Fundamental Concepts & Skills for Nursing Practice EXAM
with Questions and Answers/Plus a Rationale Updated 2026
A+/Instant Download PDF
EXAM COVERAGE
1. The Nursing Process (Assessment, Diagnosis, Planning, Implementation, Evaluation)
2. Critical Thinking, Clinical Judgment, and Decision-Making
3. Patient Safety, Infection Control, and Environmental Safety
4. Vital Signs and Physical Health Assessment Techniques
5. Medication Administration and Safe Clinical Calculations
6. Hygiene, Skin Integrity, and Pressure Injury Prevention
7. Mobility, Immobility Hazards, and Body Mechanics
8. Oxygenation, Fluid, Electrolyte, and Acid-Base Balance
9. Perioperative Nursing Care and Wound Management
1. A registered nurse is reviewing the plan of care for a newly admitted client who exhibits signs of
fluid volume deficit. Which phase of the nursing process is the nurse utilizing when synthesizing
objective laboratory values and subjective statements to establish a nursing diagnosis?
A. Assessment
B. Diagnosis
C. Implementation
D. Evaluation
, CORRECT ANSWER : B
Rationale: The diagnosis phase involves analyzing and synthesizing collected assessment data to
identify client strengths, actual health problems, or risks that can be addressed by nursing
interventions. Assessment focuses strictly on data collection, implementation executes the plan,
and evaluation measures goal attainment.
2. A nurse is evaluating a client's risk for pressure injury development using the Braden Scale.
Which intervention should the nurse integrate into the care plan for a client identified as having
moderate risk?
A. Applying a transparent occlusive dressing over all bony prominences proactively.
B. Repositioning the client every two hours and maintaining a dry, clean skin surface.
C. Massaging reddened areas over the sacrum vigorously every four hours to stimulate blood
flow.
D. Restricting protein intake to minimize metabolic waste and skin breakdown.
CORRECT ANSWER : B
Rationale: Regular repositioning every two hours relieves sustained capillary pressure, which is
the primary cause of pressure injuries, while keeping skin clean and dry prevents moisture-
associated skin damage. Massaging reddened bony prominences is contraindicated because it
causes deep tissue trauma, and protein restriction impairs tissue healing.
3. A medical-surgical nurse receives a morning shift report on four clients. Which client should the
nurse assess first?
A. A client with chronic stable angina requesting a routine morning bath.
B. A client post-thyroidectomy exhibiting new-onset stridor and restlessness.
C. A client diagnosed with type 2 diabetes mellitus with a fasting blood glucose of 135 mg/dL.
D. A client awaiting discharge instructions scheduled for 11:00 AM.
CORRECT ANSWER : B
Rationale: Using ABC (Airway, Breathing, Circulation) prioritization, a client demonstrating
post-thyroidectomy stridor is experiencing acute upper airway obstruction, which is an
immediate life-threatening emergency requiring instant intervention. The other clients are stable
and do not represent acute physiological crises.
,4. A nurse is preparing to administer several oral medications to a client who has a fine-bore
nasogastric tube in place for enteral nutrition. Which action is essential for the nurse to perform
prior to administration?
A. Crush enteric-coated tablets finely and mix them directly into the continuous tube-feeding
formula bag.
B. Flush the tube with 30 mL of sterile water before and after administering each separate
medication.
C. Mix all liquid and crushed medications together in a single cup to decrease the number of
flushes.
D. Clamp the nasogastric tube for two hours following medication administration to optimize
systemic absorption.
CORRECT ANSWER : B
Rationale: Flushing feeding tubes with water before, between, and after each medication
prevents tube occlusion caused by drug interactions or residue buildup. Crushing enteric-coated
tablets alters their pharmacokinetics, mixing drugs together increases the risk of physical
incompatibilities, and clamping continuous feeds unnecessarily disrupts nutrition.
5. A home health nurse is conducting an environmental safety assessment for an older adult client
with a history of unsteady gait. Which observation represents the highest priority hazard that
requires immediate correction?
