NUR 165 – ECPI University Final Actual Exam
pdf (100 Questions + Rationales)
Overview
This comprehensive NCLEX-style practice exam is designed to prepare ECPI University nursing
students for the NUR 165 Final Examination.
It includes 100 multiple-choice questions covering essential nursing concepts such as:
Fundamentals of Nursing
Medical-Surgical Nursing
Pharmacology and IV Therapy
Patient Safety & Infection Control
Fluid, Electrolyte, and Acid-Base Balance
Postoperative & Emergency Nursing Care
Each question includes clearly marked correct answers (in bold) and brief rationales to
reinforce critical thinking and clinical reasoning skills.
This study resource helps students strengthen exam readiness, improve confidence, and master
the foundational competencies required for safe and effective nursing practice.
1. A nurse is preparing to administer an IM injection. Which site is safest for a
3-year-old child?
A. Dorsogluteal
B. Deltoid
C. Vastus lateralis
D. Ventrogluteal
Rationale: The vastus lateralis is preferred for children because it’s well
developed and away from major nerves.
2. A patient with COPD uses oxygen at 3 L/min by nasal cannula. Which
intervention is priority?
A. Place humidifier on oxygen tubing.
, B. Encourage deep breathing exercises.
C. Remove oxygen during meals.
D. Restrict fluid intake.
Rationale: Oxygen at ≥2 L/min should be humidified to prevent mucosal
drying and improve comfort.
3. A medication order reads: "Digoxin 0.25 mg PO daily." Prior to giving dose,
the nurse should:
A. Check apical pulse for 1 full minute.
B. Measure blood pressure only.
C. Hold dose if respirations <12/min.
D. Administer with antacid.
Rationale: Always check apical pulse; hold if <60 bpm.
4. Which patient is at highest risk for developing pressure ulcers?
A. Ambulatory post-op day 1 patient.
B. Elderly patient with incontinence and limited mobility.
C. Teen with open fractures.
D. Adult on incentive spirometry.
Rationale: Immobility and incontinence increase risk.
5. A nurse sees a coworker administer the wrong medication. The best action
is to:
B. Report the incident following facility policy.
A. Ignore it — no reaction occurred.
C. Call coworker incompetent.
D. Destroy the medication label.
Rationale: Medication errors must be reported for patient safety.
6. A patient with type 1 diabetes has blood glucose 320 mg/dL and urine
ketones. The nurse anticipates:
, B. Start insulin therapy per sliding scale and assess for DKA.
A. Give oral antidiabetic.
C. Give orange juice.
D. Withhold insulin.
Rationale: High glucose + ketones indicate possible DKA; insulin needed.
7. Which statement by a patient on warfarin indicates correct understanding?
A. “I will take extra aspirin for headache.”
B. “I will avoid large amounts of leafy greens and maintain consistent
vitamin K intake.”
C. “I can stop medication if INR is high.”
D. “I don’t need to report nosebleeds.”
Rationale: Consistency in vitamin K is key; aspirin increases bleeding risk.
8. ABG results: pH 7.32, PaCO₂ 50 mmHg, HCO₃⁻ 24 mEq/L. Interpretation?
B. Respiratory acidosis.
A. Metabolic alkalosis.
C. Respiratory alkalosis.
D. Metabolic acidosis.
Rationale: Low pH and high CO₂ = respiratory acidosis.
9. For a patient with suspected MI, the nurse should prioritize:
B. Apply oxygen and prepare to give aspirin.
A. Obtain full medication history.
C. Start tube feeding.
D. Teach long-term lifestyle changes.
Rationale: Oxygen and aspirin are first-line emergency actions.
10.A patient on loop diuretic reports muscle cramps. Which lab is most
important?
A. Serum potassium.
pdf (100 Questions + Rationales)
Overview
This comprehensive NCLEX-style practice exam is designed to prepare ECPI University nursing
students for the NUR 165 Final Examination.
It includes 100 multiple-choice questions covering essential nursing concepts such as:
Fundamentals of Nursing
Medical-Surgical Nursing
Pharmacology and IV Therapy
Patient Safety & Infection Control
Fluid, Electrolyte, and Acid-Base Balance
Postoperative & Emergency Nursing Care
Each question includes clearly marked correct answers (in bold) and brief rationales to
reinforce critical thinking and clinical reasoning skills.
This study resource helps students strengthen exam readiness, improve confidence, and master
the foundational competencies required for safe and effective nursing practice.
1. A nurse is preparing to administer an IM injection. Which site is safest for a
3-year-old child?
A. Dorsogluteal
B. Deltoid
C. Vastus lateralis
D. Ventrogluteal
Rationale: The vastus lateralis is preferred for children because it’s well
developed and away from major nerves.
2. A patient with COPD uses oxygen at 3 L/min by nasal cannula. Which
intervention is priority?
A. Place humidifier on oxygen tubing.
, B. Encourage deep breathing exercises.
C. Remove oxygen during meals.
D. Restrict fluid intake.
Rationale: Oxygen at ≥2 L/min should be humidified to prevent mucosal
drying and improve comfort.
3. A medication order reads: "Digoxin 0.25 mg PO daily." Prior to giving dose,
the nurse should:
A. Check apical pulse for 1 full minute.
B. Measure blood pressure only.
C. Hold dose if respirations <12/min.
D. Administer with antacid.
Rationale: Always check apical pulse; hold if <60 bpm.
4. Which patient is at highest risk for developing pressure ulcers?
A. Ambulatory post-op day 1 patient.
B. Elderly patient with incontinence and limited mobility.
C. Teen with open fractures.
D. Adult on incentive spirometry.
Rationale: Immobility and incontinence increase risk.
5. A nurse sees a coworker administer the wrong medication. The best action
is to:
B. Report the incident following facility policy.
A. Ignore it — no reaction occurred.
C. Call coworker incompetent.
D. Destroy the medication label.
Rationale: Medication errors must be reported for patient safety.
6. A patient with type 1 diabetes has blood glucose 320 mg/dL and urine
ketones. The nurse anticipates:
, B. Start insulin therapy per sliding scale and assess for DKA.
A. Give oral antidiabetic.
C. Give orange juice.
D. Withhold insulin.
Rationale: High glucose + ketones indicate possible DKA; insulin needed.
7. Which statement by a patient on warfarin indicates correct understanding?
A. “I will take extra aspirin for headache.”
B. “I will avoid large amounts of leafy greens and maintain consistent
vitamin K intake.”
C. “I can stop medication if INR is high.”
D. “I don’t need to report nosebleeds.”
Rationale: Consistency in vitamin K is key; aspirin increases bleeding risk.
8. ABG results: pH 7.32, PaCO₂ 50 mmHg, HCO₃⁻ 24 mEq/L. Interpretation?
B. Respiratory acidosis.
A. Metabolic alkalosis.
C. Respiratory alkalosis.
D. Metabolic acidosis.
Rationale: Low pH and high CO₂ = respiratory acidosis.
9. For a patient with suspected MI, the nurse should prioritize:
B. Apply oxygen and prepare to give aspirin.
A. Obtain full medication history.
C. Start tube feeding.
D. Teach long-term lifestyle changes.
Rationale: Oxygen and aspirin are first-line emergency actions.
10.A patient on loop diuretic reports muscle cramps. Which lab is most
important?
A. Serum potassium.
