NUR 104 Final Exam 1 2026/2027 | Excelsior
University | Foundations of Nursing & NGN
Clinical Judgment Review | 100 Verified
Questions with Detailed Rationales
This exam contains verified questions drawn from actual NUR 104 Final Exam content and the
foundational nursing competencies required at Excelsior University for the 2026/2027 academic year. It
covers the nursing process, health assessment, pharmacology fundamentals, safety and infection
control, legal/ethical issues, and the application of the NCSBN Clinical Judgment Measurement Model to
clinical scenarios. Questions are designed to reflect real patient care situations and the knowledge and
skills needed for progression in the nursing curriculum.
Section 1: Foundations of Nursing Practice & Professional Identity — Questions 1–20
Q1: The nursing process is a systematic method for delivering patient-centered care. What does the
acronym "ADPIE" represent in the correct sequential order?
A. Analysis, Diagnosis, Planning, Implementation, Evaluation
B. Assessment, Diagnosis, Planning, Implementation, Evaluation [CORRECT]
C. Assessment, Documentation, Planning, Intervention, Evaluation
D. Analysis, Diagnosis, Process, Implementation, Evaluation
Correct Answer: B
Rationale: The best answer is B. This choice is correct because ADPIE stands for Assessment, Diagnosis,
Planning, Implementation, and Evaluation—the five sequential steps of the nursing process. This
framework guides nurses in providing organized, patient-centered care from initial data collection
through outcome evaluation.
Q2: A nurse is caring for a patient from a cultural background that values family decision-making over
individual autonomy. Which nursing action best demonstrates cultural competence?
,A. Insist the patient make decisions independently
B. Include family members in care discussions and respect their role in decision-making [CORRECT]
C. Ask the family to leave so the patient can decide alone
D. Make all decisions for the patient to avoid confusion
Correct Answer: B
Rationale: The best answer is B. This choice is correct because cultural competence requires recognizing
and respecting diverse values and practices. When a culture emphasizes family-centered decision-
making, the nurse should facilitate that process rather than impose Western individualistic norms. This
aligns with the principle of providing culturally sensitive care that honors the patient's beliefs.
Q3: Which of the following best describes the difference between a medical diagnosis and a nursing
diagnosis?
A. There is no difference; they are interchangeable terms
B. A medical diagnosis identifies a disease or pathology, while a nursing diagnosis identifies patient
responses to health conditions [CORRECT]
C. A nursing diagnosis is made only by physicians
D. A medical diagnosis focuses on prevention, while a nursing diagnosis focuses on treatment
Correct Answer: B
Rationale: The best answer is B. This choice is correct because medical diagnoses identify diseases,
disorders, or pathological conditions (e.g., pneumonia, diabetes), while nursing diagnoses describe
patient responses to those conditions that nurses can treat independently (e.g., impaired gas exchange,
risk for unstable blood glucose). This distinction defines the unique scope of nursing practice.
Q4: The principle of nonmaleficence in nursing ethics means:
A. Doing good for the patient
B. Avoiding harm to the patient [CORRECT]
C. Respecting the patient's right to make decisions
D. Treating all patients fairly and equally
Correct Answer: B
Rationale: The best answer is B. This choice is correct because nonmaleficence means "do no harm"—
the obligation to avoid causing harm to patients. This is one of the core ethical principles in nursing,
alongside beneficence (doing good), autonomy (respecting self-determination), and justice (fairness).
Each principle addresses a different dimension of ethical practice.
,Q5: A registered nurse is delegating a task to an unlicensed assistive personnel (UAP). Which task is
most appropriate to delegate?
A. Assessing a post-operative patient's incision
B. Measuring and recording a stable patient's vital signs [CORRECT]
C. Administering oral medications
D. Developing the patient's plan of care
Correct Answer: B
Rationale: The best answer is B. This choice is correct because measuring and recording vital signs on a
stable patient is within the scope of practice for UAPs, as it is a routine task that does not require clinical
judgment or assessment. Tasks involving assessment, medication administration, and care planning
require a licensed nurse and should not be delegated to unlicensed personnel.
Q6: In Florence Nightingale's environmental theory, which factor is considered most influential in
patient recovery?
A. Advanced medical technology
B. The patient's environment, including fresh air, light, cleanliness, and quiet [CORRECT]
C. The nurse's personality and appearance
D. The hospital's architectural design
Correct Answer: B
Rationale: The best answer is B. This choice is correct because Nightingale's theory emphasized that the
environment—clean air, pure water, efficient drainage, cleanliness, and light—was the primary factor in
promoting healing and preventing disease. Her work during the Crimean War demonstrated dramatic
improvements in patient outcomes when environmental conditions were improved.
