for Nursing Practice | Galen College | Q & A | 2026/2027
Edition (PDF)
1. A nurse is caring for a client and notes that the client has difficulty breathing. The client's oxygen
saturation is 88%. What is the nurse's priority action?
A) Document the findings in the client's chart
B) Place the client in a high-Fowler's position and notify the provider
C) Administer a PRN sedative to calm the client
D) Ask the client to rate their pain on a scale of 0 to 10
Correct Answer: Place the client in a high-Fowler's position and notify the provider
Rationale: The client is experiencing respiratory distress with hypoxia. The priority action is to position
the client to maximize oxygenation (high-Fowler's) and notify the provider for further orders.
Documentation is important but not the priority, and a sedative would worsen respiratory depression.
2. A nurse is performing an admission assessment. Which data source is considered primary?
A) A family member's description of the client's symptoms
B) The client's verbal description of their symptoms
C) The client's medical record from another facility
D) The emergency department provider's notes
Correct Answer: The client's verbal description of their symptoms
Rationale: The client is the primary source of data. Family members, medical records, and other
healthcare providers are secondary sources of information.
3. A nurse is formulating a nursing diagnosis. Which statement demonstrates the correct NANDA-I
format?
A) Risk for Infection related to surgical incision as evidenced by redness
,B) Acute Pain related to incisional trauma as evidenced by client report of 8/10 pain
C) Acute Pain related to surgical incision as evidenced by client report of pain
D) Pain caused by surgery
Correct Answer: Acute Pain related to surgical incision as evidenced by client report of pain
Rationale: The correct format is "Nursing Diagnosis (problem) related to (etiology) as evidenced by
(defining characteristics)". Option C includes all three components correctly. Option A uses "Risk for"
incorrectly with "as evidenced by" (risk diagnoses use "as evidenced by" only when describing risk
factors, not actual signs).
4. A client is exhibiting signs of fatigue, acute pain, lack of knowledge, and disturbed body image. Which
nursing diagnosis should the nurse address first while planning care?
A) Fatigue
B) Acute pain
C) Lack of knowledge
D) Disturbed body image
Correct Answer: Acute pain
Rationale: According to Maslow's Hierarchy of Needs, physiological needs (like pain, breathing, and
circulation) always take priority over psychosocial needs (body image) or safety needs (knowledge
deficits). Unmanaged acute pain can lead to physiological instability, making it the priority.
5. A nurse is preparing to administer oral medications to a client. Which action demonstrates the best
practice for preventing medication errors?
A) Administer all medications at the same time
B) Compare the medication label with the MAR at the bedside
C) Verify the client's name using two identifiers before administration
D) Ask the client if they recognize the medication
, Correct Answer: Verify the client's name using two identifiers before administration
Rationale: Using two patient identifiers (e.g., name and date of birth) is a standard safety practice to
ensure the correct patient and reduce medication errors.
6. Which of the following is the most effective way to break the chain of infection?
A) Wearing gloves for all patient contact
B) Proper hand hygiene before and after patient care
C) Using disposable equipment only
D) Placing all patients on contact precautions
Correct Answer: Proper hand hygiene before and after patient care
Rationale: Hand hygiene is the single most effective measure to prevent the transmission of pathogens
in healthcare settings.
7. A client with suspected tuberculosis is admitted. The nurse should place the client in which type of
room?
A) A standard semiprivate room
B) A negative-pressure airborne infection isolation room
C) A positive-pressure room
D) A room with a HEPA filter only
Correct Answer: A negative-pressure airborne infection isolation room
Rationale: Tuberculosis is transmitted via airborne droplet nuclei and requires airborne precautions. This
requires a negative-pressure room with at least 6-12 air exchanges per hour.
8. When communicating with an older adult who has a hearing impairment, which strategy is most
appropriate?