Free Practice Questions for Iran Nursing Competency Exam

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Exam pass rate: Typically 65% to 75% for graduates of accredited Iranian university nursing programs sitting on their first attempt.

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Key Facts: Iran Nursing Competency Exam Exam

100

Total Multiple-Choice Questions

Sanjesh Pezeshki National Blueprint

100 min

Total Examination Duration

Sanjesh Pezeshki Candidate Bulletin

Per sitting

Scaled (taraz) qualifying threshold announced with each sitting's results; scores reported out of 100

Sanjesh Pezeshki candidate guide

Negative Marking Penalty (No deduction for wrong answers)

Sanjesh Pezeshki Examination Rules

5 Years

Validity Period of Professional Competency Certificate

Iran Nursing Organization Credentialing Guidelines

The Iran Nursing Professional Competency Exam consists of 100 multiple-choice questions administered over 100 minutes, with a per-sitting scaled qualifying threshold and no negative marking. This preparation resource is an independent English-language study adaptation developed by OpenExamPrep based on the official Sanjesh Pezeshki blueprint.

Sample Iran Nursing Competency Exam Practice Questions

Try these sample questions to review concepts for the Iran Nursing Competency Exam exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 58-year-old male arrives at the emergency department with severe crushing substernal chest pain radiating to his left jaw and diaphoresis. The 12-lead electrocardiogram demonstrates ST-segment elevation in leads II, III, and aVF. Which immediate nursing intervention takes the highest priority?

A.Initiate continuous cardiac monitoring, assess vital signs, and prepare for emergency reperfusion therapy

B.Administer oral enteric-coated aspirin with a full glass of water and wait for cardiac enzyme confirmation

C.Place the patient flat in a supine position and obtain an urgent portable chest radiograph before vascular access

D.Instruct the patient to perform deep breathing exercises and administer oral acetaminophen for muscular chest wall pain

Explanation: In acute inferior ST-elevation myocardial infarction, establishing continuous cardiac monitoring, assessing hemodynamic stability, and preparing for emergent reperfusion therapy are the highest nursing priorities. Inferior wall infarctions carry a significant risk of acute bradyarrhythmias, atrioventricular blocks, and cardiogenic shock. Immediate continuous monitoring allows the clinical team to detect and manage lethal dysrhythmias without delay.

2A 66-year-old female admitted with acute decompensated heart failure exhibits marked dyspnea, orthopnea, bilateral bibasilar crackles, and an audible S3 heart sound. Which clinical manifestation is the most sensitive indicator of worsening left-sided ventricular failure?

A.Bilateral pitting peripheral edema in the lower extremities

B.Progressive pulmonary crackles and dyspnea on exertion

C.Right upper quadrant abdominal tenderness from hepatomegaly

D.Jugular venous distention measuring greater than four centimeters

Explanation: Left-sided heart failure causes backward pressure into the pulmonary circulation, leading to pulmonary venous congestion, fluid transudation into alveoli, and impaired gas exchange. Progressive dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and pulmonary crackles directly reflect elevated left ventricular end-diastolic pressures. Bilateral lung crackles and exertional shortness of breath are primary hallmarks of left ventricular decompensation.

3A 62-year-old male with severe chronic obstructive pulmonary disease (COPD) and chronic carbon dioxide retention is admitted with an acute respiratory infection. His room air oxygen saturation is 84%. Which oxygen delivery prescription should the nurse implement first?

A.Non-rebreather mask delivering 15 liters per minute of 100% oxygen

B.Simple face mask delivering 8 liters per minute of oxygen

C.Venturi mask delivering 28% oxygen titrated to maintain an oxygen saturation of 88% to 92%

D.Continuous positive airway pressure at maximum positive end-expiratory pressure without supplemental oxygen

Explanation: Patients with chronic severe hypercapnic COPD depend partly on hypoxic drive for respiratory stimulation and are susceptible to oxygen-induced hypercapnia through ventilation-perfusion mismatch and the Haldane effect. A Venturi mask delivers a precise, controlled low concentration of oxygen, safely targeting an oxygen saturation of 88% to 92%. Controlled titration alleviates tissue hypoxia while minimizing the risk of worsening acute respiratory acidosis.

4A trauma patient involved in a motor vehicle accident develops sudden acute dyspnea, cyanosis, unilateral absence of breath sounds on the right, tracheal deviation to the left, and severe hypotension (74/40 mmHg). Which emergent intervention should the nurse anticipate immediately?

