NUR 104 Midterm Exam Prep Document 2026/2027 | Foundations
of Nursing, Clinical Judgment & NGN Fundamentals Review | 50
Verified Questions with Detailed Rationales
This exam contains verified questions drawn from actual NUR 104 midterm content at Excelsior
University for the 2026/2027 academic year. It addresses the foundations of nursing practice, the
nursing process, health assessment and basic care needs, pharmacology and medication administration,
safety and infection control, ethical and legal issues, and the application of the NCSBN Clinical Judgment
Measurement Model to clinical scenarios. Questions are designed to test the essential competencies
required for success in the midterm and for progression in the nursing curriculum.
Section 1: Foundations of Nursing Practice & The Nursing Process — Questions 1–13
Q1: The nursing process is a systematic, problem-solving approach used to deliver patient-centered
care. What are the five steps of the nursing process in correct sequential order?
A. Planning, Diagnosis, Assessment, Implementation, Evaluation
B. Assessment, Diagnosis, Planning, Implementation, Evaluation [CORRECT]
C. Diagnosis, Assessment, Planning, Evaluation, Implementation
D. Implementation, Assessment, Diagnosis, Planning, Evaluation
Correct Answer: B
Rationale: The best answer is B. This choice is correct because the nursing process follows a logical
sequence: first you assess the patient to gather data, then analyze that data to form a nursing diagnosis,
next you plan interventions to address the diagnosis, then you implement those interventions, and
finally you evaluate whether the goals were met. This ADPIE framework guides organized, evidence-
based nursing care from start to finish.
Q2: A nurse is collecting data during the admission of a new patient. The patient states, "I have been
having chest pain for the past two days that gets worse when I walk." This statement is an example of:
A. Objective data
B. Subjective data [CORRECT]
,C. A nursing diagnosis
D. A medical diagnosis
Correct Answer: B
Rationale: The best answer is B. This choice is correct because subjective data is information that comes
directly from the patient—their symptoms, feelings, perceptions, and concerns that cannot be
measured or observed by someone else. The patient's description of chest pain is their personal
experience and report, making it subjective. Objective data would be something the nurse could
measure or observe, like vital signs or skin color.
Q3: During which step of the nursing process does the nurse identify patient problems and formulate
nursing diagnoses?
A. Assessment
B. Diagnosis [CORRECT]
C. Planning
D. Implementation
Correct Answer: B
Rationale: The best answer is B. This choice is correct because the diagnosis step is where the nurse
analyzes the assessment data, identifies patterns, and formulates nursing diagnoses that describe
patient responses to actual or potential health problems. This is distinct from the assessment step,
which is purely data collection, and from planning, which comes after the diagnoses are established.
Q4: A nurse is caring for a patient from a culture that believes illness is caused by an imbalance in
spiritual energy. The nurse incorporates this belief into the care plan by including meditation and prayer
alongside medical treatments. This demonstrates:
A. Cultural imposition
B. Cultural competence [CORRECT]
C. Cultural blindness
D. Ethnocentrism
Correct Answer: B
Rationale: The best answer is B. This choice is correct because cultural competence means respecting
and integrating a patient's cultural beliefs and practices into their care plan. By including meditation and
prayer alongside medical treatments, the nurse honors the patient's worldview while still providing
evidence-based care. This approach builds trust and improves health outcomes by aligning care with the
patient's values.
, Q5: Which ethical principle is demonstrated when a nurse respects a patient's decision to refuse
chemotherapy for terminal cancer, even though the nurse personally believes treatment would be
beneficial?
A. Beneficence
B. Autonomy [CORRECT]
C. Justice
D. Nonmaleficence
Correct Answer: B
Rationale: The best answer is B. This choice is correct because autonomy is the ethical principle that
recognizes a patient's right to self-determination and to make informed decisions about their own care,
free from coercion. Respecting a patient's informed refusal—even when the nurse disagrees—is a
fundamental professional obligation. Beneficence would mean doing good, but autonomy takes
precedence when the patient is competent and informed.
Q6: A nurse is documenting patient care using the PIE format. What do the letters P, I, and E represent?
A. Problem, Intervention, Evaluation [CORRECT]
B. Patient, Information, Education
C. Planning, Implementation, Evidence
D. Pain, Intervention, Effect
Correct Answer: A
Rationale: The best answer is A. This choice is correct because PIE is a focused documentation format
that stands for Problem (the nursing diagnosis or issue), Intervention (what the nurse did about it), and
Evaluation (whether the intervention was effective). It is a streamlined alternative to SOAP that keeps
documentation centered on the nursing process and patient outcomes.
Q7: Which of the following is a key difference between a medical diagnosis and a nursing diagnosis?
