1 :
  • "This is Nurse Smith on 3 East. I'm calling about Mr. Lee in room 302 who is having increasing shortness of breath"
  • "His respiratory rate is 32. oxygen saturation is 84% on 4 L nasal cannula, and he is using accessory muscles to breathe"
  • “I recommend you come evaluate him immediately. Would you like me to start oxygen via non-rebreather mask while waiting?"
  • "Mr. Lee is a 66-year-old admitted with heart failure. He has been breathing easily and regularly until a few minutes ago."

Hint : 🗣️SBAR = situation first.

Correct Order:

  • Order : 1 : No answer text available
  • Order : 2 : No answer text available
  • Order : 3 : No answer text available
  • Order : 4 : No answer text available
Rationale :

“This is Nurse Smith on 3 East. I’m calling about Mr. Lee in room 302 who is having increasing shortness of breath.”

💎 This is the Situation because the nurse identifies self, location, client, and the urgent reason for calling.

💎 SBAR begins with the immediate concern so the provider quickly understands the clinical problem.

💎 New-onset shortness of breath is a priority because it may indicate respiratory compromise.

💎 Clear identification prevents confusion and delays.

💎 This opening sets the tone for urgent provider response.

“Mr. Lee is a 66-year-old admitted with heart failure. He has been breathing easily and regularly until a few minutes ago.”

💎 This is the Background because it gives relevant history and baseline status.

💎 Heart failure places the client at risk for pulmonary edema and worsening oxygenation.

💎 Explaining that the change is new helps the provider recognize acute deterioration.

💎 Background information gives context for the current emergency.

💎 This helps guide the provider’s next decision.

“His respiratory rate is 32, oxygen saturation is 84% on 4 L nasal cannula, and he is using accessory muscles to breathe.”

💎 This is the Assessment because it reports current objective findings.

💎 The client has tachypnea, hypoxemia, and increased work of breathing.

💎 These findings suggest significant respiratory distress.

💎 Reporting exact data strengthens clinical communication.

💎 This helps the provider understand the severity of the situation.

“I recommend you come evaluate him immediately. Would you like me to start oxygen via non-rebreather mask while waiting?”

💎 This is the Recommendation because the nurse clearly states what action is needed.

💎 Immediate evaluation is appropriate because the client is unstable.

💎 Asking about a non-rebreather mask suggests an urgent oxygenation intervention.

💎 Recommendations should be clear, specific, and safety-focused.

💎 This completes SBAR and supports rapid treatment.

Distractor Analysis :

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2 :

Hint : 💊Ordered ÷ available.

Correct Answers:

  • 1.5

Rationale :

🔷The prescribed dose is Lisinopril 30 mg once daily.

🔷The available tablet strength is 20 mg per scored tablet.

🔷Formula

📌Dose ordered ÷ dose available = tablets to administer.

📌30 mg ÷ 20 mg

📍 1.5 tablets.

Distractor Analysis :

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3 :
Items to Match
  • 1. Slander
  • 2. Libel
  • 3. Beneficence
  • 4. Malpractice
Matching Options
  • C ~

    A nurse stays after shift to comfort a frightened patient

  • D ~

    A nurse administers the wrong medication, causing patient harm

  • A ~

    A nurse verbally tells a coworker false information about a patient

  • B ~

    A nurse posts false negative comments about a physician on social media

Hint : ⚖️Spoken vs written matters.

Correct Matches:

  • Slander matches with A nurse verbally tells a coworker false information about a patient
  • Libel matches with A nurse posts false negative comments about a physician on social media
  • Beneficence matches with A nurse stays after shift to comfort a frightened patient
  • Malpractice matches with A nurse administers the wrong medication, causing patient harm
Rationale :

Slander — A nurse verbally tells a coworker false information about a patient.

🟢 Slander is spoken false communication that damages another person’s reputation.

🟢 Because the nurse verbally shares false information, this is slander.

🟢 It is legally and professionally inappropriate.

🟢 Nurses must protect client dignity and avoid spreading false statements.

🟢 Spoken defamation is the key identifying feature.

Libel — A nurse posts false negative comments about a physician on social media.

🟢 Libel is written or published false communication that harms someone’s reputation.

🟢 Social media posts are considered written or published communication.

🟢 False negative comments can damage professional reputation.

🟢 Nurses must use responsible and professional communication online.

🟢 Written defamation is the key identifying feature.

Beneficence — A nurse stays after shift to comfort a frightened patient.

🟢 Beneficence means doing good and acting in the client’s best interest.

🟢 Comforting a frightened client promotes emotional well-being.

🟢 This action shows compassion and supportive nursing care.

🟢 Beneficence focuses on helping and benefiting the client.

🟢 The nurse’s action supports the client beyond basic task completion.

Malpractice — A nurse administers the wrong medication, causing patient harm.

🟢 Malpractice occurs when a nurse fails to meet the professional standard of care and causes harm.

🟢 Administering the wrong medication is a breach of safe medication practice.

🟢 Client harm makes the error legally significant.

🟢 Malpractice requires duty, breach, causation, and damages.

