A+ VERIFIED
2023 RN Fundamentals – Exam (3 Versions) | NGN-Style
2026/2027
| NGN Mastery | Fundamentals Excellence - Pass Guaranteed - A+ Graded
150 3 150
QUESTIONS SECTIONS RATIONALES
WHAT THIS COVERS
1 Version 1: Foundations of Nursing Practice and Safety3 Version 3: NGN-Style Clinical Judgment and Decision-…
2 Version 2: Patient Care and Clinical Skills
ABOUT THIS ASSESSMENT
This assessment covers 3 domains spanning 150 original, application/analysis-level items in Multiple Choice (4-option) -
NGN-Style format. Each item is paired with a concept label and a specific rationale explaining the correct answer. Items
emphasize clinical reasoning, procedural judgment, and integration of theory with practice. Difficulty is calibrated to
intermediate learners operating at the Application/Analysis cognitive level. Passing score is 75%. This material is
independently authored for review and self-assessment; it does not reproduce any secured or proprietary item bank.
PASSING SCORE: 75% LEVEL: INTERMEDIATE
FORMAT: Multiple Choice (4-option) - NGN-Style
BLOOM: Application/Analysis
STUVIA ACTUAL EXAM
,2023 RN Fundamentals – Exam (3 Versions) | NGN-Style 150 Questions | A+ Verified
Section 1 Version 1: Foundations of Nursing Practice and Safety
Foundational concepts of professional nursing: safety, infection control, patient-centered care,
communication, ethics, documentation, and the nursing process applied to basic care scenarios.
1. A nurse is caring for a patient who has just returned from surgery. Which step of the nursing
process is the nurse using when reviewing the post-anesthesia vital signs and comparing them with
baseline?
A. Diagnosis
B. Assessment
C. Planning
D. Evaluation
Concept: Nursing Process: ADPIE
Reviewing and comparing current data with baseline is part of the Assessment step, which involves gathering
and validating subjective and objective data. Diagnosis interprets these data; Planning sets goals; Evaluation
measures progress toward outcomes.
2. A patient reports feeling anxious about an upcoming procedure, but is also hypoxic with SpO2
88%. According to Maslow's hierarchy, the nurse should FIRST:
A. Address the anxiety with therapeutic communication
B. Administer an anxiolytic as prescribed
C. Document both findings and continue monitoring
D. Apply oxygen to correct the physiological hypoxia
Concept: Maslow Hierarchy Application
Maslow prioritizes physiological needs over psychosocial needs. Hypoxia is a life-threatening physiological deficit
(oxygenation) and must be corrected before addressing anxiety. Once oxygenation is restored, the nurse can
address anxiety.
3. According to the WHO Five Moments for Hand Hygiene, the nurse must perform hand hygiene:
A. Only before touching a patient
B. Only after removing gloves
C. Before touching a patient, before clean/aseptic procedures, after body fluid exposure risk, after
touching a patient, and after touching patient surroundings
D. Once at the start of each shift
Concept: Hand Hygiene: WHO Five Moments
The WHO Five Moments are: (1) before touching a patient, (2) before clean/aseptic procedures, (3) after body
fluid exposure risk, (4) after touching a patient, (5) after touching patient surroundings. This comprehensive
approach prevents transmission of pathogens.
4. When caring for a patient on contact precautions for MRSA, the correct order for DONNING
personal protective equipment is:
A. Gown → Mask → Gloves → Goggles
B. Mask → Gown → Gloves → Goggles
C. Gloves → Gown → Goggles → Mask
D. Gown → Mask or respirator → Goggles or face shield → Gloves
Concept: PPE Sequence: Donning and Doffing
STUVIA ACTUAL EXAM Page 2
,2023 RN Fundamentals – Exam (3 Versions) | NGN-Style 150 Questions | A+ Verified
The CDC donning sequence is: gown first, then mask/respirator, then goggles/face shield, then gloves last (gloves
pulled over gown cuffs). This ensures all PPE is in place before patient contact and prevents contamination
during donning.
5. When DOFFING PPE after caring for a patient on contact precautions, the correct sequence is:
A. Gown → Gloves → Mask → Goggles
B. Gloves → Goggles → Gown → Mask or respirator
C. Mask → Gown → Gloves → Goggles
D. Goggles → Mask → Gown → Gloves
Concept: PPE Sequence: Doffing
The CDC doffing sequence removes the most contaminated items first: gloves (most contaminated), then goggles,
then gown (rolled inside-out), then mask/respirator last. Hand hygiene is performed immediately after removing
all PPE.
