Registered Nurse (RN) Prometric exam questions with answers

1. Question 1Fundamentals of Nursing & Basic Careeasy

   A nurse is about to enter the room of a patient on contact and droplet precautions. In which order should the personal protective equipment be put on?

   1. AGloves, gown, surgical mask, eye protection
   2. BGown, surgical mask, eye protection, gloves
   3. CSurgical mask, gloves, gown, eye protection
   4. DGown, gloves, surgical mask, eye protection
   Show answer and explanation▾

   Answer: B. Gown, surgical mask, eye protection, gloves

   Standard donning sequence is gown first, then mask or respirator, then eye protection, and gloves last so that the glove cuffs can be pulled over the gown cuffs. Putting gloves on before the gown, or before the mask and goggles, means the gloves are handled and contaminated during the rest of the donning and leaves the wrist gap uncovered.

2. Question 2Pharmacology & Medication Administrationmedium

   A heparin infusion is prepared as 25,000 units in 500 mL of 0.9% sodium chloride. The prescription is 1,000 units per hour. At what rate should the nurse set the infusion pump?

   1. A25 mL/h
   2. B40 mL/h
   3. C10 mL/h
   4. D20 mL/h
   Show answer and explanation▾

   Answer: D. 20 mL/h

   The concentration is 25,000 units / 500 mL = 50 units/mL, so 1,000 units/h divided by 50 units/mL = 20 mL/h. A rate of 40 mL/h would come from mistakenly dividing 1,000 by 25 (using the thousands of units without the volume), doubling the dose of a high-alert anticoagulant.

3. Question 3Pharmacology & Medication Administrationmedium

   An adult is prescribed 1,000 mL of compound sodium lactate over 8 hours using a gravity administration set with a drop factor of 20 drops/mL. What is the correct drip rate?

   1. A42 drops/min
   2. B21 drops/min
   3. C63 drops/min
   4. D125 drops/min
   Show answer and explanation▾

   Answer: A. 42 drops/min

   Drip rate = volume x drop factor / time in minutes = 1,000 x 20 / 480 = 41.7, rounded to 42 drops/min. 125 is the hourly volume in mL/h (1,000 / 8), not the drop rate, and is a common error when the drop factor and minutes are ignored.

4. Question 4Adult Medical Nursinghard

   A patient with diabetic ketoacidosis is about to start a fixed-rate intravenous insulin infusion. Admission bloods show glucose 28 mmol/L, pH 7.10 and serum potassium 3.0 mmol/L. Which action is most appropriate?

   1. AStart the insulin infusion at once and recheck potassium in 4 hours
   2. BGive intravenous sodium bicarbonate before starting the insulin infusion
   3. CDelay the insulin infusion and give intravenous potassium replacement first
   4. DStart subcutaneous rapid-acting insulin instead of the intravenous infusion
   Show answer and explanation▾

   Answer: C. Delay the insulin infusion and give intravenous potassium replacement first

   Insulin drives potassium into cells, so starting it when potassium is below 3.3 mmol/L risks life-threatening hypokalaemia and arrhythmia; ADA guidance is to hold insulin and replace potassium first. Starting insulin immediately is the tempting choice because hyperglycaemia looks like the priority, but the hypokalaemia must be corrected first. Bicarbonate is not routinely indicated at pH 7.10 and would lower potassium further.

5. Question 5Adult Medical Nursingeasy

   A conscious, alert adult with type 1 diabetes reports shakiness and sweating. Capillary blood glucose is 3.2 mmol/L (58 mg/dL) and he can swallow safely. What is the most appropriate first action?

   1. AGive 1 mg of glucagon intramuscularly and recheck glucose in 15 minutes
   2. BGive a sandwich and a glass of milk and recheck glucose in one hour
   3. CGive 15-20 g of fast-acting carbohydrate and recheck glucose in 15 minutes
   4. DWithhold his next insulin dose and recheck glucose before the next meal
   Show answer and explanation▾

   Answer: C. Give 15-20 g of fast-acting carbohydrate and recheck glucose in 15 minutes

   A conscious patient who can swallow should receive 15-20 g of quick-acting carbohydrate such as glucose tablets or juice, with a recheck after 15 minutes and repeat if still low. Glucagon is reserved for patients who cannot take oral treatment safely. A sandwich alone is absorbed too slowly to correct hypoglycaemia, although a longer-acting snack is useful once glucose has recovered.

