NACE Cheat Sheet 2026

The 30 highest-yield NACE facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. A postoperative client reports sudden onset of chest pain and shortness of breath on day 2 after hip replacement surgery. What is the nurse's priority action? → Notify the physician immediately
2. A nurse observes that a patient's Jackson-Pratt (JP) drain has changed from serosanguineous to bright red output. What should the nurse do? → Notify the surgeon, as this may indicate active bleeding
3. A registered nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is appropriate to delegate? → Measuring and recording vital signs on a stable patient
4. Which of the following actions by a nurse represents a violation of the Health Insurance Portability and Accountability Act (HIPAA)? → Accessing the electronic health record of a neighbor who is a patient on a different unit.
5. A PN-RN is providing anticipatory guidance to parents of a 2-year-old. Which developmental milestone should the nurse expect the child to have achieved? → Using a spoon with some spilling
6. A patient's chart shows a temperature of 38.9°C. What is the equivalent Fahrenheit temperature? → 102.0°F
7. Which immunization is recommended for all adults aged 65 and older to prevent pneumococcal disease? → PPSV23 (Pneumovax)
8. A nurse is administering potassium chloride 40 mEq IV. Which practice is safest? → Dilute in at least 100 mL and infuse no faster than 10 mEq/hour
9. A nurse is teaching a client about incentive spirometry after abdominal surgery. Which instruction is CORRECT? → Inhale slowly and deeply to raise the piston, then hold for 3–5 seconds
10. A nurse working the night shift notices a pattern of medication errors occurring on the unit over the past month. What is the most appropriate action? → Bring the concern to the nurse manager and submit a formal quality improvement report
11. A nurse is caring for a patient with a nasogastric tube before administering a tube feeding. Which assessment confirms correct tube placement? → Aspirating gastric contents and checking pH (pH ≤5.5 confirms gastric placement)
12. Which vital sign change should the nurse report immediately to the healthcare provider? → Blood pressure of 88/52 mmHg
13. A client with chronic kidney disease has a serum phosphate of 6.5 mg/dL. The nurse anticipates which secondary electrolyte imbalance? → Hypocalcemia
14. A nurse is preparing to administer an intramuscular injection to an adult. Which site accommodates the largest volume of medication? → Ventrogluteal site
15. When triaging four patients in the emergency department, which patient requires the highest priority of care? → A 60-year-old with chest pain radiating to the left arm and diaphoresis
16. A nurse suspects that an elderly patient is being financially exploited by a family member. What is the nurse's legal obligation? → Report the suspected abuse to Adult Protective Services
17. Which IV solution is considered isotonic and is commonly used for fluid replacement? → 0.9% Normal Saline (NS)
18. A post-operative patient develops a fever of 38.9°C on day 3 after abdominal surgery. Which is the most likely physiological cause? → Wound infection establishing at the surgical site
19. A competent adult patient refuses a recommended surgical procedure after being fully informed of the risks and benefits. What should the nurse document? → That the patient was informed and voluntarily refused, including the information provided
20. A nurse is preparing to administer a tube feeding via nasogastric (NG) tube. Which action should be performed FIRST? → Verify tube placement by checking gastric pH and auscultating the abdomen
21. A nurse is caring for a client on bed rest after surgery. Which action BEST prevents venous thromboembolism (VTE)? → Apply sequential compression devices (SCDs) as ordered
22. Which electrolyte is primarily responsible for maintaining cardiac rhythm and muscle function? → Potassium
23. A nurse is teaching a newly licensed nurse about the chain of infection. Which element, if eliminated, would most effectively prevent the spread of infection? → Mode of transmission
24. The is measured using peak flow meters. → highest airflow during forced exhalation.
25. A patient is prescribed a clear liquid diet. Which item is appropriate for this diet? → Apple juice
26. A nurse is caring for a patient in septic shock. Which set of vital signs is most consistent with early (warm) septic shock? → BP 80/40, HR 120, Temp 103 degrees F, warm flushed skin
27. A patient who speaks limited English is scheduled for surgery. The nurse needs to obtain informed consent. What is the most appropriate action? → Use a hospital-approved professional medical interpreter
28. Which principle requires nurses to treat all patients equally regardless of socioeconomic status, race, or personal beliefs? → Justice
29. Which laboratory value requires the nurse to hold the next dose of warfarin and notify the provider? → INR of 5.8
30. Which nursing action BEST reduces the risk of a catheter-associated urinary tract infection (CAUTI)? → Securing the catheter to the thigh and keeping the drainage bag below bladder level