Registered Nurse (RN) Prometric exam questions

The Registered Nurse (RN) exam in every GCC country

From each regulator's own exam pages; anything a regulator does not publish says so. Assessment mode also depends on your licence title, so confirm your route on your eligibility notice.

12 worked Registered Nurse (RN) practice questions

Original exam-style questions from the bank, spread across the blueprint domains. They are not real or recalled exam questions. Try each one, then open the answer for the rationale and reference. None of them appear in the free mock exam, so reading them will not spoil it.

1. Question 1 · Maternal, Newborn & Women's Health Nursing

   A 30-year-old woman reports severe, progressively worsening dysmenorrhea, deep pain during intercourse, and difficulty conceiving over the past 2 years. Which condition should the nurse most suspect, and what is the definitive method of diagnosis?

   1. APelvic inflammatory disease; diagnosed by endocervical culture
   2. BEndometriosis; definitively diagnosed by laparoscopy with visualization or biopsy
   3. CUterine fibroids; definitively diagnosed by serum CA-125 level
   4. DOvarian cyst; definitively diagnosed by transvaginal ultrasound alone
   Show answer and explanation

   Correct answer: B. Endometriosis; definitively diagnosed by laparoscopy with visualization or biopsy

   The triad of worsening dysmenorrhea, deep dyspareunia, and subfertility strongly suggests endometriosis, and the definitive diagnosis is made by direct laparoscopic visualization of endometriotic lesions, ideally with histological confirmation. CA-125 may be mildly elevated in endometriosis but is nonspecific and not diagnostic of fibroids. Pelvic inflammatory disease typically presents with acute pain, fever, and discharge, and ultrasound alone does not definitively diagnose endometriosis.

   Reference: ESHRE Guideline on the Diagnosis and Management of Endometriosis, 2022

2. Question 2 · Adult Medical Nursing

   A patient with acute kidney injury has a serum potassium of 7.2 mmol/L with peaked T waves on the ECG. Which prescribed intervention most rapidly protects the myocardium while awaiting definitive potassium removal?

   1. AOral sodium polystyrene sulfonate
   2. BIntravenous calcium gluconate
   3. CIntravenous furosemide
   4. DSubcutaneous erythropoietin
   Show answer and explanation

   Correct answer: B. Intravenous calcium gluconate

   Intravenous calcium gluconate stabilizes the cardiac cell membrane within minutes, protecting against fatal dysrhythmias in severe hyperkalemia, although it does not lower potassium. Sodium polystyrene sulfonate removes potassium slowly, furosemide requires functioning kidneys and acts more slowly, and erythropoietin treats anemia, not hyperkalemia.

   Reference: European Resuscitation Council Guidelines: Cardiac Arrest in Special Circumstances / Electrolyte Disorders (2021)

3. Question 3 · Leadership, Management, Quality, Safety & Professional Practice

   A newly hired internationally trained nurse is asked to perform a procedure that is within the job description but which she has never been trained or assessed to do. What is the most professionally appropriate action?

   1. APerform the procedure to avoid appearing incompetent to the team
   2. BDecline until she has received appropriate training and competency assessment, and inform the supervisor
   3. CAsk another patient's family member to assist her
   4. DPerform the procedure and document that she was directed to do it
   Show answer and explanation

   Correct answer: B. Decline until she has received appropriate training and competency assessment, and inform the supervisor

   Practicing only within one's demonstrated competence and scope is a fundamental professional and legal obligation; the nurse should decline until trained and assessed and notify the supervisor so safe arrangements can be made. Performing an untrained skill endangers the patient and exposes the nurse to liability, and being 'directed' to act does not relieve her of personal accountability for competent, safe practice.

   Reference: International Council of Nurses (ICN), Code of Ethics for Nurses (2021); NMC/SCFHS scope of practice and competency standards

4. Question 4 · Community & Public Health Nursing

   A healthcare worker sustains a needlestick injury from a hollow-bore needle used on a patient with unknown HIV and hepatitis status. Which is the correct immediate first step in occupational post-exposure management?

   1. ASqueeze the wound hard to force out as much blood as possible
   2. BWash the wound with soap and running water without scrubbing, then report and seek risk assessment
   3. CApply undiluted bleach directly into the puncture site
   4. DIgnore it if no blood is visible
   Show answer and explanation

   Correct answer: B. Wash the wound with soap and running water without scrubbing, then report and seek risk assessment

   The correct first aid for a needlestick is to wash the wound with soap and running water (without scrubbing or squeezing) and then promptly report for risk assessment and possible post-exposure prophylaxis. Vigorous squeezing may worsen tissue trauma, caustic agents like bleach damage tissue, and ignoring the exposure forfeits timely prophylaxis.

