NUTC 3113 CB 2025/26 : Blueprint for Exam 1
Exam 1: 40 multiple choice, 3 multiple response (select all that apply, drop and drag format, partial
credit possible, plus/minus scoring), 1 sequencing, 2 cloze (drop down) and 3 short answer (which
may include calculations). For the multiple response items, partial credit is possible. For ABG
interpretations, you may be asked to identify the derangement (acidosis or alkalosis), the problem of
origin (metabolic or respiratory), the level of compensation (fully compensated, partially
compensated, uncompensated), and/or the likely cause of the derangement; partial credit is possible.
For the calculation items, you must include the unit of measurement (milliliters, tablets, kilograms,
pounds, etc.) to earn credit. Rules learned in Therapeutics related to preceding and trailing zeros will
be applied to this exam. If the answer to a calculation item includes a decimal, round to the nearest
tenth. For the cloze items, you may need to use the touch screen or touch pad to allow you to see all
the options for each part of the question. The cloze items are valued at 3 points each, the other items
are 2 points each.
Multiple Choice Questions (Select the BEST answer)
Prioritization & Triage
1. A nurse receives change-of-shift report on four clients. Which client should the nurse
assess first?
A. Client with chronic osteoarthritis complaining of stiffness.
B. Client 1-day post-op with a respiratory rate of 8 breaths/min and somnolence.
C. Client with diabetes requesting a snack.
D. Client awaiting discharge planning.
Answer: B (Airway/Breathing is the highest priority.)
2. Using the ABC priority framework, which finding requires immediate intervention?
A. Blood pressure 150/90 mmHg.
B. Oxygen saturation 88% on room air.
C. Complaining of incisional pain rated 6/10.
D. Urine output of 40 mL/hr.
Answer: B (Breathing/Oxygenation issue.)
3. A client is experiencing acute confusion, severe headache, and vomiting. The nurse
identifies these as which level of priority?
A. First-level (immediate, life-threatening).
B. Second-level (requiring prompt intervention).
C. Third-level (important but not urgent).
D. Health promotion.
Answer: A (Mental status change and neurological symptoms are potentially life-
threatening.)
,Safety & Infection Control
4. The nurse is preparing to enter the room of a client with active pulmonary
tuberculosis. Which transmission-based precautions are required?
A. Contact precautions.
B. Droplet precautions.
C. Airborne precautions.
D. Standard precautions only.
Answer: C
5. Which action by a nurse best demonstrates the QSEN competency of “Safety”?
A. Administering pain medication as soon as the client requests it.
B. Using two client identifiers before drawing blood.
C. Providing a detailed explanation of a procedure.
D. Collaborating with physical therapy.
Answer: B
6. When using a fire extinguisher, the nurse remembers the acronym PASS. What does
the “S” stand for?
A. Sound the alarm.
B. Sweep from side to side at the base of the fire.
C. Secure the area.
D. Shut off oxygen sources.
Answer: B
7. A client on contact precautions for C. difficile asks for a glass of water. The nurse has
just removed gloves and a gown after providing care. What should the nurse do next?
A. Get the water immediately, as hands are now clean.
B. Perform hand hygiene with soap and water, then get the water.
C. Use alcohol-based hand sanitizer and get the water.
D. Ask a family member who is not wearing PPE to get the water.
Answer: B (C. difficile spores are not killed by alcohol-based sanitizer; soap and water
are required.)
Nursing Process & Critical Thinking
8. The nurse observes a client guarding their abdomen, grimacing, and rates pain as 8/10.
This data is best classified as:
A. Subjective data.
B. Objective data.
C. A nursing diagnosis.
, D. An intervention.
Answer: B
9. “Risk for infection related to surgical incision” is an example of what type of nursing
diagnosis?
A. Problem-focused.
B. Risk nursing diagnosis.
C. Health promotion.
D. Medical diagnosis.
Answer: B
10. Which statement by a nurse demonstrates critical thinking during the planning phase?
A. “I will administer the medication exactly at 10:00 AM.”
B. “The client’s goal is to walk 50 feet by tomorrow, but considering their dizziness, I’ll
have assistance ready.”
C. “I collected all the assessment data yesterday.”
D. “The doctor’s order says to ambulate, so I will do that.”
Answer: B (Shows anticipation and individualization of the plan.)
Pain Management
11. The nurse is assessing a client’s pain using the OPQRSTU mnemonic. Asking “What
makes the pain better or worse?” assesses which component?
A. Onset.
B. Provocative/Palliative.
C. Quality.
D. Region.
Answer: B
12. A client with patient-controlled analgesia (PCA) for postoperative pain is somnolent
and difficult to arouse. The nurse’s priority action is to:
A. Administer a stimulant as ordered.
B. Check the PCA pump settings and delivery history.
C. Encourage the client to use the button more frequently.
D. Let the client sleep to promote healing.
Answer: B (Assess for over-sedation and potential respiratory depression.)
