Nightingale College BSN 366 Exam 1 (pdf) | 2026/2027 | Concepts of
Nursing IV Q&A | Nursing
1. A nurse is triaging victims of a multi-vehicle accident. Which client should
be assigned a red tag?
A) A client with a closed fracture of the right forearm
B) A client with an obstructed airway and signs of respiratory distress
C) A client who is unconscious with a pulse of 40 and agonal respirations
D) A client with a sucking chest wound and stable vital signs
Correct Answer: A client with an obstructed airway and signs of respiratory
distress
Rationale: Red tags are for emergent cases where life-saving intervention is
needed immediately, such as airway obstruction. Agonal respirations in a
mass casualty usually indicate a black tag (expectant). A sucking chest
wound with stable vitals would be a yellow tag (urgent).
2. A nurse manager is discussing the Five Rights of Delegation with a new
nurse. Which of the following is one of these rights?
A) Right Supervision
B) Right Compensation
C) Right Duration
D) Right Facility
Correct Answer: Right Supervision
Rationale: The Five Rights of Delegation are: Right Task, Right Circumstance,
Right Person, Right Direction/Communication, and Right
Supervision/Evaluation.
,3. Which leadership style is characterized by a leader who makes all
decisions without consulting the staff?
A) Transformational
B) Democratic
C) Autocratic
D) Laissez-faire
Correct Answer: Autocratic
Rationale: Autocratic leadership involves centralized decision-making with
the leader maintaining full control and giving orders to subordinates.
4. An RN is delegating tasks to an Unlicensed Assistive Personnel (UAP).
Which task is appropriate for the UAP?
A) Evaluating a patient’s response to pain medication
B) Assisting a stable patient with ambulation
C) Performing an initial admission assessment
D) Teaching a patient how to use an incentive spirometer
Correct Answer: Assisting a stable patient with ambulation
Rationale: UAPs can perform routine tasks such as ADLs and ambulation for
stable patients. Evaluation, assessment, and teaching require professional
nursing judgment.
5. A nurse is using the SBAR communication tool. Which information should
the nurse include in the ‘B’ (Background) section?
A) A summary of the patient’s medical history and reason for admission
B) The patient’s current blood pressure and heart rate
,C) A request for a specific medication change
D) The nurse’s assessment of the patient’s neurological status
Correct Answer: A summary of the patient’s medical history and reason for
admission
Rationale: The Background (B) section provides context, including admitting
diagnosis, medical history, and relevant clinical details leading to the current
situation.
6. A nurse is managing a group of patients. Which task should be prioritized?
A) Administering a routine multivitamin
B) Changing a dressing on a stage 2 pressure injury
C) Administering PRN pain medication to a client with chronic back pain
D) Assessing a patient with new-onset confusion and an oxygen saturation of
88%
Correct Answer: Assessing a patient with new-onset confusion and an oxygen
saturation of 88%
Rationale: New-onset confusion and hypoxia are signs of a life-threatening
problem (e.g., respiratory failure) and must be assessed first. Pain
management and routine care, while important, are lower priorities.
7. A patient with heart failure is receiving digoxin. Which laboratory result
should the nurse prioritize reviewing before administering the next dose?
A) Serum sodium 138 mEq/L
B) Serum creatinine 1.0 mg/dL
C) Serum potassium 3.1 mEq/L
, D) Serum glucose 110 mg/dL
Correct Answer: Serum potassium 3.1 mEq/L
Rationale: Hypokalemia significantly increases the risk of digoxin toxicity
because potassium and digoxin compete for binding sites. A level of 3.1
mEq/L is below the normal range and necessitates immediate follow-up.
8. A client is admitted with an acute exacerbation of COPD. Which oxygen
delivery device is most appropriate to ensure a precise concentration of
oxygen?
A) Nasal cannula
B) Simple face mask
C) Venturi mask
D) Non-rebreather mask
Correct Answer: Venturi mask
Rationale: The Venturi mask is the most accurate device for delivering a
specific, fixed concentration of oxygen. This is critical for COPD patients to
avoid suppressing their hypoxic drive while still treating hypoxemia.
9. A nurse is caring for a patient post-thyroidectomy. Which assessment
finding is the most critical to report to the healthcare provider?
