NUR 282/283 Comprehensive Final Exam Three-Part
Competency Assessment Actual Exam 2026/2027 – Complete
Exam-Style Questions with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Section A: Competency 1 – Foundations of Nursing & Health Assessment
Q1: A nurse is preparing to administer morning medications to a patient with dysphagia.
Which action is most appropriate to ensure safe medication administration?
A. Crush all medications and mix them in a full glass of water
B. Check with the pharmacist before crushing any medication
C. Administer all medications with applesauce to improve taste
D. Give the patient extra water to help swallow the pills whole
Correct Answer: B
Rationale: Many medications are enteric-coated or extended-release and should not be
crushed; the pharmacist must verify which medications can be safely altered. Options A,
C, and D risk compromising medication efficacy or causing harm.
Q2: A patient presents with a blood pressure of 90/60 mmHg, heart rate 110 beats per
minute, and cool clammy skin. Which nursing diagnosis should the nurse prioritize?
A. Risk for Infection
B. Deficient Fluid Volume
C. Impaired Skin Integrity
D. Anxiety
Correct Answer: B
Rationale: Hypotension, tachycardia, and cool clammy skin are classic signs of
hypovolemia/deficient fluid volume requiring immediate intervention. Options A, C, and
D are not supported by the physiological data presented.
Q3: A nurse is performing hand hygiene before patient contact. Which method is most
appropriate when hands are not visibly soiled?
A. Wash with soap and water for 40-60 seconds
B. Use alcohol-based hand rub for 20-30 seconds
,C. Use alcohol-based hand rub for 5 seconds
D. Wash with soap and water for 10 seconds
Correct Answer: B
Rationale: Alcohol-based hand rub is the preferred method for routine hand hygiene
when hands are not visibly soiled, requiring 20-30 seconds of rubbing. Soap and water
is required for visibly soiled hands or C. difficile; 5 seconds or 10 seconds is inadequate
for effective decontamination.
Q4: A patient has a serum potassium level of 6.2 mEq/L. Which medication should the
nurse anticipate administering?
A. Potassium chloride
B. Sodium polystyrene sulfonate (Kayexalate)
C. Furosemide (Lasix)
D. Both B and C
Correct Answer: D
Rationale: Hyperkalemia (K+ >5.0) is treated with cation exchangers (Kayexalate) and
loop diuretics (furosemide) to eliminate potassium. Giving potassium chloride would be
dangerous and worsen the condition.
Q5: A nurse is calculating a medication dosage. The order reads: "Give 250 mg PO every
8 hours." The pharmacy supplies 500 mg tablets. How many tablets should the nurse
administer per dose?
A. 0.5 tablet
B. 1 tablet
C. 2 tablets
D. 4 tablets
Correct Answer: A
Rationale: 250 mg ÷ 500 mg = 0.5 tablet per dose. Options B, C, and D represent
calculation errors that would result in underdosing or overdosing.
Q6: A patient is admitted with a suspected infection. Which assessment finding is the
earliest indicator of sepsis?
A. White blood cell count of 15,000/mm³
B. Temperature of 101.5°F (38.6°C)
C. Heart rate of 92 beats per minute
D. Blood pressure of 110/70 mmHg
, Correct Answer: B
Rationale: Fever (or hypothermia) is often the earliest sign of systemic infection and
sepsis, preceding leukocytosis and hemodynamic changes. Options A, C, and D may be
normal or later findings.
Q7: A nurse is teaching a patient about fall precautions. Which statement by the patient
indicates a need for further teaching?
A. "I will call for help before getting up to use the bathroom."
B. "I can keep my personal items within reach."
C. "I will wear my non-skid socks when walking."
D. "I can get up quickly if I feel dizzy."
Correct Answer: D
Rationale: Getting up quickly when dizzy significantly increases fall risk; patients should
be taught to rise slowly and call for assistance. Options A, B, and C demonstrate
appropriate fall prevention strategies.
Q8: A nurse is assessing a patient's pain using the PQRST method. What does the "P"
stand for?
A. Provocation/Palliation
B. Progression
C. Prevention
D. Previous treatment
Correct Answer: A
Rationale: PQRST stands for Provocation/Palliation (what makes it worse/better),
Quality, Region/Radiation, Severity, and Timing. Options B, C, and D are not components
of this pain assessment framework.
Q9: A patient has an intravenous infusion of 1000 mL normal saline over 8 hours. The
tubing drip factor is 15 gtt/mL. What is the correct drip rate?
