NUR 209 Final Exam Study Guide Questions
and Answers 2026/2027 | Complete Nursing
Exam Review, Practice Tests, Answer Key &
Exam Prep (2 Files Merged)
SECTION I — Nursing Process, Critical Thinking & Clinical Judgment
1. The nurse collects a client's blood pressure, pulse, and reports of nausea. This
activity represents which phase of the nursing process?
A. Planning
B. Assessment
C. Implementation
D. Evaluation
Correct Answer: B
Rationale: Data collection is the assessment phase, the first step of the nursing
process. Planning involves goal setting, implementation is carrying out
interventions, and evaluation determines whether outcomes were met.
2. A nurse identifies "Risk for Falls" as a client problem and writes "Client will
remain free from falls during hospitalization." This statement is an example of
which component of the nursing process?
A. Assessment
B. Expected outcome/goal
C. Nursing diagnosis
D. Evaluation
Correct Answer: B
Rationale: The statement describes a measurable, client-centered expected
outcome. A nursing diagnosis would be the problem label itself; assessment is data
collection; evaluation compares actual results to the outcome.
,3. Which of the following are components of a complete nursing diagnosis
statement? SATA
A. Problem
B. Etiology (related to)
C. Defining characteristics (as evidenced by)
D. Medical diagnosis
E. Physician's orders
Correct Answers: A, B, C
Rationale: A three-part nursing diagnosis includes the problem, etiology, and
defining characteristics. Medical diagnoses and physician orders are not part of
nursing diagnostic statements.
4. The nurse is using critical thinking to prioritize care for four clients. Which
client should the nurse assess first?
A. Client requesting pain medication for a headache
B. Client with new onset shortness of breath and oxygen saturation of 86%
C. Client refusing to take a scheduled laxative
D. Client asking questions about discharge instructions
Correct Answer: B
Rationale: Airway and breathing take precedence using Maslow's hierarchy
and ABC prioritization. An SpO₂ of 86% with dyspnea is an immediate threat to
oxygenation.
5. A nurse notices a colleague about to administer a medication via the wrong
route. The nurse stops the colleague. This is an example of:
A. Advocacy and risk reduction
B. Delegation
C. Time management
D. Documentation
, Correct Answer: A
Rationale: Preventing an error protects the client from harm, which is the
essence of client advocacy and risk reduction.
6. Which action best demonstrates the "evaluation" phase of the nursing process?
A. Auscultating lung sounds on admission
B. Administering an ordered diuretic
C. Comparing the client's urine output to the expected outcome
D. Writing the nursing diagnosis
Correct Answer: C
Rationale: Evaluation compares actual client responses against the expected
outcomes/goals. The other options belong to assessment, implementation, and
diagnosis, respectively.
7. The nurse uses the SBAR format during handoff. What does the "R" represent?
A. Review
B. Recommendation
C. Rationale
D. Report
Correct Answer: B
Rationale: SBAR = Situation, Background, Assessment, Recommendation.
The "R" is the nurse's recommendation for what should happen next.
8. A client's condition changes suddenly. Which type of nursing intervention is the
nurse performing when starting oxygen per standing protocol?
A. Independent
B. Dependent
C. Interdependent/collaborative
D. Not an intervention
, Correct Answer: C
Rationale: Standing protocols and oxygen titration under protocol require
collaboration between nursing and medicine; interventions carried out under a
protocol are interdependent/collaborative.
9. Which statement reflects a correctly written client-centered goal?
A. "Nurse will turn the client every 2 hours."
B. "Client will verbalize two methods to reduce anxiety by end of shift."
C. "Client will be free of infection."
D. "Client will not fall."
Correct Answer: B
Rationale: Goals must be client-centered, measurable, and time-bound. B is
specific, measurable, and includes a timeframe. A is nurse-centered; C and D are
not measurable.
10. A nurse is caring for a client who speaks limited English. Which action best
supports the assessment phase?
A. Asking a family member to interpret
B. Using a certified medical interpreter
C. Speaking loudly and slowly in English
D. Postponing the assessment
Correct Answer: B
Rationale: A certified medical interpreter ensures accurate, confidential
communication. Family members may misinterpret or filter information, especially
sensitive content.
11. The nurse is reviewing a client's chart and notes the provider documented
"client is noncompliant." What is the most appropriate nursing interpretation?
