1|P a ge
,Welcome to Your Ultimate Nursing Foundations Test Bank
This is your all-in-one study weapon — built for the modern nursing student grinding with
purpose and stepping into a legacy bigger than themselves. It mixes timeless nursing wisdom
with today’s practical reality, giving you the exact kind of mastery your exams demand.
No fluff. No outdated noise. Just clean, original questions with rationales that actually teach you
how to think like a nurse, not just memorize one.
You’ll also find a few 100% free test bank links inside — handpicked gems to boost your prep
even further. No paywalls, no sign-ups, just extra ammo for your study journey.
The entire document is fully searchable — hit Ctrl + F (Windows) or Command + F (Mac) and
type whatever you need. Every chapter, topic, and question is optimized to show up instantly.
Step in bold. Study smart. Let’s get you exam-ready.
CHAPTER 1 — High-Yield Nursing Fundamentals: Must-Know Questions
1.- A 65-year-old patient presents with confusion, fever 39°C, HR 128, BP 85/50, RR 28, SpO₂
91% on room air. What is the priority nursing action?
A. Administer acetaminophen
B. Initiate sepsis protocol
C. Notify the physician
D. Draw blood cultures
Answer: B — Initiate sepsis protocol
⭐ Rational:
This patient meets SIRS criteria and shows early severe sepsis signs (hypotension +
confusion = organ hypoperfusion).
Immediate initiation of sepsis protocol (IV fluids, oxygen, labs, prepare antibiotics) is
priority to prevent multi-organ failure.
Option Analysis:
o A ✗ Reduces fever but does not treat underlying infection.
o B ✓ Correct — addresses ABCs and sepsis management immediately.
o C ✗ Notify physician important but protocol begins immediately.
o D ✗ Blood cultures necessary but after initiating fluids/oxygen.
Step Action Rationale
1 Assess ABC Ensure airway, breathing, circulation
2 Start sepsis protocol Fluids, labs, antibiotics
3 Oxygen therapy Correct hypoxia
4 Notify physician Collaborative care
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, 5 Draw cultures After initial interventions
Clinical Pearl: Confusion in sepsis often precedes hypotension — early recognition saves
lives.
2.- A nurse identifies a patient is at risk for falls. Priority nursing action?
A. Encourage independence
B. Raise all side rails
C. Keep frequently used items within reach
D. Restrain the patient
Answer: C — Keep frequently used items within reach
⭐ Rational:
Reduces unnecessary movement while maintaining safety and dignity.
A ✗ Independence unsafe if patient is unstable.
B ✗ Side rails may cause climbing and injury.
D ✗ Restraints = last resort, strict legal/ethical limits.
3.- SATA: Interventions to reduce fall risk:
A. Non-slip socks
B. Keep call light within reach
C. Dim lighting at night
D. Encourage rapid ambulation
E. Bed alarms
Answer: A, B, E
Rational:
Non-slip socks and bed alarms prevent falls.
Dim lighting helps vision, but patient still needs supervision.
Rapid ambulation is unsafe in high-risk patients.
4.- Adult patient with RR 28/min. Breathing pattern?
A. Eupnea
B. Bradypnea
C. Tachypnea
D. Hyperventilation
Answer: C — Tachypnea
⭐ Rational:
3|P a ge
, Tachypnea = fast breathing >20/min.
Causes: fever, pain, anxiety, hypoxia.
Hyperventilation = fast + deep; bradypnea = <12/min; eupnea = 12–20/min.
Pattern Rate (breaths/min) Notes
Eupnea 12–20 Normal breathing
Bradypnea <12 Slow breathing
Tachypnea >20 Rapid breathing
Hyperventilation >20 + deep Excessive ventilation
5.- After administering antihypertensive medication, BP normalized. Nursing process step?
A. Assessment
B. Diagnosis
C. Planning
D. Evaluation
Answer: D — Evaluation
⭐ Rational:
Evaluation = measures effectiveness of interventions.
Assessment = data collection; Diagnosis = problem identification; Planning = goal
setting.