A. 21 gtt/min
B. 31 gtt/min
C. 42 gtt/min
D. 63 gtt/min
Correct Answer: B
Competency Assessment Actual Exam 2026/2027 – Complete
Exam-Style Questions with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Section A: Competency 1 – Foundations of Nursing & Health Assessment
Q1: A nurse is preparing to administer morning medications to a patient with dysphagia.
Which action is most appropriate to ensure safe medication administration?
A. Crush all medications and mix them in a full glass of water
B. Check with the pharmacist before crushing any medication
C. Administer all medications with applesauce to improve taste
D. Give the patient extra water to help swallow the pills whole
Correct Answer: B
Rationale: Many medications are enteric-coated or extended-release and should not be
crushed; the pharmacist must verify which medications can be safely altered. Options A,
C, and D risk compromising medication efficacy or causing harm.
Q2: A patient presents with a blood pressure of 90/60 mmHg, heart rate 110 beats per
minute, and cool clammy skin. Which nursing diagnosis should the nurse prioritize?
A. Risk for Infection
B. Deficient Fluid Volume
C. Impaired Skin Integrity
D. Anxiety
Correct Answer: B
Rationale: Hypotension, tachycardia, and cool clammy skin are classic signs of
hypovolemia/deficient fluid volume requiring immediate intervention. Options A, C, and
D are not supported by the physiological data presented.
Q3: A nurse is performing hand hygiene before patient contact. Which method is most
appropriate when hands are not visibly soiled?
A. Wash with soap and water for 40-60 seconds
B. Use alcohol-based hand rub for 20-30 seconds
,C. Use alcohol-based hand rub for 5 seconds
D. Wash with soap and water for 10 seconds
Correct Answer: B
Rationale: Alcohol-based hand rub is the preferred method for routine hand hygiene
when hands are not visibly soiled, requiring 20-30 seconds of rubbing. Soap and water
is required for visibly soiled hands or C. difficile; 5 seconds or 10 seconds is inadequate
for effective decontamination.
Q4: A patient has a serum potassium level of 6.2 mEq/L. Which medication should the
nurse anticipate administering?
A. Potassium chloride
B. Sodium polystyrene sulfonate (Kayexalate)
C. Furosemide (Lasix)
D. Both B and C
Correct Answer: D
Rationale: Hyperkalemia (K+ >5.0) is treated with cation exchangers (Kayexalate) and
loop diuretics (furosemide) to eliminate potassium. Giving potassium chloride would be
dangerous and worsen the condition.
Q5: A nurse is calculating a medication dosage. The order reads: "Give 250 mg PO every
8 hours." The pharmacy supplies 500 mg tablets. How many tablets should the nurse
administer per dose?
A. 0.5 tablet
B. 1 tablet
C. 2 tablets
D. 4 tablets
Correct Answer: A
Rationale: 250 mg ÷ 500 mg = 0.5 tablet per dose. Options B, C, and D represent
calculation errors that would result in underdosing or overdosing.
Q6: A patient is admitted with a suspected infection. Which assessment finding is the
earliest indicator of sepsis?
A. White blood cell count of 15,000/mm³
B. Temperature of 101.5°F (38.6°C)
C. Heart rate of 92 beats per minute
D. Blood pressure of 110/70 mmHg
, Correct Answer: B
Rationale: Fever (or hypothermia) is often the earliest sign of systemic infection and
sepsis, preceding leukocytosis and hemodynamic changes. Options A, C, and D may be
normal or later findings.
Q7: A nurse is teaching a patient about fall precautions. Which statement by the patient
indicates a need for further teaching?
A. "I will call for help before getting up to use the bathroom."
B. "I can keep my personal items within reach."
C. "I will wear my non-skid socks when walking."
D. "I can get up quickly if I feel dizzy."
Correct Answer: D
Rationale: Getting up quickly when dizzy significantly increases fall risk; patients should
be taught to rise slowly and call for assistance. Options A, B, and C demonstrate
appropriate fall prevention strategies.
Q8: A nurse is assessing a patient's pain using the PQRST method. What does the "P"
stand for?
A. Provocation/Palliation
B. Progression
C. Prevention
D. Previous treatment
Correct Answer: A
Rationale: PQRST stands for Provocation/Palliation (what makes it worse/better),
Quality, Region/Radiation, Severity, and Timing. Options B, C, and D are not components
of this pain assessment framework.
Q9: A patient has an intravenous infusion of 1000 mL normal saline over 8 hours. The
tubing drip factor is 15 gtt/mL. What is the correct drip rate?
A. 21 gtt/min
B. 31 gtt/min
C. 42 gtt/min
D. 63 gtt/min
Correct Answer: B
