NUR2349/PN1: Professional Nursing I – Exam
1 Review | Rated A Guide | 2026-2027
NCLEX-RN Fundamentals Edition
60 Questions with Foundational Principle Analysis
PILLAR 1 – Nursing Identity, Ethics & Legal Foundations (18 Qs)
Q1. A patient with a new cancer diagnosis asks, “Do you think I’m going to die?” The
nurse’s own father recently died of cancer. Which response demonstrates therapeutic
communication?
A. “I know how you feel; my dad just died of cancer too.”
B. “You should talk to your doctor about your prognosis.”
C. “This diagnosis must be very frightening. Tell me what you’re most concerned
about.”
D. “Statistics show survival rates are improving every year.”
Foundational Principle Analysis
Correct: C
Core Concept: Therapeutic Communication – patient-centered, emotion-focused,
open-ended.
,Principle Breakdown: Keeps focus on patient’s feelings; avoids advice, false
reassurance, or nurse-centered disclosure.
Application: C acknowledges emotion and invites exploration.
Violations: A shifts focus to nurse; B blocks; D intellectualizes.
Fundamental Truth: “The nurse’s words are a therapeutic tool—use them to open doors,
not close them.”
Q2. The nurse hears a colleague documenting a blood pressure that was never taken.
Which action demonstrates professional accountability?
A. Ignore it—BP will be taken on next round.
B. Report the incident to the charge nurse.
C. Confront the colleague in front of patients.
D. Re-take the BP yourself and say nothing.
Correct: B
Core Concept: Accountability & Integrity (ANA Provision 4).
Principle: Nurses are responsible for accurate documentation and must address errors
systemically.
Application: Reporting follows chain of command and maintains patient safety.
Violations: A = passive harm; C = public shaming; D = silent fix without system learning.
Truth: “If it’s not documented and not done, the lie hurts every patient.”
,Q3. An LPN asks the RN to cosign insulin he drew but did not witness. Legally correct
RN action?
A. Cosign—insulin is a routine medication.
B. Refuse and witness the draw yourself before cosigning.
C. Tell the LPN to ask another nurse.
D. Cosign after checking the vial label.
Correct: B
Core Concept: Delegation & Cosignature Integrity (Nurse Practice Act).
Principle: Cosigning affirms you witnessed the preparation; cannot attest to what you
did not see.
Application: RN must personally witness high-alert medication preparation.
Violations: A/C/D = falsification of legal document.
Truth: “Your signature is your license—never lend it to an unseen act.”
Q4. Patient refusing blood transfusion after surgery. Surgeon insists. Nurse’s role?
A. Side with surgeon—transfusion is life-saving.
B. Support patient’s right to autonomy and inform charge nurse.
C. Ask family to convince patient.
D. Document refusal and leave the room.
Correct: B
, Core Concept: Advocacy & Autonomy (ANA Provision 1).
Principle: Patient has right to refuse; nurse advocates for informed choice.
Application: Support patient, ensure informed status, escalate ethically.
Violations: A = abandonment of advocacy; C = undermines autonomy; D = incomplete
advocacy.
Truth: “Autonomy means the patient’s choice wins—even when we disagree.”
Q5. A visitor asks for the patient’s diagnosis. Nurse’s response?
A. “I can’t share that—let me call the patient to ask if it’s OK.”
B. “He has pneumonia and is doing better.”
C. “Check the board at the nurses’ station.”
D. “Only family can receive updates.”
Correct: A
Core Concept: HIPAA & Confidentiality.
Principle: Verify patient’s consent before sharing PHI with anyone.
Application: Offer to ask patient; protects privacy.
Violations: B = breach; C = public disclosure; D = assumes without consent.
Truth: “Assume every request for information is unauthorized until the patient says
otherwise.”
Q6. UAP refuses to bathe a patient with HIV. Nurse’s first action?
1 Review | Rated A Guide | 2026-2027
NCLEX-RN Fundamentals Edition
60 Questions with Foundational Principle Analysis
PILLAR 1 – Nursing Identity, Ethics & Legal Foundations (18 Qs)
Q1. A patient with a new cancer diagnosis asks, “Do you think I’m going to die?” The
nurse’s own father recently died of cancer. Which response demonstrates therapeutic
communication?
A. “I know how you feel; my dad just died of cancer too.”
B. “You should talk to your doctor about your prognosis.”
C. “This diagnosis must be very frightening. Tell me what you’re most concerned
about.”
D. “Statistics show survival rates are improving every year.”
Foundational Principle Analysis
Correct: C
Core Concept: Therapeutic Communication – patient-centered, emotion-focused,
open-ended.
,Principle Breakdown: Keeps focus on patient’s feelings; avoids advice, false
reassurance, or nurse-centered disclosure.
Application: C acknowledges emotion and invites exploration.
Violations: A shifts focus to nurse; B blocks; D intellectualizes.
Fundamental Truth: “The nurse’s words are a therapeutic tool—use them to open doors,
not close them.”
Q2. The nurse hears a colleague documenting a blood pressure that was never taken.
Which action demonstrates professional accountability?
A. Ignore it—BP will be taken on next round.
B. Report the incident to the charge nurse.
C. Confront the colleague in front of patients.
D. Re-take the BP yourself and say nothing.
Correct: B
Core Concept: Accountability & Integrity (ANA Provision 4).
Principle: Nurses are responsible for accurate documentation and must address errors
systemically.
Application: Reporting follows chain of command and maintains patient safety.
Violations: A = passive harm; C = public shaming; D = silent fix without system learning.
Truth: “If it’s not documented and not done, the lie hurts every patient.”
,Q3. An LPN asks the RN to cosign insulin he drew but did not witness. Legally correct
RN action?
A. Cosign—insulin is a routine medication.
B. Refuse and witness the draw yourself before cosigning.
C. Tell the LPN to ask another nurse.
D. Cosign after checking the vial label.
Correct: B
Core Concept: Delegation & Cosignature Integrity (Nurse Practice Act).
Principle: Cosigning affirms you witnessed the preparation; cannot attest to what you
did not see.
Application: RN must personally witness high-alert medication preparation.
Violations: A/C/D = falsification of legal document.
Truth: “Your signature is your license—never lend it to an unseen act.”
Q4. Patient refusing blood transfusion after surgery. Surgeon insists. Nurse’s role?
A. Side with surgeon—transfusion is life-saving.
B. Support patient’s right to autonomy and inform charge nurse.
C. Ask family to convince patient.
D. Document refusal and leave the room.
Correct: B
, Core Concept: Advocacy & Autonomy (ANA Provision 1).
Principle: Patient has right to refuse; nurse advocates for informed choice.
Application: Support patient, ensure informed status, escalate ethically.
Violations: A = abandonment of advocacy; C = undermines autonomy; D = incomplete
advocacy.
Truth: “Autonomy means the patient’s choice wins—even when we disagree.”
Q5. A visitor asks for the patient’s diagnosis. Nurse’s response?
A. “I can’t share that—let me call the patient to ask if it’s OK.”
B. “He has pneumonia and is doing better.”
C. “Check the board at the nurses’ station.”
D. “Only family can receive updates.”
Correct: A
Core Concept: HIPAA & Confidentiality.
Principle: Verify patient’s consent before sharing PHI with anyone.
Application: Offer to ask patient; protects privacy.
Violations: B = breach; C = public disclosure; D = assumes without consent.
Truth: “Assume every request for information is unauthorized until the patient says
otherwise.”
Q6. UAP refuses to bathe a patient with HIV. Nurse’s first action?
