PASS NUR 231 FINAL EXAM – ADULT NURSING II (2026)
ACTUAL QUESTIONS & VERIFIED ANSWERS | ILLINOIS
STATE UNIVERSITY (A+ GUARANTEE)
NUR 231 ADULT NURSING II
Final Exam Practice & Review — 2026–2027
Illinois State University
Mennonite College of Nursing
Academic Study Material
Important note: This is an original practice examination and study resource.
Table of Contents
1. Introduction — Questions 1–20
2. Core Concepts — Questions 21–70
3. Applied Scenarios — Questions 71–120
4. Critical Thinking — Questions 121–160
5. Review Questions — Questions 161–200
SECTION I — INTRODUCTION
Questions 1–20
1. Which nursing action best demonstrates use of the nursing process?
A. Administering medication without reassessment
B. Collecting data, identifying problems, planning care, implementing interventions, and
evaluating outcomes
C. Following every provider order without modification
D. Documenting care only at discharge
Correct answer: B
Rationale: The nursing process is a systematic cycle of assessment, diagnosis, planning,
implementation, and evaluation. Evaluation determines whether interventions achieved the
desired outcomes.
2. Which patient should the nurse assess first?
,A. A patient requesting a blanket
B. A patient with oxygen saturation of 86% and increasing respiratory distress
C. A patient waiting for discharge instructions
D. A patient reporting chronic back pain rated 4/10
Correct answer: B
Rationale: Airway and breathing take priority. Hypoxemia with respiratory distress can rapidly
become life-threatening and requires immediate assessment and intervention.
3. Which finding is most concerning in an acutely ill adult?
A. Mild fatigue
B. New confusion and restlessness
C. Decreased appetite
D. Chronic joint stiffness
Correct answer: B
Rationale: Acute mental-status changes can be early manifestations of hypoxemia, impaired
perfusion, infection, metabolic abnormalities, or other serious deterioration.
4. What is the primary purpose of SBAR communication?
A. Replace documentation
B. Provide structured communication about a patient's clinical condition
C. Eliminate the need for assessment
D. Transfer accountability to another nurse
Correct answer: B
Rationale: SBAR—Situation, Background, Assessment, Recommendation—provides a
standardized structure for communicating important clinical information.
5. Which assessment finding requires immediate follow-up?
A. Temperature 37.0°C
B. Respiratory rate 8/min in a patient receiving opioids
C. Heart rate 78/min
D. Blood pressure 124/76 mmHg
Correct answer: B
Rationale: Significant respiratory depression may occur with opioid therapy and requires
prompt assessment of airway, breathing, oxygenation, and level of consciousness.
6. Which principle is most important when caring for a hospitalized adult?
A. Treat the diagnosis rather than the person
B. Individualize care according to assessment findings and patient needs
,C. Prioritize routine tasks over acute changes
D. Avoid patient participation in decisions
Correct answer: B
Rationale: Safe nursing care is individualized and based on current assessment findings, clinical
priorities, patient preferences, and evidence.
7. Which intervention is an example of primary prevention?
A. Rehabilitation after stroke
B. Screening mammography
C. Immunization
D. Treatment of pneumonia
Correct answer: C
Rationale: Primary prevention seeks to prevent disease before it occurs. Immunization reduces
the risk of developing vaccine-preventable disease.
8. Which action best protects patient safety during medication administration?
A. Relying on memory
B. Verifying the medication against the prescription and patient identifiers
C. Asking another patient to identify the medication
D. Administering medications before reviewing allergies
Correct answer: B
Rationale: Medication safety requires verification of the medication, patient, dose, route, timing,
allergies, and other applicable rights of medication administration.
9. Which finding is most consistent with impaired tissue perfusion?
A. Warm skin and normal mentation
B. New confusion, cool skin, and weak peripheral pulses
C. Normal urine output
D. Capillary refill of less than two seconds
Correct answer: B
Rationale: Poor perfusion may produce altered mental status, cool skin, weak pulses, and other
manifestations of inadequate oxygen delivery.
10. Why is reassessment essential after a nursing intervention?
A. It eliminates documentation requirements
B. It determines whether the intervention produced the desired response
C. It replaces the initial assessment
D. It guarantees recovery
, Correct answer: B
Rationale: Evaluation and reassessment determine effectiveness and whether the plan of care
should be continued, modified, or escalated.
11. Which patient statement demonstrates understanding of informed consent?
A. “The nurse will decide whether I should have the procedure.”
B. “The provider should explain the procedure, risks, benefits, and alternatives.”
C. “Signing the form means I cannot ask questions.”
D. “Consent is unnecessary for invasive procedures.”
Correct answer: B
Rationale: The provider performing the procedure generally has responsibility for explaining the
procedure, risks, benefits, and alternatives. The nurse helps verify understanding and
voluntariness according to institutional policy.
12. What is the priority assessment for a patient experiencing acute deterioration?
A. Favorite foods
B. Airway, breathing, circulation, and neurologic status
C. Insurance information
D. Preferred discharge pharmacy
Correct answer: B
Rationale: Initial assessment of an unstable patient focuses on life-threatening physiologic
problems.
13. Which nursing action demonstrates clinical prioritization?
A. Completing paperwork before assessing a deteriorating patient
B. Addressing immediate threats to airway, breathing, and circulation before routine needs
C. Treating all findings as equally urgent
D. Waiting for the next shift to reassess changes
Correct answer: B
Rationale: Prioritization requires identifying and addressing actual or potential threats to life
first.
