Nursing Acceleration Challenge Exam NACE PNRN
Ultimate Exam
**Question 1.** Which of the following is the most appropriate site for a subcutaneous insulin injection
in an adult client?
A) Deltoid muscle
B) Upper outer quadrant of the buttock
C) Abdomen, 2 inches lateral to the umbilicus
D) Medial aspect of the thigh
Answer: C
Explanation: The abdomen provides consistent absorption, is easy to access, and has a large surface
area. Injections should be at least 2 inches from the umbilicus and rotated within the abdominal region.
**Question 2.** A client with a new pressure injury stage II is being assessed. Which finding confirms
the stage?
A) Full‑thickness loss of skin exposing muscle
B) Non‑blanchable erythema of intact skin
C) Partial‑thickness loss of dermis presenting as a shallow ulcer
D) Deep crater with visible bone
Answer: C
Explanation: Stage II pressure injuries involve partial‑thickness loss of dermis, presenting as a shallow
open ulcer with a red‑pink wound bed.
**Question 3.** During a head‑to‑toe physical assessment, the nurse notes a “pulsus paradoxus.” This
sign is most commonly associated with which condition?
A) Hyperthyroidism
, Nursing Acceleration Challenge Exam NACE PNRN
Ultimate Exam
B) Cardiac tamponade
C) Chronic bronchitis
D) Acute renal failure
Answer: B
Explanation: Pulsus paradoxus (an inspiratory drop in systolic BP >10 mm Hg) is classic for cardiac
tamponade due to impaired ventricular filling.
**Question 4.** A pregnant woman at 32 weeks gestation presents with a blood pressure of
160/110 mm Hg, proteinuria, and edema. What is the priority nursing intervention?
A) Encourage ambulation to improve circulation
B) Administer antihypertensive medication as ordered and monitor fetal heart rate
C) Initiate a low‑sodium diet and record daily weights
D) Offer a warm compress for the edema
Answer: B
Explanation: Severe hypertension with proteinuria indicates preeclampsia; prompt antihypertensive
therapy and fetal monitoring are critical to prevent maternal and fetal complications.
**Question 5.** Which of the following is a key component of the “rights” of medication
administration?
A) Right brand name
B) Right time interval
C) Right pharmacy
D) Right insurance coverage
, Nursing Acceleration Challenge Exam NACE PNRN
Ultimate Exam
Answer: B
Explanation: The “right time” ensures the medication is given at the correct interval to maintain
therapeutic effect and avoid toxicity.
**Question 6.** A newborn receives an APGAR score of 8 at 1 minute and 9 at 5 minutes. What does
this indicate?
A) Severe perinatal asphyxia
B) Need for immediate resuscitation
C) Normal transition to extrauterine life
D) Persistent respiratory distress
Answer: C
Explanation: An APGAR of 7–10 at 1 and 5 minutes reflects good adaptation and no immediate
intervention required.
**Question 7.** Which nursing diagnosis is most appropriate for a client with chronic obstructive
pulmonary disease (COPD) who reports dyspnea on exertion?
A) Ineffective airway clearance
B) Impaired gas exchange
C) Activity intolerance
D) Risk for infection
Answer: C
, Nursing Acceleration Challenge Exam NACE PNRN
Ultimate Exam
Explanation: Dyspnea on exertion indicates the client’s activity level is limited, making “activity
intolerance” the most specific diagnosis.
**Question 8.** A client with a newly placed urinary catheter develops a temperature of 38.5 °C
(101.3 °F). What should the nurse do first?
A) Obtain a urine sample for culture
B) Increase the catheter drainage bag height
C) Administer antipyretics as ordered
D) Replace the catheter using sterile technique
Answer: A
Explanation: Fever in a catheterized client suggests a possible catheter‑associated urinary tract
infection; obtaining a urine culture is the first step to confirm and guide treatment.
**Question 9.** Which of the following statements best reflects the principle of autonomy in nursing
ethics?
A) “The nurse decides what is best for the patient.”
B) “Patients have the right to refuse treatment even if it may cause harm.”
C) “Family members may override a patient’s wishes.”
D) “All decisions must be made by the health‑care team.”
Answer: B
Explanation: Autonomy respects the patient’s right to make informed choices about their own care,
even when those choices could be detrimental.
