West Coast University NURS 100 Exam 2 (pdf) | 2026/2027 |
Fundamentals Q&A | Nursing
1. A nurse is assessing a client's vital signs. Which finding is within the
normal range for an adult?
A) Blood pressure 140/90 mm Hg
B) Heart rate 110 beats per minute
C) Respiratory rate 16 breaths per minute
D) Temperature 100.4°F (38.0°C)
Correct Answer: Respiratory rate 16 breaths per minute
Rationale: Normal respiratory rate for an adult is 12-20 breaths per minute.
Normal blood pressure is <120/80, normal heart rate is 60-100, and normal
temperature is 96.4-99.5°F (35.8-37.5°C).
2. A patient's blood pressure is 148/94 mm Hg. How would the nurse
document this finding?
A) Normal
B) Prehypertension
C) Stage 1 hypertension
D) Stage 2 hypertension
Correct Answer: Stage 1 hypertension
Rationale: Stage 1 hypertension is defined as a systolic BP of 130-139 mm
Hg or a diastolic BP of 80-89 mm Hg. A reading of 148/94 falls into Stage 2
hypertension (≥140/90). However, the question asks for documentation;
Stage 1 is 130-139/80-89, Stage 2 is ≥140/90. Therefore, 148/94 is Stage 2
hypertension.
,3. The order reads, "Aspirin 325 mg PO q4h PRN temp > 101°F." The
patient's last temperature was 99.0°F. What should the nurse do?
A) Administer the aspirin now
B) Hold the aspirin and re-assess temperature in 30 minutes
C) Hold the aspirin
D) Call the provider
Correct Answer: Hold the aspirin
Rationale: The order specifies that aspirin should only be administered if the
temperature is above 101°F. Since the patient's temperature is 99.0°F, the
aspirin should be held. The nurse does not need to call the provider as the
order is clear.
4. A nurse is caring for a dying patient. Which intervention is considered
futile?
A) Providing pain management
B) Administering the influenza vaccine
C) Providing oral care
D) Offering emotional support to the family
Correct Answer: Administering the influenza vaccine
Rationale: Futile interventions are those that do not provide benefit to the
patient. Administering an influenza vaccine to a dying patient is considered
futile because it will not alter the outcome of their terminal condition. Pain
management, oral care, and emotional support are appropriate comfort
measures.
,5. A nurse has a duty of nonmaleficence. Which of the following would be
considered a contradiction to that duty?
A) Administering a medication as prescribed
B) Performing a procedure without informed consent
C) Providing comfort measures
D) Respecting patient autonomy
Correct Answer: Performing a procedure without informed consent
Rationale: Nonmaleficence means to "do no harm". Performing a procedure
without informed consent violates the patient's autonomy and can cause
harm, contradicting the duty of nonmaleficence.
6. A nurse is experiencing an ethical dilemma with a patient. Which
information indicates the nurse has a correct understanding of the primary
cause of ethical dilemmas?
A) Conflict between legal and ethical standards
B) Presence of conflicting values
C) Lack of institutional policies
D) Inadequate staffing levels
Correct Answer: Presence of conflicting values
Rationale: Ethical dilemmas arise when there are conflicting values, making
it difficult to determine the right course of action. These conflicts can occur
between the nurse's values, the patient's values, or institutional values.
7. A client refuses to have pain medication administered by injection. The
nurse states, "If you don't let me give you the shot, I will get help to hold you
down and give it." What crime may the nurse be committing?
, A) Battery
B) Assault
C) False imprisonment
D) Negligence
Correct Answer: Assault
Rationale: Assault is the threat of harmful or offensive contact. The nurse's
statement threatens the patient with force, which constitutes assault.
Battery is the actual harmful or offensive contact.
8. A nurse is reviewing research studies for evidence-based practice. Which
article should the nurse use for qualitative nursing research?
A) An article about the effectiveness of a new medication
B) An article about the physiological effects of a treatment
C) An article about the emotional needs of dying patients and their families
D) An article about the statistical analysis of a clinical trial
Correct Answer: An article about the emotional needs of dying patients and
their families
Rationale: Qualitative research explores experiences, meanings, and
perspectives. An article about emotional needs is qualitative. Quantitative
research focuses on numerical data and statistics.
