NUR155 EXAM 1 UNITS 1-2 Foundations Of
Nursing Actual Questions and Answers
/2026-2027
Unit 1: The Nursing Profession & Health Care Delivery
1. Which historical figure is credited with establishing the first nursing school and defining
nursing as a distinct profession?
A. Clara Barton
B. Dorothea Dix
C. Florence Nightingale
D. Mary Breckinridge
Correct Answer: C. Florence Nightingale
Rationale: Florence Nightingale is considered the founder of modern nursing. She
established the Nightingale Training School for Nurses at St. Thomas' Hospital in London in
1860. Her work during the Crimean War and her subsequent writings, particularly "Notes on
Nursing," revolutionized the profession. Clara Barton founded the American Red Cross.
Dorothea Dix was an advocate for the mentally ill. Mary Breckinridge founded the Frontier
Nursing Service.
2. A nurse is providing care to a patient who is scheduled for surgery. The nurse explains the
procedure, risks, and alternatives, and then has the patient sign the consent form. Which
nursing role is the nurse demonstrating?
A. Advocate
B. Caregiver
C. Educator
D. Manager
Correct Answer: A. Advocate
Rationale: The nurse is acting as an advocate by ensuring the patient has all the necessary
information to make an informed decision about their own healthcare. The caregiver role
involves direct physical care. The educator role involves teaching the patient. The manager role
involves coordinating care. The key here is protecting the patient's right to autonomy and
informed consent.
,3. Which of the following are key components of the Institute of Medicine's (IOM) definition
of a "health care system" that is safe, effective, patient-centered, timely, efficient, and
equitable? (Select All That Apply)
A. Providing care that is respectful of and responsive to individual patient preferences.
B. Avoiding waste of equipment, supplies, ideas, and energy.
C. Ensuring that care is based on the best available scientific evidence.
D. Reducing the time patients wait for care.
E. Focusing primarily on the needs of the healthcare provider.
Correct Answers: A, B, C, D
Rationale: The IOM's six aims for improvement are:
• Patient-centered (A): Care is respectful and responsive to patient preferences.
• Efficient (B): Care avoids waste.
• Effective (C): Care is based on scientific evidence.
• Timely (D): Care reduces waits and delays.
• Safe: Care avoids injuries to patients.
• Equitable: Care does not vary in quality based on personal characteristics.
Option E is incorrect; the system should be patient-centered, not provider-centered.
4. A nurse is working in a community health clinic. A patient asks, "What is the difference
between Medicare and Medicaid?" Which statement by the nurse is most accurate?
A. "Medicare is for people with low incomes, and Medicaid is for people over 65."
B. "Medicare is a federal program for people over 65 or with certain disabilities, while Medicaid
is a state and federal program for people with low incomes."
C. "Both are private insurance programs that you must purchase."
D. "Medicaid is only for children, and Medicare is for adults."
Correct Answer: B. "Medicare is a federal program for people over 65 or with certain
disabilities, while Medicaid is a state and federal program for people with low incomes."
Rationale: This is the correct distinction. Medicare is a federally funded health insurance
program primarily for individuals aged 65 and older, as well as those with specific disabilities,
regardless of income. Medicaid is a joint federal and state program that provides health
coverage for individuals and families with limited income and resources.
5. A nurse is caring for a patient who is a Jehovah's Witness and refuses a life-saving blood
transfusion. The patient is competent and understands the consequences. What is the nurse's
primary legal and ethical obligation?
,A. Respect the patient's refusal and document the refusal.
B. Try to persuade the patient to accept the transfusion.
C. Ask the family to sign a consent form for the transfusion.
D. Contact the hospital's ethics committee to override the refusal.
Correct Answer: A. Respect the patient's refusal and document the refusal.
Rationale: This is a cornerstone of patient autonomy and informed consent. A competent
patient has the right to refuse any medical treatment, even if it is life-saving. The nurse's duty is
to respect that decision, ensure the patient is fully informed, and document the refusal in the
medical record. Persuading or coercing the patient would be unethical and a violation of their
rights.
6. Which of the following is an example of a secondary level of disease prevention?
A. Providing immunizations to children.
B. Teaching a patient about a low-fat diet.
C. Performing a mammogram to detect breast cancer.
D. Referring a patient to a rehabilitation center after a stroke.
Correct Answer: C. Performing a mammogram to detect breast cancer.
Rationale: Secondary prevention focuses on early detection and prompt intervention. A
mammogram is a screening tool designed to detect cancer in its early stages. Primary
prevention (A, B) aims to prevent disease before it occurs (e.g., immunizations, health
education). Tertiary prevention (D) focuses on rehabilitation and restoring function after a
disease has caused lasting effects.
