NUR 106 Foundations of Nursing
Final Examination: Questions With Complete Solutions
Nursing Fundamentals | Infection Control | Medication Administration | Fluids & Electrolytes | Perioperative Care | Health
Assessment | Psychosocial & Ethical Care | Prioritization & Delegation | Comprehensive Integration
Total Questions 120
Cognitive Mix 30% Recall | 50% Application | 20% Analysis
Question Style 75% Scenario-Based | 25% Direct Recall
Sections 9 (Fundamentals through Comprehensive Integration)
Scoring Standard Complete Solutions with Clinical Judgment Rationales
Audience NUR 106 Foundational Nursing Students
Exam Format NCLEX-Style Multiple Choice (A-D, single best answer)
This comprehensive final examination assesses mastery of foundational nursing competencies across the NUR 106
curriculum. Each question is presented with the correct answer identified and a complete solution rationale that explains
the underlying nursing principle, the safety considerations, and the clinical judgment reasoning supporting the correct
response. Distractors are designed around common nursing student errors and NCLEX pitfalls: incorrect prioritization of
stable vs. unstable clients, confusion between lab values, misapplied isolation precautions, improper delegation, premature
'call the provider' selections when an independent nursing action is required, and incorrect medication calculations.
Commonly confused concept pairs (medical vs. surgical asepsis, hyperkalemia vs. hypokalemia, preoperative vs.
postoperative care, delegation vs. assignment) are explicitly addressed in the rationales. Embedded study strategy notes
support NCLEX preparation.
Section 1: Nursing Fundamentals and Patient Care
Q1: A nurse collects data about a patient's pain level, vital signs, and wound appearance. Which
step of the nursing process is the nurse performing?
A. Assessment. [CORRECT]
B. Diagnosis.
C. Planning.
D. Implementation.
Correct Answer: A. Assessment.
Rationale: Assessment is the systematic collection of subjective and objective data to identify patient needs. Option B
(Diagnosis) analyzes data to identify problems. Option C (Planning) sets goals and outcomes. Option D
(Implementation) carries out interventions. A+ verification: ADPIE = Assessment, Diagnosis, Planning,
Implementation, Evaluation. Study tip: 'data collection = Assessment.'
,Q2: A nurse formulates the nursing diagnosis 'Acute Pain related to surgical incision as evidenced
by patient rating pain 8/10.' Which component represents the defining characteristic?
A. Acute Pain.
B. Related to surgical incision.
C. As evidenced by patient rating pain 8/10. [CORRECT]
D. Surgical incision.
Correct Answer: C. As evidenced by patient rating pain 8/10.
Rationale: The 'as evidenced by' (AEB) component contains the defining characteristics (signs/symptoms/data) that
support the diagnosis. Option A is the diagnostic label. Option B is the related factor (etiology). Option D is the cause.
A+ verification: PES format = Problem + Etiology + Signs/symptoms. Study tip: 'AEB = signs/symptoms = defining
characteristics.'
Q3: Which statement correctly differentiates a nursing diagnosis from a medical diagnosis?
A. A nursing diagnosis identifies a disease; a medical diagnosis identifies a response to illness.
B. A nursing diagnosis identifies a human response to illness; a medical diagnosis identifies a specific disease
process. [CORRECT]
C. They are identical in scope and focus.
D. A nursing diagnosis is made only by physicians.
Correct Answer: B. A nursing diagnosis identifies a human response to illness; a medical
diagnosis identif...
Rationale: A nursing diagnosis (e.g., Acute Pain) describes the patient's response to illness; a medical diagnosis (e.g.,
Appendicitis) identifies a specific pathology. Option A reverses the definitions. Option C is false. Option D is false:
nursing diagnoses are made by nurses. A+ verification: this commonly confused concept pair is heavily tested on NUR
106 finals.
Q4: Which goal is written in the correct SMART format for a patient with impaired mobility?
A. Patient will ambulate as tolerated.
B. Patient will ambulate 50 feet in hallway with walker within 24 hours. [CORRECT]
C. Patient will improve mobility soon.
D. Nurse will assist patient to ambulate.
Correct Answer: B. Patient will ambulate 50 feet in hallway with walker within 24 hours.
Rationale: SMART goals are Specific, Measurable, Achievable, Realistic, and Time-bound. 'Ambulate 50 feet with
walker within 24 hours' is measurable and time-specific. Option A is vague. Option C is non-measurable. Option D is a
nursing action, not a patient goal. A+ verification: goals must be patient-centered and measurable for evaluation.
,Q5: A nurse administers prescribed furosemide to a patient with heart failure. Which step of the
nursing process does this represent?
