NU 136 EXAM 2 FUNDAMENTALS OF NURSING EXAM PRACTICE |
COMPREHENSIVE STUDY GUIDE | ADVANCED TESTBANK WITH PRACTICE
QUESTIONS & ANSWERS | LATEST UPDATE 2026/2027
TABLE OF CONTENTS
i. Safety, prioritization, and clinical judgment
ii. Infection prevention and standard precautions
iii. Medication administration and pharmacologic safety
iv. Mobility, positioning, and pressure-injury prevention
v. Nutrition, hydration, and elimination
vi. Oxygenation and respiratory care
vii. Pain, sleep, comfort, and symptom management
viii. Documentation, communication, and patient education
ix. Perioperative and procedural nursing care
x. Delegation, ethics, and professional practice
INTRODUCTION
This NU 136 Exam 2 Fundamentals of Nursing practice examination emphasizes
application of foundational nursing principles in complex clinical situations.
Questions assess safety, infection prevention, medication administration, mobility,
nutrition, elimination, oxygenation, pain management, documentation, patient
education, and professional decision-making. The difficulty progresses beyond
simple recall and requires interpretation of assessment findings, prioritization of
interventions, recognition of complications, and selection of evidence-based
nursing actions. Students should expect realistic clinical scenarios containing
competing priorities, subtle changes in patient status, and plausible distractors. The
examination is designed to strengthen clinical judgment and prepare learners for
rigorous nursing-course assessments by connecting fundamental concepts with
safe, individualized patient care.
Question 1
A nurse receives handoff for four patients. Which patient should the nurse
assess first?
,A. A patient 2 days after abdominal surgery who reports incisional pain of 7/10
before the next scheduled analgesic
B. A patient with pneumonia whose oxygen saturation decreased from 95% to 88%
while receiving oxygen at 2 L/min via nasal cannula
C. A patient with diabetes whose premeal blood glucose is 214 mg/dL
D. A patient awaiting discharge who needs clarification about a newly prescribed
stool softener
🔴 Correct Answer: B. A patient with pneumonia whose oxygen saturation
decreased from 95% to 88% while receiving oxygen at 2 L/min via nasal cannula.
🔵 Explanation: The unexpected decrease in oxygen saturation despite supplemental
oxygen indicates impaired oxygenation and requires immediate assessment. Airway
and breathing threats take priority over pain, hyperglycemia without acute symptoms,
and discharge teaching.
Question 2
A nurse is preparing to administer an oral medication to an older adult who has
difficulty swallowing. Which action is most appropriate?
A. Crush all medications and administer them with applesauce
B. Ask the patient to swallow the medication rapidly with water
C. Verify whether each medication can safely be crushed before altering its form
D. Substitute liquid medication without notifying the prescriber or pharmacist
🔴 Correct Answer: C. Verify whether each medication can safely be crushed
before altering its form.
🔵 Explanation: Some medications, including extended-release, enteric-coated, and
certain sublingual formulations, must not be crushed because doing so can alter
absorption or therapeutic effect. The formulation must be verified before modification.
Question 3
A hospitalized patient has a new prescription for an opioid analgesic. Before
administration, which assessment finding requires the nurse to question the
prescription?
A. Pain rated 8/10
B. Respiratory rate of 8/min
,C. Blood pressure of 138/78 mm Hg
D. Heart rate of 92/min
🔴 Correct Answer: B. Respiratory rate of 8/min.
🔵 Explanation: Opioids can cause respiratory depression. A respiratory rate of 8/min
represents significant hypoventilation and requires immediate clinical evaluation
before administering another opioid dose.
Question 4
A patient on bed rest is at high risk for pressure injury. Which intervention best
addresses the primary mechanism responsible for tissue injury?
A. Massage reddened areas every shift
B. Reposition the patient regularly while minimizing prolonged pressure and shear
C. Place a donut-shaped cushion beneath the sacrum
D. Apply a heating pad to areas exposed to pressure
🔴 Correct Answer: B. Reposition the patient regularly while minimizing
prolonged pressure and shear.
