BANK: 100 BLUEPRINT-ALIGNED
QUESTIONS WITH DETAILED
RATIONALES FOR 2026/2027
Section I: Safe and Effective Care Environment
(Leadership, Delegation, Safety) — 15 Questions
1. A PN is caring for four clients. Which client should the PN assess first?
A. A client requesting pain medication for a headache
B. A client with a new onset of confusion and BP 88/52
C. A client awaiting discharge teaching
D. A client with a fasting blood glucose of 110 mg/dL
Answer: B. New confusion with hypotension suggests inadequate cerebral perfusion
and possible shock; this is the priority using ABCs and safety frameworks.
2. Which task is appropriate for the PN to delegate to unlicensed assistive personnel
(UAP)?
A. Administering a scheduled oral medication
B. Measuring and recording intake and output
C. Performing a sterile dressing change
D. Teaching a client about a new prescription
Answer: B. Intake and output measurement is a standard delegate task to UAP.
Medication administration, sterile procedures, and teaching require a licensed nurse.
3. A client with suspected tuberculosis is placed on airborne precautions. Which
action is essential?
A. Wear a surgical mask when entering the room
B. Place the client in a negative-pressure room with the door closed
,C. Wear gloves only when touching the client
D. Keep the door open for observation
Answer: B. Airborne precautions require a negative-pressure airborne infection
isolation room (AIIR) with the door closed, plus an N95 respirator for staff .
4. The PN is preparing to transfer a client from bed to wheelchair. Which action
demonstrates correct body mechanics?
A. Bend at the waist with knees straight
B. Keep the client close and bend at the knees and hips
C. Twist the torso while lifting
D. Stand with feet close together
Answer: B. Keeping the load close and bending at the knees/hips uses leg muscles
and protects the lumbar spine .
5. A client's family member calls the charge nurse to complain about inadequate
nighttime care by the PN. What is the nurse's best initial response?
A. Tell the family member to speak to the unit manager
B. Ask the family member to describe what happened during the night
C. Reassure the family that care will improve
D. Explain that staff are doing their best
Answer: B. Gathering objective information is the first step in addressing concerns
and demonstrates advocacy .
6. Which finding requires immediate intervention by the PN?
A. A client's IV site with mild redness at the insertion site
B. A client with a new onset of stridor and difficulty breathing
C. A client refusing a scheduled dose of antibiotics
D. A client requesting a different type of pillow
Answer: B. Stridor indicates upper airway obstruction and is an immediate airway
emergency (ABC priority).
, 7. The PN is delegating to a UAP. Which statement reflects correct delegation?
A. "You can assess the client's lung sounds while I get supplies."
B. "Please report to me immediately if the client complains of chest pain."
C. "Give the PRN pain medication if the client asks."
D. "Decide whether the client needs a dressing change."
Answer: B. Reporting changes in condition is an appropriate UAP responsibility;
assessment, medication administration, and clinical decision-making remain with the
licensed nurse.
8. A client is on contact precautions for a wound infection. Which PPE is required for
entering the room?
A. N95 respirator only
B. Gown and gloves
C. Surgical mask only
D. No PPE is required for contact precautions
Answer: B. Contact precautions require gown and gloves for room entry .
9. Which action best demonstrates the PN's role in disaster preparedness?
A. Triaging clients according to severity of injury
B. Performing surgery in the field
C. Prescribing antibiotics for infected wounds
D. Discharging clients without provider orders
Answer: A. Triage is a core nursing role in disaster response within the PN scope of
practice.
10. A client with a history of falls is admitted. Which intervention is the priority?
A. Place the call light within reach and keep the bed in the lowest position
B. Apply restraints immediately
C. Keep the side rails up with the bed in the highest position
D. Encourage the client to ambulate without assistance
Answer: A. Basic fall precautions include bed in low position, call light accessible,
and frequent rounding. Restraints are a last resort and require specific orders.