100+ Free ENADE Enfermagem Practice Questions

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Sample ENADE Enfermagem Practice Questions

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1A municipal health department is planning resource allocation for basic health units. An isolated riverside community in the Amazon region with severe socio-environmental vulnerabilities requires mobile river clinics (Unidades Básicas de Saúde Fluviais) and expanded nursing staffing, which involves higher per-capita expenditures than urban clinics. Which fundamental principle of the Brazilian Unified Health System (Sistema Único de Saúde - SUS) justifies allocating greater financial and logistical resources to unequal populations to reduce structural health disparities?

A.Equity (Equidade), which dictates treating unequal individuals unequally according to their specific needs to achieve social justice and mitigate health disparities.

B.Universality (Universalidade), which mandates that identical healthcare packages and fixed budgets must be distributed identically across all geographic jurisdictions.

C.Decentralization (Descentralização), which transfers complete financial responsibility for healthcare delivery exclusively to municipal governments without federal co-financing.

D.Integrality (Integralidade), which requires that curative specialized hospital services always take financial precedence over preventive primary healthcare actions.

Explanation: Equity (Equidade) is the ethical and operational principle of SUS that recognizes differences in living conditions and health needs, directing more resources to vulnerable and underserved populations to achieve real equality in outcomes. While Universality guarantees healthcare as a right for all citizens and Integrality guarantees comprehensive care, Equity ensures justice in resource distribution under Law No. 8.080/1990.

2Under Federal Law No. 8.142/1990, social participation (controle social) in the Brazilian Unified Health System (SUS) is institutionalized through collegiate bodies. Regarding the composition and functioning of Health Councils (Conselhos de Saúde) and Health Conferences (Conferências de Saúde), which rule defines their parity structure?

A.Healthcare professionals and government managers combined must hold 75% of the voting seats to ensure technical predominance in deliberation.

B.Civil society users (usuários do SUS) must represent 50% of the total seats (parity), while healthcare workers represent 25%, and government managers and service providers represent the remaining 25%.

C.Elected legislative representatives from municipal and state chambers occupy 50% of all council seats as ex-officio voting members.

D.Private healthcare service providers under contract with SUS must hold a permanent majority on the executive board of municipal health councils.

Explanation: Pursuant to Federal Law No. 8.142/1990 and National Health Council Resolution (Resolução CNS nº 453/2012), Health Councils and Conferences are composed on a parity basis: 50% user representatives (usuários), 25% healthcare workers (trabalhadores de saúde), and 25% government managers and contracted private healthcare providers (gestores e prestadores de serviços). This guarantees that community users have equal representation against all institutional stakeholders combined.

3An alert, fully oriented 42-year-old adult patient diagnosed with severe anemia secondary to gastrointestinal bleeding explicitly refuses homologous blood transfusion based on deeply held religious beliefs as a Jehovah's Witness, while consenting to non-blood alternative volume expanders and medical therapies. In clinical bioethics and Brazilian medical-legal jurisprudence, which bioethical principle protects this patient's right to self-determination when fully informed of risks?

A.Beneficence (Beneficência), which empowers the healthcare team to override the patient's refusal whenever medical judgment deems a procedure life-saving.

B.Paternalism (Paternalismo Médico), which legally obligates the registered nurse to administer blood components against patient refusal in hospital settings.

C.Autonomy (Autonomia), which guarantees a competent person's moral and legal right to make informed decisions about their own body and medical treatments.

D.Non-maleficence (Não Maleficência), which defines blood component refusal as an act of self-harm that invalidates the patient's legal competence.

Explanation: Autonomy (Autonomia) establishes that a competent adult has the fundamental right to accept or refuse medical treatments according to their personal values, beliefs, and informed consent. In Brazilian bioethics and recent Federal Supreme Court (STF) jurisprudence (ADPF 618 / RE 1.212.272), the autonomous decision of a capable adult patient refusing blood transfusion for religious reasons must be respected when alternative therapeutic options are pursued, upholding human dignity and freedom of conscience.

4The Dahlgren and Whitehead model adopted by the Brazilian National Commission on Social Determinants of Health (CNDSS) stratifies determinants into concentric layers from individual to macro-structural levels. According to this framework, which factors are classified as distal (macro-determinants / determinantes estruturais)?

A.Individual age, biological sex, and non-modifiable genetic hereditary factors.

B.Individual lifestyle choices, such as cigarette smoking, alcohol consumption, and personal physical activity levels.

C.Interpersonal social and community networks, including family solidarity and peer support in neighborhoods.

D.Socioeconomic, cultural, and environmental conditions, such as national labor market policies, housing sanitation, education, and social protection systems.

