NURSING COUNCIL OF NEW ZEALAND · STATE FINAL
NZ NURSING STATE EXAM AND PRACTICE EXAM
2026/2027 Official Exam A+
A+ Verified Questions & Rationales · Registered Nurse State Final Preparation
A+ 6 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
■ 1. Professional Responsibility, Ethics, Legal & Cultural Safety
■ 2. Assessment, Clinical Judgement & Care Planning
■ 3. Medicine Calculations & Safe Medication Practice
■ 4. Mental Health, Communication & Interpersonal Relationships
■ 5. Specialty Populations — Maternity, Paediatric, Older Adult, Community
■ 6. Leadership, Quality, Interprofessional Practice & Health Promotion
STUVIAACTUALEXAM
Passing Score: 75% · 1 Mark per Question · Application/Analysis/Synthesis Level
, SECTION 1: Professional Responsibility, Ethics, Legal & Cultural Safety
Q1. A registered nurse is caring for a M■ori patient who requests that a kaum■tua be present during a significant care discussion. The nurse’s most
culturally safe response is to:
A. Proceed without the kaum■tua because family presence delays care.
B. Ignore the request and document that cultural practices are optional.
C. Support the request, facilitate the involvement of the kaum■tua, and practice in a manner consistent with Te Tiriti o Waitangi principles of partnership and
participation.
D. Only allow the kaum■tua if the medical team approves first.
Correct Answer: C
Rationale: Cultural safety and Te Tiriti require nurses to respect and facilitate M■ori processes, including the role of kaum■tua, supporting partnership and self-determination in
care.
Q2. A nurse discovers that a colleague has administered a medication without checking the patient’s identity. The professional responsibility is to:
A. Ignore the incident to protect the colleague’s reputation.
B. Confront the colleague aggressively in front of the patient.
C. Alter the medication chart to conceal the error.
D. Report the incident through the appropriate organisational pathway so that patient safety systems can respond and learning can occur.
Correct Answer: D
Rationale: Nurses have a duty to protect patients and uphold professional standards. Reporting near-misses and errors through proper channels supports a just culture and
system improvement.
Q3. A competent adult patient with capacity refuses a recommended blood transfusion on religious grounds. The nurse’s ethical and legal obligation is to:
A. Administer the transfusion against the patient’s wishes because it is life-saving.
B. Respect the refusal after ensuring the patient has received clear information about risks and benefits, and document the discussion.
C. Ask the family to override the patient’s decision.
D. Sedate the patient and give the transfusion covertly.
Correct Answer: B
Rationale: Competent adults have the right to refuse treatment. The nurse’s role is to ensure informed refusal, respect autonomy, and document thoroughly.
Q4. Under the Health Practitioners Competence Assurance Act, a nurse who has a concern about another health practitioner’s competence that may
pose a risk of harm to the public should:
A. Notify the relevant regulatory authority (Nursing Council or other) when the threshold for risk of harm is met.
B. Discuss the concern only with friends outside work.
C. Wait indefinitely without taking any action.
D. Publish the concern on social media.
Correct Answer: A
Rationale: The HPCA Act places a duty on health practitioners to report concerns about competence or conduct that may endanger the public to the appropriate authority.
Q5. A nurse is asked to witness a patient’s signature on a consent form for a procedure the nurse does not understand. The appropriate action is to:
A. Ensure the patient has received an explanation from the person responsible for the procedure and only witness if satisfied the patient appears to understand;
otherwise escalate.
B. Sign the form without reading it.
C. Explain the entire surgical procedure in place of the surgeon.
D. Refuse to have any involvement in consent processes.
Correct Answer: A
Rationale: The nurse’s role in witnessing consent is to confirm identity and that the patient appears to understand; the proceduralist remains responsible for the substantive
explanation.
Q6. A nurse is providing care to a patient who identifies as transgender. Culturally safe practice includes:
A. Using the patient’s previous name and pronouns regardless of preference.
B. Using the patient’s affirmed name and pronouns, ensuring privacy, and advocating for respectful care across the team.
C. Discussing the patient’s gender identity with other patients.
D. Avoiding any discussion of identity-related needs.
Correct Answer: B
Rationale: Cultural safety requires recognising and respecting each person’s identity, including gender, and reducing power imbalances that can cause harm.
Q7. A nurse is asked by a family member for detailed information about a competent adult patient’s diagnosis. The correct response is to:
A. Provide full clinical details immediately.
B. Share the entire clinical record by email without consent.
C. Refuse any further contact with the family.
D. Explain that information can only be shared with the patient’s consent (or as otherwise permitted by law), and offer to facilitate discussion with the patient.
Correct Answer: D
Rationale: Privacy and confidentiality laws and professional codes require patient consent before sharing personal health information with others, except in defined exceptions.
