,Hondros College NUR 150 Fundamental
Concepts of Practical Nursing I Final Exam
Practice Pack 2026–2027 | Questions, Answers
& Rationales
Q1. A nurse is performing a comprehensive assessment on a newly admitted client. Which
action is considered subjective data collection?
A. Taking the client's blood pressure
B. Listening to breath sounds
C. Asking the client about pain intensity
D. Palpating the abdomen for tenderness
Correct Answer: C. Asking the client about pain intensity
Rationale: Subjective data are information reported by the client, such as pain intensity,
nausea, or feelings. Objective data are measurable and observable, such as blood pressure,
breath sounds, and palpation findings. Assessment is the first step of the nursing process. The
nurse must distinguish between subjective and objective data to document accurately and
plan appropriate care.
Key Takeaway: Subjective data is what the client says; objective data is what you observe.
Q2. A nurse is preparing to delegate tasks to an unlicensed assistive personnel (UAP). Which
task is most appropriate for the nurse to delegate to the UAP?
A. Administering a scheduled oral pain medication
B. Obtaining vital signs on a stable client who is 2 days postoperative
C. Performing a sterile dressing change on a surgical incision
D. Assessing a client's new complaint of chest pain
Correct Answer: B. Obtaining vital signs on a stable client who is 2 days postoperative
,Rationale: UAPs can perform basic, routine tasks such as obtaining vital signs on stable clients,
assisting with hygiene, and measuring intake and output. Administering medications and
performing sterile dressing changes require the education and licensure of an LPN/LVN or RN.
Assessing a new complaint such as chest pain requires the clinical judgment of an RN and is
never delegated. Delegation must always be based on client stability and task complexity.
Key Takeaway: Delegate routine, stable tasks to UAPs; never delegate assessment or
medication administration.
Q3. A client with type 1 diabetes mellitus is found unresponsive by the nurse. The client's skin
is cool and clammy, and the nurse notes a fruity odor to the breath. Which action should the
nurse take first?
A. Administer 50% dextrose IV push
B. Check the client's blood glucose level
C. Obtain an arterial blood gas sample
D. Administer regular insulin IV push
Correct Answer: B. Check the client's blood glucose level
Rationale: The client is unresponsive with signs that could indicate either hypoglycemia (cool,
clammy skin) or hyperglycemia with ketoacidosis (fruity breath). The nurse cannot safely treat
without knowing the blood glucose level. Checking the glucose level takes only seconds and is
the critical assessment that determines the correct intervention. Giving insulin to a
hypoglycemic client would be fatal, and giving dextrose to a hyperglycemic client would
worsen the condition.
Key Takeaway: Never treat an unresponsive diabetic client without checking the glucose first.
Q4. A nurse is caring for a client who is receiving a blood transfusion. Fifteen minutes into the
transfusion, the client reports chills, flank pain, and has a temperature of 38.9 degrees C (102
degrees F). Which action should the nurse take first?
A. Slow the transfusion rate and administer acetaminophen
B. Stop the transfusion immediately and maintain IV access with normal saline
C. Collect a urine specimen and send it to the laboratory
, D. Administer diphenhydramine as prescribed
Correct Answer: B. Stop the transfusion immediately and maintain IV access with normal
saline
Rationale: The client is exhibiting signs of an acute hemolytic transfusion reaction, which
includes fever, chills, and flank pain. This is a life-threatening emergency. The first and most
critical action is to stop the transfusion immediately to prevent further administration of
incompatible blood. The IV line is then maintained with normal saline using new tubing to
keep the vein open for emergency medications and to support renal perfusion.
Key Takeaway: Stop the transfusion first; saline keeps the line open for emergency care.
Q5. A nurse is using the nursing process to care for a client. Which step involves collecting
subjective and objective data?
A. Assessment
B. Diagnosis
C. Planning
D. Evaluation
Correct Answer: A. Assessment
Rationale: The assessment phase of the nursing process involves collecting subjective data
(what the client reports) and objective data (what the nurse observes and measures). This is
the first and most critical step because all subsequent phases depend on accurate and
complete data collection. Diagnosis involves analyzing the data to identify client problems.
Planning involves setting goals and selecting interventions. Evaluation involves determining
whether goals were met.
Key Takeaway: Assessment is data collection; everything else follows.
Q6. A nurse is reviewing the nursing process with a student. Which phase involves prioritizing
client problems and setting goals?
