FUNDAMENTALS OF
COMPREHENSIVE STUDY GUIDE
2026–2027
PRACTICE QUESTIONS, KEY CONCEPTS &
RATIONALES
Fundamentals of Nursing Comprehensive Study Guide 2026–2027
,Section 1: Safety and Infection Prevention and Control
Key Concepts
Standard Precautions: Apply to all patients
regardless of diagnosis. Include hand hygiene, gloves, gown, mask, eye
protection, and safe injection practices.
Transmission-Based Precautions:
Contact: MRSA, C. difficile, RSV — gloves and
gown required
Droplet: Influenza, pertussis, mumps — mask
required
Airborne: TB, measles, varicella — N95
respirator and negative-pressure room
Hand Hygiene: The single most effective method
of infection prevention. Use soap and water when hands are visibly soiled or
after caring for patients with C. difficile. Use alcohol-based hand rub in all
other clinical situations.
Safety Priorities: Fall prevention, restraint
use (requires provider order, frequent assessment), and safe patient handling.
Practice Question
Q1. A nurse is caring for a patient with
an active C. difficile infection. Which action by the nurse requires immediate
correction?
A. The nurse performs hand hygiene with soap and water after leaving the room.
B. The nurse wears gloves and a gown when entering the patient's room.
C. The nurse uses an alcohol-based hand rub after removing gloves.
D. The nurse places the patient in a private room with a dedicated bathroom.
Answer: C
Rationale: Alcohol-based hand rubs are **not
effective against C. difficile spores**. Soap and water must be used because
the mechanical action of washing removes spores from the hands . Gloves
and gowns are appropriate for contact precautions, and a private room with a
dedicated bathroom is standard practice.
Incorrect Answers:
A: Soap and water is the correct hand hygiene
method for C. difficile.
B: Contact precautions require gloves and gown.
D: A private room with a dedicated bathroom is
appropriate for contact precautions.
Section 3: Vital Signs and Physical Assessment
Fundamentals of Nursing Comprehensive Study Guide 2026–2027
, Key Concepts
Normal Adult Vital Signs:
Temperature: 36.5–37.5°C (97.7–99.5°F)
Pulse: 60–100 beats/min
Respirations: 12–20 breaths/min
Blood Pressure: <120/80 mmHg
Oxygen Saturation: ≥95%
Pain: Often called the "fifth vital
sign." Use a validated scale (0–10 numeric, Wong-Baker FACES for children,
PAINAD for dementia patients).
Head-to-Toe Assessment: Systematic approach
including general appearance, neurological, respiratory, cardiovascular,
abdominal, musculoskeletal, and skin assessment.
Practice Question
Section 2: Vital Signs and Physical Assessment
Key Concepts
Normal Adult Vital Signs:
Temperature: 36.5–37.5°C (97.7–99.5°F)
Pulse: 60–100 beats/min
Respirations: 12–20 breaths/min
Blood Pressure: <120/80 mmHg
Oxygen Saturation: ≥95%
Pain: Often called the "fifth vital
sign." Use a validated scale (0–10 numeric, Wong-Baker FACES for children,
PAINAD for dementia patients).
Head-to-Toe Assessment: Systematic approach
including general appearance, neurological, respiratory, cardiovascular,
abdominal, musculoskeletal, and skin assessment.
Practice Question
Q2. A patient's arterial blood gas (ABG)
results are: pH 7.30, PaCO₂ 52 mmHg, and HCO₃ 26 mEq/L. How should the nurse
interpret these findings?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
Fundamentals of Nursing Comprehensive Study Guide 2026–2027
, D. Respiratory alkalosis
Answer: C
Rationale: A pH below 7.35 indicates acidosis.
The PaCO₂ is elevated (above 45 mmHg) while the HCO₃ is normal, indicating the
respiratory system is the cause. This is respiratory acidosis .
Incorrect Answers:
A: Metabolic acidosis would show a low pH with
low HCO₃.
B: Metabolic alkalosis would show a high pH with
high HCO₃.
D: Respiratory alkalosis would show a high pH
with low PaCO₂.
Section 4: Medication Administration
Key Concepts
The "Rights" of Medication Administration: Right
patient, right drug, right dose, right route, right time, right documentation
(some add right reason, right to refuse, right assessment).
Three Checks: Check the medication when pulling
from the drawer, when preparing, and at the bedside before administration.
Dosage Calculation: Always verify calculations.
Use dimensional analysis or formula method. Have another nurse verify
high-alert medications (insulin, heparin, opioids).
High-Alert Medications: Require independent
double-check: insulin, heparin, chemotherapy agents, neuromuscular blockers.
Practice Question
Section 4: Medication Administration
Key Concepts
The "Rights" of Medication Administration: Right
patient, right drug, right dose, right route, right time, right documentation
(some add right reason, right to refuse, right assessment).
Three Checks: Check the medication when pulling
from the drawer, when preparing, and at the bedside before administration.
Dosage Calculation: Always verify calculations.
Use dimensional analysis or formula method. Have another nurse verify
high-alert medications (insulin, heparin, opioids).
High-Alert Medications: Require independent
double-check: insulin, heparin, chemotherapy agents, neuromuscular blockers.
