NURS 101: Practice Questions for Exam 1 - Nursing Process & Assessment
Nursing Process
1. Which action is part of the assessment phase of the nursing process?
A. Documenting pain relief after administering medication.
B. Asking the client about their dietary preferences.
C. Collaborating with physical therapy to set mobility goals.
D. Evaluating the client’s response to a wound dressing.
2. A nurse clusters data showing a blood pressure of 150/90 mmHg,
edema, and fatigue. Which nursing diagnosis is most appropriate?
A. Risk for Falls
B. Excess Fluid Volume
C. Impaired Gas Exchange
D. Ineffective Coping
3. Which is an example of a SMART goal?
A. “Client will lose weight.”
B. “Client will ambulate 10 feet with a walker within 3 days.”
C. “Client will feel less pain.”
D. “Client will eat healthier.”
4. During implementation, a nurse provides education about insulin
administration. This is an example of:
A. Dependent nursing intervention.
B. Collaborative intervention.
C. Independent nursing intervention.
D. Unlicensed assistive personnel (UAP) task.
5. A client’s wound remains unhealed after 2 weeks of care. Which factor
most likely contributed to failure to achieve outcomes?
A. The client’s spouse visited daily.
B. The nurse used sterile technique for dressing changes.
C. The interventions were nonspecific.
D. The client ate a high-protein diet.
Health History
6. A client states, “I feel dizzy when I stand up.” This is an example of:
A. Objective data.
B. Subjective data.
C. Chief complaint.
D. Past medical history.
7. Which action violates HIPAA?
A. Discussing a client’s lab results with an authorized family member.
B. Sharing a client’s diagnosis with a colleague not involved in their care.
C. Documenting medication administration in the electronic health record.
D. Asking the client’s permission to involve a translator.
NURS 101: Practice Questions for Exam 1 - Nursing Process & Assessment
,NURS 101: Practice Questions for Exam 1 - Nursing Process & Assessment
8. A nurse is assessing a client who speaks limited English. The best action
is to:
A. Ask the client’s child to translate medical terms.
B. Use gestures to explain the procedure.
C. Request a professional interpreter.
D. Speak slowly and loudly.
9. The chief complaint is best described as:
A. A detailed surgical history.
B. The reason the client sought care.
C. The nurse’s initial impression.
D. The client’s insurance information.
10. Which component of the patient profile includes “living arrangements”
and “religious practices”?
A. Financial resources.
B. Environment.
C. Lifestyle patterns.
D. Self-concept.
Physical Assessment
11. Normal adult respiratory rate is:
A. 8–10 breaths/min.
B. 12–20 breaths/min.
C. 22–30 breaths/min.
D. 32–40 breaths/min.
12. When assessing for cyanosis in a client with dark skin, the nurse should
check the:
A. Earlobes.
B. Lips and oral mucosa.
C. Palms of the hands.
D. Nail beds.
13. The correct order for abdominal assessment is:
A. Inspection, auscultation, percussion, palpation.
B. Palpation, percussion, auscultation, inspection.
C. Auscultation, inspection, percussion, palpation.
D. Percussion, palpation, inspection, auscultation.
14. A client with poor skin turgor, dry mucous membranes, and tachycardia
is likely experiencing:
A. Dehydration.
B. Hypervolemia.
C. Hypertension.
D. Hypoglycemia.
NURS 101: Practice Questions for Exam 1 - Nursing Process & Assessment
, NURS 101: Practice Questions for Exam 1 - Nursing Process & Assessment
15. To assess cranial nerve XII (hypoglossal), the nurse asks the client to:
A. Stick out their tongue.
B. Identify a smell with eyes closed.
C. Shrug their shoulders.
D. Follow a finger with their eyes.
Injections
16. The correct angle for a subcutaneous injection is:
A. 10–15 degrees.
B. 45–90 degrees.
C. 90 degrees.
D. 180 degrees.
17. The Z-track method is used to:
A. Reduce pain during intramuscular injections.
B. Prevent medication from leaking into subcutaneous tissue.
C. Ensure proper needle insertion for intradermal injections.
D. Aspirate blood before administering medication.
18. Before administering medication, the nurse must first:
A. Verify the client’s allergies.
B. Document the medication.
C. Assess vital signs.
D. Provide education.
IV Therapy
19. Signs of infiltration include:
A. Redness and warmth at the site.
B. Edema and cool skin temperature.
C. Fever and chills.
D. A palpable cord along the vein.
20. A client reports pain at the IV site. The nurse’s first action is to:
A. Administer pain medication.
B. Discontinue the IV.
C. Assess the site for swelling or pallor.
D. Elevate the extremity.
Parenteral Nutrition
21. Tubing for total parenteral nutrition (TPN) should be changed every:
A. 4 hours.
B. 12 hours.
C. 24 hours.
D. 48 hours.
NURS 101: Practice Questions for Exam 1 - Nursing Process & Assessment
Nursing Process
1. Which action is part of the assessment phase of the nursing process?
A. Documenting pain relief after administering medication.
B. Asking the client about their dietary preferences.
C. Collaborating with physical therapy to set mobility goals.
D. Evaluating the client’s response to a wound dressing.
2. A nurse clusters data showing a blood pressure of 150/90 mmHg,
edema, and fatigue. Which nursing diagnosis is most appropriate?
