NSG 4800 Exam Comprehensive
Transition to Professional Nursing Practice
Practice Questions with Detailed
Rationales (2026)
Question 1
The nurse is caring for a 75-year-old patient who has been diagnosed with cancer. The spouse requests
that the patient not be told of the diagnosis because it would be devastating to the client. The patient
asks the nurse about the diagnosis. What is a sample of the ethical principle of veracity?
A) "Let me contact your healthcare provider to talk to you about the diagnosis."
B) "You should ask your spouse about your condition."
C) "I cannot discuss your diagnosis without your spouse present."
D) "Everything will be okay; don't worry about it."
ANSWER: A
Rationale:
Option A (Correct): This response demonstrates veracity (truthfulness) by acknowledging the patient's
right to know their diagnosis while appropriately involving the healthcare provider. The nurse is being
honest and facilitating communication about the diagnosis.
Option B (Incorrect): This avoids the patient's direct question and shifts responsibility inappropriately. It
does not demonstrate veracity as it avoids addressing the patient's legitimate question.
Option C (Incorrect): This is dishonest and violates the patient's autonomy and right to information
about their own health. The spouse does not have the right to withhold diagnosis information from a
competent patient.
Option D (Incorrect): This is a false reassurance and avoids the truth, directly violating the principle of
veracity. The nurse must be honest with patients.
Question 2
,The nurse has attended a conference on informed consent. Which statement indicates understanding of
when informed consent can be waived?
A) Informed consent can be waived per facility policy for urgent medical or surgical treatment if the
client is unconscious.
B) Informed consent can be waived if the family member signs instead.
C) Informed consent can be waived for any patient over 65 years old.
D) Informed consent can be waived if the procedure is routine.
ANSWER: A
Rationale:
Option A (Correct): In emergency situations where the patient is unconscious and unable to provide
consent, and immediate treatment is necessary to prevent death or serious harm, informed consent can
be waived under the emergency exception doctrine.
Option B (Incorrect): Family members cannot automatically provide consent unless they are the legally
designated healthcare proxy or guardian. This does not constitute a waiver of consent.
Option C (Incorrect): Age alone does not determine the need for consent. Competent adults of any age
must provide informed consent.
Option D (Incorrect): Even routine procedures require informed consent. The complexity or routine
nature of a procedure does not eliminate the consent requirement.
Question 3
The nurse is working on a medical-surgical unit and receiving report. Which patient should the nurse
assess first?
A) Patient who has an aortic aneurysm and has lumbar pain that radiates to the flank area.
B) Patient who is 2 days post-operative and requesting pain medication.
C) Patient who needs discharge teaching for a new medication.
D) Patient who is requesting assistance with bathing.
ANSWER: A
Rationale:
Option A (Correct): This patient is showing signs of a possible aortic aneurysm rupture or expansion.
Lumbar/flank pain in a patient with known aortic aneurysm is a medical emergency requiring immediate
assessment using the ABCs (Airway, Breathing, Circulation) framework
nursa.com
.
,Option B (Incorrect): While pain management is important, this is not life-threatening and can be
addressed after more urgent situations are stabilized.
Option C (Incorrect): Discharge teaching is important but is not urgent and can be completed after
addressing acute care needs.
Option D (Incorrect): Activities of daily living assistance is important for patient comfort and dignity but
is not urgent compared to potential life-threatening conditions.
Question 4
The nurse is caring for the following assigned clients who are 24 hours post-op. The nurse performs
assessment four hours ago at change of shift. Which client does the nurse identify as a priority?
A) Client who reports an increasing pain level of 8 after receiving an opioid analgesic.
B) Client who is requesting to ambulate in the hallway.
C) Client who has not had a bowel movement since surgery.
D) Client who is requesting ice chips for dry mouth.
ANSWER: A
Rationale:
Option A (Correct): Increasing pain despite opioid analgesia 24 hours post-op could indicate
complications such as hemorrhage, infection, or anastomotic leak. This requires immediate assessment
and intervention.
Option B (Incorrect): Ambulation is actually encouraged post-operatively and indicates the patient is
progressing well. This is a positive sign, not a priority concern.
Option C (Incorrect): It is normal to not have a bowel movement within 24 hours post-op due to
anesthesia effects and decreased GI motility. This is expected and not urgent.
Option D (Incorrect): Dry mouth is common post-operatively and can be addressed with oral care. This is
a comfort measure, not a priority.
Question 5
The nurse preceptor is teaching about legal principles. Which of the following is an example of
malpractice?
