NU 301 Unit 7 Exam: NCLEX-Style Fundamentals of Nursing -
with Rationales - 240 Questions and Answers Already Graded A+
Premium Exam Tested And Verified
Subject Area Fundamentals of Nursing
Description This exam assesses advanced understanding of nursing fundamentals, including
ethical-legal principles, evidence-based practice, patient safety, pharmacology,
and clinical reasoning. It is designed to mirror the rigor of NCLEX-style questions
and prepare students for professional nursing practice.
Expected Grade A+
Total Questions 240
Duration 3 hours
Learning Outcomes 1. Apply ethical and legal frameworks to complex clinical scenarios.
2. Integrate evidence-based practice into nursing interventions.
3. Demonstrate advanced clinical reasoning and prioritization in patient care.
4. Analyze pharmacological principles and safe medication administration.
5. Evaluate patient safety and quality improvement strategies.
Accreditation This exam meets the standards of AACN Essentials and is designed for top-tier
US university nursing programs.
Page 1
,1. A nursing student is preparing to administer a blood transfusion to a patient. The
student notes that the patient's identification band is missing, and the patient is
unable to confirm their identity due to sedation. According to the National Patient
Safety Goals, which action should the student take?
A. Proceed with the transfusion after verifying the patient's name on the chart.
B. Delay the transfusion until the patient can be identified using at least two identifiers.
C. Use the bed number and room number as identifiers if they match the chart.
D. Administer the transfusion and notify the charge nurse after starting.
Answer: B. Delay the transfusion until the patient can be identified using at least
two identifiers.
The National Patient Safety Goals require using at least two patient identifiers (e.g.,
name and date of birth) before any procedure, including blood transfusion. The missing
ID band and sedation prevent proper identification; delaying the transfusion is the
safest action. Options A, C, and D violate safety protocols.
2. A nurse is caring for a patient with a pressure injury on the sacrum that is stage 3.
The wound has moderate exudate and necrotic tissue. Which intervention should the
nurse prioritize?
A. Apply a transparent film dressing to protect the wound.
B. Perform sharp debridement to remove necrotic tissue.
C. Use a moisture-retentive dressing after cleansing with normal saline.
D. Administer topical antibiotics as prescribed without debridement.
Answer: B. Perform sharp debridement to remove necrotic tissue.
For a stage 3 pressure injury with necrotic tissue, debridement is essential to remove
nonviable tissue and promote healing. Sharp debridement is the most effective method
for moderate to large amounts of necrotic tissue. Option A is inappropriate for
exudative wounds; option C is correct after debridement; option D is insufficient alone.
Page 2
,3. A nurse is evaluating a patient's arterial blood gas (ABG) results: pH 7.28, PaCO2
50 mm Hg, HCO3- 24 mEq/L. The nurse interprets these findings as which
condition?
A. Metabolic acidosis with full compensation.
B. Respiratory acidosis, uncompensated.
C. Metabolic alkalosis with partial compensation.
D. Respiratory alkalosis, uncompensated.
Answer: B. Respiratory acidosis, uncompensated.
The pH is low (acidosis), PaCO2 is high (respiratory cause), and HCO3- is normal. This
indicates uncompensated respiratory acidosis. In full compensation, the HCO3- would
be elevated to compensate. Options A, C, and D are inconsistent with the values.
4. A nurse is administering a tuberculin skin test to a patient. Which site is most
appropriate for the injection?
A. The deltoid muscle of the upper arm.
B. The ventral forearm, 2-4 inches below the elbow.
C. The outer aspect of the upper arm, over the triceps.
D. The anterior thigh, midway between hip and knee.
Answer: B. The ventral forearm, 2-4 inches below the elbow.
The tuberculin skin test (Mantoux) is administered intradermally on the ventral
forearm, where the skin is thin and the site is easily accessible for reading. The deltoid
and triceps are used for intramuscular or subcutaneous injections; the thigh is used for
infants or other routes.
