NUR 104 MIDTERM EXAM
ACTUAL 2026/2027
TEST PAPER QUESTIONS AND FULL SOLUTIONS
50 Questions | 100% Verified
Foundations of Nursing
Verified | 2026/2027 Nursing Curriculum & NGN Standards
Next Generation NCLEX (NGN) | NCSBN Clinical Judgment Measurement Model
,Key Features
✓ Foundational nursing concepts and the nursing process (ADPIE)
✓ Comprehensive health assessment and physical examination techniques
✓ Basic pharmacology and safe medication administration principles
✓ Infection control, safety, and evidence-based patient care
✓ Professional communication, ethics, and legal responsibilities in nursing
Updates for 2026
1. Full integration of the NCSBN Clinical Judgment Measurement Model (CJMM) in
foundational case scenarios — The 2026 NUR 104 curriculum fully integrates the NCSBN
Clinical Judgment Measurement Model across all foundational case scenarios, requiring nursing
students to systematically recognize cues, analyze findings, prioritize hypotheses, generate
solutions, take action, and evaluate outcomes in every clinical situation, thereby aligning
foundational education with the Next Generation NCLEX competency framework.
2. Updated 2026 National Patient Safety Goals (NPSGs) for identifying patient
errors and fall prevention — The Joint Commission has updated its 2026 National Patient
Safety Goals with enhanced protocols for patient identification using two identifiers, medication
safety with look-alike and sound-alike drug differentiation, and revised fall prevention standards
incorporating the Morse Fall Scale, requiring nursing students to demonstrate competency in
applying these goals during fundamental clinical rotations.
3. New frameworks for addressing social determinants of health (SDOH) and health
equity during the initial nursing assessment — The 2026 foundational curriculum
introduces structured frameworks for screening and documenting social determinants of health,
including housing stability, food security, transportation access, and health literacy, requiring
nursing students to incorporate SDOH assessment into the comprehensive admission nursing
assessment to promote health equity and patient-centered care planning.
Abstract
This document presents a comprehensive 50-question actual midterm examination designed to
assess the foundational nursing competencies required for NUR 104, the introductory
foundations of nursing course, as defined by the 2026/2027 foundational nursing curriculum and
aligned with Next Generation NCLEX (NGN) standards. The questions are systematically
distributed across five core content domains: Nursing Process and Clinical Judgment (20%),
Health Assessment and Vital Signs (25%), Safety Infection Control and Ethics (25%), Basic
Pharmacology and Medication Safety (15%), and Professional Communication and
Documentation (15%). Each question is accompanied by a detailed rationale grounded in current
evidence-based standards for foundational nursing practice, a systematic explanation of why each
distractor is incorrect, and a specific reference to the 2026 NUR 104 course module, foundational
nursing textbook chapter (Potter and Perry, Jarvis), or current clinical guideline from which the
question is derived. The examination emphasizes the practical application of the nursing process
(ADPIE), the NCSBN Clinical Judgment Measurement Model (CJMM), and the integration of
theoretical knowledge, clinical reasoning, and basic psychomotor skills required for safe, patient-
centered care across diverse clinical settings and patient populations.
Keywords
NUR 104, Foundations of Nursing, Midterm Exam, Nursing Process, ADPIE, Health Assessment,
Infection Control, Patient Safety, Clinical Judgment, NGN
, Content Area Overview
Content Area Questions Key Topics Weight
Nursing Process & 1-10 ADPIE, CJMM, 20%
Clinical Judgment NANDA-I, SMART
goals, prioritization
Health Assessment & 11-22 Vital signs, exam 24%
Vital Signs techniques, APGAR,
GCS, pain scales
Safety, Infection 23-35 Chain of infection, 26%
Control & Ethics PPE, isolation, ethics,
HIPAA, restraints
Basic Pharmacology 36-43 10 Rights, dosage 16%
& Medication Safety calc, controlled
substances,
pharmacokinetics
Professional 44-50 Therapeutic 14%
Communication & communication,
Documentation SBAR, EHR, cultural
competence
Examination Questions
Domain: Nursing Process & Clinical Judgment
Q1. A nurse is caring for a newly admitted patient. Which step of the nursing
process involves establishing a database of patient information?
A. Diagnosis
B. Planning
C. Assessment
D. Implementation
Correct Answer: C. Assessment
Rationale: Assessment is the first step of the nursing process (ADPIE) and involves collecting,
organizing, validating, and documenting patient data to establish a comprehensive database.
This database forms the foundation for all subsequent steps, including diagnosis, planning,
implementation, and evaluation. Without accurate assessment data, the nurse cannot identify
appropriate nursing diagnoses or develop an effective care plan.
Why Wrong: Diagnosis involves analyzing assessment data to identify actual or potential health
problems, not establishing the database. Planning involves setting goals and selecting
interventions based on identified diagnoses, not data collection. Implementation involves
carrying out the planned interventions, not gathering baseline information.
Reference: Potter & Perry Fundamentals of Nursing, Chapter 5
Q2. According to the NCSBN Clinical Judgment Measurement Model (CJMM),
which action best represents 'recognizing cues'?
