NUR 3805 – Transition to Professional
Nursing Exam | 2025/2026 Verified
Questions and Answers
1. A client refuses a blood transfusion due to religious beliefs but is actively
hemorrhaging. The nurse’s best action is:Respect the client’s refusal, provide
alternative volume expanders, and document informed refusal. Rationale:
Autonomy is the primary ethical principle when a competent adult refuses
life-sustaining treatment (Jehovah’s Witness doctrine). The nurse must honor the
refusal while offering acceptable alternatives.
2. Which situation violates HIPAA?Discussing a client’s diagnosis in the elevator
with another nurse using the client’s name. Rationale: Protected health information
(PHI) cannot be disclosed in public areas where it may be overheard (minimum
necessary rule).
3. A nurse delegates vital signs to a UAP on a newly admitted client with
unstable angina. This is:Inappropriate delegation. Rationale: Assessment of
unstable clients is within the RN scope; delegation violates the “Five Rights”
(right task, right person) and NCSBN guidelines.
4. The nurse discovers a medication error (wrong dose given). The first action
is:Assess the client, notify the provider, then complete an incident report.
Rationale: Patient safety is priority (QSEN competency). Incident reports are
non-punitive and used for system improvement.
5. According to the ANA Code of Ethics, the nurse’s primary commitment is
to:The patient. Rationale: Provision 2: “The nurse’s primary commitment is to the
patient, whether an individual, family, group, community, or population.”
6. A client asks the nurse to pray with him. The nurse is an atheist. The ethical
response is:Offer to sit quietly or call the chaplain; the nurse is not obligated to
pray personally. Rationale: Respect for patient dignity and spiritual needs
(Provision 1), but nurses are not required to violate personal beliefs.
7. Which action demonstrates beneficence?Advocating for pain medication for a
client whose provider is reluctant to order opioids. Rationale: Beneficence = doing
good; advocating prevents unnecessary suffering.
8. A nurse suspects elder abuse by the client’s son. The legal obligation is:Report
to Adult Protective Services immediately. Rationale: Mandatory reporting law in
, all 50 states; nurses are mandated reporters for suspected abuse of vulnerable
adults.
9. The nurse researcher wants to include children in a study on pain
management. The ethical requirement is:Assent from the child and informed
consent from the parent/guardian. Rationale: Belmont Report and federal
regulations require assent from children ≥7 years plus parental permission.
10. A client with schizophrenia refuses antipsychotic medication. The nurse
should:Assess decision-making capacity; if lacking, follow legal process for
involuntary treatment. Rationale: Patients retain autonomy unless deemed
incompetent by court or emergency criteria.
11.Which is an example of veracity?Telling a client the full truth about a terminal
prognosis when asked directly. Rationale: Veracity = truth-telling; builds trust and
supports informed decision-making.
12. The nurse is floated to the ICU but has no critical care experience. The
ethical response is:Inform the charge nurse/supervisor of lack of competency and
request orientation or reassignment. Rationale: Provision 3 – The nurse must
practice competently and accept only assignments for which prepared.
13. SBAR communication is an example of which IOM/QSEN
competency?Teamwork and Collaboration / Safety Rationale: Standardized
handoff reduces errors (Joint Commission National Patient Safety Goal).
14. A client is declared brain dead. The family refuses organ donation. The
nurse must:Respect the family’s decision; no coercion is allowed. Rationale:
Organ donation requires explicit consent (opt-in system in most states).
15. Which action violates the Nurse Practice Act?An LPN performing initial
admission assessment on a client in the ED. Rationale: Initial assessment is
reserved for RNs in most state NPAs.
16. The nurse finds a coworker diverting narcotics. The first action is:Report
to the nurse manager or through the chain of command. Rationale: Public
protection is priority; impaired practice endangers patients.
17. Just Culture emphasizes:System accountability over individual blame for
human errors. Rationale: Encourages reporting of near-misses and errors to
improve safety (James Reason model).
18. A client on comfort care has a DNR but the family demands “everything
done.” The nurse should:Clarify goals of care with the healthcare team and
support the legally documented DNR. Rationale: DNR orders are physician orders
and legally binding.
