NSG 3130 EXAM 1: FUNDAMENTAL
CONCEPTS & SKILLS FOR NURSING
PRACTICE II
1. A nurse is preparing to administer an oral medication that has a high first-pass effect.
Which of the following is the most important clinical consideration?
A. The medication will have a faster onset of action.
B. The medication must be taken on an empty stomach to avoid interaction.
C. The medication is not metabolized by the liver.
D. A higher dose of the medication is usually required compared to the IV route.
Answer: D
Conceptual Explanation: The first-pass effect refers to the metabolism of a drug in the
liver before it reaches systemic circulation. Drugs with a high first-pass effect require
higher oral doses to achieve therapeutic levels compared to parenteral routes.
2. When performing a physical assessment of a patient’s abdomen, in which order should the
nurse perform the steps?
A. Inspection, Palpation, Percussion, Auscultation
,B. Auscultation, Inspection, Palpation, Percussion
C. Inspection, Auscultation, Percussion, Palpation
D. Palpation, Percussion, Auscultation, Inspection
Answer: C
Conceptual Explanation: For the abdominal assessment, the correct order is inspection,
auscultation, percussion, and palpation. Palpation and percussion are done last to avoid
stimulating bowel sounds, which could lead to false auscultation findings.
3. A nurse is caring for a patient diagnosed with Clostridioides difficile (C. diff). Which
infection control measure is mandatory after providing direct patient care?
A. Use of alcohol-based hand sanitizer.
B. Wiping down the stethoscope with alcohol wipes only.
C. Washing hands with soap and water.
D. Using a surgical mask when entering the room.
Answer: C
Conceptual Explanation: C. diff spores are resistant to alcohol-based sanitizers.
Handwashing with soap and water is mechanical and necessary to remove the spores from
the skin.
, 4. A provider orders an IV potassium chloride bolus for a patient with hypokalemia. What is
the nurse’s most critical action?
A. Administer the medication via IV push over 2 minutes.
B. Dilute the medication and ensure it is administered via an infusion pump.
C. Assess the patient’s radial pulse for one full minute.
D. Check the patient’s blood pressure immediately after administration.
Answer: B
Conceptual Explanation: Potassium chloride must never be given by IV push as it can
cause immediate cardiac arrest. It must always be diluted and administered via an infusion
pump at a controlled rate.
5. Which of the following findings would the nurse identify as a classic sign of orthostatic
hypotension?
A. A decrease in heart rate when moving from lying to standing.
B. A decrease in systolic BP of at least 20 mmHg within 3 minutes of standing.
C. An increase in systolic BP by 20 mmHg when sitting up.
D. Patient reporting feeling energetic upon standing.
Answer: B
CONCEPTS & SKILLS FOR NURSING
PRACTICE II
1. A nurse is preparing to administer an oral medication that has a high first-pass effect.
Which of the following is the most important clinical consideration?
A. The medication will have a faster onset of action.
B. The medication must be taken on an empty stomach to avoid interaction.
C. The medication is not metabolized by the liver.
D. A higher dose of the medication is usually required compared to the IV route.
Answer: D
Conceptual Explanation: The first-pass effect refers to the metabolism of a drug in the
liver before it reaches systemic circulation. Drugs with a high first-pass effect require
higher oral doses to achieve therapeutic levels compared to parenteral routes.
2. When performing a physical assessment of a patient’s abdomen, in which order should the
nurse perform the steps?
A. Inspection, Palpation, Percussion, Auscultation
,B. Auscultation, Inspection, Palpation, Percussion
C. Inspection, Auscultation, Percussion, Palpation
D. Palpation, Percussion, Auscultation, Inspection
Answer: C
Conceptual Explanation: For the abdominal assessment, the correct order is inspection,
auscultation, percussion, and palpation. Palpation and percussion are done last to avoid
stimulating bowel sounds, which could lead to false auscultation findings.
3. A nurse is caring for a patient diagnosed with Clostridioides difficile (C. diff). Which
infection control measure is mandatory after providing direct patient care?
A. Use of alcohol-based hand sanitizer.
B. Wiping down the stethoscope with alcohol wipes only.
C. Washing hands with soap and water.
D. Using a surgical mask when entering the room.
Answer: C
Conceptual Explanation: C. diff spores are resistant to alcohol-based sanitizers.
Handwashing with soap and water is mechanical and necessary to remove the spores from
the skin.
, 4. A provider orders an IV potassium chloride bolus for a patient with hypokalemia. What is
the nurse’s most critical action?
A. Administer the medication via IV push over 2 minutes.
B. Dilute the medication and ensure it is administered via an infusion pump.
C. Assess the patient’s radial pulse for one full minute.
D. Check the patient’s blood pressure immediately after administration.
Answer: B
Conceptual Explanation: Potassium chloride must never be given by IV push as it can
cause immediate cardiac arrest. It must always be diluted and administered via an infusion
pump at a controlled rate.
5. Which of the following findings would the nurse identify as a classic sign of orthostatic
hypotension?
A. A decrease in heart rate when moving from lying to standing.
B. A decrease in systolic BP of at least 20 mmHg within 3 minutes of standing.
C. An increase in systolic BP by 20 mmHg when sitting up.
D. Patient reporting feeling energetic upon standing.
Answer: B
