PN 2002 Final Review Latest 2025 Actual
Exam
Complete Real Exam Questions and Correct Verified
Answers
Already Graded A+ | Questions 1-200
FUNDAMENTALS OF NURSING
1. A nurse is preparing to administer an enteral feeding through a nasogastric
tube. Which action should the nurse take first?
A. Flush the tube with 30 mL of water
B. Verify tube placement by aspirating gastric contents
C. Check the residual volume
D. Position the patient in a supine position
Answer: B
Rationale: Verifying tube placement by aspirating gastric contents and checking pH is the
priority action to prevent aspiration and ensure the tube is correctly positioned in the
stomach before initiating the feeding. Flushing and checking residuals come after
placement verification. The patient should be positioned in a semi-Fowler's or Fowler's
position, not supine, to reduce aspiration risk.
2. A patient with a nasogastric tube has a gastric residual volume of 350 mL. What
is the nurse's priority action?
,A. Discard the residual and continue the feeding
B. Reinstall the residual and slow the feeding rate
C. Hold the feeding and notify the healthcare provider
D. Increase the feeding rate to compensate
Answer: C
Rationale: A gastric residual volume greater than 250-300 mL indicates delayed gastric
emptying and increased risk of aspiration. The feeding should be held, and the healthcare
provider should be notified for further instructions. Discarding or reinstalling without
notification is inappropriate, and increasing the rate would worsen the issue.
3. A nurse is caring for a patient with a colostomy. Which assessment finding
requires immediate intervention?
A. Stoma is pink and moist
B. Stoma is purplish-bluish in color
C. Moderate amount of liquid stool in the pouch
D. Slight bleeding when cleaning the stoma
Answer: B
Rationale: A purplish-bluish stoma indicates compromised blood supply and potential
necrosis, which is an emergency. A healthy stoma should be pink and moist. Moderate
liquid stool and slight bleeding when cleaning are expected findings and do not require
immediate intervention.
4. The nurse is providing ostomy care to a patient with a new ileostomy. Which
statement by the patient indicates a need for further teaching?
A. "I need to increase my fluid intake to prevent dehydration"
B. "I should avoid foods like nuts and popcorn"
C. "I can expect my stool to become more formed over time"
D. "I will empty my pouch when it is about one-third full"
Answer: C
Rationale: Ileostomy output typically remains liquid or semi-liquid because the colon,
which absorbs water, has been removed. Expecting stool to become more formed is
,incorrect and indicates a need for further teaching. Increased fluid intake, avoiding high-
fiber foods that can cause blockage, and emptying the pouch when one-third full are all
correct statements.
5. A patient is postoperative day 2 following abdominal surgery and has not had a
bowel movement. Which nursing intervention is most appropriate?
A. Administer a laxative immediately
B. Encourage ambulation and increased fluid intake
C. Perform a digital rectal examination
D. Insert a rectal tube to stimulate the bowel
Answer: B
Rationale: Ambulation stimulates peristalsis, and increased fluid intake helps soften stool,
promoting bowel movement. Administering a laxative without assessment or provider
order is premature. Digital examination and rectal tube insertion are invasive and not
first-line interventions for postoperative constipation.
6. A nurse is teaching a patient about dietary modifications to prevent
constipation. Which food selection by the patient indicates understanding?
A. White rice and bananas
B. Whole-grain bread and fresh berries
C. Cheese and yogurt
D. Pasta and applesauce
Answer: B
Rationale: Whole-grain bread and fresh berries are high in fiber, which promotes bowel
regularity. White rice, bananas, cheese, yogurt, pasta, and applesauce are all low-fiber
foods that can contribute to constipation and should be limited.
7. A patient with a urinary catheter develops cloudy urine with a foul odor. Which
action should the nurse take first?
, A. Irrigate the catheter with sterile saline
B. Increase the patient's oral fluid intake
C. Obtain a urine specimen for culture and sensitivity
D. Change the urinary drainage bag
Answer: C
Rationale: Cloudy urine with a foul odor is a sign of a urinary tract infection. The nurse
should obtain a urine specimen for culture and sensitivity to identify the causative
organism and guide antibiotic therapy. Irrigation, increasing fluids, or changing the bag
are not the priority initial actions without proper assessment.
8. A nurse is removing a urinary catheter from a patient. Which instruction should
the nurse provide to the patient during removal?
A. "Take a deep breath and hold it"
B. "Bear down as if you are having a bowel movement"
C. "Exhale slowly and relax"
D. "Empty your bladder completely first"
Answer: B
Rationale: Bearing down as if having a bowel movement relaxes the pelvic muscles and
allows for easier removal of the catheter, reducing discomfort and trauma to the urethra.
Holding breath, exhaling, or emptying the bladder are not the correct techniques during
catheter removal.
9. The nurse is caring for a patient with an indwelling urinary catheter. Which
intervention is essential to prevent catheter-associated urinary tract infections
(CAUTI)?