Nursing Exam | 2025/2026 Verified
Questions and Answers
1. A client refuses a blood transfusion due to religious beliefs but is actively
hemorrhaging. The nurse’s best action is:Respect the client’s refusal, provide
alternative volume expanders, and document informed refusal. Rationale:
Autonomy is the primary ethical principle when a competent adult refuses
life-sustaining treatment (Jehovah’s Witness doctrine). The nurse must honor the
refusal while offering acceptable alternatives.
2. Which situation violates HIPAA?Discussing a client’s diagnosis in the elevator
with another nurse using the client’s name. Rationale: Protected health information
(PHI) cannot be disclosed in public areas where it may be overheard (minimum
necessary rule).
3. A nurse delegates vital signs to a UAP on a newly admitted client with
unstable angina. This is:Inappropriate delegation. Rationale: Assessment of
unstable clients is within the RN scope; delegation violates the “Five Rights”
(right task, right person) and NCSBN guidelines.
4. The nurse discovers a medication error (wrong dose given). The first action
is:Assess the client, notify the provider, then complete an incident report.
Rationale: Patient safety is priority (QSEN competency). Incident reports are
non-punitive and used for system improvement.
5. According to the ANA Code of Ethics, the nurse’s primary commitment is
to:The patient. Rationale: Provision 2: “The nurse’s primary commitment is to the
patient, whether an individual, family, group, community, or population.”
6. A client asks the nurse to pray with him. The nurse is an atheist. The ethical
response is:Offer to sit quietly or call the chaplain; the nurse is not obligated to
pray personally. Rationale: Respect for patient dignity and spiritual needs
(Provision 1), but nurses are not required to violate personal beliefs.
7. Which action demonstrates beneficence?Advocating for pain medication for a
client whose provider is reluctant to order opioids. Rationale: Beneficence = doing
good; advocating prevents unnecessary suffering.
8. A nurse suspects elder abuse by the client’s son. The legal obligation is:Report
to Adult Protective Services immediately. Rationale: Mandatory reporting law in
, all 50 states; nurses are mandated reporters for suspected abuse of vulnerable
adults.
9. The nurse researcher wants to include children in a study on pain
management. The ethical requirement is:Assent from the child and informed
consent from the parent/guardian. Rationale: Belmont Report and federal
regulations require assent from children ≥7 years plus parental permission.
10. A client with schizophrenia refuses antipsychotic medication. The nurse
should:Assess decision-making capacity; if lacking, follow legal process for
involuntary treatment. Rationale: Patients retain autonomy unless deemed
incompetent by court or emergency criteria.
11.Which is an example of veracity?Telling a client the full truth about a terminal
prognosis when asked directly. Rationale: Veracity = truth-telling; builds trust and
supports informed decision-making.
12. The nurse is floated to the ICU but has no critical care experience. The
ethical response is:Inform the charge nurse/supervisor of lack of competency and
request orientation or reassignment. Rationale: Provision 3 – The nurse must
practice competently and accept only assignments for which prepared.
13. SBAR communication is an example of which IOM/QSEN
competency?Teamwork and Collaboration / Safety Rationale: Standardized
handoff reduces errors (Joint Commission National Patient Safety Goal).
14. A client is declared brain dead. The family refuses organ donation. The
nurse must:Respect the family’s decision; no coercion is allowed. Rationale:
Organ donation requires explicit consent (opt-in system in most states).
15. Which action violates the Nurse Practice Act?An LPN performing initial
admission assessment on a client in the ED. Rationale: Initial assessment is
reserved for RNs in most state NPAs.
16. The nurse finds a coworker diverting narcotics. The first action is:Report
to the nurse manager or through the chain of command. Rationale: Public
protection is priority; impaired practice endangers patients.
17. Just Culture emphasizes:System accountability over individual blame for
human errors. Rationale: Encourages reporting of near-misses and errors to
improve safety (James Reason model).
18. A client on comfort care has a DNR but the family demands “everything
done.” The nurse should:Clarify goals of care with the healthcare team and
support the legally documented DNR. Rationale: DNR orders are physician orders
and legally binding.