Page 4 — Infection Control & PPE
6.- Patient on droplet precautions requires which primary PPE?
A. N95 respirator
B. Surgical mask
C. Gown only
D. Gloves only
Answer: B — Surgical mask
⭐ Rational:
Droplet infections = large particles traveling short distances.
N95 = airborne (TB, measles).
Gown/gloves = situational.
Option Explanation
A Airborne only
B Correct — blocks droplets
C Optional if fluids expected
4|P a ge
, D Not primary protection
7.- Patient refuses medication. Best action?
A. Hide in food
B. Document refusal & notify provider
C. Insist patient take it
D. Ask another nurse to give it
Answer: B — Document refusal & notify provider
⭐ Rational:
Ethical/legal right to refuse medication.
Documentation + provider notification = safe, compliant care.
Forcing violates ethics.
8.- Which action demonstrates implementation step?
A. Collecting vital signs
B. Documenting outcomes
C. Carrying out planned intervention
D. Identifying patient needs
Answer: C — Carrying out planned intervention
⭐ Rational:
Implementation = hands-on execution of care.
Assessment, planning, evaluation = separate steps.
Step Example Notes
Assessment Collect VS Data-gathering
Diagnosis Identify problem Analyze data
Planning Set goals & interventions Prepare care
Implementation Perform intervention Execute care
Evaluation Document outcomes Measure success
9.- 72-year-old patient: RR 10, SpO₂ 88%, HR 140, BP 88/52. What’s priority nursing action?
A. Administer oxygen
B. Assess vital signs and lung sounds
C. Call physician
D. Encourage ambulation
Answer: B — Assess vital signs & lung sounds
5|P a ge
,⭐ Rational:
Shallow respirations + hypoxia = respiratory compromise.
Immediate assessment identifies cause. Oxygen follows after assessment.
10.- SATA: Patient at risk for pressure ulcers — preventive interventions?
A. Reposition q2h
B. Use heel protectors
C. Keep linens wrinkle-free
D. Apply topical antibiotic daily
E. Encourage high-protein diet
Answer: A, B, C, E
⭐ Rational:
Pressure relief + nutrition + skin integrity are key.
Antibiotics = treatment, not prevention.
11.- IV drip: 1000 mL NS over 8 hr, drip factor 15 gtt/mL. Rate?
Answer: 31 gtt/min
⭐ Rational:
Formula: (Volume × drip factor) ÷ time in minutes
(1000 × 15) ÷ 480 = 31.25 ≈ 31 gtt/min
12.- Subcutaneous insulin 0.1 unit/kg for 70 kg patient
Answer: 7 units
Weight × dose = 70 × 0.1 = 7 units
13.- Patient on potassium-sparing diuretics: K⁺ 6.2 mEq/L. Priority action?
A. Continue med
B. Notify provider
C. Give potassium supplement
D. Document
Answer: B — Notify provider
⭐ Rational:
Hyperkalemia (>5 mEq/L) = risk of fatal arrhythmias.
Sodium, glucose, calcium normal; immediate action = stop meds & notify provider.
6|P a ge
, Quick Lab Table — High-Yield:
Lab Normal Critical Action
K⁺ 3.5–5 >6 ECG, notify provider
Na⁺ 135–145 <120/>160 Neuro assessment
Ca²⁺ 8.5–10.5 <7/>12 Cardiac monitoring
14.- Crackles in lower lungs?
A. Dehydration
B. Fluid in alveoli
C. Pneumothorax
D. Bronchospasm
Answer: B — Fluid in alveoli
⭐ Rational:
Crackles = popping fluid in alveoli, seen in pulmonary edema, pneumonia, CHF.
Pneumothorax = absent sounds; Bronchospasm = wheezes.
15.- Early sign of hypoxia?
A. Pink skin
B. Restlessness
C. Normal SpO₂
D. Calm behavior
Answer: B — Restlessness
⭐ Rational:
Early hypoxia = restlessness, anxiety, confusion.
Cyanosis appears later; always assess vitals + O₂.
