RN Comprehensive Predictor 2026
2026/2027 Examination
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,RN Comprehensive Predictor 2026
2026/2027 Examination
Total Questions: 200
Instructions:
• Answer all questions.
• Select the single best answer.
• Each question has four answer choices: A, B, C, and D.
• Select only ONE answer for each question.
SECTION 1: Safe and Effective Care Environment — Management of Care
Questions 1–25
Q1. A charge nurse is assigning client care for the upcoming shift. Which task is most appropriate
to delegate to a licensed practical nurse (LPN)?
A. Performing an initial admission assessment on a newly admitted client
B. Administering oral pain medication to a stable postoperative client
C. Developing the plan of care for a client with multiple complex diagnoses
D. Teaching a newly diagnosed diabetic client about insulin self-administration
Correct Answer: B. Administering oral pain medication to a stable postoperative client
Rationale: LPNs may administer medications to stable clients within their scope of practice.
Initial assessments, care plan development, and client teaching are responsibilities of the registered
nurse and cannot be delegated to an LPN.
Q2. A nurse is caring for a client who speaks limited English and needs to sign an informed
consent form. Which action should the nurse take?
A. Ask the client's adult child to interpret the consent discussion
B. Use a certified medical interpreter to facilitate communication
C. Have the client sign the form and explain it afterward
D. Proceed with the procedure without consent since it is emergent
Correct Answer: B. Use a certified medical interpreter to facilitate communication
Rationale: Federal regulations require trained medical interpreters for clients with limited
English proficiency. Family members, especially minors, should not be used as interpreters, and
consent must be understood before signing.
Q3. A nurse manager is reviewing incident reports. Which situation requires immediate follow-
up as a sentinel event?
A. A client refuses to take prescribed medication
B. A client develops a Stage 2 pressure injury
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,C. A client undergoes surgery on the wrong extremity
D. A client experiences a minor fall without injury
Correct Answer: C. A client undergoes surgery on the wrong extremity
Rationale: Wrong-site surgery is a never event and a sentinel event requiring immediate
investigation and reporting to The Joint Commission. Refusal of medication, pressure injuries, and
minor falls are reportable incidents but do not meet sentinel event criteria.
Q4. A nurse is preparing to discharge a client who will need home IV antibiotics. Which referral is
the priority?
A. Physical therapy for mobility training
B. Home health nursing for infusion therapy
C. Occupational therapy for ADL assistance
D. Social work for financial counseling
Correct Answer: B. Home health nursing for infusion therapy
Rationale: The priority is ensuring the client can safely receive the prescribed IV antibiotics at
home. Home health nursing provides skilled infusion services. The other referrals are important but
not the immediate priority for this specific need.
Q5. A nurse witnesses a colleague taking a controlled substance from the medication cart
without documentation. What is the nurse's priority action?
A. Confront the colleague privately after the shift
B. Report the observation to the nurse manager immediately
C. Document the event in the client's medical record
D. Ignore the behavior to avoid workplace conflict
Correct Answer: B. Report the observation to the nurse manager immediately
Rationale: Diversion of controlled substances poses an immediate risk to client safety and
requires prompt reporting through the chain of command. Delaying or ignoring the behavior could
endanger clients and violates professional and legal obligations.
Q6. A nurse is caring for a client who is being discharged against medical advice (AMA). Which
action is most important?
A. Ask the client to sign an AMA form documenting the decision
B. Restrain the client until the provider can reassess
C. Refuse to provide discharge instructions
D. Notify the insurance company of the client's decision
Correct Answer: A. Ask the client to sign an AMA form documenting the decision
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, Rationale: When a competent client chooses to leave AMA, the nurse should document the
decision and have the client sign the AMA form. This protects the client's autonomy and the facility
legally. Restraining the client is false imprisonment.
Q7. A nurse is prioritizing care for four clients. Which client should the nurse assess first?
A. A client requesting pain medication for a headache
B. A client with a new onset of confusion and slurred speech
C. A client awaiting discharge paperwork
D. A client requesting assistance with ambulation
Correct Answer: B. A client with a new onset of confusion and slurred speech
Rationale: New confusion and slurred speech may indicate a stroke or other neurological
emergency requiring immediate assessment. The other clients have less urgent needs that can be
addressed after stabilizing this client.
Q8. A nurse is reviewing a client's advance directive. The client has a living will stating no heroic
measures. The client is now unresponsive with a treatable infection. What should the nurse do?
A. Withhold antibiotics per the living will
B. Administer antibiotics as prescribed since the condition is treatable
C. Ask the family to override the living will
D. Transfer the client to the intensive care unit without treatment
Correct Answer: B. Administer antibiotics as prescribed since the condition is treatable
Rationale: A living will typically addresses end-of-life care and heroic measures, not treatable
acute conditions. Antibiotics for a treatable infection are not considered heroic measures and should
be administered.
Q9. A nurse is serving on a quality improvement committee. Which action best demonstrates the
use of evidence-based practice?
A. Continuing a tradition because "we've always done it this way"
B. Implementing a new protocol based on current research findings
C. Following a colleague's personal preference for wound care
D. Using the cheapest supplies available regardless of outcomes
Correct Answer: B. Implementing a new protocol based on current research findings
Rationale: Evidence-based practice integrates the best available research evidence with clinical
expertise and client preferences. Implementing protocols based on current research demonstrates
this principle.
