NU 136
EXAM 5
Fundamentals of Nursing
Actual Questions w/Correct Answers
Galen College of Nursing
What you Will Get:
• 50+ verified questions
• Correct answers with Rationales.
• Ideal for exam preparation and concept
reinforcement.
,1. The nurse working on a medical-surgical unit is administering medications to
an assigned client. Which of the following actions is appropriate for the nurse to
take?
A. Initialing medications on the medication administration record (MAR) as given prior to
entering the room.
B. Notifying the primary healthcare provider (PHCP) that the client has received the
assigned medications.
C. Documenting reasons the client declined taking any medications on the medication
administration record (MAR).
D. Providing the client with a copy of the medication administration record (MAR) upon
request.
Correct Answer:
C. Documenting reasons the client declined taking any medications on the MAR.
NCLEX/NGN Focus: Medication safety, documentation, client rights
Rationale:
A competent client has the right to refuse medication. The nurse should assess the
reason for refusal, provide appropriate education, notify the provider when clinically
indicated, and document the refusal and the client’s stated reason accurately.
Documentation provides a legal record of what occurred and supports continuity of care.
Why the other choices are wrong:
• A: Medications must not be documented as administered until after the client has
actually received them. Pre-documentation can result in a medication error and
constitutes inaccurate charting.
• B: The provider does not need routine notification each time scheduled
medications are administered. Notification is appropriate for refusals, adverse
reactions, omitted doses, or clinically significant concerns.
• D: The MAR is part of the health record. Clients may request access to their
records through the facility’s established process, but the nurse should not simply
hand over a working copy of the MAR.
2. The nurse is caring for a client diagnosed with anemia. Which of the following
should the nurse encourage the client to increase in the diet?
A. Folic acid
B. Vitamin A
,C. Vitamin E
D. Niacin
Correct Answer:
A. Folic acid
NCLEX/NGN Focus: Nutrition, hematologic function
Rationale:
Folic acid is required for DNA synthesis and normal red blood cell production. A
deficiency can produce megaloblastic anemia. Increasing foods such as leafy green
vegetables, fortified cereals, beans, and citrus fruits may support treatment when folate
deficiency is present.
Why the other choices are wrong:
• B: Vitamin A supports vision, immune function, and epithelial tissue integrity. It is
not the primary nutrient associated with correcting folate-deficiency anemia.
• C: Vitamin E functions mainly as an antioxidant and protects cell membranes. It
is not the best answer for routine dietary management of anemia.
• D: Niacin is involved in cellular energy metabolism. Deficiency causes pellagra
rather than the common forms of nutritional anemia addressed by this question.
3. The nurse observes a coworker who has been dealing with a difficult family
member yell at unlicensed assistive personnel (UAP) for taking a bathroom break
without notifying the coworker. The nurse understands that the coworker is using
which of the following defense mechanisms?
A. Rationalization
B. Displacement
C. Reaction formation
D. Sublimation
Correct Answer:
B. Displacement
NCLEX/NGN Focus: Psychosocial integrity, defense mechanisms
Rationale:
Displacement occurs when a person transfers emotions from the original source to a
safer or less threatening person or object. The coworker is angry or frustrated with the
difficult family member but redirects that anger toward the UAP.
, Why the other choices are wrong:
• A: Rationalization involves creating a seemingly acceptable explanation for an
unacceptable feeling or behavior.
• C: Reaction formation involves behaving in a way that is opposite to one’s true
feelings.
• D: Sublimation involves channeling an unacceptable impulse into a socially
acceptable or productive activity, such as exercising to manage anger.
4. A nurse is caring for a client who reports feeling anxious about an upcoming
procedure. Which of the following actions should the nurse take to help reduce
the client’s anxiety?
A. Ask the primary healthcare provider to prescribe antianxiety medication.
B. Check on the client every 15 minutes until the anxiety has passed.
C. Listen carefully to the client about the client’s concerns.
D. Limit the number of visitors until the client is coping more effectively.
Correct Answer:
C. Listen carefully to the client about the client’s concerns.
NCLEX/NGN Focus: Therapeutic communication
Rationale:
Active listening allows the client to express fears, identify misconceptions, and feel
supported. The nurse should use open-ended questions, clarification, reflection, and
simple explanations to reduce anxiety and establish trust.
Why the other choices are wrong:
• A: Medication may be considered for severe anxiety, but therapeutic
communication and assessment should occur first.
• B: Routine 15-minute checks do not directly address the source of the client’s
anxiety and may be unnecessarily restrictive.
• D: Limiting visitors may be appropriate when stimulation worsens severe anxiety,
but there is no indication that visitors are causing the problem.
5. The nurse is assessing a client for clinical manifestations of stress. Which of
the following findings should the nurse recognize as an indicator of stress?