Ultimate Exam
**Question 1.** Which of the following is the most appropriate site for a subcutaneous insulin injection
in an adult client?
A) Deltoid muscle
B) Upper outer quadrant of the buttock
C) Abdomen, 2 inches lateral to the umbilicus
D) Medial aspect of the thigh
Answer: C
Explanation: The abdomen provides consistent absorption, is easy to access, and has a large surface
area. Injections should be at least 2 inches from the umbilicus and rotated within the abdominal region.
**Question 2.** A client with a new pressure injury stage II is being assessed. Which finding confirms
the stage?
A) Full‑thickness loss of skin exposing muscle
B) Non‑blanchable erythema of intact skin
C) Partial‑thickness loss of dermis presenting as a shallow ulcer
D) Deep crater with visible bone
Answer: C
Explanation: Stage II pressure injuries involve partial‑thickness loss of dermis, presenting as a shallow
open ulcer with a red‑pink wound bed.
**Question 3.** During a head‑to‑toe physical assessment, the nurse notes a “pulsus paradoxus.” This
sign is most commonly associated with which condition?
A) Hyperthyroidism
, Nursing Acceleration Challenge Exam NACE PNRN
Ultimate Exam
B) Cardiac tamponade
C) Chronic bronchitis
D) Acute renal failure
Answer: B
Explanation: Pulsus paradoxus (an inspiratory drop in systolic BP >10 mm Hg) is classic for cardiac
tamponade due to impaired ventricular filling.
**Question 4.** A pregnant woman at 32 weeks gestation presents with a blood pressure of
160/110 mm Hg, proteinuria, and edema. What is the priority nursing intervention?
A) Encourage ambulation to improve circulation
B) Administer antihypertensive medication as ordered and monitor fetal heart rate
C) Initiate a low‑sodium diet and record daily weights
D) Offer a warm compress for the edema
Answer: B
Explanation: Severe hypertension with proteinuria indicates preeclampsia; prompt antihypertensive
therapy and fetal monitoring are critical to prevent maternal and fetal complications.
**Question 5.** Which of the following is a key component of the “rights” of medication
administration?
A) Right brand name
B) Right time interval
C) Right pharmacy
D) Right insurance coverage
, Nursing Acceleration Challenge Exam NACE PNRN
Ultimate Exam
Answer: B
Explanation: The “right time” ensures the medication is given at the correct interval to maintain
therapeutic effect and avoid toxicity.
**Question 6.** A newborn receives an APGAR score of 8 at 1 minute and 9 at 5 minutes. What does
this indicate?
A) Severe perinatal asphyxia
B) Need for immediate resuscitation
C) Normal transition to extrauterine life
D) Persistent respiratory distress
Answer: C
Explanation: An APGAR of 7–10 at 1 and 5 minutes reflects good adaptation and no immediate
intervention required.
**Question 7.** Which nursing diagnosis is most appropriate for a client with chronic obstructive
pulmonary disease (COPD) who reports dyspnea on exertion?
A) Ineffective airway clearance
B) Impaired gas exchange
C) Activity intolerance
D) Risk for infection
Answer: C
, Nursing Acceleration Challenge Exam NACE PNRN
Ultimate Exam
Explanation: Dyspnea on exertion indicates the client’s activity level is limited, making “activity
intolerance” the most specific diagnosis.
**Question 8.** A client with a newly placed urinary catheter develops a temperature of 38.5 °C
(101.3 °F). What should the nurse do first?
A) Obtain a urine sample for culture
B) Increase the catheter drainage bag height
C) Administer antipyretics as ordered
D) Replace the catheter using sterile technique
Answer: A
Explanation: Fever in a catheterized client suggests a possible catheter‑associated urinary tract
infection; obtaining a urine culture is the first step to confirm and guide treatment.
**Question 9.** Which of the following statements best reflects the principle of autonomy in nursing
ethics?
A) “The nurse decides what is best for the patient.”
B) “Patients have the right to refuse treatment even if it may cause harm.”
C) “Family members may override a patient’s wishes.”
D) “All decisions must be made by the health‑care team.”
Answer: B
Explanation: Autonomy respects the patient’s right to make informed choices about their own care,
even when those choices could be detrimental.
