Swift River Health Assessment &
Fundamentals Exam 2026/2027 |
Updated Questions & Answers
EXAM
Question 1: The nurse enters the client's room and finds them
lying flat, crying, and stating, "I am so short of breath that I just
know I am going to die soon." The client's SpO2 is 89% on room
air, pulse is 102, and respirations are 22. Which actions should the
nurse implement? (Select all that apply)
A) Apply oxygen at 2 L/min via nasal cannula
B) Assist the client with deep breathing exercises
C) Place the client in a supine position
D) Assess placement of the oximeter sensor
Answer: A, B, D
Rationale: The client is hypoxic (SpO2 89%) and in respiratory
distress. Applying oxygen addresses the hypoxia. Deep breathing
exercises help expand alveoli and improve oxygenation. Assessing
the oximeter sensor ensures the reading is accurate (e.g., checking
for nail polish or poor placement). Supine positioning (C) would
worsen dyspnea; the head of the bed should be elevated .
Question 2: After stabilizing the client's breathing, the nurse
addresses the statement: "I just know I am going to die soon, and
my family won't be here." Which statements by the nurse indicate
therapeutic communication? (Select all that apply)
A) "Don't worry, you are not going to die."
,B) "Do you have an advance directive in case you cannot make
decisions?"
C) "You are worried that you will die and not see your family."
D) "It must be frightening to not have your family here."
Answer: B, C, D
Rationale: Option B addresses practical legal needs (advance
directives). Option C uses restating to validate the client's
feelings. Option D uses empathy to acknowledge the emotion.
Option A is false reassurance, which blocks further
communication and dismisses the client's fears .
Question 3: The nurse is planning interventions to help the client
reduce stress and anxiety. Which interventions should be
included? (Select all that apply)
A) Facilitate communication with family via phone or video call
B) Assist the client in using guided imagery or deep breathing
C) Encourage the client to ignore their feelings of fear
D) Provide a quiet environment by reducing noise and
interruptions
E) Ask if the client would like to speak with a chaplain
Answer: A, B, D, E
Rationale: Connecting with family provides emotional support.
Relaxation techniques reduce the physiological response to
anxiety. A calm environment lowers external stressors. Spiritual
support addresses existential distress. Encouraging a client to
ignore feelings (C) is invalidating and increases anxiety .
Question 4: The client is now on 2 L/min nasal cannula with SpO2
94%. They complain of a dry, itchy nose and keep pulling the
cannula off. What actions are appropriate? (Select all that apply)
,A) Remove the nasal cannula since the SpO2 is now normal
B) Attach a humidifier bottle to the oxygen system
C) Apply a water-soluble lubricant to the nares
D) Switch to a non-rebreather mask at 10 L/min
Answer: B, C
Rationale: Dry, itchy nares are a common side effect of oxygen
therapy. Humidification adds moisture to the oxygen. Water-
soluble lubricant soothes the nasal mucosa (petroleum-based
products like Vaseline are flammable and should not be used with
oxygen). Removing oxygen (A) is unsafe as the client still requires
the prescribed flow. A non-rebreather (D) is excessive for a stable
SpO2 of 94% .
Question 5: The nurse is delegating tasks to Unlicensed Personnel
(UP). Which tasks are appropriate to delegate?
A) Evaluate the effectiveness of the client's breathing exercises
B) Document the client's urine output in the electronic medical
record
C) Assist the client with ambulation to the bathroom
D) Rotate the client's oximeter sensor every 8 hours
E) Teach the client how to use the incentive spirometer
Answer: B, C, D
Rationale: UP can perform routine tasks: measuring/output (B),
ambulating (C), and repositioning devices (D). Evaluation (A)
and teaching (E) require licensed nursing judgment and are not
delegable .
Question 6
A client with chronic heart failure has a new prescription for
furosemide (Lasix). The nurse notes a potassium level of 3.2 mEq/L
, (normal 3.5–5.0). Which action should the nurse take first?
A) Administer the furosemide as ordered
B) Notify the healthcare provider
C) Give oral potassium supplements from the unit stock
D) Check the client’s blood pressure
Answer: B
Rationale: A potassium level of 3.2 is hypokalemia, which
increases the risk of digoxin toxicity and cardiac dysrhythmias.
Furosemide is a loop diuretic that worsens potassium loss. The
nurse must notify the provider before administration. Giving
potassium without an order is unsafe.
Question 7
The nurse is assessing a client’s radial pulse. Which finding
requires immediate action?
A) Pulse rate of 88 beats/min
B) Pulse irregularity every 4–5 beats
C) Pulse strength of 2+ (normal)
D) Pulse rate of 52 beats/min in a sleeping client
Answer: B
Rationale: An irregular pulse (e.g., every 4–5 beats) suggests an
arrhythmia such as atrial fibrillation, which increases stroke risk. A
rate of 52 in a sleeping adult can be normal. 2+ strength is
normal. Rate 88 is normal.
Question 8
A postoperative client reports pain of 8/10. The nurse administers
morphine 2 mg IV. Which reassessment time is most appropriate?
