ILE EXAM PREP: 97 COMPREHENSIVE
QUESTIONS WITH VERIFIED SOLUTIONS.
DOMAIN I: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1-15)
Question 1
A registered nurse is delegating tasks on a medical-surgical unit. Which task is appropriate to
delegate to a licensed practical nurse (LPN)?
A. Initial admission assessment of a newly diagnosed diabetic patient
B. Tracheostomy suctioning for a stable patient
C. Teaching a patient how to self-administer insulin
D. Evaluating the effectiveness of a new pain medication
Answer: B
Rationale: LPNs can perform tracheostomy suctioning on stable patients. Initial assessments (A),
patient teaching (C), and evaluation of outcomes (D) require RN-level education and licensure. The RN
retains accountability for delegation decisions.
Question 2
The nurse is preparing to administer blood to a patient. Which client identifier is most appropriate to
use?
A. "Are you Mr. John Smith in room 302?"
B. "Can you tell me your date of birth?"
C. "I'm here to give blood to the patient in bed 2"
D. "Your name is on this armband, correct?"
Answer: B
Rationale: Active identification using two identifiers (name and DOB) is required before blood
administration. Open-ended questions allow patients to self-identify. Asking "Are you Mr. Smith?" (A)
can lead to affirmative responses from confused patients. Room/bed numbers (C) are not reliable
identifiers. Armband confirmation (D) should verify what the patient states, not replace patient
involvement.
Question 3
,A patient in soft wrist restraints becomes increasingly agitated. The nurse should:
A. Release restraints every 2 hours for range of motion and toileting
B. Tighten restraints to prevent self-harm
C. Administer PRN sedation without assessment
D. Leave the patient alone to calm down
Answer: A
Rationale: Restraints require release every 2 hours for adults (every 1 hour for children) for
circulation assessment, range of motion, toileting, and hydration. Tightening restraints (B) violates
safety principles. Sedation requires assessment (C). Leaving an agitated restrained patient alone (D)
is unsafe.
Question 4
Which situation requires the registered nurse to perform the task rather than delegating to
unlicensed assistive personnel (UAP)?
A. Measuring vital signs on a stable post-operative patient
B. Collecting a urine specimen from a patient with a Foley catheter
C. Assisting a stable patient with ambulation
D. Assessing a patient who reports new onset chest pain
Answer: D
Rationale: Assessment requires RN licensure. UAP can measure vital signs on stable patients (A),
collect specimens (B), and assist with ambulation (C). New onset chest pain requires immediate RN
assessment for potential emergency.
Question 5
The nurse is caring for a patient who speaks only Spanish. An interpreter is needed for informed
consent. Who should obtain the signature on the consent form?
A. The nurse serving as interpreter
B. The physician using a certified medical interpreter
C. A family member who speaks both languages
,D. The charge nurse on duty
Answer: B
Rationale: The provider (physician, NP, PA) must obtain informed consent, explaining risks/benefits
through a certified medical interpreter. The nurse witnesses the signature but does not obtain
consent (A). Family members (C) should not interpret for consent due to potential bias or lack of
medical terminology knowledge.
Question 6
A patient with dementia is admitted with pneumonia. The family requests that no heroic measures be
taken. Which document should the nurse reference?
A. Living will only
B. POLST form with current medical orders
C. Durable power of attorney document
D. Verbal request from family only
Answer: B
Rationale: The Illinois POLST (Provider Orders for Life-Sustaining Treatment) provides medical
orders for treatment preferences. A living will (A) expresses wishes but is not a medical order.
Durable power of attorney (C) designates a decision-maker but doesn't contain specific treatment
orders. Verbal requests (D) should be documented but POLST provides clear clinical guidance.
Question 7
Which patient should the charge nurse assign to the most experienced RN?
A. A 45-year-old stable patient with chronic kidney disease scheduled for dialysis
B. A 72-year-old with new onset confusion and fever
C. A 30-year-old post-appendectomy day 2 requiring discharge teaching
D. A 55-year-old with stable angina awaiting cardiac catheterization
Answer: B
, Rationale: New onset confusion and fever in an elderly patient may indicate sepsis, delirium, or other
serious conditions requiring expert assessment and intervention. This patient is unstable and
requires experienced nursing judgment. Other patients are stable with predictable outcomes.
Question 8
The nurse discovers a fire in the medication room. Which action should be taken first?
A. Extinguish the fire with a CO2 extinguisher
B. Close all doors to contain the fire
C. Activate the fire alarm
D. Evacuate patients from immediate danger
Answer: D
Rationale: The RACE protocol: Rescue/Remove patients from danger first (D), then Activate alarm (C),
Confine the fire by closing doors (B), then Extinguish if safe to do so (A). Patient safety is the priority.
Question 9
A patient refuses medication, stating "I don't want to take anything that will harm my baby." The
nurse knows the patient is not pregnant. What is the appropriate response?
A. "You must take this medication; it's ordered by your doctor"
B. "Tell me more about your concerns about this medication"
C. "The doctor said you need this, so please take it"
D. Document the refusal and administer later
Answer: B
Rationale: Therapeutic communication uses open-ended questions to explore patient concerns. This
allows the nurse to assess understanding, provide education, and address misconceptions. Patients
have the right to refuse medication. Coercion (A, C) violates patient autonomy.
Question 10
The nurse is caring for four patients. Which patient should be seen first?
