NZ Nursing State Exam ACTUAL
EXAM 2026/2027 | New Zealand Nursing
Council Exam | Verified Q&A | Pass
Guaranteed - A+ Graded
Domain 1: Professional, Legal, & Ethical Nursing Practice
(30 Questions)
Q1: A newly registered nurse is caring for a 72-year-old Māori patient admitted with pneumonia. The
patient avoids eye contact, speaks minimally, and a younger family member answers most questions for
him. The nurse feels frustrated that the patient is "not engaging." What is the MOST culturally safe
action?
A. Gently ask the family member to leave so the patient can speak for himself
B. Continue addressing questions to the patient, allowing extra silence and observing non-verbal cues
[CORRECT]
C. Document that the patient is withdrawn and non-compliant with assessment
D. Request a Māori health worker to take over care immediately
Correct Answer: B
Rationale: Culturally safe practice under Te Tiriti o Waitangi includes respecting tikanga Māori where
direct eye contact and speaking for oneself may not be the norm for a kaumatua (elder). Allowing
silence and observing non-verbals honours patient autonomy without forcing Western communication
styles. Distractor A is wrong—removing the family member disregards whānau involvement. Distractor C
is wrong—labels the patient instead of adapting care. Distractor D is wrong—abdicates responsibility;
the nurse must develop their own cultural safety skills.
Exam strategy: When a patient from a different cultural background communicates differently, adjust
your approach—don't require them to adapt to you.
,Q2: A nurse administers a medication to the wrong patient due to a checking error. The patient suffers
no ill effects. Under the Health and Disability Commissioner (HDC) Code of Rights, which Right is MOST
directly breached initially?
A. Right 4: Right to services of an appropriate standard
B. Right 6: Right to be fully informed
C. Right 7: Right to make an informed choice and give informed consent
D. Right 10: Right to complain
Correct Answer: A
Rationale: Right 4 states that every consumer has the right to have services provided with reasonable
care and skill. Administering medication to the wrong patient is a failure of professional standards
(reasonable care). Distractor B relates to information provision. Distractor C relates to consent; while
the patient didn't consent to the wrong drug, the primary breach is the standard of care in
administration. Distractor D relates to the complaint process, not the incident itself.
Clinical Pearl: In NZ, near-misses or no-harm incidents still constitute a breach of Right 4 and require an
incident report (Adverse Event Report) and disclosure to the patient.
Q3: An Enrolled Nurse (EN) asks a Registered Nurse (RN) if they can administer a controlled drug (e.g.,
morphine) via IV push. According to NCNZ scopes of practice and medication management guidelines,
what is the correct response?
A. "Yes, as long as I (the RN) have prepared and checked the drug."
B. "Yes, but you must complete a medication competency first."
C. "No, ENs cannot administer controlled drugs by IV push; this is restricted to RNs." [CORRECT]
D. "No, only a Nurse Practitioner can administer IV controlled drugs."
Correct Answer: C
Rationale: While ENs can administer some medications, the administration of controlled drugs via the IV
route is generally outside the EN scope of practice and requires an RN or NP due to the high risk and
need for immediate assessment of effects. Distractor A is wrong—delegation cannot override scope of
,practice restrictions. Distractor B is wrong—competency does not override legislative or scope
restrictions. Distractor D is wrong—RNs can administer IV controlled drugs.
Exam strategy: Know the "Red Line" differences between RN and EN scopes, specifically regarding IV
medications and blood products.
Q4: A patient requests to see their medical notes immediately. Under the Privacy Act 2020 and the HDC
Code of Rights, what is the nurse's obligation?
A. Deny access until the patient is discharged to avoid interfering with treatment.
B. Inform the patient they must submit a written request to the Privacy Officer.
C. Facilitate access promptly, unless there is a lawful reason to withhold (e.g., risk of serious harm).
[CORRECT]
D. Ask the doctor for permission before allowing the patient to view the notes.
Correct Answer: C
Rationale: Under the Privacy Act 2020 (Principle 6) and Right 6 of the HDC Code, individuals have the
right to access information about them. There are limited grounds for refusal (e.g., endangerment to self
or others), but the default is to facilitate access. Distractor A is wrong—access is not conditional on
discharge. Distractor B creates unnecessary barriers; while a formal request can be made, immediate
informal access is often encouraged. Distractor D is wrong—the patient does not need doctor
permission to access their own records.
