Foundations of Nursing Practice – Comprehensive Clinical Competency Assessment
Foundations of Nursing Practice:
Comprehensive Clinical
Competency Assessment
────────────────────────────────────────
75 Questions with Correct Answers
and Detailed Rationales
Academic Year 2026/2027
Exam-Ready Format | Updated Questions
Study Guide Edition
Page 1 of 22
, Foundations of Nursing Practice – Comprehensive Clinical Competency Assessment
Section 1: Nursing Process & Clinical Judgment
Questions 1–8
1. A nurse is caring for a patient admitted with dehydration. During the assessment phase,
which of the following data collection methods yields objective information?
A. Patient states “I feel very tired” B. Blood pressure reading of 90/58 mmHg
C. Patient reports nausea D. Family states patient has been urinating less
Correct Answer: B. Blood pressure reading of 90/58 mmHg
Rationale: Objective data is measurable and observable through physical examination, laboratory values, or
diagnostic tests. A blood pressure of 90/58 mmHg is a quantifiable, measurable finding obtained through
assessment techniques, making it objective. Patient statements and family reports are subjective data because
they represent perceptions and feelings that cannot be directly measured or verified by the nurse.
2. A nurse using the NCSBN Clinical Judgment Measurement Model (CJMM) is reviewing
cues for a postoperative patient. The nurse notices the patient’s respiratory rate is 28
breaths/min, SpO2 is 91% on room air, and the patient appears restless. According to the
CJMM, which cognitive skill should the nurse perform next?
A. Generate Solutions B. Recognize Cues
C. Take Action D. Evaluate Outcomes
Correct Answer: B. Recognize Cues
Rationale: The CJMM framework progresses sequentially. The nurse has already recognized the individual
cues (respiratory rate, SpO2, restlessness). The next step is to “Analyze Cues” by interpreting the clinical
significance of these findings collectively—recognizing that decreased oxygen saturation, tachypnea, and
restlessness in a postoperative patient may indicate hypoxemia or respiratory complications requiring immediate
intervention.
3. Which statement accurately describes the nursing diagnosis step of the nursing process?
A. It identifies the medical disease causing the B. It is a clinical judgment about human responses
patient’s symptoms to health conditions or life processes
C. It is performed exclusively by the physician D. It focuses only on the patient’s physical
complaints
Correct Answer: B. It is a clinical judgment about human responses to health conditions or life
processes
Rationale: NANDA-I defines a nursing diagnosis as a clinical judgment about individual, family, or community
responses to actual or potential health problems or life processes. Unlike medical diagnoses that focus on
disease pathology, nursing diagnoses address the patient’s holistic response and guide independent nursing
interventions.
4. A nurse is developing a care plan for a patient at risk for falls. Which statement represents
a correctly formulated nursing diagnosis with the PES format?
A. Risk for Falls related to altered gait as B. Risk for Falls related to history of previous fall
evidenced by unsteady ambulation
C. Falls related to unsteady gait D. Impaired mobility related to weakness
Correct Answer: A. Risk for Falls related to altered gait as evidenced by unsteady ambulation
Page 2 of 22
, Foundations of Nursing Practice – Comprehensive Clinical Competency Assessment
Rationale: The PES format (Problem, Etiology, Signs/Symptoms) structures nursing diagnoses accurately. For
risk diagnoses, “as evidenced by” may reflect risk factors rather than manifested signs. Option A properly
identifies the problem (Risk for Falls), connects it to the etiology (altered gait), and provides supporting
evidence (unsteady ambulation).
5. During the evaluation phase of the nursing process, a nurse determines that a patient’s
outcome goal of “Patient will ambulate 50 feet with assistance by day 3” has not been met.
What is the nurse’s most appropriate next action?