A. Risk for Falls
B. Excess Fluid Volume
C. Impaired Gas Exchange
D. Ineffective Coping
3. Which is an example of a SMART goal?
A. “Client will lose weight.”
B. “Client will ambulate 10 feet with a walker within 3 days.”
C. “Client will feel less pain.”
D. “Client will eat healthier.”
4. During implementation, a nurse provides education about insulin
administration. This is an example of:
A. Dependent nursing intervention.
B. Collaborative intervention.
C. Independent nursing intervention.
D. Unlicensed assistive personnel (UAP) task.
5. A client’s wound remains unhealed after 2 weeks of care. Which factor
most likely contributed to failure to achieve outcomes?
A. The client’s spouse visited daily.
B. The nurse used sterile technique for dressing changes.
C. The interventions were nonspecific.
D. The client ate a high-protein diet.
Health History
6. A client states, “I feel dizzy when I stand up.” This is an example of:
A. Objective data.
B. Subjective data.
C. Chief complaint.
D. Past medical history.
7. Which action violates HIPAA?
A. Discussing a client’s lab results with an authorized family member.
B. Sharing a client’s diagnosis with a colleague not involved in their care.
C. Documenting medication administration in the electronic health record.
D. Asking the client’s permission to involve a translator.
NURS 101: Practice Questions for Exam 1 - Nursing Process & Assessment
,NURS 101: Practice Questions for Exam 1 - Nursing Process & Assessment
8. A nurse is assessing a client who speaks limited English. The best action
is to:
A. Ask the client’s child to translate medical terms.
B. Use gestures to explain the procedure.
C. Request a professional interpreter.
D. Speak slowly and loudly.
9. The chief complaint is best described as:
A. A detailed surgical history.
B. The reason the client sought care.
C. The nurse’s initial impression.
D. The client’s insurance information.
10. Which component of the patient profile includes “living arrangements”
and “religious practices”?
A. Financial resources.
B. Environment.
C. Lifestyle patterns.
D. Self-concept.
Physical Assessment
11. Normal adult respiratory rate is:
A. 8–10 breaths/min.
B. 12–20 breaths/min.
C. 22–30 breaths/min.
D. 32–40 breaths/min.
12. When assessing for cyanosis in a client with dark skin, the nurse should
check the:
A. Earlobes.
B. Lips and oral mucosa.
C. Palms of the hands.
D. Nail beds.
13. The correct order for abdominal assessment is:
A. Inspection, auscultation, percussion, palpation.
B. Palpation, percussion, auscultation, inspection.
C. Auscultation, inspection, percussion, palpation.
D. Percussion, palpation, inspection, auscultation.
14. A client with poor skin turgor, dry mucous membranes, and tachycardia
is likely experiencing:
A. Dehydration.
B. Hypervolemia.
C. Hypertension.
D. Hypoglycemia.
NURS 101: Practice Questions for Exam 1 - Nursing Process & Assessment
, NURS 101: Practice Questions for Exam 1 - Nursing Process & Assessment
15. To assess cranial nerve XII (hypoglossal), the nurse asks the client to:
A. Stick out their tongue.
B. Identify a smell with eyes closed.
C. Shrug their shoulders.
D. Follow a finger with their eyes.
Injections
16. The correct angle for a subcutaneous injection is:
A. 10–15 degrees.
B. 45–90 degrees.
C. 90 degrees.
D. 180 degrees.
17. The Z-track method is used to:
A. Reduce pain during intramuscular injections.
B. Prevent medication from leaking into subcutaneous tissue.
C. Ensure proper needle insertion for intradermal injections.
D. Aspirate blood before administering medication.
18. Before administering medication, the nurse must first:
A. Verify the client’s allergies.
B. Document the medication.
C. Assess vital signs.
D. Provide education.
IV Therapy
19. Signs of infiltration include:
A. Redness and warmth at the site.
B. Edema and cool skin temperature.
C. Fever and chills.
D. A palpable cord along the vein.
20. A client reports pain at the IV site. The nurse’s first action is to:
A. Administer pain medication.
B. Discontinue the IV.
C. Assess the site for swelling or pallor.
D. Elevate the extremity.
Parenteral Nutrition
21. Tubing for total parenteral nutrition (TPN) should be changed every:
A. 4 hours.
B. 12 hours.
C. 24 hours.
D. 48 hours.
NURS 101: Practice Questions for Exam 1 - Nursing Process & Assessment
