Green Light Test A / Form A ACTUAL
EXAM 2026/2027 | 75 Questions | Nursing
Program Progression & NCLEX
Readiness | Verified Q&A | Pass
Guaranteed - A+ Graded
[75 Questions | Verified Q&A with Clinical Rationales]
[SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT — 18 QUESTIONS]
Q1
The nurse is caring for a client admitted with community-acquired pneumonia. The client has a
temperature of 102.2°F (39°C), heart rate 110 bpm, respiratory rate 28/min, blood pressure 98/62
mmHg, and oxygen saturation 88% on room air. Which action should the nurse take first?
A. Administer prescribed antibiotics
B. Apply supplemental oxygen via nasal cannula [CORRECT]
C. Obtain blood cultures
D. Encourage deep breathing exercises
Correct Answer: B
Rationale: The priority framework is ABC—Airway, Breathing, Circulation. The client's SpO2 of 88%
indicates significant hypoxemia requiring immediate oxygenation intervention. A is incorrect because
antibiotics address infection but not immediate oxygenation needs. C is important but secondary to
establishing adequate oxygenation. D is appropriate but not the priority when hypoxemia is present.
GREEN LIGHT thinking recognizes that oxygenation takes precedence over all other interventions when
saturation falls below 90%.
Q2
The charge nurse is making assignments for the shift. Which client should be assigned to the RN rather
than the LPN?
,A. Client with stable angina requiring routine medication administration
B. Client 2 hours post-op appendectomy with PCA pump and epidural catheter [CORRECT]
C. Client with type 2 diabetes needing blood glucose monitoring before meals
D. Client with urinary tract infection awaiting discharge
Correct Answer: B
Rationale: The RN scope of practice includes managing complex pain control systems (PCA/epidural),
assessment of surgical recovery, and monitoring for complications. A, C, and D represent stable clients
with predictable outcomes appropriate for LPN assignment within their scope. GREEN LIGHT thinking
ensures high-acuity, complex interventions remain with the RN while delegating stable tasks to
maximize team efficiency.
Q3
The nurse discovers a client has fallen in the bathroom. The client is conscious but complains of right hip
pain and cannot bear weight. Which is the nurse's immediate priority?
A. Complete the incident report
B. Notify the physician
C. Assess for injury and maintain C-spine precautions if indicated [CORRECT]
D. Move the client back to bed for comfort
Correct Answer: C
Rationale: Safety and injury assessment take precedence over documentation or notification. The
mechanism of injury (fall with hip pain) requires systematic assessment before movement to prevent
further injury. A and B are necessary but follow initial assessment. D is unsafe without first ruling out
fracture or spinal injury. GREEN LIGHT thinking prioritizes client safety through systematic assessment
before any other action.
Q4 [SATA - Select All That Apply]
The nurse is caring for a client with Clostridioides difficile infection. Which actions demonstrate
appropriate infection control practices? (Select all that apply.)
A. Placing the client in a private room with dedicated equipment [CORRECT]
B. Wearing a gown and gloves when entering the room [CORRECT]
C. Performing hand hygiene with alcohol-based hand rub after removing gloves
D. Wearing an N95 respirator when providing routine care
E. Continuing contact precautions for 48 hours after diarrhea resolves [CORRECT]
,Correct Answer: A, B, E
Rationale: C. difficile requires contact precautions with private room, dedicated equipment, and
gown/gloves for contact. Alcohol-based hand rub is not effective against C. difficile spores—soap and
water handwashing is required (making C incorrect). N95 respirators are unnecessary as C. difficile is not
airborne (D incorrect). Contact precautions continue until diarrhea has resolved for at least 48 hours (E
correct). GREEN LIGHT thinking demonstrates knowledge of organism-specific transmission precautions
and appropriate PPE selection.
Q5 [Dosage Calculation]
The physician orders heparin 4,000 units subcutaneous daily for DVT prophylaxis. The available vial
contains heparin 5,000 units/mL. How many mL should the nurse administer?
A. 0.6 mL
B. 0.8 mL [CORRECT]
C. 1.0 mL
D. 1.25 mL
Correct Answer: B
Rationale: Using the formula D/H × V: 4,000 units ÷ 5,000 units/mL = 0.8 mL. A represents a calculation
error using 3,000 units. C is the volume of the ordered dose without calculation. D results from incorrect
formula application. GREEN LIGHT thinking requires accurate medication calculation verification—this is
a "stop and verify" moment where mathematical errors could lead to under-dosing (treatment failure)
or over-dosing (bleeding risk).
Q6
The nurse receives report on four clients. Which client requires the nurse's immediate attention?