EXAM 5
Fundamentals of Nursing
Actual Questions w/Correct Answers
Galen College of Nursing
What you Will Get:
• 50+ verified questions
• Correct answers with Rationales.
• Ideal for exam preparation and concept
reinforcement.
,1. The nurse working on a medical-surgical unit is administering medications to
an assigned client. Which of the following actions is appropriate for the nurse to
take?
A. Initialing medications on the medication administration record (MAR) as given prior to
entering the room.
B. Notifying the primary healthcare provider (PHCP) that the client has received the
assigned medications.
C. Documenting reasons the client declined taking any medications on the medication
administration record (MAR).
D. Providing the client with a copy of the medication administration record (MAR) upon
request.
Correct Answer:
C. Documenting reasons the client declined taking any medications on the MAR.
NCLEX/NGN Focus: Medication safety, documentation, client rights
Rationale:
A competent client has the right to refuse medication. The nurse should assess the
reason for refusal, provide appropriate education, notify the provider when clinically
indicated, and document the refusal and the client’s stated reason accurately.
Documentation provides a legal record of what occurred and supports continuity of care.
Why the other choices are wrong:
• A: Medications must not be documented as administered until after the client has
actually received them. Pre-documentation can result in a medication error and
constitutes inaccurate charting.
• B: The provider does not need routine notification each time scheduled
medications are administered. Notification is appropriate for refusals, adverse
reactions, omitted doses, or clinically significant concerns.
• D: The MAR is part of the health record. Clients may request access to their
records through the facility’s established process, but the nurse should not simply
hand over a working copy of the MAR.
2. The nurse is caring for a client diagnosed with anemia. Which of the following
should the nurse encourage the client to increase in the diet?
A. Folic acid
B. Vitamin A
,C. Vitamin E
D. Niacin
Correct Answer:
A. Folic acid
NCLEX/NGN Focus: Nutrition, hematologic function
Rationale:
Folic acid is required for DNA synthesis and normal red blood cell production. A
deficiency can produce megaloblastic anemia. Increasing foods such as leafy green
vegetables, fortified cereals, beans, and citrus fruits may support treatment when folate
deficiency is present.
Why the other choices are wrong:
• B: Vitamin A supports vision, immune function, and epithelial tissue integrity. It is
not the primary nutrient associated with correcting folate-deficiency anemia.
• C: Vitamin E functions mainly as an antioxidant and protects cell membranes. It
is not the best answer for routine dietary management of anemia.
• D: Niacin is involved in cellular energy metabolism. Deficiency causes pellagra
rather than the common forms of nutritional anemia addressed by this question.
3. The nurse observes a coworker who has been dealing with a difficult family
member yell at unlicensed assistive personnel (UAP) for taking a bathroom break
without notifying the coworker. The nurse understands that the coworker is using
which of the following defense mechanisms?
A. Rationalization
B. Displacement
C. Reaction formation
D. Sublimation
Correct Answer:
B. Displacement
NCLEX/NGN Focus: Psychosocial integrity, defense mechanisms
Rationale:
Displacement occurs when a person transfers emotions from the original source to a
safer or less threatening person or object. The coworker is angry or frustrated with the
difficult family member but redirects that anger toward the UAP.
, Why the other choices are wrong:
• A: Rationalization involves creating a seemingly acceptable explanation for an
unacceptable feeling or behavior.
• C: Reaction formation involves behaving in a way that is opposite to one’s true
feelings.
• D: Sublimation involves channeling an unacceptable impulse into a socially
acceptable or productive activity, such as exercising to manage anger.
4. A nurse is caring for a client who reports feeling anxious about an upcoming
procedure. Which of the following actions should the nurse take to help reduce
the client’s anxiety?
A. Ask the primary healthcare provider to prescribe antianxiety medication.
B. Check on the client every 15 minutes until the anxiety has passed.
C. Listen carefully to the client about the client’s concerns.
D. Limit the number of visitors until the client is coping more effectively.
Correct Answer:
C. Listen carefully to the client about the client’s concerns.
NCLEX/NGN Focus: Therapeutic communication
Rationale:
Active listening allows the client to express fears, identify misconceptions, and feel
supported. The nurse should use open-ended questions, clarification, reflection, and
simple explanations to reduce anxiety and establish trust.
Why the other choices are wrong:
• A: Medication may be considered for severe anxiety, but therapeutic
communication and assessment should occur first.
• B: Routine 15-minute checks do not directly address the source of the client’s
anxiety and may be unnecessarily restrictive.
• D: Limiting visitors may be appropriate when stimulation worsens severe anxiety,
but there is no indication that visitors are causing the problem.
5. The nurse is assessing a client for clinical manifestations of stress. Which of
the following findings should the nurse recognize as an indicator of stress?
