Nursing 109 Final Exam EXAM with
Questions and Answers/Plus a Rationale
Updated 2026 A+/Instant Download PDF
Table of Contents
1. Foundations of Professional Nursing Practice
2. Nursing Process and Clinical Judgment
3. Patient Safety and Quality Improvement
4. Infection Prevention and Control
5. Health Assessment
6. Pharmacology and Medication Administration
7. Fluid, Electrolyte, and Acid–Base Balance
8. Adult Medical-Surgical Nursing
9. Cardiovascular Disorders
10. Respiratory Disorders
11. Endocrine Disorders
12. Neurological Disorders
, 13. Renal and Urinary Disorders
14. Gastrointestinal Disorders
15. Musculoskeletal Disorders
16. Perioperative Nursing
17. Mental Health Nursing
18. Maternal and Newborn Nursing
19. Pediatric Nursing
20. Geriatric Nursing
21. Ethical, Legal, and Professional Issues
1. A nurse is caring for a postoperative patient who suddenly becomes restless, tachycardic,
and reports shortness of breath. Which nursing action demonstrates the highest priority
clinical judgment?
A. Administer the prescribed PRN opioid analgesic.
B. Encourage the patient to use the incentive spirometer.
C. Assess airway, breathing, oxygen saturation, and activate the rapid response
team as indicated.
D. Reassure the patient that postoperative anxiety is common.
CORRECT ANSWER : C [Assess airway, breathing, oxygen saturation, and activate the rapid
response team as indicated]
Rationale: Option C is correct because the patient's presentation suggests possible respiratory
compromise or pulmonary embolism requiring immediate assessment and escalation using ABC
priorities. Option A treats a symptom without evaluating the cause. Option B may be appropriate
later but delays urgent assessment. Option D minimizes potentially life-threatening findings.
2. A nurse delegates care to an experienced unlicensed assistive personnel (UAP). Which
task is most appropriate to delegate?
A. Initial assessment of a newly admitted patient.
, B. Patient education regarding insulin self-administration.
C. Evaluation of pain relief after medication administration.
D. Obtaining and documenting routine vital signs for a stable patient.
CORRECT ANSWER : D [Obtaining and documenting routine vital signs for a stable patient]
Rationale: Option D is appropriate because routine data collection for stable patients may be
delegated according to scope of practice. Initial assessments, patient teaching, and evaluation
require nursing judgment and remain the responsibility of the registered nurse.
3. A hospitalized patient with heart failure develops increasing crackles and oxygen
saturation decreases despite oxygen therapy. Which provider prescription should the
nurse anticipate?
A. Increase oral fluid intake.
B. Administer an intravenous loop diuretic.
C. Discontinue oxygen therapy.
D. Encourage prolonged bed rest without reassessment.
CORRECT ANSWER : B [Administer an intravenous loop diuretic]
Rationale: Intravenous loop diuretics rapidly reduce pulmonary congestion associated with fluid
overload. Increasing fluids worsens volume excess, discontinuing oxygen compromises
oxygenation, and delaying reassessment fails to address the patient's deteriorating status.
4. A nurse identifies a medication dosage that appears significantly higher than the usual
therapeutic range. What is the most appropriate action?
A. Administer the medication because it was prescribed.
B. Ask another nurse to administer it.
C. Delay administration until the next scheduled dose.
D. Verify the order with the prescriber before administering the medication.
CORRECT ANSWER : D [Verify the order with the prescriber before administering the
medication]
Rationale: The nurse has a professional responsibility to question potentially unsafe medication
orders before administration. Administering the drug without clarification may cause harm,
while asking another nurse or delaying without communication fails to resolve the safety
concern.
5. A patient receiving heparin develops hematuria and bleeding from the gums. Which
laboratory value is most important to review?