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2026/2027 Examination
1|Page
,RN Comprehensive Predictor 2026
2026/2027 Examination
Total Questions: 200
Instructions:
• Answer all questions.
• Select the single best answer.
• Each question has four answer choices: A, B, C, and D.
• Select only ONE answer for each question.
SECTION 1: Safe and Effective Care Environment — Management of Care
Questions 1–25
Q1. A charge nurse is assigning client care for the upcoming shift. Which task is most appropriate
to delegate to a licensed practical nurse (LPN)?
A. Performing an initial admission assessment on a newly admitted client
B. Administering oral pain medication to a stable postoperative client
C. Developing the plan of care for a client with multiple complex diagnoses
D. Teaching a newly diagnosed diabetic client about insulin self-administration
Correct Answer: B. Administering oral pain medication to a stable postoperative client
Rationale: LPNs may administer medications to stable clients within their scope of practice.
Initial assessments, care plan development, and client teaching are responsibilities of the registered
nurse and cannot be delegated to an LPN.
Q2. A nurse is caring for a client who speaks limited English and needs to sign an informed
consent form. Which action should the nurse take?
A. Ask the client's adult child to interpret the consent discussion
B. Use a certified medical interpreter to facilitate communication
C. Have the client sign the form and explain it afterward
D. Proceed with the procedure without consent since it is emergent
Correct Answer: B. Use a certified medical interpreter to facilitate communication
Rationale: Federal regulations require trained medical interpreters for clients with limited
English proficiency. Family members, especially minors, should not be used as interpreters, and
consent must be understood before signing.
Q3. A nurse manager is reviewing incident reports. Which situation requires immediate follow-
up as a sentinel event?
A. A client refuses to take prescribed medication
B. A client develops a Stage 2 pressure injury
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,C. A client undergoes surgery on the wrong extremity
D. A client experiences a minor fall without injury
Correct Answer: C. A client undergoes surgery on the wrong extremity
Rationale: Wrong-site surgery is a never event and a sentinel event requiring immediate
investigation and reporting to The Joint Commission. Refusal of medication, pressure injuries, and
minor falls are reportable incidents but do not meet sentinel event criteria.
Q4. A nurse is preparing to discharge a client who will need home IV antibiotics. Which referral is
the priority?
A. Physical therapy for mobility training
B. Home health nursing for infusion therapy
C. Occupational therapy for ADL assistance
D. Social work for financial counseling
Correct Answer: B. Home health nursing for infusion therapy
Rationale: The priority is ensuring the client can safely receive the prescribed IV antibiotics at
home. Home health nursing provides skilled infusion services. The other referrals are important but
not the immediate priority for this specific need.
Q5. A nurse witnesses a colleague taking a controlled substance from the medication cart
without documentation. What is the nurse's priority action?
A. Confront the colleague privately after the shift
B. Report the observation to the nurse manager immediately
C. Document the event in the client's medical record
D. Ignore the behavior to avoid workplace conflict
Correct Answer: B. Report the observation to the nurse manager immediately
Rationale: Diversion of controlled substances poses an immediate risk to client safety and
requires prompt reporting through the chain of command. Delaying or ignoring the behavior could
endanger clients and violates professional and legal obligations.
Q6. A nurse is caring for a client who is being discharged against medical advice (AMA). Which
action is most important?
A. Ask the client to sign an AMA form documenting the decision
B. Restrain the client until the provider can reassess
C. Refuse to provide discharge instructions
D. Notify the insurance company of the client's decision
Correct Answer: A. Ask the client to sign an AMA form documenting the decision
3|Page
, Rationale: When a competent client chooses to leave AMA, the nurse should document the
decision and have the client sign the AMA form. This protects the client's autonomy and the facility
legally. Restraining the client is false imprisonment.
Q7. A nurse is prioritizing care for four clients. Which client should the nurse assess first?
A. A client requesting pain medication for a headache
B. A client with a new onset of confusion and slurred speech
C. A client awaiting discharge paperwork
D. A client requesting assistance with ambulation
Correct Answer: B. A client with a new onset of confusion and slurred speech
Rationale: New confusion and slurred speech may indicate a stroke or other neurological
emergency requiring immediate assessment. The other clients have less urgent needs that can be
addressed after stabilizing this client.
Q8. A nurse is reviewing a client's advance directive. The client has a living will stating no heroic
measures. The client is now unresponsive with a treatable infection. What should the nurse do?
A. Withhold antibiotics per the living will
B. Administer antibiotics as prescribed since the condition is treatable
C. Ask the family to override the living will
D. Transfer the client to the intensive care unit without treatment
Correct Answer: B. Administer antibiotics as prescribed since the condition is treatable
Rationale: A living will typically addresses end-of-life care and heroic measures, not treatable
acute conditions. Antibiotics for a treatable infection are not considered heroic measures and should
be administered.
Q9. A nurse is serving on a quality improvement committee. Which action best demonstrates the
use of evidence-based practice?
A. Continuing a tradition because "we've always done it this way"
B. Implementing a new protocol based on current research findings
C. Following a colleague's personal preference for wound care
D. Using the cheapest supplies available regardless of outcomes
Correct Answer: B. Implementing a new protocol based on current research findings
Rationale: Evidence-based practice integrates the best available research evidence with clinical
expertise and client preferences. Implementing protocols based on current research demonstrates
this principle.
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