NR 351
Foundational Concepts for the
Practicing RN
Complete Midterm Review
(Questions & Solutions)
2025
1
,1. A 68-year-old patient with chronic heart failure presents with
increasing peripheral edema and weight gain of 2.5 kg over 48 hours.
Which nursing intervention takes highest priority?
A. Encourage a high-protein diet
B. Restrict sodium intake
C. Elevate lower extremities
D. Administer prescribed furosemide
ANS: D
Rationale: Acute fluid overload in heart failure requires prompt
diuresis to reduce preload and relieve symptoms. Elevation and sodium
restriction are supportive but secondary to diuretic therapy.
2. A 52-year-old patient with type II diabetes mellitus reports numbness
and tingling in both feet. Which instruction is most critical to prevent foot
injury?
A. Inspect shoes for foreign objects before wearing
B. Soak feet daily in warm water
C. Apply lotion between the toes
D. Check blood glucose before bedtime
ANS: A
Rationale: Inspecting footwear removes hazards that neuropathic
patients may not feel. Daily soaks risk maceration; lotion between toes
can foster fungal growth.
3. During admission, an 80-year-old patient on multiple medications
arrives. Which action best exemplifies effective medication
reconciliation?
2
, A. Comparing home and hospital medication lists
B. Discontinuing all non-essential medications
C. Allowing patient to self-administer home meds
D. Scheduling a pharmacy consult
ANS: A
Rationale: Reconciliation requires verifying home medications against
new orders to prevent duplication or omission. Other options are
supportive but secondary.
4. A staff nurse needs to notify the physician of a sudden drop in blood
pressure (BP 88/54 mm Hg). Which SBAR statement is correct for
Recommendation?
A. “I recommend increasing the IV fluid rate.”
B. “My patient’s BP is 88/54 mm Hg.”
C. “I’m concerned the patient is hypotensive.”
D. “The patient underwent surgery two days ago.”
ANS: A
Rationale: Recommendation is the nurse’s suggestion for next steps.
Situation & background are separate SBAR elements.
5. A patient recovering from major abdominal surgery is anxious about
self-care post-discharge. According to Maslow’s hierarchy, which need
should the nurse address first?
A. Esteem needs
B. Safety needs
C. Physiological needs
D. Love and belonging needs
3
Foundational Concepts for the
Practicing RN
Complete Midterm Review
(Questions & Solutions)
2025
1
,1. A 68-year-old patient with chronic heart failure presents with
increasing peripheral edema and weight gain of 2.5 kg over 48 hours.
Which nursing intervention takes highest priority?
A. Encourage a high-protein diet
B. Restrict sodium intake
C. Elevate lower extremities
D. Administer prescribed furosemide
ANS: D
Rationale: Acute fluid overload in heart failure requires prompt
diuresis to reduce preload and relieve symptoms. Elevation and sodium
restriction are supportive but secondary to diuretic therapy.
2. A 52-year-old patient with type II diabetes mellitus reports numbness
and tingling in both feet. Which instruction is most critical to prevent foot
injury?
A. Inspect shoes for foreign objects before wearing
B. Soak feet daily in warm water
C. Apply lotion between the toes
D. Check blood glucose before bedtime
ANS: A
Rationale: Inspecting footwear removes hazards that neuropathic
patients may not feel. Daily soaks risk maceration; lotion between toes
can foster fungal growth.
3. During admission, an 80-year-old patient on multiple medications
arrives. Which action best exemplifies effective medication
reconciliation?
2
, A. Comparing home and hospital medication lists
B. Discontinuing all non-essential medications
C. Allowing patient to self-administer home meds
D. Scheduling a pharmacy consult
ANS: A
Rationale: Reconciliation requires verifying home medications against
new orders to prevent duplication or omission. Other options are
supportive but secondary.
4. A staff nurse needs to notify the physician of a sudden drop in blood
pressure (BP 88/54 mm Hg). Which SBAR statement is correct for
Recommendation?
A. “I recommend increasing the IV fluid rate.”
B. “My patient’s BP is 88/54 mm Hg.”
C. “I’m concerned the patient is hypotensive.”
D. “The patient underwent surgery two days ago.”
ANS: A
Rationale: Recommendation is the nurse’s suggestion for next steps.
Situation & background are separate SBAR elements.
5. A patient recovering from major abdominal surgery is anxious about
self-care post-discharge. According to Maslow’s hierarchy, which need
should the nurse address first?
A. Esteem needs
B. Safety needs
C. Physiological needs
D. Love and belonging needs
3
