PROPHECY – CORE MANDATORY PART II (NURSING) EXAM 2025–2026 |
QUESTIONS & CORRECT ANSWERS | 100% VERIFIED SOLUTIONS OF
APPROVED EXCELLENCY | ALREADY GRADED A+
Nursing Competency Assessment | Key Domains: Patient Safety, Clinical Judgment,
Pharmacology, Medical-Surgical Care, Maternal & Child Health, Mental Health, Evidence-
Based Practice, and Professional Nursing Standards | Expert-Verified Format & Structure |
Exam-Ready
Introduction
This 2025–2026 Prophecy Core Mandatory Part II Nursing Exam format provides the
complete structural layout for generating validated nursing exam content with correct
solutions. It emphasizes safe, evidence-based nursing practices, clinical decision-making,
priority interventions, and professional standards. All exam content created using this
format supports mastery of essential nursing competencies and high-level clinical reasoning.
Answer Format
All correct answers must appear in bold green, with concise rationales that explain clinical
reasoning, nursing priorities, and why alternative responses are less appropriate.
PATIENT SAFETY & CLINICAL JUDGMENT (Questions 1–20)
1. A patient is receiving IV heparin. The nurse notes the patient has black tarry
stools. What is the priority action?
a) Increase the heparin dose
b) Document the finding and continue monitoring
c) Hold the heparin and notify the provider immediately
d) Administer vitamin K
Rationale: Black tarry stools indicate GI bleeding; heparin increases bleeding risk and must
be stopped immediately.
2. Which action best prevents catheter-associated urinary tract infections
(CAUTI)?
a) Daily catheter irrigation
b) Apply antibiotic ointment to the meatus
c) Remove the catheter as soon as clinically indicated
d) Change the catheter every 3 days
Rationale: Early removal is the most effective evidence-based strategy to prevent CAUTI.
3. A patient is on contact precautions for MRSA. Which action by the nurse is
appropriate?
a) Share a stethoscope between patients
b) Wear a gown only during invasive procedures
c) Wear gloves and gown upon room entry
d) Remove precautions after 24 hours
Rationale: Contact precautions require gloves and gown every time you enter the room.
4. The nurse is preparing to administer a blood transfusion. Which patient
observation indicates a possible hemolytic reaction?
a) Mild fever
b) Itching
c) Severe lower back pain and hypotension
, d) Slight chills
Rationale: Severe back pain and hypotension are classic signs of acute hemolytic reaction—
stop transfusion immediately.
5. A patient is receiving morphine via PCA. The nurse notes a respiratory rate of
8/min. What is the first action?
a) Encourage deep breathing
b) Reduce the PCA dose
c) Stop the PCA and administer naloxone per protocol
d) Apply oxygen only
Rationale: Respiratory rate <10 is life-threatening; naloxone reverses opioid toxicity.
6. A patient is at risk for falls. Which intervention is most effective?
a) Keep bed in high position
b) Apply restraints
c) Perform hourly rounding and keep bed in low position
d) Dim lights completely
Rationale: Hourly rounding and low bed position reduce fall risk significantly.
7. A patient is receiving IV potassium. Which finding requires immediate
intervention?
a) Urine output 40 mL/hr
b) BP 130/80
c) Cardiac dysrhythmias on the monitor
d) Patient reports mild warmth at IV site
Rationale: IV potassium can cause fatal arrhythmias if infused too quickly—stop infusion
and notify provider.
8. The nurse is preparing insulin. Which insulin can be given IV?
a) NPH
b) Lantus
c) Regular
d) Levemir
Rationale: Only regular insulin can be administered intravenously.
9. A patient is on warfarin. The nurse notes an INR of 5.2. What is the priority?
a) Give the next dose as scheduled
b) Administer vitamin K without an order
c) Hold warfarin and notify provider
d) Increase the dose
Rationale: INR >4.5 increases bleeding risk; warfarin should be held and provider notified.
10. A patient is receiving a heparin drip. The aPTT is 120 seconds (normal 30–
40). What should the nurse do?
a) Increase the drip rate
b) Document and continue
c) Stop the infusion and notify the provider
d) Administer protamine sulfate without an order
Rationale: aPTT >3x normal indicates over-anticoagulation; stop infusion and call
provider.
