NEW ZEALAND NURSING STATE FINAL EXAM
AND PRACTICE EXAM NEWEST 2026 QUESTIONS
AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
Core Domains
• Professional Responsibility and Ethics
• Clinical Judgement and Decision-Making
• Medication Calculations and Administration
• Cultural Safety and Te Tiriti o Waitangi
• Mental Health and Addictions
• Maternal and Child Health
• Medical and Surgical Nursing
• Community and Primary Health Care
• Critical Care and Emergency Nursing
• Leadership, Delegation, and Advocacy
Introduction
The New Zealand Nursing State Final Examination assesses the candidate's
readiness to practise as a registered or enrolled nurse under the Health
Practitioners Competence Assurance Act 2003. It evaluates professional
responsibility, clinical judgement, medication calculation, cultural safety, and
application of the nursing process across the lifespan. The examination uses
multiple-choice questions with four options, requiring selection of the single best
answer. A pass mark of 70% overall is required. Candidates must demonstrate
critical thinking, ethical decision-making, and safe clinical practice aligned with
Nursing Council of New Zealand standards.
SECTION ONE: QUESTIONS 1–100
1. The role of the Nursing Council of New Zealand is to:
,A. Protect the unregulated and regulated health workforce
B. Regulate doctors to protect public safety
C. Regulate nursing to protect public safety
D. Protect the nursing workforce
C. Regulate nursing to protect public safety
RATIONALE: The Nursing Council is a statutory body under the Health
Practitioners Competence Assurance Act 2003. Its primary purpose is to protect
the health and safety of members of the public by ensuring nurses are competent
and fit to practise.
2. A patient has been prescribed morphine 8 mg 2–3 hourly PRN for pain.
Unit stock of morphine is 10 mg/1 mL. How much morphine should be drawn
up for the patient?
A. 0.08 mL
B. 0.25 mL
C. 0.75 mL
D. 0.80 mL
D. 0.80 mL
RATIONALE: 8 mg ÷ 10 mg/mL = 0.8 mL. Medication calculations are
approximately 10% of the examination and test accuracy under time pressure.
3. A child weighs 22.4 kg, and the prescription is for 24 mg/kg of body weight.
The medication comes at a strength of 50 mg/mL. How many mL (to one
decimal place) should the child receive?
A. 7.5 mL
B. 8.5 mL
C. 9.8 mL
D. 10.8 mL
D. 10.8 mL
RATIONALE: 22.4 kg × 24 mg/kg = 537.6 mg. 537.6 mg ÷ 50 mg/mL =
10.752 mL, rounded to 10.8 mL.
,4. A patient is prescribed 250 mg of antibiotics in 200 mL of intravenous fluid
over 30 minutes. What rate in mL per hour should the infusion device be set
to?
A. 100 mL per hour
B. 200 mL per hour
C. 400 mL per hour
D. 500 mL per hour
C. 400 mL per hour
RATIONALE: 200 mL over 30 minutes equals 400 mL over 60 minutes. The
rate is therefore 400 mL per hour.
5. A mother asks why her child needs to be weighed before scheduled surgery.
What is the best response?
A. "Surgery is not carried out on children above the ideal body weight."
B. "We need to compare your child's weight before and after the procedure."
C. "Medication doses for children are often based on weight to ensure safety."
D. "It is routine for all paediatric admissions."
C. "Medication doses for children are often based on weight to ensure safety."
RATIONALE: Paediatric medication dosing is frequently weight-based. The
nurse's response should provide a clear, honest rationale that supports the family's
understanding.
6. Prior to surgery, a patient is to have nothing to eat or drink. This is
necessary to:
A. Assist in the proper absorption of the anaesthetic
B. Prevent nausea and vomiting immediately after surgery
C. Avoid the danger of inhaling stomach contents (aspiration)
D. Avoid incontinence during surgery
C. Avoid the danger of inhaling stomach contents (aspiration)
RATIONALE: Fasting before surgery reduces the risk of aspiration during
anaesthesia. This is a fundamental patient safety measure.
, 7. A nurse notices a colleague administered medication without checking the
patient's identity. What is the appropriate professional action?
A. Ignore the incident to protect the colleague's reputation
B. Confront the colleague aggressively in front of the patient
C. Alter the medication chart to conceal the error
D. Report the incident through the appropriate organisational pathway
D. Report the incident through the appropriate organisational pathway
RATIONALE: Nurses have a duty to protect patients and uphold professional
standards. Reporting errors and near-misses through proper channels supports a
just culture and system improvement.
8. A competent adult patient with capacity refuses a recommended blood
transfusion on religious grounds. What is the nurse's ethical and legal
obligation?
A. Administer the transfusion against the patient's wishes because it is life-saving
B. Respect the refusal after ensuring the patient has received clear information, and
document the discussion
C. Ask the family to override the patient's decision
D. Sedate the patient and give the transfusion covertly
B. Respect the refusal after ensuring the patient has received clear information,
and document the discussion
RATIONALE: Competent adults have the right to refuse treatment. The
nurse's role is to ensure informed refusal, respect autonomy, and document
thoroughly.
9. A patient with an advance directive states they do not want CPR. The
patient arrests. What should the nurse do?
