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NZ NURSING STATE EXAM Actual Exam
2026/2027 Complete Questions and Verified
Answers with Detailed Rationales Pass
Guaranteed - A+ Graded
Section 1: NZ Nursing State Examination
Q1: Which of the following best describes the principle of tino rangatiratanga under the Treaty of
Waitangi?
A. Crown sovereignty over all land and resources
B. Self-determination and autonomy for Māori over their own affairs and resources [CORRECT]
C. Equal distribution of healthcare resources between all ethnic groups
D. Priority healthcare access for non-Māori populations
Correct Answer: B
Rationale: Tino rangatiratanga is the Māori text guarantee of self-determination, sovereignty, and
control over lands, villages, and treasures (taonga), recognizing Māori autonomy in health and
other domains.
Q2: A 68-year-old patient of Māori descent is admitted with uncontrolled type 2 diabetes. Which
culturally safe nursing approach demonstrates understanding of social determinants of health?
A. Focus exclusively on medication compliance without discussing lifestyle factors
B. Explore the patient's whānau support, food security, and access to traditional foods when
developing a care plan [CORRECT]
C. Assume the patient lacks health literacy due to ethnicity
D. Recommend immediate hospitalization for all diabetes management
Correct Answer: B
Rationale: Culturally safe nursing requires understanding how social determinants—including
whānau structure, food security, and cultural food practices—impact health outcomes, enabling
collaborative, culturally appropriate care planning.
Q3: The Nursing Council of New Zealand Code of Conduct requires nurses to maintain
professional boundaries. Which scenario demonstrates appropriate boundary maintenance?
,2
A. Accepting expensive gifts from grateful patients
B. Sharing personal contact details with patients to provide 24/7 support
C. Declining a patient's friend request on social media while explaining the professional nature
of the therapeutic relationship [CORRECT]
D. Discussing personal relationship problems with patients to build rapport
Correct Answer: C
Rationale: Maintaining professional boundaries includes appropriately managing social media
interactions, declining personal connections while preserving therapeutic relationships, and
prioritizing patient welfare over personal relationships.
Q4: A patient is prescribed oral morphine solution 5mg every 4 hours PRN for post-operative
pain. The available stock is morphine 10mg/5ml. What volume should the nurse administer?
A. 1ml
B. 2.5ml [CORRECT]
C. 5ml
D. 10ml
Correct Answer: B
Rationale: Using the formula (Desired dose ÷ Stock strength) × Volume: (5mg ÷ 10mg) × 5ml =
0.5 × 5ml = 2.5ml.
Q5: Under the Health and Disability Commissioner Act, what is the primary purpose of the Code
of Health and Disability Services Consumers' Rights?
A. To protect healthcare providers from litigation
B. To establish the rights of consumers and the obligations of providers to comply with those
rights [CORRECT]
C. To limit access to healthcare services
D. To standardize medical treatment protocols nationwide
Correct Answer: B
Rationale: The Code establishes ten fundamental rights for health and disability service
consumers, including rights to respect, freedom from discrimination, dignity, communication,
informed consent, and quality care, placing corresponding obligations on providers.
,3
Q6: Which assessment finding in a postpartum Māori woman requires immediate nursing
intervention on day 3 after birth?
A. Mild perineal discomfort controlled by oral analgesia
B. Heavy lochia with large clots and foul odor [CORRECT]
C. Emotional lability and mild fatigue
D. Decreased appetite but adequate fluid intake
Correct Answer: B
Rationale: Heavy lochia with large clots and foul odor indicates possible postpartum hemorrhage
or endometritis, requiring immediate assessment and intervention to prevent serious
complications.
Q7: A nurse is caring for a patient with advanced dementia who refuses personal care. The
patient's enduring power of attorney (EPOA) for personal care and welfare requests that the
nurse proceed with care against the patient's current wishes. What is the appropriate nursing
action?
A. Immediately follow the EPOA's instructions without question
B. Assess the patient's current capacity and best interests, consulting the EPOA while
recognizing that the patient's present wishes must be considered [CORRECT]
C. Ignore the EPOA and follow only the patient's refusal
D. Sedate the patient to complete care procedures
Correct Answer: B
Rationale: While an EPOA can make decisions when the patient lacks capacity, nurses must
assess current capacity, consider the patient's present wishes and best interests, and work
collaboratively with the EPOA, balancing substituted judgment with the patient's dignity and
autonomy.