16.- A patient receiving 0.9% NS at 125 mL/hr develops dyspnea, crackles, and O₂ sat 88%.
Priority action?
A. Slow IV rate
B. Administer diuretic
C. Assess lung sounds and vitals
D. Call provider
Answer: C — Assess lung sounds and vitals
⭐ Rational:
7|P a ge
, Signs of fluid overload: crackles, dyspnea, low SpO₂.
Immediate assessment identifies severity and guides intervention.
Option analysis:
o A ✗ May help, but first assess to confirm overload.
o B ✗ Diuretic only after evaluation.
o D ✗ Provider notification follows assessment.
17.- SATA: Interventions for hypernatremia
A. Encourage oral fluids
B. Administer hypotonic IV solution
C. Restrict free water
D. Monitor neurological status
E. Administer sodium supplements
Answer: A, B, D
⭐ Rational:
Hypernatremia = high sodium, often dehydration-related.
Free water restriction ✗ worsens hypernatremia; sodium supplements ✗ contraindicated.
18.- A 70 kg patient requires maintenance fluids using 4-2-1 rule.
Calculate hourly rate.
Answer: 70 kg → 10 kg × 4 = 40 mL, 10 kg × 2 = 20 mL, 50 kg ×1 = 50 mL → 110 mL/hr
19.- Patient on warfarin presents with INR 5.5. Priority action?
A. Administer vitamin K
B. Notify provider
C. Hold next dose
D. Document lab
Answer: B — Notify provider
⭐ Rational:
INR > 5 = high bleeding risk.
Provider decides on vitamin K and dose adjustment.
Holding dose and documentation are secondary actions.
20.- A patient refuses insulin. What should nurse do first?
A. Force injection
B. Hide in food
8|P a ge
,C. Document refusal and notify provider
D. Call another nurse to give injection
Answer: C — Document refusal & notify provider
⭐ Rational:
Ethical principle: autonomy.
Safety and compliance require documentation + provider notification.
21.- SATA: Safe medication administration practices
A. Five rights of medication
B. Check allergies
C. Crush all pills for ease
D. Verify patient ID
E. Administer meds without label if confident
Answer: A, B, D
⭐ Rational:
Five Rights, allergy check, patient verification = core safety measures
Crushing all pills ✗ may harm patient; skipping labels ✗ dangerous.
22.- Patient with COPD, SpO₂ 84%, RR 32. RN priority?
A. Increase oxygen flow
B. Assess lung sounds
C. Encourage deep breathing
D. Notify provider
Answer: B — Assess lung sounds
⭐ Rational:
Assessment identifies cause of hypoxia (bronchospasm, obstruction).
Oxygen adjustment follows proper assessment to prevent CO₂ retention in COPD.
23.- Incentive spirometer teaching correct rationale?
A. Measures BP
B. Prevents DVT
C. Promotes lung expansion and prevents atelectasis
D. Monitors SpO₂
Answer: C — Promotes lung expansion
9|P a ge
, ⭐ Rational:
Encourages deep breathing, prevents alveolar collapse.
Other options ✗ unrelated to device function.
24.- Patient presents with peaked T waves and K⁺ 6.2 mEq/L. Priority action?
A. Monitor vitals
B. Prepare for ECG and notify provider
C. Administer potassium supplement
D. Encourage fluids
Answer: B — ECG + notify provider
⭐ Rational:
Hyperkalemia can cause fatal arrhythmias.
Peaked T waves = ECG warning; prompt intervention critical.
25.- SATA: Early signs of hypoxia
A. Restlessness
B. Tachycardia
C. Cyanosis
D. Confusion
E. Pink skin
Answer: A, B, D
⭐ Rational:
Cyanosis = late sign; pink skin = normal.
Early recognition = prevents deterioration.
26.- Patient with CHF, receives furosemide. Which is priority?
A. Monitor weight and fluid status
B. Assess liver enzymes
C. Check glucose
D. Monitor vision
Answer: A — Weight and fluid status
⭐ Rational:
Daily weight = most sensitive fluid retention measure
Other assessments are secondary.