A. A patient requesting pain medication 30 minutes before the next scheduled dose
QUESTIONS WITH VERIFIED SOLUTIONS.
DOMAIN I: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1-15)
Question 1
A registered nurse is delegating tasks on a medical-surgical unit. Which task is appropriate to
delegate to a licensed practical nurse (LPN)?
A. Initial admission assessment of a newly diagnosed diabetic patient
B. Tracheostomy suctioning for a stable patient
C. Teaching a patient how to self-administer insulin
D. Evaluating the effectiveness of a new pain medication
Answer: B
Rationale: LPNs can perform tracheostomy suctioning on stable patients. Initial assessments (A),
patient teaching (C), and evaluation of outcomes (D) require RN-level education and licensure. The RN
retains accountability for delegation decisions.
Question 2
The nurse is preparing to administer blood to a patient. Which client identifier is most appropriate to
use?
A. "Are you Mr. John Smith in room 302?"
B. "Can you tell me your date of birth?"
C. "I'm here to give blood to the patient in bed 2"
D. "Your name is on this armband, correct?"
Answer: B
Rationale: Active identification using two identifiers (name and DOB) is required before blood
administration. Open-ended questions allow patients to self-identify. Asking "Are you Mr. Smith?" (A)
can lead to affirmative responses from confused patients. Room/bed numbers (C) are not reliable
identifiers. Armband confirmation (D) should verify what the patient states, not replace patient
involvement.
Question 3
,A patient in soft wrist restraints becomes increasingly agitated. The nurse should:
A. Release restraints every 2 hours for range of motion and toileting
B. Tighten restraints to prevent self-harm
C. Administer PRN sedation without assessment
D. Leave the patient alone to calm down
Answer: A
Rationale: Restraints require release every 2 hours for adults (every 1 hour for children) for
circulation assessment, range of motion, toileting, and hydration. Tightening restraints (B) violates
safety principles. Sedation requires assessment (C). Leaving an agitated restrained patient alone (D)
is unsafe.
Question 4
Which situation requires the registered nurse to perform the task rather than delegating to
unlicensed assistive personnel (UAP)?
A. Measuring vital signs on a stable post-operative patient
B. Collecting a urine specimen from a patient with a Foley catheter
C. Assisting a stable patient with ambulation
D. Assessing a patient who reports new onset chest pain
Answer: D
Rationale: Assessment requires RN licensure. UAP can measure vital signs on stable patients (A),
collect specimens (B), and assist with ambulation (C). New onset chest pain requires immediate RN
assessment for potential emergency.
Question 5
The nurse is caring for a patient who speaks only Spanish. An interpreter is needed for informed
consent. Who should obtain the signature on the consent form?
A. The nurse serving as interpreter
B. The physician using a certified medical interpreter
C. A family member who speaks both languages
,D. The charge nurse on duty
Answer: B
Rationale: The provider (physician, NP, PA) must obtain informed consent, explaining risks/benefits
through a certified medical interpreter. The nurse witnesses the signature but does not obtain
consent (A). Family members (C) should not interpret for consent due to potential bias or lack of
medical terminology knowledge.
Question 6
A patient with dementia is admitted with pneumonia. The family requests that no heroic measures be
taken. Which document should the nurse reference?
A. Living will only
B. POLST form with current medical orders
C. Durable power of attorney document
D. Verbal request from family only
Answer: B
Rationale: The Illinois POLST (Provider Orders for Life-Sustaining Treatment) provides medical
orders for treatment preferences. A living will (A) expresses wishes but is not a medical order.
Durable power of attorney (C) designates a decision-maker but doesn't contain specific treatment
orders. Verbal requests (D) should be documented but POLST provides clear clinical guidance.
Question 7
Which patient should the charge nurse assign to the most experienced RN?
A. A 45-year-old stable patient with chronic kidney disease scheduled for dialysis
B. A 72-year-old with new onset confusion and fever
C. A 30-year-old post-appendectomy day 2 requiring discharge teaching
D. A 55-year-old with stable angina awaiting cardiac catheterization
Answer: B
, Rationale: New onset confusion and fever in an elderly patient may indicate sepsis, delirium, or other
serious conditions requiring expert assessment and intervention. This patient is unstable and
requires experienced nursing judgment. Other patients are stable with predictable outcomes.
Question 8
The nurse discovers a fire in the medication room. Which action should be taken first?
A. Extinguish the fire with a CO2 extinguisher
B. Close all doors to contain the fire
C. Activate the fire alarm
D. Evacuate patients from immediate danger
Answer: D
Rationale: The RACE protocol: Rescue/Remove patients from danger first (D), then Activate alarm (C),
Confine the fire by closing doors (B), then Extinguish if safe to do so (A). Patient safety is the priority.
Question 9
A patient refuses medication, stating "I don't want to take anything that will harm my baby." The
nurse knows the patient is not pregnant. What is the appropriate response?
A. "You must take this medication; it's ordered by your doctor"
B. "Tell me more about your concerns about this medication"
C. "The doctor said you need this, so please take it"
D. Document the refusal and administer later
Answer: B
Rationale: Therapeutic communication uses open-ended questions to explore patient concerns. This
allows the nurse to assess understanding, provide education, and address misconceptions. Patients
have the right to refuse medication. Coercion (A, C) violates patient autonomy.
Question 10
The nurse is caring for four patients. Which patient should be seen first?
A. A patient requesting pain medication 30 minutes before the next scheduled dose