14. Which finding should cause the nurse to suspect infection?
A. New fever with chills and increasing heart rate
B. Stable vital signs
C. Improved appetite
D. Clear urine without symptoms
ACTUAL QUESTIONS & VERIFIED ANSWERS | ILLINOIS
STATE UNIVERSITY (A+ GUARANTEE)
NUR 231 ADULT NURSING II
Final Exam Practice & Review — 2026–2027
Illinois State University
Mennonite College of Nursing
Academic Study Material
Important note: This is an original practice examination and study resource.
Table of Contents
1. Introduction — Questions 1–20
2. Core Concepts — Questions 21–70
3. Applied Scenarios — Questions 71–120
4. Critical Thinking — Questions 121–160
5. Review Questions — Questions 161–200
SECTION I — INTRODUCTION
Questions 1–20
1. Which nursing action best demonstrates use of the nursing process?
A. Administering medication without reassessment
B. Collecting data, identifying problems, planning care, implementing interventions, and
evaluating outcomes
C. Following every provider order without modification
D. Documenting care only at discharge
Correct answer: B
Rationale: The nursing process is a systematic cycle of assessment, diagnosis, planning,
implementation, and evaluation. Evaluation determines whether interventions achieved the
desired outcomes.
2. Which patient should the nurse assess first?
,A. A patient requesting a blanket
B. A patient with oxygen saturation of 86% and increasing respiratory distress
C. A patient waiting for discharge instructions
D. A patient reporting chronic back pain rated 4/10
Correct answer: B
Rationale: Airway and breathing take priority. Hypoxemia with respiratory distress can rapidly
become life-threatening and requires immediate assessment and intervention.
3. Which finding is most concerning in an acutely ill adult?
A. Mild fatigue
B. New confusion and restlessness
C. Decreased appetite
D. Chronic joint stiffness
Correct answer: B
Rationale: Acute mental-status changes can be early manifestations of hypoxemia, impaired
perfusion, infection, metabolic abnormalities, or other serious deterioration.
4. What is the primary purpose of SBAR communication?
A. Replace documentation
B. Provide structured communication about a patient's clinical condition
C. Eliminate the need for assessment
D. Transfer accountability to another nurse
Correct answer: B
Rationale: SBAR—Situation, Background, Assessment, Recommendation—provides a
standardized structure for communicating important clinical information.
5. Which assessment finding requires immediate follow-up?
A. Temperature 37.0°C
B. Respiratory rate 8/min in a patient receiving opioids
C. Heart rate 78/min
D. Blood pressure 124/76 mmHg
Correct answer: B
Rationale: Significant respiratory depression may occur with opioid therapy and requires
prompt assessment of airway, breathing, oxygenation, and level of consciousness.
6. Which principle is most important when caring for a hospitalized adult?
A. Treat the diagnosis rather than the person
B. Individualize care according to assessment findings and patient needs
,C. Prioritize routine tasks over acute changes
D. Avoid patient participation in decisions
Correct answer: B
Rationale: Safe nursing care is individualized and based on current assessment findings, clinical
priorities, patient preferences, and evidence.
7. Which intervention is an example of primary prevention?
A. Rehabilitation after stroke
B. Screening mammography
C. Immunization
D. Treatment of pneumonia
Correct answer: C
Rationale: Primary prevention seeks to prevent disease before it occurs. Immunization reduces
the risk of developing vaccine-preventable disease.
8. Which action best protects patient safety during medication administration?
A. Relying on memory
B. Verifying the medication against the prescription and patient identifiers
C. Asking another patient to identify the medication
D. Administering medications before reviewing allergies
Correct answer: B
Rationale: Medication safety requires verification of the medication, patient, dose, route, timing,
allergies, and other applicable rights of medication administration.
9. Which finding is most consistent with impaired tissue perfusion?
A. Warm skin and normal mentation
B. New confusion, cool skin, and weak peripheral pulses
C. Normal urine output
D. Capillary refill of less than two seconds
Correct answer: B
Rationale: Poor perfusion may produce altered mental status, cool skin, weak pulses, and other
manifestations of inadequate oxygen delivery.
10. Why is reassessment essential after a nursing intervention?
A. It eliminates documentation requirements
B. It determines whether the intervention produced the desired response
C. It replaces the initial assessment
D. It guarantees recovery
, Correct answer: B
Rationale: Evaluation and reassessment determine effectiveness and whether the plan of care
should be continued, modified, or escalated.
11. Which patient statement demonstrates understanding of informed consent?
A. “The nurse will decide whether I should have the procedure.”
B. “The provider should explain the procedure, risks, benefits, and alternatives.”
C. “Signing the form means I cannot ask questions.”
D. “Consent is unnecessary for invasive procedures.”
Correct answer: B
Rationale: The provider performing the procedure generally has responsibility for explaining the
procedure, risks, benefits, and alternatives. The nurse helps verify understanding and
voluntariness according to institutional policy.
12. What is the priority assessment for a patient experiencing acute deterioration?
A. Favorite foods
B. Airway, breathing, circulation, and neurologic status
C. Insurance information
D. Preferred discharge pharmacy
Correct answer: B
Rationale: Initial assessment of an unstable patient focuses on life-threatening physiologic
problems.
13. Which nursing action demonstrates clinical prioritization?
A. Completing paperwork before assessing a deteriorating patient
B. Addressing immediate threats to airway, breathing, and circulation before routine needs
C. Treating all findings as equally urgent
D. Waiting for the next shift to reassess changes
Correct answer: B
Rationale: Prioritization requires identifying and addressing actual or potential threats to life
first.
14. Which finding should cause the nurse to suspect infection?
A. New fever with chills and increasing heart rate
B. Stable vital signs
C. Improved appetite
D. Clear urine without symptoms