A. Client with heart failure with 2+ pitting edema and weight gain of 2 lbs over 3 days
B. Client post-thyroidectomy with calcium level of 8.2 mg/dL
C. Client with COPD with respiratory rate of 8/min and difficult to arouse [CORRECT]
D. Client with gastroenteritis who has had three loose stools in the past 4 hours
Correct Answer: C
Rationale: The ABC priority framework identifies C as immediately life-threatening—respiratory
depression with altered mental status indicates possible CO2 narcosis or impending respiratory failure.
A, B, and D require intervention but are not immediately life-threatening. B's calcium level is low but not
, critical (critical is <7.5 or symptomatic). GREEN LIGHT thinking recognizes unstable versus stable
conditions and responds to airway/breathing threats first.
Q7 [Delegation]
The RN is delegating tasks to the UAP (Unlicensed Assistive Personnel). Which task is appropriate for
UAP delegation?
A. Assessing a post-operative client's incision for signs of infection
B. Feeding a client with dysphagia who requires thickened liquids [CORRECT]
C. Administering a scheduled dose of metformin to a diabetic client
D. Teaching a client about wound care before discharge
Correct Answer: B
Rationale: Feeding clients with dysphagia precautions is within UAP scope when the care plan is
established and UAP has been trained on the specific client needs. A requires nursing assessment and
judgment. C is medication administration, outside UAP scope. D requires teaching, which is an RN
responsibility. GREEN LIGHT thinking appropriately delegates tasks that are routine, predictable, and do
not require clinical judgment while retaining assessment, teaching, and medication administration for
licensed personnel.
Q8
The nurse is caring for a client with a central line who suddenly develops chest pain, dyspnea, and
tachycardia during IV medication administration. Which is the nurse's priority action?
A. Notify the physician immediately
B. Stop the infusion and clamp the line [CORRECT]
C. Obtain a STAT chest x-ray
D. Administer supplemental oxygen
Correct Answer: B
Rationale: These symptoms suggest air embolism—immediate priority is stopping the infusion and
clamping the line to prevent further air entry. A, C, and D are important but secondary to preventing
additional air entry. The nurse should also place client in left lateral Trendelenburg if air embolism is
suspected. GREEN LIGHT thinking recognizes life-threatening complications and takes immediate action
to stop the causative factor before proceeding with supportive interventions.
Q9
EXAM 2026/2027 | 75 Questions | Nursing
Program Progression & NCLEX
Readiness | Verified Q&A | Pass
Guaranteed - A+ Graded
[75 Questions | Verified Q&A with Clinical Rationales]
[SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT — 18 QUESTIONS]
Q1
The nurse is caring for a client admitted with community-acquired pneumonia. The client has a
temperature of 102.2°F (39°C), heart rate 110 bpm, respiratory rate 28/min, blood pressure 98/62
mmHg, and oxygen saturation 88% on room air. Which action should the nurse take first?
A. Administer prescribed antibiotics
B. Apply supplemental oxygen via nasal cannula [CORRECT]
C. Obtain blood cultures
D. Encourage deep breathing exercises
Correct Answer: B
Rationale: The priority framework is ABC—Airway, Breathing, Circulation. The client's SpO2 of 88%
indicates significant hypoxemia requiring immediate oxygenation intervention. A is incorrect because
antibiotics address infection but not immediate oxygenation needs. C is important but secondary to
establishing adequate oxygenation. D is appropriate but not the priority when hypoxemia is present.
GREEN LIGHT thinking recognizes that oxygenation takes precedence over all other interventions when
saturation falls below 90%.
Q2
The charge nurse is making assignments for the shift. Which client should be assigned to the RN rather
than the LPN?
,A. Client with stable angina requiring routine medication administration
B. Client 2 hours post-op appendectomy with PCA pump and epidural catheter [CORRECT]
C. Client with type 2 diabetes needing blood glucose monitoring before meals
D. Client with urinary tract infection awaiting discharge
Correct Answer: B
Rationale: The RN scope of practice includes managing complex pain control systems (PCA/epidural),
assessment of surgical recovery, and monitoring for complications. A, C, and D represent stable clients
with predictable outcomes appropriate for LPN assignment within their scope. GREEN LIGHT thinking
ensures high-acuity, complex interventions remain with the RN while delegating stable tasks to
maximize team efficiency.
Q3
The nurse discovers a client has fallen in the bathroom. The client is conscious but complains of right hip
pain and cannot bear weight. Which is the nurse's immediate priority?
