NUR 155 Foundations of Nursing
Exam 2
2026/2027 (Newly Released
Content Focus : : Mobility, Immobility, & Body Mechanics, Nutrition,
Hydration, & Elimination ,Medication Administration –
Basics,Oxygenation, Respiratory Care, & Suctioning, Wound Care &
Pressure Injury Prevention
Section 1: Mobility, Immobility, & Body Mechanics
Q1: A nurse is preparing to transfer a patient from the bed to a wheelchair using a gait belt.
Which instruction regarding the gait belt is correct?
A. Place the gait belt over the patient's clothing for comfort.
B. Apply the gait belt snugly around the patient's waist, with the buckle in the front.
[CORRECT]
C. Position the gait belt loosely to allow for lung expansion.
D. Place the gait belt at the level of the patient's nipples.
Correct Answer: B
,Rationale: The gait belt should be applied snugly around the waist over clothing (or directly on
skin if necessary) with the buckle in front to allow for a secure grip and to prevent injury during
the transfer.
Board Pearl: Gait Belt = Snug waist, buckle front, secure grip.
Q2: A patient reports feeling dizzy and lightheaded when moving from a lying position to a
standing position. The nurse recognizes this as:
A. Orthostatic hypotension. [CORRECT]
B. Vertigo.
C. Syncope.
D. Thrombophlebitis.
Correct Answer: A
Rationale: Orthostatic hypotension is a drop in blood pressure (usually >20 mm Hg systolic or
>10 mm Hg diastolic) upon standing, causing dizziness.
Board Pearl: Stand up + Dizzy = Orthostatic Hypotension (Check BP lying/standing).
Q3: The nurse must apply wrist restraints to a patient to prevent self-extubation. Which action is
most important for safety?
A. Tie the restraints to the side rails.
B. Ensure the restraint is snug enough to prevent movement.
C. Secure the restraint to the movable part of the bed frame. [CORRECT]
D. Leave one finger width of space between the restraint and the wrist.
Correct Answer: C
Rationale: Restraints must be tied to the bed frame (movable part) so they automatically loosen
if the side rail is raised, preventing strangulation or injury.
Board Pearl: Restraints tie to the Bed Frame, not the side rail.
, Q4: Which patient position is appropriate for a patient experiencing hypotension and shock to
promote blood flow to the brain?
A. High Fowler's position.
B. Trendelenburg position. [CORRECT]
C. Semi-Fowler's position.
D. Orthopneic position.
Correct Answer: B
Rationale: Trendelenburg position (head down, feet up) uses gravity to shift blood from the legs
to the vital organs, including the brain, to improve perfusion in shock.
Board Pearl: Shock/Low BP = Trendelenburg (Feet up).
Q5: The nurse asks the patient to perform range of motion (ROM) exercises independently. This
is an example of:
A. Passive ROM.
B. Active ROM. [CORRECT]
C. Active-assistive ROM.
D. Resistive ROM.
Correct Answer: B
Rationale: Active ROM is when the patient moves the joints independently without assistance.
Board Pearl: Patient moves = Active; Nurse moves = Passive.
Q6: Which urinary complication is associated with prolonged immobility due to the stasis of
urine in the renal pelvis?
A. Renal calculi (kidney stones). [CORRECT]
B. Glomerulonephritis.
C. Acute renal failure.
D. Nephrotic syndrome.
Exam 2
2026/2027 (Newly Released
Content Focus : : Mobility, Immobility, & Body Mechanics, Nutrition,
Hydration, & Elimination ,Medication Administration –
Basics,Oxygenation, Respiratory Care, & Suctioning, Wound Care &
Pressure Injury Prevention
Section 1: Mobility, Immobility, & Body Mechanics
Q1: A nurse is preparing to transfer a patient from the bed to a wheelchair using a gait belt.
Which instruction regarding the gait belt is correct?
A. Place the gait belt over the patient's clothing for comfort.
B. Apply the gait belt snugly around the patient's waist, with the buckle in the front.
[CORRECT]
C. Position the gait belt loosely to allow for lung expansion.
D. Place the gait belt at the level of the patient's nipples.
Correct Answer: B
,Rationale: The gait belt should be applied snugly around the waist over clothing (or directly on
skin if necessary) with the buckle in front to allow for a secure grip and to prevent injury during
the transfer.
Board Pearl: Gait Belt = Snug waist, buckle front, secure grip.
Q2: A patient reports feeling dizzy and lightheaded when moving from a lying position to a
standing position. The nurse recognizes this as:
A. Orthostatic hypotension. [CORRECT]
B. Vertigo.
C. Syncope.
D. Thrombophlebitis.
Correct Answer: A
Rationale: Orthostatic hypotension is a drop in blood pressure (usually >20 mm Hg systolic or
>10 mm Hg diastolic) upon standing, causing dizziness.
Board Pearl: Stand up + Dizzy = Orthostatic Hypotension (Check BP lying/standing).
Q3: The nurse must apply wrist restraints to a patient to prevent self-extubation. Which action is
most important for safety?
A. Tie the restraints to the side rails.
B. Ensure the restraint is snug enough to prevent movement.
C. Secure the restraint to the movable part of the bed frame. [CORRECT]
D. Leave one finger width of space between the restraint and the wrist.
Correct Answer: C
Rationale: Restraints must be tied to the bed frame (movable part) so they automatically loosen
if the side rail is raised, preventing strangulation or injury.
Board Pearl: Restraints tie to the Bed Frame, not the side rail.
, Q4: Which patient position is appropriate for a patient experiencing hypotension and shock to
promote blood flow to the brain?
A. High Fowler's position.
B. Trendelenburg position. [CORRECT]
C. Semi-Fowler's position.
D. Orthopneic position.
Correct Answer: B
Rationale: Trendelenburg position (head down, feet up) uses gravity to shift blood from the legs
to the vital organs, including the brain, to improve perfusion in shock.
Board Pearl: Shock/Low BP = Trendelenburg (Feet up).
Q5: The nurse asks the patient to perform range of motion (ROM) exercises independently. This
is an example of:
A. Passive ROM.
B. Active ROM. [CORRECT]
C. Active-assistive ROM.
D. Resistive ROM.
Correct Answer: B
Rationale: Active ROM is when the patient moves the joints independently without assistance.
Board Pearl: Patient moves = Active; Nurse moves = Passive.
Q6: Which urinary complication is associated with prolonged immobility due to the stasis of
urine in the renal pelvis?
A. Renal calculi (kidney stones). [CORRECT]
B. Glomerulonephritis.
C. Acute renal failure.
D. Nephrotic syndrome.