6. Question 6Adult Surgical & Perioperative Nursingmedium

   On the first evening after a total thyroidectomy, a patient reports tingling around the mouth and in the fingertips. Tapping in front of the ear causes twitching of the corner of the mouth. Which action should the nurse take?

   1. ACheck serum calcium urgently and prepare intravenous calcium gluconate
   2. BInspect the neck dressing for bleeding and loosen it at once
   3. CAssess the voice for hoarseness from recurrent laryngeal nerve injury
   4. DGive the prescribed oral levothyroxine dose earlier than scheduled
   Show answer and explanation▾

   Answer: A. Check serum calcium urgently and prepare intravenous calcium gluconate

   Perioral and digital paraesthesia with a positive Chvostek sign indicate hypocalcaemia from parathyroid injury or removal, which can progress to tetany and laryngospasm; urgent calcium level and IV calcium gluconate are needed. Checking for haematoma is an important post-thyroidectomy assessment, but bleeding presents with neck swelling and airway compromise, not paraesthesia and facial twitching.

7. Question 7Adult Surgical & Perioperative Nursinghard

   During general anaesthesia with a volatile agent and suxamethonium, a patient develops masseter rigidity, a rapidly rising end-tidal carbon dioxide, tachycardia and a climbing temperature. Which drug is the specific treatment?

   1. ANeostigmine
   2. BBromocriptine
   3. CSugammadex
   4. DDantrolene
   Show answer and explanation▾

   Answer: D. Dantrolene

   This is malignant hyperthermia, a hypermetabolic reaction of skeletal muscle to volatile anaesthetics and suxamethonium; the triggering agent is stopped and dantrolene, which reduces calcium release from the sarcoplasmic reticulum, is given. Bromocriptine is used in neuroleptic malignant syndrome, which can look similar but is caused by dopamine antagonists, not anaesthetic agents.

8. Question 8Critical Care & Emergency Nursingmedium

   An adult in ventricular fibrillation remains in VF after a third shock. Adrenaline 1 mg was given after the second shock and high-quality CPR continues. Which drug should be given now?

   1. AAmiodarone 150 mg IV
   2. BAmiodarone 300 mg IV
   3. CAtropine 1 mg IV
   4. DAdenosine 6 mg IV
   Show answer and explanation▾

   Answer: B. Amiodarone 300 mg IV

   In shockable cardiac arrest, AHA and ERC guidance is to give amiodarone 300 mg IV after the third shock, with a further 150 mg after the fifth shock if VF persists. The 150 mg dose is the second, later bolus, not the first. Atropine is no longer recommended in cardiac arrest, and adenosine is for stable narrow-complex tachycardia.

9. Question 9Critical Care & Emergency Nursinghard

   A 35-year-old woman develops widespread urticaria, lip swelling, wheeze and a blood pressure of 80/50 mmHg minutes after receiving an intravenous antibiotic. The infusion has been stopped. What is the most appropriate immediate drug treatment?

   1. AAdrenaline 0.5 mg (0.5 mL of 1 mg/mL) IM into the anterolateral thigh
   2. BAdrenaline 1 mg (10 mL of 0.1 mg/mL) as a rapid intravenous bolus
   3. CChlorphenamine 10 mg intravenously followed by hydrocortisone 200 mg
   4. DAdrenaline 0.5 mg (0.5 mL of 1 mg/mL) subcutaneously into the upper arm
   Show answer and explanation▾

   Answer: A. Adrenaline 0.5 mg (0.5 mL of 1 mg/mL) IM into the anterolateral thigh

   Anaphylaxis is treated first with intramuscular adrenaline 0.5 mg for an adult into the anterolateral thigh, repeated after 5 minutes if needed. The 1 mg IV bolus is the cardiac arrest dose and can cause fatal arrhythmia or hypertension in a patient with a pulse. Antihistamines and steroids are not first-line and do not reverse airway swelling or shock.

10. Question 10Mental Health & Psychiatric Nursinghard

    A patient started on haloperidol 3 days ago develops a temperature of 40 C, generalised lead-pipe rigidity, fluctuating consciousness, labile blood pressure and a markedly raised creatine kinase. Which is the most appropriate first action?

