Davis Advantage Series – Integrated
Learning Review Guide 2025/2026
(Maternal, Fundamentals, Med-Surg)
Fundamentals of Nursing (Questions 1-30)
1. A nurse is performing hand hygiene before assisting with a sterile procedure. Which
method is most effective?
A. Washing with soap and water for 10 seconds.
B. Using an alcohol-based hand rub for 15-20 seconds.
C. Washing with soap and water for at least 20 seconds.
D. Using an alcohol-based hand rub for 5-10 seconds.
Answer: B. Using an alcohol-based hand rub for 15-20 seconds. ✓
Rationale: For most clinical situations, an alcohol-based hand rub is the preferred method if
hands are not visibly soiled. It is faster and more effective at reducing microorganism counts
than soap and water.
2. The nurse is teaching a client about the principle of nonmaleficence. Which statement by
the client indicates understanding?
A. "I will be given my medication on time."
B. "The nurse will do no harm to me."
C. "My privacy will be respected."
D. "I have the right to make my own decisions."
Answer: B. "The nurse will do no harm to me." ✓
Rationale: Nonmaleficence is the ethical principle of "do no harm."
3. When documenting a client's care, the nurse understands that which is the primary
purpose of accurate documentation?
A. To provide a legal record of care.
B. To facilitate communication among the healthcare team.
C. To justify billing and reimbursement.
D. To evaluate nursing performance.
Answer: B. To facilitate communication among the healthcare team. ✓
Rationale: While all are important, the primary purpose is to ensure clear, continuous
communication for safe and effective client care.
,4. A client has a core body temperature of 39.2°C (102.6°F). The nurse should anticipate which
set of assessment findings?
A. Bradycardia, bradypnea, shivering.
B. Tachycardia, tachypnea, flushed skin.
C. Hypertension, bradycardia, diaphoresis.
D. Hypotension, bradycardia, cyanosis.
Answer: B. Tachycardia, tachypnea, flushed skin. ✓
Rationale: Fever increases metabolic rate, leading to increased heart rate (tachycardia),
respiratory rate (tachypnea), and vasodilation (flushed, warm skin).
5. A nurse is preparing to administer a controlled substance and discovers a discrepancy in the
narcotic count. What is the nurse's first action?
A. Notify the pharmacy.
B. File an incident report.
C. Notify the charge nurse.
D. Re-count the controlled substances with another nurse.
Answer: D. Re-count the controlled substances with another nurse. ✓
Rationale: The first step is to verify the discrepancy by re-counting with a second nurse to rule
out a simple counting error.
6. Which action by a student nurse during a bed bath requires intervention by the supervising
nurse?
A. Washing from the cleanest to the dirtiest area.
B. Using long, firm strokes when washing the legs.
C. Adding soap to the water in the basin.
D. Placing a waterproof pad under the client when washing perineal area.
Answer: C. Adding soap to the water in the basin. ✓
Rationale: Soap should be applied to a wet washcloth, not added to the basin water, to avoid
bathing the client in soapy water which can dry and irritate the skin.
7. A client is on contact precautions for Clostridium difficile. Which personal protective
equipment (PPE) is essential for the nurse?
A. Gown and gloves.
B. Gloves, gown, and N95 respirator.
C. Gloves and surgical mask.
D. Gown, gloves, and face shield.
Answer: A. Gown and gloves. ✓
Rationale: C. diff is spread via spores in feces, requiring contact precautions (gown and gloves).
A mask is not required unless splashing is anticipated.
,8. The nurse is assessing a client's pulse pressure. The blood pressure is 132/84 mmHg. What
is the client's pulse pressure?
A. 48 mmHg
B. 216 mmHg
C. 84 mmHg
D. 132 mmHg
Answer: A. 48 mmHg ✓
*Rationale: Pulse pressure is the difference between systolic and diastolic pressure (132 - 84 =
48).*
9. A client is having difficulty sleeping. Which nursing intervention is most appropriate to
promote rest?
A. Administer a prescribed PRN sleeping medication.
B. Offer a warm milk and a back rub at bedtime.
C. Keep the room well-lit for safety.
D. Encourage watching television to fall asleep.
Answer: B. Offer a warm milk and a back rub at bedtime. ✓
Rationale: Non-pharmacological interventions should be attempted first. Warm milk and a back
rub promote relaxation.
10. When moving a client up in bed, the nurse should:
A. Keep the bed in a high position.
B. Use a lifting motion with the back muscles.
C. Raise the head of the bed to a flat position.
D. Use a friction-reducing device and get help.
Answer: D. Use a friction-reducing device and get help. ✓
Rationale: This practice protects both the nurse and the client from injury by reducing strain and
shearing forces.
