— Code: MA-RN-JP | 100-Question
Advanced Practice Exam 2026 |
Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1.
A Massachusetts RN is asked to delegate a nursing activity to an unlicensed
assistive personnel (UAP). The patient is clinically unstable and the task requires
the UAP to recognize changes in the patient's condition. What is the most
appropriate action?
A. Delegate the task because the UAP has completed hospital orientation
B. Delegate the task and require the UAP to report abnormalities
C. Do not delegate the activity because it requires nursing assessment and
judgment
D. Delegate the task if another RN is available on the unit
,Answer: Do not delegate the activity because it requires nursing assessment and
judgment
Rationale: Massachusetts regulations require the RN to determine whether a
task can safely be delegated. Activities requiring nursing assessment or
judgment during implementation are not appropriate for delegation to an
unlicensed person.
2.
Under Massachusetts nursing regulations, which person remains directly
responsible for nursing care after delegating an appropriate activity to a UAP?
A. The UAP
B. The nurse manager
C. The attending physician
D. The licensed nurse who delegated the activity
Answer: The licensed nurse who delegated the activity
Rationale: The qualified licensed nurse remains directly responsible for the
nursing care provided and makes the professional judgment regarding whether
delegation is appropriate.
3.
An RN delegates assistance with ambulation to a trained UAP. Which factor is
most important in determining the required level of supervision?
A. The UAP's seniority
B. The hospital's staffing budget
C. The patient's stability, the UAP's competence, the task, and nurse availability
D. Whether the UAP has worked at the facility for more than one year
,Answer: The patient's stability, the UAP's competence, the task, and nurse
availability
Rationale: Massachusetts delegation rules identify patient stability, UAP
training and capability, the nature of the task, and the proximity and availability
of the licensed nurse as factors in determining supervision.
4.
Which activity would generally be inappropriate for delegation to a UAP?
A. Assisting with hygiene
B. Measuring routine intake and output
C. Assisting with mobility
D. Evaluating a patient's response to nursing interventions
Answer: Evaluating a patient's response to nursing interventions
Rationale: Evaluation of the patient's response requires nursing judgment and
remains within the licensed nurse's responsibilities.
5.
An RN delegates a task to a UAP who has no documented competency for the
task. What should the RN do?
A. Proceed because the task is simple
B. Allow the UAP to perform it under verbal supervision
C. Do not delegate the task until the required competency has been established
and documented
D. Ask another UAP to supervise the individual
Answer: Do not delegate the task until the required competency has been
established and documented
, Rationale: Massachusetts delegation requirements include documented
competency appropriate to the delegated activity.
6.
A Massachusetts RN observes another Massachusetts nurse diverting a controlled
substance from a patient's medication supply. What is the most appropriate legal
response?
A. Wait until the nurse admits the diversion
B. Discuss the matter only with coworkers
C. Report the observed conduct through the required channels, including the
Board when the applicable reporting requirement is triggered
D. Ignore it unless patient harm has already occurred
Answer: Report the observed conduct through the required channels, including
the Board when the applicable reporting requirement is triggered
Rationale: Massachusetts standards address a nurse's duty to report certain
directly observed conduct, including diversion of controlled substances.
7.
A nurse hears from another employee that a colleague may be diverting narcotics
but did not personally observe the conduct. Under the Massachusetts Board's
specific duty-to-report guidance, what is significant?
A. A rumor automatically creates a mandatory Board report
B. The nurse must immediately report every rumor to the Board
C. The specific duty described by the Board applies when the nurse personally
observes the reportable conduct
D. The nurse can report the colleague anonymously without further consideration