A. Grab bars securely installed inside the bathtub enclosure and next to the toilet.
B. Adequate overhead lighting in the primary hallway and stairwell.
C. Unsecured, frayed-edge throw rugs placed across polished hardwood flooring.
D. Electrical cords routed neatly behind heavy furniture units.
CORRECT ANSWER : C
Rationale: Unsecured throw rugs present a severe, immediate environmental trip hazard that
frequently leads to falls and hip fractures in vulnerable older adults. The other options describe
protective safety measures or safely managed elements.
6. While performing an initial physical assessment, a nurse utilizes inspection as the first technique
for several body systems. Which core action defines proper inspection technique?
A. Using the fingertips to assess skin turgor and underlying masses.
, B. Striking the body surface to produce vibrations and evaluate tissue density.
C. Visually observing the client's overall appearance, symmetry, and specific body
structures deliberately.
D. Listening to vascular sounds using the bell of a stethoscope.
CORRECT ANSWER : C
Rationale: Inspection involves meticulous, deliberate visual observation of the client's body,
appearance, and behavior, and it always precedes palpation, percussion, and auscultation.
Palpation uses touch, percussion involves striking, and auscultation involves listening.
7. A nurse is caring for an adult client who develops a sudden febrile episode, shivering, and
generalized malaise. Which physiological mechanism accounts for the initial onset of chills?
A. The hypothalamus lowers the body's set point, triggering systemic vasodilation and sweating.
B. The hypothalamus raises the set point, causing vasoconstriction and involuntary muscle
contractions to generate heat.
C. Peripheral thermoreceptors send inhibitory signals to skeletal muscles to stop metabolic heat
production.
D. The sympathetic nervous system shuts down metabolic basal rates to conserve core thermal
energy.
CORRECT ANSWER : B
Rationale: During a fever, pyrogens reset the hypothalamic thermostat to a higher temperature;
the body responds by initiating heat-producing mechanisms, such as shivering and peripheral
vasoconstriction, until the blood matches the new set point.
8. A nurse is reviewing standard precautions and transmission-based precautions with a nursing
student. Which client requires the implementation of airborne precautions?
A. A client diagnosed with Clostridium difficile colitis.
B. A client with influenza presenting with severe cough and fever.
C. A client evaluated for active pulmonary tuberculosis.
D. A client with a localized wound infection caused by methicillin-resistant Staphylococcus
aureus.
CORRECT ANSWER : C
with Questions and Answers/Plus a Rationale Updated 2026
A+/Instant Download PDF
EXAM COVERAGE
1. The Nursing Process (Assessment, Diagnosis, Planning, Implementation, Evaluation)
2. Critical Thinking, Clinical Judgment, and Decision-Making
3. Patient Safety, Infection Control, and Environmental Safety
4. Vital Signs and Physical Health Assessment Techniques
5. Medication Administration and Safe Clinical Calculations
6. Hygiene, Skin Integrity, and Pressure Injury Prevention
7. Mobility, Immobility Hazards, and Body Mechanics
8. Oxygenation, Fluid, Electrolyte, and Acid-Base Balance
9. Perioperative Nursing Care and Wound Management
1. A registered nurse is reviewing the plan of care for a newly admitted client who exhibits signs of
fluid volume deficit. Which phase of the nursing process is the nurse utilizing when synthesizing
objective laboratory values and subjective statements to establish a nursing diagnosis?
A. Assessment
B. Diagnosis
C. Implementation
D. Evaluation
, CORRECT ANSWER : B
Rationale: The diagnosis phase involves analyzing and synthesizing collected assessment data to
identify client strengths, actual health problems, or risks that can be addressed by nursing
interventions. Assessment focuses strictly on data collection, implementation executes the plan,
and evaluation measures goal attainment.
2. A nurse is evaluating a client's risk for pressure injury development using the Braden Scale.
Which intervention should the nurse integrate into the care plan for a client identified as having
moderate risk?
A. Applying a transparent occlusive dressing over all bony prominences proactively.
B. Repositioning the client every two hours and maintaining a dry, clean skin surface.
C. Massaging reddened areas over the sacrum vigorously every four hours to stimulate blood
flow.
D. Restricting protein intake to minimize metabolic waste and skin breakdown.
CORRECT ANSWER : B
Rationale: Regular repositioning every two hours relieves sustained capillary pressure, which is
the primary cause of pressure injuries, while keeping skin clean and dry prevents moisture-
associated skin damage. Massaging reddened bony prominences is contraindicated because it
causes deep tissue trauma, and protein restriction impairs tissue healing.
