RN Fundamentals of Nursing 2025/2026 Exam
Instructions: Choose the best answer for each question.
Section 1: Safe & Effective Care Environment (Questions 1-25)
1. A nurse is preparing to administer medications to a client. Which of the following
actions is the priority to ensure client safety?
A. Checking the client's identification band.
B. Performing the three checks of medication administration.
C. Assessing the client's allergies.
D. Using two client identifiers.
Answer: D. Using two client identifiers.
Rationale: The priority action in medication administration is to ensure the right client
receives the medication. Using two client identifiers (e.g., name and date of birth) is the
most reliable method to confirm identity and is a National Patient Safety Goal. While all
options are important, correct identification is the foundational step to prevent a
medication error.
2. A client has a new prescription for a restraint. Which of the following is the most
appropriate action for the nurse to take?
A. Apply the restraint tightly to prevent the client from freeing themselves.
,B. Document the client's behavior that led to the need for the restraint.
C. Tie the restraint to the side rail of the bed.
D. Obtain a PRN order for restraints from the provider.
Answer: B. Document the client's behavior that led to the need for the restraint.
Rationale: The nurse must document the specific behaviors that indicate a need for
restraints and the less restrictive measures attempted. Restraints should never be
applied for staff convenience. Restraints must be tied to a non-movable part of the bed
frame, not the side rail. PRN orders for restraints are not allowed; a provider must see
and evaluate the client within a specific time frame (usually 1 hour) and write a new
order.
3. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task
should the nurse delegate to the UAP?
A. Assessing a client's surgical incision.
B. Teaching a client about their new medication.
C. Administering a scheduled oral medication.
D. Performing a routine bed bath for a stable client.
Answer: D. Performing a routine bed bath for a stable client.
Rationale: The RN can delegate routine, non-invasive tasks like bathing, feeding, and
ambulating stable clients. Assessment, teaching, and medication administration require
the clinical judgment and licensure of an RN and cannot be delegated.
,4. A client is on fall precautions. Which of the following interventions is most important
to implement?
A. Place the bed in the high position.
B. Keep all four side rails up.
C. Place the call light within the client's reach.
D. Apply wrist restraints.
Answer: C. Place the call light within the client's reach.
Rationale: Ensuring the client can easily call for assistance is a primary intervention to
prevent falls. The bed should be in the lowest position, and side rails should be used
appropriately (not all four up, as this can be considered a restraint). Restraints are a
last resort.
5. A nurse is preparing to insert a nasogastric (NG) tube. Which of the following actions
is correct to confirm placement prior to the initial feeding?
A. Auscultate for air instilled into the tube.
B. Check the pH of the aspirated fluid.
C. Obtain an x-ray.
D. Observe for bubbling at the end of the tube when the client exhales.
Answer: C. Obtain an x-ray.
Rationale: For initial placement, an x-ray is the only definitive method to confirm the NG
, tube is in the stomach and not the lungs. While pH testing and auscultation are used for
ongoing monitoring, they are not considered reliable for confirming initial placement.
6. A nurse is caring for a client who is post-operative. Which of the following findings
should be reported to the provider immediately?
A. Pain level of 4 on a 0-10 scale.
B. A urine output of 60 mL over the last 2 hours.
C. A temperature of 37.8°C (100.0°F).
D. Blood pressure of 88/52 mm Hg.
Answer: D. Blood pressure of 88/52 mm Hg.
Rationale: A blood pressure of 88/52 is indicative of hypotension, which could be a sign
of shock (e.g., hypovolemic, septic). This is a critical finding that requires immediate
intervention. The other findings are abnormal but not immediately life-threatening.
7. A nurse is caring for a client with a new prescription for a blood transfusion. Which of
the following actions should the nurse take first?
A. Start an IV line with normal saline.
B. Obtain the blood product from the blood bank.
C. Verify the client's identity with another licensed nurse.
D. Check the client's vital signs.
Instructions: Choose the best answer for each question.
