NUR 2811 EXAM / ACTUAL NUR 2811 MIDTERM TEST 2026/2027
PRACTICE QUESTIONS AND STUDY GUIDE COMPLETE ACCURATE EXAM
1. A nurse is caring for several clients on a medical-surgical unit and receives a
report describing four different clinical situations. Which client should the
nurse assess first when applying the principles of priority setting and
recognizing the most immediate threat to physiologic stability?
A. A client with chronic heart failure who has gained 2 lb over the past week
and reports mild ankle edema
B. A client with pneumonia who has a respiratory rate of 32/min, new
confusion, and an oxygen saturation of 84% despite supplemental oxygen
C. A client with diabetes mellitus whose premeal blood glucose is 214
mg/dL and who requests assistance ordering lunch
D. A client recovering from abdominal surgery who reports incisional pain
rated 6/10 before receiving the prescribed analgesic
Answer: B
2. During a clinical shift, a newly licensed nurse is caring for four clients and
must determine which task requires immediate intervention rather than
routine follow-up. Which finding should the nurse recognize as the highest
priority because it may represent acute deterioration requiring rapid
assessment and intervention?
A. A client with stable chronic kidney disease who has a potassium level of
4.8 mEq/L
B. A client with osteoarthritis who requests assistance with ambulation to
the bathroom
C. A client receiving IV antibiotics who reports mild nausea after breakfast
D. A client with heart failure who suddenly develops severe dyspnea, pink
frothy sputum, and bilateral crackles
Answer: D
3. A nurse is organizing care for multiple clients and is deciding which
intervention should be completed first using airway, breathing, circulation,
disability, and exposure principles. Which situation requires the nurse's
1
, immediate attention?
A. A postoperative client with a respiratory rate of 8/min and increasing
somnolence after receiving IV opioid medication
B. A client with a healing pressure injury who needs a scheduled dressing
change
C. A client with hypertension whose blood pressure is 158/92 mm Hg
without acute symptoms
D. A client with anemia who reports fatigue while walking to the bathroom
Answer: A
4. A charge nurse is assigning clients to members of the nursing team and
must consider scope of practice, client stability, and the complexity of
required nursing judgment. Which assignment is most appropriate for a
licensed practical/vocational nurse when the client is stable?
A. Performing the initial assessment of a newly admitted client with chest
pain
B. Developing the initial nursing care plan for a client with newly diagnosed
sepsis
C. Administering scheduled oral medications and reinforcing previously
taught instructions for a stable client
D. Evaluating a client's response to a newly initiated blood transfusion
Answer: C
5. A registered nurse is delegating activities to an experienced nursing
assistant on a medical-surgical unit. Which delegated activity is most
appropriate when the client is stable and the activity does not require
nursing assessment or clinical judgment?
A. Measuring and documenting the oral intake of a stable client who has an
established fluid restriction
B. Teaching a client how to recognize symptoms of hypoglycemia
C. Determining whether a client is ready for discharge after surgery
D. Evaluating the effectiveness of a newly prescribed analgesic
Answer: A
2
, 6. A nurse is caring for a client who has suddenly become confused,
hypotensive, tachycardic, and febrile. The nurse recognizes that the findings
may indicate systemic deterioration. Which action is most appropriate
initially?
A. Document the findings and reassess the client after the next scheduled
medication pass
B. Encourage oral fluids and return after completing routine treatments for
other clients
C. Notify the provider without obtaining additional assessment information
D. Rapidly assess airway, breathing, circulation, vital signs, oxygenation, and
level of consciousness while initiating appropriate emergency measures
Answer: D
7. A nurse is participating in a multidisciplinary discharge planning meeting for
a client with newly diagnosed heart failure who will require medication
management, dietary modification, follow-up appointments, and assistance
obtaining home equipment. Which nursing action best demonstrates
effective care coordination?
A. Telling the client that all discharge decisions will be made by the provider
B. Coordinating communication among the client, family, pharmacy,
provider, and appropriate community services
C. Asking the nursing assistant to determine which medications the client
should continue at home
D. Delaying discharge planning until the day the client is scheduled to leave
the hospital
Answer: B
8. A nurse manager is evaluating whether delegation has been performed
safely. Which statement best reflects appropriate delegation principles in
professional nursing practice?
A. Once a task is delegated, the registered nurse is no longer accountable
for the client's overall nursing care
B. Delegation is appropriate whenever the nurse is too busy to complete the
activity personally
3
, C. The nurse remains accountable for appropriate delegation and
supervision while the delegatee is responsible for performing the assigned
task correctly
D. Any nursing task can be delegated if the person receiving the task has
performed it previously
Answer: C
9. A nurse is caring for a client who refuses a recommended blood transfusion
because of personal beliefs. The healthcare team disagrees with the client's
decision, but the client is alert, understands the risks, and demonstrates
decision-making capacity. Which ethical principle should guide the nurse's
response?
A. Autonomy
B. Justice
C. Fidelity
D. Veracity
Answer: A
10. A nurse discovers that a medication was administered to the wrong client
but that no injury is immediately apparent. Which action best reflects
professional responsibility and a culture of patient safety?
A. Avoid reporting the event because the client experienced no harm
B. Document only that the medication was administered without
mentioning the error
C. Wait until the end of the shift to determine whether symptoms develop
D. Assess the client, notify the appropriate healthcare professionals, follow
institutional reporting procedures, and disclose the error according to policy
Answer: D
11. A client who has decision-making capacity tells the nurse that the client
does not want a proposed invasive procedure. The family insists that the
procedure should occur because they believe it is necessary. Which
response by the nurse best protects the client's legal and ethical rights?