Practice Question
Fundamentals of Nursing Comprehensive Study Guide 2026–2027
COMPREHENSIVE STUDY GUIDE
2026–2027
PRACTICE QUESTIONS, KEY CONCEPTS &
RATIONALES
Fundamentals of Nursing Comprehensive Study Guide 2026–2027
,Section 1: Safety and Infection Prevention and Control
Key Concepts
Standard Precautions: Apply to all patients
regardless of diagnosis. Include hand hygiene, gloves, gown, mask, eye
protection, and safe injection practices.
Transmission-Based Precautions:
Contact: MRSA, C. difficile, RSV — gloves and
gown required
Droplet: Influenza, pertussis, mumps — mask
required
Airborne: TB, measles, varicella — N95
respirator and negative-pressure room
Hand Hygiene: The single most effective method
of infection prevention. Use soap and water when hands are visibly soiled or
after caring for patients with C. difficile. Use alcohol-based hand rub in all
other clinical situations.
Safety Priorities: Fall prevention, restraint
use (requires provider order, frequent assessment), and safe patient handling.
Practice Question
Q1. A nurse is caring for a patient with
an active C. difficile infection. Which action by the nurse requires immediate
correction?
A. The nurse performs hand hygiene with soap and water after leaving the room.
B. The nurse wears gloves and a gown when entering the patient's room.
C. The nurse uses an alcohol-based hand rub after removing gloves.
D. The nurse places the patient in a private room with a dedicated bathroom.
Answer: C
Rationale: Alcohol-based hand rubs are **not
effective against C. difficile spores**. Soap and water must be used because
the mechanical action of washing removes spores from the hands . Gloves
and gowns are appropriate for contact precautions, and a private room with a
dedicated bathroom is standard practice.
Incorrect Answers:
A: Soap and water is the correct hand hygiene
method for C. difficile.
B: Contact precautions require gloves and gown.
D: A private room with a dedicated bathroom is
appropriate for contact precautions.
Section 3: Vital Signs and Physical Assessment
Fundamentals of Nursing Comprehensive Study Guide 2026–2027
, Key Concepts
Normal Adult Vital Signs:
Temperature: 36.5–37.5°C (97.7–99.5°F)
Pulse: 60–100 beats/min
Respirations: 12–20 breaths/min
Blood Pressure: <120/80 mmHg
Oxygen Saturation: ≥95%
Pain: Often called the "fifth vital
sign." Use a validated scale (0–10 numeric, Wong-Baker FACES for children,
PAINAD for dementia patients).
Head-to-Toe Assessment: Systematic approach
including general appearance, neurological, respiratory, cardiovascular,
abdominal, musculoskeletal, and skin assessment.
Practice Question
Section 2: Vital Signs and Physical Assessment
Key Concepts
Normal Adult Vital Signs:
Temperature: 36.5–37.5°C (97.7–99.5°F)
Pulse: 60–100 beats/min
Respirations: 12–20 breaths/min
Blood Pressure: <120/80 mmHg
Oxygen Saturation: ≥95%
Pain: Often called the "fifth vital
sign." Use a validated scale (0–10 numeric, Wong-Baker FACES for children,
PAINAD for dementia patients).
Head-to-Toe Assessment: Systematic approach
including general appearance, neurological, respiratory, cardiovascular,
abdominal, musculoskeletal, and skin assessment.
Practice Question
Q2. A patient's arterial blood gas (ABG)
results are: pH 7.30, PaCO₂ 52 mmHg, and HCO₃ 26 mEq/L. How should the nurse
interpret these findings?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
Fundamentals of Nursing Comprehensive Study Guide 2026–2027
, D. Respiratory alkalosis
Answer: C
Rationale: A pH below 7.35 indicates acidosis.
The PaCO₂ is elevated (above 45 mmHg) while the HCO₃ is normal, indicating the
respiratory system is the cause. This is respiratory acidosis .
Incorrect Answers:
A: Metabolic acidosis would show a low pH with
low HCO₃.
B: Metabolic alkalosis would show a high pH with
high HCO₃.
D: Respiratory alkalosis would show a high pH
with low PaCO₂.
Section 4: Medication Administration
Key Concepts
The "Rights" of Medication Administration: Right
patient, right drug, right dose, right route, right time, right documentation
(some add right reason, right to refuse, right assessment).
Three Checks: Check the medication when pulling
from the drawer, when preparing, and at the bedside before administration.
Dosage Calculation: Always verify calculations.
Use dimensional analysis or formula method. Have another nurse verify
high-alert medications (insulin, heparin, opioids).
High-Alert Medications: Require independent
double-check: insulin, heparin, chemotherapy agents, neuromuscular blockers.
Practice Question
Section 4: Medication Administration
Key Concepts
The "Rights" of Medication Administration: Right
patient, right drug, right dose, right route, right time, right documentation
(some add right reason, right to refuse, right assessment).
Three Checks: Check the medication when pulling
from the drawer, when preparing, and at the bedside before administration.
Dosage Calculation: Always verify calculations.
Use dimensional analysis or formula method. Have another nurse verify
high-alert medications (insulin, heparin, opioids).
High-Alert Medications: Require independent
double-check: insulin, heparin, chemotherapy agents, neuromuscular blockers.
Practice Question
Fundamentals of Nursing Comprehensive Study Guide 2026–2027