Clinical Pearl: Always check your facility's policy on "Open Notes," but remember the legal right belongs
to the patient.
Q5: A nurse witnesses a colleague roughly handling a patient with dementia who is resistive to care. The
colleague rolls their eyes and says, "He's just being difficult." What is the nurse's PRIMARY professional
responsibility?
A. Report the colleague to the Charge Nurse immediately.
B. Document the incident in the patient's notes and monitor the patient.
C. Intervene to stop the rough handling and advocate for the patient, then report internally. [CORRECT]
D. Ignore it as the colleague is more senior and experienced with dementia patients.
, Correct Answer: C
Rationale: Patient safety is paramount. The nurse has a duty to protect the patient from harm (Code of
Conduct). Immediate intervention stops the harm. Following this, mandatory reporting of the conduct is
required. Distractor A is correct eventually but does not stop the immediate harm. Distractor B is
passive. Distractor D is negligence and complicity in abuse.
Exam strategy: In "witnessing abuse" scenarios, the answer is always Stop the harm first, then
Report/Document.
Q6: Which principle of Te Tiriti o Waitangi is exemplified when a District Health Board (now Health NZ)
actively partners with local Iwi to design a diabetes clinic specifically for their community?
A. Protection
B. Partnership [CORRECT]
C. Participation
D. Permission
Correct Answer: B
Rationale: Partnership involves working together with Māori at all levels of the health sector to develop
strategies for Māori health gain. Distractor A (Protection) involves ensuring Māori have at least the same
level of health as non-Māori and safeguarding Māori cultural concepts. Distractor C (Participation)
involves involving Māori in the delivery of services. Distractor D is not a Treaty principle in this context.
Clinical Pearl: Memorize the "3 Ps": Partnership (governance/planning), Protection (equity/safeguarding
culture), Participation (workforce/service delivery).
Q7: A 16-year-old patient is brought to the ED by police following a suicide attempt. The patient refuses
treatment and demands to leave. Under the Mental Health (Compulsory Assessment and Treatment)
Act 1992, what is the initial step to detain this patient for assessment?
A. The nurse can detain them for up to 6 hours using the "holding power."
B. The doctor must sign a Section 8A Certificate.
C. A duly authorised officer (DAO) must be contacted to begin the process.
EXAM 2026/2027 | New Zealand Nursing
Council Exam | Verified Q&A | Pass
Guaranteed - A+ Graded
Domain 1: Professional, Legal, & Ethical Nursing Practice
(30 Questions)
Q1: A newly registered nurse is caring for a 72-year-old Māori patient admitted with pneumonia. The
patient avoids eye contact, speaks minimally, and a younger family member answers most questions for
him. The nurse feels frustrated that the patient is "not engaging." What is the MOST culturally safe
action?
A. Gently ask the family member to leave so the patient can speak for himself
B. Continue addressing questions to the patient, allowing extra silence and observing non-verbal cues
[CORRECT]
C. Document that the patient is withdrawn and non-compliant with assessment
D. Request a Māori health worker to take over care immediately
Correct Answer: B
Rationale: Culturally safe practice under Te Tiriti o Waitangi includes respecting tikanga Māori where
direct eye contact and speaking for oneself may not be the norm for a kaumatua (elder). Allowing
silence and observing non-verbals honours patient autonomy without forcing Western communication
styles. Distractor A is wrong—removing the family member disregards whānau involvement. Distractor C
is wrong—labels the patient instead of adapting care. Distractor D is wrong—abdicates responsibility;
the nurse must develop their own cultural safety skills.
Exam strategy: When a patient from a different cultural background communicates differently, adjust
your approach—don't require them to adapt to you.
,Q2: A nurse administers a medication to the wrong patient due to a checking error. The patient suffers
no ill effects. Under the Health and Disability Commissioner (HDC) Code of Rights, which Right is MOST
directly breached initially?
A. Right 4: Right to services of an appropriate standard
B. Right 6: Right to be fully informed
C. Right 7: Right to make an informed choice and give informed consent
D. Right 10: Right to complain
Correct Answer: A
Rationale: Right 4 states that every consumer has the right to have services provided with reasonable
care and skill. Administering medication to the wrong patient is a failure of professional standards
(reasonable care). Distractor B relates to information provision. Distractor C relates to consent; while
the patient didn't consent to the wrong drug, the primary breach is the standard of care in
administration. Distractor D relates to the complaint process, not the incident itself.