Q7: A nurse is documenting patient care using the SOAP format. What does the "S" in SOAP stand for?
A. System
B. Subjective [CORRECT]
C. Summary
D. Standard
Correct Answer: B
Rationale: The best answer is B. This choice is correct because SOAP stands for Subjective (what the
patient reports), Objective (measurable data), Assessment (the nurse's clinical judgment), and Plan
, (interventions and goals). The subjective component includes the patient's statements about symptoms,
feelings, and concerns that cannot be directly measured.
Q8: Which of the following is an example of a nurse acting within the scope of practice for a registered
nurse?
A. Prescribing antibiotics for a patient with a bacterial infection
B. Performing a comprehensive patient assessment and formulating nursing diagnoses [CORRECT]
C. Performing surgery under the supervision of a physician
D. Interpreting a chest X-ray and diagnosing pneumonia
Correct Answer: B
Rationale: The best answer is B. This choice is correct because comprehensive patient assessment and
nursing diagnosis formulation are core functions of registered nursing practice. Prescribing medications,
performing surgery, and interpreting diagnostic imaging are outside the RN scope and require additional
licensure or physician oversight.
Q9: The American Nurses Association (ANA) Standards of Professional Practice include which of the
following as a standard?
A. The nurse must work overtime whenever requested
B. The nurse evaluates progress toward attainment of goals [CORRECT]
C. The nurse should avoid documenting errors to protect the profession
D. The nurse may refuse to care for patients based on personal beliefs
Correct Answer: B
Rationale: The best answer is B. This choice is correct because evaluation of progress toward goal
attainment is one of the ANA standards of professional nursing practice. The standards outline
competencies for assessment, diagnosis, outcomes identification, planning, implementation, and
evaluation. Nurses are accountable for measuring the effectiveness of their interventions.
Q10: A nurse is caring for a patient who refuses a blood transfusion based on religious beliefs. The nurse
understands that honoring this refusal is an application of which ethical principle?
A. Beneficence
B. Autonomy [CORRECT]
C. Justice
D. Fidelity
University | Foundations of Nursing & NGN
Clinical Judgment Review | 100 Verified
Questions with Detailed Rationales
This exam contains verified questions drawn from actual NUR 104 Final Exam content and the
foundational nursing competencies required at Excelsior University for the 2026/2027 academic year. It
covers the nursing process, health assessment, pharmacology fundamentals, safety and infection
control, legal/ethical issues, and the application of the NCSBN Clinical Judgment Measurement Model to
clinical scenarios. Questions are designed to reflect real patient care situations and the knowledge and
skills needed for progression in the nursing curriculum.
Section 1: Foundations of Nursing Practice & Professional Identity — Questions 1–20
Q1: The nursing process is a systematic method for delivering patient-centered care. What does the
acronym "ADPIE" represent in the correct sequential order?
A. Analysis, Diagnosis, Planning, Implementation, Evaluation
B. Assessment, Diagnosis, Planning, Implementation, Evaluation [CORRECT]
C. Assessment, Documentation, Planning, Intervention, Evaluation
D. Analysis, Diagnosis, Process, Implementation, Evaluation
Correct Answer: B
Rationale: The best answer is B. This choice is correct because ADPIE stands for Assessment, Diagnosis,
Planning, Implementation, and Evaluation—the five sequential steps of the nursing process. This
framework guides nurses in providing organized, patient-centered care from initial data collection
through outcome evaluation.
Q2: A nurse is caring for a patient from a cultural background that values family decision-making over
individual autonomy. Which nursing action best demonstrates cultural competence?
,A. Insist the patient make decisions independently
B. Include family members in care discussions and respect their role in decision-making [CORRECT]
C. Ask the family to leave so the patient can decide alone
D. Make all decisions for the patient to avoid confusion
Correct Answer: B
Rationale: The best answer is B. This choice is correct because cultural competence requires recognizing
and respecting diverse values and practices. When a culture emphasizes family-centered decision-
making, the nurse should facilitate that process rather than impose Western individualistic norms. This
aligns with the principle of providing culturally sensitive care that honors the patient's beliefs.
Q3: Which of the following best describes the difference between a medical diagnosis and a nursing
diagnosis?
