Fundamentals Nursing 2026 Clinical Judgment
Study Guide: Case-Based Questions, Assessment
Priorities, Patient Safety, Nursing Interventions,
Outcomes & Clinical Reasoning Review
SECTION 1: CLINICAL JUDGMENT & ASSESSMENT PRIORITIES
(Questions 1–30)
Question 1
A nurse is caring for four patients on a medical-surgical unit. Which patient should
the nurse assess first?
A. A patient requesting pain medication for chronic back pain
B. A patient with new-onset shortness of breath and oxygen saturation of 86%
C. A patient requesting assistance with ambulation
D. A patient needing discharge teaching
Rationale: New-onset shortness of breath with oxygen saturation of 86% indicates
acute hypoxemia requiring immediate assessment and intervention. This is a life-
threatening condition that takes priority over routine care.
Question 2
A nurse is prioritizing care using the ABCDE framework. Which patient should the
nurse see first?
A. A patient with a blood pressure of 150/90 mm Hg
B. A patient with an obstructed airway
C. A patient with a heart rate of 110 beats/min
D. A patient with a temperature of 101°F
,Rationale: The ABCDE framework prioritizes Airway first. An obstructed airway
is an immediate life threat requiring intervention before breathing, circulation, or
other concerns.
Question 3
A nurse is assessing a patient who just returned from surgery. Which finding
requires immediate intervention?
A. Blood pressure 118/76 mm Hg
B. Respiratory rate 8 breaths/min and shallow
C. Heart rate 88 beats/min
D. Temperature 98.6°F
Rationale: A respiratory rate of 8 breaths/min with shallow breathing indicates
respiratory depression, which may be caused by anesthesia or opioids. This
requires immediate intervention.
Question 4
A nurse is caring for a patient with a new diagnosis of diabetes. Which assessment
finding is priority?
A. Blood glucose 180 mg/dL
B. Blood glucose 45 mg/dL with confusion
C. Blood glucose 250 mg/dL
D. Blood glucose 120 mg/dL
Rationale: A blood glucose of 45 mg/dL with confusion indicates severe
hypoglycemia, which is a life-threatening emergency requiring immediate
intervention.
,Question 5
A nurse is assessing a patient with heart failure. Which finding indicates worsening
condition?
A. Weight stable
B. Crackles in lung bases and increased shortness of breath
C. Blood pressure 120/80 mm Hg
D. Heart rate 88 beats/min
Rationale: Crackles and increased shortness of breath indicate pulmonary edema,
a worsening of heart failure requiring immediate intervention.
Question 6
A nurse is caring for a patient with a suspected stroke. Which assessment finding is
priority?
A. Headache
B. Sudden weakness on one side and facial drooping
C. Nausea
D. Dizziness
Rationale: Sudden weakness and facial drooping are classic signs of stroke. Time
is critical for intervention, so this is the priority finding.
Question 7
A nurse is assessing a patient who is post-operative day 1 after abdominal surgery.
Which finding requires immediate intervention?
A. Pain at incision site
B. Decreased breath sounds and shortness of breath
C. Temperature 99.2°F
D. Heart rate 88 beats/min
Rationale: Decreased breath sounds and shortness of breath may indicate
atelectasis or pneumonia, which requires immediate intervention.
, Question 8
A nurse is caring for a patient with a pulmonary embolism. Which finding is
priority?
A. Anxiety
B. Sudden shortness of breath and chest pain
C. Leg pain
D. Heart rate 100 beats/min
Rationale: Sudden shortness of breath and chest pain are classic signs of
pulmonary embolism, a life-threatening condition requiring immediate
intervention.
Question 9
A nurse is assessing a patient with a head injury. Which finding requires
immediate intervention?
A. Headache
B. Decreased level of consciousness and unequal pupils
C. Nausea
D. Dizziness
Rationale: Decreased level of consciousness and unequal pupils indicate increased
intracranial pressure, a life-threatening condition requiring immediate intervention.
Question 10
A nurse is caring for a patient with sepsis. Which finding is priority?
