PN COMPREHENSIVE PREDICTOR 2023/2024 WITH NGN NEWEST
VERSION 180 REAL EXAM QUESTIONS WITH CORRECT DETAILED
ANSWERS & RATIONALES (NEW!!)
Question 1
An assistive personnel (AP) tells the charge nurse that her assignment is too demanding. She
angrily tells the nurse to reassign one of her tasks to another AP. Which of the following actions
should the nurse take to resolve the conflict?
A) Tell the AP that she must complete the entire assignment.
B) Immediately reassign the task to another AP to maintain unit peace.
C) Ask the AP to discuss the issue in a private area.
D) Document the AP's refusal to perform the task.
E) Remind the AP that the assignment is based on client acuity.
Correct Answer: C) Ask the AP to discuss the issue in a private area.
Rationale: When addressing conflict or unprofessional behavior, the nurse should first
remove the discussion from the public ear (e.g., nurses' station or hallway) to protect client
confidentiality, maintain professionalism, and facilitate a constructive, non-confrontational
conversation.
Question 2
A nurse is supervising an assistive personnel (AP) obtaining supplies for a client who is on
seizure precautions. Which of the following materials should the AP place in the client's room?
A) Wrist restraints
B) Padded tongue blade
C) Pulse oximeter
D) Oral suction equipment
E) Nasal cannula set at 6 L/min
Correct Answer: D) Oral suction equipment
Rationale: The priority during and after a seizure is maintaining a patent airway and
preventing aspiration. Oral suction equipment (like a Yankauer catheter) should be
immediately available at the bedside to clear secretions from the client's mouth.
Question 3
A charge nurse on a mental health unit is supervising a newly licensed nurse. For which of the
,following actions by the newly licensed nurse should the supervising nurse intervene?
A) Asks the client to discuss the reasons for their anxiety.
B) Tells a client he will lose his phone privileges if he does not take his medication.
C) Sets clear boundaries for the time spent talking with a client.
D) Allows the client to choose the seating arrangement in the day room.
E) Uses silence when the client pauses during a discussion.
Correct Answer: B) Tells a client he will lose his phone privileges if he does not take his
medication.
Rationale: Threatening the loss of privileges to force a client to comply with medication
administration is coercive and violates the client's right to refuse medication. This is an
inappropriate, punitive, and unethical intervention.
Question 4
A nurse is caring for a client who follows a kosher diet. Which of the following menu items
should the nurse include in the meal tray?
A) Shrimp cocktail
B) Grilled cheese sandwich made with non-kosher cheddar
C) Roasted Salmon
D) Bacon cheeseburger
E) Pork chops with mashed potatoes
Correct Answer: C) Roasted Salmon
Rationale: A kosher diet requires that only fish with fins and scales are permitted. Salmon is
acceptable. Shellfish (A), pork products (D, E), and combining meat (e.g., beef in the
burger) with dairy (cheese) are prohibited.
Question 5
A nurse is reviewing information about advance directives (AD) with a newly admitted client.
Which of the following statements by the client indicates an understanding of the information?
A) "I can wait until I'm very sick to sign my advance directives."
B) "Advance directives include a living will."
C) "My power of attorney must be an attorney-at-law."
D) "Once I sign this document, I can never change it."
,E) "The nurse is responsible for explaining the legal implications of the document."
Correct Answer: B) "Advance directives include a living will."
Rationale: Advance directives are composed of two main documents: the Living Will
(instructions regarding medical treatments) and the Durable Power of Attorney for
Healthcare (identifying a decision-maker).
Question 6
A nurse is collecting data from the caregiver of a client who has Alzheimer's disease. The
caregiver reports the client has difficulty sleeping at night and wanders throughout the house.
Which of the following interventions should the nurse recommend?
A) Administer a sedative before the client goes to bed.
B) Discourage the client from taking any daytime naps.
C) Encourage the client to take frequent walks during the day.
D) Lock the client's bedroom door at night to prevent wandering.
E) Allow the client to watch TV for 1 hour before bedtime.
Correct Answer: C) Encourage the client to take frequent walks during the day.
Rationale: Increasing physical activity during the day promotes nighttime sleep, thereby
reducing the client's nighttime restlessness and wandering. This is a common non-
pharmacological strategy for "sundowning" and sleep issues.