A. Serum sodium.
B. Hemoglobin A1c.
C. Activated partial thromboplastin time (aPTT).
D. Serum potassium.
Questions and Answers/Plus a Rationale
Updated 2026 A+/Instant Download PDF
Table of Contents
1. Foundations of Professional Nursing Practice
2. Nursing Process and Clinical Judgment
3. Patient Safety and Quality Improvement
4. Infection Prevention and Control
5. Health Assessment
6. Pharmacology and Medication Administration
7. Fluid, Electrolyte, and Acid–Base Balance
8. Adult Medical-Surgical Nursing
9. Cardiovascular Disorders
10. Respiratory Disorders
11. Endocrine Disorders
12. Neurological Disorders
, 13. Renal and Urinary Disorders
14. Gastrointestinal Disorders
15. Musculoskeletal Disorders
16. Perioperative Nursing
17. Mental Health Nursing
18. Maternal and Newborn Nursing
19. Pediatric Nursing
20. Geriatric Nursing
21. Ethical, Legal, and Professional Issues
1. A nurse is caring for a postoperative patient who suddenly becomes restless, tachycardic,
and reports shortness of breath. Which nursing action demonstrates the highest priority
clinical judgment?
A. Administer the prescribed PRN opioid analgesic.
B. Encourage the patient to use the incentive spirometer.
C. Assess airway, breathing, oxygen saturation, and activate the rapid response
team as indicated.
D. Reassure the patient that postoperative anxiety is common.
CORRECT ANSWER : C [Assess airway, breathing, oxygen saturation, and activate the rapid
response team as indicated]
Rationale: Option C is correct because the patient's presentation suggests possible respiratory
compromise or pulmonary embolism requiring immediate assessment and escalation using ABC
priorities. Option A treats a symptom without evaluating the cause. Option B may be appropriate
later but delays urgent assessment. Option D minimizes potentially life-threatening findings.
2. A nurse delegates care to an experienced unlicensed assistive personnel (UAP). Which
task is most appropriate to delegate?
A. Initial assessment of a newly admitted patient.
, B. Patient education regarding insulin self-administration.
C. Evaluation of pain relief after medication administration.
D. Obtaining and documenting routine vital signs for a stable patient.
CORRECT ANSWER : D [Obtaining and documenting routine vital signs for a stable patient]
Rationale: Option D is appropriate because routine data collection for stable patients may be
delegated according to scope of practice. Initial assessments, patient teaching, and evaluation
require nursing judgment and remain the responsibility of the registered nurse.
3. A hospitalized patient with heart failure develops increasing crackles and oxygen
saturation decreases despite oxygen therapy. Which provider prescription should the
nurse anticipate?
A. Increase oral fluid intake.
B. Administer an intravenous loop diuretic.
C. Discontinue oxygen therapy.
D. Encourage prolonged bed rest without reassessment.
CORRECT ANSWER : B [Administer an intravenous loop diuretic]
Rationale: Intravenous loop diuretics rapidly reduce pulmonary congestion associated with fluid
overload. Increasing fluids worsens volume excess, discontinuing oxygen compromises
oxygenation, and delaying reassessment fails to address the patient's deteriorating status.
4. A nurse identifies a medication dosage that appears significantly higher than the usual
therapeutic range. What is the most appropriate action?
A. Administer the medication because it was prescribed.
B. Ask another nurse to administer it.
C. Delay administration until the next scheduled dose.
D. Verify the order with the prescriber before administering the medication.
CORRECT ANSWER : D [Verify the order with the prescriber before administering the
medication]
Rationale: The nurse has a professional responsibility to question potentially unsafe medication
orders before administration. Administering the drug without clarification may cause harm,
while asking another nurse or delaying without communication fails to resolve the safety
concern.
5. A patient receiving heparin develops hematuria and bleeding from the gums. Which
laboratory value is most important to review?
A. Serum sodium.
B. Hemoglobin A1c.
C. Activated partial thromboplastin time (aPTT).
D. Serum potassium.
