NSG 3130
Fundamental Concepts and Skills of Nursing II
Exam 1 — Latest Prep Guide
Galen College of Nursing • Edition
86 Questions and Correct Answers with Rationales
Comprehensive Coverage of NSG 3130 Exam 1 Course Objectives
Secti
Focus Questions
on
1 Advanced Nursing Process and Clinical Judgment (ADPIE) Q1 – Q15
2 Safety, Infection Control, and Medication Administration Q16 – Q30
3 Fluid, Electrolyte, and Acid-Base Balance Q31 – Q45
4 Perioperative and Wound Care Nursing Q46 – Q58
5 Oxygenation and Respiratory Care Q59 – Q70
6 Mobility, Immobility, and Body Mechanics Q71 – Q80
7 Comprehensive Clinical Case Scenarios Q81 – Q86
TOTAL 86 Questions
Cognitive Level Distribution: 25% Recall | 55% Application | 20% Analysis
,NSG 3130 — Fundamental Concepts and Skills of Nursing II — Exam 1 Galen College of Nursing
Question Style: 75% Scenario-Based | 25% Direct Recall / Calculation
Format: Multiple Choice, 4 Options (A–D), One Correct Answer
Page 2
,NSG 3130 — Fundamental Concepts and Skills of Nursing II — Exam 1 Galen College of Nursing
Section 1: Advanced Nursing Process and Clinical Judgment
Questions Q1 – Q15 • ADPIE, Clinical Reasoning, Prioritization, and Maslow's Hierarchy of Needs.
Q1: A nurse is caring for four clients. Using the nursing process, which client should the nurse assess first
based on the ABC (Airway, Breathing, Circulation) prioritization framework?
A. A client admitted 2 hours ago with a closed femur fracture reporting pain rated 8/10
B. A client with chronic obstructive pulmonary disease (COPD) experiencing new-onset
wheezing and an SpO2 of 88% on room air [CORRECT]
C. A client 1 day postoperative requesting assistance to ambulate to the bathroom
D. A client with diabetes mellitus scheduled to receive morning insulin with a breakfast tray present at
the bedside
Correct Answer: B — A client with chronic obstructive pulmonary disease (COPD) experiencing
new-o...
Rationale: The ABC prioritization framework identifies airway and breathing as the highest priority. The client
with COPD experiencing new-onset wheezing and an SpO2 of 88% has a compromised airway/breathing that
requires immediate assessment and intervention to prevent respiratory failure. Option A (pain) is important but
follows ABC. Option C (ambulation) is a safety priority but can wait. Option D (insulin with breakfast)
addresses circulation/metabolism but is not an immediate threat. The nursing process begins with assessment
to gather data before formulating interventions, and clinical judgment requires recognizing life-threatening
changes first.
Q2: A nurse is developing a plan of care for a client newly diagnosed with heart failure. Which step of the
nursing process (ADPIE) involves establishing measurable, client-centered outcomes?
A. Assessment
B. Diagnosis
C. Planning [CORRECT]
D. Implementation
Correct Answer: C — Planning
Rationale: The Planning step (P in ADPIE) involves setting measurable, client-centered goals and outcomes,
establishing priorities of care, and identifying specific nursing interventions. Assessment (option A) involves
gathering subjective and objective data. Diagnosis (option B) involves analyzing data to identify actual or
potential health problems. Implementation (option D) involves carrying out the planned interventions.
Evaluation (the E) involves measuring the client's progress toward outcomes. Goals should be SMART:
Specific, Measurable, Achievable, Relevant, and Time-bound, ensuring the plan guides individualized,
evidence-based care.
Q3: A nurse is caring for a client who is NPO after surgery and has an IV of D5LR infusing at 100 mL/hr.
The client reports incisional pain rated 7/10, has a urine output of 25 mL/hr, and is anxious about
recovery. Using Maslow's Hierarchy of Needs, which client need should the nurse address first?
A. The client's anxiety about recovery
B. The client's incisional pain rated 7/10
C. The client's urine output of 25 mL/hr [CORRECT]
Page 3
, NSG 3130 — Fundamental Concepts and Skills of Nursing II — Exam 1 Galen College of Nursing
D. The client's lack of oral intake (NPO status)
Correct Answer: C — The client's urine output of 25 mL/hr
Rationale: Maslow's Hierarchy prioritizes physiological needs first, followed by safety, love/belonging,
esteem, and self-actualization. A urine output of 25 mL/hr indicates possible decreased renal perfusion or
hypovolemia, which is a physiological threat requiring immediate assessment and intervention to prevent
acute kidney injury. Pain rated 7/10 (option B) is also a physiological need but is not immediately
life-threatening. NPO status (option D) is being addressed with IV fluids. Anxiety (option A) is a higher-level
need that should be addressed after physiological stability is ensured. Clinical judgment requires recognizing
that oliguria may signal hemodynamic instability.