🔵 Explanation: Sustained pressure, particularly when combined with shear,
compromises tissue perfusion and contributes to pressure injury. Repositioning and
pressure redistribution are central preventive interventions. Massage, donut devices,
and heat can worsen tissue damage.
Question 5
A nurse is assisting a weak patient from the bed to a chair. Which action best
reduces the risk of injury?
A. Pull the patient upward by both arms
B. Have the patient stand before the chair is positioned
C. Lock the bed and chair wheels and use an appropriate transfer device
D. Ask the patient to hold onto the nurse's neck during transfer
🔴 Correct Answer: C. Lock the bed and chair wheels and use an appropriate
transfer device.
🔵 Explanation: Safe transfers require environmental stabilization, appropriate
, equipment, and proper body mechanics. Pulling on the patient's arms or neck
increases the risk of injury to both patient and nurse.
Question 6
A patient receiving continuous enteral feeding develops coughing, dyspnea, and a
sudden decrease in oxygen saturation. What should the nurse do first?
A. Increase the feeding rate to compensate for the interruption
B. Stop the feeding and immediately assess respiratory status
C. Flush the feeding tube with 30 mL of water
D. Place the patient flat and obtain a new feeding bag
🔴 Correct Answer: B. Stop the feeding and immediately assess respiratory
status.
🔵 Explanation: Coughing, dyspnea, and hypoxemia during enteral feeding raise
concern for aspiration. The feeding should be stopped while airway and respiratory
status are assessed and appropriate interventions initiated.
Question 7
A patient receiving IV fluids develops new crackles, increasing dyspnea, and
peripheral edema. Which complication should the nurse suspect?
A. Fluid volume deficit
B. Impaired urinary elimination
C. Fluid volume excess
D. Hypoglycemia
🔴 Correct Answer: C. Fluid volume excess.
🔵 Explanation: Crackles, dyspnea, and edema are classic findings associated with
excess intravascular or interstitial fluid. The nurse should promptly assess respiratory
status and notify the appropriate clinician because pulmonary edema may develop.
Question 8
A nurse is caring for a patient with suspected Clostridioides difficile infection. Which
infection-control practice is most appropriate?
COMPREHENSIVE STUDY GUIDE | ADVANCED TESTBANK WITH PRACTICE
QUESTIONS & ANSWERS | LATEST UPDATE 2026/2027
TABLE OF CONTENTS
i. Safety, prioritization, and clinical judgment
ii. Infection prevention and standard precautions
iii. Medication administration and pharmacologic safety
iv. Mobility, positioning, and pressure-injury prevention
v. Nutrition, hydration, and elimination
vi. Oxygenation and respiratory care
vii. Pain, sleep, comfort, and symptom management
viii. Documentation, communication, and patient education
ix. Perioperative and procedural nursing care
x. Delegation, ethics, and professional practice
INTRODUCTION
This NU 136 Exam 2 Fundamentals of Nursing practice examination emphasizes
application of foundational nursing principles in complex clinical situations.
Questions assess safety, infection prevention, medication administration, mobility,
nutrition, elimination, oxygenation, pain management, documentation, patient
education, and professional decision-making. The difficulty progresses beyond
simple recall and requires interpretation of assessment findings, prioritization of
interventions, recognition of complications, and selection of evidence-based
nursing actions. Students should expect realistic clinical scenarios containing
competing priorities, subtle changes in patient status, and plausible distractors. The
examination is designed to strengthen clinical judgment and prepare learners for
rigorous nursing-course assessments by connecting fundamental concepts with
safe, individualized patient care.
Question 1
A nurse receives handoff for four patients. Which patient should the nurse
assess first?
,A. A patient 2 days after abdominal surgery who reports incisional pain of 7/10
before the next scheduled analgesic
B. A patient with pneumonia whose oxygen saturation decreased from 95% to 88%
while receiving oxygen at 2 L/min via nasal cannula
C. A patient with diabetes whose premeal blood glucose is 214 mg/dL
D. A patient awaiting discharge who needs clarification about a newly prescribed
stool softener
🔴 Correct Answer: B. A patient with pneumonia whose oxygen saturation
decreased from 95% to 88% while receiving oxygen at 2 L/min via nasal cannula.