A. Change the catheter every 24 hours
B. Irrigate the catheter twice daily with normal saline
C. Maintain a closed drainage system
D. Keep the drainage bag on the bed
Answer: C
Rationale: Maintaining a closed drainage system is the most important intervention to
Exam
Complete Real Exam Questions and Correct Verified
Answers
Already Graded A+ | Questions 1-200
FUNDAMENTALS OF NURSING
1. A nurse is preparing to administer an enteral feeding through a nasogastric
tube. Which action should the nurse take first?
A. Flush the tube with 30 mL of water
B. Verify tube placement by aspirating gastric contents
C. Check the residual volume
D. Position the patient in a supine position
Answer: B
Rationale: Verifying tube placement by aspirating gastric contents and checking pH is the
priority action to prevent aspiration and ensure the tube is correctly positioned in the
stomach before initiating the feeding. Flushing and checking residuals come after
placement verification. The patient should be positioned in a semi-Fowler's or Fowler's
position, not supine, to reduce aspiration risk.
2. A patient with a nasogastric tube has a gastric residual volume of 350 mL. What
is the nurse's priority action?
,A. Discard the residual and continue the feeding
B. Reinstall the residual and slow the feeding rate
C. Hold the feeding and notify the healthcare provider
D. Increase the feeding rate to compensate
Answer: C
Rationale: A gastric residual volume greater than 250-300 mL indicates delayed gastric
emptying and increased risk of aspiration. The feeding should be held, and the healthcare
provider should be notified for further instructions. Discarding or reinstalling without
notification is inappropriate, and increasing the rate would worsen the issue.
3. A nurse is caring for a patient with a colostomy. Which assessment finding
requires immediate intervention?
A. Stoma is pink and moist
B. Stoma is purplish-bluish in color
C. Moderate amount of liquid stool in the pouch
D. Slight bleeding when cleaning the stoma
Answer: B
Rationale: A purplish-bluish stoma indicates compromised blood supply and potential
necrosis, which is an emergency. A healthy stoma should be pink and moist. Moderate
liquid stool and slight bleeding when cleaning are expected findings and do not require
immediate intervention.
4. The nurse is providing ostomy care to a patient with a new ileostomy. Which
statement by the patient indicates a need for further teaching?
A. "I need to increase my fluid intake to prevent dehydration"
B. "I should avoid foods like nuts and popcorn"
C. "I can expect my stool to become more formed over time"
D. "I will empty my pouch when it is about one-third full"
Answer: C
Rationale: Ileostomy output typically remains liquid or semi-liquid because the colon,
which absorbs water, has been removed. Expecting stool to become more formed is
,incorrect and indicates a need for further teaching. Increased fluid intake, avoiding high-
fiber foods that can cause blockage, and emptying the pouch when one-third full are all
correct statements.
5. A patient is postoperative day 2 following abdominal surgery and has not had a
bowel movement. Which nursing intervention is most appropriate?
A. Administer a laxative immediately
B. Encourage ambulation and increased fluid intake
C. Perform a digital rectal examination
D. Insert a rectal tube to stimulate the bowel
Answer: B
Rationale: Ambulation stimulates peristalsis, and increased fluid intake helps soften stool,
promoting bowel movement. Administering a laxative without assessment or provider
order is premature. Digital examination and rectal tube insertion are invasive and not
first-line interventions for postoperative constipation.
6. A nurse is teaching a patient about dietary modifications to prevent
constipation. Which food selection by the patient indicates understanding?
A. White rice and bananas
B. Whole-grain bread and fresh berries
C. Cheese and yogurt
D. Pasta and applesauce
Answer: B
Rationale: Whole-grain bread and fresh berries are high in fiber, which promotes bowel
regularity. White rice, bananas, cheese, yogurt, pasta, and applesauce are all low-fiber
foods that can contribute to constipation and should be limited.
7. A patient with a urinary catheter develops cloudy urine with a foul odor. Which
action should the nurse take first?
, A. Irrigate the catheter with sterile saline
B. Increase the patient's oral fluid intake
C. Obtain a urine specimen for culture and sensitivity
D. Change the urinary drainage bag
Answer: C
Rationale: Cloudy urine with a foul odor is a sign of a urinary tract infection. The nurse
should obtain a urine specimen for culture and sensitivity to identify the causative
organism and guide antibiotic therapy. Irrigation, increasing fluids, or changing the bag
are not the priority initial actions without proper assessment.
8. A nurse is removing a urinary catheter from a patient. Which instruction should
the nurse provide to the patient during removal?
A. "Take a deep breath and hold it"
B. "Bear down as if you are having a bowel movement"
C. "Exhale slowly and relax"
D. "Empty your bladder completely first"
Answer: B
Rationale: Bearing down as if having a bowel movement relaxes the pelvic muscles and
allows for easier removal of the catheter, reducing discomfort and trauma to the urethra.
Holding breath, exhaling, or emptying the bladder are not the correct techniques during
catheter removal.
9. The nurse is caring for a patient with an indwelling urinary catheter. Which
intervention is essential to prevent catheter-associated urinary tract infections
(CAUTI)?
A. Change the catheter every 24 hours
B. Irrigate the catheter twice daily with normal saline
C. Maintain a closed drainage system
D. Keep the drainage bag on the bed
Answer: C
Rationale: Maintaining a closed drainage system is the most important intervention to