11. The nurse is teaching a client about deep breathing and coughing exercises post-
operatively. The primary rationale for these exercises is to prevent:
A. Atelectasis.
B. Hypertension.
C. Thrombophlebitis.
D. Urinary retention.
Answer: A. Atelectasis. ✓
Rationale: Deep breathing and coughing help expand the lungs and clear secretions, preventing
post-operative atelectasis (lung collapse).
, 12. A nurse is calculating a client's fluid intake. The client consumed 4 oz of juice, 8 oz of soup,
and 300 mL of water. What is the total intake in milliliters? (1 oz = 30 mL)
A. 540 mL
B. 660 mL
C. 780 mL
D. 900 mL
Answer: B. 660 mL ✓
*Rationale: (4 oz x 30) + (8 oz x 30) + 300 mL = 120 + 240 + 300 = 660 mL.*
13. Which client is at the highest risk for developing a pressure injury?
A. A 25-year-old with a fractured femur in traction.
B. A 50-year-old ambulatory post-myocardial infarction client.
C. A 70-year-old with fecal incontinence and malnutrition.
D. A 40-year-old with a migraine headache.
Answer: C. A 70-year-old with fecal incontinence and malnutrition. ✓
Rationale: This client has multiple risk factors: immobility (likely), moisture (incontinence), and
poor nutrition, which all significantly increase the risk for pressure injuries.
14. The "Evaluation" phase of the nursing process involves:
A. Collecting client data.
B. Determining if goals have been met.
C. Carrying out the planned interventions.
D. Identifying client problems.
Answer: B. Determining if goals have been met. ✓
Rationale: Evaluation is the step where the nurse assesses the client's response to interventions
and determines the extent to which goals were achieved.
15. A nurse is providing discharge teaching for a client. Which statement by the client best
demonstrates the affective domain of learning?
A. "I can list the three side effects of my new medication."
B. "I will check my blood sugar before each meal."
C. "I feel confident that I can change my own dressing."
D. "I understand how my heart medication works."
Answer: C. "I feel confident that I can change my own dressing." ✓
Rationale: The affective domain deals with feelings, attitudes, beliefs, and values. Expressing
confidence reflects a change in attitude.
Learning Review Guide 2025/2026
(Maternal, Fundamentals, Med-Surg)
Fundamentals of Nursing (Questions 1-30)
1. A nurse is performing hand hygiene before assisting with a sterile procedure. Which
method is most effective?
A. Washing with soap and water for 10 seconds.
B. Using an alcohol-based hand rub for 15-20 seconds.
C. Washing with soap and water for at least 20 seconds.
D. Using an alcohol-based hand rub for 5-10 seconds.
Answer: B. Using an alcohol-based hand rub for 15-20 seconds. ✓
Rationale: For most clinical situations, an alcohol-based hand rub is the preferred method if
hands are not visibly soiled. It is faster and more effective at reducing microorganism counts
than soap and water.
2. The nurse is teaching a client about the principle of nonmaleficence. Which statement by
the client indicates understanding?
A. "I will be given my medication on time."
B. "The nurse will do no harm to me."
C. "My privacy will be respected."
D. "I have the right to make my own decisions."
Answer: B. "The nurse will do no harm to me." ✓
Rationale: Nonmaleficence is the ethical principle of "do no harm."
3. When documenting a client's care, the nurse understands that which is the primary
purpose of accurate documentation?
A. To provide a legal record of care.
B. To facilitate communication among the healthcare team.
C. To justify billing and reimbursement.
D. To evaluate nursing performance.
Answer: B. To facilitate communication among the healthcare team. ✓
Rationale: While all are important, the primary purpose is to ensure clear, continuous
communication for safe and effective client care.
,4. A client has a core body temperature of 39.2°C (102.6°F). The nurse should anticipate which
set of assessment findings?
A. Bradycardia, bradypnea, shivering.
B. Tachycardia, tachypnea, flushed skin.
C. Hypertension, bradycardia, diaphoresis.
D. Hypotension, bradycardia, cyanosis.
Answer: B. Tachycardia, tachypnea, flushed skin. ✓
Rationale: Fever increases metabolic rate, leading to increased heart rate (tachycardia),
respiratory rate (tachypnea), and vasodilation (flushed, warm skin).
5. A nurse is preparing to administer a controlled substance and discovers a discrepancy in the
narcotic count. What is the nurse's first action?
