NU 136 / NU136 EXAM 2
FUNDAMENTALS OF NURSING 100
Practice Questions with ANSWER>.>s & Detailed
Rationales
Latest 2026/2027 Update
Galen College of Nursing
SECTION 1: NURSING PROCESS & CLINICAL JUDGMENT
(Questions 1–25)
1. A nurse is caring for a client who is 1 day post-operative following abdominal surgery. The client
reports pain rated 8/10 and requests pain medication. The nurse administers the prescribed analgesic.
One hour later, the client reports pain rated 3/10. Which phase of the nursing process does this
represent?
A. Assessment
B. Diagnosis
C. Planning
D. Evaluation
ANSWER>.>: D. Evaluation
Rationale: The nursing process consists of Assessment, Diagnosis, Planning, Implementation, and
Evaluation (ADPIE). Evaluation involves determining whether the client's goals have been met and if
interventions were effective. The nurse administering the medication is Implementation; reassessing
pain after the intervention is Evaluation because the nurse is determining the effectiveness of the
intervention by measuring the client's response (pain reduction from 8/10 to 3/10).
,2. A nurse begins caring for a newly admitted client. Which action should the nurse perform FIRST?
A. Review the client's dietary preferences
B. Assess the client's airway, breathing, and circulation (ABCs)
C. Explain the hospital visiting policy
D. Complete the discharge planning form
ANSWER>.>: B. Assess the client's airway, breathing, and circulation (ABCs)
Rationale: Initial nursing assessment prioritizes physiologic stability. Airway, breathing, and circulation
are immediate priorities because compromise in any of these areas can rapidly become life-threatening.
Administrative tasks and routine education can occur after immediate safety and physiologic needs have
been assessed.
3. A client with diabetes mellitus has a blood glucose level of 45 mg/dL. The client is confused and
diaphoretic. After administering 15 grams of fast-acting carbohydrate, the nurse reassesses the client's
blood glucose 15 minutes later and finds it has increased to 65 mg/dL. Which nursing process phase is
being demonstrated?
A. Assessment
B. Diagnosis
C. Implementation
D. Evaluation
ANSWER>.>: D. Evaluation
Rationale: Evaluation involves comparing the client's response to the nursing intervention against the
expected outcome. The nurse evaluated the effectiveness of the carbohydrate administration by
reassessing the blood glucose level. Assessment would be the initial identification of the low blood
glucose; Implementation would be the actual administration of the carbohydrate.
,4. A nurse is developing a care plan for a client with impaired mobility. The nurse writes the goal: "Client
will turn from supine to side-lying position independently within 48 hours." This is an example of which
phase of the nursing process?
A. Assessment
B. Diagnosis
C. Planning
D. Evaluation
ANSWER>.>: C. Planning
Rationale: Planning involves establishing client goals and outcome criteria. The nurse is creating a
measurable, time-specific goal during the planning phase. Assessment involves data collection, Diagnosis
involves identifying the problem, and Evaluation involves determining if goals were met.
5. A nurse documents in the client's chart: "Client reports pain 6/10 in right knee, rates pain 3/10 after
administration of ibuprofen 600 mg, states pain is 'much better.'" Which phases of the nursing process
are reflected?
A. Assessment and Diagnosis
B. Assessment and Evaluation
C. Planning and Implementation
D. Implementation and Evaluation
ANSWER>.>: B. Assessment and Evaluation
Rationale: The initial pain assessment (reporting pain 6/10) represents Assessment. The follow-up
assessment after medication (pain 3/10) represents Evaluation of the intervention's effectiveness.
Diagnosis involves identifying a nursing problem, and Implementation is the action of giving the
medication, which is not described in the documentation.
, 6. A nurse identifies the following client problem: "Impaired skin integrity related to immobility as
evidenced by stage II pressure injury on coccyx." This is an example of which phase of the nursing
process?
A. Assessment
B. Diagnosis
C. Planning
D. Implementation
ANSWER>.>: B. Diagnosis
Rationale: The nursing diagnosis phase involves identifying and labeling the client's health problem
based on assessment data. The statement follows the PES format (Problem, Etiology, Signs/Symptoms):
Impaired skin integrity (problem) related to immobility (etiology) as evidenced by pressure injury
(signs/symptoms).
7. A nurse is preparing to ambulate a client who had a stroke 3 days ago. The client has left-sided
weakness and requires moderate assistance. The nurse uses a gait belt and positions the client's strong
side toward the nurse. This action represents which phase of the nursing process?
A. Assessment
B. Diagnosis
C. Planning
D. Implementation
ANSWER>.>: D. Implementation
Rationale: Implementation involves carrying out the planned nursing interventions. The nurse is
performing the actual intervention of ambulating the client using appropriate safety measures.
Assessment would involve evaluating the client's strength; Planning would involve determining the best
approach; Evaluation would occur after the intervention.