6. When using SBAR to communicate a change in patient status to a provider, the 'S' (Situation)
component should include:
A. The patient's complete medical history
B. A brief, focused statement of the current problem and its urgency
C. All laboratory values since admission
D. A list of the patient's home medications
Concept: SBAR Communication
SBAR's Situation is a brief, focused opening statement that includes the patient's name, location, and the
immediate problem. Background (B) covers relevant history; Assessment (A) is the nurse's clinical interpretation;
Recommendation (R) is the requested action.
7. Before administering a medication, the nurse verifies patient identity using two identifiers.
Which of the following is an ACCEPTABLE pair of identifiers?
A. Patient's room number and bed assignment
B. Patient's physician name and admission date
C. Patient's diagnosis and room number
D. Patient's full name and date of birth
Concept: Patient Identification: Two Identifiers
Joint Commission requires at least two patient identifiers (e.g., full name, date of birth, medical record number).
Room numbers and bed assignments are NOT acceptable identifiers because they can change. The patient (or
family) should verbally state the identifiers whenever possible.
8. A competent adult patient refuses a prescribed blood transfusion due to religious beliefs. The
nurse's BEST action is to:
A. Administer the transfusion because the provider ordered it
B. Respect the patient's refusal and document the informed refusal
C. Transfer the patient to another facility
D. Have the family override the patient's decision
Concept: Ethical Principle: Autonomy
Autonomy is the ethical principle that competent adults have the right to make decisions about their own care,
even if refusal may lead to harm. The nurse must respect the refusal, ensure the patient is informed of
consequences, document the refusal, and notify the provider.
STUVIA ACTUAL EXAM Page 3
, 2023 RN Fundamentals – Exam (3 Versions) | NGN-Style 150 Questions | A+ Verified
9. A nurse advocating for adequate pain management for a postoperative patient is demonstrating
which ethical principle?
A. Autonomy
B. Beneficence
C. Justice
D. Fidelity
Concept: Ethical Principle: Beneficence
Beneficence is the duty to act in the patient's best interest and promote good. Advocating for pain relief is acting
for the patient's benefit. Autonomy respects patient choice; Justice is fairness in resource distribution; Fidelity is
keeping promises.
10. Which documentation principle is most important when correcting an error in a paper medical
record?
A. Use white-out to remove the error completely
B. Erase the error and rewrite the correct entry
C. Draw a single line through the error, write 'error,' initial, date, and write the correct entry
D. Black out the error with a marker to obscure it
Concept: Documentation: Legal Principles
Legal documentation requires that errors be corrected transparently: draw a single line through the error so the
original is still legible, write 'error' or 'mistaken entry,' initial, date, and write the correct entry. White-out,
erasure, or blacking out makes the record legally suspect.
11. At the start of a shift, the nurse has four patients with the following needs. Which should the
nurse address FIRST?
A. A patient requesting pain medication for chronic arthritis
B. A patient with new-onset shortness of breath and SpO2 88%
C. A patient who needs teaching prior to discharge
D. A patient who is due for routine vital signs
Concept: Time Management: Prioritization
Use the ABC (Airway, Breathing, Circulation) priority framework. New-onset shortness of breath with hypoxia is
a potential immediate threat to life and requires urgent assessment. The other needs are important but not
immediately life-threatening.
12. When delegating a task to unlicensed assistive personnel (UAP), the nurse considers the 'Right
Task.' Which task is APPROPRIATE to delegate to UAP?
A. Administering an oral medication
B. Obtaining routine vital signs on a stable patient
C. Ambulating a patient on a heparin drip for the first time postoperatively
D. Performing initial admission assessment
Concept: Delegation: Five Rights
The Five Rights of Delegation are: Right Task, Right Circumstance, Right Person, Right
Direction/Communication, Right Supervision. Obtaining routine vitals on a stable patient is within UAP scope.
Medication administration, initial assessments, and complex care require licensed nurses.