A.Endotracheal intubation followed by mechanical ventilation at high positive end-expiratory pressure

B.Stat portable upright chest radiograph to confirm the thoracic diagnosis

C.Administration of a 1,000 mL intravenous bolus of 0.9% normal saline over fifteen minutes

D.Immediate needle thoracostomy decompression in the second intercostal space at the midclavicular line

Explanation: The clinical findings of severe respiratory distress, absent breath sounds on the affected side, contralateral tracheal shift, and hemodynamic collapse indicate a tension pneumothorax. Intrapleural air accumulation creates positive pressure, compressing the vena cava and collapsing cardiopulmonary structures. Immediate needle decompression relieves intrathoracic pressure and restores venous return and cardiac output prior to definitive chest tube placement.

5A 24-year-old female with type 1 diabetes mellitus presents to the intensive care unit with diabetic ketoacidosis. Her blood glucose is 540 mg/dL, arterial pH is 7.18, serum bicarbonate is 10 mEq/L, and serum potassium is 4.8 mEq/L. Which intravenous therapy should the nurse administer first?

A.Intravenous regular insulin bolus followed by immediate subcutaneous glargine

B.Isotonic 0.9% sodium chloride infusion to restore intravascular volume

C.Intravenous sodium bicarbonate push to rapidly correct metabolic acidosis

D.Intravenous potassium chloride infusion to prevent anticipated hypokalemia

Explanation: The initial priority in diabetic ketoacidosis management is rapid restoration of intravascular fluid volume using isotonic crystalloids (0.9% sodium chloride). Patients in DKA experience profound osmotic diuresis leading to an average fluid deficit of 5 to 8 liters. Restoring circulating volume improves tissue perfusion, reduces counter-regulatory stress hormones, and prevents circulatory collapse before initiating continuous regular insulin infusions.

6A patient with acute kidney injury exhibits a serum potassium level of 7.2 mEq/L. The continuous cardiac monitor reveals tall peaked T waves, prolonged PR intervals, and widening of the QRS complexes. Which medication should the nurse prepare to administer first?

A.Sodium polystyrene sulfonate orally with sorbitol

B.Intravenous regular insulin mixed with 50% dextrose solution

C.Intravenous calcium gluconate administered over two to five minutes

D.Inhaled nebulized albuterol administered continuously for twenty minutes

Explanation: Intravenous calcium gluconate is the first-line emergency intervention for severe hyperkalemia with electrocardiographic changes because it antagonizes the cardiotoxic effects of elevated potassium on the cardiac membrane. Calcium raises the action potential threshold, stabilizing myocardial cell membranes and preventing fatal ventricular arrhythmias within one to three minutes, although it does not lower the serum potassium concentration.

7A patient with stage 5 chronic kidney disease on maintenance hemodialysis is being discharged. When reviewing outpatient dietary guidelines, which dietary recommendation should the nurse emphasize to prevent uremic and electrolyte complications?

A.Encourage high dietary intake of potassium-rich citrus fruits, bananas, and dark leafy greens

B.Promote unrestricted dietary sodium and free water intake to support kidney filtration

C.Advise the patient to increase whole grains, nuts, and dairy products to ensure adequate calcium absorption

D.Restrict dietary phosphorus, potassium, sodium, and adhere strictly to calculated daily fluid allowances

Explanation: In end-stage chronic kidney disease, the failing kidneys cannot clear excess phosphorus, potassium, sodium, or metabolic wastes, leading to hyperphosphatemia, hyperkalemia, secondary hyperparathyroidism, and fluid volume overload. Restricting high-phosphorus foods (dairy, nuts, colas), high-potassium foods, and limiting dietary sodium and fluids to urine output plus 500 to 700 mL/day is vital to prevent interdialytic weight gain and hypertensive pulmonary edema.

8A 42-year-old male is admitted following severe gastrointestinal bleeding. His heart rate is 126 beats/min, blood pressure is 88/54 mmHg, respiratory rate is 24 breaths/min, and peripheral pulses are weak and thready. What physiological mechanism explains his persistent tachycardia?

A.Sympathetic nervous system baroreceptor activation releasing catecholamines to maintain cardiac output

B.Parasympathetic stimulation via the vagus nerve to decrease myocardial metabolic oxygen demand

C.Direct suppression of the renin-angiotensin-aldosterone cascade leading to systemic vasodilation

D.Inhibition of central chemoreceptors in response to acute metabolic acidosis and hypoxemia

Explanation: In hypovolemic hemorrhagic shock, acute blood loss reduces circulating volume, venous return, and stroke volume. Arterial baroreceptors in the carotid sinus and aortic arch detect decreased stretch, triggering rapid sympathetic stimulation and release of epinephrine and norepinephrine. This compensatory mechanism increases heart rate and systemic vascular resistance to sustain mean arterial pressure and cardiac output.