A. The client is difficult
B. The client may have barriers to adherence that should be explored
and Answers 2026/2027 | Complete Nursing
Exam Review, Practice Tests, Answer Key &
Exam Prep (2 Files Merged)
SECTION I — Nursing Process, Critical Thinking & Clinical Judgment
1. The nurse collects a client's blood pressure, pulse, and reports of nausea. This
activity represents which phase of the nursing process?
A. Planning
B. Assessment
C. Implementation
D. Evaluation
Correct Answer: B
Rationale: Data collection is the assessment phase, the first step of the nursing
process. Planning involves goal setting, implementation is carrying out
interventions, and evaluation determines whether outcomes were met.
2. A nurse identifies "Risk for Falls" as a client problem and writes "Client will
remain free from falls during hospitalization." This statement is an example of
which component of the nursing process?
A. Assessment
B. Expected outcome/goal
C. Nursing diagnosis
D. Evaluation
Correct Answer: B
Rationale: The statement describes a measurable, client-centered expected
outcome. A nursing diagnosis would be the problem label itself; assessment is data
collection; evaluation compares actual results to the outcome.
,3. Which of the following are components of a complete nursing diagnosis
statement? SATA
A. Problem
B. Etiology (related to)
C. Defining characteristics (as evidenced by)
D. Medical diagnosis
E. Physician's orders
Correct Answers: A, B, C
Rationale: A three-part nursing diagnosis includes the problem, etiology, and
defining characteristics. Medical diagnoses and physician orders are not part of
nursing diagnostic statements.
4. The nurse is using critical thinking to prioritize care for four clients. Which
client should the nurse assess first?
A. Client requesting pain medication for a headache
B. Client with new onset shortness of breath and oxygen saturation of 86%
C. Client refusing to take a scheduled laxative
D. Client asking questions about discharge instructions
Correct Answer: B
Rationale: Airway and breathing take precedence using Maslow's hierarchy
and ABC prioritization. An SpO₂ of 86% with dyspnea is an immediate threat to
oxygenation.
5. A nurse notices a colleague about to administer a medication via the wrong
route. The nurse stops the colleague. This is an example of:
A. Advocacy and risk reduction
B. Delegation
C. Time management
D. Documentation
, Correct Answer: A
Rationale: Preventing an error protects the client from harm, which is the
essence of client advocacy and risk reduction.
6. Which action best demonstrates the "evaluation" phase of the nursing process?
A. Auscultating lung sounds on admission
B. Administering an ordered diuretic
C. Comparing the client's urine output to the expected outcome
D. Writing the nursing diagnosis
Correct Answer: C
Rationale: Evaluation compares actual client responses against the expected
outcomes/goals. The other options belong to assessment, implementation, and
diagnosis, respectively.
7. The nurse uses the SBAR format during handoff. What does the "R" represent?
A. Review
B. Recommendation
C. Rationale
D. Report
Correct Answer: B
Rationale: SBAR = Situation, Background, Assessment, Recommendation.
The "R" is the nurse's recommendation for what should happen next.
8. A client's condition changes suddenly. Which type of nursing intervention is the
nurse performing when starting oxygen per standing protocol?
A. Independent
B. Dependent
C. Interdependent/collaborative
D. Not an intervention
, Correct Answer: C
Rationale: Standing protocols and oxygen titration under protocol require
collaboration between nursing and medicine; interventions carried out under a
protocol are interdependent/collaborative.
9. Which statement reflects a correctly written client-centered goal?
A. "Nurse will turn the client every 2 hours."
B. "Client will verbalize two methods to reduce anxiety by end of shift."
C. "Client will be free of infection."
D. "Client will not fall."
Correct Answer: B
Rationale: Goals must be client-centered, measurable, and time-bound. B is
specific, measurable, and includes a timeframe. A is nurse-centered; C and D are
not measurable.
10. A nurse is caring for a client who speaks limited English. Which action best
supports the assessment phase?
A. Asking a family member to interpret
B. Using a certified medical interpreter
C. Speaking loudly and slowly in English
D. Postponing the assessment
Correct Answer: B
Rationale: A certified medical interpreter ensures accurate, confidential
communication. Family members may misinterpret or filter information, especially
sensitive content.
11. The nurse is reviewing a client's chart and notes the provider documented
"client is noncompliant." What is the most appropriate nursing interpretation?
A. The client is difficult
B. The client may have barriers to adherence that should be explored
