with the prescribing provider before administering
C. Ask a colleague to interpret the order instead of the prescriber
D. Assume the intended dose based on similar patients
Answer: B
2. A nurse is assessing a peripheral IV site and notes swelling, coolness, and pain around the insertion site
with a sluggish infusion rate. What does this most likely indicate?
A. Normal expected finding
B. IV infiltration
C. Phlebitis with warmth and redness
D. A properly functioning IV site
Answer: B
3. A nurse is completing the first step of the nursing process for a newly admitted patient. Which action
reflects this step?
A. Writing a nursing diagnosis
B. Collecting subjective and objective data through interview and physical exam
C. Administering scheduled medications
D. Evaluating whether goals were met
Answer: B
4. A nurse is assessing a patient's readiness to learn about a new diagnosis. Which factor is most important
to assess first?
A. The patient's preferred learning style only
B. The patient's current emotional state, motivation, and any barriers to learning
C. The time of day the teaching will occur
D. The nurse's personal preference for teaching method
Answer: B
5. Which principle is important when using restraints alternatives to promote patient safety without
restriction of movement?
A. Restraint alternatives are never appropriate and should not be attempted
B. Consider interventions such as increased supervision, environmental modification, and addressing
underlying causes of behavior before considering restraints
C. Restraints should always be the first intervention used
D. Alternatives to restraints are only relevant in pediatric care
Answer: B
6. A nurse is teaching a patient about the correct technique for using crutches. Which instruction is
appropriate?
A. Bear weight on the axillae to support the body
B. Support body weight through the hands and arms, not the axillae
C. Move both crutches and the affected leg simultaneously without a pattern
D. Crutches should be fitted without regard to the patient's height
Answer: B
7. A nurse is performing a sterile dressing change. Which action would break sterile technique?
A. Keeping sterile items within the nurse's field of vision
B. Reaching across a sterile field to retrieve a supply
C. Considering the outer one-inch border of a sterile field as unsterile
,D. Facing the sterile field at all times during the procedure
Answer: B
8. Which finding in the immediate postoperative period would require the nurse to notify the provider
urgently?
A. Patient is drowsy but arousable and oriented
B. Increasing respiratory distress and decreasing oxygen saturation
C. Mild surgical site discomfort
D. Patient voids 300 mL of clear urine
Answer: B
9. A patient with dysphagia is at greatest risk for which complication related to nutrition?
A. Constipation only
B. Aspiration and impaired airway protection during swallowing
C. Excess protein intake
D. Hypertension
Answer: B
10. A nurse is caring for a patient with a new prescription for an anticoagulant. Which teaching point is
most important for patient safety?
A. Increase intake of vitamin K-rich foods without restriction
B. Report any unusual bruising, bleeding, or blood in stool or urine to the provider
C. Discontinue the medication if a dose is missed without notifying the provider
D. No monitoring or precautions are needed with anticoagulant therapy
Answer: B
11. Which developmental milestone would the nurse expect in a healthy 12-month-old infant?
A. Full sentence formation
B. Pulling to stand and beginning to walk with support
C. Running independently
D. Bicycle riding
Answer: B
12. Which action best supports safe sleep practices to reduce the risk of sudden infant death syndrome?
A. Placing the infant to sleep in the prone position on a soft mattress
B. Placing the infant to sleep on their back on a firm, flat surface without loose bedding
C. Allowing the infant to sleep with a blanket covering the face
D. Co-sleeping with the infant in the same bed for safety
Answer: B
13. A nurse identifies a needlestick injury after administering an injection. What is the priority action?
A. Continue with patient care and report the incident at the end of the shift
B. Wash the area immediately, report the incident per facility protocol, and seek appropriate follow-up
care
C. Ignore the injury since it appears minor
D. Only document the injury without seeking medical follow-up
Answer: B
14. During an emergency response, which action reflects correct prioritization when a patient is found
unresponsive and not breathing?
