Prophecy Core Mandatory Part II Nursing Exam — 2026/2027 Academic Year
Prophecy Core Mandatory Part II
Nursing Exam — 2026/2027 Academic Year
Comprehensive Study Guide with Answers and Rationales
Instructions
This exam consists of 30 multiple-choice questions aligned with Prophecy/Relias Core Mandatory Part II
competencies for nursing. Questions are distributed across seven sections covering age-specific care, infection
control, hazard communication, fire safety, patient rights and HIPAA, workplace violence prevention, and
documentation standards.
• Each question is worth 1 point (Total: 30 points)
• Select the ONE BEST answer for each question
• Correct answers are highlighted in bold cyan for self-assessment
• Detailed rationales reference Joint Commission, OSHA, CDC, and HIPAA standards
References: Joint Commission NPSGs, OSHA 29 CFR 1910.1030 (Bloodborne Pathogens) & 1910.1200 (HazCom), CDC
Guidelines for Infection Control, HIPAA Privacy Rule (45 CFR Part 164), AHA ACLS Guidelines 2020, ANA Code of Ethics, DHS
Run-Hide-Fight
Section I: Age-Specific Patient Care & Cultural Competence (Questions 1–4)
1. A nurse is preparing to administer medication to a 4-year-old patient. Which approach BEST demonstrates
age-appropriate communication?
A. Speak directly to the child’s parents about the B. Use simple words, allow the child to handle a
medication plan while the child listens quietly. syringe without a needle, and explain the
procedure in short sentences.
C. Provide a detailed pharmacological explanation D. Tell the child the medication will not hurt and
of the drug to the child using medical terminology. offer no preparation or explanation before
administration.
Correct Answer: B. Use simple words, allow the child to handle a syringe without a needle, and explain the
procedure in short sentences.
Rationale: Age-appropriate communication for a preschool-aged child includes using simple language, allowing
hands-on interaction with equipment to reduce fear, and explaining procedures in short, concrete sentences. Speaking
only to parents (option A) excludes the child. Medical terminology (option C) is inappropriate for a 4-year-old’s
cognitive level. Telling the child it will not hurt (option D) is dishonest and erodes trust, making future interactions
more difficult.
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, Prophecy Core Mandatory Part II Nursing Exam — 2026/2027 Academic Year
2. A nurse is obtaining informed consent from a 68-year-old patient who has limited health literacy. Which
strategy is MOST effective for ensuring the patient understands the procedure?
A. Provide a lengthy written consent form printed at B. Ask the patient’s family member to explain the
a 12th-grade reading level and ask the patient to procedure, since the patient may not understand.
read it.
C. Use the teach-back method, explain in plain D. Have the patient sign the consent form
language with visual aids, and verify immediately to avoid delaying the scheduled
comprehension by asking the patient to describe procedure.
the procedure in their own words.
Correct Answer: C. Use the teach-back method, explain in plain language with visual aids, and verify
comprehension by asking the patient to describe the procedure in their own words.
Rationale: The teach-back method is the gold standard for verifying patient understanding, especially for patients with
limited health literacy. It involves explaining information in plain language (at or below a 6th-grade reading level),
supplementing with visual aids, and asking the patient to restate the information in their own words. Written forms at
high reading levels (option A), delegating to family (option B), and rushing the signature (option D) do not ensure
informed consent.
3. A nurse is caring for an 85-year-old patient who has begun experiencing progressive cognitive decline.
Which intervention addresses the GREATEST fall risk in this patient?
A. Encourage independent ambulation to maintain B. Implement fall precautions including a low
muscle strength. bed, bed alarm, non-slip footwear, and frequent
orientation to surroundings.
C. Apply bilateral soft wrist restraints during D. Administer a sedative at bedtime to promote
nighttime hours to prevent wandering. uninterrupted sleep.
Correct Answer: B. Implement fall precautions including a low bed, bed alarm, non-slip footwear, and frequent
orientation to surroundings.
Rationale: Cognitive decline significantly increases fall risk due to impaired judgment, disorientation, and altered
awareness of surroundings. The least-restrictive, evidence-based approach includes environmental modifications (low
bed, bed alarm), assistive devices (non-slip footwear), and reorientation. Independent ambulation (option A) is unsafe
without assessment. Restraints (option C) worsen confusion and are a last resort per Joint Commission standards.
Sedatives (option D) further impair cognition and increase fall risk.
4. A nurse is caring for a patient who is a devout Muslim and requires a blood transfusion. The patient
expresses hesitation. Which nursing action is MOST appropriate?
A. Proceed with the transfusion because it is a B. Stop the discussion and document that the patient
medical necessity, overriding the patient’s concerns. refused the recommended treatment.
C. Assess the patient’s specific concerns, involve D. Ask a family member to make the decision on
the chaplain or Islamic spiritual care provider, behalf of the patient.
facilitate shared decision-making, and respect
the patient’s autonomous choice.
Correct Answer: C. Assess the patient’s specific concerns, involve the chaplain or Islamic spiritual care provider,
facilitate shared decision-making, and respect the patient’s autonomous choice.
