NZ NURSING STATE EXAM LATEST 2026/2027 ACCURATE TEST
APPROVED QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (100% CORRECT VERIFIED SOLUTIONS) NEWEST
UPDATED VERSION 2026 EDITION |GUARANTEED PASS A+ |ACTUAL
NZ NURSING STATE EXAM
1. A client with chronic obstructive pulmonary disease (COPD) has an
oxygen saturation of 86% on room air. Which oxygen delivery device
should the nurse apply first?
A. Simple face mask at 6 L/min
B. Nasal cannula at 2 L/min
C. Nasal cannula at 1 L/min → CORRECT ANSWER
D. Non-rebreather mask at 15 L/min
Rationale: In COPD, hypoxic drive is a concern; starting low (1–2 L/min via
nasal cannula) and titrating up prevents respiratory depression while
improving oxygenation. 1 L/min is the safest initial rate.
2. A Māori client refuses a blood transfusion due to tape (sacred) beliefs
regarding blood. The nurse’s priority action is to:
A. Explain the medical necessity of the transfusion
B. Respect the client’s decision and consult the cultural support team
→ CORRECT ANSWER
C. Ask a family member to persuade the client
D. Administer the transfusion after sedation
,Rationale: Under the Nursing Council of New Zealand’s Code of Conduct,
cultural safety requires respecting taking Māori. The nurse must advocate
for the client’s autonomous choice and involve appropriate cultural liaison.
3. A postpartum mother reports a “gush of blood” and a firm fundus at the
umbilicus one hour after vaginal delivery. What is the most likely cause?
A. Uterine atony
B. Retained placenta
C. Lochia rubric with normal involution → CORRECT ANSWER
D. Cervical laceration
Rationale: Lochia rubric is normal for 1–3 days postpartum. A firm fundus
rules out atony; the gush is expected with position change or bladder
filling.
4. Which finding in a newborn requires immediate reporting to the
pediatric team?
A. Acrocyanosis of hands and feet
B. Respiratory rate of 50 breaths per minute
C. Grunting with nasal flaring → CORRECT ANSWER
D. Heart rate of 140 beats per minute
Rationale: Grunting indicates respiratory distress and possible surfactant
deficiency or infection. Acrocyanosis, mild tachypnea (RR 30–60), and HR
120–160 are normal in newborns.
,5. A client on haloperidol presents with neck rigidity, tongue protrusion,
and oculogyric crisis. Which medication should the nurse prepare to
administer stat?
A. Naloxone
B. Benztropine → CORRECT ANSWER
C. Flumazenil
D. Sodium bicarbonate
Rationale: These are acute dystonic reactions from antipsychotics.
Benztropine (anticholinergic) reverses dystonia by correcting dopamine-
acetylcholine imbalance.
6. A nurse is caring for a client with major depressive disorder who
suddenly becomes cheerful and energetic. The nurse should first assess for:
A. Improvement in mood due to medication
B. A manic switch in bipolar disorder
C. Suicidal plan with increased energy → CORRECT ANSWER
D. Side effects of antidepressants
Rationale: Sudden mood elevation in severe depression can signal
suicidality — the client now has energy to act on ideation. Safety
assessment is priority.
7. The nurse receives handover for four clients. Which client should be seen
first?
A. Client with type 2 diabetes and blood glucose 14 moll/L
, B. Client post-appendectomy with pain 4/10
C. Client with chest pain radiating to the jaw and diaphoresis →
CORRECT ANSWER
D. Client with a urinary tract infection and temperature 37.8°C
Rationale: Jaw pain with diaphoresis is an acute coronary syndrome
presentation until proven otherwise. This is a life-threatening emergency.
8. A client receiving furosemide has a potassium level of 2.9 moll/L. Which
assessment finding correlates?
A. Bounding pedal pulses
B. U-shaped waves on ECG → CORRECT ANSWER
C. Increased deep tendon reflexes
D. Hypertension
Rationale: Hypokalemia (<3.5 moll/L) causes U waves, flat T waves, and
arrhythmias. Furosemide is a loop diuretic that wastes potassium.