A. Begin CPR immediately regardless of the directive
B. Call a code and begin compressions
C. Respect the advance directive and withhold CPR, following organisational
policy
D. Ask the family what they want
AND PRACTICE EXAM NEWEST 2026 QUESTIONS
AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
Core Domains
• Professional Responsibility and Ethics
• Clinical Judgement and Decision-Making
• Medication Calculations and Administration
• Cultural Safety and Te Tiriti o Waitangi
• Mental Health and Addictions
• Maternal and Child Health
• Medical and Surgical Nursing
• Community and Primary Health Care
• Critical Care and Emergency Nursing
• Leadership, Delegation, and Advocacy
Introduction
The New Zealand Nursing State Final Examination assesses the candidate's
readiness to practise as a registered or enrolled nurse under the Health
Practitioners Competence Assurance Act 2003. It evaluates professional
responsibility, clinical judgement, medication calculation, cultural safety, and
application of the nursing process across the lifespan. The examination uses
multiple-choice questions with four options, requiring selection of the single best
answer. A pass mark of 70% overall is required. Candidates must demonstrate
critical thinking, ethical decision-making, and safe clinical practice aligned with
Nursing Council of New Zealand standards.
SECTION ONE: QUESTIONS 1–100
1. The role of the Nursing Council of New Zealand is to:
,A. Protect the unregulated and regulated health workforce
B. Regulate doctors to protect public safety
C. Regulate nursing to protect public safety
D. Protect the nursing workforce
C. Regulate nursing to protect public safety
RATIONALE: The Nursing Council is a statutory body under the Health
Practitioners Competence Assurance Act 2003. Its primary purpose is to protect
the health and safety of members of the public by ensuring nurses are competent
and fit to practise.
2. A patient has been prescribed morphine 8 mg 2–3 hourly PRN for pain.
Unit stock of morphine is 10 mg/1 mL. How much morphine should be drawn
up for the patient?
A. 0.08 mL
B. 0.25 mL
C. 0.75 mL
D. 0.80 mL
D. 0.80 mL
RATIONALE: 8 mg ÷ 10 mg/mL = 0.8 mL. Medication calculations are
approximately 10% of the examination and test accuracy under time pressure.
3. A child weighs 22.4 kg, and the prescription is for 24 mg/kg of body weight.
The medication comes at a strength of 50 mg/mL. How many mL (to one
decimal place) should the child receive?
A. 7.5 mL
B. 8.5 mL
C. 9.8 mL
D. 10.8 mL
D. 10.8 mL
RATIONALE: 22.4 kg × 24 mg/kg = 537.6 mg. 537.6 mg ÷ 50 mg/mL =
10.752 mL, rounded to 10.8 mL.
,4. A patient is prescribed 250 mg of antibiotics in 200 mL of intravenous fluid
over 30 minutes. What rate in mL per hour should the infusion device be set
to?
A. 100 mL per hour
B. 200 mL per hour
C. 400 mL per hour
D. 500 mL per hour
C. 400 mL per hour
RATIONALE: 200 mL over 30 minutes equals 400 mL over 60 minutes. The
rate is therefore 400 mL per hour.
5. A mother asks why her child needs to be weighed before scheduled surgery.
What is the best response?
A. "Surgery is not carried out on children above the ideal body weight."
B. "We need to compare your child's weight before and after the procedure."
C. "Medication doses for children are often based on weight to ensure safety."
D. "It is routine for all paediatric admissions."
C. "Medication doses for children are often based on weight to ensure safety."
RATIONALE: Paediatric medication dosing is frequently weight-based. The
nurse's response should provide a clear, honest rationale that supports the family's
understanding.
6. Prior to surgery, a patient is to have nothing to eat or drink. This is
necessary to:
A. Assist in the proper absorption of the anaesthetic
B. Prevent nausea and vomiting immediately after surgery
C. Avoid the danger of inhaling stomach contents (aspiration)
D. Avoid incontinence during surgery
C. Avoid the danger of inhaling stomach contents (aspiration)
RATIONALE: Fasting before surgery reduces the risk of aspiration during
anaesthesia. This is a fundamental patient safety measure.
, 7. A nurse notices a colleague administered medication without checking the
patient's identity. What is the appropriate professional action?
A. Ignore the incident to protect the colleague's reputation
B. Confront the colleague aggressively in front of the patient
C. Alter the medication chart to conceal the error
D. Report the incident through the appropriate organisational pathway
D. Report the incident through the appropriate organisational pathway
RATIONALE: Nurses have a duty to protect patients and uphold professional
standards. Reporting errors and near-misses through proper channels supports a
just culture and system improvement.
8. A competent adult patient with capacity refuses a recommended blood
transfusion on religious grounds. What is the nurse's ethical and legal
obligation?
A. Administer the transfusion against the patient's wishes because it is life-saving
B. Respect the refusal after ensuring the patient has received clear information, and
document the discussion
C. Ask the family to override the patient's decision
D. Sedate the patient and give the transfusion covertly
B. Respect the refusal after ensuring the patient has received clear information,
and document the discussion
RATIONALE: Competent adults have the right to refuse treatment. The
nurse's role is to ensure informed refusal, respect autonomy, and document
thoroughly.
9. A patient with an advance directive states they do not want CPR. The
patient arrests. What should the nurse do?
A. Begin CPR immediately regardless of the directive
B. Call a code and begin compressions
C. Respect the advance directive and withhold CPR, following organisational
policy
D. Ask the family what they want