A. Assessment.
B. Diagnosis.
C. Planning.
D. Implementation. [CORRECT]
Correct Answer: D. Implementation.
Rationale: Implementation is the execution of nursing interventions, including medication administration. Option A is
data collection. Option B is problem identification. Option C is goal setting. A+ verification: any direct patient care
action = Implementation. Study tip: 'do the action = implement.'
Q6: A nurse evaluates whether a patient achieved the goal of 'pain rated 4/10 or less within 1 hour.'
The patient reports pain 6/10. Which action is most appropriate?
A. Document goal as met and discontinue the plan.
B. Reassess pain characteristics and consider a non-pharmacologic intervention while notifying the provider.
[CORRECT]
C. Increase the medication dose independently.
D. Withhold all further pain medication.
Correct Answer: B. Reassess pain characteristics and consider a non-pharmacologic intervention
while notif...
Rationale: Evaluation reveals the goal was not met; the nurse must reassess and adjust the plan, including
non-pharmacologic measures and provider notification. Option A is wrong: goal not met. Option C is unsafe: nurses
cannot change medication doses independently. Option D is unsafe: pain is unrelieved. A+ verification: Evaluation
includes modifying the plan when goals are not achieved.
Q7: A patient's oral temperature is 102.8°F (39.3°C). What is the priority nursing action?
A. Document the finding and continue routine care.
B. Notify the provider and implement cooling measures such as antipyretic administration and fluid
replacement. [CORRECT]
C. Apply a warming blanket.
D. Recheck temperature in 4 hours.
Correct Answer: B. Notify the provider and implement cooling measures such as antipyretic
administration a...
Rationale: A temperature of 102.8°F is febrile and requires provider notification and antipyretic/cooling measures.
Option A ignores a significant finding. Option C would worsen hyperthermia. Option D delays intervention. A+
verification: normal oral temp is 98.6°F (37°C); fever >100.4°F (38°C) requires intervention.
, Q8: A patient has a radial pulse of 48 beats/min and reports dizziness. Which action should the
nurse take first?
A. Document the finding; it is normal for athletes.
B. Assess apical pulse for 1 full minute and notify the provider. [CORRECT]
C. Administer a stimulant medication.
D. Encourage the patient to ambulate.
Correct Answer: B. Assess apical pulse for 1 full minute and notify the provider.
Rationale: A radial pulse of 48 with dizziness suggests bradycardia and requires confirming with a full apical pulse
assessment and provider notification. Option A is unsafe: symptomatic bradycardia needs intervention. Option C is
outside nursing scope. Option D risks further compromise. A+ verification: normal adult pulse is 60-100 bpm;
bradycardia with symptoms is concerning.
Q9: A patient's respirations are 28/min and irregular with periods of apnea. The nurse should:
A. Document as normal.
B. Notify the provider; assess oxygen saturation and level of consciousness. [CORRECT]
C. Encourage deep breathing exercises only.
D. Recheck in 1 hour.
Correct Answer: B. Notify the provider; assess oxygen saturation and level of consciousness.
Rationale: Tachypnea with irregular pattern and apnea periods is abnormal and warrants immediate assessment and
provider notification. Option A is unsafe. Option C alone is insufficient. Option D delays intervention. A+ verification:
normal adult respirations are 12-20/min; abnormal rate or pattern requires escalation.
Q10: Which technique ensures accurate blood pressure measurement?
A. Placing the cuff on whichever arm is most convenient.
B. Positioning the patient's arm at heart level with appropriate cuff size. [CORRECT]
C. Using a cuff that covers 25% of the upper arm.
D. Deflating the cuff at 10 mm Hg/sec to ensure speed.
Correct Answer: B. Positioning the patient's arm at heart level with appropriate cuff size.
Rationale: The arm must be at heart level and the cuff must be the correct size (40% of arm circumference or 80%
length) for accurate readings. Option A may cause inaccurate readings if patient has IV, mastectomy, or fistula. Option
C is incorrect sizing. Option D is too fast; proper deflation rate is 2-3 mm Hg/sec. A+ verification: improper cuff size
causes false high or false low readings.
Q11: Which of the following is the most reliable indicator of pain in an alert adult patient?
A. Vital sign changes.
B. Facial grimacing.
C. The patient's self-report. [CORRECT]
D. Behavioral observation by family.
Correct Answer: C. The patient's self-report.
Rationale: Pain is subjective; the patient's self-report is the gold standard. Vital signs (A) and behaviors (B, D) may
indicate pain but are not reliable indicators alone. A+ verification: 'Pain is whatever the patient says it is.' Study tip:
always ask alert adults to rate their pain on a 0-10 scale.
