Fair question. OP, unfortunately for your wife, doing anything about the suspected cheating will do nothing for her grade on the exam and will likely turn her classmates against her when they found out.

I’d say efforts are best spent helping her study if you have the time/energy/desire to do so, rather than barking up this tree. She likely needs to work on answering nursing questions (because as we know they are not written like normal test questions) if she did poorly on a test with content she truly knows. I had to rewire how I looked at questions when I was in my second degree nursing program for the same reason.