A. Assessment
B. Diagnosis
C. Planning
Concepts of Practical Nursing I Final Exam
Practice Pack 2026–2027 | Questions, Answers
& Rationales
Q1. A nurse is performing a comprehensive assessment on a newly admitted client. Which
action is considered subjective data collection?
A. Taking the client's blood pressure
B. Listening to breath sounds
C. Asking the client about pain intensity
D. Palpating the abdomen for tenderness
Correct Answer: C. Asking the client about pain intensity
Rationale: Subjective data are information reported by the client, such as pain intensity,
nausea, or feelings. Objective data are measurable and observable, such as blood pressure,
breath sounds, and palpation findings. Assessment is the first step of the nursing process. The
nurse must distinguish between subjective and objective data to document accurately and
plan appropriate care.
Key Takeaway: Subjective data is what the client says; objective data is what you observe.
Q2. A nurse is preparing to delegate tasks to an unlicensed assistive personnel (UAP). Which
task is most appropriate for the nurse to delegate to the UAP?
A. Administering a scheduled oral pain medication
B. Obtaining vital signs on a stable client who is 2 days postoperative
C. Performing a sterile dressing change on a surgical incision
D. Assessing a client's new complaint of chest pain
Correct Answer: B. Obtaining vital signs on a stable client who is 2 days postoperative
,Rationale: UAPs can perform basic, routine tasks such as obtaining vital signs on stable clients,
assisting with hygiene, and measuring intake and output. Administering medications and
performing sterile dressing changes require the education and licensure of an LPN/LVN or RN.
Assessing a new complaint such as chest pain requires the clinical judgment of an RN and is
never delegated. Delegation must always be based on client stability and task complexity.
Key Takeaway: Delegate routine, stable tasks to UAPs; never delegate assessment or
medication administration.
Q3. A client with type 1 diabetes mellitus is found unresponsive by the nurse. The client's skin
is cool and clammy, and the nurse notes a fruity odor to the breath. Which action should the
nurse take first?
A. Administer 50% dextrose IV push
B. Check the client's blood glucose level
C. Obtain an arterial blood gas sample
D. Administer regular insulin IV push
Correct Answer: B. Check the client's blood glucose level
Rationale: The client is unresponsive with signs that could indicate either hypoglycemia (cool,
clammy skin) or hyperglycemia with ketoacidosis (fruity breath). The nurse cannot safely treat
without knowing the blood glucose level. Checking the glucose level takes only seconds and is
the critical assessment that determines the correct intervention. Giving insulin to a
hypoglycemic client would be fatal, and giving dextrose to a hyperglycemic client would
worsen the condition.
Key Takeaway: Never treat an unresponsive diabetic client without checking the glucose first.
Q4. A nurse is caring for a client who is receiving a blood transfusion. Fifteen minutes into the
transfusion, the client reports chills, flank pain, and has a temperature of 38.9 degrees C (102
degrees F). Which action should the nurse take first?
A. Slow the transfusion rate and administer acetaminophen
B. Stop the transfusion immediately and maintain IV access with normal saline
C. Collect a urine specimen and send it to the laboratory
, D. Administer diphenhydramine as prescribed
Correct Answer: B. Stop the transfusion immediately and maintain IV access with normal
saline
Rationale: The client is exhibiting signs of an acute hemolytic transfusion reaction, which
includes fever, chills, and flank pain. This is a life-threatening emergency. The first and most
critical action is to stop the transfusion immediately to prevent further administration of
incompatible blood. The IV line is then maintained with normal saline using new tubing to
keep the vein open for emergency medications and to support renal perfusion.
Key Takeaway: Stop the transfusion first; saline keeps the line open for emergency care.
Q5. A nurse is using the nursing process to care for a client. Which step involves collecting
subjective and objective data?
A. Assessment
B. Diagnosis
C. Planning
D. Evaluation
Correct Answer: A. Assessment
Rationale: The assessment phase of the nursing process involves collecting subjective data
(what the client reports) and objective data (what the nurse observes and measures). This is
the first and most critical step because all subsequent phases depend on accurate and
complete data collection. Diagnosis involves analyzing the data to identify client problems.
Planning involves setting goals and selecting interventions. Evaluation involves determining
whether goals were met.
Key Takeaway: Assessment is data collection; everything else follows.
Q6. A nurse is reviewing the nursing process with a student. Which phase involves prioritizing
client problems and setting goals?
A. Assessment
B. Diagnosis
C. Planning