A) 1–2 minutes
B) 5–10 minutes
Fundamentals Exam 2026/2027 |
Updated Questions & Answers
EXAM
Question 1: The nurse enters the client's room and finds them
lying flat, crying, and stating, "I am so short of breath that I just
know I am going to die soon." The client's SpO2 is 89% on room
air, pulse is 102, and respirations are 22. Which actions should the
nurse implement? (Select all that apply)
A) Apply oxygen at 2 L/min via nasal cannula
B) Assist the client with deep breathing exercises
C) Place the client in a supine position
D) Assess placement of the oximeter sensor
Answer: A, B, D
Rationale: The client is hypoxic (SpO2 89%) and in respiratory
distress. Applying oxygen addresses the hypoxia. Deep breathing
exercises help expand alveoli and improve oxygenation. Assessing
the oximeter sensor ensures the reading is accurate (e.g., checking
for nail polish or poor placement). Supine positioning (C) would
worsen dyspnea; the head of the bed should be elevated .
Question 2: After stabilizing the client's breathing, the nurse
addresses the statement: "I just know I am going to die soon, and
my family won't be here." Which statements by the nurse indicate
therapeutic communication? (Select all that apply)
A) "Don't worry, you are not going to die."
,B) "Do you have an advance directive in case you cannot make
decisions?"
C) "You are worried that you will die and not see your family."
D) "It must be frightening to not have your family here."
Answer: B, C, D
Rationale: Option B addresses practical legal needs (advance
directives). Option C uses restating to validate the client's
feelings. Option D uses empathy to acknowledge the emotion.
Option A is false reassurance, which blocks further
communication and dismisses the client's fears .
Question 3: The nurse is planning interventions to help the client
reduce stress and anxiety. Which interventions should be
included? (Select all that apply)
A) Facilitate communication with family via phone or video call
B) Assist the client in using guided imagery or deep breathing
C) Encourage the client to ignore their feelings of fear
D) Provide a quiet environment by reducing noise and
interruptions
E) Ask if the client would like to speak with a chaplain
Answer: A, B, D, E
Rationale: Connecting with family provides emotional support.
Relaxation techniques reduce the physiological response to
anxiety. A calm environment lowers external stressors. Spiritual
support addresses existential distress. Encouraging a client to
ignore feelings (C) is invalidating and increases anxiety .
Question 4: The client is now on 2 L/min nasal cannula with SpO2
94%. They complain of a dry, itchy nose and keep pulling the
cannula off. What actions are appropriate? (Select all that apply)
,A) Remove the nasal cannula since the SpO2 is now normal
B) Attach a humidifier bottle to the oxygen system
C) Apply a water-soluble lubricant to the nares
D) Switch to a non-rebreather mask at 10 L/min
Answer: B, C
Rationale: Dry, itchy nares are a common side effect of oxygen
therapy. Humidification adds moisture to the oxygen. Water-
soluble lubricant soothes the nasal mucosa (petroleum-based
products like Vaseline are flammable and should not be used with
oxygen). Removing oxygen (A) is unsafe as the client still requires
the prescribed flow. A non-rebreather (D) is excessive for a stable
SpO2 of 94% .
Question 5: The nurse is delegating tasks to Unlicensed Personnel
(UP). Which tasks are appropriate to delegate?
A) Evaluate the effectiveness of the client's breathing exercises
B) Document the client's urine output in the electronic medical
record
C) Assist the client with ambulation to the bathroom
D) Rotate the client's oximeter sensor every 8 hours
E) Teach the client how to use the incentive spirometer
Answer: B, C, D
Rationale: UP can perform routine tasks: measuring/output (B),
ambulating (C), and repositioning devices (D). Evaluation (A)
and teaching (E) require licensed nursing judgment and are not
delegable .
Question 6
A client with chronic heart failure has a new prescription for
furosemide (Lasix). The nurse notes a potassium level of 3.2 mEq/L
, (normal 3.5–5.0). Which action should the nurse take first?
A) Administer the furosemide as ordered
B) Notify the healthcare provider
C) Give oral potassium supplements from the unit stock
D) Check the client’s blood pressure
Answer: B
Rationale: A potassium level of 3.2 is hypokalemia, which
increases the risk of digoxin toxicity and cardiac dysrhythmias.
Furosemide is a loop diuretic that worsens potassium loss. The
nurse must notify the provider before administration. Giving
potassium without an order is unsafe.
Question 7
The nurse is assessing a client’s radial pulse. Which finding
requires immediate action?
A) Pulse rate of 88 beats/min
B) Pulse irregularity every 4–5 beats
C) Pulse strength of 2+ (normal)
D) Pulse rate of 52 beats/min in a sleeping client
Answer: B
Rationale: An irregular pulse (e.g., every 4–5 beats) suggests an
arrhythmia such as atrial fibrillation, which increases stroke risk. A
rate of 52 in a sleeping adult can be normal. 2+ strength is
normal. Rate 88 is normal.
Question 8
A postoperative client reports pain of 8/10. The nurse administers
morphine 2 mg IV. Which reassessment time is most appropriate?
A) 1–2 minutes
B) 5–10 minutes
