Comprehensive Nursing Major Exam (200+ Questions)
Section 1: Fundamentals of Nursing (40 Questions)
1. Which of the following is the primary purpose of the nursing process?
a) To diagnose medical conditions
b) To provide a framework for delivering holistic, patient-centered care
c) To ensure financial reimbursement for services
d) To establish a hierarchy within the healthcare team
Answer: b) To provide a framework for delivering holistic, patient-centered care
Rationale: The nursing process (ADPIE: Assessment, Diagnosis, Planning,
Implementation, Evaluation) is a systematic, client-centered method for structuring the
delivery of nursing care. It is not used for medical diagnosis or financial purposes.
2. A nurse is assessing a patient's pain. Which of the following is considered the most
reliable indicator of pain?
a) The patient's facial grimacing
b) An increase in heart rate and blood pressure
c) The patient's self-report
d) The nurse's objective observation
Answer: c) The patient's self-report
Rationale: Pain is a subjective experience. The patient's self-report is the gold standard
and most reliable indicator of the existence and intensity of pain.
3. What is the correct order for donning (putting on) personal protective equipment (PPE)?
a) Gown, mask, goggles, gloves
b) Gloves, gown, mask, goggles
c) Gown, mask, gloves, goggles
d) Mask, goggles, gown, gloves
Answer: a) Gown, mask, goggles, gloves
Rationale: The correct sequence for donning PPE is: 1. Gown, 2. Mask/respirator, 3.
Goggles/face shield, 4. Gloves. Gloves are always put on last as they are the most
contaminated piece of equipment.
4. A nurse is preparing to administer an intramuscular (IM) injection to an adult. Which site
is generally contraindicated due to the risk of sciatic nerve injury?
a) Ventrogluteal
b) Vastus lateralis
, c) Dorsogluteal
d) Deltoid
Answer: c) Dorsogluteal
Rationale: The dorsogluteal site is no longer recommended for IM injections because of
the risk of inadvertently hitting the sciatic nerve or major blood vessels. The
ventrogluteal site is now the preferred site for adults.
5. Which of the following vital sign findings should a nurse report immediately?
a) Blood pressure 118/76 mmHg
b) Heart rate 88 beats/min
c) Respiratory rate 8 breaths/min
d) Temperature 37.2°C (99°F)
Answer: c) Respiratory rate 8 breaths/min
Rationale: A respiratory rate of 8 breaths/min is bradypnea and is significantly below
the normal adult range of 12-20 breaths/min. This indicates respiratory depression and
requires immediate intervention.
6. The nurse is teaching a patient about a low-sodium diet. Which food should the patient
be instructed to avoid?
a) Fresh apples
b) Canned soup
c) Grilled chicken breast
d) Brown rice
Answer: b) Canned soup
Rationale: Canned soups are typically very high in sodium as it is used as a preservative
and flavor enhancer. Fresh fruits, unprocessed meats, and whole grains are generally low
in sodium.
7. What is the primary goal of sterile technique?
a) To prevent the spread of infection from the patient to the nurse
b) To eliminate all microorganisms from an object
c) To prevent the introduction of pathogens into a sterile area
d) To clean the environment
Answer: c) To prevent the introduction of pathogens into a sterile area
Rationale: Sterile technique, or aseptic technique, is a set of specific practices and
procedures performed to make equipment and areas free from all microorganisms and
to maintain that sterility. Its primary goal is to prevent contamination of a sterile field,
thereby protecting the patient from infection.
8. A patient has an order for "NPO." The nurse understands this means:
a) Nothing by mouth
b) New patient order
c) Normal protein output
d) Not post-operative
, Answer: a) Nothing by mouth
Rationale: NPO is the abbreviation for the Latin "nil per os," which translates to
"nothing by mouth." This means the patient should not eat or drink anything.
9. Which of the following is a normal finding when assessing an older adult?
a) Decreased sense of smell
b) Increased respiratory rate
c) Elevated body temperature
d) Increased skin turgor
Answer: a) Decreased sense of smell
Rationale: A decrease in the sense of smell (presbyosmia) is a common age-related
change. Other normal changes include decreased skin turgor, decreased respiratory
function, and a lower baseline body temperature.
10. A nurse is calculating a patient's fluid intake. The patient drank 8 oz of coffee, 4 oz of
juice, and 12 oz of water. What is the total intake in milliliters? (1 oz = 30 mL)
a) 480 mL
b) 600 mL
c) 720 mL
d) 840 mL
Answer: c) 720 mL
Rationale: Total intake is 8 oz + 4 oz + 12 oz = 24 oz. 24 oz * 30 mL/oz = 720 mL.