A. A medical diagnosis is made by nurses, and a nursing diagnosis is made by physicians
B. A medical diagnosis identifies a disease or pathology, while a nursing diagnosis identifies a patient's
response to a health condition [CORRECT]
C. There is no difference; the terms are interchangeable
D. A nursing diagnosis is more serious than a medical diagnosis
Correct Answer: B
of Nursing, Clinical Judgment & NGN Fundamentals Review | 50
Verified Questions with Detailed Rationales
This exam contains verified questions drawn from actual NUR 104 midterm content at Excelsior
University for the 2026/2027 academic year. It addresses the foundations of nursing practice, the
nursing process, health assessment and basic care needs, pharmacology and medication administration,
safety and infection control, ethical and legal issues, and the application of the NCSBN Clinical Judgment
Measurement Model to clinical scenarios. Questions are designed to test the essential competencies
required for success in the midterm and for progression in the nursing curriculum.
Section 1: Foundations of Nursing Practice & The Nursing Process — Questions 1–13
Q1: The nursing process is a systematic, problem-solving approach used to deliver patient-centered
care. What are the five steps of the nursing process in correct sequential order?
A. Planning, Diagnosis, Assessment, Implementation, Evaluation
B. Assessment, Diagnosis, Planning, Implementation, Evaluation [CORRECT]
C. Diagnosis, Assessment, Planning, Evaluation, Implementation
D. Implementation, Assessment, Diagnosis, Planning, Evaluation
Correct Answer: B
Rationale: The best answer is B. This choice is correct because the nursing process follows a logical
sequence: first you assess the patient to gather data, then analyze that data to form a nursing diagnosis,
next you plan interventions to address the diagnosis, then you implement those interventions, and
finally you evaluate whether the goals were met. This ADPIE framework guides organized, evidence-
based nursing care from start to finish.
Q2: A nurse is collecting data during the admission of a new patient. The patient states, "I have been
having chest pain for the past two days that gets worse when I walk." This statement is an example of:
A. Objective data
B. Subjective data [CORRECT]
,C. A nursing diagnosis
D. A medical diagnosis
Correct Answer: B
Rationale: The best answer is B. This choice is correct because subjective data is information that comes
directly from the patient—their symptoms, feelings, perceptions, and concerns that cannot be
measured or observed by someone else. The patient's description of chest pain is their personal
experience and report, making it subjective. Objective data would be something the nurse could
measure or observe, like vital signs or skin color.
Q3: During which step of the nursing process does the nurse identify patient problems and formulate
nursing diagnoses?
A. Assessment
B. Diagnosis [CORRECT]
C. Planning
D. Implementation
Correct Answer: B
Rationale: The best answer is B. This choice is correct because the diagnosis step is where the nurse
analyzes the assessment data, identifies patterns, and formulates nursing diagnoses that describe
patient responses to actual or potential health problems. This is distinct from the assessment step,
which is purely data collection, and from planning, which comes after the diagnoses are established.
Q4: A nurse is caring for a patient from a culture that believes illness is caused by an imbalance in
spiritual energy. The nurse incorporates this belief into the care plan by including meditation and prayer
alongside medical treatments. This demonstrates:
A. Cultural imposition
B. Cultural competence [CORRECT]
C. Cultural blindness
D. Ethnocentrism
Correct Answer: B
Rationale: The best answer is B. This choice is correct because cultural competence means respecting
and integrating a patient's cultural beliefs and practices into their care plan. By including meditation and
prayer alongside medical treatments, the nurse honors the patient's worldview while still providing
evidence-based care. This approach builds trust and improves health outcomes by aligning care with the
patient's values.
, Q5: Which ethical principle is demonstrated when a nurse respects a patient's decision to refuse
chemotherapy for terminal cancer, even though the nurse personally believes treatment would be
beneficial?
A. Beneficence
B. Autonomy [CORRECT]
C. Justice
D. Nonmaleficence
Correct Answer: B
Rationale: The best answer is B. This choice is correct because autonomy is the ethical principle that
recognizes a patient's right to self-determination and to make informed decisions about their own care,
free from coercion. Respecting a patient's informed refusal—even when the nurse disagrees—is a
fundamental professional obligation. Beneficence would mean doing good, but autonomy takes
precedence when the patient is competent and informed.
Q6: A nurse is documenting patient care using the PIE format. What do the letters P, I, and E represent?
A. Problem, Intervention, Evaluation [CORRECT]
B. Patient, Information, Education
C. Planning, Implementation, Evidence
D. Pain, Intervention, Effect
Correct Answer: A
Rationale: The best answer is A. This choice is correct because PIE is a focused documentation format
that stands for Problem (the nursing diagnosis or issue), Intervention (what the nurse did about it), and
Evaluation (whether the intervention was effective). It is a streamlined alternative to SOAP that keeps
documentation centered on the nursing process and patient outcomes.
Q7: Which of the following is a key difference between a medical diagnosis and a nursing diagnosis?
A. A medical diagnosis is made by nurses, and a nursing diagnosis is made by physicians
B. A medical diagnosis identifies a disease or pathology, while a nursing diagnosis identifies a patient's
response to a health condition [CORRECT]
C. There is no difference; the terms are interchangeable
D. A nursing diagnosis is more serious than a medical diagnosis
Correct Answer: B