Q8: The therapeutic plasma concentration range for lithium carbonate is:
A. 0.2-0.5 mmol/L
B. 0.6-1.0 mmol/L [CORRECT]
C. 1.2-1.8 mmol/L
D. 2.0-2.5 mmol/L
Correct Answer: B
, 4
Rationale: The therapeutic range for lithium in acute mania and maintenance therapy is 0.6-1.0
mmol/L (narrow therapeutic index); levels above 1.5 mmol/L indicate toxicity requiring
immediate intervention.
Q9: Which nursing intervention demonstrates cultural safety when caring for a Māori patient
undergoing a surgical procedure?
A. Avoiding discussion of cultural practices to prevent stereotyping
B. Offering to arrange for a karakia (prayer/blessing) before surgery if desired, and ensuring
whānau involvement in care decisions [CORRECT]
C. Assuming all Māori patients share identical cultural beliefs
D. Discouraging family presence to maintain clinical efficiency
Correct Answer: B
Rationale: Cultural safety involves recognizing and respecting individual cultural needs, offering
appropriate spiritual support (karakia), facilitating whānau participation in care, and avoiding
both cultural avoidance and stereotyping.
Q10: A patient with chronic heart failure is prescribed furosemide 40mg daily. Which laboratory
value requires immediate nursing attention?
A. Serum sodium 138 mmol/L
B. Serum potassium 2.8 mmol/L [CORRECT]
C. Serum creatinine 95 μmol/L
D. Haemoglobin 135 g/L
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting; a serum potassium of 2.8
mmol/L indicates severe hypokalemia (normal 3.5-5.0 mmol/L), risking cardiac arrhythmias and
requiring immediate potassium replacement and physician notification.
Q11: Under New Zealand's Medicines Act 1981, which medication classification requires a
prescription from an authorized prescriber?
A. Pharmacy-only medicines (P)
B. Restricted medicines (R)
C. Prescription-only medicines (Prescription) [CORRECT]
D. General sale medicines (GSL)
NZ NURSING STATE EXAM Actual Exam
2026/2027 Complete Questions and Verified
Answers with Detailed Rationales Pass
Guaranteed - A+ Graded
Section 1: NZ Nursing State Examination
Q1: Which of the following best describes the principle of tino rangatiratanga under the Treaty of
Waitangi?
A. Crown sovereignty over all land and resources
B. Self-determination and autonomy for Māori over their own affairs and resources [CORRECT]
C. Equal distribution of healthcare resources between all ethnic groups
D. Priority healthcare access for non-Māori populations
Correct Answer: B
Rationale: Tino rangatiratanga is the Māori text guarantee of self-determination, sovereignty, and
control over lands, villages, and treasures (taonga), recognizing Māori autonomy in health and
other domains.
Q2: A 68-year-old patient of Māori descent is admitted with uncontrolled type 2 diabetes. Which
culturally safe nursing approach demonstrates understanding of social determinants of health?
A. Focus exclusively on medication compliance without discussing lifestyle factors
B. Explore the patient's whānau support, food security, and access to traditional foods when
developing a care plan [CORRECT]
C. Assume the patient lacks health literacy due to ethnicity
D. Recommend immediate hospitalization for all diabetes management
Correct Answer: B
Rationale: Culturally safe nursing requires understanding how social determinants—including
whānau structure, food security, and cultural food practices—impact health outcomes, enabling
collaborative, culturally appropriate care planning.
Q3: The Nursing Council of New Zealand Code of Conduct requires nurses to maintain
professional boundaries. Which scenario demonstrates appropriate boundary maintenance?
,2
A. Accepting expensive gifts from grateful patients
B. Sharing personal contact details with patients to provide 24/7 support
C. Declining a patient's friend request on social media while explaining the professional nature
of the therapeutic relationship [CORRECT]
D. Discussing personal relationship problems with patients to build rapport
Correct Answer: C
Rationale: Maintaining professional boundaries includes appropriately managing social media
interactions, declining personal connections while preserving therapeutic relationships, and
prioritizing patient welfare over personal relationships.