A. Check for a pulse only, without further action
B. Call for help, activate the emergency response system, and begin CPR per current guidelines
C. Wait for the provider to arrive before taking any action
D. Document the finding before initiating a response
Answer: B
15. Which principle should guide a nurse when delegating a task to unlicensed assistive personnel?
A. Any task can be delegated regardless of complexity
, B. Delegate tasks that are routine, have predictable outcomes, and do not require nursing judgment
C. Delegation removes the nurse's accountability for patient outcomes
D. Delegate only tasks involving medication administration
Answer: B
16. Which finding in a patient with diabetes would indicate a need for further diabetic foot care education?
A. Patient inspects feet daily and wears properly fitted shoes
B. Patient reports walking barefoot frequently and has not noticed a small wound on the foot
C. Patient reports scheduled podiatry visits
D. Patient demonstrates proper foot hygiene technique
Answer: B
17. Which nursing intervention is most appropriate for a patient experiencing acute anxiety?
A. Leave the patient alone in a quiet room without checking in
B. Remain with the patient, speak calmly, and use short, simple statements
C. Encourage the patient to make major decisions immediately
D. Minimize the environment stimulation is not necessary
Answer: B
18. Which finding in a postpartum patient would be considered a normal expected change?
A. Heavy bright red bleeding saturating a pad within 15 minutes
B. Fundus firm and located at the level of the umbilicus shortly after delivery
C. Temperature of 102°F on postpartum day two
D. Severe unilateral calf pain and swelling
Answer: B
19. When prioritizing care for multiple patients, which situation should the nurse assess first?
A. A patient requesting routine pain medication that is not yet due
B. A patient reporting new onset chest pain and shortness of breath
C. A patient asking for extra blankets
D. A patient due for a scheduled dressing change in one hour
Answer: B
20. A patient recovering from hip replacement surgery should avoid which movement to prevent
dislocation?
A. Keeping the hip in a neutral, extended position
B. Crossing the legs or flexing the hip beyond 90 degrees
C. Using an abduction pillow as instructed
D. Avoiding internal rotation of the hip
Answer: B
21. Which action is appropriate before administering an oral medication to a patient?
A. Verify the patient's identity using at least two identifiers and assess for swallowing ability
B. Assume the patient can swallow without any assessment
C. Skip identity verification if the nurse knows the patient well
D. Crush all oral medications routinely regardless of formulation
Answer: A
22. A patient is scheduled for a procedure requiring conscious sedation. Which monitoring parameter is
most critical during the procedure?
A. Blood glucose only
B. Continuous monitoring of respiratory status, oxygen saturation, and level of consciousness
C. Body temperature only
D. No monitoring is required during conscious sedation
Answer: B
23. Which nursing action is appropriate when caring for a patient receiving supplemental oxygen via nasal
cannula?
Study Guide (2026/2027)
1. Which action should the nurse take when a medication order is unclear or appears to contain an error?
A. Administer the medication as written to avoid delaying care
B. Clarify the order with the prescribing provider before administering
C. Ask a colleague to interpret the order instead of the prescriber
D. Assume the intended dose based on similar patients
Answer: B
2. A nurse is assessing a peripheral IV site and notes swelling, coolness, and pain around the insertion site
with a sluggish infusion rate. What does this most likely indicate?
A. Normal expected finding
B. IV infiltration
C. Phlebitis with warmth and redness
D. A properly functioning IV site
Answer: B
3. A nurse is completing the first step of the nursing process for a newly admitted patient. Which action
reflects this step?
A. Writing a nursing diagnosis
B. Collecting subjective and objective data through interview and physical exam
C. Administering scheduled medications
D. Evaluating whether goals were met
Answer: B
4. A nurse is assessing a patient's readiness to learn about a new diagnosis. Which factor is most important
to assess first?
A. The patient's preferred learning style only
B. The patient's current emotional state, motivation, and any barriers to learning
C. The time of day the teaching will occur
D. The nurse's personal preference for teaching method
Answer: B
5. Which principle is important when using restraints alternatives to promote patient safety without
restriction of movement?
A. Restraint alternatives are never appropriate and should not be attempted
B. Consider interventions such as increased supervision, environmental modification, and addressing
underlying causes of behavior before considering restraints
C. Restraints should always be the first intervention used
D. Alternatives to restraints are only relevant in pediatric care
Answer: B
6. A nurse is teaching a patient about the correct technique for using crutches. Which instruction is
appropriate?
A. Bear weight on the axillae to support the body
B. Support body weight through the hands and arms, not the axillae
C. Move both crutches and the affected leg simultaneously without a pattern
D. Crutches should be fitted without regard to the patient's height
Answer: B
7. A nurse is performing a sterile dressing change. Which action would break sterile technique?
A. Keeping sterile items within the nurse's field of vision
B. Reaching across a sterile field to retrieve a supply
C. Considering the outer one-inch border of a sterile field as unsterile
,D. Facing the sterile field at all times during the procedure
Answer: B
8. Which finding in the immediate postoperative period would require the nurse to notify the provider
urgently?