A. Proceed with the procedure because the family believes it is necessary
4
PRACTICE QUESTIONS AND STUDY GUIDE COMPLETE ACCURATE EXAM
1. A nurse is caring for several clients on a medical-surgical unit and receives a
report describing four different clinical situations. Which client should the
nurse assess first when applying the principles of priority setting and
recognizing the most immediate threat to physiologic stability?
A. A client with chronic heart failure who has gained 2 lb over the past week
and reports mild ankle edema
B. A client with pneumonia who has a respiratory rate of 32/min, new
confusion, and an oxygen saturation of 84% despite supplemental oxygen
C. A client with diabetes mellitus whose premeal blood glucose is 214
mg/dL and who requests assistance ordering lunch
D. A client recovering from abdominal surgery who reports incisional pain
rated 6/10 before receiving the prescribed analgesic
Answer: B
2. During a clinical shift, a newly licensed nurse is caring for four clients and
must determine which task requires immediate intervention rather than
routine follow-up. Which finding should the nurse recognize as the highest
priority because it may represent acute deterioration requiring rapid
assessment and intervention?
A. A client with stable chronic kidney disease who has a potassium level of
4.8 mEq/L
B. A client with osteoarthritis who requests assistance with ambulation to
the bathroom
C. A client receiving IV antibiotics who reports mild nausea after breakfast
D. A client with heart failure who suddenly develops severe dyspnea, pink
frothy sputum, and bilateral crackles
Answer: D
3. A nurse is organizing care for multiple clients and is deciding which
intervention should be completed first using airway, breathing, circulation,
disability, and exposure principles. Which situation requires the nurse's
1
, immediate attention?
A. A postoperative client with a respiratory rate of 8/min and increasing
somnolence after receiving IV opioid medication
B. A client with a healing pressure injury who needs a scheduled dressing
change
C. A client with hypertension whose blood pressure is 158/92 mm Hg
without acute symptoms
D. A client with anemia who reports fatigue while walking to the bathroom
Answer: A
4. A charge nurse is assigning clients to members of the nursing team and
must consider scope of practice, client stability, and the complexity of
required nursing judgment. Which assignment is most appropriate for a
licensed practical/vocational nurse when the client is stable?
A. Performing the initial assessment of a newly admitted client with chest
pain
B. Developing the initial nursing care plan for a client with newly diagnosed
sepsis
C. Administering scheduled oral medications and reinforcing previously
taught instructions for a stable client
D. Evaluating a client's response to a newly initiated blood transfusion
Answer: C
5. A registered nurse is delegating activities to an experienced nursing
assistant on a medical-surgical unit. Which delegated activity is most
appropriate when the client is stable and the activity does not require
nursing assessment or clinical judgment?
A. Measuring and documenting the oral intake of a stable client who has an
established fluid restriction
B. Teaching a client how to recognize symptoms of hypoglycemia
C. Determining whether a client is ready for discharge after surgery
D. Evaluating the effectiveness of a newly prescribed analgesic
Answer: A
2
, 6. A nurse is caring for a client who has suddenly become confused,
hypotensive, tachycardic, and febrile. The nurse recognizes that the findings
may indicate systemic deterioration. Which action is most appropriate
initially?
A. Document the findings and reassess the client after the next scheduled
medication pass
B. Encourage oral fluids and return after completing routine treatments for
other clients
C. Notify the provider without obtaining additional assessment information
D. Rapidly assess airway, breathing, circulation, vital signs, oxygenation, and
level of consciousness while initiating appropriate emergency measures
Answer: D
7. A nurse is participating in a multidisciplinary discharge planning meeting for
a client with newly diagnosed heart failure who will require medication
management, dietary modification, follow-up appointments, and assistance
obtaining home equipment. Which nursing action best demonstrates
effective care coordination?
A. Telling the client that all discharge decisions will be made by the provider
B. Coordinating communication among the client, family, pharmacy,
provider, and appropriate community services
C. Asking the nursing assistant to determine which medications the client
should continue at home
D. Delaying discharge planning until the day the client is scheduled to leave
the hospital
Answer: B
8. A nurse manager is evaluating whether delegation has been performed
safely. Which statement best reflects appropriate delegation principles in
professional nursing practice?
A. Once a task is delegated, the registered nurse is no longer accountable
for the client's overall nursing care
B. Delegation is appropriate whenever the nurse is too busy to complete the
activity personally
3
, C. The nurse remains accountable for appropriate delegation and
supervision while the delegatee is responsible for performing the assigned
task correctly
D. Any nursing task can be delegated if the person receiving the task has
performed it previously
Answer: C
9. A nurse is caring for a client who refuses a recommended blood transfusion
because of personal beliefs. The healthcare team disagrees with the client's
decision, but the client is alert, understands the risks, and demonstrates
decision-making capacity. Which ethical principle should guide the nurse's
response?
A. Autonomy
B. Justice
C. Fidelity
D. Veracity
Answer: A
10. A nurse discovers that a medication was administered to the wrong client
but that no injury is immediately apparent. Which action best reflects
professional responsibility and a culture of patient safety?
A. Avoid reporting the event because the client experienced no harm
B. Document only that the medication was administered without
mentioning the error
C. Wait until the end of the shift to determine whether symptoms develop
D. Assess the client, notify the appropriate healthcare professionals, follow
institutional reporting procedures, and disclose the error according to policy
Answer: D
11. A client who has decision-making capacity tells the nurse that the client
does not want a proposed invasive procedure. The family insists that the
procedure should occur because they believe it is necessary. Which
response by the nurse best protects the client's legal and ethical rights?
A. Proceed with the procedure because the family believes it is necessary
4