🟢 This example meets those elements because the wrong medication directly harmed the client.

Distractor Analysis :

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4 :

Hint : 💬 Ask about concerns.

Correct Answers:

  • "What concerns do you have about giving yourself insulin at home?"

Rationale :

🟣 This statement demonstrates patient-centered communication because it invites the client to express concerns.

🟣 New-onset diabetes requires teaching that addresses emotions, readiness, skills, and barriers.

🟣 Asking an open-ended question helps the nurse assess understanding and fears about insulin administration.

🟣 It supports collaboration rather than simply giving instructions.

🟣 This approach promotes trust, learning, and safer self-management after discharge.

“Your doctor has already explained everything, so I’ll be quick.”

🟣This dismisses the client’s learning needs and may prevent questions.

🟣Discharge teaching should confirm understanding and allow time for concerns.

“You must take your medications as prescribed, or you will get sicker.”

🟣This sounds threatening and does not support collaborative learning.

🟣Patient-centered teaching should encourage understanding and problem-solving.

“Here are your discharge papers; make sure you follow the instructions.”

🟣Handing papers to the client is not enough for effective teaching.

🟣The nurse must assess understanding, demonstrate skills, and answer questions.

Distractor Analysis :

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5 :

Hint : 🫁 Oxygen first.

Correct Answers:

  • Mr. Thomas who was admitted with pneumonia and has oxygen saturations of 88% on RA and a RR of 26.

Rationale :

🟠 Mr. Thomas should be assessed first because he has impaired oxygenation.

🟠 An oxygen saturation of 88% on room air is low and indicates hypoxemia.

🟠 A respiratory rate of 26/min shows increased work of breathing.

🟠 Using the ABCs, breathing problems take priority over pain, questions, or mild edema.

🟠 Pneumonia can worsen quickly, so prompt respiratory assessment and intervention are needed.

“Mr. Smith who is 1 day post op after a knee replacement and is requesting pain medication for his pain of 7/10.”

🟠Pain should be treated promptly, but it is not the highest priority over respiratory compromise.

🟠The client with low oxygen saturation requires assessment first.

“Mrs. Miner who has questions regarding her heart catheterization scheduled for this afternoon.”

🟠Client questions are important and should be addressed.

🟠However, education can wait until the unstable respiratory client is assessed.

“Mrs. Jones who is diagnosed with heart failure and is reporting new onset bilateral ankle edema.”

🟠New edema in heart failure requires follow-up assessment.

🟠However, it is less urgent than active hypoxemia and tachypnea.

Distractor Analysis :

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6 :

Hint : ⚖️Equal values conflict.

Correct Answers:

  • The principles appear to have equal moral weight and value.

Rationale :

🔵 An ethical dilemma occurs when two or more ethical principles conflict.

🔵 The principles involved often appear equally important and morally valid.

🔵 For example, a nurse may need to balance autonomy, beneficence, nonmaleficence, justice, and fidelity.

🔵 Ethical dilemmas are difficult because choosing one action may compromise another ethical value.

🔵 Careful reasoning, policy review, ethics consultation, and client-centered discussion may be needed.

The principle of autonomy only refers to individuals.

🔵Autonomy usually focuses on an individual’s right to make informed choices.

🔵However, ethical dilemmas involve more than simply defining autonomy.

The principles discussed are easy to compare.

🔵Ethical principles are often difficult to compare because each may carry strong moral value.

🔵This difficulty is what makes the situation a dilemma.

The conflict between principles has a clear outlined decision-making procedure.

🔵Ethical dilemmas usually do not have one simple automatic solution.

🔵Nurses use ethical reasoning, policies, professional standards, and consultation to guide decisions.

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7 :

Hint : 📱No patient details.

Correct Answers:

  • A meme with a picture of "Happy Nurses Week!" sent out by their employer.

Rationale :

🟤 A general Happy Nurses Week meme from the employer is appropriate because it does not include client information.

🟤 It does not reveal a client’s identity, diagnosis, location, image, or care details.

🟤 Nurses may share professional, nonconfidential content that follows employer policy.

🟤 Social media posts must protect privacy, confidentiality, and professional boundaries.

🟤 This option is safest because it is general workplace recognition rather than client-related content.

“A comment on another nurse’s post that states ‘I took care of that patient yesterday.’”

🟤This reveals involvement in a client’s care and may breach confidentiality.

🟤Even without a name, contextual details can identify a patient.

“A post stating ‘understaffed again, hope all my patients sleep through the night.’”

🟤This is unprofessional and may reflect poorly on the nurse and facility.

🟤It may also suggest unsafe staffing or neglectful attitudes toward clients.

“A picture in the room of a patient with the caption ‘flu season is here.’”

🟤Posting a patient image or room photo can violate privacy even if the name is not shown.

🟤Client images require strict authorization and should not be shared casually.

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8 :

Hint : ⚖️ BON regulates practice.

Correct Answers:

  • Board of Nursing

Rationale :

⚫ Nurses are legally and ethically obligated to practice within standards set by the State Board of Nursing.

