Prophecy Core Mandatory Part II (Nursing) Exam 2026/2027 – Questions & Answers |
100% Verified
Core Domains: Patient Safety Protocols, Clinical Judgment & Prioritization, Pharmacology Safety
(Anticoagulation, Opioid Safety), Medical-Surgical Nursing Standards, National Patient Safety Goals
(NPSG), Infection Control & Prevention, Professional Nursing Ethics, Patient Rights & Advocacy,
Cultural Competence in Healthcare, Evidence-Based Practice Application, Healthcare Regulatory
Compliance (Joint Commission, CMS), Adverse Event Management, and Interdisciplinary
Communication
Exam Structure: 50-question, multiple-choice examination designed to evaluate clinical judgment,
safety competencies, and professional nursing standards essential for healthcare facility compliance and
onboarding.
[Domain 1: Patient Safety Protocols]
1. A patient is receiving IV heparin. The nurse notes the patient has black tarry stools.
What is the priority action?
1. A) Increase the heparin dose
2. B) Document the finding and continue monitoring
3. C) Hold the heparin and notify the provider immediately
4. D) Administer vitamin K
Hold the heparin and notify the provider immediately Black tarry stools (melena)
indicate gastrointestinal bleeding; heparin increases bleeding risk and must be
stopped immediately while the provider is notified for further orders. This aligns with
National Patient Safety Goals for anticoagulation therapy safety.
Reference: NPSG.03.05.01 (Anticoagulation Therapy), Joint Commission, 2026.
2. A patient is at risk for falls. Which intervention is most effective?
, 1. A) Keep bed in high position
2. B) Apply restraints
3. C) Perform hourly rounding and keep bed in low position
4. D) Dim lights completely
Perform hourly rounding and keep bed in low position Hourly rounding addresses
patient needs proactively, while maintaining the bed in the lowest position reduces
injury risk if falls occur. This combination is evidence-based for fall prevention.
Reference: NPSG.07.01.01 (Fall Reduction), Joint Commission, 2026.
3. A patient is receiving morphine via PCA. The nurse notes a respiratory rate of 8/min.
What is the first action?
1. A) Encourage deep breathing
2. B) Reduce the PCA dose
3. C) Stop the PCA and administer naloxone per protocol
4. D) Apply oxygen only
Stop the PCA and administer naloxone per protocol Respiratory rate below 10/min
indicates life-threatening opioid-induced respiratory depression. Naloxone is the
reversal agent that must be administered immediately while the opioid infusion is
stopped.
Reference: NPSG.03.06.01 (Clinical Alarm Management), Joint Commission, 2026.
4. A patient is receiving IV potassium. Which finding requires immediate intervention?
1. A) Urine output 40 mL/hr
2. B) BP 130/80
3. C) Cardiac dysrhythmias on the monitor
4. D) Patient reports mild warmth at IV site
, Cardiac dysrhythmias on the monitor IV potassium can cause fatal cardiac
dysrhythmias if infused too rapidly or if serum potassium becomes elevated.
Dysrhythmias require stopping the infusion and immediate provider notification.
Reference: NPSG.03.05.01 (Anticoagulation Therapy), Joint Commission, 2026.
5. A patient with a history of falls is ambulating in the hallway. Which action by the nurse is
most appropriate?
1. A) Allow the patient to ambulate independently
2. B) Stay within arm's reach of the patient and use a gait belt
3. C) Restrain the patient to the bed
4. D) Encourage the patient to hold onto the IV pole for support
Stay within arm's reach of the patient and use a gait belt Ensures immediate support if
the patient begins to fall, reducing injury risk. Gait belts provide secure assistance
during ambulation.
Reference: NPSG.07.01.01 (Fall Reduction), Joint Commission, 2026.
[Domain 2: Clinical Judgment & Prioritization]
6. The nurse is caring for four patients. Which patient should the nurse assess FIRST?
1. A) A patient with a blood glucose of 220 mg/dL
2. B) A patient with chest pain and diaphoresis
3. C) A patient requesting pain medication
4. D) A patient with a stage II pressure injury
A patient with chest pain and diaphoresis Chest pain and diaphoresis are classic signs
of acute coronary syndrome, which is life-threatening and requires immediate
assessment and intervention.