9. A nursing student asks why the “5 rights” of medication administration
are not enough. The preceptor’s best response includes the right:
A. Room number
B. Reason, response, and documentation → CORRECT ANSWER
C. Time of day
D. Pill color
Rationale: Modern practice expands to “right reason,” “right response,”
APPROVED QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (100% CORRECT VERIFIED SOLUTIONS) NEWEST
UPDATED VERSION 2026 EDITION |GUARANTEED PASS A+ |ACTUAL
NZ NURSING STATE EXAM
1. A client with chronic obstructive pulmonary disease (COPD) has an
oxygen saturation of 86% on room air. Which oxygen delivery device
should the nurse apply first?
A. Simple face mask at 6 L/min
B. Nasal cannula at 2 L/min
C. Nasal cannula at 1 L/min → CORRECT ANSWER
D. Non-rebreather mask at 15 L/min
Rationale: In COPD, hypoxic drive is a concern; starting low (1–2 L/min via
nasal cannula) and titrating up prevents respiratory depression while
improving oxygenation. 1 L/min is the safest initial rate.
2. A Māori client refuses a blood transfusion due to tape (sacred) beliefs
regarding blood. The nurse’s priority action is to:
A. Explain the medical necessity of the transfusion
B. Respect the client’s decision and consult the cultural support team
→ CORRECT ANSWER
C. Ask a family member to persuade the client
D. Administer the transfusion after sedation
,Rationale: Under the Nursing Council of New Zealand’s Code of Conduct,
cultural safety requires respecting taking Māori. The nurse must advocate
for the client’s autonomous choice and involve appropriate cultural liaison.
3. A postpartum mother reports a “gush of blood” and a firm fundus at the
umbilicus one hour after vaginal delivery. What is the most likely cause?
A. Uterine atony
B. Retained placenta
C. Lochia rubric with normal involution → CORRECT ANSWER
D. Cervical laceration
Rationale: Lochia rubric is normal for 1–3 days postpartum. A firm fundus
rules out atony; the gush is expected with position change or bladder
filling.
4. Which finding in a newborn requires immediate reporting to the
pediatric team?
A. Acrocyanosis of hands and feet
B. Respiratory rate of 50 breaths per minute
C. Grunting with nasal flaring → CORRECT ANSWER
D. Heart rate of 140 beats per minute
Rationale: Grunting indicates respiratory distress and possible surfactant
deficiency or infection. Acrocyanosis, mild tachypnea (RR 30–60), and HR
120–160 are normal in newborns.
,5. A client on haloperidol presents with neck rigidity, tongue protrusion,
and oculogyric crisis. Which medication should the nurse prepare to
administer stat?
A. Naloxone
B. Benztropine → CORRECT ANSWER
C. Flumazenil
D. Sodium bicarbonate
Rationale: These are acute dystonic reactions from antipsychotics.
Benztropine (anticholinergic) reverses dystonia by correcting dopamine-
acetylcholine imbalance.
6. A nurse is caring for a client with major depressive disorder who
suddenly becomes cheerful and energetic. The nurse should first assess for:
A. Improvement in mood due to medication
B. A manic switch in bipolar disorder
C. Suicidal plan with increased energy → CORRECT ANSWER
D. Side effects of antidepressants
Rationale: Sudden mood elevation in severe depression can signal
suicidality — the client now has energy to act on ideation. Safety
assessment is priority.
7. The nurse receives handover for four clients. Which client should be seen
first?
A. Client with type 2 diabetes and blood glucose 14 moll/L
, B. Client post-appendectomy with pain 4/10
C. Client with chest pain radiating to the jaw and diaphoresis →
CORRECT ANSWER
D. Client with a urinary tract infection and temperature 37.8°C
Rationale: Jaw pain with diaphoresis is an acute coronary syndrome
presentation until proven otherwise. This is a life-threatening emergency.
8. A client receiving furosemide has a potassium level of 2.9 moll/L. Which
assessment finding correlates?
A. Bounding pedal pulses
B. U-shaped waves on ECG → CORRECT ANSWER
C. Increased deep tendon reflexes
D. Hypertension
Rationale: Hypokalemia (<3.5 moll/L) causes U waves, flat T waves, and
arrhythmias. Furosemide is a loop diuretic that wastes potassium.
9. A nursing student asks why the “5 rights” of medication administration
are not enough. The preceptor’s best response includes the right:
A. Room number
B. Reason, response, and documentation → CORRECT ANSWER
C. Time of day
D. Pill color
Rationale: Modern practice expands to “right reason,” “right response,”