Question 7
A nurse is assisting in the care of a client who is 8 hr postpartum and has uterine atony with
increased bleeding. Which of the following actions should the nurse take? (Select all that apply)
A) Administer prescribed oxytocin intravenously.
B) Assist the client to empty her bladder.
C) Massage the fundus gently but firmly.
D) Place the client in a high-Fowler's position.
E) Apply cold compresses to the client's perineum.
Correct Answer: B) Assist the client to empty her bladder. and C) Massage the fundus gently
but firmly.
Rationale: The two priority interventions for uterine atony (the most common cause of
postpartum hemorrhage) are to empty the bladder (a full bladder prevents the uterus from
, contracting effectively) and to vigorously massage the fundus to stimulate contractions and
expel clots.
Question 8
A nurse is reinforcing teaching with the support person of a client who is in the first stage of
labor. Which of the following instructions should the nurse include regarding effleurage?
A) "Apply firm, steady pressure to her lower back during contractions."
B) "Gently stroke her abdomen during contractions."
C) "Guide her to push hard when she feels the urge."
D) "Assist her in taking shallow, rapid breaths between contractions."
E) "Give her a strong massage on her shoulders while the contraction peaks."
Correct Answer: B) "Gently stroke her abdomen during contractions."
Rationale: Effleurage is a light, rhythmic stroking or massaging of the abdomen (or other
body part) during contractions. This serves as a distracting cutaneous stimulation
technique for pain management in labor.
Question 9
A nurse is caring for an older adult client who is postoperative following a total hip arthroplasty.
The client is incontinent of stool and urine. Which of the following actions should the nurse take
to prevent skin breakdown?
A) Turn the client every 4 hours.
B) Use a moisture barrier on the client's skin.
C) Restrict the client's fluid intake to 1,000 mL/day.
D) Use talcum powder after cleaning the skin.
E) Place a heating pad over the coccyx area.
Correct Answer: B) Use a moisture barrier on the client's skin.
Rationale: Moisture (from urine and stool) is a primary cause of skin maceration and
breakdown. A moisture barrier cream or ointment helps protect the skin from the
damaging effects of excessive moisture and is the appropriate intervention.
Question 10
A nurse is caring for a client who has terminal cancer. Which of the following actions should the
nurse take to promote the client's autonomy?
VERSION 180 REAL EXAM QUESTIONS WITH CORRECT DETAILED
ANSWERS & RATIONALES (NEW!!)
Question 1
An assistive personnel (AP) tells the charge nurse that her assignment is too demanding. She
angrily tells the nurse to reassign one of her tasks to another AP. Which of the following actions
should the nurse take to resolve the conflict?
A) Tell the AP that she must complete the entire assignment.
B) Immediately reassign the task to another AP to maintain unit peace.
C) Ask the AP to discuss the issue in a private area.
D) Document the AP's refusal to perform the task.
E) Remind the AP that the assignment is based on client acuity.
Correct Answer: C) Ask the AP to discuss the issue in a private area.
Rationale: When addressing conflict or unprofessional behavior, the nurse should first
remove the discussion from the public ear (e.g., nurses' station or hallway) to protect client
confidentiality, maintain professionalism, and facilitate a constructive, non-confrontational
conversation.
Question 2
A nurse is supervising an assistive personnel (AP) obtaining supplies for a client who is on
seizure precautions. Which of the following materials should the AP place in the client's room?
A) Wrist restraints
B) Padded tongue blade
C) Pulse oximeter
D) Oral suction equipment
E) Nasal cannula set at 6 L/min
Correct Answer: D) Oral suction equipment
Rationale: The priority during and after a seizure is maintaining a patent airway and
preventing aspiration. Oral suction equipment (like a Yankauer catheter) should be
immediately available at the bedside to clear secretions from the client's mouth.
Question 3
A charge nurse on a mental health unit is supervising a newly licensed nurse. For which of the
,following actions by the newly licensed nurse should the supervising nurse intervene?
A) Asks the client to discuss the reasons for their anxiety.
B) Tells a client he will lose his phone privileges if he does not take his medication.
C) Sets clear boundaries for the time spent talking with a client.
D) Allows the client to choose the seating arrangement in the day room.
E) Uses silence when the client pauses during a discussion.
Correct Answer: B) Tells a client he will lose his phone privileges if he does not take his
medication.