Explanation: In the Dahlgren and Whitehead social determinants of health model, the outermost layer represents distal structural macro-determinants, which encompass general socioeconomic, cultural, and environmental conditions (e.g., educational systems, housing, basic sanitation, macroeconomic policies, and labor conditions). These macro-factors shape intermediary living conditions and individual behaviors.

5The National Humanization Policy (Política Nacional de Humanização - HumanizaSUS), instituted by the Brazilian Ministry of Health, proposes cross-cutting changes in healthcare management and clinical practices. Which operational guideline of HumanizaSUS directly addresses the reorganization of user reception in health facilities by replacing first-come-first-served bureaucratic queues with ethical-clinical vulnerability assessment?

A.Acolhimento com Classificação de Risco (User Reception with Risk Classification), which organizes patient flow based on clinical urgency and social vulnerability rather than order of arrival.

B.Ambiência, which focuses exclusively on purchasing high-cost decorative furniture for hospital administrative suites.

C.Clínica Ampliada, which prohibits multi-professional teamwork in favor of exclusive individual physician autonomy.

D.Colegiado Gestor, which eliminates patient participation in institutional governance and clinical discussions.

Explanation: Acolhimento com Classificação de Risco (Reception with Risk Classification) is a core operational tool of HumanizaSUS. It transforms the reception process into an active listening and clinical triage intervention, ensuring that patients with higher clinical risk and vulnerability receive immediate, prioritized care rather than waiting in arbitrary chronological lines.

6Under Article 200, VIII, of the Brazilian Federal Constitution of 1988 and Law No. 8.080/1990, the Unified Health System (SUS) is constitutionally mandated to participate in the control and protection of the environment, including the work environment. In this context, what is the primary objective of Environmental Health Surveillance (Vigilância em Saúde Ambiental - VIGISAM)?

A.To inspect and license heavy industrial machinery without coordinating with epidemiological surveillance data.

B.To continuously monitor, assess, and recommend interventions on environmental risk factors—such as drinking water quality (VIGIAGUA), air pollution (VIGIAR), soil contaminants (VIGISOLO), and natural disasters (VIGIDESASTRES)—that directly impact human health.

C.To enforce commercial deforestation permits for agricultural corporations operating in protected biomes.

D.To transfer public health water safety inspections entirely to private international audit conglomerates.

Explanation: Environmental Health Surveillance (Vigilância em Saúde Ambiental) within SUS monitors non-biological environmental risks that threaten human health. It operates specialized subsystems including VIGIAGUA (water for human consumption), VIGIAR (air quality), VIGISOLO (chemical contaminants in soil), and VIGIDESASTRES (natural and technological disasters), providing evidence-based data for preventive health policies.

7The National Policy for Comprehensive Health of the Black Population (Política Nacional de Saúde Integral da População Negra - PNSIPN) and the National Policy for Comprehensive Health of LGBT+ Persons are equity policies within SUS. What is the fundamental rationale behind the PNSIPN in clinical nursing practice?

A.To segregate clinical appointments by creating separate healthcare facilities for distinct racial groups.

B.To establish genetic screening tests while ignoring institutional racism and socioeconomic vulnerabilities in health outcomes.

C.To recognize racism and ethnic-racial inequalities as structural social determinants of health, promoting actions to reduce inequities in diseases with high racial prevalence (such as Sickle Cell Disease and severe arterial hypertension) and eliminating institutional discrimination.

D.To replace standard clinical guidelines with non-scientific folkloric practices across all public healthcare facilities.

Explanation: The PNSIPN recognizes institutional and structural racism as a major social determinant of health that generates disparities in morbimortality. It directs clinical and educational actions toward health conditions with higher prevalence or vulnerability among Afro-Brazilians (e.g., Sickle Cell Anemia, severe hypertension, maternal mortality) and mandates the recording of the 'raça/cor' (race/color) field in SUS health information systems to guide equity policies.

8Complementary Law No. 141/2012 regulates the constitutional minimum percentages of tax revenues that Brazilian federative entities must invest annually in Public Health Actions and Services (Ações e Serviços Públicos de Saúde - ASPS). Which statement accurately states the statutory minimum investment requirements for Municipalities and States?

A.Municipalities must invest at least 5% and States must invest at least 8% of their respective tax revenues.

B.Municipalities must invest at least 25% and States must invest at least 25%, mirroring the constitutional educational spending thresholds.

C.Municipalities must invest at least 10% and States must invest at least 15% of their total gross domestic product.

D.Municipalities must invest at least 15% and States must invest at least 12% of their respective eligible tax revenues and constitutional transfers.

Explanation: Under Complementary Law No. 141/2012 (which regulated Constitutional Amendment No. 29/2000), Municipalities are legally bound to apply at least 15% of their tax revenues (and constitutional transfers) in ASPS, while States and the Federal District must apply at least 12%. The Union's contribution is calculated according to net current revenue formulas.

