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NU 518 EXAM 1 – NURSING NOTES / COURSE REVIEW
ACTUAL EXAM [QUESTION 1-200] AND ANSWERS
UPDATED 2026/2027 | 100% VERIFIED | DETAILED
RATIONALES – PASS GUARANTEED A+ GRADED |
INSTANT DOWNLOAD
INTRODUCTION
NU 518 Exam 1 – Nursing Notes / Course Review is designed as an advanced practice resource
for nursing students preparing to demonstrate clinical reasoning, assessment, prioritization,
communication, safety, documentation, and evidence-based nursing practice. Exam 1 content in
nursing courses commonly requires students to move beyond memorization and apply
foundational concepts to realistic patient-care situations. This question bank therefore
emphasizes scenario-based decision making, prioritization, interpretation of clinical findings,
delegation, patient safety, professional communication, and nursing documentation.
The 200 questions are intentionally challenging and structured in a four-option multiple-choice
format. Each question has one best answer followed by a detailed rationale explaining the correct
choice and the reasoning behind the distractors. Working through the questions can help students
identify knowledge gaps, strengthen clinical judgment, recognize priority interventions, and
become more comfortable with examination-style wording.
Because the exact NU 518 curriculum varies by institution, students should compare these
questions with their instructor's syllabus, lecture notes, assigned textbook chapters, and learning
objectives before treating any topic as exam-specific.
CORE DOMAINS TESTED
1. Nursing Process and Clinical Judgment — Assessment, diagnosis, planning,
implementation, evaluation, and prioritization.
2. Health Assessment — Collection and interpretation of subjective and objective patient
data.
3. Patient Safety — Fall prevention, infection prevention, medication safety, and
environmental hazards.
4. Communication — Therapeutic communication, handoff, documentation, and
interprofessional communication.
5. Vital Signs and Basic Measurements — Recognition of abnormal findings and
appropriate nursing responses.
6. Infection Prevention and Control — Standard precautions, transmission-based
precautions, and aseptic technique.
7. Patient-Centered Care — Respect for preferences, culture, autonomy, dignity, and
informed participation.
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8. Clinical Documentation — Accurate, objective, timely, and legally appropriate
documentation.
9. Delegation and Scope of Practice — Appropriate assignment of nursing activities and
accountability.
10. Ethics and Professional Practice — Advocacy, confidentiality, autonomy, beneficence,
nonmaleficence, and justice.
11. Mobility and Functional Status — Safe transfers, positioning, activity tolerance, and
prevention of complications.
12. Nutrition and Hydration — Assessment of nutritional status, fluid balance, and safe
nutritional support.
13. Pain and Comfort — Comprehensive pain assessment and individualized interventions.
14. Skin Integrity — Pressure-injury prevention, wound assessment, and tissue protection.
15. Elimination — Assessment and nursing management of bowel and urinary function.
16. Medication Administration Principles — Safe administration, assessment, monitoring,
and error prevention.
17. Patient Education — Teaching strategies, readiness to learn, health literacy, and
evaluation of understanding.
18. Emergency and Priority Care — Recognition of deterioration and appropriate
sequencing of interventions.
QUESTIONS 1-200
Q1: A nurse receives report on four patients. Which patient should the nurse assess first?
A) A patient requesting assistance with bathing
B) A patient with new-onset difficulty breathing and an oxygen saturation of 88%
C) A patient reporting chronic back pain rated 6/10
D) A patient awaiting discharge instructions
Rationale: The correct answer is B because new respiratory difficulty with hypoxemia represents
a potentially immediate threat to oxygenation and requires prompt assessment. Option A is
important but nonurgent. Option C requires pain management but does not indicate an
immediate life threat based on the information given. Option D can safely be delayed while an
unstable patient is assessed.
Q2: During an initial assessment, a patient states, “I have been feeling dizzy since yesterday.”
Which response best demonstrates therapeutic communication?
A) “You probably just need more sleep.”
B) “Is your dizziness caused by stress?”
