NACE General Practice 2 — Questions and Answers
Question 1: The NACE I PN-RN exam is designed for which population of nursing students?
- New nursing students entering an LPN program
- Licensed practical nurses seeking registered nurse licensure through an accelerated program (Correct answer)
- Registered nurses pursuing a master's degree
- Nursing students entering a doctoral program
Correct answer: Licensed practical nurses seeking registered nurse licensure through an accelerated program
The NACE I (Nursing Acceleration Challenge Exam) is designed for LPNs/LVNs who wish to transition to RN status by demonstrating competency in nursing knowledge.
The NACE I PN-RN exam, published by the National League for Nursing (NLN), allows licensed practical nurses or licensed vocational nurses to receive credit for prior nursing knowledge and experience when entering an RN program. It tests knowledge across multiple nursing content areas including foundations, pharmacology, and clinical nursing. Passing scores vary by institution but typically range from 85-120 on the scaled score.
Question 2: A nurse is caring for a patient who reports chest pain radiating to the left arm. Which action should the nurse take first?
- Administer aspirin as ordered
- Apply oxygen via nasal cannula
- Obtain a 12-lead ECG
- Assess the patient's pain characteristics and vital signs (Correct answer)
Correct answer: Assess the patient's pain characteristics and vital signs
Assessment is always the first step in the nursing process. The nurse must gather data about the pain and current vital signs before initiating interventions.
While chest pain radiating to the left arm is concerning for acute coronary syndrome, the nurse must first assess before intervening. Assessment includes: pain characteristics (PQRST: Provocation, Quality, Region/Radiation, Severity, Timing), vital signs, oxygen saturation, skin color, and history. This information guides subsequent interventions and is essential for accurate reporting to the provider. After assessment, typical interventions follow the MONA protocol: Morphine, Oxygen, Nitroglycerin, Aspirin.
Question 3: Which electrolyte is primarily responsible for maintaining cardiac rhythm and muscle function?
- Sodium
- Potassium (Correct answer)
- Calcium
- Chloride
Correct answer: Potassium
Potassium is the primary intracellular electrolyte responsible for maintaining cardiac rhythm, nerve impulse conduction, and muscle contraction.
Potassium (K+) is the major intracellular cation with a normal serum range of 3.5-5.0 mEq/L. Even small deviations can cause life-threatening cardiac dysrhythmias. Hypokalemia causes flattened T waves, U waves, and increased digoxin sensitivity. Hyperkalemia causes peaked T waves, widened QRS, and can lead to cardiac arrest. Potassium is regulated primarily by the kidneys. Sources include bananas, oranges, potatoes, spinach, and tomatoes. Patients on diuretics, those with renal disease, and those receiving IV fluids require close monitoring.
Question 4: A nurse is providing discharge teaching to a patient with newly diagnosed hypertension. Which lifestyle modification should be emphasized first?
- Begin a high-intensity exercise program immediately
- Reduce sodium intake to less than 2,300 mg per day (Correct answer)
- Take herbal supplements for blood pressure control
- Increase caffeine intake to boost metabolism
Correct answer: Reduce sodium intake to less than 2,300 mg per day
Sodium restriction is a primary lifestyle modification for hypertension management, as excess sodium promotes fluid retention and increases blood pressure.
The DASH (Dietary Approaches to Stop Hypertension) diet recommends limiting sodium to less than 2,300 mg/day, with an ideal target of 1,500 mg/day for most adults with hypertension. Additional lifestyle modifications include: regular aerobic exercise (150 minutes/week of moderate intensity), maintaining a healthy weight (BMI 18.5-24.9), limiting alcohol consumption, smoking cessation, and managing stress. These modifications can reduce systolic BP by 5-20 mmHg. Patients should read food labels, avoid processed foods, and cook with herbs and spices instead of salt.
Question 5: A patient is prescribed a clear liquid diet. Which item is appropriate for this diet?
- Tomato soup
- Vanilla pudding
- Apple juice (Correct answer)
- Yogurt
Correct answer: Apple juice
Apple juice is a clear liquid that can be seen through when held up to light. Clear liquids include broth, gelatin, clear juices without pulp, popsicles, tea, and coffee.
A clear liquid diet includes items that are liquid at room temperature and transparent. Permitted items: water, clear broth, gelatin (not red before colonoscopy), clear juices (apple, grape, cranberry without pulp), tea and coffee without cream, popsicles, and clear carbonated beverages. Not permitted: milk, cream soups, juices with pulp (orange juice), pudding, and yogurt. This diet provides hydration and some electrolytes but is nutritionally inadequate for extended use. It is typically prescribed before procedures, after surgery before advancing diet, or during acute GI disturbances.
Question 6: Which nursing intervention is most appropriate for preventing hospital-acquired pressure injuries?
- Massaging reddened bony prominences vigorously
- Performing regular skin assessments using the Braden Scale (Correct answer)
- Keeping the skin moist at all times to prevent dryness
- Using donut-shaped cushions for all bed-bound patients
Correct answer: Performing regular skin assessments using the Braden Scale
Regular skin assessment using a validated tool like the Braden Scale identifies at-risk patients early and guides preventive interventions.
The Braden Scale is the most widely used pressure injury risk assessment tool, scoring six subscales: sensory perception, moisture, activity, mobility, nutrition, and friction/shear. Scores range from 6-23; lower scores indicate higher risk (15-18 mild risk, 13-14 moderate, 10-12 high, 9 or below very high). NEVER massage reddened areas as this can cause additional tissue damage. Donut-shaped cushions are contraindicated as they concentrate pressure on surrounding tissue. Keep skin clean and dry (not moist). Prevention includes regular repositioning, pressure-redistribution surfaces, adequate nutrition, and moisture management.
NACE General Practice 2
The NACE I PN-RN exam is designed for which population of nursing students?