9Twelve hours after undergoing a total thyroidectomy for multinodular goiter, a patient reports circumoral numbness, tingling in the fingertips, and painful muscle cramping in both hands. Which bedside assessment should the nurse perform immediately to evaluate for hypocalcemia?

A.Evaluate for the presence of Kernig's and Brudzinski's signs in the lower extremities

B.Assess for Romberg's sign by asking the patient to stand with eyes closed

C.Inflate a blood pressure cuff on the upper arm to assess for Trousseau's carpopedal spasm

D.Palpate the right upper quadrant during deep inspiration to elicit Murphy's sign

Explanation: Inadvertent damage or devascularization of the parathyroid glands during total thyroidectomy leads to acute hypoparathyroidism and hypocalcemia. Inflating a blood pressure cuff above systolic pressure for three minutes tests for Trousseau's sign, where ischemia-induced neuromuscular irritability produces painful carpopedal spasm. Tapping the facial nerve anterior to the ear canal tests for Chvostek's sign; both are key diagnostic indicators of acute postoperative hypocalcemia.

10A patient with a severe traumatic brain injury has an intraparenchymal intracranial pressure (ICP) monitor displaying a reading of 24 mmHg (normal: 5 to 15 mmHg). Which nursing action is essential to promote cerebral venous drainage and prevent further elevations in ICP?

A.Place the patient in a Trendelenburg position with pillows supporting the shoulders

B.Flex the patient's neck sharply to the right side to allow unilateral jugular vein decompression

C.Keep the head of the bed flat and encourage extreme hip flexion to ease abdominal pressure

D.Elevate the head of the bed 30 degrees while maintaining the patient's head and neck in neutral midline alignment

Explanation: Elevating the head of the bed to 30 degrees facilitates jugular venous outflow by gravity without compromising cerebral perfusion pressure, thereby lowering intracranial pressure. Maintaining a neutral midline head position avoids compression of the internal jugular veins, which would otherwise obstruct venous return and cause venous engorgement inside the rigid cranial vault.

About the Iran Nursing Competency Exam Exam

The Iran Nursing Professional Competency Exam (آزمون صلاحیت حرفه‌ای پرستاران) is the national licensure assessment administered semi-annually or annually by the National Center for Health Assessment (Sanjesh Pezeshki) under the supervision of the Ministry of Health and Medical Education (MOHME) and the Iran Nursing Organization (INO). Established to ensure safe, ethical, and evidence-based patient care across public and private health sectors in the Islamic Republic of Iran, the examination tests practical clinical application across six major domains: medical-surgical nursing, nursing fundamentals and patient safety, pediatric nursing, psychiatric-mental health care, maternal-newborn health, and healthcare management and professional ethics. This practice question bank is an independent English-language MCQ study adaptation developed by OpenExamPrep to assist nursing graduates, international candidates, and healthcare professionals preparing for the Iranian competency framework.

Exam sponsor: National Center for Health Assessment / Sanjesh Pezeshki & Iran Nursing Organization. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

100 questions

Time Limit

100 minutes

Passing Score

Scaled threshold announced per sitting (score reported out of 100)

Exam / Certification Fees

Set for each sitting by Sanjesh Pezeshki and payable online at sanjeshp.ir (8,000,000 IRR / 800,000 toman for the 1405 sittings).

Exam sponsor website

Reported exam pass rate: Typically 65% to 75% for graduates of accredited Iranian university nursing programs sitting on their first attempt.. Official qualification statistics are published by the National Center for Health Assessment (Sanjesh Pezeshki) following each testing cycle. This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

30%

Medical-Surgical Nursing

Adult clinical assessment, cardiovascular emergencies, respiratory management, fluid and electrolyte disturbances, neurological status, gastrointestinal pathology, and perioperative care grounded in Brunner & Suddarth's Textbook of Medical-Surgical Nursing.

20%

Fundamentals of Nursing, Patient Safety & Infection Control

Core nursing techniques, transmission-based isolation precautions, aseptic procedural standards, hospital-acquired infection prevention, medication safety rights, and fall prevention based on Potter & Perry and Kozier & Erb.

15%

Pediatric Nursing

Growth and developmental milestones across childhood, pediatric dehydration, respiratory syncytial virus, croup, asthma management, congenital heart anomalies, and family-centered pediatric interventions from Wong's Essentials of Pediatric Nursing.

