PROPHECY CORE MANDATORY PART II NURSING RELIAS
EXAM 2026/2027 | Complete Test Solved 100% Correct |
Nursing Competency Assessment | Pass Guaranteed - A+
Graded
Domain 1: Patient Safety & Quality Improvement (15 Questions)
Q1: A nurse is preparing to administer medications to a patient. According to the Joint
Commission National Patient Safety Goals, what is the minimum requirement for
patient identification before medication administration?
A. Ask the patient to state their full name only
B. Verify the patient's room number and bed assignment
C. Check the patient's wristband against the medication administration record using two
patient identifiers [CORRECT]
D. Confirm the patient's diagnosis with the charge nurse
Correct Answer: C
Rationale: The Joint Commission National Patient Safety Goal 01.01.01 requires using
at least two patient identifiers when providing care, treatment, or services. Acceptable
identifiers include the patient's name, date of birth, medical record number, or assigned
identification number. Room numbers and bed assignments are not acceptable
identifiers as they can change and do not uniquely identify the patient. Option A is
insufficient as it uses only one identifier. Option B uses location-based identifiers which
are prohibited. Option D is not a standard patient identification process.
Q2: During a pre-operative "time-out" procedure, which action demonstrates proper
surgical safety protocol?
A. The surgeon begins the procedure while the team confirms the site
,B. The entire surgical team stops all activity to verify patient identity, procedure, and site
[CORRECT]
C. Only the circulating nurse and surgeon participate in the verification
D. The time-out is conducted after the incision is made
Correct Answer: B
Rationale: The Universal Protocol and Joint Commission standards require that the
time-out be conducted immediately before starting the procedure, with the participation
of all team members. All activity must cease during this verification process. Option A
violates safety protocols by proceeding before verification. Option C excludes required
team members (anesthesia provider, surgical technologist, nurses). Option D occurs too
late to prevent wrong-site surgery.
Q3: A nurse discovers a near-miss medication error that did not reach the patient.
According to patient safety principles, what is the most appropriate action?
A. Document the incident only if the patient was harmed
B. Report the near-miss through the facility's incident reporting system [CORRECT]
C. Discuss it only with the charge nurse verbally
D. Document in the patient's medical record that an error almost occurred
Correct Answer: B
Rationale: Near-miss reporting is essential for quality improvement and preventing
future errors. The Institute for Safe Medication Practices (ISMP) and Joint Commission
encourage reporting of near-misses to identify system failures. Option A is incorrect
because near-misses should be reported regardless of patient harm. Option C limits
learning opportunities and proper documentation. Option D violates patient record
documentation standards by including unnecessary information that could cause
confusion.
,Q4: Which medication is classified as a high-alert medication requiring extra
precautions?
A. Multivitamins
B. Insulin [CORRECT]
C. Acetaminophen
D. Antihistamines
Correct Answer: B
Rationale: Insulin is classified as a high-alert medication by ISMP due to its narrow
therapeutic index and potential for serious harm if dosing errors occur. High-alert
medications require independent double-checks, clear labeling, and enhanced
monitoring. Options A, C, and D are not classified as high-alert medications as they have
wider safety margins and lower risk profiles.
Q5: When using SBAR for handoff communication, what information is included in the
"Background" component?
A. The nurse's immediate assessment and recommendations
B. Current vital signs and immediate concerns
C. Relevant medical history and current medications [CORRECT]
D. The patient's room number and admission date
Correct Answer: C
Rationale: SBAR stands for Situation, Background, Assessment, Recommendation. The
Background component includes relevant medical history, admitting diagnosis, current
medications, allergies, and recent procedures. Option A describes the Recommendation
component. Option B describes the Assessment component. Option D is not a standard
SBAR component and represents incomplete handoff information.
Q6: A nurse is caring for a patient at risk for falls. Which intervention is most
appropriate according to fall prevention protocols?
A. Keep all side rails up at all times
, B. Place the call light within reach and ensure non-skid footwear is worn [CORRECT]
C. Restrain the patient to prevent unassisted ambulation
D. Remove the bed alarm to prevent patient anxiety
Correct Answer: B
Rationale: Fall prevention strategies include placing call lights within reach, ensuring
proper footwear, keeping beds in low position, and using bed alarms appropriately.
Option A can be considered a restraint if used improperly. Option C violates patient
rights and restraint regulations. Option D removes a safety device that alerts staff when
at-risk patients attempt to get up unassisted.
Q7: Which action demonstrates proper pressure injury prevention?
A. Massaging bony prominences to increase circulation
B. Repositioning immobile patients every 2 hours [CORRECT]
C. Using donut-shaped cushions under the sacrum
D. Keeping the head of the bed elevated above 45 degrees continuously
Correct Answer: B
Rationale: Repositioning every 2 hours is the standard of care for pressure injury
prevention in immobile patients, reducing sustained pressure on tissues. Option A is
contraindicated as massage can damage underlying tissues. Option C concentrates
pressure rather than redistributing it. Option D increases shear forces and pressure on
the sacrum, increasing pressure injury risk.
Q8: During a root cause analysis (RCA) of a sentinel event, what is the primary focus?