C) “Tell me more about what you mean when you say you feel dizzy.”
D) “Have you taken anything for it?”
Rationale: The correct answer is C because it uses an open-ended clarification that allows the
patient to describe the symptom in their own words. Option A prematurely minimizes the
,3|Page
complaint. Option B introduces an assumption about the cause. Option D may eventually be
appropriate but moves prematurely toward treatment rather than clarifying the symptom.
Q3: A nurse documents that a patient is “uncooperative and difficult.” Why is this
documentation inappropriate?
A) It is too brief.
B) It uses medical terminology.
C) It is subjective and does not describe observable behavior.
D) It violates the patient's right to refuse care.
Rationale: The correct answer is C because professional documentation should describe
observable, objective behavior rather than judgmental labels. Option A is not the primary
problem. Option B is incorrect because the issue is not inappropriate medical terminology.
Option D is unrelated to the documentation concern.
Q4: A patient refuses a recommended procedure after receiving an explanation of its purpose and
risks. What is the nurse's priority action?
A) Tell the patient the procedure is mandatory.
B) Ask the family to convince the patient.
C) Determine the patient's understanding and notify the appropriate provider of the
refusal.
D) Document that the patient is noncompliant and end the discussion.
Rationale: The correct answer is C because an informed patient generally has the right to refuse
treatment. The nurse should verify understanding, communicate the refusal to the appropriate
healthcare professional, and document appropriately. Option A disregards autonomy. Option B
improperly pressures the patient. Option D is judgmental and fails to address informed decision
making.
Q5: A nurse enters a patient's room and finds the patient sitting on the floor. What should the
nurse do first?
A) Move the patient immediately into bed.
B) Complete an incident report.
C) Assess the patient for injury and immediate instability.
D) Call the patient's family.
Rationale: The correct answer is C because assessment comes before documentation or
notification. Moving a potentially injured patient without assessment may worsen an injury.
Option B is necessary after immediate care but is not the first priority. Option D is not the
immediate clinical priority.
Q6: A nurse is preparing to administer medication but notices that the patient's identification
band does not match the medication record. What should the nurse do?
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A) Ask another nurse to identify the patient.
B) Administer the medication because the patient recognizes it.
C) Stop the medication process and resolve the identification discrepancy.
D) Document that the medication was refused.
Rationale: The correct answer is C because accurate patient identification is a fundamental
medication-safety requirement. Option A does not eliminate the discrepancy. Option B relies on
patient recognition rather than the required identification process. Option D falsely documents a
refusal that did not occur.
Q7: A nurse is receiving a verbal handoff. Which information is most important to communicate
first?
A) The patient's preferred television channel
B) The patient's usual breakfast preference
C) A recent change in respiratory status requiring increased oxygen support
D) The patient's expected discharge date
Rationale: The correct answer is C because a change suggesting clinical deterioration is high-
priority information during handoff. Options A and B are low-priority personal preferences.
Option D may be relevant but is less urgent than a significant change in condition.
Q8: A patient asks a nurse, “What is my diagnosis?” The nurse is uncertain whether the
diagnosis has been confirmed. What is the best response?
A) “I think you probably have pneumonia.”
B) “Your family already knows.”
C) “Let me clarify what information has been discussed with you and contact the
appropriate provider if you need further explanation.”
D) “You should look it up online.”
Rationale: The correct answer is C because the nurse should avoid speculation and facilitate
accurate communication. Option A provides an unsupported diagnosis. Option B does not
answer the patient's question. Option D shifts responsibility away from appropriate clinical
communication.
Q9: Which assessment finding requires the most immediate nursing attention?
A) Temperature of 37.4°C (99.3°F)
B) Pulse of 82/min
C) Sudden change in level of consciousness
D) Mild chronic joint stiffness
Rationale: The correct answer is C because an acute change in consciousness may indicate
serious neurological, metabolic, respiratory, or circulatory compromise. The other findings do
not indicate an immediately life-threatening change based on the information provided.