11. The best way to prevent the spread of infection is:
a) Wearing a mask at all times
b) Hand hygiene
c) Isolating all patients
d) Prescribing antibiotics prophylactically
Answer: b) Hand hygiene
Rationale: Hand hygiene is the single most effective and important measure for
preventing the spread of infection in healthcare settings.
12. A nurse is assessing a patient for dehydration. Which of the following findings would be
expected?
a) Bounding pulse
b) Hypertension
c) Poor skin turgor
d) Peripheral edema
Answer: c) Poor skin turgor
Rationale: Poor skin turgor (tenting of the skin) is a classic sign of dehydration. Other
signs include dry mucous membranes, tachycardia, hypotension, and concentrated
urine.
13. A patient is on fall precautions. Which of the following interventions is most important?
a) Keeping the bed in the highest position
, b) Keeping the call light within reach
c) Using a wheelchair for all transport
d) Administering sedatives to prevent agitation
Answer: b) Keeping the call light within reach
Rationale: Ensuring the patient can call for help is a primary fall prevention strategy.
The bed should be in the lowest position, and sedatives should be avoided as they can
increase the risk of falls.
14. What is the term for a document that specifies a patient's wishes for end-of-life care?
a) Durable Power of Attorney
b) Living Will
c) Do Not Resuscitate (DNR) order
d) Informed Consent
Answer: b) Living Will
Rationale: A living will is a legal document that expresses a person's wishes regarding
medical treatment in the event they become unable to communicate their decisions. A
DNR is a specific medical order.
15. The nurse is performing a sterile dressing change. Which action would break the sterile
field?
a) Opening the sterile package away from the body
b) Placing sterile supplies on the sterile field
c) Reaching over the sterile field
d) Keeping the sterile field above waist level
Answer: c) Reaching over the sterile field
Rationale: Reaching over a sterile field contaminates it. Microorganisms from the
nurse's clothing or body could fall onto the field. All other actions are correct principles
of sterile technique.
16. A patient's intake and output (I&O) record shows an intake of 1500 mL and an output of
800 mL. The nurse should:
a) Document the findings as normal
b) Report the findings to the healthcare provider
c) Restrict the patient's fluids
d) Increase the patient's fluid intake
Answer: b) Report the findings to the healthcare provider
Rationale: A significant positive fluid balance (intake > output) could indicate fluid
retention and requires further evaluation by the healthcare provider.
17. Which of the following is a sign of impending death?
a) Increased urine output
b) Cheyne-Stokes respirations
c) Increased blood pressure
d) Warm, flushed skin
Section 1: Fundamentals of Nursing (40 Questions)
1. Which of the following is the primary purpose of the nursing process?
a) To diagnose medical conditions
b) To provide a framework for delivering holistic, patient-centered care
c) To ensure financial reimbursement for services
d) To establish a hierarchy within the healthcare team
Answer: b) To provide a framework for delivering holistic, patient-centered care
Rationale: The nursing process (ADPIE: Assessment, Diagnosis, Planning,
Implementation, Evaluation) is a systematic, client-centered method for structuring the
delivery of nursing care. It is not used for medical diagnosis or financial purposes.
2. A nurse is assessing a patient's pain. Which of the following is considered the most
reliable indicator of pain?
a) The patient's facial grimacing
b) An increase in heart rate and blood pressure
c) The patient's self-report
d) The nurse's objective observation
Answer: c) The patient's self-report
Rationale: Pain is a subjective experience. The patient's self-report is the gold standard
and most reliable indicator of the existence and intensity of pain.
3. What is the correct order for donning (putting on) personal protective equipment (PPE)?
a) Gown, mask, goggles, gloves
b) Gloves, gown, mask, goggles
c) Gown, mask, gloves, goggles
d) Mask, goggles, gown, gloves
Answer: a) Gown, mask, goggles, gloves
Rationale: The correct sequence for donning PPE is: 1. Gown, 2. Mask/respirator, 3.
Goggles/face shield, 4. Gloves. Gloves are always put on last as they are the most
contaminated piece of equipment.
4. A nurse is preparing to administer an intramuscular (IM) injection to an adult. Which site
is generally contraindicated due to the risk of sciatic nerve injury?
a) Ventrogluteal
b) Vastus lateralis
, c) Dorsogluteal
d) Deltoid
Answer: c) Dorsogluteal
Rationale: The dorsogluteal site is no longer recommended for IM injections because of
the risk of inadvertently hitting the sciatic nerve or major blood vessels. The
ventrogluteal site is now the preferred site for adults.
5. Which of the following vital sign findings should a nurse report immediately?
a) Blood pressure 118/76 mmHg
b) Heart rate 88 beats/min
c) Respiratory rate 8 breaths/min
d) Temperature 37.2°C (99°F)
Answer: c) Respiratory rate 8 breaths/min
Rationale: A respiratory rate of 8 breaths/min is bradypnea and is significantly below
the normal adult range of 12-20 breaths/min. This indicates respiratory depression and
requires immediate intervention.
