NR-500 nr-500:Practice Exam & Study Guide:
Foundational Concepts, Application, and Advanced
Nursing Principles 2025/2026
1. A hospital has noticed increased incidence of pressure injuries on one of
its medical-surgical units. A DNP student reviews incident reports, staff
workflows, and patient risk factors. The student develops a multifaceted
intervention including staff education, repositioning schedules, and use of
pressure-relieving devices. Which approach is being applied?
A) Individual nurse accountability
B) Single-intervention solution
C) Systems-level quality improvement
D) Routine task delegation
Rationale: The intervention targets the structure, process, and staff
behavior across multiple points of care, reflecting a systems-level approach.
Addressing only individual behavior or a single intervention would likely be
insufficient for sustained improvement.
2. During an EBP project, a DNP student compares two different wound care
dressings in preventing infection. The student designs a protocol that
randomly assigns patients to each dressing type and collects infection
rates over six months. Which research design is being used?
A) Observational study
B) Cohort study
C) Randomized controlled trial
D) Case series
Rationale: Random assignment and controlled comparison of interventions
over time characterize a randomized controlled trial, which is the gold
standard for determining intervention effectiveness.
,3. A patient with advanced heart failure expresses a desire to forgo
hospitalization and receive care at home. The nurse collaborates with the
patient, family, and interprofessional team to develop a home-based
palliative plan, ensuring symptom control and patient preferences are
prioritized. Which principle is most directly demonstrated?
A) Beneficence
B) Justice
C) Nonmaleficence
D) Autonomy
Rationale: Supporting the patient’s informed choices and ensuring care
aligns with personal values demonstrates respect for autonomy.
4. A DNP student is tasked with improving hand hygiene adherence in an
ICU. After reviewing observational audits, the student notices adherence
decreases during high-acuity shifts. The student implements real-time
feedback, reminders, and unit-based incentives. What type of strategy is
this?
A) Passive educational approach
B) Policy enforcement only
C) Behavioral and system-level intervention
D) Individual reprimand
Rationale: Combining behavioral reinforcement with system-level supports
(feedback, incentives) addresses human and environmental factors that
influence adherence, rather than relying on education or punishment alone.
5. During a hospital merger, two nursing units with different electronic
documentation systems are integrated. Staff report confusion and delayed
charting. The DNP student leads workflow analysis, develops standardized
protocols, and provides iterative training sessions. Which leadership
, approach is being applied?
A) Authoritative
B) Delegative
C) Transformational change leadership
D) Laissez-faire
Rationale: Transformational change leadership involves engaging staff,
addressing barriers, creating new workflows, and guiding teams through
complex organizational change.
6. A DNP student evaluates EHR data and identifies that patients discharged
on weekends have higher readmission rates. The student hypothesizes
that limited access to follow-up services contributes to this trend and
proposes targeted interventions. Which reasoning method is being
applied?
A) Pattern recognition only
B) Trial and error
C) Hypothetico-deductive reasoning
D) Routine observation
Rationale: Hypothetico-deductive reasoning involves identifying a problem,
generating hypotheses based on data, and planning interventions to test
and address the root cause.
7. A patient with type 2 diabetes is nonadherent to medication due to
financial barriers. The nurse collaborates with the social worker to identify
cost-effective alternatives and arranges home delivery of medications.
Which core nursing function is demonstrated?
A) Direct care
B) Documentation
C) Advocacy
D) Delegation
Rationale: Advocacy involves identifying barriers to care and actively
, collaborating with resources to ensure the patient receives necessary
treatment while addressing social determinants of health.
8. A nurse researcher designs a study to evaluate a new telehealth program
for hypertension management. The research question is framed as: “In
adults with uncontrolled hypertension (P), does remote blood pressure
monitoring (I) compared to standard clinic visits (C) improve blood
pressure control (O)?” What framework is being used?
A) SWOT
B) FINER
C) Root cause analysis
D) PICO
Rationale: PICO (Population, Intervention, Comparison, Outcome)
structures clinical questions to guide evidence-based practice and research
planning.
9. A DNP student is reviewing hospital data on central line-associated
bloodstream infections (CLABSI) and notices clusters during night shifts.
The student analyzes staffing levels, patient acuity, and adherence to
protocols to identify patterns and develop targeted interventions. What
type of analysis is this?
A) Meta-analysis
B) Descriptive only
C) Qualitative content analysis
D) Predictive and trend analysis
Rationale: The student examines trends and potential predictive factors to
guide operational and clinical decision-making for proactive interventions.