Q4: A nurse is using clinical reasoning to interpret assessment findings for a client with pneumonia. The
client has a respiratory rate of 28/min, crackles in the right lower lobe, productive cough with yellow
sputum, and a temperature of 38.5°C (101.3°F). Which nursing diagnosis should be the highest priority?
A. Ineffective Airway Clearance related to retained secretions [CORRECT]
B. Hyperthermia related to infectious process
C. Acute Pain related to coughing and inflammation
D. Activity Intolerance related to impaired oxygen transport
Correct Answer: A — Ineffective Airway Clearance related to retained secretions
Rationale: Ineffective Airway Clearance is the highest priority because the client's increased respiratory rate
(28/min), crackles, and productive cough with yellow sputum indicate retained secretions that compromise
airway patency and gas exchange. The ABC framework prioritizes airway first. Hyperthermia (option B) and
pain (option C) are important but follow airway. Activity intolerance (option D) is a longer-term concern. The
nursing process requires the nurse to prioritize diagnoses that pose the greatest threat to the client's
physiological stability and to address airway clearance before other concerns.
Q5: A nurse receives a handoff report on four clients. Which client should the nurse see first based on the
acute vs. chronic prioritization framework?
A. A client with chronic back pain rated 6/10 for the past 3 months
B. A client with chronic hypertension whose blood pressure is 150/92 mmHg
C. A client with a new onset of confusion and restlessness [CORRECT]
D. A client with chronic osteoarthritis requesting PRN analgesic
Correct Answer: C — A client with a new onset of confusion and restlessness
Rationale: The acute vs. chronic framework prioritizes acute changes over chronic, stable conditions.
New-onset confusion and restlessness is an acute change that may indicate hypoxia, infection, medication
toxicity, or a neurological event, requiring immediate assessment. Chronic pain (option A), chronic
hypertension (option B), and chronic osteoarthritis (option D) are stable conditions that can wait. The nursing
process emphasizes that acute changes often signal clinical deterioration and require prompt evaluation.
Using SBAR for communication, the nurse would escalate concerns to the provider after gathering
assessment data.
Q6: A nurse is evaluating the effectiveness of a care plan for a client with impaired gas exchange. Which
finding best indicates that the goal has been met?
A. The client reports feeling less short of breath
B. The client's SpO2 is 95% on 2L oxygen via nasal cannula [CORRECT]
C. The client's respiratory rate is 22/min
Page 4
Fundamental Concepts and Skills of Nursing II
Exam 1 — Latest Prep Guide
Galen College of Nursing • Edition
86 Questions and Correct Answers with Rationales
Comprehensive Coverage of NSG 3130 Exam 1 Course Objectives
Secti
Focus Questions
on
1 Advanced Nursing Process and Clinical Judgment (ADPIE) Q1 – Q15
2 Safety, Infection Control, and Medication Administration Q16 – Q30
3 Fluid, Electrolyte, and Acid-Base Balance Q31 – Q45
4 Perioperative and Wound Care Nursing Q46 – Q58
5 Oxygenation and Respiratory Care Q59 – Q70
6 Mobility, Immobility, and Body Mechanics Q71 – Q80
7 Comprehensive Clinical Case Scenarios Q81 – Q86
TOTAL 86 Questions
Cognitive Level Distribution: 25% Recall | 55% Application | 20% Analysis
,NSG 3130 — Fundamental Concepts and Skills of Nursing II — Exam 1 Galen College of Nursing
Question Style: 75% Scenario-Based | 25% Direct Recall / Calculation
Format: Multiple Choice, 4 Options (A–D), One Correct Answer
Page 2
,NSG 3130 — Fundamental Concepts and Skills of Nursing II — Exam 1 Galen College of Nursing
Section 1: Advanced Nursing Process and Clinical Judgment
Questions Q1 – Q15 • ADPIE, Clinical Reasoning, Prioritization, and Maslow's Hierarchy of Needs.
Q1: A nurse is caring for four clients. Using the nursing process, which client should the nurse assess first
based on the ABC (Airway, Breathing, Circulation) prioritization framework?
