NR 446
EXAM 1
Verified Questions & Answers With Rationales
(Collaborative Healthcare)
Chamberlain
IT COVERS CONTENT
from Week 1, Week 2, and Week 3
,1. A nurse manager must assign limited staff to two units. One unit has higher
acuity clients; the other has stable clients. Which ethical principle should guide
the manager's decision?
A. Autonomy
B. Fidelity
C. Justice
D. Veracity
Correct Answer: C
Rationale: Justice = fairness and equitable distribution of resources. Higher acuity units
require more staffing to ensure safe care.
NCLEX Tip: Resource allocation questions almost always test justice.
2. A nurse enters a client's room and notes the following findings:
Respiratory rate: 28/min
Oxygen saturation: 90% on room air
Client is sitting upright and using accessory muscles
Blood pressure: 136/82 mm Hg
Heart rate: 104 bpm
Which action should the nurse take first?
A. Obtain a STAT chest x-ray
B. Apply supplemental oxygen
C. Notify the provider
D. Obtain a full set of vital signs
Correct Answer: B
Rationale: Breathing is compromised (tachypnea, accessory muscle use, borderline
SpO2). The nurse does not delay intervention to collect more data when oxygenation is
threatened. Applying oxygen is within nursing scope and addresses immediate need.
Why the others are wrong:
- A: Diagnostic tests come after stabilization.
- C: The nurse intervenes before notifying.
, - D: Enough data already shows a breathing problem.
NCLEX Insight: If breathing is impaired, intervene immediately — assessment is
already complete.
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3. A nurse is caring for a client who reports dizziness when standing. What
should the nurse do first?
A. Assist the client to the rest room
B. Obtain orthostatic vital signs
C. Notify the provider
D. Administer IV fluids
Correct Answer: B
Rationale: Nursing Process = Assess before Act. Orthostatic vitals gather data to
determine cause. Interventions and provider notification come after assessment.
Test-Taking Tip: If you haven't collected data yet, the answer is usually assessment.
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4. Which client should the nurse assess first?
A. Client with chronic back pain requesting PRN medication
B. Client with anxiety awaiting biopsy results
C. Client with shallow respirations after opioid administration
D. Client requesting assistance with hygiene
Correct Answer: C
Rationale: Opioids depress respiration → airway and breathing risk. Maslow + ABC
place respiratory status above pain and emotional needs.
NCLEX Insight: Pain is important — until breathing isn't.
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EXAM 1
Verified Questions & Answers With Rationales
(Collaborative Healthcare)
Chamberlain
IT COVERS CONTENT
from Week 1, Week 2, and Week 3
,1. A nurse manager must assign limited staff to two units. One unit has higher
acuity clients; the other has stable clients. Which ethical principle should guide
the manager's decision?
A. Autonomy
B. Fidelity
C. Justice
D. Veracity
Correct Answer: C
Rationale: Justice = fairness and equitable distribution of resources. Higher acuity units
require more staffing to ensure safe care.
NCLEX Tip: Resource allocation questions almost always test justice.
2. A nurse enters a client's room and notes the following findings:
Respiratory rate: 28/min
Oxygen saturation: 90% on room air
Client is sitting upright and using accessory muscles
Blood pressure: 136/82 mm Hg
Heart rate: 104 bpm
Which action should the nurse take first?
A. Obtain a STAT chest x-ray
B. Apply supplemental oxygen
C. Notify the provider
D. Obtain a full set of vital signs
Correct Answer: B
Rationale: Breathing is compromised (tachypnea, accessory muscle use, borderline
SpO2). The nurse does not delay intervention to collect more data when oxygenation is
threatened. Applying oxygen is within nursing scope and addresses immediate need.
Why the others are wrong:
- A: Diagnostic tests come after stabilization.
- C: The nurse intervenes before notifying.
, - D: Enough data already shows a breathing problem.
NCLEX Insight: If breathing is impaired, intervene immediately — assessment is
already complete.
---
3. A nurse is caring for a client who reports dizziness when standing. What
should the nurse do first?
A. Assist the client to the rest room
B. Obtain orthostatic vital signs
C. Notify the provider
D. Administer IV fluids
Correct Answer: B
Rationale: Nursing Process = Assess before Act. Orthostatic vitals gather data to
determine cause. Interventions and provider notification come after assessment.
Test-Taking Tip: If you haven't collected data yet, the answer is usually assessment.
---
4. Which client should the nurse assess first?
A. Client with chronic back pain requesting PRN medication
B. Client with anxiety awaiting biopsy results
C. Client with shallow respirations after opioid administration
D. Client requesting assistance with hygiene
Correct Answer: C
Rationale: Opioids depress respiration → airway and breathing risk. Maslow + ABC
place respiratory status above pain and emotional needs.
NCLEX Insight: Pain is important — until breathing isn't.
---
