NU 136 Fundamentals of Nursing: EXAM 3
FOUNDATIONAL PRINCIPLES MASTERY |
Application-Based Learning System | 500+ Clinical
Judgment Scenarios | 2026/2027 Edition
This exam consists of 55 questions based on the 2026/2027 NU 136 curriculum. It
tests the application of fundamental nursing principles, including safety, basic care,
infection control, and documentation. Choose the nurse's best action. Time: 90 minutes.
1. A nurse is preparing to insert a saline lock on a medical floor. After performing
hand hygiene and applying clean gloves, the nurse opens the sterile catheter
package and notices the inner tray is damp.
A. Continue; the catheter is still sterile.
*B. Discard the entire package and obtain a new sterile catheter.
C. Ask the provider to insert the catheter instead.
D. Dry the tray with a clean paper towel before use.
Rationale: 1) B is correct because moisture breaches sterile packaging and
introduces pathogens. 2) A ignores contamination. 3) C is unnecessary
escalation; task remains within RN scope. 4) D does not restore sterility.
2. A visitor enters an isolation room for a patient on contact precautions for MRSA.
The visitor is carrying a purse and a half-eaten sandwich.
A. Allow the visitor to enter after applying a mask.
*B. Ask the visitor to leave food and personal items outside, provide education on
contact precautions, and ensure proper PPE use.
C. Tell the visitor that only the doctor can give permission.
D. Suggest the visitor finish the sandwich inside the anteroom.
Rationale: 1) B follows 2026 CDC isolation guidelines preventing
cross-contamination. 2) A wrong precaution type. 3) C misplaces responsibility.
4) D still risks pathogen spread.
3. A student nurse is about to administer PO acetaminophen. The patient asks to
keep the pills in a plastic bag to take later.
A. Agree to maintain patient satisfaction.
*B. Explain that medications must be taken while observed for safety and legal
, reasons; contact the nurse if nausea is a concern.
C. Refuse and walk away.
D. Suggest the patient hide them in the bedside table.
Rationale: 1) B upholds “right time” and prevents diversion. 2) A allows
non-adherence and risk. 3) C lacks therapeutic communication. 4) D encourages
diversion.
4. A nurse finds a confused elderly patient on the floor next to the bed after hearing
a thud. The patient is alert and denies pain.
A. Help the patient back to bed immediately and document “no injury.”
*B. Assess for injury first, call for assistance, perform neuro-vital signs, and
complete incident report per facility policy.
C. Scold the patient for getting up alone.
D. Apply restraints to prevent further falls.
Rationale: 1) B follows 2026 TJC fall-response protocol ensuring safety. 2) A
risks moving an injured person. 3) C non-therapeutic. 4) D least-restraint principle
violated.
5. During medication preparation the nurse discovers that the ordered 500 mg
tablet is unavailable in unit-dose and only 250 mg tablets remain.
A. Give two 250 mg tablets and document “as ordered.”
*B. Verify the order, check facility policy on tablet splitting, obtain pharmacist
approval if needed, and document administration correctly.
C. Hold the medication until the next shift.
D. Crush both tablets and mix in applesauce without checking.
Rationale: 1) B ensures accuracy and policy compliance. 2) A omits verification
steps. 3) C delays therapy. 4) D alters form without order.
6. A nurse notes that a colleague recaps a used insulin needle with two hands.
A. Ignore the practice to avoid conflict.
B. Report the colleague to the board of nursing immediately.
*C. Politely intervene, remind the colleague of no-recap policy, and offer a safety
device or sharps container.
D. Assume the colleague is experienced and continue charting.
Rationale: 1) C follows OSHA needle-safety regulations. 2) A allows unsafe
practice. 3) B escalates prematurely. 4) D condones risk.
7. A patient’s chest tube becomes disconnected from the drainage system while
ambulating.
A. Reconnect quickly without gloves to limit air leak.
*B. Clamp the tube momentarily with a provided hemostat, don clean gloves,
reconnect to a new sterile drainage unit, and assess respiratory status.