15%

Mental Health & Psychiatric-Mental Health Nursing

Therapeutic nurse-patient relationship, de-escalation of aggressive behaviors, suicide risk evaluation, major depressive disorder, bipolar disorder, schizophrenia spectrum management, and psychotropic medication adverse effects based on Townsend & Morgan.

10%

Maternal-Newborn Nursing & Reproductive Health

Stages of labor, fetal heart rate monitoring, postpartum hemorrhage protocols, preeclampsia and eclampsia management, immediate neonatal care, and breastfeeding promotion.

10%

Nursing Management, Professional Ethics & Patient Advocacy

Iranian nursing code of ethics, patient charter of rights, clinical delegation principles, multidisciplinary teamwork, accurate medical documentation, informed consent verification, and professional accountability.

Preparing for the Iran Nursing Competency Exam Exam

What You Need to Know

Passing score: Scaled threshold announced per sitting (score reported out of 100)
Exam length: 100 questions
Time limit: 100 minutes
Exam / certification fees: Set for each sitting by Sanjesh Pezeshki and payable online at sanjeshp.ir (8,000,000 IRR / 800,000 toman for the 1405 sittings). Official sources

Using Our Practice Resources

Work through all 100 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

Iran Nursing Competency Exam: Suggested Study Strategy

1Prioritize Medical-Surgical Nursing (30% weighting): Focus heavily on cardiovascular, respiratory, endocrine, and perioperative nursing care from Brunner & Suddarth, as these account for nearly a third of all exam items.

2Master the Iranian Patient Rights Charter and Ethics Guidelines: Ensure you understand legal principles of informed consent, patient autonomy, delegation boundaries, and mandatory reporting protocols within the Iranian healthcare system.

3Apply the ABCs and Maslow's Hierarchy to Priority Questions: When questions ask for the nurse's 'first action' or 'highest priority,' systematically evaluate Airway, Breathing, and Circulation before secondary interventions or routine provider notifications.

4Memorize High-Alert Medications and Antidotes: Thoroughly review dosing safeguards, adverse effects, and reversal agents for insulin, heparin, warfarin, digoxin, opioids, and magnesium sulfate across clinical domains.

5Pace Your Practice at One Minute Per Question: Because the exam allocates 100 minutes for 100 questions, practice timed question sets to build clinical reading speed and prompt decision-making under exam conditions.

Frequently Asked Questions

What is the Iran Nursing Professional Competency Exam (آزمون صلاحیت حرفه‌ای پرستاران)?

The Iran Nursing Professional Competency Exam is a national standardized examination established by the Ministry of Health and Medical Education (MOHME) in coordination with the Iran Nursing Organization (INO) and administered by Sanjesh Pezeshki. It evaluates the essential clinical knowledge, clinical reasoning, and ethical standards required for nursing graduates to obtain their professional competency certificate and practice independently in clinical settings throughout Iran.

How many questions are on the exam, and how long does it take?

The examination consists of exactly 100 four-option multiple-choice questions administered in a single testing session of 100 minutes. Candidates have on average one minute per question to review clinical stems and select the best answer.

What is the passing score, and is there negative marking?

The qualifying threshold is a scaled (taraz) cut score fixed for each sitting and announced with the results rather than a fixed percentage. Unlike standard university entrance exams in Iran (Konkur), there is NO negative marking on the Nursing Professional Competency Exam; unanswered or incorrect items do not deduct points, so candidates should answer every question.

Who is eligible to take the Iran Nursing Licensure Exam?

Graduates holding a recognized Bachelor of Science in Nursing (BSN), Master of Science in Nursing (MSN), or doctoral degree in nursing from accredited Iranian universities of medical sciences, as well as foreign-educated nurses whose credentials have been officially verified and equalized by MOHME, are eligible to register. Candidates must also meet or be actively completing mandatory government service regulations (Tarh-e Khedmat) as specified in the testing bulletin.

What reference textbooks are used to construct exam questions?

The official blueprint references established core nursing curricula approved by the Iranian Ministry of Health, primarily Brunner & Suddarth's Textbook of Medical-Surgical Nursing, Potter & Perry's Fundamentals of Nursing (along with Kozier & Erb), Wong's Essentials of Pediatric Nursing, Townsend & Morgan's Psychiatric Mental Health Nursing, and official MOHME national clinical practice and ethical guidelines.

What role does this OpenExamPrep practice bank serve?

This practice test bank is an independent English-language MCQ study adaptation developed by OpenExamPrep. It replicates the official 100-question domain weighting, clinical difficulty, and pedagogical structure to assist bilingual candidates, international nurses, and Iranian graduates in consolidating clinical knowledge and preparing effectively for the national competency exam.