A) A client who is competent and refuses an antidepressant medication. The nurse dissolves the
medication in food and administers it to the client without their knowledge.
B) A client falls while attempting to get out of bed independently.
C) A client develops a pressure injury despite turning every 2 hours.
D) A client experiences an allergic reaction to a medication they were not aware they were allergic to.
ANSWER: A
, Rationale:
Option A (Correct): This constitutes malpractice and battery. Administering medication to a competent
patient who has refused treatment, especially by disguising it in food, violates patient autonomy,
informed consent, and constitutes assault and battery. This is a clear breach of the standard of care.
Option B (Incorrect): If the nurse followed proper protocols (bed alarms, patient education, call light
within reach), a patient choosing to get up independently does not constitute malpractice.
Option C (Incorrect): If the nurse implemented appropriate preventive measures (regular turning, skin
assessment, proper nutrition), the development of a pressure injury does not automatically indicate
malpractice.
Option D (Incorrect): If proper allergy checks were performed and the patient had no known allergies
documented, an unexpected allergic reaction does not constitute malpractice.
Question 6
The nurse has a priority follow-up with a client who is:
A) Receiving a pyridostigmine and reports nausea and congestive cough.
B) Taking acetaminophen for mild headache.
C) Receiving routine vitamin supplements.
D) Using saline nasal spray for congestion.
ANSWER: A
Rationale:
Option A (Correct): Pyridostigmine is used to treat myasthenia gravis. Nausea and congestive cough
could indicate cholinergic crisis (medication toxicity), which is life-threatening. Signs include increased
bronchial secretions, bronchospasm, and respiratory distress. This requires immediate assessment and
possible medication adjustment.
Option B (Incorrect): Acetaminophen for mild headache is routine and does not require priority follow-
up unless there are signs of hepatotoxicity or overdose.
Option C (Incorrect): Routine vitamin supplements are generally safe and do not require priority follow-
up.
Option D (Incorrect): Saline nasal spray is a benign intervention for congestion and does not require
priority follow-up.
Question 7
The nurse on a pediatric unit is reviewing telemetry monitors for clients. Which of the following patients
should the nurse plan to assess first?
A) A 1-month-old infant sleeping with a pulse of 180.
Transition to Professional Nursing Practice
Practice Questions with Detailed
Rationales (2026)
Question 1
The nurse is caring for a 75-year-old patient who has been diagnosed with cancer. The spouse requests
that the patient not be told of the diagnosis because it would be devastating to the client. The patient
asks the nurse about the diagnosis. What is a sample of the ethical principle of veracity?
A) "Let me contact your healthcare provider to talk to you about the diagnosis."
B) "You should ask your spouse about your condition."
C) "I cannot discuss your diagnosis without your spouse present."
D) "Everything will be okay; don't worry about it."
ANSWER: A
Rationale:
Option A (Correct): This response demonstrates veracity (truthfulness) by acknowledging the patient's
right to know their diagnosis while appropriately involving the healthcare provider. The nurse is being
honest and facilitating communication about the diagnosis.
Option B (Incorrect): This avoids the patient's direct question and shifts responsibility inappropriately. It
does not demonstrate veracity as it avoids addressing the patient's legitimate question.
Option C (Incorrect): This is dishonest and violates the patient's autonomy and right to information
about their own health. The spouse does not have the right to withhold diagnosis information from a
competent patient.
Option D (Incorrect): This is a false reassurance and avoids the truth, directly violating the principle of
veracity. The nurse must be honest with patients.
Question 2
,The nurse has attended a conference on informed consent. Which statement indicates understanding of
when informed consent can be waived?
A) Informed consent can be waived per facility policy for urgent medical or surgical treatment if the
client is unconscious.
B) Informed consent can be waived if the family member signs instead.
C) Informed consent can be waived for any patient over 65 years old.
D) Informed consent can be waived if the procedure is routine.
ANSWER: A
Rationale:
Option A (Correct): In emergency situations where the patient is unconscious and unable to provide
consent, and immediate treatment is necessary to prevent death or serious harm, informed consent can
be waived under the emergency exception doctrine.
Option B (Incorrect): Family members cannot automatically provide consent unless they are the legally
designated healthcare proxy or guardian. This does not constitute a waiver of consent.
Option C (Incorrect): Age alone does not determine the need for consent. Competent adults of any age
must provide informed consent.