   Reference: WHO Post-Exposure Prophylaxis guidelines (2014); CDC Occupational Exposure to Bloodborne Pathogens management

5. Question 5 · Health Assessment & Physical Examination

   A patient has a large right-sided pleural effusion. On examination of the affected area, the nurse would MOST likely find:

   1. AHyperresonance to percussion with increased tactile fremitus
   2. BTympany to percussion with bronchial breath sounds
   3. CResonance to percussion with normal breath sounds
   4. DDullness to percussion with decreased tactile fremitus and diminished breath sounds
   Show answer and explanation

   Correct answer: D. Dullness to percussion with decreased tactile fremitus and diminished breath sounds

   Fluid in the pleural space (effusion) transmits sound poorly, producing dullness to percussion, decreased tactile fremitus, and diminished or absent breath sounds over the effusion. Hyperresonance with decreased fremitus suggests air trapping or pneumothorax, whereas consolidation (pneumonia) typically increases fremitus and produces bronchial breath sounds.

   Reference: Bickley, Bates' Guide to Physical Examination and History Taking, 13th ed. (2021)

6. Question 6 · Pharmacology & Medication Administration

   After a single dose of naloxone reverses opioid overdose from a long-acting opioid, the patient becomes alert. What is the priority nursing consideration?

   1. AThe patient can be discharged immediately as the overdose is resolved
   2. BWithhold all further monitoring since respiratory drive has returned
   3. CAdminister a large dose of a benzodiazepine to keep the patient calm
   4. DContinue close monitoring because naloxone has a shorter duration than many opioids and re-sedation may occur
   Show answer and explanation

   Correct answer: D. Continue close monitoring because naloxone has a shorter duration than many opioids and re-sedation may occur

   Naloxone has a relatively short half-life compared with many opioids, so its effect can wear off before the opioid is cleared, causing recurrent respiratory depression. Continued monitoring and possible repeat dosing are essential. Immediate discharge or stopping monitoring is unsafe, and benzodiazepines would worsen sedation.

   Reference: AHA/ACLS opioid overdose guidance (2020); naloxone pharmacokinetics

7. Question 7 · Pediatric Nursing

   A child receiving a continuous IV morphine infusion becomes difficult to arouse with a respiratory rate of 8 breaths per minute and shallow breathing. What is the nurse's priority action?

   1. AContinue the infusion and reassess the child in 30 minutes
   2. BStop the morphine, support ventilation, and prepare to give naloxone
   3. CIncrease the IV fluid rate to help flush the medication
   4. DPlace the child in the Trendelenburg position
   Show answer and explanation

   Correct answer: B. Stop the morphine, support ventilation, and prepare to give naloxone

   Excessive sedation with a low respiratory rate indicates opioid-induced respiratory depression, so the priority is to stop the opioid, support oxygenation and ventilation, and prepare the antagonist naloxone. Continuing the infusion worsens the depression, increasing IV fluids does not reverse the opioid, and Trendelenburg positioning does not address the airway or breathing problem.

   Reference: American Heart Association PALS Provider Manual (2020); Hockenberry & Wilson, Wong's Nursing Care of Infants and Children (2019)

8. Question 8 · Adult Surgical & Perioperative Nursing

   During preoperative assessment, a patient reports taking several medications. Which one is most important to clarify and typically withhold on the morning of surgery to reduce intraoperative bleeding risk?

   1. AMetformin
   2. BClopidogrel
   3. CLevothyroxine
   4. DOmeprazole
   Show answer and explanation

   Correct answer: B. Clopidogrel

   Clopidogrel is an antiplatelet agent that irreversibly inhibits platelet aggregation and markedly increases surgical bleeding, so it is usually stopped several days preoperatively per surgical/cardiology guidance. Metformin is typically held for other reasons (lactic acidosis/contrast) but is not the primary bleeding concern. Levothyroxine and omeprazole do not increase bleeding and are generally continued.

   Reference: ACC/AHA Perioperative Cardiovascular Management Guideline, 2014; Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.

9. Question 9 · Fundamentals of Nursing & Basic Care

   A nurse is administering a cleansing tap-water enema to an adult. During instillation the patient reports abdominal cramping. What is the most appropriate nursing action?

