AMERICAN NURSES CREDENTIALING CENTER
NEA-BC
Nurse Executive, Advanced Certification
Official Practice Exam
2026/2027 Edition
QUESTIONS MINUTES PASSING SCORE RECERTIFICATION
100 180 75% 5 Years
Table of Contents
Section 1: Scientific Foundation ........... 15 Questions (Q1-Q15)
Section 2: Leadership and Governance ........... 25 Questions (Q16-Q40)
Section 3: Health Care Economics and Finance ........... 15 Questions (Q41-Q55)
Section 4: Health Care Policy ........... 15 Questions (Q56-Q70)
Section 5: Professional Practice ........... 15 Questions (Q71-Q85)
Section 6: Quality and Safety ........... 15 Questions (Q86-Q100)
Instructions
This practice exam contains 100 multiple-choice questions divided into 6 sections. Each question has four answer
choices (A through D). Select the one best answer for each question. You have 180 minutes to complete the
exam. A score of 75% or higher (75 out of 100 questions correct) is required to pass. Read each question
carefully, noting the clinical scenario before selecting your answer. Review the rationale provided after each
question for learning purposes.
Disclaimer: This is a practice exam for study purposes only. It is not affiliated with or endorsed by ANCC.
NEA-BC Certification -- 2026/2027 | Passing Score: 75% | Page 1
, Section 1: Scientific Foundation -- 2026/2027
Q1 Question 1 of 100
A nurse executive reviews a study that used a randomized controlled trial design to evaluate a new
staffing model. The p-value reported is 0.03. The executive should interpret this finding as evidence
that the results are statistically significant at which threshold?
A. 0.05 level
B. 0.01 level only
C. 0.10 level only
D. 0.001 level only
Correct Answer: A
Rationale:
A p-value of 0.03 is less than the conventional alpha of 0.05, indicating statistical significance at that
threshold. The result would not reach significance at the stricter 0.01 or 0.001 levels, making 0.05 the most
appropriate interpretation.
Q2 Question 2 of 100
A chief nursing officer is evaluating research evidence using the hierarchy of evidence model. Where
do systematic reviews of randomized controlled trials rank on this hierarchy?
A. Below expert opinion
B. At the highest level of evidence
C. At the same level as case reports
D. Below single randomized controlled trials
Correct Answer: B
Rationale:
Systematic reviews and meta-analyses of RCTs occupy the apex of the evidence hierarchy because they
synthesize data from multiple rigorous studies, reducing bias and increasing confidence in findings. Single
RCTs rank below systematic reviews, and case reports and expert opinion rank even lower.
,Q3 Question 3 of 100
During a journal club presentation, a nurse leader questions whether a study's sample size was
adequate. The concept being evaluated is most closely related to which statistical principle?
A. Construct validity
B. Internal consistency
C. Statistical power
D. Content validity
Correct Answer: C
Rationale:
Statistical power is the probability of detecting a true effect when one exists, and it is directly influenced by
sample size. Inadequate sample sizes reduce power and increase the risk of a Type II error. Construct validity
and content validity relate to measurement accuracy, not sample adequacy.
Q4 Question 4 of 100
A nurse executive encounters a research article reporting a confidence interval of 95% for a treatment
effect ranging from 1.2 to 3.8. The executive should understand that this interval indicates which of
the following?
A. The p-value must be greater than 0.05
B. The study has 95% power to detect the effect
C. The effect is clinically insignificant
D. There is a 95% chance the true effect lies between 1.2 and 3.8
Correct Answer: D
Rationale:
A 95% confidence interval means that if the study were repeated many times, approximately 95% of those
intervals would contain the true population parameter. It does not mean there is a 95% probability that the
specific interval contains the true value, nor does it directly indicate power or p-values.
NEA-BC Certification -- 2026/2027 | Passing Score: 75% | Page 3
, Q5 Question 5 of 100
A nursing director wants to implement an evidence-based practice change and uses the Iowa Model
as a framework. The first step in this model involves which action?
A. Identifying a trigger or clinical question
B. Implementing the practice change on a pilot unit
C. Evaluating outcomes of the change
D. Selecting a theoretical framework
Correct Answer: A
Rationale:
The Iowa Model Revised begins with identifying a trigger--either a knowledge-focused trigger (new research
findings) or a problem-focused trigger (clinical issue). This trigger leads to forming a clinical question before
searching for and appraising evidence. Implementation and evaluation occur later in the process.
Q6 Question 6 of 100
A nurse researcher reports a Pearson correlation coefficient of -0.82 between nurse staffing ratios
and patient fall rates. The executive should interpret this as indicating which relationship?
A. A weak negative relationship
B. A strong negative linear relationship
C. No significant relationship
D. A strong positive relationship
Correct Answer: B
Rationale:
A Pearson r of -0.82 indicates a strong negative linear relationship between the two variables. As staffing
ratios increase (fewer nurses per patient), fall rates also increase, and the strength of this inverse association
is strong because the absolute value approaches 1.0.