10.A nurse is developing a protocol for managing sudden hyperkalemia in
hospitalized patients. The protocol includes immediate assessment, lab
Foundational Concepts, Application, and Advanced
Nursing Principles 2025/2026
1. A hospital has noticed increased incidence of pressure injuries on one of
its medical-surgical units. A DNP student reviews incident reports, staff
workflows, and patient risk factors. The student develops a multifaceted
intervention including staff education, repositioning schedules, and use of
pressure-relieving devices. Which approach is being applied?
A) Individual nurse accountability
B) Single-intervention solution
C) Systems-level quality improvement
D) Routine task delegation
Rationale: The intervention targets the structure, process, and staff
behavior across multiple points of care, reflecting a systems-level approach.
Addressing only individual behavior or a single intervention would likely be
insufficient for sustained improvement.
2. During an EBP project, a DNP student compares two different wound care
dressings in preventing infection. The student designs a protocol that
randomly assigns patients to each dressing type and collects infection
rates over six months. Which research design is being used?
A) Observational study
B) Cohort study
C) Randomized controlled trial
D) Case series
Rationale: Random assignment and controlled comparison of interventions
over time characterize a randomized controlled trial, which is the gold
standard for determining intervention effectiveness.
,3. A patient with advanced heart failure expresses a desire to forgo
hospitalization and receive care at home. The nurse collaborates with the
patient, family, and interprofessional team to develop a home-based
palliative plan, ensuring symptom control and patient preferences are
prioritized. Which principle is most directly demonstrated?
A) Beneficence
B) Justice
C) Nonmaleficence
D) Autonomy
Rationale: Supporting the patient’s informed choices and ensuring care
aligns with personal values demonstrates respect for autonomy.
4. A DNP student is tasked with improving hand hygiene adherence in an
ICU. After reviewing observational audits, the student notices adherence
decreases during high-acuity shifts. The student implements real-time
feedback, reminders, and unit-based incentives. What type of strategy is
this?
A) Passive educational approach
B) Policy enforcement only
C) Behavioral and system-level intervention
D) Individual reprimand
Rationale: Combining behavioral reinforcement with system-level supports
(feedback, incentives) addresses human and environmental factors that
influence adherence, rather than relying on education or punishment alone.
5. During a hospital merger, two nursing units with different electronic
documentation systems are integrated. Staff report confusion and delayed
charting. The DNP student leads workflow analysis, develops standardized
protocols, and provides iterative training sessions. Which leadership
, approach is being applied?
A) Authoritative
B) Delegative
C) Transformational change leadership
D) Laissez-faire
Rationale: Transformational change leadership involves engaging staff,
addressing barriers, creating new workflows, and guiding teams through
complex organizational change.
6. A DNP student evaluates EHR data and identifies that patients discharged
on weekends have higher readmission rates. The student hypothesizes
that limited access to follow-up services contributes to this trend and
proposes targeted interventions. Which reasoning method is being
applied?
A) Pattern recognition only
B) Trial and error
C) Hypothetico-deductive reasoning
D) Routine observation
Rationale: Hypothetico-deductive reasoning involves identifying a problem,
generating hypotheses based on data, and planning interventions to test
and address the root cause.
7. A patient with type 2 diabetes is nonadherent to medication due to
financial barriers. The nurse collaborates with the social worker to identify
cost-effective alternatives and arranges home delivery of medications.
Which core nursing function is demonstrated?
A) Direct care
B) Documentation
C) Advocacy
D) Delegation
Rationale: Advocacy involves identifying barriers to care and actively
, collaborating with resources to ensure the patient receives necessary
treatment while addressing social determinants of health.
8. A nurse researcher designs a study to evaluate a new telehealth program
for hypertension management. The research question is framed as: “In
adults with uncontrolled hypertension (P), does remote blood pressure
monitoring (I) compared to standard clinic visits (C) improve blood
pressure control (O)?” What framework is being used?
A) SWOT
B) FINER
C) Root cause analysis
D) PICO
Rationale: PICO (Population, Intervention, Comparison, Outcome)
structures clinical questions to guide evidence-based practice and research
planning.
9. A DNP student is reviewing hospital data on central line-associated
bloodstream infections (CLABSI) and notices clusters during night shifts.
The student analyzes staffing levels, patient acuity, and adherence to
protocols to identify patterns and develop targeted interventions. What
type of analysis is this?
A) Meta-analysis
B) Descriptive only
C) Qualitative content analysis
D) Predictive and trend analysis
Rationale: The student examines trends and potential predictive factors to
guide operational and clinical decision-making for proactive interventions.
10.A nurse is developing a protocol for managing sudden hyperkalemia in
hospitalized patients. The protocol includes immediate assessment, lab
