PASS NUR 231 EXAM 4 – ADULT NURSING II (2026)
ACTUAL QUESTIONS & VERIFIED ANSWERS |
ILLINOIS STATE UNIVERSITY (A+ GUARANTEE)
NUR 231 Adult Nursing II Exam 4 — 2026 Practice Questions & Detailed Rationales
Illinois State University — Mennonite College of Nursing
Course: NUR 231 Adult Nursing II
Academic Year: 2026–2027
Resource Type: Original Practice Exam and Exam-Success Study Resource
Academic-use notice: This is an independently created practice resource.
Table of Contents
1. Introduction — Questions 1–20
2. Core Concepts — Questions 21–80
3. Applied Scenarios — Questions 81–140
4. Critical Thinking — Questions 141–180
5. Review Questions — Questions 181–200
Section I — Introduction
Questions 1–20
1. Which nursing action best demonstrates the first step of the nursing process?
A. Establishing expected outcomes
B. Collecting and analyzing patient data
C. Implementing prescribed interventions
D. Evaluating the patient's response
Correct answer: B. Collecting and analyzing patient data
Rationale: Assessment is the first step of the nursing process. The nurse gathers subjective and
objective information before identifying nursing diagnoses, planning care, implementing
interventions, and evaluating outcomes.
2. Which patient should the nurse assess first?
,A. Patient requesting discharge instructions
B. Patient reporting new difficulty breathing
C. Patient requesting a blanket
D. Patient waiting for routine medication
Correct answer: B. Patient reporting new difficulty breathing
Rationale: New respiratory difficulty may indicate an immediate threat to airway or
oxygenation. Acute physiologic instability takes priority over routine requests.
3. What is the primary purpose of SBAR communication?
A. To replace documentation
B. To provide structured clinical communication
C. To eliminate interdisciplinary communication
D. To determine a patient's diagnosis
Correct answer: B. To provide structured clinical communication
Rationale: SBAR—Situation, Background, Assessment, Recommendation—organizes important
clinical information and helps reduce communication errors during handoffs and changes in
patient condition.
4. Which finding represents objective data?
A. “I feel dizzy.”
B. “My pain is severe.”
C. Blood pressure of 88/54 mm Hg
D. “I feel anxious.”
Correct answer: C. Blood pressure of 88/54 mm Hg
Rationale: Objective data are measurable or observable findings. Blood pressure is obtained
through direct measurement, whereas the other choices are subjective reports.
5. Which intervention is an example of primary prevention?
A. Rehabilitation after a stroke
B. Screening mammography
C. Immunization
D. Physical therapy after surgery
Correct answer: C. Immunization
Rationale: Primary prevention attempts to prevent disease before it occurs. Immunization
reduces the likelihood of developing specific infectious diseases.
6. Which action is most appropriate when a patient's condition suddenly deteriorates?
,A. Complete routine documentation first
B. Reassess the patient immediately
C. Wait for the next scheduled assessment
D. Ask another patient whether the symptoms are expected
Correct answer: B. Reassess the patient immediately
Rationale: A sudden change requires prompt assessment to determine severity, identify the
cause, and initiate appropriate interventions.
7. Which principle should guide prioritization of care?
A. Complete the easiest task first
B. Address life-threatening problems first
C. Treat patients according to admission time
D. Perform documentation before assessment
Correct answer: B. Address life-threatening problems first
Rationale: Nursing priorities generally begin with airway, breathing, circulation, and other
immediate threats to life or safety.
8. Which patient statement demonstrates effective teach-back?
A. “I listened to everything.”
B. “The nurse explained it clearly.”
C. “I can explain how I will take this medication at home.”
D. “My family will remember it for me.”
Correct answer: C. “I can explain how I will take this medication at home.”
Rationale: Teach-back asks the patient to explain information in their own words. It verifies
understanding rather than merely asking whether the patient understands.