9A nursing researcher is conducting a clinical study involving hospitalized adolescents aged 12 to 17 to evaluate the efficacy of a digital educational application for diabetes self-management. In accordance with National Health Council Resolution No. 466/2012 (Resolução CNS nº 466/2012) governing research with human subjects, what ethical consent documents are legally required?

A.The Free and Informed Consent Form (Termo de Consentimento Livre e Esclarecido - TCLE) signed by the legal guardians AND the Assent Form (Termo de Assentimento Livre e Esclarecido - TALE) signed by the adolescent, provided in age-appropriate language.

B.Only the adolescent's verbal agreement, as parental consent is strictly waived for participants older than 10 years in clinical nursing research.

C.Only the hospital clinical director's institutional authorization, replacing the need for individual patient and guardian consent.

D.An irrevocable waiver of liability signed by the adolescent exempting researchers from all research-related adverse events.

Explanation: Under CNS Resolution No. 466/2012 (item IV), research involving children or adolescents (minors/vulnerable populations) requires obtaining the Free and Informed Consent Form (TCLE) signed by their legal representatives, alongside the Assent Form (Termo de Assentimento) obtained directly from the minor in accessible language appropriate to their cognitive maturity, respecting their developing autonomy.

10Presidential Decree No. 7.508/2011 regulates Organic Health Law No. 8.080/1990, establishing clear rules for the organization of SUS, Health Regions (Regiões de Saúde), and Health Care Networks (Redes de Atenção à Saúde - RAS). To be officially established, what minimum structural actions and services must a Health Region contain?

A.Only a tertiary quaternary university hospital and a central specialized blood bank (Hemocentro).

B.Primary health care; urgency and emergency care; psychosocial care; specialized ambulatory and hospital care; and health surveillance.

C.An international airport epidemiological border post and a private pharmaceutical research laboratory.

D.A municipal health council, a private health insurance bureau, and a specialized organ transplant unit.

Explanation: Under Article 5 of Decree No. 7.508/2011, to be instituted, a Health Region (Região de Saúde) must contain at least five essential actions and services: I - Primary Health Care (Atenção Primária); II - Urgency and Emergency (Urgência e Emergência); III - Psychosocial Care (Atenção Psicossocial); IV - Specialized Ambulatory and Hospital Care (Atenção Ambulatorial Especializada e Hospitalar); and V - Health Surveillance (Vigilância em Saúde).

About the ENADE Enfermagem Exam

The Exame Nacional de Desempenho dos Estudantes (ENADE) for Enfermagem evaluates graduating nursing bachelor students across Brazil on clinical decision-making, Nursing Care Systematization (Sistematização da Assistência de Enfermagem - SAE / Processo de Enfermagem), public health principles of the Sistema Único de Saúde (SUS), primary care and epidemiological surveillance, medical-surgical and critical care nursing, maternal-child health, psychiatric nursing, and ethical-legal frameworks under COFEN/COREN regulations and Lei nº 7.498/1986. While the official examination is administered in Portuguese by INEP, this English-language study bank provides 100 rigorous multiple-choice questions modeled on the official ENADE matrix to prepare nursing students for academic assessments and professional practice.

Assessment

4-hour written examination made up of 10 Formação Geral items, common to every area and weighted at 25% of the mark, and 30 Componente Específico items weighted at 75%. Both components combine multiple-choice and discursive items built on situações-problema and case studies; the precise objective/discursive split is set by the Inep edital for each edition, and the Formação Geral component follows the diretrizes in Portaria MEC nº 154/2026 from the 2026 edition onwards. Our practice bank is MCQ-only study support and does not reproduce the discursive items.

Time Limit

4 hours

Passing Score

No individual passing grade; generates Conceito Enade (1-5) for undergraduate program quality evaluation. Mandatory for graduation.

Exam Fee

Free (mandatory national assessment) (INEP — Ministério da Educação)

ENADE Enfermagem Exam Content Outline

15%

Formação Geral, Bioética e Políticas Públicas de Saúde (SUS)

General education principles, bioethics (autonomy, beneficence, non-maleficence, justice), constitutional health principles under CF/88 and Organic Health Laws (Lei nº 8.080/1990 and Lei nº 8.142/1990), social determinants of health, human rights, and healthcare equity.

15%

Fundamentos de Enfermagem, Semiologia e Sistematização da Assistência (SAE)

Nursing Care Systematization (SAE) and Nursing Process (Resolução COFEN nº 736/2024), standard taxonomies (NANDA-I, NIC, NOC), physical assessment and semiotics, patient safety international goals, wound care staging, and pharmacotherapy safety.