11. A patient is on contact isolation. Which statement is correct?
a) Visitors do not need to wear PPE
b) Isolation can be discontinued after 48 hours
QUESTIONS & CORRECT ANSWERS | 100% VERIFIED SOLUTIONS OF
APPROVED EXCELLENCY | ALREADY GRADED A+
Nursing Competency Assessment | Key Domains: Patient Safety, Clinical Judgment,
Pharmacology, Medical-Surgical Care, Maternal & Child Health, Mental Health, Evidence-
Based Practice, and Professional Nursing Standards | Expert-Verified Format & Structure |
Exam-Ready
Introduction
This 2025–2026 Prophecy Core Mandatory Part II Nursing Exam format provides the
complete structural layout for generating validated nursing exam content with correct
solutions. It emphasizes safe, evidence-based nursing practices, clinical decision-making,
priority interventions, and professional standards. All exam content created using this
format supports mastery of essential nursing competencies and high-level clinical reasoning.
Answer Format
All correct answers must appear in bold green, with concise rationales that explain clinical
reasoning, nursing priorities, and why alternative responses are less appropriate.
PATIENT SAFETY & CLINICAL JUDGMENT (Questions 1–20)
1. A patient is receiving IV heparin. The nurse notes the patient has black tarry
stools. What is the priority action?
a) Increase the heparin dose
b) Document the finding and continue monitoring
c) Hold the heparin and notify the provider immediately
d) Administer vitamin K
Rationale: Black tarry stools indicate GI bleeding; heparin increases bleeding risk and must
be stopped immediately.
2. Which action best prevents catheter-associated urinary tract infections
(CAUTI)?
a) Daily catheter irrigation
b) Apply antibiotic ointment to the meatus
c) Remove the catheter as soon as clinically indicated
d) Change the catheter every 3 days
Rationale: Early removal is the most effective evidence-based strategy to prevent CAUTI.
3. A patient is on contact precautions for MRSA. Which action by the nurse is
appropriate?
a) Share a stethoscope between patients
b) Wear a gown only during invasive procedures
c) Wear gloves and gown upon room entry
d) Remove precautions after 24 hours
Rationale: Contact precautions require gloves and gown every time you enter the room.
4. The nurse is preparing to administer a blood transfusion. Which patient
observation indicates a possible hemolytic reaction?
a) Mild fever
b) Itching
c) Severe lower back pain and hypotension
, d) Slight chills
Rationale: Severe back pain and hypotension are classic signs of acute hemolytic reaction—
stop transfusion immediately.
5. A patient is receiving morphine via PCA. The nurse notes a respiratory rate of
8/min. What is the first action?
a) Encourage deep breathing
b) Reduce the PCA dose
c) Stop the PCA and administer naloxone per protocol
d) Apply oxygen only
Rationale: Respiratory rate <10 is life-threatening; naloxone reverses opioid toxicity.
6. A patient is at risk for falls. Which intervention is most effective?
a) Keep bed in high position
b) Apply restraints
c) Perform hourly rounding and keep bed in low position
d) Dim lights completely
Rationale: Hourly rounding and low bed position reduce fall risk significantly.
7. A patient is receiving IV potassium. Which finding requires immediate
intervention?
a) Urine output 40 mL/hr
b) BP 130/80
c) Cardiac dysrhythmias on the monitor
d) Patient reports mild warmth at IV site
Rationale: IV potassium can cause fatal arrhythmias if infused too quickly—stop infusion
and notify provider.
8. The nurse is preparing insulin. Which insulin can be given IV?
a) NPH
b) Lantus
c) Regular
d) Levemir
Rationale: Only regular insulin can be administered intravenously.
9. A patient is on warfarin. The nurse notes an INR of 5.2. What is the priority?
a) Give the next dose as scheduled
b) Administer vitamin K without an order
c) Hold warfarin and notify provider
d) Increase the dose
Rationale: INR >4.5 increases bleeding risk; warfarin should be held and provider notified.
10. A patient is receiving a heparin drip. The aPTT is 120 seconds (normal 30–
40). What should the nurse do?
a) Increase the drip rate
b) Document and continue
c) Stop the infusion and notify the provider
d) Administer protamine sulfate without an order
Rationale: aPTT >3x normal indicates over-anticoagulation; stop infusion and call
provider.
11. A patient is on contact isolation. Which statement is correct?
a) Visitors do not need to wear PPE
b) Isolation can be discontinued after 48 hours