⚫ The Board of Nursing regulates nursing practice through the state nurse practice act.

⚫ It defines scope of practice, licensure requirements, disciplinary actions, and professional expectations.

⚫ Nurses must know and follow the rules of the state where they practice.

⚫ Practicing outside the Board’s standards can result in legal action or loss of license.

Scope of Nursing

⚫Scope of nursing describes what nurses are legally allowed to do.

⚫However, it is not the regulatory body that sets and enforces practice standards.

School of Nursing

⚫A school of nursing educates and prepares students for practice.

⚫It does not legally regulate licensed nursing practice after graduation.

American Nurses Association

⚫The ANA provides professional standards, ethics guidance, and advocacy.

⚫However, it does not license nurses or enforce state nursing laws.

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9 :

Hint : 🚨 Error + harm = malpractice.

Correct Answers:

  • Malpractice

Rationale :

🔴 This situation is malpractice because the nurse failed to administer a prescribed antibiotic and the client was harmed.

🔴 Malpractice occurs when a licensed professional breaches the standard of care.

🔴 The missed antibiotic contributed to a systemic infection and prolonged hospitalization.

🔴 The elements include duty, breach of duty, causation, and damages.

🔴 Because the medication omission caused measurable client harm, this meets the definition of malpractice.

Medication error

🔴Forgetting to administer an antibiotic is a medication error.

🔴However, because the error caused harm and prolonged hospitalization, the stronger legal term is malpractice.

Error in judgment

🔴An error in judgment refers to a poor decision, often without clear proof of professional negligence or harm.

🔴This case involves failure to follow a medication order with direct harm.

Negligence

🔴Negligence is failure to provide reasonable care.

🔴In nursing practice, when professional negligence causes harm, it is considered malpractice.

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10 :

Which tasks can be appropriately delegated or assigned to the following staff? Select all that apply.

Task RN LPN/LVN UAP
Bathing assistance for Patient C
Dressing change for Patient A
Vital Signs for Patient C
Initial assessment of Patient B
Oral medication for Patient A
Diabetes teaching for Patient D

Hint : 👥 RN assesses & teaches; UAP assists.

Correct Answers

  • Bathing assistance for Patient C [ UAP ]
  • Dressing change for Patient A [ LPN/LVN ]
  • Vital Signs for Patient C [ UAP ]
  • Initial assessment of Patient B [ RN ]
  • Oral medication for Patient A [ LPN/LVN ]
  • Diabetes teaching for Patient D [ RN ]
Rationale :

✅ Bathing assistance for Patient C

📌 Bathing assistance is a routine activity of daily living that does not require nursing judgment.

📌 Patient C is stable and has a chronic condition with predictable needs.

📌 The UAP can assist with hygiene while observing for obvious changes.

📌 Any abnormal findings should be reported to the nurse.

📌 The UAP does not assess or interpret the patient’s condition.

📌 This task is appropriate because it is routine, non-invasive, and low risk.

✅ Dressing change for Patient A

📌 An LPN/LVN may perform a routine dressing change for a stable postoperative patient.

📌 Patient A has stable vital signs and predictable care needs.

📌 The LPN/LVN can observe the wound and report drainage, redness, or separation.

📌 The RN remains responsible for comprehensive assessment and evaluation.

📌 Complex wounds or unstable patients would require RN involvement.

📌 This assignment is appropriate within the LPN/LVN’s usual scope.

✅ Vital signs for Patient C

📌 A UAP can obtain routine vital signs for a stable patient.

📌 Patient C has a chronic, stable condition and predictable outcomes.

📌 The UAP should accurately record the findings.

📌 Abnormal results must be reported promptly to the nurse.

📌 The UAP cannot interpret the findings or modify the care plan.

📌 The RN or LPN/LVN evaluates the clinical significance of the results.

✅ Initial assessment of Patient B

📌 The initial nursing assessment requires professional nursing judgment.

📌 It establishes the patient’s baseline condition after admission.

📌 The assessment guides nursing diagnoses, priorities, and the plan of care.

📌 It cannot be delegated to a UAP.

📌 The LPN/LVN may collect focused data but does not perform the comprehensive initial assessment.

📌 Therefore, the RN must complete this task.

✅ Oral pain medication for Patient A

📌 An LPN/LVN may administer routine oral medications to a stable patient.

📌 Patient A is postoperative but has stable vital signs and predictable needs.

📌 The LPN/LVN should verify the prescription and medication rights.

📌 The patient should be monitored for adverse effects and pain relief.

📌 Significant changes must be reported to the RN.

📌 The exact scope may vary according to facility policy and local regulations.

✅ Diabetes teaching for Patient D

📌 Initial teaching for a new diabetes diagnosis requires assessment and nursing judgment.

📌 The RN evaluates the patient’s learning needs, readiness, and understanding.

📌 Teaching may include glucose monitoring, medications, diet, and complication prevention.

📌 The RN must determine whether the patient can safely perform required self-care.

📌 An LPN/LVN may reinforce teaching that the RN has already provided.

📌 A UAP cannot provide formal patient education.

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