13. A nurse discussing a patient's care with the interdisciplinary team in an elevator should follow
the HIPAA 'minimum necessary' standard by:
STUVIA ACTUAL EXAM Page 4
2023 RN Fundamentals – Exam (3 Versions) | NGN-Style
2026/2027
| NGN Mastery | Fundamentals Excellence - Pass Guaranteed - A+ Graded
150 3 150
QUESTIONS SECTIONS RATIONALES
WHAT THIS COVERS
1 Version 1: Foundations of Nursing Practice and Safety3 Version 3: NGN-Style Clinical Judgment and Decision-…
2 Version 2: Patient Care and Clinical Skills
ABOUT THIS ASSESSMENT
This assessment covers 3 domains spanning 150 original, application/analysis-level items in Multiple Choice (4-option) -
NGN-Style format. Each item is paired with a concept label and a specific rationale explaining the correct answer. Items
emphasize clinical reasoning, procedural judgment, and integration of theory with practice. Difficulty is calibrated to
intermediate learners operating at the Application/Analysis cognitive level. Passing score is 75%. This material is
independently authored for review and self-assessment; it does not reproduce any secured or proprietary item bank.
PASSING SCORE: 75% LEVEL: INTERMEDIATE
FORMAT: Multiple Choice (4-option) - NGN-Style
BLOOM: Application/Analysis
STUVIA ACTUAL EXAM
,2023 RN Fundamentals – Exam (3 Versions) | NGN-Style 150 Questions | A+ Verified
Section 1 Version 1: Foundations of Nursing Practice and Safety
Foundational concepts of professional nursing: safety, infection control, patient-centered care,
communication, ethics, documentation, and the nursing process applied to basic care scenarios.
1. A nurse is caring for a patient who has just returned from surgery. Which step of the nursing
process is the nurse using when reviewing the post-anesthesia vital signs and comparing them with
baseline?
A. Diagnosis
B. Assessment
C. Planning
D. Evaluation
Concept: Nursing Process: ADPIE
Reviewing and comparing current data with baseline is part of the Assessment step, which involves gathering
and validating subjective and objective data. Diagnosis interprets these data; Planning sets goals; Evaluation
measures progress toward outcomes.
2. A patient reports feeling anxious about an upcoming procedure, but is also hypoxic with SpO2
88%. According to Maslow's hierarchy, the nurse should FIRST:
A. Address the anxiety with therapeutic communication
B. Administer an anxiolytic as prescribed
C. Document both findings and continue monitoring
D. Apply oxygen to correct the physiological hypoxia
Concept: Maslow Hierarchy Application
Maslow prioritizes physiological needs over psychosocial needs. Hypoxia is a life-threatening physiological deficit
(oxygenation) and must be corrected before addressing anxiety. Once oxygenation is restored, the nurse can
address anxiety.
3. According to the WHO Five Moments for Hand Hygiene, the nurse must perform hand hygiene:
A. Only before touching a patient
B. Only after removing gloves
C. Before touching a patient, before clean/aseptic procedures, after body fluid exposure risk, after
touching a patient, and after touching patient surroundings
D. Once at the start of each shift
Concept: Hand Hygiene: WHO Five Moments
The WHO Five Moments are: (1) before touching a patient, (2) before clean/aseptic procedures, (3) after body
fluid exposure risk, (4) after touching a patient, (5) after touching patient surroundings. This comprehensive
approach prevents transmission of pathogens.
4. When caring for a patient on contact precautions for MRSA, the correct order for DONNING
personal protective equipment is:
A. Gown → Mask → Gloves → Goggles
B. Mask → Gown → Gloves → Goggles
C. Gloves → Gown → Goggles → Mask
D. Gown → Mask or respirator → Goggles or face shield → Gloves
Concept: PPE Sequence: Donning and Doffing
STUVIA ACTUAL EXAM Page 2
,2023 RN Fundamentals – Exam (3 Versions) | NGN-Style 150 Questions | A+ Verified
The CDC donning sequence is: gown first, then mask/respirator, then goggles/face shield, then gloves last (gloves
pulled over gown cuffs). This ensures all PPE is in place before patient contact and prevents contamination
during donning.
5. When DOFFING PPE after caring for a patient on contact precautions, the correct sequence is:
A. Gown → Gloves → Mask → Goggles
B. Gloves → Goggles → Gown → Mask or respirator
C. Mask → Gown → Gloves → Goggles
D. Goggles → Mask → Gown → Gloves
Concept: PPE Sequence: Doffing
The CDC doffing sequence removes the most contaminated items first: gloves (most contaminated), then goggles,
then gown (rolled inside-out), then mask/respirator last. Hand hygiene is performed immediately after removing
all PPE.