A. Discontinue the care plan and document that B. Revise the care plan by reassessing the patient
the goal was unrealistic and modifying interventions or timelines
C. Continue with the same interventions and wait D. Transfer care to another nurse
for the patient to improve
Correct Answer: B. Revise the care plan by reassessing the patient and modifying interventions
or timelines
Rationale: The evaluation phase determines whether patient outcomes have been achieved. When goals are not
met, the nurse must reassess, modify the plan of care, and adjust interventions or timelines. This iterative
process ensures that care remains responsive to the patient’s evolving clinical status.
6. A nurse caring for a patient with chest pain prioritizes which action first according to the
ABC framework?
A. Administer prescribed analgesic medication B. Assess airway patency and breathing effort
C. Obtain a detailed pain history D. Check the patient’s medication allergies
Correct Answer: B. Assess airway patency and breathing effort
Rationale: The ABC (Airway-Breathing-Circulation) framework is a universal priority-setting approach in
clinical nursing. Chest pain may indicate cardiac ischemia, which can compromise circulation and oxygenation.
However, the airway must always be secured and breathing confirmed adequate before addressing circulatory
concerns, following the fundamental principle that oxygen delivery is the highest physiological priority.
7. A nurse is implementing an intervention for a patient with constipation. Which action
reflects the implementation step of ADPIE?
A. Assessing the patient’s current bowel pattern B. Determining that the patient is at risk for
constipation
C. Encouraging fluid intake of 2,000 mL daily and D. Evaluating whether the patient had a bowel
providing high-fiber foods movement
Correct Answer: C. Encouraging fluid intake of 2,000 mL daily and providing high-fiber foods
Rationale: The implementation phase involves executing the planned nursing interventions. Encouraging fluid
intake and providing dietary fiber are direct nursing actions designed to address the nursing diagnosis of
constipation. Assessment (A), diagnosis (B), and evaluation (D) represent other distinct phases of the nursing
process.
8. A nurse delegates vital sign measurement to a nursing assistant. Which component of the
Five Rights of Delegation is the nurse demonstrating by ensuring the assistant has been
trained and competency-validated in this task?
A. Right Task B. Right Circumstance
C. Right Person D. Right Direction/Communication
Page 3 of 22
Foundations of Nursing Practice:
Comprehensive Clinical
Competency Assessment
────────────────────────────────────────
75 Questions with Correct Answers
and Detailed Rationales
Academic Year 2026/2027
Exam-Ready Format | Updated Questions
Study Guide Edition
Page 1 of 22
, Foundations of Nursing Practice – Comprehensive Clinical Competency Assessment
Section 1: Nursing Process & Clinical Judgment
Questions 1–8
1. A nurse is caring for a patient admitted with dehydration. During the assessment phase,
which of the following data collection methods yields objective information?
A. Patient states “I feel very tired” B. Blood pressure reading of 90/58 mmHg
C. Patient reports nausea D. Family states patient has been urinating less
Correct Answer: B. Blood pressure reading of 90/58 mmHg
Rationale: Objective data is measurable and observable through physical examination, laboratory values, or
diagnostic tests. A blood pressure of 90/58 mmHg is a quantifiable, measurable finding obtained through
assessment techniques, making it objective. Patient statements and family reports are subjective data because
they represent perceptions and feelings that cannot be directly measured or verified by the nurse.
2. A nurse using the NCSBN Clinical Judgment Measurement Model (CJMM) is reviewing
cues for a postoperative patient. The nurse notices the patient’s respiratory rate is 28
breaths/min, SpO2 is 91% on room air, and the patient appears restless. According to the
CJMM, which cognitive skill should the nurse perform next?
A. Generate Solutions B. Recognize Cues
C. Take Action D. Evaluate Outcomes
Correct Answer: B. Recognize Cues
Rationale: The CJMM framework progresses sequentially. The nurse has already recognized the individual
cues (respiratory rate, SpO2, restlessness). The next step is to “Analyze Cues” by interpreting the clinical
significance of these findings collectively—recognizing that decreased oxygen saturation, tachypnea, and
restlessness in a postoperative patient may indicate hypoxemia or respiratory complications requiring immediate
intervention.