7. A nurse is reviewing the scope of practice for a Registered Nurse (RN) versus a Licensed
Practical Nurse (LPN). Which task is typically within the scope of practice for an RN but not an
LPN?
A. Administering oral medications.
B. Performing a sterile dressing change.
C. Developing a patient's plan of care.
D. Collecting a urine specimen.
Correct Answer: C. Developing a patient's plan of care.
Rationale: The development of the initial nursing care plan and the assessment of the
patient are core responsibilities of the RN. While LPNs contribute to the plan and provide direct
care (A, B, D), the critical thinking and clinical judgment required for the initial assessment and
care plan development fall under the RN's scope of practice.
, 8. A nurse manager is implementing a change to reduce medication errors on the unit. Which
of the following actions is an example of using evidence-based practice (EBP)?
A. Implementing a "do not disturb" policy during medication administration based on research
showing it reduces errors.
B. Asking the most senior nurse on the unit what they think is the best approach.
C. Following the hospital's policy because it has always been done that way.
D. Trying a new strategy without evaluating its effectiveness.
Correct Answer: A. Implementing a "do not disturb" policy during medication
administration based on research showing it reduces errors.
Rationale: Evidence-based practice involves integrating the best available research evidence
with clinical expertise and patient preferences. Option A is the only choice that describes a
practice change based on research evidence. The other options rely on tradition, opinion, or
lack evaluation.
9. A nurse is explaining the concept of "continuity of care" to a patient. Which statement best
describes this concept?
A. "It means you will see the same doctor every time you visit."
B. "It ensures your care is coordinated across different providers and settings over time."
C. "It means your insurance will cover all of your medical expenses."
D. "It refers to the speed at which you receive care in the emergency room."
Correct Answer: B. "It ensures your care is coordinated across different providers and
settings over time."
Rationale: Continuity of care is a patient-centered concept that emphasizes the seamless
coordination of healthcare services as a patient moves through different levels of care (e.g.,
hospital to home, primary care to specialist). It involves communication and information sharing
among all providers involved in the patient's care.
10. Which of the following is an example of a nurse acting as a change agent?
A. Administering a prescribed medication to a patient.
B. Teaching a patient how to self-administer insulin.
C. Identifying a problem with the unit's handoff report process and proposing a new, evidence-
based protocol.
D. Comforting a patient who is anxious about surgery.
Correct Answer: C. Identifying a problem with the unit's handoff report process and
proposing a new, evidence-based protocol.
Rationale: A change agent is a nurse who identifies a need for change and works to
Nursing Actual Questions and Answers
/2026-2027
Unit 1: The Nursing Profession & Health Care Delivery
1. Which historical figure is credited with establishing the first nursing school and defining
nursing as a distinct profession?
A. Clara Barton
B. Dorothea Dix
C. Florence Nightingale
D. Mary Breckinridge
Correct Answer: C. Florence Nightingale
Rationale: Florence Nightingale is considered the founder of modern nursing. She
established the Nightingale Training School for Nurses at St. Thomas' Hospital in London in
1860. Her work during the Crimean War and her subsequent writings, particularly "Notes on
Nursing," revolutionized the profession. Clara Barton founded the American Red Cross.
Dorothea Dix was an advocate for the mentally ill. Mary Breckinridge founded the Frontier
Nursing Service.
2. A nurse is providing care to a patient who is scheduled for surgery. The nurse explains the
procedure, risks, and alternatives, and then has the patient sign the consent form. Which
nursing role is the nurse demonstrating?
A. Advocate
B. Caregiver
C. Educator
D. Manager
Correct Answer: A. Advocate
Rationale: The nurse is acting as an advocate by ensuring the patient has all the necessary
information to make an informed decision about their own healthcare. The caregiver role
involves direct physical care. The educator role involves teaching the patient. The manager role
involves coordinating care. The key here is protecting the patient's right to autonomy and
informed consent.
,3. Which of the following are key components of the Institute of Medicine's (IOM) definition
of a "health care system" that is safe, effective, patient-centered, timely, efficient, and
equitable? (Select All That Apply)
A. Providing care that is respectful of and responsive to individual patient preferences.
B. Avoiding waste of equipment, supplies, ideas, and energy.
C. Ensuring that care is based on the best available scientific evidence.
D. Reducing the time patients wait for care.
E. Focusing primarily on the needs of the healthcare provider.
Correct Answers: A, B, C, D
Rationale: The IOM's six aims for improvement are:
• Patient-centered (A): Care is respectful and responsive to patient preferences.
• Efficient (B): Care avoids waste.
• Effective (C): Care is based on scientific evidence.
• Timely (D): Care reduces waits and delays.
• Safe: Care avoids injuries to patients.
• Equitable: Care does not vary in quality based on personal characteristics.
Option E is incorrect; the system should be patient-centered, not provider-centered.
