1
Exam 2: NUR155 / NUR 155
(Latest 2025/2026)
Foundations of Nursing Exam
| Questions and Answers |
Grade A | Galen
1. Which of the following is the first step in the nursing process?
o A. Planning
o B. Assessment
o C. Implementation
o D. Evaluation
B. Assessment
Rationale: Assessment is the initial phase of the nursing process where
data is collected to identify patient needs, grounded in evidence-based
practice for systematic clinical reasoning.
2. What is the normal range for an adult's oral temperature in
Celsius?
o A. 35.5–37.0°C
o B. 36.5–37.5°C
o C. 37.5–38.5°C
o D. 38.0–39.0°C
B. 36.5–37.5°C
Rationale: The standard normal range for adult oral temperature is
36.5–37.5°C, based on physiological norms in nursing fundamentals to
guide accurate vital sign interpretation.
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3. Which isolation precaution is used for patients with airborne
infections like tuberculosis?
o A. Contact
o B. Droplet
o C. Airborne
o D. Standard
C. Airborne
Rationale: Airborne precautions prevent transmission of small particles
that remain suspended in air, aligning with CDC guidelines for infection
control in evidence-based nursing practice.
4. What is the primary purpose of hand hygiene in nursing?
o A. To reduce microbial load on skin
o B. To improve patient comfort
o C. To comply with hospital policy
o D. To prevent skin irritation
A. To reduce microbial load on skin
Rationale: Hand hygiene primarily decreases the number of
microorganisms, a core principle of asepsis and infection prevention in
clinical reasoning.
5. Which ethical principle involves doing no harm to the patient?
o A. Autonomy
o B. Beneficence
o C. Nonmaleficence
o D. Justice
C. Nonmaleficence
Rationale: Nonmaleficence requires nurses to avoid causing harm, a
foundational ethic in nursing that supports safe patient care decisions.
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6. What is the correct technique for measuring blood pressure using a
manual sphygmomanometer?
o A. Inflate cuff 30 mmHg above palpated systolic pressure
o B. Place stethoscope over radial artery
o C. Deflate cuff at 10 mmHg per second
o D. Use a cuff that covers 40% of the arm circumference
A. Inflate cuff 30 mmHg above palpated systolic pressure
Rationale: Proper inflation to 30 mmHg above estimated systolic
ensures accurate Korotkoff sound detection, per AHA guidelines for
evidence-based vital sign assessment.
7. A patient reports pain rated 8/10. What is the nurse’s priority
action?
o A. Administer PRN analgesic as ordered
o B. Reassess pain in 1 hour
o C. Teach non-pharmacologic pain relief
o D. Document the pain score
A. Administer PRN analgesic as ordered
Rationale: Acute severe pain requires prompt pharmacologic
intervention per pain management standards to promote comfort and
prevent physiological stress.
8. Which position is contraindicated for a patient with suspected
spinal injury?
o A. Supine with head elevated 30°
o B. Log roll technique
o C. Flexion of the neck
o D. Neutral alignment with cervical collar
C. Flexion of the neck
Rationale: Neck flexion risks further spinal cord damage; neutral
alignment with immobilization is required per trauma nursing protocols.
Exam 2: NUR155 / NUR 155
(Latest 2025/2026)
Foundations of Nursing Exam
| Questions and Answers |
Grade A | Galen
1. Which of the following is the first step in the nursing process?
o A. Planning
o B. Assessment
o C. Implementation
o D. Evaluation
B. Assessment
Rationale: Assessment is the initial phase of the nursing process where
data is collected to identify patient needs, grounded in evidence-based
practice for systematic clinical reasoning.
2. What is the normal range for an adult's oral temperature in
Celsius?
o A. 35.5–37.0°C
o B. 36.5–37.5°C
o C. 37.5–38.5°C
o D. 38.0–39.0°C
B. 36.5–37.5°C
Rationale: The standard normal range for adult oral temperature is
36.5–37.5°C, based on physiological norms in nursing fundamentals to
guide accurate vital sign interpretation.
, 2
3. Which isolation precaution is used for patients with airborne
infections like tuberculosis?
o A. Contact
o B. Droplet
o C. Airborne
o D. Standard
C. Airborne
Rationale: Airborne precautions prevent transmission of small particles
that remain suspended in air, aligning with CDC guidelines for infection
control in evidence-based nursing practice.
4. What is the primary purpose of hand hygiene in nursing?
o A. To reduce microbial load on skin
o B. To improve patient comfort
o C. To comply with hospital policy
o D. To prevent skin irritation
A. To reduce microbial load on skin
Rationale: Hand hygiene primarily decreases the number of
microorganisms, a core principle of asepsis and infection prevention in
clinical reasoning.
5. Which ethical principle involves doing no harm to the patient?
o A. Autonomy
o B. Beneficence
o C. Nonmaleficence
o D. Justice
C. Nonmaleficence
Rationale: Nonmaleficence requires nurses to avoid causing harm, a
foundational ethic in nursing that supports safe patient care decisions.
, 3
6. What is the correct technique for measuring blood pressure using a
manual sphygmomanometer?
o A. Inflate cuff 30 mmHg above palpated systolic pressure
o B. Place stethoscope over radial artery
o C. Deflate cuff at 10 mmHg per second
o D. Use a cuff that covers 40% of the arm circumference
A. Inflate cuff 30 mmHg above palpated systolic pressure
Rationale: Proper inflation to 30 mmHg above estimated systolic
ensures accurate Korotkoff sound detection, per AHA guidelines for
evidence-based vital sign assessment.
7. A patient reports pain rated 8/10. What is the nurse’s priority
action?
o A. Administer PRN analgesic as ordered
o B. Reassess pain in 1 hour
o C. Teach non-pharmacologic pain relief
o D. Document the pain score
A. Administer PRN analgesic as ordered
Rationale: Acute severe pain requires prompt pharmacologic
intervention per pain management standards to promote comfort and
prevent physiological stress.
8. Which position is contraindicated for a patient with suspected
spinal injury?
o A. Supine with head elevated 30°
o B. Log roll technique
o C. Flexion of the neck
o D. Neutral alignment with cervical collar
C. Flexion of the neck
Rationale: Neck flexion risks further spinal cord damage; neutral
alignment with immobilization is required per trauma nursing protocols.
