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EXAM UPDATE
Core Domains
Advanced Pharmacology in Nursing
Complex Medical-Surgical Management
Ethical and Legal Decision-Making in Acute Care
Nursing Leadership and Health Policy
Evidence-Based Practice in Critical Care
Patient Safety and Risk Management
Informatics and Healthcare Technology
Professional Standards and Scope of Practice
, Introduction
This practice examination is designed to prepare students for the complexities of NSG 3450.
The purpose of this assessment is to evaluate the mastery of foundational theory, clinical
judgment, and regulatory compliance required for professional nursing practice. The content
features a rigorous mix of multiple-choice and scenario-based questions, specifically
engineered to test real-world application and ethical decision-making capabilities. By
engaging with these diverse clinical challenges, students will refine their ability to synthesize
evidence-based knowledge to optimize patient outcomes. This comprehensive review mirrors
the professional standards expected in contemporary healthcare settings, ensuring students
are thoroughly equipped for success.
SECTION ONE: QUESTIONS 1–100
1. A nurse is reviewing the legal implications of documenting a medication error. Which
action demonstrates an understanding of professional standards and risk
management?
A. Documenting the error in the patient's medical record with a detailed account of the
event and the follow-up care provided.
B. Including the incident report in the patient’s permanent medical record to ensure
transparency.
, C. Noting in the medical record that an incident report was filed for the medication error.
D. Discussing the error with the patient's family before notifying the healthcare provider.
🟢 A. Option
🔴 Explanation: Documentation in the patient's medical record must be factual and focused
on patient care. The incident report is an internal risk management document and should
never be mentioned in the medical record.
2. A patient with end-stage heart failure asks about the legal requirements for a Do Not
Resuscitate (DNR) order. Which statement by the nurse is accurate?
A. A DNR order is only valid if signed by a judge.
B. A DNR order must be renewed every 24 hours to remain active.
C. A DNR order dictates that no medical care will be provided to the patient.
D. A DNR order specifies that cardiopulmonary resuscitation will not be performed if the
patient stops breathing or the heart stops.
🟢 D. Option
🔴 Explanation: A DNR order is a medical order that specifically addresses the withholding of
CPR and does not preclude other forms of palliative or comfort care.
3. During an ethical dilemma regarding resource allocation, which framework best guides
the nurse’s decision-making process?
A. Utilitarianism
B. Deontology
, C. Nihilism
D. Relativism
🟢 A. Option
🔴 Explanation: Utilitarianism focuses on the greatest good for the greatest number of
people, which is the standard ethical framework used in triaging and resource allocation
dilemmas.
4. A nurse prepares to administer a high-alert medication. What is the most effective
safety strategy to prevent a medication error?
A. Using the drug's brand name only.
B. Performing a double-check with another nurse.
C. Relying on personal experience with the medication.
D. Calculating the dose mentally to save time.
🟢 B. Option
🔴 Explanation: Independent double-checks are a gold-standard safety strategy for high-
alert medications to minimize the risk of human error in dosage calculations or identification.
5. A nurse observes a colleague failing to perform hand hygiene before entering a sterile
field. What is the nurse's primary ethical obligation?
A. Ignore the behavior to maintain unit harmony.
B. Document the incident and report it to the Board of Nursing immediately.
C. Intervene immediately to protect the patient and address the breach of standards.
D. Wait until the end of the shift to discuss the behavior privately with the colleague.