A. Determining which staff member made the error
B. Identifying system failures and process improvements [CORRECT]
C. Assigning disciplinary action to responsible parties
D. Calculating financial costs of the event
Correct Answer: B
EXAM 2026/2027 | Complete Test Solved 100% Correct |
Nursing Competency Assessment | Pass Guaranteed - A+
Graded
Domain 1: Patient Safety & Quality Improvement (15 Questions)
Q1: A nurse is preparing to administer medications to a patient. According to the Joint
Commission National Patient Safety Goals, what is the minimum requirement for
patient identification before medication administration?
A. Ask the patient to state their full name only
B. Verify the patient's room number and bed assignment
C. Check the patient's wristband against the medication administration record using two
patient identifiers [CORRECT]
D. Confirm the patient's diagnosis with the charge nurse
Correct Answer: C
Rationale: The Joint Commission National Patient Safety Goal 01.01.01 requires using
at least two patient identifiers when providing care, treatment, or services. Acceptable
identifiers include the patient's name, date of birth, medical record number, or assigned
identification number. Room numbers and bed assignments are not acceptable
identifiers as they can change and do not uniquely identify the patient. Option A is
insufficient as it uses only one identifier. Option B uses location-based identifiers which
are prohibited. Option D is not a standard patient identification process.
Q2: During a pre-operative "time-out" procedure, which action demonstrates proper
surgical safety protocol?
A. The surgeon begins the procedure while the team confirms the site
,B. The entire surgical team stops all activity to verify patient identity, procedure, and site
[CORRECT]
C. Only the circulating nurse and surgeon participate in the verification
D. The time-out is conducted after the incision is made
Correct Answer: B
Rationale: The Universal Protocol and Joint Commission standards require that the
time-out be conducted immediately before starting the procedure, with the participation
of all team members. All activity must cease during this verification process. Option A
violates safety protocols by proceeding before verification. Option C excludes required
team members (anesthesia provider, surgical technologist, nurses). Option D occurs too
late to prevent wrong-site surgery.
Q3: A nurse discovers a near-miss medication error that did not reach the patient.
According to patient safety principles, what is the most appropriate action?
A. Document the incident only if the patient was harmed
B. Report the near-miss through the facility's incident reporting system [CORRECT]
C. Discuss it only with the charge nurse verbally
D. Document in the patient's medical record that an error almost occurred
Correct Answer: B
Rationale: Near-miss reporting is essential for quality improvement and preventing
future errors. The Institute for Safe Medication Practices (ISMP) and Joint Commission
encourage reporting of near-misses to identify system failures. Option A is incorrect
because near-misses should be reported regardless of patient harm. Option C limits
learning opportunities and proper documentation. Option D violates patient record
documentation standards by including unnecessary information that could cause
confusion.
,Q4: Which medication is classified as a high-alert medication requiring extra
precautions?
A. Multivitamins
B. Insulin [CORRECT]
C. Acetaminophen
D. Antihistamines
Correct Answer: B
Rationale: Insulin is classified as a high-alert medication by ISMP due to its narrow
therapeutic index and potential for serious harm if dosing errors occur. High-alert
medications require independent double-checks, clear labeling, and enhanced
monitoring. Options A, C, and D are not classified as high-alert medications as they have
wider safety margins and lower risk profiles.
Q5: When using SBAR for handoff communication, what information is included in the
"Background" component?
A. The nurse's immediate assessment and recommendations
B. Current vital signs and immediate concerns
C. Relevant medical history and current medications [CORRECT]
D. The patient's room number and admission date
Correct Answer: C
Rationale: SBAR stands for Situation, Background, Assessment, Recommendation. The
Background component includes relevant medical history, admitting diagnosis, current
medications, allergies, and recent procedures. Option A describes the Recommendation
component. Option B describes the Assessment component. Option D is not a standard
SBAR component and represents incomplete handoff information.
Q6: A nurse is caring for a patient at risk for falls. Which intervention is most
appropriate according to fall prevention protocols?
A. Keep all side rails up at all times
, B. Place the call light within reach and ensure non-skid footwear is worn [CORRECT]
C. Restrain the patient to prevent unassisted ambulation
D. Remove the bed alarm to prevent patient anxiety
Correct Answer: B
Rationale: Fall prevention strategies include placing call lights within reach, ensuring
proper footwear, keeping beds in low position, and using bed alarms appropriately.
Option A can be considered a restraint if used improperly. Option C violates patient
rights and restraint regulations. Option D removes a safety device that alerts staff when
at-risk patients attempt to get up unassisted.
Q7: Which action demonstrates proper pressure injury prevention?
A. Massaging bony prominences to increase circulation
B. Repositioning immobile patients every 2 hours [CORRECT]
C. Using donut-shaped cushions under the sacrum
D. Keeping the head of the bed elevated above 45 degrees continuously
Correct Answer: B
Rationale: Repositioning every 2 hours is the standard of care for pressure injury
prevention in immobile patients, reducing sustained pressure on tissues. Option A is
contraindicated as massage can damage underlying tissues. Option C concentrates
pressure rather than redistributing it. Option D increases shear forces and pressure on
the sacrum, increasing pressure injury risk.
Q8: During a root cause analysis (RCA) of a sentinel event, what is the primary focus?
A. Determining which staff member made the error
B. Identifying system failures and process improvements [CORRECT]
C. Assigning disciplinary action to responsible parties
D. Calculating financial costs of the event
Correct Answer: B