🔵 Explanation: The unexpected decrease in oxygen saturation despite supplemental
oxygen indicates impaired oxygenation and requires immediate assessment. Airway
and breathing threats take priority over pain, hyperglycemia without acute symptoms,
and discharge teaching.
Question 2
A nurse is preparing to administer an oral medication to an older adult who has
difficulty swallowing. Which action is most appropriate?
A. Crush all medications and administer them with applesauce
B. Ask the patient to swallow the medication rapidly with water
C. Verify whether each medication can safely be crushed before altering its form
D. Substitute liquid medication without notifying the prescriber or pharmacist
🔴 Correct Answer: C. Verify whether each medication can safely be crushed
before altering its form.
🔵 Explanation: Some medications, including extended-release, enteric-coated, and
certain sublingual formulations, must not be crushed because doing so can alter
absorption or therapeutic effect. The formulation must be verified before modification.
Question 3
A hospitalized patient has a new prescription for an opioid analgesic. Before
administration, which assessment finding requires the nurse to question the
prescription?
A. Pain rated 8/10
B. Respiratory rate of 8/min
,C. Blood pressure of 138/78 mm Hg
D. Heart rate of 92/min
🔴 Correct Answer: B. Respiratory rate of 8/min.
🔵 Explanation: Opioids can cause respiratory depression. A respiratory rate of 8/min
represents significant hypoventilation and requires immediate clinical evaluation
before administering another opioid dose.
Question 4
A patient on bed rest is at high risk for pressure injury. Which intervention best
addresses the primary mechanism responsible for tissue injury?
A. Massage reddened areas every shift
B. Reposition the patient regularly while minimizing prolonged pressure and shear
C. Place a donut-shaped cushion beneath the sacrum
D. Apply a heating pad to areas exposed to pressure
🔴 Correct Answer: B. Reposition the patient regularly while minimizing
prolonged pressure and shear.
🔵 Explanation: Sustained pressure, particularly when combined with shear,
compromises tissue perfusion and contributes to pressure injury. Repositioning and
pressure redistribution are central preventive interventions. Massage, donut devices,
and heat can worsen tissue damage.
Question 5
A nurse is assisting a weak patient from the bed to a chair. Which action best
reduces the risk of injury?
A. Pull the patient upward by both arms
B. Have the patient stand before the chair is positioned
C. Lock the bed and chair wheels and use an appropriate transfer device
D. Ask the patient to hold onto the nurse's neck during transfer
🔴 Correct Answer: C. Lock the bed and chair wheels and use an appropriate
transfer device.
🔵 Explanation: Safe transfers require environmental stabilization, appropriate
, equipment, and proper body mechanics. Pulling on the patient's arms or neck
increases the risk of injury to both patient and nurse.
Question 6
A patient receiving continuous enteral feeding develops coughing, dyspnea, and a
sudden decrease in oxygen saturation. What should the nurse do first?
A. Increase the feeding rate to compensate for the interruption
B. Stop the feeding and immediately assess respiratory status
C. Flush the feeding tube with 30 mL of water
D. Place the patient flat and obtain a new feeding bag
🔴 Correct Answer: B. Stop the feeding and immediately assess respiratory
status.
🔵 Explanation: Coughing, dyspnea, and hypoxemia during enteral feeding raise
concern for aspiration. The feeding should be stopped while airway and respiratory
status are assessed and appropriate interventions initiated.
Question 7
A patient receiving IV fluids develops new crackles, increasing dyspnea, and
peripheral edema. Which complication should the nurse suspect?
A. Fluid volume deficit
B. Impaired urinary elimination
C. Fluid volume excess
D. Hypoglycemia
🔴 Correct Answer: C. Fluid volume excess.
🔵 Explanation: Crackles, dyspnea, and edema are classic findings associated with
excess intravascular or interstitial fluid. The nurse should promptly assess respiratory
status and notify the appropriate clinician because pulmonary edema may develop.
Question 8
A nurse is caring for a patient with suspected Clostridioides difficile infection. Which
infection-control practice is most appropriate?