Final Examination: Questions With Complete Solutions
Nursing Fundamentals | Infection Control | Medication Administration | Fluids & Electrolytes | Perioperative Care | Health
Assessment | Psychosocial & Ethical Care | Prioritization & Delegation | Comprehensive Integration
Total Questions 120
Cognitive Mix 30% Recall | 50% Application | 20% Analysis
Question Style 75% Scenario-Based | 25% Direct Recall
Sections 9 (Fundamentals through Comprehensive Integration)
Scoring Standard Complete Solutions with Clinical Judgment Rationales
Audience NUR 106 Foundational Nursing Students
Exam Format NCLEX-Style Multiple Choice (A-D, single best answer)
This comprehensive final examination assesses mastery of foundational nursing competencies across the NUR 106
curriculum. Each question is presented with the correct answer identified and a complete solution rationale that explains
the underlying nursing principle, the safety considerations, and the clinical judgment reasoning supporting the correct
response. Distractors are designed around common nursing student errors and NCLEX pitfalls: incorrect prioritization of
stable vs. unstable clients, confusion between lab values, misapplied isolation precautions, improper delegation, premature
'call the provider' selections when an independent nursing action is required, and incorrect medication calculations.
Commonly confused concept pairs (medical vs. surgical asepsis, hyperkalemia vs. hypokalemia, preoperative vs.
postoperative care, delegation vs. assignment) are explicitly addressed in the rationales. Embedded study strategy notes
support NCLEX preparation.
Section 1: Nursing Fundamentals and Patient Care
Q1: A nurse collects data about a patient's pain level, vital signs, and wound appearance. Which
step of the nursing process is the nurse performing?
A. Assessment. [CORRECT]
B. Diagnosis.
C. Planning.
D. Implementation.
Correct Answer: A. Assessment.
Rationale: Assessment is the systematic collection of subjective and objective data to identify patient needs. Option B
(Diagnosis) analyzes data to identify problems. Option C (Planning) sets goals and outcomes. Option D
(Implementation) carries out interventions. A+ verification: ADPIE = Assessment, Diagnosis, Planning,
Implementation, Evaluation. Study tip: 'data collection = Assessment.'
,Q2: A nurse formulates the nursing diagnosis 'Acute Pain related to surgical incision as evidenced
by patient rating pain 8/10.' Which component represents the defining characteristic?
A. Acute Pain.
B. Related to surgical incision.
C. As evidenced by patient rating pain 8/10. [CORRECT]
D. Surgical incision.
Correct Answer: C. As evidenced by patient rating pain 8/10.
Rationale: The 'as evidenced by' (AEB) component contains the defining characteristics (signs/symptoms/data) that
support the diagnosis. Option A is the diagnostic label. Option B is the related factor (etiology). Option D is the cause.
A+ verification: PES format = Problem + Etiology + Signs/symptoms. Study tip: 'AEB = signs/symptoms = defining
characteristics.'
Q3: Which statement correctly differentiates a nursing diagnosis from a medical diagnosis?
A. A nursing diagnosis identifies a disease; a medical diagnosis identifies a response to illness.
B. A nursing diagnosis identifies a human response to illness; a medical diagnosis identifies a specific disease
process. [CORRECT]
C. They are identical in scope and focus.
D. A nursing diagnosis is made only by physicians.
Correct Answer: B. A nursing diagnosis identifies a human response to illness; a medical
diagnosis identif...
Rationale: A nursing diagnosis (e.g., Acute Pain) describes the patient's response to illness; a medical diagnosis (e.g.,
Appendicitis) identifies a specific pathology. Option A reverses the definitions. Option C is false. Option D is false:
nursing diagnoses are made by nurses. A+ verification: this commonly confused concept pair is heavily tested on NUR
106 finals.
Q4: Which goal is written in the correct SMART format for a patient with impaired mobility?
A. Patient will ambulate as tolerated.
B. Patient will ambulate 50 feet in hallway with walker within 24 hours. [CORRECT]
C. Patient will improve mobility soon.
D. Nurse will assist patient to ambulate.
Correct Answer: B. Patient will ambulate 50 feet in hallway with walker within 24 hours.
Rationale: SMART goals are Specific, Measurable, Achievable, Realistic, and Time-bound. 'Ambulate 50 feet with
walker within 24 hours' is measurable and time-specific. Option A is vague. Option C is non-measurable. Option D is a
nursing action, not a patient goal. A+ verification: goals must be patient-centered and measurable for evaluation.
,Q5: A nurse administers prescribed furosemide to a patient with heart failure. Which step of the
nursing process does this represent?