Intake & Output / Calculations
13. A client’s intake for the shift is: 4 oz juice, 8 oz broth, 2 cups of water, and one 250 mL
ice pop. What is the total intake in mL? (1 oz = 30 mL; 1 cup = 240 mL)
A. 720 mL.
Exam 1: 40 multiple choice, 3 multiple response (select all that apply, drop and drag format, partial
credit possible, plus/minus scoring), 1 sequencing, 2 cloze (drop down) and 3 short answer (which
may include calculations). For the multiple response items, partial credit is possible. For ABG
interpretations, you may be asked to identify the derangement (acidosis or alkalosis), the problem of
origin (metabolic or respiratory), the level of compensation (fully compensated, partially
compensated, uncompensated), and/or the likely cause of the derangement; partial credit is possible.
For the calculation items, you must include the unit of measurement (milliliters, tablets, kilograms,
pounds, etc.) to earn credit. Rules learned in Therapeutics related to preceding and trailing zeros will
be applied to this exam. If the answer to a calculation item includes a decimal, round to the nearest
tenth. For the cloze items, you may need to use the touch screen or touch pad to allow you to see all
the options for each part of the question. The cloze items are valued at 3 points each, the other items
are 2 points each.
Multiple Choice Questions (Select the BEST answer)
Prioritization & Triage
1. A nurse receives change-of-shift report on four clients. Which client should the nurse
assess first?
A. Client with chronic osteoarthritis complaining of stiffness.
B. Client 1-day post-op with a respiratory rate of 8 breaths/min and somnolence.
C. Client with diabetes requesting a snack.
D. Client awaiting discharge planning.
Answer: B (Airway/Breathing is the highest priority.)
2. Using the ABC priority framework, which finding requires immediate intervention?
A. Blood pressure 150/90 mmHg.
B. Oxygen saturation 88% on room air.
C. Complaining of incisional pain rated 6/10.
D. Urine output of 40 mL/hr.
Answer: B (Breathing/Oxygenation issue.)
3. A client is experiencing acute confusion, severe headache, and vomiting. The nurse
identifies these as which level of priority?
A. First-level (immediate, life-threatening).
B. Second-level (requiring prompt intervention).
C. Third-level (important but not urgent).
D. Health promotion.
Answer: A (Mental status change and neurological symptoms are potentially life-
threatening.)
,Safety & Infection Control
4. The nurse is preparing to enter the room of a client with active pulmonary
tuberculosis. Which transmission-based precautions are required?
A. Contact precautions.
B. Droplet precautions.
C. Airborne precautions.
D. Standard precautions only.
Answer: C
5. Which action by a nurse best demonstrates the QSEN competency of “Safety”?
A. Administering pain medication as soon as the client requests it.
B. Using two client identifiers before drawing blood.
C. Providing a detailed explanation of a procedure.
D. Collaborating with physical therapy.
Answer: B
6. When using a fire extinguisher, the nurse remembers the acronym PASS. What does
the “S” stand for?
A. Sound the alarm.
B. Sweep from side to side at the base of the fire.
C. Secure the area.
D. Shut off oxygen sources.
Answer: B
7. A client on contact precautions for C. difficile asks for a glass of water. The nurse has
just removed gloves and a gown after providing care. What should the nurse do next?
A. Get the water immediately, as hands are now clean.
B. Perform hand hygiene with soap and water, then get the water.
C. Use alcohol-based hand sanitizer and get the water.
D. Ask a family member who is not wearing PPE to get the water.
Answer: B (C. difficile spores are not killed by alcohol-based sanitizer; soap and water
are required.)
Nursing Process & Critical Thinking
8. The nurse observes a client guarding their abdomen, grimacing, and rates pain as 8/10.
This data is best classified as:
A. Subjective data.
B. Objective data.
C. A nursing diagnosis.
, D. An intervention.
Answer: B
9. “Risk for infection related to surgical incision” is an example of what type of nursing
diagnosis?
A. Problem-focused.
B. Risk nursing diagnosis.
C. Health promotion.
D. Medical diagnosis.
Answer: B
10. Which statement by a nurse demonstrates critical thinking during the planning phase?
A. “I will administer the medication exactly at 10:00 AM.”
B. “The client’s goal is to walk 50 feet by tomorrow, but considering their dizziness, I’ll
have assistance ready.”
C. “I collected all the assessment data yesterday.”
D. “The doctor’s order says to ambulate, so I will do that.”
Answer: B (Shows anticipation and individualization of the plan.)
Pain Management
11. The nurse is assessing a client’s pain using the OPQRSTU mnemonic. Asking “What
makes the pain better or worse?” assesses which component?
A. Onset.
B. Provocative/Palliative.
C. Quality.
D. Region.
Answer: B
12. A client with patient-controlled analgesia (PCA) for postoperative pain is somnolent
and difficult to arouse. The nurse’s priority action is to:
A. Administer a stimulant as ordered.
B. Check the PCA pump settings and delivery history.
C. Encourage the client to use the button more frequently.
D. Let the client sleep to promote healing.
Answer: B (Assess for over-sedation and potential respiratory depression.)
Intake & Output / Calculations
13. A client’s intake for the shift is: 4 oz juice, 8 oz broth, 2 cups of water, and one 250 mL
ice pop. What is the total intake in mL? (1 oz = 30 mL; 1 cup = 240 mL)
A. 720 mL.
