BSN 266 Nursing Concepts exam guide
200 Original NCLEX/HESI-Style Practice Questions and Answers
Original review questions covering core BSN-level nursing content areas.
FUNDAMENTALS OF NURSING
1. What is the correct order of steps in the nursing process?
Answer: Assessment, Diagnosis, Planning, Implementation, Evaluation (ADPIE).
2. What is the priority action before administering any medication?
Answer: Verify the patient's identity using two identifiers (e.g., name and date of birth).
3. What are the 'rights' of medication administration (at minimum)?
Answer: Right patient, right drug, right dose, right route, right time (plus right documentation and right reason).
4. What is the purpose of hand hygiene before and after every patient contact?
Answer: To prevent the transmission of microorganisms and reduce healthcare-associated infections.
5. What does the acronym SBAR stand for in nurse communication?
Answer: Situation, Background, Assessment, Recommendation.
6. What is informed consent, and who is responsible for obtaining it for a procedure?
Answer: A patient's voluntary agreement to a treatment after understanding risks/benefits/alternatives; the provider
performing the procedure is responsible for obtaining it (the nurse witnesses the signature).
7. What is the correct technique when performing sterile procedures?
Answer: Maintain aseptic (sterile) technique by keeping the sterile field free from contamination, avoiding reaching over it,
and considering the outer 1 inch border non-sterile.
8. What is the normal range for adult oral body temperature?
Answer: Approximately 97.8°F to 99.1°F (36.5°C to 37.3°C).
9. What should a nurse do first when discovering a change in a patient's condition?
Answer: Assess the patient directly before taking further action or notifying the provider.
10. What is the purpose of using the Glasgow Coma Scale?
Answer: To objectively assess a patient's level of consciousness based on eye, verbal, and motor responses.
VITAL SIGNS & PHYSICAL ASSESSMENT
11. What is a normal adult resting heart rate range?
Answer: 60-100 beats per minute.
12. What is considered a normal adult respiratory rate?
Answer: 12-20 breaths per minute.
13. What blood pressure reading is generally classified as hypertensive crisis requiring immediate action?
Answer: Systolic ≥180 mmHg and/or diastolic ≥120 mmHg.
14. What is orthostatic hypotension, and how is it assessed?
Answer: A drop in blood pressure (typically ≥20 mmHg systolic or ≥10 mmHg diastolic) when moving from lying to standing;
assessed by comparing BP/HR in supine, sitting, and standing positions.
15. What does a pulse oximetry reading below 90% generally indicate?
Answer: Hypoxemia, requiring further assessment and likely supplemental oxygen.
16. What are signs of respiratory distress the nurse should assess for?
Answer: Tachypnea, use of accessory muscles, nasal flaring, retractions, and cyanosis.
17. What is Cheyne-Stokes respiration?
, Answer: A breathing pattern with alternating periods of deep/rapid breathing and apnea, often seen near end of life or with
certain neurological/cardiac conditions.
18. What does capillary refill time greater than 3 seconds suggest?
Answer: Poor peripheral perfusion.
19. What is the correct sequence for abdominal assessment?
Answer: Inspection, auscultation, percussion, palpation (auscultation is done before palpation to avoid altering bowel
sounds).
20. What does a Homans' sign (though now considered unreliable) traditionally assess for?
Answer: Deep vein thrombosis (calf pain on dorsiflexion of the foot).
CARDIOVASCULAR NURSING
21. What is the classic symptom triad for acute myocardial infarction?
Answer: Chest pain/pressure, diaphoresis, and shortness of breath (though presentation varies, especially in women and
older adults).
22. What is the priority nursing action for a patient reporting new-onset chest pain?
Answer: Obtain a 12-lead ECG and vital signs immediately, and notify the provider.
23. What does ST-segment elevation on an ECG typically indicate?
Answer: Acute myocardial infarction (STEMI) with full-thickness myocardial injury.
24. What is the nursing priority when caring for a patient in heart failure exacerbation?
Answer: Assess respiratory status and oxygenation; monitor for signs of fluid overload (weight gain, edema, crackles).
25. What position best facilitates breathing in a patient with acute pulmonary edema?
Answer: High Fowler's position (upright, legs dependent).
26. What is a key nursing consideration when a patient is on IV heparin therapy?
Answer: Monitor aPTT levels and assess for signs of bleeding.
27. What does JVD (jugular venous distention) suggest?
Answer: Fluid overload or right-sided heart failure.
28. What is the priority assessment finding indicating a hypertensive emergency?
Answer: Severe headache, visual changes, or altered mental status with markedly elevated blood pressure.
29. What lab value is most specific for confirming myocardial infarction?
Answer: Troponin (cardiac-specific troponin I or T).
30. What should the nurse teach a patient being discharged on a beta blocker?
Answer: Do not stop the medication abruptly; monitor pulse and blood pressure; report dizziness or very slow heart rate.
RESPIRATORY NURSING
31. What is the priority nursing intervention for a patient with an acute asthma exacerbation?
Answer: Administer a short-acting beta-2 agonist (bronchodilator) and assess oxygenation/respiratory status.
32. What position optimizes oxygenation for a patient with COPD?
Answer: High Fowler's or tripod position.
33. What is a key teaching point for a patient with COPD regarding oxygen therapy?
Answer: Use the lowest effective oxygen flow rate, as high concentrations can suppress the hypoxic drive to breathe.
34. What are signs of pneumothorax the nurse should monitor for after chest trauma or central line placement?
Answer: Sudden sharp chest pain, dyspnea, decreased/absent breath sounds on the affected side, and tracheal deviation (late
sign).