NZ Nursing State Exam · Page 2
NZ NURSING STATE EXAM AND PRACTICE EXAM
2026/2027 Official Exam A+
A+ Verified Questions & Rationales · Registered Nurse State Final Preparation
A+ 6 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
■ 1. Professional Responsibility, Ethics, Legal & Cultural Safety
■ 2. Assessment, Clinical Judgement & Care Planning
■ 3. Medicine Calculations & Safe Medication Practice
■ 4. Mental Health, Communication & Interpersonal Relationships
■ 5. Specialty Populations — Maternity, Paediatric, Older Adult, Community
■ 6. Leadership, Quality, Interprofessional Practice & Health Promotion
STUVIAACTUALEXAM
Passing Score: 75% · 1 Mark per Question · Application/Analysis/Synthesis Level
, SECTION 1: Professional Responsibility, Ethics, Legal & Cultural Safety
Q1. A registered nurse is caring for a M■ori patient who requests that a kaum■tua be present during a significant care discussion. The nurse’s most
culturally safe response is to:
A. Proceed without the kaum■tua because family presence delays care.
B. Ignore the request and document that cultural practices are optional.
C. Support the request, facilitate the involvement of the kaum■tua, and practice in a manner consistent with Te Tiriti o Waitangi principles of partnership and
participation.
D. Only allow the kaum■tua if the medical team approves first.
Correct Answer: C
Rationale: Cultural safety and Te Tiriti require nurses to respect and facilitate M■ori processes, including the role of kaum■tua, supporting partnership and self-determination in
care.
Q2. A nurse discovers that a colleague has administered a medication without checking the patient’s identity. The professional responsibility is to:
A. Ignore the incident to protect the colleague’s reputation.
B. Confront the colleague aggressively in front of the patient.
C. Alter the medication chart to conceal the error.
D. Report the incident through the appropriate organisational pathway so that patient safety systems can respond and learning can occur.
Correct Answer: D
Rationale: Nurses have a duty to protect patients and uphold professional standards. Reporting near-misses and errors through proper channels supports a just culture and
system improvement.
Q3. A competent adult patient with capacity refuses a recommended blood transfusion on religious grounds. The nurse’s ethical and legal obligation is to:
A. Administer the transfusion against the patient’s wishes because it is life-saving.
B. Respect the refusal after ensuring the patient has received clear information about risks and benefits, and document the discussion.
C. Ask the family to override the patient’s decision.
D. Sedate the patient and give the transfusion covertly.
Correct Answer: B
Rationale: Competent adults have the right to refuse treatment. The nurse’s role is to ensure informed refusal, respect autonomy, and document thoroughly.
Q4. Under the Health Practitioners Competence Assurance Act, a nurse who has a concern about another health practitioner’s competence that may
pose a risk of harm to the public should:
A. Notify the relevant regulatory authority (Nursing Council or other) when the threshold for risk of harm is met.
B. Discuss the concern only with friends outside work.
C. Wait indefinitely without taking any action.
D. Publish the concern on social media.
Correct Answer: A
Rationale: The HPCA Act places a duty on health practitioners to report concerns about competence or conduct that may endanger the public to the appropriate authority.
Q5. A nurse is asked to witness a patient’s signature on a consent form for a procedure the nurse does not understand. The appropriate action is to:
A. Ensure the patient has received an explanation from the person responsible for the procedure and only witness if satisfied the patient appears to understand;
otherwise escalate.
B. Sign the form without reading it.
C. Explain the entire surgical procedure in place of the surgeon.
D. Refuse to have any involvement in consent processes.
Correct Answer: A
Rationale: The nurse’s role in witnessing consent is to confirm identity and that the patient appears to understand; the proceduralist remains responsible for the substantive
explanation.
Q6. A nurse is providing care to a patient who identifies as transgender. Culturally safe practice includes:
A. Using the patient’s previous name and pronouns regardless of preference.
B. Using the patient’s affirmed name and pronouns, ensuring privacy, and advocating for respectful care across the team.
C. Discussing the patient’s gender identity with other patients.
D. Avoiding any discussion of identity-related needs.
Correct Answer: B
Rationale: Cultural safety requires recognising and respecting each person’s identity, including gender, and reducing power imbalances that can cause harm.
Q7. A nurse is asked by a family member for detailed information about a competent adult patient’s diagnosis. The correct response is to:
A. Provide full clinical details immediately.
B. Share the entire clinical record by email without consent.
C. Refuse any further contact with the family.
D. Explain that information can only be shared with the patient’s consent (or as otherwise permitted by law), and offer to facilitate discussion with the patient.
Correct Answer: D
Rationale: Privacy and confidentiality laws and professional codes require patient consent before sharing personal health information with others, except in defined exceptions.
NZ Nursing State Exam · Page 2
