NURS 3511 | 442 QUESTIONS AND ANSWERS | WITH COMPLETE SOLUTION.
A nurse is assessing a client with pneumonia. Which finding is the priority cue requiring immediate
action? - (answer)A. Temperature 38.5°C B. RR 32/min C. Productive cough D. Fatigue Answer: B
The nurse recognizes cues of hypoxia in a patient. Which findings support this? Select all that apply. -
(answer)A. SpO₂ 88% B. RR 10/min C. Cyanosis D. Confusion E. Bradycardia Answer: A, C, D
A nurse is in the "analyze cues" step of the CJMM. Which action best reflects this step? - (answer)A.
Collecting vital signs B. Comparing SpO₂ to normal range C. Administering oxygen D. Reassessing patient
Answer: B
Which patient should the nurse prioritize? - (answer)A. Fever 38°C B. SpO₂ 90% on RA C. Mild pain 3/10
D. BP 130/80 Answer: B
The nurse identifies hypoxia as the priority problem. Which framework is being used? - (answer)A.
Maslow B. ABCs C. Nursing process D. SBAR Answer: B
Which action is an independent nursing intervention? - (answer)A. Administer IV antibiotics B. Apply
oxygen C. Order ABG D. Prescribe steroids Answer: B
A patient's SpO₂ improves from 88% to 95% after oxygen therapy. Which CJMM step is this? - (answer)A.
Recognize cues B. Analyze cues C. Evaluate outcomes D. Generate solutions Answer: C
Which situation requires immediate escalation? - (answer)A. Productive cough B. Crackles C. Absent
breath sounds D. Fever Answer: C
The nurse is planning care. Which action reflects "generate solutions"? - (answer)A. Giving medication B.
Identifying hypoxia C. Listing possible interventions D. Reassessing Answer: C
Which finding indicates worsening respiratory status? - (answer)A. RR 20 B. SpO₂ 97% C. Decreased
wheezing D. Calm patient Answer: C
,NURS 3511 | 442 QUESTIONS AND ANSWERS | WITH COMPLETE SOLUTION.
A nurse is teaching a patient. Which factor most affects learning? - (answer)A. Nurse experience B.
Patient readiness C. Hospital policy D. Time of day Answer: B
Which is an example of medical asepsis? - (answer)A. Sterile gloves B. Hand hygiene C. Surgical field D.
Foley insertion Answer: B
Which situation breaks sterile technique? - (answer)A. Sterile touches sterile B. Sterile below waist C.
Dry sterile field D. Sterile in sight Answer: B
Which is the most important infection control measure? - (answer)A. PPE B. Isolation C. Hand hygiene D.
Sterile gloves Answer: C
Which patient requires droplet precautions? - (answer)A. TB B. RSV C. MRSA D. C. diff Answer: B
Which finding is a portal of entry? - (answer)A. Skin breakdown B. Mask use C. Hand hygiene D. Isolation
Answer: A
Which action prevents transmission? - (answer)A. Reusing equipment B. Hand hygiene C. Overfilling
linen bags D. No PPE Answer: B
A nurse is preparing a patient for a procedure. What must be verified first? - (answer)A. Consent B.
Transport C. Results D. Family presence Answer: A
Which indicates proper teaching? - (answer)A. Patient nods B. Patient repeats info C. Patient signs form
D. Patient listens Answer: B
Which is a barrier to learning? - (answer)A. Motivation B. Fatigue C. Interest D. Readiness Answer: B
Which is a correct teaching goal? - (answer)A. Nurse satisfaction B. Patient independence C. Short visit
D. Less work Answer: B
, NURS 3511 | 442 QUESTIONS AND ANSWERS | WITH COMPLETE SOLUTION.
A patient is anxious before a test. What is the nurse's priority? - (answer)A. Give meds B. Explain
procedure C. Ignore D. Call MD Answer: B
Which indicates contamination? - (answer)A. Dry sterile field B. Wet sterile field C. Clean gloves D.
Closed package Answer: B
Which is surgical asepsis? - (answer)A. Hand hygiene B. Sterile gloves C. Cleaning room D. Linen change
Answer: B
Which patient is most at risk for infection? - (answer)A. Healthy adult B. Elderly with IV C. Teen D.
Athlete Answer: B
Which finding indicates infection transmission risk? - (answer)A. Clean equipment B. Shared
thermometer C. Hand hygiene D. PPE use Answer: B
Which action is incorrect? - (answer)A. Gloves for body fluids B. Carry linen close to body C. Wash hands
D. Use PPE Answer: B
Which indicates need for education? - (answer)A. Uses sanitizer B. Washes hands after care C. Wears
gloves always D. Skips handwashing Answer: D
Which finding requires follow-up? - (answer)A. Consent signed B. No explanation given C. ID band
present D. IV secured Answer: B
Which reflects effective evaluation? - (answer)A. No reassessment B. Patient improves C. No
documentation D. No change Answer: B
A 3-month-old infant presents with nasal flaring and retractions. What is the priority nursing action? -
(answer)A. Administer antibiotics B. Suction airway C. Encourage fluids D. Monitor temperature Answer:
B
A nurse is assessing a client with pneumonia. Which finding is the priority cue requiring immediate
action? - (answer)A. Temperature 38.5°C B. RR 32/min C. Productive cough D. Fatigue Answer: B
The nurse recognizes cues of hypoxia in a patient. Which findings support this? Select all that apply. -
(answer)A. SpO₂ 88% B. RR 10/min C. Cyanosis D. Confusion E. Bradycardia Answer: A, C, D
A nurse is in the "analyze cues" step of the CJMM. Which action best reflects this step? - (answer)A.