10 | P a g e
,Welcome to Your Ultimate Nursing Foundations Test Bank
This is your all-in-one study weapon — built for the modern nursing student grinding with
purpose and stepping into a legacy bigger than themselves. It mixes timeless nursing wisdom
with today’s practical reality, giving you the exact kind of mastery your exams demand.
No fluff. No outdated noise. Just clean, original questions with rationales that actually teach you
how to think like a nurse, not just memorize one.
You’ll also find a few 100% free test bank links inside — handpicked gems to boost your prep
even further. No paywalls, no sign-ups, just extra ammo for your study journey.
The entire document is fully searchable — hit Ctrl + F (Windows) or Command + F (Mac) and
type whatever you need. Every chapter, topic, and question is optimized to show up instantly.
Step in bold. Study smart. Let’s get you exam-ready.
CHAPTER 1 — High-Yield Nursing Fundamentals: Must-Know Questions
1.- A 65-year-old patient presents with confusion, fever 39°C, HR 128, BP 85/50, RR 28, SpO₂
91% on room air. What is the priority nursing action?
A. Administer acetaminophen
B. Initiate sepsis protocol
C. Notify the physician
D. Draw blood cultures
Answer: B — Initiate sepsis protocol
⭐ Rational:
This patient meets SIRS criteria and shows early severe sepsis signs (hypotension +
confusion = organ hypoperfusion).
Immediate initiation of sepsis protocol (IV fluids, oxygen, labs, prepare antibiotics) is
priority to prevent multi-organ failure.
Option Analysis:
o A ✗ Reduces fever but does not treat underlying infection.
o B ✓ Correct — addresses ABCs and sepsis management immediately.
o C ✗ Notify physician important but protocol begins immediately.
o D ✗ Blood cultures necessary but after initiating fluids/oxygen.
Step Action Rationale
1 Assess ABC Ensure airway, breathing, circulation
2 Start sepsis protocol Fluids, labs, antibiotics
3 Oxygen therapy Correct hypoxia
4 Notify physician Collaborative care
2|P a ge
, 5 Draw cultures After initial interventions
Clinical Pearl: Confusion in sepsis often precedes hypotension — early recognition saves
lives.
2.- A nurse identifies a patient is at risk for falls. Priority nursing action?
A. Encourage independence
B. Raise all side rails
C. Keep frequently used items within reach
D. Restrain the patient
Answer: C — Keep frequently used items within reach
⭐ Rational:
Reduces unnecessary movement while maintaining safety and dignity.
A ✗ Independence unsafe if patient is unstable.
B ✗ Side rails may cause climbing and injury.
D ✗ Restraints = last resort, strict legal/ethical limits.
3.- SATA: Interventions to reduce fall risk:
A. Non-slip socks
B. Keep call light within reach
C. Dim lighting at night
D. Encourage rapid ambulation
E. Bed alarms
Answer: A, B, E
Rational:
Non-slip socks and bed alarms prevent falls.
Dim lighting helps vision, but patient still needs supervision.
Rapid ambulation is unsafe in high-risk patients.
4.- Adult patient with RR 28/min. Breathing pattern?
A. Eupnea
B. Bradypnea
C. Tachypnea
D. Hyperventilation
Answer: C — Tachypnea
⭐ Rational:
3|P a ge
, Tachypnea = fast breathing >20/min.
Causes: fever, pain, anxiety, hypoxia.
Hyperventilation = fast + deep; bradypnea = <12/min; eupnea = 12–20/min.
Pattern Rate (breaths/min) Notes
Eupnea 12–20 Normal breathing
Bradypnea <12 Slow breathing
Tachypnea >20 Rapid breathing
Hyperventilation >20 + deep Excessive ventilation
5.- After administering antihypertensive medication, BP normalized. Nursing process step?
A. Assessment
B. Diagnosis
C. Planning
D. Evaluation
Answer: D — Evaluation
⭐ Rational:
Evaluation = measures effectiveness of interventions.
Assessment = data collection; Diagnosis = problem identification; Planning = goal
setting.
