NUR 215 Exam 1: Fundamentals V1 - Arizona College
Updated and Latest Questions and Correct Answers with
Rationale
1. Which nursing action is the most effective way to break the chain of infection?
A. Wearing gloves for all patient contact
B. Administering prophylactic antibiotics
C. Performing hand hygiene frequently
D. Providing private rooms for all patients
Ans: C
Explanation: Hand hygiene is the single most important intervention in preventing the transmission of
microorganisms. It should be performed before and after patient contact and after removing gloves.
Proper technique involves using soap and water or alcohol-based hand rub depending on the situation.
This simple action significantly reduces the risk of healthcare-associated infections. All healthcare
workers must adhere to strict hand hygiene protocols to ensure patient safety.
2. The nurse is collecting data from a patient who reports feeling ‘dizzy’ and ‘nauseated’. This information is
categorized as:
A. Subjective data
B. Secondary data
C. Objective data
D. Inference data
Ans: A
,Explanation: Subjective data consist of information provided by the patient that cannot be measured by
the nurse. Examples include feelings, perceptions, and self-reported symptoms like pain or dizziness.
Objective data, in contrast, are measurable signs such as blood pressure or heart rate. Collecting accurate
subjective data is essential for a comprehensive patient assessment. The nurse must document these
findings using the patient’s own words whenever possible.
3. Which phase of the nursing process involves setting patient-centered goals and outcomes?
A. Assessment
B. Planning
C. Diagnosis
D. Implementation
Ans: B
Explanation: The planning phase is where the nurse develops a care plan with specific goals. These goals
must be measurable, attainable, and patient-centered to be effective. During this stage, the nurse also
selects appropriate nursing interventions to achieve the desired outcomes. Collaboration with the patient
ensures that the plan aligns with their personal health values. Effective planning provides a roadmap for
the subsequent implementation and evaluation phases.
4. What is the first step the nurse should take when a patient is found lying on the floor?
A. Call the provider immediately
B. Assess the patient for injuries
C. Complete an incident report
D. Move the patient back to bed
Ans: B
, Explanation: Safety and assessment are the priorities when a patient is found on the floor. The nurse
must check for immediate life-threatening injuries or loss of consciousness before moving the patient.
Assessing vital signs and neurovascular status is a critical component of this initial response. Only after
the patient is stable and assessed should they be moved with appropriate assistance. Documentation of
the event and notification of the provider follow the initial assessment.
5. In the ‘RACE’ acronym for fire safety, what does the letter ‘A’ stand for?
A. Action
B. Alarm
C. Assess
D. Aim
Ans: B
Explanation: The RACE acronym stands for Rescue, Alarm, Confine, and Extinguish/Evacuate. Activating
the fire alarm is the second step to ensure emergency services and other staff are notified. This helps
initiate the facility’s emergency response plan immediately. While rescue is the first priority, notifying
others is essential for collective safety. Each letter represents a sequential action to manage a fire
emergency effectively.
6. Which pulse site is considered the most accurate for measuring a patient’s heart rate?
A. Apical
B. Carotid
C. Radial
D. Brachial
Ans: A
Updated and Latest Questions and Correct Answers with
Rationale
1. Which nursing action is the most effective way to break the chain of infection?
A. Wearing gloves for all patient contact
B. Administering prophylactic antibiotics
C. Performing hand hygiene frequently
D. Providing private rooms for all patients
Ans: C
Explanation: Hand hygiene is the single most important intervention in preventing the transmission of
microorganisms. It should be performed before and after patient contact and after removing gloves.
Proper technique involves using soap and water or alcohol-based hand rub depending on the situation.
This simple action significantly reduces the risk of healthcare-associated infections. All healthcare
workers must adhere to strict hand hygiene protocols to ensure patient safety.
2. The nurse is collecting data from a patient who reports feeling ‘dizzy’ and ‘nauseated’. This information is
categorized as:
A. Subjective data
B. Secondary data
C. Objective data
D. Inference data
Ans: A
,Explanation: Subjective data consist of information provided by the patient that cannot be measured by
the nurse. Examples include feelings, perceptions, and self-reported symptoms like pain or dizziness.
Objective data, in contrast, are measurable signs such as blood pressure or heart rate. Collecting accurate
subjective data is essential for a comprehensive patient assessment. The nurse must document these
findings using the patient’s own words whenever possible.
3. Which phase of the nursing process involves setting patient-centered goals and outcomes?
A. Assessment
B. Planning
C. Diagnosis
D. Implementation
Ans: B
Explanation: The planning phase is where the nurse develops a care plan with specific goals. These goals
must be measurable, attainable, and patient-centered to be effective. During this stage, the nurse also
selects appropriate nursing interventions to achieve the desired outcomes. Collaboration with the patient
ensures that the plan aligns with their personal health values. Effective planning provides a roadmap for
the subsequent implementation and evaluation phases.
4. What is the first step the nurse should take when a patient is found lying on the floor?
A. Call the provider immediately
B. Assess the patient for injuries
C. Complete an incident report
D. Move the patient back to bed
Ans: B
, Explanation: Safety and assessment are the priorities when a patient is found on the floor. The nurse
must check for immediate life-threatening injuries or loss of consciousness before moving the patient.
Assessing vital signs and neurovascular status is a critical component of this initial response. Only after
the patient is stable and assessed should they be moved with appropriate assistance. Documentation of
the event and notification of the provider follow the initial assessment.
5. In the ‘RACE’ acronym for fire safety, what does the letter ‘A’ stand for?
A. Action
B. Alarm
C. Assess
D. Aim
Ans: B
Explanation: The RACE acronym stands for Rescue, Alarm, Confine, and Extinguish/Evacuate. Activating
the fire alarm is the second step to ensure emergency services and other staff are notified. This helps
initiate the facility’s emergency response plan immediately. While rescue is the first priority, notifying
others is essential for collective safety. Each letter represents a sequential action to manage a fire
emergency effectively.
6. Which pulse site is considered the most accurate for measuring a patient’s heart rate?
A. Apical
B. Carotid
C. Radial
D. Brachial
Ans: A