   1. AImmediately remove the tubing and stop the procedure permanently
   2. BRaise the enema container higher to increase the flow rate
   3. CTemporarily stop the flow, then resume slowly after the cramping subsides
   4. DInstruct the patient to hold their breath and bear down
   Show answer and explanation

   Correct answer: C. Temporarily stop the flow, then resume slowly after the cramping subsides

   Cramping during an enema usually results from fluid instilled too quickly; temporarily clamping the tubing until the cramping subsides and then resuming at a slower rate allows the patient to tolerate the procedure. Raising the container increases flow and worsens cramping, and abandoning the procedure entirely is unnecessary if the discomfort can be managed.

   Reference: Potter & Perry, Fundamentals of Nursing, 11th ed. (2022)

10. Question 10 · Critical Care & Emergency Nursing

    A patient presents with a sudden 'worst headache of my life,' photophobia, and nuchal rigidity, and a CT scan confirms subarachnoid hemorrhage from a ruptured aneurysm. Which nursing priority helps prevent rebleeding before definitive treatment?

    1. AEncourage early ambulation and bright lighting to assess neurologic status
    2. BAdminister a stimulant laxative and enemas frequently
    3. CMaintain a quiet, dim environment, control blood pressure and pain, and minimize activities that raise intracranial pressure
    4. DKeep the patient in a high-Fowler position and restrict all analgesia
    Show answer and explanation

    Correct answer: C. Maintain a quiet, dim environment, control blood pressure and pain, and minimize activities that raise intracranial pressure

    Before the aneurysm is secured, care focuses on preventing rebleeding by maintaining a calm, quiet, dim environment, controlling blood pressure and pain, and avoiding straining or activities that spike intracranial pressure. Early ambulation, bright lights, frequent enemas, and withholding analgesia all increase blood pressure or ICP and the risk of rebleeding.

    Reference: American Heart Association / American Stroke Association Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage, 2023

11. Question 11 · Mental Health & Psychiatric Nursing

    A patient involuntarily admitted for acute psychosis refuses to take his prescribed oral antipsychotic. He is calm, not currently a danger to himself or others at this moment, and states he does not want the medication. Which statement best reflects the correct legal and ethical principle?

    1. AInvoluntary admission automatically authorizes the team to give any medication by force
    2. BThe patient may refuse the medication, as the right to refuse treatment is not automatically lost with involuntary admission
    3. CThe nurse should hide the medication in food to ensure the patient receives it
    4. DBecause he is psychotic he cannot have capacity, so his refusal is legally void
    Show answer and explanation

    Correct answer: B. The patient may refuse the medication, as the right to refuse treatment is not automatically lost with involuntary admission

    Involuntary admission (detention) and the right to refuse treatment are legally distinct; being detained does not by itself remove a patient's right to consent to or refuse specific treatments, which typically requires a separate capacity assessment or legal authorization. Covert administration in food is deceptive and generally not permitted without specific legal/ethical authorization. A diagnosis of psychosis does not equate to a blanket loss of decision-making capacity, which must be assessed for the specific decision.

    Reference: WHO Mental Health, Human Rights and Legislation Guidance (2023); Varcarolis Foundations of Psychiatric-Mental Health Nursing, 8th ed. (2017)

12. Question 12 · Pharmacology & Medication Administration

    A physician gives a verbal order during a code for '1 milligram of epinephrine IV.' Which action best fulfills the right documentation and reduces error?

    1. AAdminister immediately and document from memory after the code ends
    2. BWait for the order to be entered in the electronic record before giving it
    3. CAsk another nurse to document while you focus only on giving the drug
    4. DRepeat the order back (read-back), administer, then document the drug, dose, route, and time promptly
    Show answer and explanation

    Correct answer: D. Repeat the order back (read-back), administer, then document the drug, dose, route, and time promptly

    Verbal orders in emergencies require a closed-loop 'read-back' to confirm accuracy, followed by prompt and accurate documentation of drug, dose, route, and time once given. Delaying administration to wait for entry is unsafe in a code, and documenting purely from memory later increases the risk of omissions and inaccuracies.

    Reference: Joint Commission verbal/telephone order read-back requirement; AHA ACLS guidelines (2020)

Registered Nurse (RN) reference books and guidelines

Every question in this bank names the textbook or guideline its answer rests on. These are the sources our Registered Nurse (RN) questions cite most often - the reading list to revise from alongside the bank.

Sitting the SNLE? SCFHS publishes its own list: SCFHS's SNLE reading list. Where your regulator publishes a reading list, use the editions it names. Exam questions are not taken from any one book.