Page 4 — Infection Control & PPE
6.- Patient on droplet precautions requires which primary PPE?
A. N95 respirator
B. Surgical mask
C. Gown only
D. Gloves only
Answer: B — Surgical mask
⭐ Rational:
Droplet infections = large particles traveling short distances.
N95 = airborne (TB, measles).
Gown/gloves = situational.
Option Explanation
A Airborne only
B Correct — blocks droplets
C Optional if fluids expected
4|P a ge
, D Not primary protection
7.- Patient refuses medication. Best action?
A. Hide in food
B. Document refusal & notify provider
C. Insist patient take it
D. Ask another nurse to give it
Answer: B — Document refusal & notify provider
⭐ Rational:
Ethical/legal right to refuse medication.
Documentation + provider notification = safe, compliant care.
Forcing violates ethics.
8.- Which action demonstrates implementation step?
A. Collecting vital signs
B. Documenting outcomes
C. Carrying out planned intervention
D. Identifying patient needs
Answer: C — Carrying out planned intervention
⭐ Rational:
Implementation = hands-on execution of care.
Assessment, planning, evaluation = separate steps.
Step Example Notes
Assessment Collect VS Data-gathering
Diagnosis Identify problem Analyze data
Planning Set goals & interventions Prepare care
Implementation Perform intervention Execute care
Evaluation Document outcomes Measure success
9.- 72-year-old patient: RR 10, SpO₂ 88%, HR 140, BP 88/52. What’s priority nursing action?
A. Administer oxygen
B. Assess vital signs and lung sounds
C. Call physician
D. Encourage ambulation
Answer: B — Assess vital signs & lung sounds
5|P a ge
,⭐ Rational:
Shallow respirations + hypoxia = respiratory compromise.
Immediate assessment identifies cause. Oxygen follows after assessment.
10.- SATA: Patient at risk for pressure ulcers — preventive interventions?
A. Reposition q2h
B. Use heel protectors
C. Keep linens wrinkle-free
D. Apply topical antibiotic daily
E. Encourage high-protein diet
Answer: A, B, C, E
⭐ Rational:
Pressure relief + nutrition + skin integrity are key.
Antibiotics = treatment, not prevention.
11.- IV drip: 1000 mL NS over 8 hr, drip factor 15 gtt/mL. Rate?
Answer: 31 gtt/min
⭐ Rational:
Formula: (Volume × drip factor) ÷ time in minutes
(1000 × 15) ÷ 480 = 31.25 ≈ 31 gtt/min
12.- Subcutaneous insulin 0.1 unit/kg for 70 kg patient
Answer: 7 units
Weight × dose = 70 × 0.1 = 7 units
13.- Patient on potassium-sparing diuretics: K⁺ 6.2 mEq/L. Priority action?
A. Continue med
B. Notify provider
C. Give potassium supplement
D. Document
Answer: B — Notify provider
⭐ Rational:
Hyperkalemia (>5 mEq/L) = risk of fatal arrhythmias.
Sodium, glucose, calcium normal; immediate action = stop meds & notify provider.
6|P a ge
, Quick Lab Table — High-Yield:
Lab Normal Critical Action
K⁺ 3.5–5 >6 ECG, notify provider
Na⁺ 135–145 <120/>160 Neuro assessment
Ca²⁺ 8.5–10.5 <7/>12 Cardiac monitoring
14.- Crackles in lower lungs?
A. Dehydration
B. Fluid in alveoli
C. Pneumothorax
D. Bronchospasm
Answer: B — Fluid in alveoli
⭐ Rational:
Crackles = popping fluid in alveoli, seen in pulmonary edema, pneumonia, CHF.
Pneumothorax = absent sounds; Bronchospasm = wheezes.
15.- Early sign of hypoxia?
A. Pink skin
B. Restlessness
C. Normal SpO₂
D. Calm behavior
Answer: B — Restlessness
⭐ Rational:
Early hypoxia = restlessness, anxiety, confusion.
Cyanosis appears later; always assess vitals + O₂.