9. Which is the nurse's best legal safeguard?
A) Carrying malpractice insurance
B) Competent practice
C) Following physician orders without question
Fundamentals Q&A | Nursing
1. A nurse is assessing a client's vital signs. Which finding is within the
normal range for an adult?
A) Blood pressure 140/90 mm Hg
B) Heart rate 110 beats per minute
C) Respiratory rate 16 breaths per minute
D) Temperature 100.4°F (38.0°C)
Correct Answer: Respiratory rate 16 breaths per minute
Rationale: Normal respiratory rate for an adult is 12-20 breaths per minute.
Normal blood pressure is <120/80, normal heart rate is 60-100, and normal
temperature is 96.4-99.5°F (35.8-37.5°C).
2. A patient's blood pressure is 148/94 mm Hg. How would the nurse
document this finding?
A) Normal
B) Prehypertension
C) Stage 1 hypertension
D) Stage 2 hypertension
Correct Answer: Stage 1 hypertension
Rationale: Stage 1 hypertension is defined as a systolic BP of 130-139 mm
Hg or a diastolic BP of 80-89 mm Hg. A reading of 148/94 falls into Stage 2
hypertension (≥140/90). However, the question asks for documentation;
Stage 1 is 130-139/80-89, Stage 2 is ≥140/90. Therefore, 148/94 is Stage 2
hypertension.
,3. The order reads, "Aspirin 325 mg PO q4h PRN temp > 101°F." The
patient's last temperature was 99.0°F. What should the nurse do?
A) Administer the aspirin now
B) Hold the aspirin and re-assess temperature in 30 minutes
C) Hold the aspirin
D) Call the provider
Correct Answer: Hold the aspirin
Rationale: The order specifies that aspirin should only be administered if the
temperature is above 101°F. Since the patient's temperature is 99.0°F, the
aspirin should be held. The nurse does not need to call the provider as the
order is clear.
4. A nurse is caring for a dying patient. Which intervention is considered
futile?
A) Providing pain management
B) Administering the influenza vaccine
C) Providing oral care
D) Offering emotional support to the family
Correct Answer: Administering the influenza vaccine
Rationale: Futile interventions are those that do not provide benefit to the
patient. Administering an influenza vaccine to a dying patient is considered
futile because it will not alter the outcome of their terminal condition. Pain
management, oral care, and emotional support are appropriate comfort
measures.
,5. A nurse has a duty of nonmaleficence. Which of the following would be
considered a contradiction to that duty?
A) Administering a medication as prescribed
B) Performing a procedure without informed consent
C) Providing comfort measures
D) Respecting patient autonomy
Correct Answer: Performing a procedure without informed consent
Rationale: Nonmaleficence means to "do no harm". Performing a procedure
without informed consent violates the patient's autonomy and can cause
harm, contradicting the duty of nonmaleficence.
6. A nurse is experiencing an ethical dilemma with a patient. Which
information indicates the nurse has a correct understanding of the primary
cause of ethical dilemmas?
A) Conflict between legal and ethical standards
B) Presence of conflicting values
C) Lack of institutional policies
D) Inadequate staffing levels
Correct Answer: Presence of conflicting values
Rationale: Ethical dilemmas arise when there are conflicting values, making
it difficult to determine the right course of action. These conflicts can occur
between the nurse's values, the patient's values, or institutional values.
7. A client refuses to have pain medication administered by injection. The
nurse states, "If you don't let me give you the shot, I will get help to hold you
down and give it." What crime may the nurse be committing?
, A) Battery
B) Assault
C) False imprisonment
D) Negligence
Correct Answer: Assault
Rationale: Assault is the threat of harmful or offensive contact. The nurse's
statement threatens the patient with force, which constitutes assault.
Battery is the actual harmful or offensive contact.
8. A nurse is reviewing research studies for evidence-based practice. Which
article should the nurse use for qualitative nursing research?
A) An article about the effectiveness of a new medication
B) An article about the physiological effects of a treatment
C) An article about the emotional needs of dying patients and their families
D) An article about the statistical analysis of a clinical trial
Correct Answer: An article about the emotional needs of dying patients and
their families
Rationale: Qualitative research explores experiences, meanings, and
perspectives. An article about emotional needs is qualitative. Quantitative
research focuses on numerical data and statistics.
9. Which is the nurse's best legal safeguard?
A) Carrying malpractice insurance
B) Competent practice
C) Following physician orders without question