5. A nurse is teaching a patient with a new diagnosis of type 2 diabetes about foot
care. Which statement by the patient indicates a need for further teaching?
A. "I will inspect my feet daily using a mirror."
B. "I should soak my feet in warm water every evening."
C. "I will wear cotton socks and well-fitting shoes."
D. "I will trim my toenails straight across."
Answer: B. "I should soak my feet in warm water every evening."
Soaking feet can lead to maceration and increase infection risk. Daily inspection,
wearing cotton socks, and trimming nails straight across are correct practices. The
patient's statement about soaking indicates a need for teaching.
Page 3
, 6. A nurse is preparing to administer a nasogastric tube feeding via a pump. The
nurse checks the residual volume and finds 150 mL. The patient's abdomen is
distended and they report nausea. What action should the nurse take?
A. Administer the feeding at a reduced rate.
B. Hold the feeding and notify the healthcare provider.
C. Administer the feeding after flushing the tube.
D. Increase the feeding rate to clear the residual.
Answer: B. Hold the feeding and notify the healthcare provider.
A residual volume of 150 mL with distension and nausea indicates delayed gastric
emptying and risk of aspiration. The feeding should be held, and the healthcare
provider notified. Reducing the rate or flushing may not address the underlying issue;
increasing the rate is dangerous.
7. A nurse is assessing a patient who is receiving a continuous intravenous infusion of
normal saline at 100 mL/hr. The patient develops crackles in the lungs, jugular vein
distension, and edema in the lower extremities. Which action should the nurse take
first?
A. Increase the IV rate to 150 mL/hr to dilute the blood.
B. Administer a diuretic as prescribed.
C. Slow the IV rate and notify the healthcare provider.
D. Place the patient in the Trendelenburg position.
Answer: C. Slow the IV rate and notify the healthcare provider.
The signs indicate fluid volume overload. The immediate nursing action is to slow the
IV rate to prevent further overload and notify the healthcare provider for further
orders. Increasing the rate worsens the condition; diuretics may be prescribed but are
not the first action; Trendelenburg increases venous return.
Page 4
with Rationales - 240 Questions and Answers Already Graded A+
Premium Exam Tested And Verified
Subject Area Fundamentals of Nursing
Description This exam assesses advanced understanding of nursing fundamentals, including
ethical-legal principles, evidence-based practice, patient safety, pharmacology,
and clinical reasoning. It is designed to mirror the rigor of NCLEX-style questions
and prepare students for professional nursing practice.
Expected Grade A+
Total Questions 240
Duration 3 hours
Learning Outcomes 1. Apply ethical and legal frameworks to complex clinical scenarios.
2. Integrate evidence-based practice into nursing interventions.
3. Demonstrate advanced clinical reasoning and prioritization in patient care.
4. Analyze pharmacological principles and safe medication administration.
5. Evaluate patient safety and quality improvement strategies.
Accreditation This exam meets the standards of AACN Essentials and is designed for top-tier
US university nursing programs.
Page 1
,1. A nursing student is preparing to administer a blood transfusion to a patient. The
student notes that the patient's identification band is missing, and the patient is
unable to confirm their identity due to sedation. According to the National Patient
Safety Goals, which action should the student take?
A. Proceed with the transfusion after verifying the patient's name on the chart.
B. Delay the transfusion until the patient can be identified using at least two identifiers.
C. Use the bed number and room number as identifiers if they match the chart.
D. Administer the transfusion and notify the charge nurse after starting.
Answer: B. Delay the transfusion until the patient can be identified using at least
two identifiers.
The National Patient Safety Goals require using at least two patient identifiers (e.g.,
name and date of birth) before any procedure, including blood transfusion. The missing
ID band and sedation prevent proper identification; delaying the transfusion is the
safest action. Options A, C, and D violate safety protocols.
2. A nurse is caring for a patient with a pressure injury on the sacrum that is stage 3.
The wound has moderate exudate and necrotic tissue. Which intervention should the
nurse prioritize?
