Chamberlain University NR-
226 Fundamentals – Patient
Care Exam
Section 1: Nursing Process and Clinical Judgment
(Questions 1-20)
1. Which step of the NCJMM involves deciding which patient problems are the
most urgent?
A. Generate Solutions
B. Evaluate Outcomes
C. Analyze Cues
D. Prioritize Hypotheses
Rationale: Prioritizing hypotheses involves evaluating all possibilities and determining
which ones are most likely or most urgent. This step requires the nurse to use clinical
judgment to rank patient problems by severity and immediacy.
2. During which phase does the nurse determine if the patient's condition
improved after an intervention?
A. Diagnosis
B. Analysis
C. Evaluation
D. Assessment
Rationale: Evaluation is the final step where the nurse compares the patient's health
status with the desired outcomes to see if the plan was effective. This phase determines
whether goals were met and if modifications to the care plan are needed.
,3. Which of the following is a correctly written SMART goal?
A. The patient will feel better by the end of the shift.
B. The patient will walk 50 feet in the hallway by tomorrow morning.
C. The nurse will give pain medication every 4 hours.
D. The patient will understand how to use an inhaler.
Rationale: This goal is specific (walk 50 feet), measurable (50 feet), and time-bound (by
tomorrow morning). SMART goals must be Specific, Measurable, Achievable, Relevant,
and Time-bound.
4. A nurse uses an SBAR tool to communicate with a physician. What does the 'B'
stand for?
A. Behavior
B. Basic Needs
C. Beliefs
D. Background
Rationale: SBAR stands for Situation, Background, Assessment, and Recommendation.
The "Background" component provides relevant context about the patient's history,
diagnosis, and current treatment.
5. Which skill involves looking for patterns and themes in data?
A. Data clustering
B. Inductive reasoning
C. Deductive reasoning
D. Validation
Rationale: Data clustering involves organizing assessment data into meaningful groups
to identify nursing diagnoses. This process helps nurses recognize patterns that suggest
specific health problems.
,6. What is the primary purpose of the nursing process?
A. To diagnose medical conditions
B. To provide a standardized way of billing
C. To follow physician orders exactly
D. To provide a systematic method for delivering patient care
Rationale: The nursing process is a scientific, systematic method used by nurses to
provide individualized, effective care. It consists of Assessment, Diagnosis, Planning,
Implementation, and Evaluation (ADPIE).
7. The nurse notes that a patient is grimacing and holding their abdomen. The
nurse then asks the patient to rate their pain. This is an example of:
A. Validating data
B. Reflecting on action
C. Subjective assessment
D. Implementing care
Rationale: Validating data involves confirming the accuracy of subjective or objective
findings (e.g., checking if a non-verbal cue matches the patient's self-report). This
ensures the nurse's interpretation is accurate.
8. In the NCJMM, 'Analyzing Cues' involves which of the following?
A. Administering medications
B. Setting a discharge date
C. Documenting the physical exam
D. Interpreting cues and relating them to the patient's clinical state
Rationale: Analyzing cues involves linking data together and determining what it means
in the context of the patient's condition. This step requires critical thinking to identify
patterns and draw conclusions.
, 9. Which is an example of an independent nursing intervention?
A. Administering Morphine for pain
B. Ordering a Chest X-ray
C. Starting an IV line
D. Teaching a patient how to perform deep breathing exercises
Rationale: Independent interventions are actions that a nurse is legally permitted to
perform without an order from another healthcare provider. Patient teaching is a core
independent nursing function.
10. A 'Risk for Infection' diagnosis is different from an actual 'Infection' diagnosis
because:
A. It does not have related factors.
B. It only applies to surgical patients.
C. It is not a priority.
D. It does not have defining characteristics (signs/symptoms).
Rationale: Risk diagnoses represent potential problems that have not yet occurred, so
they lack the 'as evidenced by' signs and symptoms found in actual diagnoses. Risk
diagnoses are supported by risk factors instead.
11. The nurse is using critical thinking to decide which patient to see first. Which
patient is the highest priority?