    1. AGive an additional dose of haloperidol to control the agitation
    2. BGive a cyproheptadine loading dose for suspected serotonin syndrome
    3. CWithhold the antipsychotic and escalate for urgent medical management
    4. DGive oral procyclidine and continue the antipsychotic at the same dose
    Show answer and explanation▾

    Answer: C. Withhold the antipsychotic and escalate for urgent medical management

    Fever, lead-pipe rigidity, altered consciousness, autonomic instability and raised CK after starting a dopamine antagonist indicate neuroleptic malignant syndrome, a medical emergency: the antipsychotic is stopped and the patient is cooled, hydrated and escalated. Serotonin syndrome is the tempting alternative, but it typically follows serotonergic drugs and presents with clonus and hyperreflexia rather than lead-pipe rigidity.

11. Question 11Mental Health & Psychiatric Nursingeasy

    A malnourished patient with alcohol dependence is admitted confused and is prescribed an intravenous glucose infusion. Which medication should be given before the glucose?

    1. AFolic acid
    2. BThiamine
    3. CLorazepam
    4. DNaloxone
    Show answer and explanation▾

    Answer: B. Thiamine

    Glucose loading in a thiamine-deficient patient can precipitate or worsen Wernicke encephalopathy, so parenteral thiamine is given before or with glucose. Folic acid is often also replaced in alcohol dependence, but its deficiency does not cause this acute neurological risk.

12. Question 12Community & Public Health Nursingeasy

    A nurse running a community immunisation clinic checks the vaccine refrigerator at the start of the day. Within which temperature range should most vaccines be stored?

    1. A-2 C to +2 C
    2. B+8 C to +12 C
    3. C-25 C to -15 C
    4. D+2 C to +8 C
    Show answer and explanation▾

    Answer: D. +2 C to +8 C

    Most routine vaccines are stored between +2 C and +8 C as part of the cold chain recommended by WHO. Temperatures near or below 0 C can freeze and inactivate adsorbed vaccines such as those containing aluminium adjuvants, so the -2 to +2 C range is not safe. Freezer storage is only used for specific products such as some varicella or certain mRNA vaccines.

13. Question 13Maternal, Newborn & Women's Health Nursingmedium

    Twenty minutes after a vaginal birth, a woman has heavy bright red bleeding. The uterus is soft, boggy and palpable above the umbilicus, and the placenta has been delivered complete. What is the first nursing action?

    1. AInsert a urinary catheter to empty the bladder
    2. BPlace the woman in a head-down position
    3. CInspect the perineum for an unrepaired tear
    4. DMassage the uterine fundus firmly until it contracts
    Show answer and explanation▾

    Answer: D. Massage the uterine fundus firmly until it contracts

    A soft, boggy, high uterus indicates uterine atony, the commonest cause of postpartum haemorrhage; rubbing up a contraction with fundal massage is the immediate measure while help is called and uterotonics are given. Emptying the bladder helps the uterus contract and is part of management, but it does not take priority over fundal massage. A tear is suspected when bleeding continues despite a well-contracted uterus.

14. Question 14Pediatric Nursingmedium

    A 4-year-old has a sudden high fever, is drooling, sitting forward with the neck extended and has a soft inspiratory stridor. Which action should the nurse avoid?

    1. AExamining the throat with a tongue depressor
    2. BAllowing the child to stay on the parent's lap
    3. COffering blow-by oxygen held near the face
    4. DCalling for senior airway support urgently
    Show answer and explanation▾

    Answer: A. Examining the throat with a tongue depressor

    This presentation suggests acute epiglottitis, and examining the throat or upsetting the child can provoke complete airway obstruction, so inspection is deferred until a team able to secure the airway is present. Keeping the child calm on the parent's lap and giving non-threatening oxygen are recommended, not harmful.

15. Question 15Leadership, Management, Quality, Safety & Professional Practicemedium

    A registered nurse is planning care for a medical ward. Which task is most appropriate to delegate to a trained nursing assistant?

    1. ACompleting the admission assessment for a patient arriving from the emergency department
    2. BMeasuring and recording vital signs for a stable patient admitted two days ago
    3. CTeaching a newly diagnosed patient how to self-inject insulin
    4. DAssessing a postoperative patient who reports new chest pain
    Show answer and explanation▾

    Answer: B. Measuring and recording vital signs for a stable patient admitted two days ago

    Routine, predictable tasks on stable patients, such as recording vital signs, can be delegated, while the registered nurse retains accountability for reviewing the results. Admission assessment, patient education and assessment of an unstable or deteriorating patient require nursing judgement and cannot be delegated to unlicensed staff.

Last reviewed September 2026. Questions are original and written to the published exam blueprint; they are not taken from any real paper.