NU 518 EXAM 1 – NURSING NOTES / COURSE REVIEW
ACTUAL EXAM [QUESTION 1-200] AND ANSWERS
UPDATED 2026/2027 | 100% VERIFIED | DETAILED
RATIONALES – PASS GUARANTEED A+ GRADED |
INSTANT DOWNLOAD
INTRODUCTION
NU 518 Exam 1 – Nursing Notes / Course Review is designed as an advanced practice resource
for nursing students preparing to demonstrate clinical reasoning, assessment, prioritization,
communication, safety, documentation, and evidence-based nursing practice. Exam 1 content in
nursing courses commonly requires students to move beyond memorization and apply
foundational concepts to realistic patient-care situations. This question bank therefore
emphasizes scenario-based decision making, prioritization, interpretation of clinical findings,
delegation, patient safety, professional communication, and nursing documentation.
The 200 questions are intentionally challenging and structured in a four-option multiple-choice
format. Each question has one best answer followed by a detailed rationale explaining the correct
choice and the reasoning behind the distractors. Working through the questions can help students
identify knowledge gaps, strengthen clinical judgment, recognize priority interventions, and
become more comfortable with examination-style wording.
Because the exact NU 518 curriculum varies by institution, students should compare these
questions with their instructor's syllabus, lecture notes, assigned textbook chapters, and learning
objectives before treating any topic as exam-specific.
CORE DOMAINS TESTED
1. Nursing Process and Clinical Judgment — Assessment, diagnosis, planning,
implementation, evaluation, and prioritization.
2. Health Assessment — Collection and interpretation of subjective and objective patient
data.
3. Patient Safety — Fall prevention, infection prevention, medication safety, and
environmental hazards.
4. Communication — Therapeutic communication, handoff, documentation, and
interprofessional communication.
5. Vital Signs and Basic Measurements — Recognition of abnormal findings and
appropriate nursing responses.
6. Infection Prevention and Control — Standard precautions, transmission-based
precautions, and aseptic technique.
7. Patient-Centered Care — Respect for preferences, culture, autonomy, dignity, and
informed participation.
,2|Page
8. Clinical Documentation — Accurate, objective, timely, and legally appropriate
documentation.
9. Delegation and Scope of Practice — Appropriate assignment of nursing activities and
accountability.
10. Ethics and Professional Practice — Advocacy, confidentiality, autonomy, beneficence,
nonmaleficence, and justice.
11. Mobility and Functional Status — Safe transfers, positioning, activity tolerance, and
prevention of complications.
12. Nutrition and Hydration — Assessment of nutritional status, fluid balance, and safe
nutritional support.
13. Pain and Comfort — Comprehensive pain assessment and individualized interventions.
14. Skin Integrity — Pressure-injury prevention, wound assessment, and tissue protection.
15. Elimination — Assessment and nursing management of bowel and urinary function.
16. Medication Administration Principles — Safe administration, assessment, monitoring,
and error prevention.
17. Patient Education — Teaching strategies, readiness to learn, health literacy, and
evaluation of understanding.
18. Emergency and Priority Care — Recognition of deterioration and appropriate
sequencing of interventions.
QUESTIONS 1-200
Q1: A nurse receives report on four patients. Which patient should the nurse assess first?
A) A patient requesting assistance with bathing
B) A patient with new-onset difficulty breathing and an oxygen saturation of 88%
C) A patient reporting chronic back pain rated 6/10
D) A patient awaiting discharge instructions
Rationale: The correct answer is B because new respiratory difficulty with hypoxemia represents
a potentially immediate threat to oxygenation and requires prompt assessment. Option A is
important but nonurgent. Option C requires pain management but does not indicate an
immediate life threat based on the information given. Option D can safely be delayed while an
unstable patient is assessed.
Q2: During an initial assessment, a patient states, “I have been feeling dizzy since yesterday.”
Which response best demonstrates therapeutic communication?
A) “You probably just need more sleep.”
B) “Is your dizziness caused by stress?”