Collecting vital signs B. Comparing SpO₂ to normal range C. Administering oxygen D. Reassessing patient
Answer: B
Which patient should the nurse prioritize? - (answer)A. Fever 38°C B. SpO₂ 90% on RA C. Mild pain 3/10
D. BP 130/80 Answer: B
The nurse identifies hypoxia as the priority problem. Which framework is being used? - (answer)A.
Maslow B. ABCs C. Nursing process D. SBAR Answer: B
Which action is an independent nursing intervention? - (answer)A. Administer IV antibiotics B. Apply
oxygen C. Order ABG D. Prescribe steroids Answer: B
A patient's SpO₂ improves from 88% to 95% after oxygen therapy. Which CJMM step is this? - (answer)A.
Recognize cues B. Analyze cues C. Evaluate outcomes D. Generate solutions Answer: C
Which situation requires immediate escalation? - (answer)A. Productive cough B. Crackles C. Absent
breath sounds D. Fever Answer: C
The nurse is planning care. Which action reflects "generate solutions"? - (answer)A. Giving medication B.
Identifying hypoxia C. Listing possible interventions D. Reassessing Answer: C
Which finding indicates worsening respiratory status? - (answer)A. RR 20 B. SpO₂ 97% C. Decreased
wheezing D. Calm patient Answer: C
,NURS 3511 | 442 QUESTIONS AND ANSWERS | WITH COMPLETE SOLUTION.
A nurse is teaching a patient. Which factor most affects learning? - (answer)A. Nurse experience B.
Patient readiness C. Hospital policy D. Time of day Answer: B
Which is an example of medical asepsis? - (answer)A. Sterile gloves B. Hand hygiene C. Surgical field D.
Foley insertion Answer: B
Which situation breaks sterile technique? - (answer)A. Sterile touches sterile B. Sterile below waist C.
Dry sterile field D. Sterile in sight Answer: B
Which is the most important infection control measure? - (answer)A. PPE B. Isolation C. Hand hygiene D.
Sterile gloves Answer: C
Which patient requires droplet precautions? - (answer)A. TB B. RSV C. MRSA D. C. diff Answer: B
Which finding is a portal of entry? - (answer)A. Skin breakdown B. Mask use C. Hand hygiene D. Isolation
Answer: A
Which action prevents transmission? - (answer)A. Reusing equipment B. Hand hygiene C. Overfilling
linen bags D. No PPE Answer: B
A nurse is preparing a patient for a procedure. What must be verified first? - (answer)A. Consent B.
Transport C. Results D. Family presence Answer: A
Which indicates proper teaching? - (answer)A. Patient nods B. Patient repeats info C. Patient signs form
D. Patient listens Answer: B
Which is a barrier to learning? - (answer)A. Motivation B. Fatigue C. Interest D. Readiness Answer: B
Which is a correct teaching goal? - (answer)A. Nurse satisfaction B. Patient independence C. Short visit
D. Less work Answer: B
, NURS 3511 | 442 QUESTIONS AND ANSWERS | WITH COMPLETE SOLUTION.
A patient is anxious before a test. What is the nurse's priority? - (answer)A. Give meds B. Explain
procedure C. Ignore D. Call MD Answer: B
Which indicates contamination? - (answer)A. Dry sterile field B. Wet sterile field C. Clean gloves D.
Closed package Answer: B
Which is surgical asepsis? - (answer)A. Hand hygiene B. Sterile gloves C. Cleaning room D. Linen change
Answer: B
Which patient is most at risk for infection? - (answer)A. Healthy adult B. Elderly with IV C. Teen D.
Athlete Answer: B
Which finding indicates infection transmission risk? - (answer)A. Clean equipment B. Shared
thermometer C. Hand hygiene D. PPE use Answer: B
Which action is incorrect? - (answer)A. Gloves for body fluids B. Carry linen close to body C. Wash hands
D. Use PPE Answer: B
Which indicates need for education? - (answer)A. Uses sanitizer B. Washes hands after care C. Wears
gloves always D. Skips handwashing Answer: D
Which finding requires follow-up? - (answer)A. Consent signed B. No explanation given C. ID band
present D. IV secured Answer: B
Which reflects effective evaluation? - (answer)A. No reassessment B. Patient improves C. No
documentation D. No change Answer: B
A 3-month-old infant presents with nasal flaring and retractions. What is the priority nursing action? -
(answer)A. Administer antibiotics B. Suction airway C. Encourage fluids D. Monitor temperature Answer:
B