15%

Atenção Primária, Saúde Coletiva e Imunizações (PNAB / PNI)

Primary Healthcare Policy (PNAB), Family Health Strategy (ESF), National Immunization Program (PNI) vaccine schedule and cold chain management, epidemiological surveillance, compulsory notification diseases, and management of endemic and communicable conditions (tuberculosis, leprosy, arboviruses, STIs/HIV).

15%

Enfermagem Médico-Cirúrgica, Doenças Crônicas e Gerontologia

Perioperative nursing care (WHO safe surgery checklist, PACU Aldrete-Kroulik score), clinical management of chronic cardiovascular, respiratory, renal, and metabolic disorders, oncology nursing, palliative care (WHO analgesic ladder, SPIKES protocol), and comprehensive geriatric assessment.

15%

Saúde da Mulher, Enfermagem Obstétrica e Ginecológica

Reproductive planning and contraception, cervical and breast cancer screening (INCA guidelines), low- and high-risk prenatal care, labor and humanized delivery assistance, obstetric emergencies (preeclampsia, eclampsia, HELLP, postpartum hemorrhage), and puerperal care with breastfeeding support.

10%

Saúde da Criança, do Adolescente e Neonatologia

Immediate neonatal resuscitation (SBP guidelines), Apgar and Capurro assessments, neonatal screening (teste do pezinho, reflexo vermelho, orelhinha, coraçãozinho), growth and neurodevelopment monitoring (Caderneta da Criança), and management of acute childhood illnesses (IMCI/AIDPI: ARI, acute diarrhea, dehydration).

10%

Urgência, Emergência e Cuidados Críticos (UTI)

Emergency risk classification (Manchester Triage System), Basic and Advanced Cardiac Life Support (AHA/SBC guidelines), poly-trauma care (PHTLS/ATLS XABCDE), shock and sepsis protocols (ILAS 1-hour bundle), invasive hemodynamic monitoring, and mechanical ventilation nursing care.

Saúde Mental, Gestão em Enfermagem e Legislação Profissional (COFEN)

Psychiatric reform (Lei nº 10.216/2001) and Psychosocial Care Network (RAPS/CAPS), crisis de-escalation, nursing management and team sizing (Resolução COFEN nº 543/2017), professional practice law (Lei nº 7.498/1986, Decreto nº 94.406/1987), and nursing code of ethics (Resolução COFEN nº 564/2017).

How to Pass the ENADE Enfermagem Exam

What You Need to Know

Passing score: No individual passing grade; generates Conceito Enade (1-5) for undergraduate program quality evaluation. Mandatory for graduation.
Assessment: 4-hour written examination made up of 10 Formação Geral items, common to every area and weighted at 25% of the mark, and 30 Componente Específico items weighted at 75%. Both components combine multiple-choice and discursive items built on situações-problema and case studies; the precise objective/discursive split is set by the Inep edital for each edition, and the Formação Geral component follows the diretrizes in Portaria MEC nº 154/2026 from the 2026 edition onwards. Our practice bank is MCQ-only study support and does not reproduce the discursive items.
Time limit: 4 hours
Exam fee: Free (mandatory national assessment)

Keys to Passing

Work through all 100 available questions
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ENADE Enfermagem Study Tips from Top Performers

1Master the 5 steps of the Nursing Process (Processo de Enfermagem) according to the updated Resolução COFEN nº 736/2024 and standard NANDA-I/NIC/NOC diagnostic linkages.

2Thoroughly review SUS constitutional principles, the National Primary Care Policy (PNAB), and the National Immunization Program (PNI) vaccination schedule.

3Memorize critical emergency protocols including the 2020-2025 AHA/SBC CPR guidelines, Manchester Triage color codes, and the SBP Neonatal Resuscitation algorithm.

4Review the Professional Practice Law (Lei nº 7.498/1986) to clearly distinguish private nursing activities (atividades privativas do enfermeiro) from team-delegated procedures.

Frequently Asked Questions

What is the format and duration of the ENADE Enfermagem exam?

Standard 4-hour written examination comprising 10 Formação Geral items (25% of the mark) and 30 Componente Específico items (75%), each component mixing objective and discursive questions as set by the Inep edital for that edition

Is ENADE mandatory for concluding nursing undergraduates in Brazil?

Yes. ENADE is a mandatory curricular component defined by Federal Law nº 10.861/2004 (SINAES). Concluding students enrolled by their higher education institutions must sit the exam to regularize their academic status and receive their nursing diploma.

Is this practice question bank an official INEP product?

No. This question bank is an English-language study adaptation designed to help nursing students master Brazilian healthcare protocols, SUS directives, SAE/NANDA-I taxonomies, and COFEN ethical-legal regulations evaluated on the official Portuguese ENADE examination.

100+ Free ENADE Enfermagem Practice Questions

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