A. Determining which findings are most important
B. Comparing findings to expected reference ranges
C. Identifying relevant information from assessment data
D. Selecting interventions to address patient problems
Correct Answer: C. Identifying relevant information from assessment data
Rationale: Recognizing cues is the first layer of the NCSBN CJMM and involves identifying
relevant information from the patient's assessment data that requires attention. The nurse sifts
through available data to determine what is clinically significant to the patient's current
ACTUAL 2026/2027
TEST PAPER QUESTIONS AND FULL SOLUTIONS
50 Questions | 100% Verified
Foundations of Nursing
Verified | 2026/2027 Nursing Curriculum & NGN Standards
Next Generation NCLEX (NGN) | NCSBN Clinical Judgment Measurement Model
,Key Features
✓ Foundational nursing concepts and the nursing process (ADPIE)
✓ Comprehensive health assessment and physical examination techniques
✓ Basic pharmacology and safe medication administration principles
✓ Infection control, safety, and evidence-based patient care
✓ Professional communication, ethics, and legal responsibilities in nursing
Updates for 2026
1. Full integration of the NCSBN Clinical Judgment Measurement Model (CJMM) in
foundational case scenarios — The 2026 NUR 104 curriculum fully integrates the NCSBN
Clinical Judgment Measurement Model across all foundational case scenarios, requiring nursing
students to systematically recognize cues, analyze findings, prioritize hypotheses, generate
solutions, take action, and evaluate outcomes in every clinical situation, thereby aligning
foundational education with the Next Generation NCLEX competency framework.
2. Updated 2026 National Patient Safety Goals (NPSGs) for identifying patient
errors and fall prevention — The Joint Commission has updated its 2026 National Patient
Safety Goals with enhanced protocols for patient identification using two identifiers, medication
safety with look-alike and sound-alike drug differentiation, and revised fall prevention standards
incorporating the Morse Fall Scale, requiring nursing students to demonstrate competency in
applying these goals during fundamental clinical rotations.
3. New frameworks for addressing social determinants of health (SDOH) and health
equity during the initial nursing assessment — The 2026 foundational curriculum
introduces structured frameworks for screening and documenting social determinants of health,
including housing stability, food security, transportation access, and health literacy, requiring
nursing students to incorporate SDOH assessment into the comprehensive admission nursing
assessment to promote health equity and patient-centered care planning.
Abstract
This document presents a comprehensive 50-question actual midterm examination designed to
assess the foundational nursing competencies required for NUR 104, the introductory
foundations of nursing course, as defined by the 2026/2027 foundational nursing curriculum and
aligned with Next Generation NCLEX (NGN) standards. The questions are systematically
distributed across five core content domains: Nursing Process and Clinical Judgment (20%),
Health Assessment and Vital Signs (25%), Safety Infection Control and Ethics (25%), Basic
Pharmacology and Medication Safety (15%), and Professional Communication and
Documentation (15%). Each question is accompanied by a detailed rationale grounded in current
evidence-based standards for foundational nursing practice, a systematic explanation of why each
distractor is incorrect, and a specific reference to the 2026 NUR 104 course module, foundational
nursing textbook chapter (Potter and Perry, Jarvis), or current clinical guideline from which the
question is derived. The examination emphasizes the practical application of the nursing process
(ADPIE), the NCSBN Clinical Judgment Measurement Model (CJMM), and the integration of
theoretical knowledge, clinical reasoning, and basic psychomotor skills required for safe, patient-
centered care across diverse clinical settings and patient populations.
Keywords
NUR 104, Foundations of Nursing, Midterm Exam, Nursing Process, ADPIE, Health Assessment,
Infection Control, Patient Safety, Clinical Judgment, NGN
, Content Area Overview
Content Area Questions Key Topics Weight
Nursing Process & 1-10 ADPIE, CJMM, 20%
Clinical Judgment NANDA-I, SMART
goals, prioritization
Health Assessment & 11-22 Vital signs, exam 24%
Vital Signs techniques, APGAR,
GCS, pain scales
Safety, Infection 23-35 Chain of infection, 26%
Control & Ethics PPE, isolation, ethics,
HIPAA, restraints
Basic Pharmacology 36-43 10 Rights, dosage 16%
& Medication Safety calc, controlled
substances,
pharmacokinetics
Professional 44-50 Therapeutic 14%
Communication & communication,
Documentation SBAR, EHR, cultural
competence
Examination Questions
Domain: Nursing Process & Clinical Judgment
Q1. A nurse is caring for a newly admitted patient. Which step of the nursing
process involves establishing a database of patient information?
A. Diagnosis
B. Planning
C. Assessment
D. Implementation
Correct Answer: C. Assessment
Rationale: Assessment is the first step of the nursing process (ADPIE) and involves collecting,
organizing, validating, and documenting patient data to establish a comprehensive database.
This database forms the foundation for all subsequent steps, including diagnosis, planning,
implementation, and evaluation. Without accurate assessment data, the nurse cannot identify
appropriate nursing diagnoses or develop an effective care plan.
Why Wrong: Diagnosis involves analyzing assessment data to identify actual or potential health
problems, not establishing the database. Planning involves setting goals and selecting
interventions based on identified diagnoses, not data collection. Implementation involves
carrying out the planned interventions, not gathering baseline information.
Reference: Potter & Perry Fundamentals of Nursing, Chapter 5
Q2. According to the NCSBN Clinical Judgment Measurement Model (CJMM),
which action best represents 'recognizing cues'?
A. Determining which findings are most important
B. Comparing findings to expected reference ranges
C. Identifying relevant information from assessment data
D. Selecting interventions to address patient problems
Correct Answer: C. Identifying relevant information from assessment data
Rationale: Recognizing cues is the first layer of the NCSBN CJMM and involves identifying
relevant information from the patient's assessment data that requires attention. The nurse sifts
through available data to determine what is clinically significant to the patient's current