35. What is the purpose of chest tube water-seal drainage?
200 Original NCLEX/HESI-Style Practice Questions and Answers
Original review questions covering core BSN-level nursing content areas.
FUNDAMENTALS OF NURSING
1. What is the correct order of steps in the nursing process?
Answer: Assessment, Diagnosis, Planning, Implementation, Evaluation (ADPIE).
2. What is the priority action before administering any medication?
Answer: Verify the patient's identity using two identifiers (e.g., name and date of birth).
3. What are the 'rights' of medication administration (at minimum)?
Answer: Right patient, right drug, right dose, right route, right time (plus right documentation and right reason).
4. What is the purpose of hand hygiene before and after every patient contact?
Answer: To prevent the transmission of microorganisms and reduce healthcare-associated infections.
5. What does the acronym SBAR stand for in nurse communication?
Answer: Situation, Background, Assessment, Recommendation.
6. What is informed consent, and who is responsible for obtaining it for a procedure?
Answer: A patient's voluntary agreement to a treatment after understanding risks/benefits/alternatives; the provider
performing the procedure is responsible for obtaining it (the nurse witnesses the signature).
7. What is the correct technique when performing sterile procedures?
Answer: Maintain aseptic (sterile) technique by keeping the sterile field free from contamination, avoiding reaching over it,
and considering the outer 1 inch border non-sterile.
8. What is the normal range for adult oral body temperature?
Answer: Approximately 97.8°F to 99.1°F (36.5°C to 37.3°C).
9. What should a nurse do first when discovering a change in a patient's condition?
Answer: Assess the patient directly before taking further action or notifying the provider.
10. What is the purpose of using the Glasgow Coma Scale?
Answer: To objectively assess a patient's level of consciousness based on eye, verbal, and motor responses.
VITAL SIGNS & PHYSICAL ASSESSMENT
11. What is a normal adult resting heart rate range?
Answer: 60-100 beats per minute.
12. What is considered a normal adult respiratory rate?
Answer: 12-20 breaths per minute.
13. What blood pressure reading is generally classified as hypertensive crisis requiring immediate action?
Answer: Systolic ≥180 mmHg and/or diastolic ≥120 mmHg.
14. What is orthostatic hypotension, and how is it assessed?
Answer: A drop in blood pressure (typically ≥20 mmHg systolic or ≥10 mmHg diastolic) when moving from lying to standing;
assessed by comparing BP/HR in supine, sitting, and standing positions.
15. What does a pulse oximetry reading below 90% generally indicate?
Answer: Hypoxemia, requiring further assessment and likely supplemental oxygen.
16. What are signs of respiratory distress the nurse should assess for?
Answer: Tachypnea, use of accessory muscles, nasal flaring, retractions, and cyanosis.
17. What is Cheyne-Stokes respiration?
, Answer: A breathing pattern with alternating periods of deep/rapid breathing and apnea, often seen near end of life or with
certain neurological/cardiac conditions.
18. What does capillary refill time greater than 3 seconds suggest?
Answer: Poor peripheral perfusion.
19. What is the correct sequence for abdominal assessment?
Answer: Inspection, auscultation, percussion, palpation (auscultation is done before palpation to avoid altering bowel
sounds).
20. What does a Homans' sign (though now considered unreliable) traditionally assess for?
Answer: Deep vein thrombosis (calf pain on dorsiflexion of the foot).
CARDIOVASCULAR NURSING
21. What is the classic symptom triad for acute myocardial infarction?
Answer: Chest pain/pressure, diaphoresis, and shortness of breath (though presentation varies, especially in women and
older adults).
22. What is the priority nursing action for a patient reporting new-onset chest pain?
Answer: Obtain a 12-lead ECG and vital signs immediately, and notify the provider.
23. What does ST-segment elevation on an ECG typically indicate?
Answer: Acute myocardial infarction (STEMI) with full-thickness myocardial injury.
24. What is the nursing priority when caring for a patient in heart failure exacerbation?
Answer: Assess respiratory status and oxygenation; monitor for signs of fluid overload (weight gain, edema, crackles).
25. What position best facilitates breathing in a patient with acute pulmonary edema?
Answer: High Fowler's position (upright, legs dependent).
26. What is a key nursing consideration when a patient is on IV heparin therapy?
Answer: Monitor aPTT levels and assess for signs of bleeding.
27. What does JVD (jugular venous distention) suggest?
Answer: Fluid overload or right-sided heart failure.
28. What is the priority assessment finding indicating a hypertensive emergency?
Answer: Severe headache, visual changes, or altered mental status with markedly elevated blood pressure.
29. What lab value is most specific for confirming myocardial infarction?
Answer: Troponin (cardiac-specific troponin I or T).
30. What should the nurse teach a patient being discharged on a beta blocker?
Answer: Do not stop the medication abruptly; monitor pulse and blood pressure; report dizziness or very slow heart rate.
RESPIRATORY NURSING
31. What is the priority nursing intervention for a patient with an acute asthma exacerbation?
Answer: Administer a short-acting beta-2 agonist (bronchodilator) and assess oxygenation/respiratory status.
32. What position optimizes oxygenation for a patient with COPD?
Answer: High Fowler's or tripod position.
33. What is a key teaching point for a patient with COPD regarding oxygen therapy?
Answer: Use the lowest effective oxygen flow rate, as high concentrations can suppress the hypoxic drive to breathe.
34. What are signs of pneumothorax the nurse should monitor for after chest trauma or central line placement?
Answer: Sudden sharp chest pain, dyspnea, decreased/absent breath sounds on the affected side, and tracheal deviation (late
sign).
35. What is the purpose of chest tube water-seal drainage?