16.- A patient receiving 0.9% NS at 125 mL/hr develops dyspnea, crackles, and O₂ sat 88%.
Priority action?
A. Slow IV rate
B. Administer diuretic
C. Assess lung sounds and vitals
D. Call provider
Answer: C — Assess lung sounds and vitals
⭐ Rational:
7|P a ge
, Signs of fluid overload: crackles, dyspnea, low SpO₂.
Immediate assessment identifies severity and guides intervention.
Option analysis:
o A ✗ May help, but first assess to confirm overload.
o B ✗ Diuretic only after evaluation.
o D ✗ Provider notification follows assessment.
17.- SATA: Interventions for hypernatremia
A. Encourage oral fluids
B. Administer hypotonic IV solution
C. Restrict free water
D. Monitor neurological status
E. Administer sodium supplements
Answer: A, B, D
⭐ Rational:
Hypernatremia = high sodium, often dehydration-related.
Free water restriction ✗ worsens hypernatremia; sodium supplements ✗ contraindicated.
18.- A 70 kg patient requires maintenance fluids using 4-2-1 rule.
Calculate hourly rate.
Answer: 70 kg → 10 kg × 4 = 40 mL, 10 kg × 2 = 20 mL, 50 kg ×1 = 50 mL → 110 mL/hr
19.- Patient on warfarin presents with INR 5.5. Priority action?
A. Administer vitamin K
B. Notify provider
C. Hold next dose
D. Document lab
Answer: B — Notify provider
⭐ Rational:
INR > 5 = high bleeding risk.
Provider decides on vitamin K and dose adjustment.
Holding dose and documentation are secondary actions.
20.- A patient refuses insulin. What should nurse do first?
A. Force injection
B. Hide in food
8|P a ge
,C. Document refusal and notify provider
D. Call another nurse to give injection
Answer: C — Document refusal & notify provider
⭐ Rational:
Ethical principle: autonomy.
Safety and compliance require documentation + provider notification.
21.- SATA: Safe medication administration practices
A. Five rights of medication
B. Check allergies
C. Crush all pills for ease
D. Verify patient ID
E. Administer meds without label if confident
Answer: A, B, D
⭐ Rational:
Five Rights, allergy check, patient verification = core safety measures
Crushing all pills ✗ may harm patient; skipping labels ✗ dangerous.
22.- Patient with COPD, SpO₂ 84%, RR 32. RN priority?
A. Increase oxygen flow
B. Assess lung sounds
C. Encourage deep breathing
D. Notify provider
Answer: B — Assess lung sounds
⭐ Rational:
Assessment identifies cause of hypoxia (bronchospasm, obstruction).
Oxygen adjustment follows proper assessment to prevent CO₂ retention in COPD.
23.- Incentive spirometer teaching correct rationale?
A. Measures BP
B. Prevents DVT
C. Promotes lung expansion and prevents atelectasis
D. Monitors SpO₂
Answer: C — Promotes lung expansion
9|P a ge
, ⭐ Rational:
Encourages deep breathing, prevents alveolar collapse.
Other options ✗ unrelated to device function.
24.- Patient presents with peaked T waves and K⁺ 6.2 mEq/L. Priority action?
A. Monitor vitals
B. Prepare for ECG and notify provider
C. Administer potassium supplement
D. Encourage fluids
Answer: B — ECG + notify provider
⭐ Rational:
Hyperkalemia can cause fatal arrhythmias.
Peaked T waves = ECG warning; prompt intervention critical.
25.- SATA: Early signs of hypoxia
A. Restlessness
B. Tachycardia
C. Cyanosis
D. Confusion
E. Pink skin
Answer: A, B, D
⭐ Rational:
Cyanosis = late sign; pink skin = normal.
Early recognition = prevents deterioration.
26.- Patient with CHF, receives furosemide. Which is priority?
A. Monitor weight and fluid status
B. Assess liver enzymes
C. Check glucose
D. Monitor vision
Answer: A — Weight and fluid status
⭐ Rational:
Daily weight = most sensitive fluid retention measure
Other assessments are secondary.
10 | P a g e