A) Sore throat when swallowing
B) Incisional pain
C) Laryngeal stridor
D) Hoarseness when speaking
Nursing IV Q&A | Nursing
1. A nurse is triaging victims of a multi-vehicle accident. Which client should
be assigned a red tag?
A) A client with a closed fracture of the right forearm
B) A client with an obstructed airway and signs of respiratory distress
C) A client who is unconscious with a pulse of 40 and agonal respirations
D) A client with a sucking chest wound and stable vital signs
Correct Answer: A client with an obstructed airway and signs of respiratory
distress
Rationale: Red tags are for emergent cases where life-saving intervention is
needed immediately, such as airway obstruction. Agonal respirations in a
mass casualty usually indicate a black tag (expectant). A sucking chest
wound with stable vitals would be a yellow tag (urgent).
2. A nurse manager is discussing the Five Rights of Delegation with a new
nurse. Which of the following is one of these rights?
A) Right Supervision
B) Right Compensation
C) Right Duration
D) Right Facility
Correct Answer: Right Supervision
Rationale: The Five Rights of Delegation are: Right Task, Right Circumstance,
Right Person, Right Direction/Communication, and Right
Supervision/Evaluation.
,3. Which leadership style is characterized by a leader who makes all
decisions without consulting the staff?
A) Transformational
B) Democratic
C) Autocratic
D) Laissez-faire
Correct Answer: Autocratic
Rationale: Autocratic leadership involves centralized decision-making with
the leader maintaining full control and giving orders to subordinates.
4. An RN is delegating tasks to an Unlicensed Assistive Personnel (UAP).
Which task is appropriate for the UAP?
A) Evaluating a patient’s response to pain medication
B) Assisting a stable patient with ambulation
C) Performing an initial admission assessment
D) Teaching a patient how to use an incentive spirometer
Correct Answer: Assisting a stable patient with ambulation
Rationale: UAPs can perform routine tasks such as ADLs and ambulation for
stable patients. Evaluation, assessment, and teaching require professional
nursing judgment.
5. A nurse is using the SBAR communication tool. Which information should
the nurse include in the ‘B’ (Background) section?
A) A summary of the patient’s medical history and reason for admission
B) The patient’s current blood pressure and heart rate
,C) A request for a specific medication change
D) The nurse’s assessment of the patient’s neurological status
Correct Answer: A summary of the patient’s medical history and reason for
admission
Rationale: The Background (B) section provides context, including admitting
diagnosis, medical history, and relevant clinical details leading to the current
situation.
6. A nurse is managing a group of patients. Which task should be prioritized?
A) Administering a routine multivitamin
B) Changing a dressing on a stage 2 pressure injury
C) Administering PRN pain medication to a client with chronic back pain
D) Assessing a patient with new-onset confusion and an oxygen saturation of
88%
Correct Answer: Assessing a patient with new-onset confusion and an oxygen
saturation of 88%
Rationale: New-onset confusion and hypoxia are signs of a life-threatening
problem (e.g., respiratory failure) and must be assessed first. Pain
management and routine care, while important, are lower priorities.
7. A patient with heart failure is receiving digoxin. Which laboratory result
should the nurse prioritize reviewing before administering the next dose?
A) Serum sodium 138 mEq/L
B) Serum creatinine 1.0 mg/dL
C) Serum potassium 3.1 mEq/L
, D) Serum glucose 110 mg/dL
Correct Answer: Serum potassium 3.1 mEq/L
Rationale: Hypokalemia significantly increases the risk of digoxin toxicity
because potassium and digoxin compete for binding sites. A level of 3.1
mEq/L is below the normal range and necessitates immediate follow-up.
8. A client is admitted with an acute exacerbation of COPD. Which oxygen
delivery device is most appropriate to ensure a precise concentration of
oxygen?
A) Nasal cannula
B) Simple face mask
C) Venturi mask
D) Non-rebreather mask
Correct Answer: Venturi mask
Rationale: The Venturi mask is the most accurate device for delivering a
specific, fixed concentration of oxygen. This is critical for COPD patients to
avoid suppressing their hypoxic drive while still treating hypoxemia.
9. A nurse is caring for a patient post-thyroidectomy. Which assessment
finding is the most critical to report to the healthcare provider?
A) Sore throat when swallowing
B) Incisional pain
C) Laryngeal stridor
D) Hoarseness when speaking