Section 1: Safe & Effective Care Environment (Questions 1-25)
1. A nurse is preparing to administer medications to a client. Which of the following
actions is the priority to ensure client safety?
A. Checking the client's identification band.
B. Performing the three checks of medication administration.
C. Assessing the client's allergies.
D. Using two client identifiers.
Answer: D. Using two client identifiers.
Rationale: The priority action in medication administration is to ensure the right client
receives the medication. Using two client identifiers (e.g., name and date of birth) is the
most reliable method to confirm identity and is a National Patient Safety Goal. While all
options are important, correct identification is the foundational step to prevent a
medication error.
2. A client has a new prescription for a restraint. Which of the following is the most
appropriate action for the nurse to take?
A. Apply the restraint tightly to prevent the client from freeing themselves.
,B. Document the client's behavior that led to the need for the restraint.
C. Tie the restraint to the side rail of the bed.
D. Obtain a PRN order for restraints from the provider.
Answer: B. Document the client's behavior that led to the need for the restraint.
Rationale: The nurse must document the specific behaviors that indicate a need for
restraints and the less restrictive measures attempted. Restraints should never be
applied for staff convenience. Restraints must be tied to a non-movable part of the bed
frame, not the side rail. PRN orders for restraints are not allowed; a provider must see
and evaluate the client within a specific time frame (usually 1 hour) and write a new
order.
3. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task
should the nurse delegate to the UAP?
A. Assessing a client's surgical incision.
B. Teaching a client about their new medication.
C. Administering a scheduled oral medication.
D. Performing a routine bed bath for a stable client.
Answer: D. Performing a routine bed bath for a stable client.
Rationale: The RN can delegate routine, non-invasive tasks like bathing, feeding, and
ambulating stable clients. Assessment, teaching, and medication administration require
the clinical judgment and licensure of an RN and cannot be delegated.
,4. A client is on fall precautions. Which of the following interventions is most important
to implement?
A. Place the bed in the high position.
B. Keep all four side rails up.
C. Place the call light within the client's reach.
D. Apply wrist restraints.
Answer: C. Place the call light within the client's reach.
Rationale: Ensuring the client can easily call for assistance is a primary intervention to
prevent falls. The bed should be in the lowest position, and side rails should be used
appropriately (not all four up, as this can be considered a restraint). Restraints are a
last resort.
5. A nurse is preparing to insert a nasogastric (NG) tube. Which of the following actions
is correct to confirm placement prior to the initial feeding?
A. Auscultate for air instilled into the tube.
B. Check the pH of the aspirated fluid.
C. Obtain an x-ray.
D. Observe for bubbling at the end of the tube when the client exhales.
Answer: C. Obtain an x-ray.
Rationale: For initial placement, an x-ray is the only definitive method to confirm the NG
, tube is in the stomach and not the lungs. While pH testing and auscultation are used for
ongoing monitoring, they are not considered reliable for confirming initial placement.
6. A nurse is caring for a client who is post-operative. Which of the following findings
should be reported to the provider immediately?
A. Pain level of 4 on a 0-10 scale.
B. A urine output of 60 mL over the last 2 hours.
C. A temperature of 37.8°C (100.0°F).
D. Blood pressure of 88/52 mm Hg.
Answer: D. Blood pressure of 88/52 mm Hg.
Rationale: A blood pressure of 88/52 is indicative of hypotension, which could be a sign
of shock (e.g., hypovolemic, septic). This is a critical finding that requires immediate
intervention. The other findings are abnormal but not immediately life-threatening.
7. A nurse is caring for a client with a new prescription for a blood transfusion. Which of
the following actions should the nurse take first?
A. Start an IV line with normal saline.
B. Obtain the blood product from the blood bank.
C. Verify the client's identity with another licensed nurse.
D. Check the client's vital signs.