A. Assessment.
B. Diagnosis.
C. Planning.
D. Implementation. [CORRECT]
Correct Answer: D. Implementation.
Rationale: Implementation is the execution of nursing interventions, including medication administration. Option A is
data collection. Option B is problem identification. Option C is goal setting. A+ verification: any direct patient care
action = Implementation. Study tip: 'do the action = implement.'
Q6: A nurse evaluates whether a patient achieved the goal of 'pain rated 4/10 or less within 1 hour.'
The patient reports pain 6/10. Which action is most appropriate?
A. Document goal as met and discontinue the plan.
B. Reassess pain characteristics and consider a non-pharmacologic intervention while notifying the provider.
[CORRECT]
C. Increase the medication dose independently.
D. Withhold all further pain medication.
Correct Answer: B. Reassess pain characteristics and consider a non-pharmacologic intervention
while notif...
Rationale: Evaluation reveals the goal was not met; the nurse must reassess and adjust the plan, including
non-pharmacologic measures and provider notification. Option A is wrong: goal not met. Option C is unsafe: nurses
cannot change medication doses independently. Option D is unsafe: pain is unrelieved. A+ verification: Evaluation
includes modifying the plan when goals are not achieved.
Q7: A patient's oral temperature is 102.8°F (39.3°C). What is the priority nursing action?
A. Document the finding and continue routine care.
B. Notify the provider and implement cooling measures such as antipyretic administration and fluid
replacement. [CORRECT]
C. Apply a warming blanket.
D. Recheck temperature in 4 hours.
Correct Answer: B. Notify the provider and implement cooling measures such as antipyretic
administration a...
Rationale: A temperature of 102.8°F is febrile and requires provider notification and antipyretic/cooling measures.
Option A ignores a significant finding. Option C would worsen hyperthermia. Option D delays intervention. A+
verification: normal oral temp is 98.6°F (37°C); fever >100.4°F (38°C) requires intervention.
, Q8: A patient has a radial pulse of 48 beats/min and reports dizziness. Which action should the
nurse take first?
A. Document the finding; it is normal for athletes.
B. Assess apical pulse for 1 full minute and notify the provider. [CORRECT]
C. Administer a stimulant medication.
D. Encourage the patient to ambulate.
Correct Answer: B. Assess apical pulse for 1 full minute and notify the provider.
Rationale: A radial pulse of 48 with dizziness suggests bradycardia and requires confirming with a full apical pulse
assessment and provider notification. Option A is unsafe: symptomatic bradycardia needs intervention. Option C is
outside nursing scope. Option D risks further compromise. A+ verification: normal adult pulse is 60-100 bpm;
bradycardia with symptoms is concerning.
Q9: A patient's respirations are 28/min and irregular with periods of apnea. The nurse should:
A. Document as normal.
B. Notify the provider; assess oxygen saturation and level of consciousness. [CORRECT]
C. Encourage deep breathing exercises only.
D. Recheck in 1 hour.
Correct Answer: B. Notify the provider; assess oxygen saturation and level of consciousness.
Rationale: Tachypnea with irregular pattern and apnea periods is abnormal and warrants immediate assessment and
provider notification. Option A is unsafe. Option C alone is insufficient. Option D delays intervention. A+ verification:
normal adult respirations are 12-20/min; abnormal rate or pattern requires escalation.
Q10: Which technique ensures accurate blood pressure measurement?
A. Placing the cuff on whichever arm is most convenient.
B. Positioning the patient's arm at heart level with appropriate cuff size. [CORRECT]
C. Using a cuff that covers 25% of the upper arm.
D. Deflating the cuff at 10 mm Hg/sec to ensure speed.
Correct Answer: B. Positioning the patient's arm at heart level with appropriate cuff size.
Rationale: The arm must be at heart level and the cuff must be the correct size (40% of arm circumference or 80%
length) for accurate readings. Option A may cause inaccurate readings if patient has IV, mastectomy, or fistula. Option
C is incorrect sizing. Option D is too fast; proper deflation rate is 2-3 mm Hg/sec. A+ verification: improper cuff size
causes false high or false low readings.
Q11: Which of the following is the most reliable indicator of pain in an alert adult patient?
A. Vital sign changes.
B. Facial grimacing.
C. The patient's self-report. [CORRECT]
D. Behavioral observation by family.
Correct Answer: C. The patient's self-report.
Rationale: Pain is subjective; the patient's self-report is the gold standard. Vital signs (A) and behaviors (B, D) may
indicate pain but are not reliable indicators alone. A+ verification: 'Pain is whatever the patient says it is.' Study tip:
always ask alert adults to rate their pain on a 0-10 scale.