A. Complete the incident report
B. Notify the physician
C. Assess for injury and maintain C-spine precautions if indicated [CORRECT]
D. Move the client back to bed for comfort
Correct Answer: C
Rationale: Safety and injury assessment take precedence over documentation or notification. The
mechanism of injury (fall with hip pain) requires systematic assessment before movement to prevent
further injury. A and B are necessary but follow initial assessment. D is unsafe without first ruling out
fracture or spinal injury. GREEN LIGHT thinking prioritizes client safety through systematic assessment
before any other action.
Q4 [SATA - Select All That Apply]
The nurse is caring for a client with Clostridioides difficile infection. Which actions demonstrate
appropriate infection control practices? (Select all that apply.)
A. Placing the client in a private room with dedicated equipment [CORRECT]
B. Wearing a gown and gloves when entering the room [CORRECT]
C. Performing hand hygiene with alcohol-based hand rub after removing gloves
D. Wearing an N95 respirator when providing routine care
E. Continuing contact precautions for 48 hours after diarrhea resolves [CORRECT]
,Correct Answer: A, B, E
Rationale: C. difficile requires contact precautions with private room, dedicated equipment, and
gown/gloves for contact. Alcohol-based hand rub is not effective against C. difficile spores—soap and
water handwashing is required (making C incorrect). N95 respirators are unnecessary as C. difficile is not
airborne (D incorrect). Contact precautions continue until diarrhea has resolved for at least 48 hours (E
correct). GREEN LIGHT thinking demonstrates knowledge of organism-specific transmission precautions
and appropriate PPE selection.
Q5 [Dosage Calculation]
The physician orders heparin 4,000 units subcutaneous daily for DVT prophylaxis. The available vial
contains heparin 5,000 units/mL. How many mL should the nurse administer?
A. 0.6 mL
B. 0.8 mL [CORRECT]
C. 1.0 mL
D. 1.25 mL
Correct Answer: B
Rationale: Using the formula D/H × V: 4,000 units ÷ 5,000 units/mL = 0.8 mL. A represents a calculation
error using 3,000 units. C is the volume of the ordered dose without calculation. D results from incorrect
formula application. GREEN LIGHT thinking requires accurate medication calculation verification—this is
a "stop and verify" moment where mathematical errors could lead to under-dosing (treatment failure)
or over-dosing (bleeding risk).
Q6
The nurse receives report on four clients. Which client requires the nurse's immediate attention?
A. Client with heart failure with 2+ pitting edema and weight gain of 2 lbs over 3 days
B. Client post-thyroidectomy with calcium level of 8.2 mg/dL
C. Client with COPD with respiratory rate of 8/min and difficult to arouse [CORRECT]
D. Client with gastroenteritis who has had three loose stools in the past 4 hours
Correct Answer: C
Rationale: The ABC priority framework identifies C as immediately life-threatening—respiratory
depression with altered mental status indicates possible CO2 narcosis or impending respiratory failure.
A, B, and D require intervention but are not immediately life-threatening. B's calcium level is low but not
, critical (critical is <7.5 or symptomatic). GREEN LIGHT thinking recognizes unstable versus stable
conditions and responds to airway/breathing threats first.
Q7 [Delegation]
The RN is delegating tasks to the UAP (Unlicensed Assistive Personnel). Which task is appropriate for
UAP delegation?
A. Assessing a post-operative client's incision for signs of infection
B. Feeding a client with dysphagia who requires thickened liquids [CORRECT]
C. Administering a scheduled dose of metformin to a diabetic client
D. Teaching a client about wound care before discharge
Correct Answer: B
Rationale: Feeding clients with dysphagia precautions is within UAP scope when the care plan is
established and UAP has been trained on the specific client needs. A requires nursing assessment and
judgment. C is medication administration, outside UAP scope. D requires teaching, which is an RN
responsibility. GREEN LIGHT thinking appropriately delegates tasks that are routine, predictable, and do
not require clinical judgment while retaining assessment, teaching, and medication administration for
licensed personnel.
Q8
The nurse is caring for a client with a central line who suddenly develops chest pain, dyspnea, and
tachycardia during IV medication administration. Which is the nurse's priority action?
A. Notify the physician immediately
B. Stop the infusion and clamp the line [CORRECT]
C. Obtain a STAT chest x-ray
D. Administer supplemental oxygen
Correct Answer: B
Rationale: These symptoms suggest air embolism—immediate priority is stopping the infusion and
clamping the line to prevent further air entry. A, C, and D are important but secondary to preventing
additional air entry. The nurse should also place client in left lateral Trendelenburg if air embolism is
suspected. GREEN LIGHT thinking recognizes life-threatening complications and takes immediate action
to stop the causative factor before proceeding with supportive interventions.
Q9
