Sample Nursing Acceleration Challenge Exam (NACE) I PN-RN Practice Questions

Try these questions from our free Nursing Acceleration Challenge Exam (NACE) I PN-RN practice tests. The correct answer and an explanation follow each question.

1. Which action by a nursing student demonstrates correct understanding of surgical asepsis?

   • A. Reaching over a sterile field to pass instruments
   • B. Placing sterile items at the edge of the sterile field for easy access
   • C. Keeping sterile gloved hands above the waist and in view
   • D. Considering a sterile item safe to use if it was opened 2 hours ago

   Answer: C. Keeping sterile gloved hands above the waist and in view

   Sterile gloved hands must remain above waist level and in the nurse's field of vision to maintain sterility.

2. A nurse is reviewing the lab results for a client with end-stage renal disease. The serum potassium level is 6.2 mEq/L. Which of the following is the priority nursing assessment?

   • A. Assessing for peripheral edema
   • B. Monitoring bowel sounds
   • C. Evaluating skin turgor and mucous membranes
   • D. Monitoring cardiac rate and rhythm

   Answer: D. Monitoring cardiac rate and rhythm

   Hyperkalemia (an elevated potassium level) is a life-threatening emergency primarily because of its effect on the heart's electrical conduction system. It can lead to dangerous and fatal dysrhythmias, such as ventricular fibrillation and cardiac arrest. Therefore, continuous cardiac monitoring is the highest priority assessment.

3. Which nursing intervention best reduces the risk of aspiration in a client receiving continuous enteral tube feedings?

   • A. Flush the tube with 30 mL water every 8 hours
   • B. Keep the head of bed elevated at 30–45 degrees
   • C. Check residual volumes once per shift
   • D. Administer feedings at room temperature

   Answer: B. Keep the head of bed elevated at 30–45 degrees

   Elevating the head of the bed 30–45 degrees reduces gastroesophageal reflux and the risk of aspiration pneumonia.

4. A nurse discovers a patient left the unit without notifying staff (elopement). What is the priority nursing action?

   • A. Search the facility and notify the charge nurse and security immediately
   • B. Document the absence in the chart and wait 30 minutes
   • C. Call the patient's emergency contact before notifying security
   • D. Complete an incident report before taking any other action

   Answer: A. Search the facility and notify the charge nurse and security immediately

   Patient elopement is a safety emergency; the nurse must immediately alert the charge nurse and security to initiate a search.

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