9. What is the primary purpose of a medication reconciliation?
A. To increase the number of medications prescribed
B. To compare medication lists and identify discrepancies
C. To discontinue all home medications
D. To replace patient education
Correct answer: B. To compare medication lists and identify discrepancies
Rationale: Medication reconciliation compares current medications with newly prescribed
medications to identify omissions, duplications, interactions, or other discrepancies.
10. Which finding requires the most immediate nursing attention?
, A. Temperature of 37.1°C
B. Oxygen saturation of 86% with respiratory distress
C. Mild postoperative pain
D. Request for assistance with bathing
Correct answer: B. Oxygen saturation of 86% with respiratory distress
Rationale: Significant hypoxemia combined with respiratory distress represents an immediate
physiologic threat and requires prompt intervention.
11. What is the purpose of informed consent?
A. To allow the nurse to choose treatment
B. To ensure the patient receives sufficient information to make an informed decision
C. To transfer all legal responsibility to the nurse
D. To guarantee a successful procedure
Correct answer: B. To ensure the patient receives sufficient information to make an informed
decision
Rationale: Informed consent involves disclosure of relevant information and voluntary patient
authorization. The provider performing the procedure is responsible for explaining the procedure,
risks, benefits, and alternatives.
12. Which action promotes patient-centered care?
A. Using identical interventions for every patient
B. Incorporating the patient's preferences and goals
C. Avoiding family involvement in every situation
D. Making decisions without patient participation
Correct answer: B. Incorporating the patient's preferences and goals
Rationale: Patient-centered care respects individual preferences, values, cultural considerations,
and goals while maintaining safe evidence-based practice.
13. Which statement best describes evidence-based nursing practice?
A. Using tradition alone
B. Using the most recent opinion available
C. Integrating evidence, clinical expertise, and patient preferences
D. Following every intervention found online
Correct answer: C. Integrating evidence, clinical expertise, and patient preferences
Rationale: Evidence-based practice integrates best available evidence with clinical expertise and
the patient's values, preferences, and circumstances.
ACTUAL QUESTIONS & VERIFIED ANSWERS |
ILLINOIS STATE UNIVERSITY (A+ GUARANTEE)
NUR 231 Adult Nursing II Exam 4 — 2026 Practice Questions & Detailed Rationales
Illinois State University — Mennonite College of Nursing
Course: NUR 231 Adult Nursing II
Academic Year: 2026–2027
Resource Type: Original Practice Exam and Exam-Success Study Resource
Academic-use notice: This is an independently created practice resource.
Table of Contents
1. Introduction — Questions 1–20
2. Core Concepts — Questions 21–80
3. Applied Scenarios — Questions 81–140
4. Critical Thinking — Questions 141–180
5. Review Questions — Questions 181–200
Section I — Introduction
Questions 1–20
1. Which nursing action best demonstrates the first step of the nursing process?
A. Establishing expected outcomes
B. Collecting and analyzing patient data
C. Implementing prescribed interventions
D. Evaluating the patient's response
Correct answer: B. Collecting and analyzing patient data
Rationale: Assessment is the first step of the nursing process. The nurse gathers subjective and
objective information before identifying nursing diagnoses, planning care, implementing
interventions, and evaluating outcomes.
2. Which patient should the nurse assess first?
,A. Patient requesting discharge instructions
B. Patient reporting new difficulty breathing
C. Patient requesting a blanket
D. Patient waiting for routine medication
Correct answer: B. Patient reporting new difficulty breathing
Rationale: New respiratory difficulty may indicate an immediate threat to airway or
oxygenation. Acute physiologic instability takes priority over routine requests.
3. What is the primary purpose of SBAR communication?
A. To replace documentation
B. To provide structured clinical communication
C. To eliminate interdisciplinary communication
D. To determine a patient's diagnosis
Correct answer: B. To provide structured clinical communication
Rationale: SBAR—Situation, Background, Assessment, Recommendation—organizes important
clinical information and helps reduce communication errors during handoffs and changes in
patient condition.
