RNSG 1430| RN CONCEPT-BASED ASSESSMENT
LEVEL 1 NEWEST 2024 ACTUAL EXAM 100
QUESTIONS AND CORRECT DETAILED ANSWERS
Introduction
This practice examination replicates the scope, cognitive level and 2024 curriculum
standards of the RNSG 1430 Level-1 concept-based assessment for pre-licensure BSN
programs.
Domains covered include nursing fundamentals, clinical judgment, patient safety,
foundational skills, healthcare delivery, professional practice, communication &
collaboration.
All items are original and mapped to AACN Essentials, QSEN competencies and ANA
scope-of-practice statements to support mastery-level performance.
General Instructions
• Choose the ONE best answer for each scenario.
• Total: 100 questions (all scored).
• Reference: ANA Scope & Standards (2024), QSEN 2020, AACN Essentials 2021,
CDC Guidelines 2024.
• Passing benchmark: ≥ 78 % (≥ 78/100).
Questions
Question 1
A 68-year-old post-op client receiving morphine IV PCA reports pain 8/10 and
respiratory rate 8/min. Which action is most appropriate?
A. Increase PCA dose for better analgesia
B. Administer naloxone 0.4 mg IV and notify provider
C. Discontinue PCA and switch to oral opioid
D. Encourage deep breathing and coughing
Answer: B. Administer naloxone 0.4 mg IV and notify provider
Solution: Respiratory depression (RR ≤ 8) with opioid use constitutes emergency;
naloxone reverses opioid, maintains airway. Other options delay rescue.
pg. 1
,Question 2
A client on contact isolation asks why staff wear yellow gowns. The nurse’s best
response is:
A. “It’s hospital policy—no special reason.”
B. “We’re protecting you from our germs.”
C. “We use gowns to prevent spreading organisms between patients.”
D. “Gowns protect us from your infection.”
Answer: C. “We use gowns to prevent spreading organisms between patients.”
Solution: Contact precautions prevent cross-transmission; response C explains patient-
to-patient protection and maintains therapeutic relationship.
Question 3
A nurse notes a colleague documenting vital signs before assessment. Which concept is
violated?
A. Accountability
B. Confidentiality
C. Accuracy
D. Privacy
Answer: C. Accuracy
Solution: Recording data not yet obtained constitutes inaccurate documentation,
breaching ANA Code 5.1 (accurate representation).
Question 4
A client with COPD receives O₂ at 4 L/min via nasal cannula. O₂ sat is 97 %. Nurse’s
priority action?
A. Reduce O₂ to 2 L/min
B. Switch to Venturi mask
C. Increase to 6 L/min
D. Document findings
Answer: A. Reduce O₂ to 2 L/min
Solution: High O₂ in COPD can abolish hypoxic drive; target SpO₂ 88–92 %. Reducing
flow prevents CO₂ narcosis.
Question 5
Which action best demonstrates clinical judgment during morning meds?
A. Giving meds on time
B. Checking MAR five times
pg. 2
, C. Holding digoxin when HR 48 and calling provider
D. Signing MAR after administration
Answer: C. Holding digoxin when HR 48 and calling provider
Solution: Clinical judgment integrates assessment (bradycardia), pharmacology
(digoxin), and action (hold + notify) to prevent toxicity.
Question 6
A client’s wound culture grows MRSA. Which PPE is required?
A. Gloves only
B. Gloves and gown
C. Gloves, gown, N95
D. Standard precautions
Answer: B. Gloves and gown
Solution: MRSA = contact precautions → gloves + gown; N95 reserved for airborne
organisms (TB, varicella).
Question 7
A nurse delegates ambulation to AP. Which instruction is most appropriate?
A. “Help patient walk when ready.”
B. “Ambulate patient 50 ft using gait belt, report pain.”
C. “Let patient walk alone if stable.”
D. “Walk patient until tired.”
Answer: B. “Ambulate patient 50 ft using gait belt, report pain.”
Solution: Delegation must be specific, measurable, safe; includes equipment (gait
belt) and reporting parameters.