A. Apply a transparent film dressing to protect the wound.
B. Perform sharp debridement to remove necrotic tissue.
C. Use a moisture-retentive dressing after cleansing with normal saline.
D. Administer topical antibiotics as prescribed without debridement.
Answer: B. Perform sharp debridement to remove necrotic tissue.
For a stage 3 pressure injury with necrotic tissue, debridement is essential to remove
nonviable tissue and promote healing. Sharp debridement is the most effective method
for moderate to large amounts of necrotic tissue. Option A is inappropriate for
exudative wounds; option C is correct after debridement; option D is insufficient alone.
Page 2
,3. A nurse is evaluating a patient's arterial blood gas (ABG) results: pH 7.28, PaCO2
50 mm Hg, HCO3- 24 mEq/L. The nurse interprets these findings as which
condition?
A. Metabolic acidosis with full compensation.
B. Respiratory acidosis, uncompensated.
C. Metabolic alkalosis with partial compensation.
D. Respiratory alkalosis, uncompensated.
Answer: B. Respiratory acidosis, uncompensated.
The pH is low (acidosis), PaCO2 is high (respiratory cause), and HCO3- is normal. This
indicates uncompensated respiratory acidosis. In full compensation, the HCO3- would
be elevated to compensate. Options A, C, and D are inconsistent with the values.
4. A nurse is administering a tuberculin skin test to a patient. Which site is most
appropriate for the injection?
A. The deltoid muscle of the upper arm.
B. The ventral forearm, 2-4 inches below the elbow.
C. The outer aspect of the upper arm, over the triceps.
D. The anterior thigh, midway between hip and knee.
Answer: B. The ventral forearm, 2-4 inches below the elbow.
The tuberculin skin test (Mantoux) is administered intradermally on the ventral
forearm, where the skin is thin and the site is easily accessible for reading. The deltoid
and triceps are used for intramuscular or subcutaneous injections; the thigh is used for
infants or other routes.
5. A nurse is teaching a patient with a new diagnosis of type 2 diabetes about foot
care. Which statement by the patient indicates a need for further teaching?
A. "I will inspect my feet daily using a mirror."
B. "I should soak my feet in warm water every evening."
C. "I will wear cotton socks and well-fitting shoes."
D. "I will trim my toenails straight across."
Answer: B. "I should soak my feet in warm water every evening."
Soaking feet can lead to maceration and increase infection risk. Daily inspection,
wearing cotton socks, and trimming nails straight across are correct practices. The
patient's statement about soaking indicates a need for teaching.
Page 3
, 6. A nurse is preparing to administer a nasogastric tube feeding via a pump. The
nurse checks the residual volume and finds 150 mL. The patient's abdomen is
distended and they report nausea. What action should the nurse take?
A. Administer the feeding at a reduced rate.
B. Hold the feeding and notify the healthcare provider.
C. Administer the feeding after flushing the tube.
D. Increase the feeding rate to clear the residual.
Answer: B. Hold the feeding and notify the healthcare provider.
A residual volume of 150 mL with distension and nausea indicates delayed gastric
emptying and risk of aspiration. The feeding should be held, and the healthcare
provider notified. Reducing the rate or flushing may not address the underlying issue;
increasing the rate is dangerous.
7. A nurse is assessing a patient who is receiving a continuous intravenous infusion of
normal saline at 100 mL/hr. The patient develops crackles in the lungs, jugular vein
distension, and edema in the lower extremities. Which action should the nurse take
first?
A. Increase the IV rate to 150 mL/hr to dilute the blood.
B. Administer a diuretic as prescribed.
C. Slow the IV rate and notify the healthcare provider.
D. Place the patient in the Trendelenburg position.
Answer: C. Slow the IV rate and notify the healthcare provider.
The signs indicate fluid volume overload. The immediate nursing action is to slow the
IV rate to prevent further overload and notify the healthcare provider for further
orders. Increasing the rate worsens the condition; diuretics may be prescribed but are
not the first action; Trendelenburg increases venous return.
Page 4