6. The nurse is teaching a patient about a low-sodium diet. Which food should the patient
be instructed to avoid?
a) Fresh apples
b) Canned soup
c) Grilled chicken breast
d) Brown rice
Answer: b) Canned soup
Rationale: Canned soups are typically very high in sodium as it is used as a preservative
and flavor enhancer. Fresh fruits, unprocessed meats, and whole grains are generally low
in sodium.
7. What is the primary goal of sterile technique?
a) To prevent the spread of infection from the patient to the nurse
b) To eliminate all microorganisms from an object
c) To prevent the introduction of pathogens into a sterile area
d) To clean the environment
Answer: c) To prevent the introduction of pathogens into a sterile area
Rationale: Sterile technique, or aseptic technique, is a set of specific practices and
procedures performed to make equipment and areas free from all microorganisms and
to maintain that sterility. Its primary goal is to prevent contamination of a sterile field,
thereby protecting the patient from infection.
8. A patient has an order for "NPO." The nurse understands this means:
a) Nothing by mouth
b) New patient order
c) Normal protein output
d) Not post-operative
, Answer: a) Nothing by mouth
Rationale: NPO is the abbreviation for the Latin "nil per os," which translates to
"nothing by mouth." This means the patient should not eat or drink anything.
9. Which of the following is a normal finding when assessing an older adult?
a) Decreased sense of smell
b) Increased respiratory rate
c) Elevated body temperature
d) Increased skin turgor
Answer: a) Decreased sense of smell
Rationale: A decrease in the sense of smell (presbyosmia) is a common age-related
change. Other normal changes include decreased skin turgor, decreased respiratory
function, and a lower baseline body temperature.
10. A nurse is calculating a patient's fluid intake. The patient drank 8 oz of coffee, 4 oz of
juice, and 12 oz of water. What is the total intake in milliliters? (1 oz = 30 mL)
a) 480 mL
b) 600 mL
c) 720 mL
d) 840 mL
Answer: c) 720 mL
Rationale: Total intake is 8 oz + 4 oz + 12 oz = 24 oz. 24 oz * 30 mL/oz = 720 mL.
11. The best way to prevent the spread of infection is:
a) Wearing a mask at all times
b) Hand hygiene
c) Isolating all patients
d) Prescribing antibiotics prophylactically
Answer: b) Hand hygiene
Rationale: Hand hygiene is the single most effective and important measure for
preventing the spread of infection in healthcare settings.
12. A nurse is assessing a patient for dehydration. Which of the following findings would be
expected?
a) Bounding pulse
b) Hypertension
c) Poor skin turgor
d) Peripheral edema
Answer: c) Poor skin turgor
Rationale: Poor skin turgor (tenting of the skin) is a classic sign of dehydration. Other
signs include dry mucous membranes, tachycardia, hypotension, and concentrated
urine.
13. A patient is on fall precautions. Which of the following interventions is most important?
a) Keeping the bed in the highest position
, b) Keeping the call light within reach
c) Using a wheelchair for all transport
d) Administering sedatives to prevent agitation
Answer: b) Keeping the call light within reach
Rationale: Ensuring the patient can call for help is a primary fall prevention strategy.
The bed should be in the lowest position, and sedatives should be avoided as they can
increase the risk of falls.
14. What is the term for a document that specifies a patient's wishes for end-of-life care?
a) Durable Power of Attorney
b) Living Will
c) Do Not Resuscitate (DNR) order
d) Informed Consent
Answer: b) Living Will
Rationale: A living will is a legal document that expresses a person's wishes regarding
medical treatment in the event they become unable to communicate their decisions. A
DNR is a specific medical order.
15. The nurse is performing a sterile dressing change. Which action would break the sterile
field?
a) Opening the sterile package away from the body
b) Placing sterile supplies on the sterile field
c) Reaching over the sterile field
d) Keeping the sterile field above waist level
Answer: c) Reaching over the sterile field
Rationale: Reaching over a sterile field contaminates it. Microorganisms from the
nurse's clothing or body could fall onto the field. All other actions are correct principles
of sterile technique.
16. A patient's intake and output (I&O) record shows an intake of 1500 mL and an output of
800 mL. The nurse should:
a) Document the findings as normal
b) Report the findings to the healthcare provider
c) Restrict the patient's fluids
d) Increase the patient's fluid intake
Answer: b) Report the findings to the healthcare provider
Rationale: A significant positive fluid balance (intake > output) could indicate fluid
retention and requires further evaluation by the healthcare provider.
17. Which of the following is a sign of impending death?
a) Increased urine output
b) Cheyne-Stokes respirations
c) Increased blood pressure
d) Warm, flushed skin