4. Which finding represents objective data?
A. “I feel dizzy.”
B. “My pain is severe.”
C. Blood pressure of 88/54 mm Hg
D. “I feel anxious.”
Correct answer: C. Blood pressure of 88/54 mm Hg
Rationale: Objective data are measurable or observable findings. Blood pressure is obtained
through direct measurement, whereas the other choices are subjective reports.
5. Which intervention is an example of primary prevention?
A. Rehabilitation after a stroke
B. Screening mammography
C. Immunization
D. Physical therapy after surgery
Correct answer: C. Immunization
Rationale: Primary prevention attempts to prevent disease before it occurs. Immunization
reduces the likelihood of developing specific infectious diseases.
6. Which action is most appropriate when a patient's condition suddenly deteriorates?
,A. Complete routine documentation first
B. Reassess the patient immediately
C. Wait for the next scheduled assessment
D. Ask another patient whether the symptoms are expected
Correct answer: B. Reassess the patient immediately
Rationale: A sudden change requires prompt assessment to determine severity, identify the
cause, and initiate appropriate interventions.
7. Which principle should guide prioritization of care?
A. Complete the easiest task first
B. Address life-threatening problems first
C. Treat patients according to admission time
D. Perform documentation before assessment
Correct answer: B. Address life-threatening problems first
Rationale: Nursing priorities generally begin with airway, breathing, circulation, and other
immediate threats to life or safety.
8. Which patient statement demonstrates effective teach-back?
A. “I listened to everything.”
B. “The nurse explained it clearly.”
C. “I can explain how I will take this medication at home.”
D. “My family will remember it for me.”
Correct answer: C. “I can explain how I will take this medication at home.”
Rationale: Teach-back asks the patient to explain information in their own words. It verifies
understanding rather than merely asking whether the patient understands.
9. What is the primary purpose of a medication reconciliation?
A. To increase the number of medications prescribed
B. To compare medication lists and identify discrepancies
C. To discontinue all home medications
D. To replace patient education
Correct answer: B. To compare medication lists and identify discrepancies
Rationale: Medication reconciliation compares current medications with newly prescribed
medications to identify omissions, duplications, interactions, or other discrepancies.
10. Which finding requires the most immediate nursing attention?
, A. Temperature of 37.1°C
B. Oxygen saturation of 86% with respiratory distress
C. Mild postoperative pain
D. Request for assistance with bathing
Correct answer: B. Oxygen saturation of 86% with respiratory distress
Rationale: Significant hypoxemia combined with respiratory distress represents an immediate
physiologic threat and requires prompt intervention.
11. What is the purpose of informed consent?
A. To allow the nurse to choose treatment
B. To ensure the patient receives sufficient information to make an informed decision
C. To transfer all legal responsibility to the nurse
D. To guarantee a successful procedure
Correct answer: B. To ensure the patient receives sufficient information to make an informed
decision
Rationale: Informed consent involves disclosure of relevant information and voluntary patient
authorization. The provider performing the procedure is responsible for explaining the procedure,
risks, benefits, and alternatives.
12. Which action promotes patient-centered care?
A. Using identical interventions for every patient
B. Incorporating the patient's preferences and goals
C. Avoiding family involvement in every situation
D. Making decisions without patient participation
Correct answer: B. Incorporating the patient's preferences and goals
Rationale: Patient-centered care respects individual preferences, values, cultural considerations,
and goals while maintaining safe evidence-based practice.
13. Which statement best describes evidence-based nursing practice?
A. Using tradition alone
B. Using the most recent opinion available
C. Integrating evidence, clinical expertise, and patient preferences
D. Following every intervention found online
Correct answer: C. Integrating evidence, clinical expertise, and patient preferences
Rationale: Evidence-based practice integrates best available evidence with clinical expertise and
the patient's values, preferences, and circumstances.