4. A nurse is working in a community health clinic. A patient asks, "What is the difference
between Medicare and Medicaid?" Which statement by the nurse is most accurate?
A. "Medicare is for people with low incomes, and Medicaid is for people over 65."
B. "Medicare is a federal program for people over 65 or with certain disabilities, while Medicaid
is a state and federal program for people with low incomes."
C. "Both are private insurance programs that you must purchase."
D. "Medicaid is only for children, and Medicare is for adults."
Correct Answer: B. "Medicare is a federal program for people over 65 or with certain
disabilities, while Medicaid is a state and federal program for people with low incomes."
Rationale: This is the correct distinction. Medicare is a federally funded health insurance
program primarily for individuals aged 65 and older, as well as those with specific disabilities,
regardless of income. Medicaid is a joint federal and state program that provides health
coverage for individuals and families with limited income and resources.
5. A nurse is caring for a patient who is a Jehovah's Witness and refuses a life-saving blood
transfusion. The patient is competent and understands the consequences. What is the nurse's
primary legal and ethical obligation?
,A. Respect the patient's refusal and document the refusal.
B. Try to persuade the patient to accept the transfusion.
C. Ask the family to sign a consent form for the transfusion.
D. Contact the hospital's ethics committee to override the refusal.
Correct Answer: A. Respect the patient's refusal and document the refusal.
Rationale: This is a cornerstone of patient autonomy and informed consent. A competent
patient has the right to refuse any medical treatment, even if it is life-saving. The nurse's duty is
to respect that decision, ensure the patient is fully informed, and document the refusal in the
medical record. Persuading or coercing the patient would be unethical and a violation of their
rights.
6. Which of the following is an example of a secondary level of disease prevention?
A. Providing immunizations to children.
B. Teaching a patient about a low-fat diet.
C. Performing a mammogram to detect breast cancer.
D. Referring a patient to a rehabilitation center after a stroke.
Correct Answer: C. Performing a mammogram to detect breast cancer.
Rationale: Secondary prevention focuses on early detection and prompt intervention. A
mammogram is a screening tool designed to detect cancer in its early stages. Primary
prevention (A, B) aims to prevent disease before it occurs (e.g., immunizations, health
education). Tertiary prevention (D) focuses on rehabilitation and restoring function after a
disease has caused lasting effects.
7. A nurse is reviewing the scope of practice for a Registered Nurse (RN) versus a Licensed
Practical Nurse (LPN). Which task is typically within the scope of practice for an RN but not an
LPN?
A. Administering oral medications.
B. Performing a sterile dressing change.
C. Developing a patient's plan of care.
D. Collecting a urine specimen.
Correct Answer: C. Developing a patient's plan of care.
Rationale: The development of the initial nursing care plan and the assessment of the
patient are core responsibilities of the RN. While LPNs contribute to the plan and provide direct
care (A, B, D), the critical thinking and clinical judgment required for the initial assessment and
care plan development fall under the RN's scope of practice.
, 8. A nurse manager is implementing a change to reduce medication errors on the unit. Which
of the following actions is an example of using evidence-based practice (EBP)?
A. Implementing a "do not disturb" policy during medication administration based on research
showing it reduces errors.
B. Asking the most senior nurse on the unit what they think is the best approach.
C. Following the hospital's policy because it has always been done that way.
D. Trying a new strategy without evaluating its effectiveness.
Correct Answer: A. Implementing a "do not disturb" policy during medication
administration based on research showing it reduces errors.
Rationale: Evidence-based practice involves integrating the best available research evidence
with clinical expertise and patient preferences. Option A is the only choice that describes a
practice change based on research evidence. The other options rely on tradition, opinion, or
lack evaluation.
9. A nurse is explaining the concept of "continuity of care" to a patient. Which statement best
describes this concept?
A. "It means you will see the same doctor every time you visit."
B. "It ensures your care is coordinated across different providers and settings over time."
C. "It means your insurance will cover all of your medical expenses."
D. "It refers to the speed at which you receive care in the emergency room."
Correct Answer: B. "It ensures your care is coordinated across different providers and
settings over time."
Rationale: Continuity of care is a patient-centered concept that emphasizes the seamless
coordination of healthcare services as a patient moves through different levels of care (e.g.,
hospital to home, primary care to specialist). It involves communication and information sharing
among all providers involved in the patient's care.
10. Which of the following is an example of a nurse acting as a change agent?
A. Administering a prescribed medication to a patient.
B. Teaching a patient how to self-administer insulin.
C. Identifying a problem with the unit's handoff report process and proposing a new, evidence-
based protocol.
D. Comforting a patient who is anxious about surgery.
Correct Answer: C. Identifying a problem with the unit's handoff report process and
proposing a new, evidence-based protocol.
Rationale: A change agent is a nurse who identifies a need for change and works to
