NZ Nursing State Exam Actual Exam
2026/2027 – Complete Exam-Style Questions
with Detailed Rationales | 100% Verified |
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[SECTION 1: Professional Responsibility & Legal/Ethical Nursing — Questions 1-20]
Q1: Under the Health Practitioners Competence Assurance Act 2003 (HPCA Act), what is the
primary responsibility of the Nursing Council of New Zealand regarding registered nurses?
A. To provide financial support for nurses facing disciplinary action
B. To set standards of clinical competence for the profession
C. To negotiate employment contracts and salary rates for nurses
D. To direct the daily operational policies of hospital wards
C. To set standards of clinical competence for the profession [CORRECT]
Correct Answer: C
Rationale: The HPCA Act mandates the Nursing Council of New Zealand to protect the public
by ensuring nurses are competent and fit to practice. This is achieved by setting registration
standards, competencies, and a code of conduct. Option A is incorrect as the Council does not
provide legal defense funds. Option C is the responsibility of unions like NZNO, and Option D is
the responsibility of individual DHBs or health providers.
Q2: A nurse is caring for a competent adult patient who refuses a life-saving blood transfusion
due to religious beliefs. According to the Code of Health and Disability Services Consumers'
Rights, which action should the nurse take?
A. Administer the transfusion immediately to preserve life
B. Document the refusal and inform the medical team, respecting the patient's autonomy
C. Contact the patient's family to override the decision
D. Ask the patient to sign a liability waiver before proceeding
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B. Document the refusal and inform the medical team, respecting the patient's autonomy
[CORRECT]
Correct Answer: B
Rationale: Right 7 of the Code affirms the right of a competent consumer to make an informed
choice and give informed consent, including the right to refuse services. A nurse must respect
this legal and ethical autonomy, even if the outcome may be death. Option A is battery and
illegal. Options C and D violate the patient's right to self-determination.
Q3: A nurse witnesses a colleague making a medication error that does not harm the patient but
is concealed in the documentation. According to the Code of Conduct for nurses, what is the
most appropriate immediate action?
A. Confront the colleague aggressively and demand they change the notes
B. Report the incident to the nurse in charge or manager immediately
C. Ignore the error as no harm came to the patient
D. Wait until the end of the shift to see if the colleague self-reports
B. Report the incident to the nurse in charge or manager immediately [CORRECT]
Correct Answer: B
Rationale: The Nursing Council Code of Conduct requires nurses to maintain public trust and act
with integrity. Covering up errors is professional misconduct and compromises patient safety.
The nurse must report the conduct through appropriate channels (manager/Nurse Leader) to
ensure accountability and patient safety. Option A creates workplace hostility, and Option C is
complicity in negligence.
Q4: During a busy shift, a nurse is asked to perform a task that is outside their scope of practice
and for which they have not received training. Which response best demonstrates professional
responsibility?
A. Perform the task to help the team, relying on the assistance of a colleague
B. Decline the task politely, explaining it is outside the current scope of competence
C. Attempt the task but document that it was outside the scope
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D. Ask the patient for permission to try the procedure
B. Decline the task politely, explaining it is outside the current scope of competence
[CORRECT]
Correct Answer: B
Rationale: Nurses must practice only within their scope of practice and personal level of
competence (NCNZ Competencies). Accepting tasks without the necessary skill set places the
patient at risk and violates professional standards. Option A and C endanger the patient. Option
D does not validate the nurse's competence to perform the procedure safely.
Q5: Under the Privacy Act 2020 and the Health Information Privacy Code 2020, who is
considered the primary "Kaitiaki" (guardian) of a patient's health information while they are
hospitalized?
A. The Hospital Board CEO
B. The Ministry of Health
C. The agency or provider collecting the information (e.g., the DHB)
D. The patient's family members
C. The agency or provider collecting the information (e.g., the DHB) [CORRECT]
Correct Answer: C
Rationale: Under the Health Information Privacy Code 2020, the health agency holding the
information acts as the agency responsible for protecting it. They must ensure information is kept
secure and only disclosed for lawful purposes. While the patient has rights regarding their data,
the provider is the legal guardian (Kaitiaki) of the records during care. Options A and B are too
broad; D does not have legal authority over records.
Q6: A nurse wants to share a patient's progress notes with a specialist at another hospital. Which
privacy rule permits this disclosure?
A. Rule 2 of the Health Information Privacy Code (Source of information)
B. Rule 11 of the Health Information Privacy Code (Disclosure of information)
C. The patient's verbal consent to a family member
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D. The Freedom of Information Act
B. Rule 11 of the Health Information Privacy Code (Disclosure of information) [CORRECT]
Correct Answer: B
Rationale: Rule 11 allows health information to be disclosed to another health provider for the
purpose of providing ongoing healthcare to the patient, provided the health consumer is informed
of this usual practice. This facilitates continuity of care. Option A refers to where info comes
from, not sharing. Option D does not typically override health privacy rules for clinical care.
Q7: Which document outlines the specific nursing competencies for registration as a Registered
Nurse in New Zealand?
A. The Public Health and Disability Act
B. The Nurses Act 1977
C. Competencies for the Registered Nurse Scope of Practice (NCNZ)
D. The Health and Safety at Work Act
C. Competencies for the Registered Nurse Scope of Practice (NCNZ) [CORRECT]
Correct Answer: C
Rationale: The Nursing Council of New Zealand publishes "Competencies for the Registered
Nurse Scope of Practice," which defines the standards of practice, evidence-based care, and
professional behaviour required. The Nurses Act 1977 is repealed (superseded by HPCA). The
Public Health and Disability Act governs the health system structure, not specific nursing
standards.
Q8: A nurse receives a notification from the Nursing Council regarding their "Recertification".
What is the primary purpose of this process?
A. To assess the nurse's salary banding
B. To ensure the nurse remains fit to practice and meets continuing professional development
(CPD) requirements
C. To check the nurse's criminal record every 6 months