Rationale: Threatening the loss of privileges to force a client to comply with medication
administration is coercive and violates the client's right to refuse medication. This is an
inappropriate, punitive, and unethical intervention.
Question 4
A nurse is caring for a client who follows a kosher diet. Which of the following menu items
should the nurse include in the meal tray?
A) Shrimp cocktail
B) Grilled cheese sandwich made with non-kosher cheddar
C) Roasted Salmon
D) Bacon cheeseburger
E) Pork chops with mashed potatoes
Correct Answer: C) Roasted Salmon
Rationale: A kosher diet requires that only fish with fins and scales are permitted. Salmon is
acceptable. Shellfish (A), pork products (D, E), and combining meat (e.g., beef in the
burger) with dairy (cheese) are prohibited.
Question 5
A nurse is reviewing information about advance directives (AD) with a newly admitted client.
Which of the following statements by the client indicates an understanding of the information?
A) "I can wait until I'm very sick to sign my advance directives."
B) "Advance directives include a living will."
C) "My power of attorney must be an attorney-at-law."
D) "Once I sign this document, I can never change it."
,E) "The nurse is responsible for explaining the legal implications of the document."
Correct Answer: B) "Advance directives include a living will."
Rationale: Advance directives are composed of two main documents: the Living Will
(instructions regarding medical treatments) and the Durable Power of Attorney for
Healthcare (identifying a decision-maker).
Question 6
A nurse is collecting data from the caregiver of a client who has Alzheimer's disease. The
caregiver reports the client has difficulty sleeping at night and wanders throughout the house.
Which of the following interventions should the nurse recommend?
A) Administer a sedative before the client goes to bed.
B) Discourage the client from taking any daytime naps.
C) Encourage the client to take frequent walks during the day.
D) Lock the client's bedroom door at night to prevent wandering.
E) Allow the client to watch TV for 1 hour before bedtime.
Correct Answer: C) Encourage the client to take frequent walks during the day.
Rationale: Increasing physical activity during the day promotes nighttime sleep, thereby
reducing the client's nighttime restlessness and wandering. This is a common non-
pharmacological strategy for "sundowning" and sleep issues.
Question 7
A nurse is assisting in the care of a client who is 8 hr postpartum and has uterine atony with
increased bleeding. Which of the following actions should the nurse take? (Select all that apply)
A) Administer prescribed oxytocin intravenously.
B) Assist the client to empty her bladder.
C) Massage the fundus gently but firmly.
D) Place the client in a high-Fowler's position.
E) Apply cold compresses to the client's perineum.
Correct Answer: B) Assist the client to empty her bladder. and C) Massage the fundus gently
but firmly.
Rationale: The two priority interventions for uterine atony (the most common cause of
postpartum hemorrhage) are to empty the bladder (a full bladder prevents the uterus from
, contracting effectively) and to vigorously massage the fundus to stimulate contractions and
expel clots.
Question 8
A nurse is reinforcing teaching with the support person of a client who is in the first stage of
labor. Which of the following instructions should the nurse include regarding effleurage?
A) "Apply firm, steady pressure to her lower back during contractions."
B) "Gently stroke her abdomen during contractions."
C) "Guide her to push hard when she feels the urge."
D) "Assist her in taking shallow, rapid breaths between contractions."
E) "Give her a strong massage on her shoulders while the contraction peaks."
Correct Answer: B) "Gently stroke her abdomen during contractions."
Rationale: Effleurage is a light, rhythmic stroking or massaging of the abdomen (or other
body part) during contractions. This serves as a distracting cutaneous stimulation
technique for pain management in labor.
Question 9
A nurse is caring for an older adult client who is postoperative following a total hip arthroplasty.
The client is incontinent of stool and urine. Which of the following actions should the nurse take
to prevent skin breakdown?
A) Turn the client every 4 hours.
B) Use a moisture barrier on the client's skin.
C) Restrict the client's fluid intake to 1,000 mL/day.
D) Use talcum powder after cleaning the skin.
E) Place a heating pad over the coccyx area.
Correct Answer: B) Use a moisture barrier on the client's skin.
Rationale: Moisture (from urine and stool) is a primary cause of skin maceration and
breakdown. A moisture barrier cream or ointment helps protect the skin from the
damaging effects of excessive moisture and is the appropriate intervention.
Question 10
A nurse is caring for a client who has terminal cancer. Which of the following actions should the
nurse take to promote the client's autonomy?