A. Fever
B. Hypotension and tachycardia
C. Confusion
D. Warm skin
Study Guide: Case-Based Questions, Assessment
Priorities, Patient Safety, Nursing Interventions,
Outcomes & Clinical Reasoning Review
SECTION 1: CLINICAL JUDGMENT & ASSESSMENT PRIORITIES
(Questions 1–30)
Question 1
A nurse is caring for four patients on a medical-surgical unit. Which patient should
the nurse assess first?
A. A patient requesting pain medication for chronic back pain
B. A patient with new-onset shortness of breath and oxygen saturation of 86%
C. A patient requesting assistance with ambulation
D. A patient needing discharge teaching
Rationale: New-onset shortness of breath with oxygen saturation of 86% indicates
acute hypoxemia requiring immediate assessment and intervention. This is a life-
threatening condition that takes priority over routine care.
Question 2
A nurse is prioritizing care using the ABCDE framework. Which patient should the
nurse see first?
A. A patient with a blood pressure of 150/90 mm Hg
B. A patient with an obstructed airway
C. A patient with a heart rate of 110 beats/min
D. A patient with a temperature of 101°F
,Rationale: The ABCDE framework prioritizes Airway first. An obstructed airway
is an immediate life threat requiring intervention before breathing, circulation, or
other concerns.
Question 3
A nurse is assessing a patient who just returned from surgery. Which finding
requires immediate intervention?
A. Blood pressure 118/76 mm Hg
B. Respiratory rate 8 breaths/min and shallow
C. Heart rate 88 beats/min
D. Temperature 98.6°F
Rationale: A respiratory rate of 8 breaths/min with shallow breathing indicates
respiratory depression, which may be caused by anesthesia or opioids. This
requires immediate intervention.
Question 4
A nurse is caring for a patient with a new diagnosis of diabetes. Which assessment
finding is priority?
A. Blood glucose 180 mg/dL
B. Blood glucose 45 mg/dL with confusion
C. Blood glucose 250 mg/dL
D. Blood glucose 120 mg/dL
Rationale: A blood glucose of 45 mg/dL with confusion indicates severe
hypoglycemia, which is a life-threatening emergency requiring immediate
intervention.
,Question 5
A nurse is assessing a patient with heart failure. Which finding indicates worsening
condition?
A. Weight stable
B. Crackles in lung bases and increased shortness of breath
C. Blood pressure 120/80 mm Hg
D. Heart rate 88 beats/min
Rationale: Crackles and increased shortness of breath indicate pulmonary edema,
a worsening of heart failure requiring immediate intervention.
Question 6
A nurse is caring for a patient with a suspected stroke. Which assessment finding is
priority?
A. Headache
B. Sudden weakness on one side and facial drooping
C. Nausea
D. Dizziness
Rationale: Sudden weakness and facial drooping are classic signs of stroke. Time
is critical for intervention, so this is the priority finding.
Question 7
A nurse is assessing a patient who is post-operative day 1 after abdominal surgery.
Which finding requires immediate intervention?
A. Pain at incision site
B. Decreased breath sounds and shortness of breath
C. Temperature 99.2°F
D. Heart rate 88 beats/min
Rationale: Decreased breath sounds and shortness of breath may indicate
atelectasis or pneumonia, which requires immediate intervention.
, Question 8
A nurse is caring for a patient with a pulmonary embolism. Which finding is
priority?
A. Anxiety
B. Sudden shortness of breath and chest pain
C. Leg pain
D. Heart rate 100 beats/min
Rationale: Sudden shortness of breath and chest pain are classic signs of
pulmonary embolism, a life-threatening condition requiring immediate
intervention.
Question 9
A nurse is assessing a patient with a head injury. Which finding requires
immediate intervention?
A. Headache
B. Decreased level of consciousness and unequal pupils
C. Nausea
D. Dizziness
Rationale: Decreased level of consciousness and unequal pupils indicate increased
intracranial pressure, a life-threatening condition requiring immediate intervention.
Question 10
A nurse is caring for a patient with sepsis. Which finding is priority?
A. Fever
B. Hypotension and tachycardia
C. Confusion
D. Warm skin