2
Prophecy Core Mandatory Part II
Nursing Exam — 2026/2027 Academic Year
Comprehensive Study Guide with Answers and Rationales
Instructions
This exam consists of 30 multiple-choice questions aligned with Prophecy/Relias Core Mandatory Part II
competencies for nursing. Questions are distributed across seven sections covering age-specific care, infection
control, hazard communication, fire safety, patient rights and HIPAA, workplace violence prevention, and
documentation standards.
• Each question is worth 1 point (Total: 30 points)
• Select the ONE BEST answer for each question
• Correct answers are highlighted in bold cyan for self-assessment
• Detailed rationales reference Joint Commission, OSHA, CDC, and HIPAA standards
References: Joint Commission NPSGs, OSHA 29 CFR 1910.1030 (Bloodborne Pathogens) & 1910.1200 (HazCom), CDC
Guidelines for Infection Control, HIPAA Privacy Rule (45 CFR Part 164), AHA ACLS Guidelines 2020, ANA Code of Ethics, DHS
Run-Hide-Fight
Section I: Age-Specific Patient Care & Cultural Competence (Questions 1–4)
1. A nurse is preparing to administer medication to a 4-year-old patient. Which approach BEST demonstrates
age-appropriate communication?
A. Speak directly to the child’s parents about the B. Use simple words, allow the child to handle a
medication plan while the child listens quietly. syringe without a needle, and explain the
procedure in short sentences.
C. Provide a detailed pharmacological explanation D. Tell the child the medication will not hurt and
of the drug to the child using medical terminology. offer no preparation or explanation before
administration.
Correct Answer: B. Use simple words, allow the child to handle a syringe without a needle, and explain the
procedure in short sentences.
Rationale: Age-appropriate communication for a preschool-aged child includes using simple language, allowing
hands-on interaction with equipment to reduce fear, and explaining procedures in short, concrete sentences. Speaking
only to parents (option A) excludes the child. Medical terminology (option C) is inappropriate for a 4-year-old’s
cognitive level. Telling the child it will not hurt (option D) is dishonest and erodes trust, making future interactions
more difficult.
1
, Prophecy Core Mandatory Part II Nursing Exam — 2026/2027 Academic Year
2. A nurse is obtaining informed consent from a 68-year-old patient who has limited health literacy. Which
strategy is MOST effective for ensuring the patient understands the procedure?
A. Provide a lengthy written consent form printed at B. Ask the patient’s family member to explain the
a 12th-grade reading level and ask the patient to procedure, since the patient may not understand.
read it.
C. Use the teach-back method, explain in plain D. Have the patient sign the consent form
language with visual aids, and verify immediately to avoid delaying the scheduled
comprehension by asking the patient to describe procedure.
the procedure in their own words.
Correct Answer: C. Use the teach-back method, explain in plain language with visual aids, and verify
comprehension by asking the patient to describe the procedure in their own words.
Rationale: The teach-back method is the gold standard for verifying patient understanding, especially for patients with
limited health literacy. It involves explaining information in plain language (at or below a 6th-grade reading level),
supplementing with visual aids, and asking the patient to restate the information in their own words. Written forms at
high reading levels (option A), delegating to family (option B), and rushing the signature (option D) do not ensure
informed consent.
3. A nurse is caring for an 85-year-old patient who has begun experiencing progressive cognitive decline.
Which intervention addresses the GREATEST fall risk in this patient?
A. Encourage independent ambulation to maintain B. Implement fall precautions including a low
muscle strength. bed, bed alarm, non-slip footwear, and frequent
orientation to surroundings.
C. Apply bilateral soft wrist restraints during D. Administer a sedative at bedtime to promote
nighttime hours to prevent wandering. uninterrupted sleep.
Correct Answer: B. Implement fall precautions including a low bed, bed alarm, non-slip footwear, and frequent
orientation to surroundings.
Rationale: Cognitive decline significantly increases fall risk due to impaired judgment, disorientation, and altered
awareness of surroundings. The least-restrictive, evidence-based approach includes environmental modifications (low
bed, bed alarm), assistive devices (non-slip footwear), and reorientation. Independent ambulation (option A) is unsafe
without assessment. Restraints (option C) worsen confusion and are a last resort per Joint Commission standards.
Sedatives (option D) further impair cognition and increase fall risk.
4. A nurse is caring for a patient who is a devout Muslim and requires a blood transfusion. The patient
expresses hesitation. Which nursing action is MOST appropriate?
A. Proceed with the transfusion because it is a B. Stop the discussion and document that the patient
medical necessity, overriding the patient’s concerns. refused the recommended treatment.
C. Assess the patient’s specific concerns, involve D. Ask a family member to make the decision on
the chaplain or Islamic spiritual care provider, behalf of the patient.
facilitate shared decision-making, and respect
the patient’s autonomous choice.
Correct Answer: C. Assess the patient’s specific concerns, involve the chaplain or Islamic spiritual care provider,
facilitate shared decision-making, and respect the patient’s autonomous choice.
2