C) “Tell me more about what you mean when you say you feel dizzy.”
D) “Have you taken anything for it?”
Rationale: The correct answer is C because it uses an open-ended clarification that allows the
patient to describe the symptom in their own words. Option A prematurely minimizes the
,3|Page
complaint. Option B introduces an assumption about the cause. Option D may eventually be
appropriate but moves prematurely toward treatment rather than clarifying the symptom.
Q3: A nurse documents that a patient is “uncooperative and difficult.” Why is this
documentation inappropriate?
A) It is too brief.
B) It uses medical terminology.
C) It is subjective and does not describe observable behavior.
D) It violates the patient's right to refuse care.
Rationale: The correct answer is C because professional documentation should describe
observable, objective behavior rather than judgmental labels. Option A is not the primary
problem. Option B is incorrect because the issue is not inappropriate medical terminology.
Option D is unrelated to the documentation concern.
Q4: A patient refuses a recommended procedure after receiving an explanation of its purpose and
risks. What is the nurse's priority action?
A) Tell the patient the procedure is mandatory.
B) Ask the family to convince the patient.
C) Determine the patient's understanding and notify the appropriate provider of the
refusal.
D) Document that the patient is noncompliant and end the discussion.
Rationale: The correct answer is C because an informed patient generally has the right to refuse
treatment. The nurse should verify understanding, communicate the refusal to the appropriate
healthcare professional, and document appropriately. Option A disregards autonomy. Option B
improperly pressures the patient. Option D is judgmental and fails to address informed decision
making.
Q5: A nurse enters a patient's room and finds the patient sitting on the floor. What should the
nurse do first?
A) Move the patient immediately into bed.
B) Complete an incident report.
C) Assess the patient for injury and immediate instability.
D) Call the patient's family.
Rationale: The correct answer is C because assessment comes before documentation or
notification. Moving a potentially injured patient without assessment may worsen an injury.
Option B is necessary after immediate care but is not the first priority. Option D is not the
immediate clinical priority.
Q6: A nurse is preparing to administer medication but notices that the patient's identification
band does not match the medication record. What should the nurse do?
, 4|Page
A) Ask another nurse to identify the patient.
B) Administer the medication because the patient recognizes it.
C) Stop the medication process and resolve the identification discrepancy.
D) Document that the medication was refused.
Rationale: The correct answer is C because accurate patient identification is a fundamental
medication-safety requirement. Option A does not eliminate the discrepancy. Option B relies on
patient recognition rather than the required identification process. Option D falsely documents a
refusal that did not occur.
Q7: A nurse is receiving a verbal handoff. Which information is most important to communicate
first?
A) The patient's preferred television channel
B) The patient's usual breakfast preference
C) A recent change in respiratory status requiring increased oxygen support
D) The patient's expected discharge date
Rationale: The correct answer is C because a change suggesting clinical deterioration is high-
priority information during handoff. Options A and B are low-priority personal preferences.
Option D may be relevant but is less urgent than a significant change in condition.
Q8: A patient asks a nurse, “What is my diagnosis?” The nurse is uncertain whether the
diagnosis has been confirmed. What is the best response?
A) “I think you probably have pneumonia.”
B) “Your family already knows.”
C) “Let me clarify what information has been discussed with you and contact the
appropriate provider if you need further explanation.”
D) “You should look it up online.”
Rationale: The correct answer is C because the nurse should avoid speculation and facilitate
accurate communication. Option A provides an unsupported diagnosis. Option B does not
answer the patient's question. Option D shifts responsibility away from appropriate clinical
communication.
Q9: Which assessment finding requires the most immediate nursing attention?
A) Temperature of 37.4°C (99.3°F)
B) Pulse of 82/min
C) Sudden change in level of consciousness
D) Mild chronic joint stiffness
Rationale: The correct answer is C because an acute change in consciousness may indicate
serious neurological, metabolic, respiratory, or circulatory compromise. The other findings do
not indicate an immediately life-threatening change based on the information provided.