A. Patient is drowsy but arousable and oriented
B. Increasing respiratory distress and decreasing oxygen saturation
C. Mild surgical site discomfort
D. Patient voids 300 mL of clear urine
Answer: B
9. A patient with dysphagia is at greatest risk for which complication related to nutrition?
A. Constipation only
B. Aspiration and impaired airway protection during swallowing
C. Excess protein intake
D. Hypertension
Answer: B
10. A nurse is caring for a patient with a new prescription for an anticoagulant. Which teaching point is
most important for patient safety?
A. Increase intake of vitamin K-rich foods without restriction
B. Report any unusual bruising, bleeding, or blood in stool or urine to the provider
C. Discontinue the medication if a dose is missed without notifying the provider
D. No monitoring or precautions are needed with anticoagulant therapy
Answer: B
11. Which developmental milestone would the nurse expect in a healthy 12-month-old infant?
A. Full sentence formation
B. Pulling to stand and beginning to walk with support
C. Running independently
D. Bicycle riding
Answer: B
12. Which action best supports safe sleep practices to reduce the risk of sudden infant death syndrome?
A. Placing the infant to sleep in the prone position on a soft mattress
B. Placing the infant to sleep on their back on a firm, flat surface without loose bedding
C. Allowing the infant to sleep with a blanket covering the face
D. Co-sleeping with the infant in the same bed for safety
Answer: B
13. A nurse identifies a needlestick injury after administering an injection. What is the priority action?
A. Continue with patient care and report the incident at the end of the shift
B. Wash the area immediately, report the incident per facility protocol, and seek appropriate follow-up
care
C. Ignore the injury since it appears minor
D. Only document the injury without seeking medical follow-up
Answer: B
14. During an emergency response, which action reflects correct prioritization when a patient is found
unresponsive and not breathing?
A. Check for a pulse only, without further action
B. Call for help, activate the emergency response system, and begin CPR per current guidelines
C. Wait for the provider to arrive before taking any action
D. Document the finding before initiating a response
Answer: B
15. Which principle should guide a nurse when delegating a task to unlicensed assistive personnel?
A. Any task can be delegated regardless of complexity
, B. Delegate tasks that are routine, have predictable outcomes, and do not require nursing judgment
C. Delegation removes the nurse's accountability for patient outcomes
D. Delegate only tasks involving medication administration
Answer: B
16. Which finding in a patient with diabetes would indicate a need for further diabetic foot care education?
A. Patient inspects feet daily and wears properly fitted shoes
B. Patient reports walking barefoot frequently and has not noticed a small wound on the foot
C. Patient reports scheduled podiatry visits
D. Patient demonstrates proper foot hygiene technique
Answer: B
17. Which nursing intervention is most appropriate for a patient experiencing acute anxiety?
A. Leave the patient alone in a quiet room without checking in
B. Remain with the patient, speak calmly, and use short, simple statements
C. Encourage the patient to make major decisions immediately
D. Minimize the environment stimulation is not necessary
Answer: B
18. Which finding in a postpartum patient would be considered a normal expected change?
A. Heavy bright red bleeding saturating a pad within 15 minutes
B. Fundus firm and located at the level of the umbilicus shortly after delivery
C. Temperature of 102°F on postpartum day two
D. Severe unilateral calf pain and swelling
Answer: B
19. When prioritizing care for multiple patients, which situation should the nurse assess first?
A. A patient requesting routine pain medication that is not yet due
B. A patient reporting new onset chest pain and shortness of breath
C. A patient asking for extra blankets
D. A patient due for a scheduled dressing change in one hour
Answer: B
20. A patient recovering from hip replacement surgery should avoid which movement to prevent
dislocation?
A. Keeping the hip in a neutral, extended position
B. Crossing the legs or flexing the hip beyond 90 degrees
C. Using an abduction pillow as instructed
D. Avoiding internal rotation of the hip
Answer: B
21. Which action is appropriate before administering an oral medication to a patient?
A. Verify the patient's identity using at least two identifiers and assess for swallowing ability
B. Assume the patient can swallow without any assessment
C. Skip identity verification if the nurse knows the patient well
D. Crush all oral medications routinely regardless of formulation
Answer: A
22. A patient is scheduled for a procedure requiring conscious sedation. Which monitoring parameter is
most critical during the procedure?
A. Blood glucose only
B. Continuous monitoring of respiratory status, oxygen saturation, and level of consciousness
C. Body temperature only
D. No monitoring is required during conscious sedation
Answer: B
23. Which nursing action is appropriate when caring for a patient receiving supplemental oxygen via nasal
cannula?