100% Verified
Core Domains: Patient Safety Protocols, Clinical Judgment & Prioritization, Pharmacology Safety
(Anticoagulation, Opioid Safety), Medical-Surgical Nursing Standards, National Patient Safety Goals
(NPSG), Infection Control & Prevention, Professional Nursing Ethics, Patient Rights & Advocacy,
Cultural Competence in Healthcare, Evidence-Based Practice Application, Healthcare Regulatory
Compliance (Joint Commission, CMS), Adverse Event Management, and Interdisciplinary
Communication
Exam Structure: 50-question, multiple-choice examination designed to evaluate clinical judgment,
safety competencies, and professional nursing standards essential for healthcare facility compliance and
onboarding.
[Domain 1: Patient Safety Protocols]
1. A patient is receiving IV heparin. The nurse notes the patient has black tarry stools.
What is the priority action?
1. A) Increase the heparin dose
2. B) Document the finding and continue monitoring
3. C) Hold the heparin and notify the provider immediately
4. D) Administer vitamin K
Hold the heparin and notify the provider immediately Black tarry stools (melena)
indicate gastrointestinal bleeding; heparin increases bleeding risk and must be
stopped immediately while the provider is notified for further orders. This aligns with
National Patient Safety Goals for anticoagulation therapy safety.
Reference: NPSG.03.05.01 (Anticoagulation Therapy), Joint Commission, 2026.
2. A patient is at risk for falls. Which intervention is most effective?
, 1. A) Keep bed in high position
2. B) Apply restraints
3. C) Perform hourly rounding and keep bed in low position
4. D) Dim lights completely
Perform hourly rounding and keep bed in low position Hourly rounding addresses
patient needs proactively, while maintaining the bed in the lowest position reduces
injury risk if falls occur. This combination is evidence-based for fall prevention.
Reference: NPSG.07.01.01 (Fall Reduction), Joint Commission, 2026.
3. A patient is receiving morphine via PCA. The nurse notes a respiratory rate of 8/min.
What is the first action?
1. A) Encourage deep breathing
2. B) Reduce the PCA dose
3. C) Stop the PCA and administer naloxone per protocol
4. D) Apply oxygen only
Stop the PCA and administer naloxone per protocol Respiratory rate below 10/min
indicates life-threatening opioid-induced respiratory depression. Naloxone is the
reversal agent that must be administered immediately while the opioid infusion is
stopped.
Reference: NPSG.03.06.01 (Clinical Alarm Management), Joint Commission, 2026.
4. A patient is receiving IV potassium. Which finding requires immediate intervention?
1. A) Urine output 40 mL/hr
2. B) BP 130/80
3. C) Cardiac dysrhythmias on the monitor
4. D) Patient reports mild warmth at IV site
, Cardiac dysrhythmias on the monitor IV potassium can cause fatal cardiac
dysrhythmias if infused too rapidly or if serum potassium becomes elevated.
Dysrhythmias require stopping the infusion and immediate provider notification.
Reference: NPSG.03.05.01 (Anticoagulation Therapy), Joint Commission, 2026.
5. A patient with a history of falls is ambulating in the hallway. Which action by the nurse is
most appropriate?
1. A) Allow the patient to ambulate independently
2. B) Stay within arm's reach of the patient and use a gait belt
3. C) Restrain the patient to the bed
4. D) Encourage the patient to hold onto the IV pole for support
Stay within arm's reach of the patient and use a gait belt Ensures immediate support if
the patient begins to fall, reducing injury risk. Gait belts provide secure assistance
during ambulation.
Reference: NPSG.07.01.01 (Fall Reduction), Joint Commission, 2026.
[Domain 2: Clinical Judgment & Prioritization]
6. The nurse is caring for four patients. Which patient should the nurse assess FIRST?
1. A) A patient with a blood glucose of 220 mg/dL
2. B) A patient with chest pain and diaphoresis
3. C) A patient requesting pain medication
4. D) A patient with a stage II pressure injury
A patient with chest pain and diaphoresis Chest pain and diaphoresis are classic signs
of acute coronary syndrome, which is life-threatening and requires immediate
assessment and intervention.