3. A medical-surgical nurse receives a morning shift report on four clients. Which client should the
nurse assess first?
A. A client with chronic stable angina requesting a routine morning bath.
B. A client post-thyroidectomy exhibiting new-onset stridor and restlessness.
C. A client diagnosed with type 2 diabetes mellitus with a fasting blood glucose of 135 mg/dL.
D. A client awaiting discharge instructions scheduled for 11:00 AM.
CORRECT ANSWER : B
Rationale: Using ABC (Airway, Breathing, Circulation) prioritization, a client demonstrating
post-thyroidectomy stridor is experiencing acute upper airway obstruction, which is an
immediate life-threatening emergency requiring instant intervention. The other clients are stable
and do not represent acute physiological crises.
,4. A nurse is preparing to administer several oral medications to a client who has a fine-bore
nasogastric tube in place for enteral nutrition. Which action is essential for the nurse to perform
prior to administration?
A. Crush enteric-coated tablets finely and mix them directly into the continuous tube-feeding
formula bag.
B. Flush the tube with 30 mL of sterile water before and after administering each separate
medication.
C. Mix all liquid and crushed medications together in a single cup to decrease the number of
flushes.
D. Clamp the nasogastric tube for two hours following medication administration to optimize
systemic absorption.
CORRECT ANSWER : B
Rationale: Flushing feeding tubes with water before, between, and after each medication
prevents tube occlusion caused by drug interactions or residue buildup. Crushing enteric-coated
tablets alters their pharmacokinetics, mixing drugs together increases the risk of physical
incompatibilities, and clamping continuous feeds unnecessarily disrupts nutrition.
5. A home health nurse is conducting an environmental safety assessment for an older adult client
with a history of unsteady gait. Which observation represents the highest priority hazard that
requires immediate correction?
A. Grab bars securely installed inside the bathtub enclosure and next to the toilet.
B. Adequate overhead lighting in the primary hallway and stairwell.
C. Unsecured, frayed-edge throw rugs placed across polished hardwood flooring.
D. Electrical cords routed neatly behind heavy furniture units.
CORRECT ANSWER : C
Rationale: Unsecured throw rugs present a severe, immediate environmental trip hazard that
frequently leads to falls and hip fractures in vulnerable older adults. The other options describe
protective safety measures or safely managed elements.
6. While performing an initial physical assessment, a nurse utilizes inspection as the first technique
for several body systems. Which core action defines proper inspection technique?
A. Using the fingertips to assess skin turgor and underlying masses.
, B. Striking the body surface to produce vibrations and evaluate tissue density.
C. Visually observing the client's overall appearance, symmetry, and specific body
structures deliberately.
D. Listening to vascular sounds using the bell of a stethoscope.
CORRECT ANSWER : C
Rationale: Inspection involves meticulous, deliberate visual observation of the client's body,
appearance, and behavior, and it always precedes palpation, percussion, and auscultation.
Palpation uses touch, percussion involves striking, and auscultation involves listening.
7. A nurse is caring for an adult client who develops a sudden febrile episode, shivering, and
generalized malaise. Which physiological mechanism accounts for the initial onset of chills?
A. The hypothalamus lowers the body's set point, triggering systemic vasodilation and sweating.
B. The hypothalamus raises the set point, causing vasoconstriction and involuntary muscle
contractions to generate heat.
C. Peripheral thermoreceptors send inhibitory signals to skeletal muscles to stop metabolic heat
production.
D. The sympathetic nervous system shuts down metabolic basal rates to conserve core thermal
energy.
CORRECT ANSWER : B
Rationale: During a fever, pyrogens reset the hypothalamic thermostat to a higher temperature;
the body responds by initiating heat-producing mechanisms, such as shivering and peripheral
vasoconstriction, until the blood matches the new set point.
8. A nurse is reviewing standard precautions and transmission-based precautions with a nursing
student. Which client requires the implementation of airborne precautions?
A. A client diagnosed with Clostridium difficile colitis.
B. A client with influenza presenting with severe cough and fever.
C. A client evaluated for active pulmonary tuberculosis.
D. A client with a localized wound infection caused by methicillin-resistant Staphylococcus
aureus.
CORRECT ANSWER : C