Clinical Pearl: In NZ, near-misses or no-harm incidents still constitute a breach of Right 4 and require an
incident report (Adverse Event Report) and disclosure to the patient.
Q3: An Enrolled Nurse (EN) asks a Registered Nurse (RN) if they can administer a controlled drug (e.g.,
morphine) via IV push. According to NCNZ scopes of practice and medication management guidelines,
what is the correct response?
A. "Yes, as long as I (the RN) have prepared and checked the drug."
B. "Yes, but you must complete a medication competency first."
C. "No, ENs cannot administer controlled drugs by IV push; this is restricted to RNs." [CORRECT]
D. "No, only a Nurse Practitioner can administer IV controlled drugs."
Correct Answer: C
Rationale: While ENs can administer some medications, the administration of controlled drugs via the IV
route is generally outside the EN scope of practice and requires an RN or NP due to the high risk and
need for immediate assessment of effects. Distractor A is wrong—delegation cannot override scope of
,practice restrictions. Distractor B is wrong—competency does not override legislative or scope
restrictions. Distractor D is wrong—RNs can administer IV controlled drugs.
Exam strategy: Know the "Red Line" differences between RN and EN scopes, specifically regarding IV
medications and blood products.
Q4: A patient requests to see their medical notes immediately. Under the Privacy Act 2020 and the HDC
Code of Rights, what is the nurse's obligation?
A. Deny access until the patient is discharged to avoid interfering with treatment.
B. Inform the patient they must submit a written request to the Privacy Officer.
C. Facilitate access promptly, unless there is a lawful reason to withhold (e.g., risk of serious harm).
[CORRECT]
D. Ask the doctor for permission before allowing the patient to view the notes.
Correct Answer: C
Rationale: Under the Privacy Act 2020 (Principle 6) and Right 6 of the HDC Code, individuals have the
right to access information about them. There are limited grounds for refusal (e.g., endangerment to self
or others), but the default is to facilitate access. Distractor A is wrong—access is not conditional on
discharge. Distractor B creates unnecessary barriers; while a formal request can be made, immediate
informal access is often encouraged. Distractor D is wrong—the patient does not need doctor
permission to access their own records.
Clinical Pearl: Always check your facility's policy on "Open Notes," but remember the legal right belongs
to the patient.
Q5: A nurse witnesses a colleague roughly handling a patient with dementia who is resistive to care. The
colleague rolls their eyes and says, "He's just being difficult." What is the nurse's PRIMARY professional
responsibility?
A. Report the colleague to the Charge Nurse immediately.
B. Document the incident in the patient's notes and monitor the patient.
C. Intervene to stop the rough handling and advocate for the patient, then report internally. [CORRECT]
D. Ignore it as the colleague is more senior and experienced with dementia patients.
, Correct Answer: C
Rationale: Patient safety is paramount. The nurse has a duty to protect the patient from harm (Code of
Conduct). Immediate intervention stops the harm. Following this, mandatory reporting of the conduct is
required. Distractor A is correct eventually but does not stop the immediate harm. Distractor B is
passive. Distractor D is negligence and complicity in abuse.
Exam strategy: In "witnessing abuse" scenarios, the answer is always Stop the harm first, then
Report/Document.
Q6: Which principle of Te Tiriti o Waitangi is exemplified when a District Health Board (now Health NZ)
actively partners with local Iwi to design a diabetes clinic specifically for their community?
A. Protection
B. Partnership [CORRECT]
C. Participation
D. Permission
Correct Answer: B
Rationale: Partnership involves working together with Māori at all levels of the health sector to develop
strategies for Māori health gain. Distractor A (Protection) involves ensuring Māori have at least the same
level of health as non-Māori and safeguarding Māori cultural concepts. Distractor C (Participation)
involves involving Māori in the delivery of services. Distractor D is not a Treaty principle in this context.
Clinical Pearl: Memorize the "3 Ps": Partnership (governance/planning), Protection (equity/safeguarding
culture), Participation (workforce/service delivery).
Q7: A 16-year-old patient is brought to the ED by police following a suicide attempt. The patient refuses
treatment and demands to leave. Under the Mental Health (Compulsory Assessment and Treatment)
Act 1992, what is the initial step to detain this patient for assessment?
A. The nurse can detain them for up to 6 hours using the "holding power."
B. The doctor must sign a Section 8A Certificate.
C. A duly authorised officer (DAO) must be contacted to begin the process.