A. Notify the pharmacy.
B. File an incident report.
C. Notify the charge nurse.
D. Re-count the controlled substances with another nurse.
Answer: D. Re-count the controlled substances with another nurse. ✓
Rationale: The first step is to verify the discrepancy by re-counting with a second nurse to rule
out a simple counting error.
6. Which action by a student nurse during a bed bath requires intervention by the supervising
nurse?
A. Washing from the cleanest to the dirtiest area.
B. Using long, firm strokes when washing the legs.
C. Adding soap to the water in the basin.
D. Placing a waterproof pad under the client when washing perineal area.
Answer: C. Adding soap to the water in the basin. ✓
Rationale: Soap should be applied to a wet washcloth, not added to the basin water, to avoid
bathing the client in soapy water which can dry and irritate the skin.
7. A client is on contact precautions for Clostridium difficile. Which personal protective
equipment (PPE) is essential for the nurse?
A. Gown and gloves.
B. Gloves, gown, and N95 respirator.
C. Gloves and surgical mask.
D. Gown, gloves, and face shield.
Answer: A. Gown and gloves. ✓
Rationale: C. diff is spread via spores in feces, requiring contact precautions (gown and gloves).
A mask is not required unless splashing is anticipated.
,8. The nurse is assessing a client's pulse pressure. The blood pressure is 132/84 mmHg. What
is the client's pulse pressure?
A. 48 mmHg
B. 216 mmHg
C. 84 mmHg
D. 132 mmHg
Answer: A. 48 mmHg ✓
*Rationale: Pulse pressure is the difference between systolic and diastolic pressure (132 - 84 =
48).*
9. A client is having difficulty sleeping. Which nursing intervention is most appropriate to
promote rest?
A. Administer a prescribed PRN sleeping medication.
B. Offer a warm milk and a back rub at bedtime.
C. Keep the room well-lit for safety.
D. Encourage watching television to fall asleep.
Answer: B. Offer a warm milk and a back rub at bedtime. ✓
Rationale: Non-pharmacological interventions should be attempted first. Warm milk and a back
rub promote relaxation.
10. When moving a client up in bed, the nurse should:
A. Keep the bed in a high position.
B. Use a lifting motion with the back muscles.
C. Raise the head of the bed to a flat position.
D. Use a friction-reducing device and get help.
Answer: D. Use a friction-reducing device and get help. ✓
Rationale: This practice protects both the nurse and the client from injury by reducing strain and
shearing forces.
11. The nurse is teaching a client about deep breathing and coughing exercises post-
operatively. The primary rationale for these exercises is to prevent:
A. Atelectasis.
B. Hypertension.
C. Thrombophlebitis.
D. Urinary retention.
Answer: A. Atelectasis. ✓
Rationale: Deep breathing and coughing help expand the lungs and clear secretions, preventing
post-operative atelectasis (lung collapse).
, 12. A nurse is calculating a client's fluid intake. The client consumed 4 oz of juice, 8 oz of soup,
and 300 mL of water. What is the total intake in milliliters? (1 oz = 30 mL)
A. 540 mL
B. 660 mL
C. 780 mL
D. 900 mL
Answer: B. 660 mL ✓
*Rationale: (4 oz x 30) + (8 oz x 30) + 300 mL = 120 + 240 + 300 = 660 mL.*
13. Which client is at the highest risk for developing a pressure injury?
A. A 25-year-old with a fractured femur in traction.
B. A 50-year-old ambulatory post-myocardial infarction client.
C. A 70-year-old with fecal incontinence and malnutrition.
D. A 40-year-old with a migraine headache.
Answer: C. A 70-year-old with fecal incontinence and malnutrition. ✓
Rationale: This client has multiple risk factors: immobility (likely), moisture (incontinence), and
poor nutrition, which all significantly increase the risk for pressure injuries.
14. The "Evaluation" phase of the nursing process involves:
A. Collecting client data.
B. Determining if goals have been met.
C. Carrying out the planned interventions.
D. Identifying client problems.
Answer: B. Determining if goals have been met. ✓
Rationale: Evaluation is the step where the nurse assesses the client's response to interventions
and determines the extent to which goals were achieved.
15. A nurse is providing discharge teaching for a client. Which statement by the client best
demonstrates the affective domain of learning?
A. "I can list the three side effects of my new medication."
B. "I will check my blood sugar before each meal."
C. "I feel confident that I can change my own dressing."
D. "I understand how my heart medication works."
Answer: C. "I feel confident that I can change my own dressing." ✓
Rationale: The affective domain deals with feelings, attitudes, beliefs, and values. Expressing
confidence reflects a change in attitude.