NEA-BC Certification -- 2026/2027 | Passing Score: 75% | Page 4
NEA-BC
Nurse Executive, Advanced Certification
Official Practice Exam
2026/2027 Edition
QUESTIONS MINUTES PASSING SCORE RECERTIFICATION
100 180 75% 5 Years
Table of Contents
Section 1: Scientific Foundation ........... 15 Questions (Q1-Q15)
Section 2: Leadership and Governance ........... 25 Questions (Q16-Q40)
Section 3: Health Care Economics and Finance ........... 15 Questions (Q41-Q55)
Section 4: Health Care Policy ........... 15 Questions (Q56-Q70)
Section 5: Professional Practice ........... 15 Questions (Q71-Q85)
Section 6: Quality and Safety ........... 15 Questions (Q86-Q100)
Instructions
This practice exam contains 100 multiple-choice questions divided into 6 sections. Each question has four answer
choices (A through D). Select the one best answer for each question. You have 180 minutes to complete the
exam. A score of 75% or higher (75 out of 100 questions correct) is required to pass. Read each question
carefully, noting the clinical scenario before selecting your answer. Review the rationale provided after each
question for learning purposes.
Disclaimer: This is a practice exam for study purposes only. It is not affiliated with or endorsed by ANCC.
NEA-BC Certification -- 2026/2027 | Passing Score: 75% | Page 1
, Section 1: Scientific Foundation -- 2026/2027
Q1 Question 1 of 100
A nurse executive reviews a study that used a randomized controlled trial design to evaluate a new
staffing model. The p-value reported is 0.03. The executive should interpret this finding as evidence
that the results are statistically significant at which threshold?
A. 0.05 level
B. 0.01 level only
C. 0.10 level only
D. 0.001 level only
Correct Answer: A
Rationale:
A p-value of 0.03 is less than the conventional alpha of 0.05, indicating statistical significance at that
threshold. The result would not reach significance at the stricter 0.01 or 0.001 levels, making 0.05 the most
appropriate interpretation.
Q2 Question 2 of 100
A chief nursing officer is evaluating research evidence using the hierarchy of evidence model. Where
do systematic reviews of randomized controlled trials rank on this hierarchy?
A. Below expert opinion
B. At the highest level of evidence
C. At the same level as case reports
D. Below single randomized controlled trials
Correct Answer: B
Rationale:
Systematic reviews and meta-analyses of RCTs occupy the apex of the evidence hierarchy because they
synthesize data from multiple rigorous studies, reducing bias and increasing confidence in findings. Single
RCTs rank below systematic reviews, and case reports and expert opinion rank even lower.
,Q3 Question 3 of 100
During a journal club presentation, a nurse leader questions whether a study's sample size was
adequate. The concept being evaluated is most closely related to which statistical principle?
A. Construct validity
B. Internal consistency
C. Statistical power
D. Content validity
Correct Answer: C
Rationale:
Statistical power is the probability of detecting a true effect when one exists, and it is directly influenced by
sample size. Inadequate sample sizes reduce power and increase the risk of a Type II error. Construct validity
and content validity relate to measurement accuracy, not sample adequacy.
Q4 Question 4 of 100
A nurse executive encounters a research article reporting a confidence interval of 95% for a treatment
effect ranging from 1.2 to 3.8. The executive should understand that this interval indicates which of
the following?
A. The p-value must be greater than 0.05
B. The study has 95% power to detect the effect
C. The effect is clinically insignificant
D. There is a 95% chance the true effect lies between 1.2 and 3.8
Correct Answer: D
Rationale:
A 95% confidence interval means that if the study were repeated many times, approximately 95% of those
intervals would contain the true population parameter. It does not mean there is a 95% probability that the
specific interval contains the true value, nor does it directly indicate power or p-values.
NEA-BC Certification -- 2026/2027 | Passing Score: 75% | Page 3
, Q5 Question 5 of 100
A nursing director wants to implement an evidence-based practice change and uses the Iowa Model
as a framework. The first step in this model involves which action?
A. Identifying a trigger or clinical question
B. Implementing the practice change on a pilot unit
C. Evaluating outcomes of the change
D. Selecting a theoretical framework
Correct Answer: A
Rationale:
The Iowa Model Revised begins with identifying a trigger--either a knowledge-focused trigger (new research
findings) or a problem-focused trigger (clinical issue). This trigger leads to forming a clinical question before
searching for and appraising evidence. Implementation and evaluation occur later in the process.
Q6 Question 6 of 100
A nurse researcher reports a Pearson correlation coefficient of -0.82 between nurse staffing ratios
and patient fall rates. The executive should interpret this as indicating which relationship?
A. A weak negative relationship
B. A strong negative linear relationship
C. No significant relationship
D. A strong positive relationship
Correct Answer: B
Rationale:
A Pearson r of -0.82 indicates a strong negative linear relationship between the two variables. As staffing
ratios increase (fewer nurses per patient), fall rates also increase, and the strength of this inverse association
is strong because the absolute value approaches 1.0.
NEA-BC Certification -- 2026/2027 | Passing Score: 75% | Page 4