Option D (Incorrect): Even routine procedures require informed consent. The complexity or routine
nature of a procedure does not eliminate the consent requirement.
Question 3
The nurse is working on a medical-surgical unit and receiving report. Which patient should the nurse
assess first?
A) Patient who has an aortic aneurysm and has lumbar pain that radiates to the flank area.
B) Patient who is 2 days post-operative and requesting pain medication.
C) Patient who needs discharge teaching for a new medication.
D) Patient who is requesting assistance with bathing.
ANSWER: A
Rationale:
Option A (Correct): This patient is showing signs of a possible aortic aneurysm rupture or expansion.
Lumbar/flank pain in a patient with known aortic aneurysm is a medical emergency requiring immediate
assessment using the ABCs (Airway, Breathing, Circulation) framework
nursa.com
.
,Option B (Incorrect): While pain management is important, this is not life-threatening and can be
addressed after more urgent situations are stabilized.
Option C (Incorrect): Discharge teaching is important but is not urgent and can be completed after
addressing acute care needs.
Option D (Incorrect): Activities of daily living assistance is important for patient comfort and dignity but
is not urgent compared to potential life-threatening conditions.
Question 4
The nurse is caring for the following assigned clients who are 24 hours post-op. The nurse performs
assessment four hours ago at change of shift. Which client does the nurse identify as a priority?
A) Client who reports an increasing pain level of 8 after receiving an opioid analgesic.
B) Client who is requesting to ambulate in the hallway.
C) Client who has not had a bowel movement since surgery.
D) Client who is requesting ice chips for dry mouth.
ANSWER: A
Rationale:
Option A (Correct): Increasing pain despite opioid analgesia 24 hours post-op could indicate
complications such as hemorrhage, infection, or anastomotic leak. This requires immediate assessment
and intervention.
Option B (Incorrect): Ambulation is actually encouraged post-operatively and indicates the patient is
progressing well. This is a positive sign, not a priority concern.
Option C (Incorrect): It is normal to not have a bowel movement within 24 hours post-op due to
anesthesia effects and decreased GI motility. This is expected and not urgent.
Option D (Incorrect): Dry mouth is common post-operatively and can be addressed with oral care. This is
a comfort measure, not a priority.
Question 5
The nurse preceptor is teaching about legal principles. Which of the following is an example of
malpractice?
A) A client who is competent and refuses an antidepressant medication. The nurse dissolves the
medication in food and administers it to the client without their knowledge.
B) A client falls while attempting to get out of bed independently.
C) A client develops a pressure injury despite turning every 2 hours.
D) A client experiences an allergic reaction to a medication they were not aware they were allergic to.
ANSWER: A
, Rationale:
Option A (Correct): This constitutes malpractice and battery. Administering medication to a competent
patient who has refused treatment, especially by disguising it in food, violates patient autonomy,
informed consent, and constitutes assault and battery. This is a clear breach of the standard of care.
Option B (Incorrect): If the nurse followed proper protocols (bed alarms, patient education, call light
within reach), a patient choosing to get up independently does not constitute malpractice.
Option C (Incorrect): If the nurse implemented appropriate preventive measures (regular turning, skin
assessment, proper nutrition), the development of a pressure injury does not automatically indicate
malpractice.
Option D (Incorrect): If proper allergy checks were performed and the patient had no known allergies
documented, an unexpected allergic reaction does not constitute malpractice.
Question 6
The nurse has a priority follow-up with a client who is:
A) Receiving a pyridostigmine and reports nausea and congestive cough.
B) Taking acetaminophen for mild headache.
C) Receiving routine vitamin supplements.
D) Using saline nasal spray for congestion.
ANSWER: A
Rationale:
Option A (Correct): Pyridostigmine is used to treat myasthenia gravis. Nausea and congestive cough
could indicate cholinergic crisis (medication toxicity), which is life-threatening. Signs include increased
bronchial secretions, bronchospasm, and respiratory distress. This requires immediate assessment and
possible medication adjustment.
Option B (Incorrect): Acetaminophen for mild headache is routine and does not require priority follow-
up unless there are signs of hepatotoxicity or overdose.
Option C (Incorrect): Routine vitamin supplements are generally safe and do not require priority follow-
up.
Option D (Incorrect): Saline nasal spray is a benign intervention for congestion and does not require
priority follow-up.
Question 7
The nurse on a pediatric unit is reviewing telemetry monitors for clients. Which of the following patients
should the nurse plan to assess first?
A) A 1-month-old infant sleeping with a pulse of 180.