FUNDAMENTALS OF NURSING 100
Practice Questions with ANSWER>.>s & Detailed
Rationales
Latest 2026/2027 Update
Galen College of Nursing
SECTION 1: NURSING PROCESS & CLINICAL JUDGMENT
(Questions 1–25)
1. A nurse is caring for a client who is 1 day post-operative following abdominal surgery. The client
reports pain rated 8/10 and requests pain medication. The nurse administers the prescribed analgesic.
One hour later, the client reports pain rated 3/10. Which phase of the nursing process does this
represent?
A. Assessment
B. Diagnosis
C. Planning
D. Evaluation
ANSWER>.>: D. Evaluation
Rationale: The nursing process consists of Assessment, Diagnosis, Planning, Implementation, and
Evaluation (ADPIE). Evaluation involves determining whether the client's goals have been met and if
interventions were effective. The nurse administering the medication is Implementation; reassessing
pain after the intervention is Evaluation because the nurse is determining the effectiveness of the
intervention by measuring the client's response (pain reduction from 8/10 to 3/10).
,2. A nurse begins caring for a newly admitted client. Which action should the nurse perform FIRST?
A. Review the client's dietary preferences
B. Assess the client's airway, breathing, and circulation (ABCs)
C. Explain the hospital visiting policy
D. Complete the discharge planning form
ANSWER>.>: B. Assess the client's airway, breathing, and circulation (ABCs)
Rationale: Initial nursing assessment prioritizes physiologic stability. Airway, breathing, and circulation
are immediate priorities because compromise in any of these areas can rapidly become life-threatening.
Administrative tasks and routine education can occur after immediate safety and physiologic needs have
been assessed.
3. A client with diabetes mellitus has a blood glucose level of 45 mg/dL. The client is confused and
diaphoretic. After administering 15 grams of fast-acting carbohydrate, the nurse reassesses the client's
blood glucose 15 minutes later and finds it has increased to 65 mg/dL. Which nursing process phase is
being demonstrated?
A. Assessment
B. Diagnosis
C. Implementation
D. Evaluation
ANSWER>.>: D. Evaluation
Rationale: Evaluation involves comparing the client's response to the nursing intervention against the
expected outcome. The nurse evaluated the effectiveness of the carbohydrate administration by
reassessing the blood glucose level. Assessment would be the initial identification of the low blood
glucose; Implementation would be the actual administration of the carbohydrate.
,4. A nurse is developing a care plan for a client with impaired mobility. The nurse writes the goal: "Client
will turn from supine to side-lying position independently within 48 hours." This is an example of which
phase of the nursing process?
A. Assessment
B. Diagnosis
C. Planning
D. Evaluation
ANSWER>.>: C. Planning
Rationale: Planning involves establishing client goals and outcome criteria. The nurse is creating a
measurable, time-specific goal during the planning phase. Assessment involves data collection, Diagnosis
involves identifying the problem, and Evaluation involves determining if goals were met.
5. A nurse documents in the client's chart: "Client reports pain 6/10 in right knee, rates pain 3/10 after
administration of ibuprofen 600 mg, states pain is 'much better.'" Which phases of the nursing process
are reflected?
A. Assessment and Diagnosis
B. Assessment and Evaluation
C. Planning and Implementation
D. Implementation and Evaluation
ANSWER>.>: B. Assessment and Evaluation
Rationale: The initial pain assessment (reporting pain 6/10) represents Assessment. The follow-up
assessment after medication (pain 3/10) represents Evaluation of the intervention's effectiveness.
Diagnosis involves identifying a nursing problem, and Implementation is the action of giving the
medication, which is not described in the documentation.
, 6. A nurse identifies the following client problem: "Impaired skin integrity related to immobility as
evidenced by stage II pressure injury on coccyx." This is an example of which phase of the nursing
process?
A. Assessment
B. Diagnosis
C. Planning
D. Implementation
ANSWER>.>: B. Diagnosis
Rationale: The nursing diagnosis phase involves identifying and labeling the client's health problem
based on assessment data. The statement follows the PES format (Problem, Etiology, Signs/Symptoms):
Impaired skin integrity (problem) related to immobility (etiology) as evidenced by pressure injury
(signs/symptoms).
7. A nurse is preparing to ambulate a client who had a stroke 3 days ago. The client has left-sided
weakness and requires moderate assistance. The nurse uses a gait belt and positions the client's strong
side toward the nurse. This action represents which phase of the nursing process?
A. Assessment
B. Diagnosis
C. Planning
D. Implementation
ANSWER>.>: D. Implementation
Rationale: Implementation involves carrying out the planned nursing interventions. The nurse is
performing the actual intervention of ambulating the client using appropriate safety measures.
Assessment would involve evaluating the client's strength; Planning would involve determining the best
approach; Evaluation would occur after the intervention.