3. Which statement accurately describes the nursing diagnosis step of the nursing process?
A. It identifies the medical disease causing the B. It is a clinical judgment about human responses
patient’s symptoms to health conditions or life processes
C. It is performed exclusively by the physician D. It focuses only on the patient’s physical
complaints
Correct Answer: B. It is a clinical judgment about human responses to health conditions or life
processes
Rationale: NANDA-I defines a nursing diagnosis as a clinical judgment about individual, family, or community
responses to actual or potential health problems or life processes. Unlike medical diagnoses that focus on
disease pathology, nursing diagnoses address the patient’s holistic response and guide independent nursing
interventions.
4. A nurse is developing a care plan for a patient at risk for falls. Which statement represents
a correctly formulated nursing diagnosis with the PES format?
A. Risk for Falls related to altered gait as B. Risk for Falls related to history of previous fall
evidenced by unsteady ambulation
C. Falls related to unsteady gait D. Impaired mobility related to weakness
Correct Answer: A. Risk for Falls related to altered gait as evidenced by unsteady ambulation
Page 2 of 22
, Foundations of Nursing Practice – Comprehensive Clinical Competency Assessment
Rationale: The PES format (Problem, Etiology, Signs/Symptoms) structures nursing diagnoses accurately. For
risk diagnoses, “as evidenced by” may reflect risk factors rather than manifested signs. Option A properly
identifies the problem (Risk for Falls), connects it to the etiology (altered gait), and provides supporting
evidence (unsteady ambulation).
5. During the evaluation phase of the nursing process, a nurse determines that a patient’s
outcome goal of “Patient will ambulate 50 feet with assistance by day 3” has not been met.
What is the nurse’s most appropriate next action?
A. Discontinue the care plan and document that B. Revise the care plan by reassessing the patient
the goal was unrealistic and modifying interventions or timelines
C. Continue with the same interventions and wait D. Transfer care to another nurse
for the patient to improve
Correct Answer: B. Revise the care plan by reassessing the patient and modifying interventions
or timelines
Rationale: The evaluation phase determines whether patient outcomes have been achieved. When goals are not
met, the nurse must reassess, modify the plan of care, and adjust interventions or timelines. This iterative
process ensures that care remains responsive to the patient’s evolving clinical status.
6. A nurse caring for a patient with chest pain prioritizes which action first according to the
ABC framework?
A. Administer prescribed analgesic medication B. Assess airway patency and breathing effort
C. Obtain a detailed pain history D. Check the patient’s medication allergies
Correct Answer: B. Assess airway patency and breathing effort
Rationale: The ABC (Airway-Breathing-Circulation) framework is a universal priority-setting approach in
clinical nursing. Chest pain may indicate cardiac ischemia, which can compromise circulation and oxygenation.
However, the airway must always be secured and breathing confirmed adequate before addressing circulatory
concerns, following the fundamental principle that oxygen delivery is the highest physiological priority.
7. A nurse is implementing an intervention for a patient with constipation. Which action
reflects the implementation step of ADPIE?
A. Assessing the patient’s current bowel pattern B. Determining that the patient is at risk for
constipation
C. Encouraging fluid intake of 2,000 mL daily and D. Evaluating whether the patient had a bowel
providing high-fiber foods movement
Correct Answer: C. Encouraging fluid intake of 2,000 mL daily and providing high-fiber foods
Rationale: The implementation phase involves executing the planned nursing interventions. Encouraging fluid
intake and providing dietary fiber are direct nursing actions designed to address the nursing diagnosis of
constipation. Assessment (A), diagnosis (B), and evaluation (D) represent other distinct phases of the nursing
process.
8. A nurse delegates vital sign measurement to a nursing assistant. Which component of the
Five Rights of Delegation is the nurse demonstrating by ensuring the assistant has been
trained and competency-validated in this task?
A. Right Task B. Right Circumstance
C. Right Person D. Right Direction/Communication
Page 3 of 22