A. A patient whose pulse oximetry is 82% on room air
B. A patient complaining of mild nausea
C. A patient requesting a scheduled dressing change
D. A patient who needs discharge instructions
226 Fundamentals – Patient
Care Exam
Section 1: Nursing Process and Clinical Judgment
(Questions 1-20)
1. Which step of the NCJMM involves deciding which patient problems are the
most urgent?
A. Generate Solutions
B. Evaluate Outcomes
C. Analyze Cues
D. Prioritize Hypotheses
Rationale: Prioritizing hypotheses involves evaluating all possibilities and determining
which ones are most likely or most urgent. This step requires the nurse to use clinical
judgment to rank patient problems by severity and immediacy.
2. During which phase does the nurse determine if the patient's condition
improved after an intervention?
A. Diagnosis
B. Analysis
C. Evaluation
D. Assessment
Rationale: Evaluation is the final step where the nurse compares the patient's health
status with the desired outcomes to see if the plan was effective. This phase determines
whether goals were met and if modifications to the care plan are needed.
,3. Which of the following is a correctly written SMART goal?
A. The patient will feel better by the end of the shift.
B. The patient will walk 50 feet in the hallway by tomorrow morning.
C. The nurse will give pain medication every 4 hours.
D. The patient will understand how to use an inhaler.
Rationale: This goal is specific (walk 50 feet), measurable (50 feet), and time-bound (by
tomorrow morning). SMART goals must be Specific, Measurable, Achievable, Relevant,
and Time-bound.
4. A nurse uses an SBAR tool to communicate with a physician. What does the 'B'
stand for?
A. Behavior
B. Basic Needs
C. Beliefs
D. Background
Rationale: SBAR stands for Situation, Background, Assessment, and Recommendation.
The "Background" component provides relevant context about the patient's history,
diagnosis, and current treatment.
5. Which skill involves looking for patterns and themes in data?
A. Data clustering
B. Inductive reasoning
C. Deductive reasoning
D. Validation
Rationale: Data clustering involves organizing assessment data into meaningful groups
to identify nursing diagnoses. This process helps nurses recognize patterns that suggest
specific health problems.
,6. What is the primary purpose of the nursing process?
A. To diagnose medical conditions
B. To provide a standardized way of billing
C. To follow physician orders exactly
D. To provide a systematic method for delivering patient care
Rationale: The nursing process is a scientific, systematic method used by nurses to
provide individualized, effective care. It consists of Assessment, Diagnosis, Planning,
Implementation, and Evaluation (ADPIE).
7. The nurse notes that a patient is grimacing and holding their abdomen. The
nurse then asks the patient to rate their pain. This is an example of:
A. Validating data
B. Reflecting on action
C. Subjective assessment
D. Implementing care
Rationale: Validating data involves confirming the accuracy of subjective or objective
findings (e.g., checking if a non-verbal cue matches the patient's self-report). This
ensures the nurse's interpretation is accurate.
8. In the NCJMM, 'Analyzing Cues' involves which of the following?
A. Administering medications
B. Setting a discharge date
C. Documenting the physical exam
D. Interpreting cues and relating them to the patient's clinical state
Rationale: Analyzing cues involves linking data together and determining what it means
in the context of the patient's condition. This step requires critical thinking to identify
patterns and draw conclusions.
, 9. Which is an example of an independent nursing intervention?
A. Administering Morphine for pain
B. Ordering a Chest X-ray
C. Starting an IV line
D. Teaching a patient how to perform deep breathing exercises
Rationale: Independent interventions are actions that a nurse is legally permitted to
perform without an order from another healthcare provider. Patient teaching is a core
independent nursing function.
10. A 'Risk for Infection' diagnosis is different from an actual 'Infection' diagnosis
because:
A. It does not have related factors.
B. It only applies to surgical patients.
C. It is not a priority.
D. It does not have defining characteristics (signs/symptoms).
Rationale: Risk diagnoses represent potential problems that have not yet occurred, so
they lack the 'as evidenced by' signs and symptoms found in actual diagnoses. Risk
diagnoses are supported by risk factors instead.
11. The nurse is using critical thinking to decide which patient to see first. Which
patient is the highest priority?
A. A patient whose pulse oximetry is 82% on room air
B. A patient complaining of mild nausea
C. A patient requesting a scheduled dressing change
D. A patient who needs discharge instructions