Q4: A patient is prescribed oral morphine solution 5mg every 4 hours PRN for post-operative
pain. The available stock is morphine 10mg/5ml. What volume should the nurse administer?
A. 1ml
B. 2.5ml [CORRECT]
C. 5ml
D. 10ml
Correct Answer: B
Rationale: Using the formula (Desired dose ÷ Stock strength) × Volume: (5mg ÷ 10mg) × 5ml =
0.5 × 5ml = 2.5ml.
Q5: Under the Health and Disability Commissioner Act, what is the primary purpose of the Code
of Health and Disability Services Consumers' Rights?
A. To protect healthcare providers from litigation
B. To establish the rights of consumers and the obligations of providers to comply with those
rights [CORRECT]
C. To limit access to healthcare services
D. To standardize medical treatment protocols nationwide
Correct Answer: B
Rationale: The Code establishes ten fundamental rights for health and disability service
consumers, including rights to respect, freedom from discrimination, dignity, communication,
informed consent, and quality care, placing corresponding obligations on providers.
,3
Q6: Which assessment finding in a postpartum Māori woman requires immediate nursing
intervention on day 3 after birth?
A. Mild perineal discomfort controlled by oral analgesia
B. Heavy lochia with large clots and foul odor [CORRECT]
C. Emotional lability and mild fatigue
D. Decreased appetite but adequate fluid intake
Correct Answer: B
Rationale: Heavy lochia with large clots and foul odor indicates possible postpartum hemorrhage
or endometritis, requiring immediate assessment and intervention to prevent serious
complications.
Q7: A nurse is caring for a patient with advanced dementia who refuses personal care. The
patient's enduring power of attorney (EPOA) for personal care and welfare requests that the
nurse proceed with care against the patient's current wishes. What is the appropriate nursing
action?
A. Immediately follow the EPOA's instructions without question
B. Assess the patient's current capacity and best interests, consulting the EPOA while
recognizing that the patient's present wishes must be considered [CORRECT]
C. Ignore the EPOA and follow only the patient's refusal
D. Sedate the patient to complete care procedures
Correct Answer: B
Rationale: While an EPOA can make decisions when the patient lacks capacity, nurses must
assess current capacity, consider the patient's present wishes and best interests, and work
collaboratively with the EPOA, balancing substituted judgment with the patient's dignity and
autonomy.
Q8: The therapeutic plasma concentration range for lithium carbonate is:
A. 0.2-0.5 mmol/L
B. 0.6-1.0 mmol/L [CORRECT]
C. 1.2-1.8 mmol/L
D. 2.0-2.5 mmol/L
Correct Answer: B
, 4
Rationale: The therapeutic range for lithium in acute mania and maintenance therapy is 0.6-1.0
mmol/L (narrow therapeutic index); levels above 1.5 mmol/L indicate toxicity requiring
immediate intervention.
Q9: Which nursing intervention demonstrates cultural safety when caring for a Māori patient
undergoing a surgical procedure?
A. Avoiding discussion of cultural practices to prevent stereotyping
B. Offering to arrange for a karakia (prayer/blessing) before surgery if desired, and ensuring
whānau involvement in care decisions [CORRECT]
C. Assuming all Māori patients share identical cultural beliefs
D. Discouraging family presence to maintain clinical efficiency
Correct Answer: B
Rationale: Cultural safety involves recognizing and respecting individual cultural needs, offering
appropriate spiritual support (karakia), facilitating whānau participation in care, and avoiding
both cultural avoidance and stereotyping.
Q10: A patient with chronic heart failure is prescribed furosemide 40mg daily. Which laboratory
value requires immediate nursing attention?
A. Serum sodium 138 mmol/L
B. Serum potassium 2.8 mmol/L [CORRECT]
C. Serum creatinine 95 μmol/L
D. Haemoglobin 135 g/L
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting; a serum potassium of 2.8
mmol/L indicates severe hypokalemia (normal 3.5-5.0 mmol/L), risking cardiac arrhythmias and
requiring immediate potassium replacement and physician notification.
Q11: Under New Zealand's Medicines Act 1981, which medication classification requires a
prescription from an authorized prescriber?
A. Pharmacy-only medicines (P)
B. Restricted medicines (R)
C. Prescription-only medicines (Prescription) [CORRECT]
D. General sale medicines (GSL)
