NU 180 Nursing and Healthcare II exam verified with correct answers and
rationales/instant pdf 2026/2027 version
1. Which action should the nurse perform before any patient contact?
A. Administer medications
B. Perform hand hygiene
C. Review laboratory results
D. Assess pain
Correct Answer: B
Rationale: Hand hygiene is the most effective way to prevent the spread of
healthcare-associated infections.
2. Which patient should the nurse assess first?
A. Patient with oxygen saturation of 84% on room air
B. Patient requesting a blanket
C. Patient waiting for discharge instructions
D. Patient requesting lunch
Correct Answer: A
Rationale: Airway and breathing take priority. An oxygen saturation of 84%
indicates significant hypoxemia requiring immediate intervention.
3. Which nursing process step involves collecting patient information?
A. Assessment
B. Planning
C. Implementation
D. Evaluation
Correct Answer: A
,Rationale: Assessment is the systematic collection of subjective and objective
patient data.
4. Which vital sign should concern the nurse the most?
A. Respiratory rate of 8 breaths/minute
B. Temperature 37°C (98.6°F)
C. Pulse 78 beats/minute
D. Blood pressure 122/76 mmHg
Correct Answer: A
Rationale: A respiratory rate of 8 breaths/minute indicates respiratory depression
and requires immediate intervention.
5. Which action best prevents falls in hospitalized patients?
A. Keep the bed in the lowest position and ensure the call light is within reach.
B. Raise all four side rails routinely.
C. Leave the floor wet after cleaning.
D. Encourage patients to walk without assistance when weak.
Correct Answer: A
Rationale: Keeping the bed low and ensuring access to the call light are evidence-
based fall prevention measures.
6. Which route of medication administration provides the fastest systemic
effect?
A. Intravenous (IV)
B. Oral
C. Intramuscular
D. Subcutaneous
Correct Answer: A
,Rationale: IV medications enter the bloodstream immediately, producing the
fastest onset of action.
7. Before administering medication, the nurse should verify:
A. Two approved patient identifiers
B. Room number only
C. Patient diagnosis only
D. Physician's specialty
Correct Answer: A
Rationale: Using two approved patient identifiers reduces medication
administration errors.
8. Which symptom is most consistent with hypoglycemia?
A. Sweating, tremors, and confusion
B. Dry mouth and excessive thirst only
C. Polyuria only
D. Warm, dry skin
Correct Answer: A
Rationale: Hypoglycemia stimulates the sympathetic nervous system, causing
sweating, shakiness, and confusion.
9. Which intervention is appropriate for a conscious patient with
hypoglycemia?
A. Give 15 grams of fast-acting carbohydrate
B. Administer insulin
C. Restrict food intake
D. Encourage exercise
Correct Answer: A
, Rationale: The "15-15 Rule" recommends 15 g of carbohydrate followed by
reassessment after 15 minutes.
10. Which patient is most at risk for pressure injuries?
A. Immobile older adult with poor nutrition
B. Healthy young adult
C. Patient with seasonal allergies
D. Patient with a healed incision
Correct Answer: A
Rationale: Immobility, advanced age, and malnutrition increase pressure injury
risk.
11. Which intervention best prevents pressure injuries?
A. Reposition the patient at least every two hours (or as clinically appropriate)
B. Massage reddened skin
C. Limit fluid intake
D. Keep the patient in one position
Correct Answer: A
Rationale: Regular repositioning reduces prolonged pressure and improves tissue
perfusion.
12. Which finding indicates dehydration?
A. Dry mucous membranes and poor skin turgor
B. Peripheral edema
C. Pulmonary crackles
D. Weight gain
Correct Answer: A
rationales/instant pdf 2026/2027 version
1. Which action should the nurse perform before any patient contact?
A. Administer medications
B. Perform hand hygiene
C. Review laboratory results
D. Assess pain
Correct Answer: B
Rationale: Hand hygiene is the most effective way to prevent the spread of
healthcare-associated infections.
2. Which patient should the nurse assess first?
A. Patient with oxygen saturation of 84% on room air
B. Patient requesting a blanket
C. Patient waiting for discharge instructions
D. Patient requesting lunch
Correct Answer: A
Rationale: Airway and breathing take priority. An oxygen saturation of 84%
indicates significant hypoxemia requiring immediate intervention.
3. Which nursing process step involves collecting patient information?
A. Assessment
B. Planning
C. Implementation
D. Evaluation
Correct Answer: A
,Rationale: Assessment is the systematic collection of subjective and objective
patient data.
4. Which vital sign should concern the nurse the most?
A. Respiratory rate of 8 breaths/minute
B. Temperature 37°C (98.6°F)
C. Pulse 78 beats/minute
D. Blood pressure 122/76 mmHg
Correct Answer: A
Rationale: A respiratory rate of 8 breaths/minute indicates respiratory depression
and requires immediate intervention.
5. Which action best prevents falls in hospitalized patients?
A. Keep the bed in the lowest position and ensure the call light is within reach.
B. Raise all four side rails routinely.
C. Leave the floor wet after cleaning.
D. Encourage patients to walk without assistance when weak.
Correct Answer: A
Rationale: Keeping the bed low and ensuring access to the call light are evidence-
based fall prevention measures.
6. Which route of medication administration provides the fastest systemic
effect?
A. Intravenous (IV)
B. Oral
C. Intramuscular
D. Subcutaneous
Correct Answer: A
,Rationale: IV medications enter the bloodstream immediately, producing the
fastest onset of action.
7. Before administering medication, the nurse should verify:
A. Two approved patient identifiers
B. Room number only
C. Patient diagnosis only
D. Physician's specialty
Correct Answer: A
Rationale: Using two approved patient identifiers reduces medication
administration errors.
8. Which symptom is most consistent with hypoglycemia?
A. Sweating, tremors, and confusion
B. Dry mouth and excessive thirst only
C. Polyuria only
D. Warm, dry skin
Correct Answer: A
Rationale: Hypoglycemia stimulates the sympathetic nervous system, causing
sweating, shakiness, and confusion.
9. Which intervention is appropriate for a conscious patient with
hypoglycemia?
A. Give 15 grams of fast-acting carbohydrate
B. Administer insulin
C. Restrict food intake
D. Encourage exercise
Correct Answer: A
, Rationale: The "15-15 Rule" recommends 15 g of carbohydrate followed by
reassessment after 15 minutes.
10. Which patient is most at risk for pressure injuries?
A. Immobile older adult with poor nutrition
B. Healthy young adult
C. Patient with seasonal allergies
D. Patient with a healed incision
Correct Answer: A
Rationale: Immobility, advanced age, and malnutrition increase pressure injury
risk.
11. Which intervention best prevents pressure injuries?
A. Reposition the patient at least every two hours (or as clinically appropriate)
B. Massage reddened skin
C. Limit fluid intake
D. Keep the patient in one position
Correct Answer: A
Rationale: Regular repositioning reduces prolonged pressure and improves tissue
perfusion.
12. Which finding indicates dehydration?
A. Dry mucous membranes and poor skin turgor
B. Peripheral edema
C. Pulmonary crackles
D. Weight gain
Correct Answer: A