Question 8
A post-op client has serous drainage on dressing. Nurse documents color as:
A. Green
B. Yellow
C. Clear-straw
D. Brown
Answer: C. Clear-straw
Solution: Serous = clear-straw plasma fluid; green = purulent, yellow = seropurulent,
brown = old blood.
pg. 3
LEVEL 1 NEWEST 2024 ACTUAL EXAM 100
QUESTIONS AND CORRECT DETAILED ANSWERS
Introduction
This practice examination replicates the scope, cognitive level and 2024 curriculum
standards of the RNSG 1430 Level-1 concept-based assessment for pre-licensure BSN
programs.
Domains covered include nursing fundamentals, clinical judgment, patient safety,
foundational skills, healthcare delivery, professional practice, communication &
collaboration.
All items are original and mapped to AACN Essentials, QSEN competencies and ANA
scope-of-practice statements to support mastery-level performance.
General Instructions
• Choose the ONE best answer for each scenario.
• Total: 100 questions (all scored).
• Reference: ANA Scope & Standards (2024), QSEN 2020, AACN Essentials 2021,
CDC Guidelines 2024.
• Passing benchmark: ≥ 78 % (≥ 78/100).
Questions
Question 1
A 68-year-old post-op client receiving morphine IV PCA reports pain 8/10 and
respiratory rate 8/min. Which action is most appropriate?
A. Increase PCA dose for better analgesia
B. Administer naloxone 0.4 mg IV and notify provider
C. Discontinue PCA and switch to oral opioid
D. Encourage deep breathing and coughing
Answer: B. Administer naloxone 0.4 mg IV and notify provider
Solution: Respiratory depression (RR ≤ 8) with opioid use constitutes emergency;
naloxone reverses opioid, maintains airway. Other options delay rescue.
pg. 1
,Question 2
A client on contact isolation asks why staff wear yellow gowns. The nurse’s best
response is:
A. “It’s hospital policy—no special reason.”
B. “We’re protecting you from our germs.”
C. “We use gowns to prevent spreading organisms between patients.”
D. “Gowns protect us from your infection.”
Answer: C. “We use gowns to prevent spreading organisms between patients.”
Solution: Contact precautions prevent cross-transmission; response C explains patient-
to-patient protection and maintains therapeutic relationship.
Question 3
A nurse notes a colleague documenting vital signs before assessment. Which concept is
violated?
A. Accountability
B. Confidentiality
C. Accuracy
D. Privacy
Answer: C. Accuracy
Solution: Recording data not yet obtained constitutes inaccurate documentation,
breaching ANA Code 5.1 (accurate representation).
Question 4
A client with COPD receives O₂ at 4 L/min via nasal cannula. O₂ sat is 97 %. Nurse’s
priority action?
A. Reduce O₂ to 2 L/min
B. Switch to Venturi mask
C. Increase to 6 L/min
D. Document findings
Answer: A. Reduce O₂ to 2 L/min
Solution: High O₂ in COPD can abolish hypoxic drive; target SpO₂ 88–92 %. Reducing
flow prevents CO₂ narcosis.
Question 5
Which action best demonstrates clinical judgment during morning meds?
A. Giving meds on time
B. Checking MAR five times
pg. 2
, C. Holding digoxin when HR 48 and calling provider
D. Signing MAR after administration
Answer: C. Holding digoxin when HR 48 and calling provider
Solution: Clinical judgment integrates assessment (bradycardia), pharmacology
(digoxin), and action (hold + notify) to prevent toxicity.
Question 6
A client’s wound culture grows MRSA. Which PPE is required?
A. Gloves only
B. Gloves and gown
C. Gloves, gown, N95
D. Standard precautions
Answer: B. Gloves and gown
Solution: MRSA = contact precautions → gloves + gown; N95 reserved for airborne
organisms (TB, varicella).
Question 7
A nurse delegates ambulation to AP. Which instruction is most appropriate?
A. “Help patient walk when ready.”
B. “Ambulate patient 50 ft using gait belt, report pain.”
C. “Let patient walk alone if stable.”
D. “Walk patient until tired.”
Answer: B. “Ambulate patient 50 ft using gait belt, report pain.”
Solution: Delegation must be specific, measurable, safe; includes equipment (gait
belt) and reporting parameters.
Question 8
A post-op client has serous drainage on dressing. Nurse documents color as:
A. Green
B. Yellow
C. Clear-straw
D. Brown
Answer: C. Clear-straw
Solution: Serous = clear-straw plasma fluid; green = purulent, yellow = seropurulent,
brown = old blood.
pg. 3