A. There is no difference; they are interchangeable terms
B. A medical diagnosis identifies a disease or pathology, while a nursing diagnosis identifies patient
responses to health conditions [CORRECT]
C. A nursing diagnosis is made only by physicians
D. A medical diagnosis focuses on prevention, while a nursing diagnosis focuses on treatment
Correct Answer: B
Rationale: The best answer is B. This choice is correct because medical diagnoses identify diseases,
disorders, or pathological conditions (e.g., pneumonia, diabetes), while nursing diagnoses describe
patient responses to those conditions that nurses can treat independently (e.g., impaired gas exchange,
risk for unstable blood glucose). This distinction defines the unique scope of nursing practice.
Q4: The principle of nonmaleficence in nursing ethics means:
A. Doing good for the patient
B. Avoiding harm to the patient [CORRECT]
C. Respecting the patient's right to make decisions
D. Treating all patients fairly and equally
Correct Answer: B
Rationale: The best answer is B. This choice is correct because nonmaleficence means "do no harm"—
the obligation to avoid causing harm to patients. This is one of the core ethical principles in nursing,
alongside beneficence (doing good), autonomy (respecting self-determination), and justice (fairness).
Each principle addresses a different dimension of ethical practice.
,Q5: A registered nurse is delegating a task to an unlicensed assistive personnel (UAP). Which task is
most appropriate to delegate?
A. Assessing a post-operative patient's incision
B. Measuring and recording a stable patient's vital signs [CORRECT]
C. Administering oral medications
D. Developing the patient's plan of care
Correct Answer: B
Rationale: The best answer is B. This choice is correct because measuring and recording vital signs on a
stable patient is within the scope of practice for UAPs, as it is a routine task that does not require clinical
judgment or assessment. Tasks involving assessment, medication administration, and care planning
require a licensed nurse and should not be delegated to unlicensed personnel.
Q6: In Florence Nightingale's environmental theory, which factor is considered most influential in
patient recovery?
A. Advanced medical technology
B. The patient's environment, including fresh air, light, cleanliness, and quiet [CORRECT]
C. The nurse's personality and appearance
D. The hospital's architectural design
Correct Answer: B
Rationale: The best answer is B. This choice is correct because Nightingale's theory emphasized that the
environment—clean air, pure water, efficient drainage, cleanliness, and light—was the primary factor in
promoting healing and preventing disease. Her work during the Crimean War demonstrated dramatic
improvements in patient outcomes when environmental conditions were improved.
Q7: A nurse is documenting patient care using the SOAP format. What does the "S" in SOAP stand for?
A. System
B. Subjective [CORRECT]
C. Summary
D. Standard
Correct Answer: B
Rationale: The best answer is B. This choice is correct because SOAP stands for Subjective (what the
patient reports), Objective (measurable data), Assessment (the nurse's clinical judgment), and Plan
, (interventions and goals). The subjective component includes the patient's statements about symptoms,
feelings, and concerns that cannot be directly measured.
Q8: Which of the following is an example of a nurse acting within the scope of practice for a registered
nurse?
A. Prescribing antibiotics for a patient with a bacterial infection
B. Performing a comprehensive patient assessment and formulating nursing diagnoses [CORRECT]
C. Performing surgery under the supervision of a physician
D. Interpreting a chest X-ray and diagnosing pneumonia
Correct Answer: B
Rationale: The best answer is B. This choice is correct because comprehensive patient assessment and
nursing diagnosis formulation are core functions of registered nursing practice. Prescribing medications,
performing surgery, and interpreting diagnostic imaging are outside the RN scope and require additional
licensure or physician oversight.
Q9: The American Nurses Association (ANA) Standards of Professional Practice include which of the
following as a standard?
A. The nurse must work overtime whenever requested
B. The nurse evaluates progress toward attainment of goals [CORRECT]
C. The nurse should avoid documenting errors to protect the profession
D. The nurse may refuse to care for patients based on personal beliefs
Correct Answer: B
Rationale: The best answer is B. This choice is correct because evaluation of progress toward goal
attainment is one of the ANA standards of professional nursing practice. The standards outline
competencies for assessment, diagnosis, outcomes identification, planning, implementation, and
evaluation. Nurses are accountable for measuring the effectiveness of their interventions.
Q10: A nurse is caring for a patient who refuses a blood transfusion based on religious beliefs. The nurse
understands that honoring this refusal is an application of which ethical principle?
A. Beneficence
B. Autonomy [CORRECT]
C. Justice
D. Fidelity