6. When using SBAR to communicate a change in patient status to a provider, the 'S' (Situation)
component should include:
A. The patient's complete medical history
B. A brief, focused statement of the current problem and its urgency
C. All laboratory values since admission
D. A list of the patient's home medications
Concept: SBAR Communication
SBAR's Situation is a brief, focused opening statement that includes the patient's name, location, and the
immediate problem. Background (B) covers relevant history; Assessment (A) is the nurse's clinical interpretation;
Recommendation (R) is the requested action.
7. Before administering a medication, the nurse verifies patient identity using two identifiers.
Which of the following is an ACCEPTABLE pair of identifiers?
A. Patient's room number and bed assignment
B. Patient's physician name and admission date
C. Patient's diagnosis and room number
D. Patient's full name and date of birth
Concept: Patient Identification: Two Identifiers
Joint Commission requires at least two patient identifiers (e.g., full name, date of birth, medical record number).
Room numbers and bed assignments are NOT acceptable identifiers because they can change. The patient (or
family) should verbally state the identifiers whenever possible.
8. A competent adult patient refuses a prescribed blood transfusion due to religious beliefs. The
nurse's BEST action is to:
A. Administer the transfusion because the provider ordered it
B. Respect the patient's refusal and document the informed refusal
C. Transfer the patient to another facility
D. Have the family override the patient's decision
Concept: Ethical Principle: Autonomy
Autonomy is the ethical principle that competent adults have the right to make decisions about their own care,
even if refusal may lead to harm. The nurse must respect the refusal, ensure the patient is informed of
consequences, document the refusal, and notify the provider.
STUVIA ACTUAL EXAM Page 3
, 2023 RN Fundamentals – Exam (3 Versions) | NGN-Style 150 Questions | A+ Verified
9. A nurse advocating for adequate pain management for a postoperative patient is demonstrating
which ethical principle?
A. Autonomy
B. Beneficence
C. Justice
D. Fidelity
Concept: Ethical Principle: Beneficence
Beneficence is the duty to act in the patient's best interest and promote good. Advocating for pain relief is acting
for the patient's benefit. Autonomy respects patient choice; Justice is fairness in resource distribution; Fidelity is
keeping promises.
10. Which documentation principle is most important when correcting an error in a paper medical
record?
A. Use white-out to remove the error completely
B. Erase the error and rewrite the correct entry
C. Draw a single line through the error, write 'error,' initial, date, and write the correct entry
D. Black out the error with a marker to obscure it
Concept: Documentation: Legal Principles
Legal documentation requires that errors be corrected transparently: draw a single line through the error so the
original is still legible, write 'error' or 'mistaken entry,' initial, date, and write the correct entry. White-out,
erasure, or blacking out makes the record legally suspect.
11. At the start of a shift, the nurse has four patients with the following needs. Which should the
nurse address FIRST?
A. A patient requesting pain medication for chronic arthritis
B. A patient with new-onset shortness of breath and SpO2 88%
C. A patient who needs teaching prior to discharge
D. A patient who is due for routine vital signs
Concept: Time Management: Prioritization
Use the ABC (Airway, Breathing, Circulation) priority framework. New-onset shortness of breath with hypoxia is
a potential immediate threat to life and requires urgent assessment. The other needs are important but not
immediately life-threatening.
12. When delegating a task to unlicensed assistive personnel (UAP), the nurse considers the 'Right
Task.' Which task is APPROPRIATE to delegate to UAP?
A. Administering an oral medication
B. Obtaining routine vital signs on a stable patient
C. Ambulating a patient on a heparin drip for the first time postoperatively
D. Performing initial admission assessment
Concept: Delegation: Five Rights
The Five Rights of Delegation are: Right Task, Right Circumstance, Right Person, Right
Direction/Communication, Right Supervision. Obtaining routine vitals on a stable patient is within UAP scope.
Medication administration, initial assessments, and complex care require licensed nurses.
13. A nurse discussing a patient's care with the interdisciplinary team in an elevator should follow
the HIPAA 'minimum necessary' standard by:
STUVIA ACTUAL EXAM Page 4