C. Tell the patient to return to bed and call the physician.
FOUNDATIONAL PRINCIPLES MASTERY |
Application-Based Learning System | 500+ Clinical
Judgment Scenarios | 2026/2027 Edition
This exam consists of 55 questions based on the 2026/2027 NU 136 curriculum. It
tests the application of fundamental nursing principles, including safety, basic care,
infection control, and documentation. Choose the nurse's best action. Time: 90 minutes.
1. A nurse is preparing to insert a saline lock on a medical floor. After performing
hand hygiene and applying clean gloves, the nurse opens the sterile catheter
package and notices the inner tray is damp.
A. Continue; the catheter is still sterile.
*B. Discard the entire package and obtain a new sterile catheter.
C. Ask the provider to insert the catheter instead.
D. Dry the tray with a clean paper towel before use.
Rationale: 1) B is correct because moisture breaches sterile packaging and
introduces pathogens. 2) A ignores contamination. 3) C is unnecessary
escalation; task remains within RN scope. 4) D does not restore sterility.
2. A visitor enters an isolation room for a patient on contact precautions for MRSA.
The visitor is carrying a purse and a half-eaten sandwich.
A. Allow the visitor to enter after applying a mask.
*B. Ask the visitor to leave food and personal items outside, provide education on
contact precautions, and ensure proper PPE use.
C. Tell the visitor that only the doctor can give permission.
D. Suggest the visitor finish the sandwich inside the anteroom.
Rationale: 1) B follows 2026 CDC isolation guidelines preventing
cross-contamination. 2) A wrong precaution type. 3) C misplaces responsibility.
4) D still risks pathogen spread.
3. A student nurse is about to administer PO acetaminophen. The patient asks to
keep the pills in a plastic bag to take later.
A. Agree to maintain patient satisfaction.
*B. Explain that medications must be taken while observed for safety and legal
, reasons; contact the nurse if nausea is a concern.
C. Refuse and walk away.
D. Suggest the patient hide them in the bedside table.
Rationale: 1) B upholds “right time” and prevents diversion. 2) A allows
non-adherence and risk. 3) C lacks therapeutic communication. 4) D encourages
diversion.
4. A nurse finds a confused elderly patient on the floor next to the bed after hearing
a thud. The patient is alert and denies pain.
A. Help the patient back to bed immediately and document “no injury.”
*B. Assess for injury first, call for assistance, perform neuro-vital signs, and
complete incident report per facility policy.
C. Scold the patient for getting up alone.
D. Apply restraints to prevent further falls.
Rationale: 1) B follows 2026 TJC fall-response protocol ensuring safety. 2) A
risks moving an injured person. 3) C non-therapeutic. 4) D least-restraint principle
violated.
5. During medication preparation the nurse discovers that the ordered 500 mg
tablet is unavailable in unit-dose and only 250 mg tablets remain.
A. Give two 250 mg tablets and document “as ordered.”
*B. Verify the order, check facility policy on tablet splitting, obtain pharmacist
approval if needed, and document administration correctly.
C. Hold the medication until the next shift.
D. Crush both tablets and mix in applesauce without checking.
Rationale: 1) B ensures accuracy and policy compliance. 2) A omits verification
steps. 3) C delays therapy. 4) D alters form without order.
6. A nurse notes that a colleague recaps a used insulin needle with two hands.
A. Ignore the practice to avoid conflict.
B. Report the colleague to the board of nursing immediately.
*C. Politely intervene, remind the colleague of no-recap policy, and offer a safety
device or sharps container.
D. Assume the colleague is experienced and continue charting.
Rationale: 1) C follows OSHA needle-safety regulations. 2) A allows unsafe
practice. 3) B escalates prematurely. 4) D condones risk.
7. A patient’s chest tube becomes disconnected from the drainage system while
ambulating.
A. Reconnect quickly without gloves to limit air leak.
*B. Clamp the tube momentarily with a provided hemostat, don clean gloves,
reconnect to a new sterile drainage unit, and assess respiratory status.
C. Tell the patient to return to bed and call the physician.
