NUR 210 & NUR 242 | Nursing Fundamentals & Med-Surg
Foundations | Exam 4 2026 |Galen College
1. A nurse is preparing to administer an intramuscular injection to an adult
patient. Which site is considered the safest and most preferred for large volume
injections?
A. Deltoid
B. Ventrogluteal
C. Dorsogluteal
D. Vastus Lateralis
Answer: B
Rationale: The ventrogluteal site is the preferred site for IM injections because it is away
from major blood vessels and nerves and has a thick muscle mass.
2. When assessing a patient with a fluid volume deficit, which clinical
manifestation should the nurse expect to find?
A. Distended neck veins
B. Dependent edema
C. Crackles in the lungs
D. Orthostatic hypotension
Answer: D
Rationale: Fluid volume deficit (dehydration) leads to decreased circulating volume, often
causing a drop in blood pressure when changing positions (orthostatic hypotension).
,3. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 52 mmHg, and
HCO3 24 mEq/L. How should the nurse interpret these results?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. An elevated PaCO2 (normal 35-45)
indicates a respiratory cause for the acidosis.
4. Which nursing intervention is a priority for a patient who is post-operative
and at risk for pulmonary embolism?
A. Applying sequential compression devices (SCDs)
B. Encouraging the use of an incentive spirometer
C. Administering prophylactic antibiotics
D. Restricting fluid intake
Answer: A
Rationale: SCDs help prevent deep vein thrombosis (DVT), which is the primary cause of
pulmonary embolism in post-operative patients.
5. The nurse is caring for a patient with a stage 3 pressure injury. How should
the nurse describe this wound in the documentation?
A. Full-thickness skin loss with visible subcutaneous fat
B. Partial-thickness skin loss involving the dermis
C. Non-blanchable erythema of intact skin
D. Full-thickness tissue loss with exposed bone or muscle
Answer: A
Rationale: Stage 3 pressure injuries involve full-thickness skin loss where subcutaneous
fat may be visible, but bone, tendon, or muscle are not exposed.
, 6. Which electrolyte imbalance is a patient most at risk for when taking a non-
potassium-sparing loop diuretic like furosemide?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B
Rationale: Loop diuretics increase the excretion of potassium in the urine, frequently
leading to hypokalemia (low potassium).
7. A nurse is witnessing a patient sign an informed consent form for surgery.
What is the nurse’s primary legal responsibility in this role?
A. Explaining the risks and benefits of the procedure
B. Describing alternative treatments to the patient
C. Ensuring the patient is signing the form voluntarily
D. Confirming the patient’s medical history is accurate
Answer: C
Rationale: The nurse’s role is to witness the signature and ensure the patient is competent
and signing voluntarily. The surgeon is responsible for explaining the procedure.
8. Which type of isolation precaution should the nurse implement for a patient
diagnosed with Vancomycin-Resistant Enterococcus (VRE)?
A. Airborne Precautions
B. Contact Precautions
C. Droplet Precautions
D. Protective Environment
Answer: B
Rationale: VRE is transmitted via direct or indirect contact; therefore, Contact Precautions
(gloves and gown) are required.
Foundations | Exam 4 2026 |Galen College
1. A nurse is preparing to administer an intramuscular injection to an adult
patient. Which site is considered the safest and most preferred for large volume
injections?
A. Deltoid
B. Ventrogluteal
C. Dorsogluteal
D. Vastus Lateralis
Answer: B
Rationale: The ventrogluteal site is the preferred site for IM injections because it is away
from major blood vessels and nerves and has a thick muscle mass.
2. When assessing a patient with a fluid volume deficit, which clinical
manifestation should the nurse expect to find?
A. Distended neck veins
B. Dependent edema
C. Crackles in the lungs
D. Orthostatic hypotension
Answer: D
Rationale: Fluid volume deficit (dehydration) leads to decreased circulating volume, often
causing a drop in blood pressure when changing positions (orthostatic hypotension).
,3. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 52 mmHg, and
HCO3 24 mEq/L. How should the nurse interpret these results?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. An elevated PaCO2 (normal 35-45)
indicates a respiratory cause for the acidosis.
4. Which nursing intervention is a priority for a patient who is post-operative
and at risk for pulmonary embolism?
A. Applying sequential compression devices (SCDs)
B. Encouraging the use of an incentive spirometer
C. Administering prophylactic antibiotics
D. Restricting fluid intake
Answer: A
Rationale: SCDs help prevent deep vein thrombosis (DVT), which is the primary cause of
pulmonary embolism in post-operative patients.
5. The nurse is caring for a patient with a stage 3 pressure injury. How should
the nurse describe this wound in the documentation?
A. Full-thickness skin loss with visible subcutaneous fat
B. Partial-thickness skin loss involving the dermis
C. Non-blanchable erythema of intact skin
D. Full-thickness tissue loss with exposed bone or muscle
Answer: A
Rationale: Stage 3 pressure injuries involve full-thickness skin loss where subcutaneous
fat may be visible, but bone, tendon, or muscle are not exposed.
, 6. Which electrolyte imbalance is a patient most at risk for when taking a non-
potassium-sparing loop diuretic like furosemide?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B
Rationale: Loop diuretics increase the excretion of potassium in the urine, frequently
leading to hypokalemia (low potassium).
7. A nurse is witnessing a patient sign an informed consent form for surgery.
What is the nurse’s primary legal responsibility in this role?
A. Explaining the risks and benefits of the procedure
B. Describing alternative treatments to the patient
C. Ensuring the patient is signing the form voluntarily
D. Confirming the patient’s medical history is accurate
Answer: C
Rationale: The nurse’s role is to witness the signature and ensure the patient is competent
and signing voluntarily. The surgeon is responsible for explaining the procedure.
8. Which type of isolation precaution should the nurse implement for a patient
diagnosed with Vancomycin-Resistant Enterococcus (VRE)?
A. Airborne Precautions
B. Contact Precautions
C. Droplet Precautions
D. Protective Environment
Answer: B
Rationale: VRE is transmitted via direct or indirect contact; therefore, Contact Precautions
(gloves and gown) are required.