A. A client admitted 2 hours ago with a closed femur fracture reporting pain rated 8/10
B. A client with chronic obstructive pulmonary disease (COPD) experiencing new-onset
wheezing and an SpO2 of 88% on room air [CORRECT]
C. A client 1 day postoperative requesting assistance to ambulate to the bathroom
D. A client with diabetes mellitus scheduled to receive morning insulin with a breakfast tray present at
the bedside
Correct Answer: B — A client with chronic obstructive pulmonary disease (COPD) experiencing
new-o...
Rationale: The ABC prioritization framework identifies airway and breathing as the highest priority. The client
with COPD experiencing new-onset wheezing and an SpO2 of 88% has a compromised airway/breathing that
requires immediate assessment and intervention to prevent respiratory failure. Option A (pain) is important but
follows ABC. Option C (ambulation) is a safety priority but can wait. Option D (insulin with breakfast)
addresses circulation/metabolism but is not an immediate threat. The nursing process begins with assessment
to gather data before formulating interventions, and clinical judgment requires recognizing life-threatening
changes first.
Q2: A nurse is developing a plan of care for a client newly diagnosed with heart failure. Which step of the
nursing process (ADPIE) involves establishing measurable, client-centered outcomes?
A. Assessment
B. Diagnosis
C. Planning [CORRECT]
D. Implementation
Correct Answer: C — Planning
Rationale: The Planning step (P in ADPIE) involves setting measurable, client-centered goals and outcomes,
establishing priorities of care, and identifying specific nursing interventions. Assessment (option A) involves
gathering subjective and objective data. Diagnosis (option B) involves analyzing data to identify actual or
potential health problems. Implementation (option D) involves carrying out the planned interventions.
Evaluation (the E) involves measuring the client's progress toward outcomes. Goals should be SMART:
Specific, Measurable, Achievable, Relevant, and Time-bound, ensuring the plan guides individualized,
evidence-based care.
Q3: A nurse is caring for a client who is NPO after surgery and has an IV of D5LR infusing at 100 mL/hr.
The client reports incisional pain rated 7/10, has a urine output of 25 mL/hr, and is anxious about
recovery. Using Maslow's Hierarchy of Needs, which client need should the nurse address first?
A. The client's anxiety about recovery
B. The client's incisional pain rated 7/10
C. The client's urine output of 25 mL/hr [CORRECT]
Page 3
, NSG 3130 — Fundamental Concepts and Skills of Nursing II — Exam 1 Galen College of Nursing
D. The client's lack of oral intake (NPO status)
Correct Answer: C — The client's urine output of 25 mL/hr
Rationale: Maslow's Hierarchy prioritizes physiological needs first, followed by safety, love/belonging,
esteem, and self-actualization. A urine output of 25 mL/hr indicates possible decreased renal perfusion or
hypovolemia, which is a physiological threat requiring immediate assessment and intervention to prevent
acute kidney injury. Pain rated 7/10 (option B) is also a physiological need but is not immediately
life-threatening. NPO status (option D) is being addressed with IV fluids. Anxiety (option A) is a higher-level
need that should be addressed after physiological stability is ensured. Clinical judgment requires recognizing
that oliguria may signal hemodynamic instability.
Q4: A nurse is using clinical reasoning to interpret assessment findings for a client with pneumonia. The
client has a respiratory rate of 28/min, crackles in the right lower lobe, productive cough with yellow
sputum, and a temperature of 38.5°C (101.3°F). Which nursing diagnosis should be the highest priority?
A. Ineffective Airway Clearance related to retained secretions [CORRECT]
B. Hyperthermia related to infectious process
C. Acute Pain related to coughing and inflammation
D. Activity Intolerance related to impaired oxygen transport
Correct Answer: A — Ineffective Airway Clearance related to retained secretions
Rationale: Ineffective Airway Clearance is the highest priority because the client's increased respiratory rate
(28/min), crackles, and productive cough with yellow sputum indicate retained secretions that compromise
airway patency and gas exchange. The ABC framework prioritizes airway first. Hyperthermia (option B) and
pain (option C) are important but follow airway. Activity intolerance (option D) is a longer-term concern. The
nursing process requires the nurse to prioritize diagnoses that pose the greatest threat to the client's
physiological stability and to address airway clearance before other concerns.
Q5: A nurse receives a handoff report on four clients. Which client should the nurse see first based on the
acute vs. chronic prioritization framework?
A. A client with chronic back pain rated 6/10 for the past 3 months
B. A client with chronic hypertension whose blood pressure is 150/92 mmHg
C. A client with a new onset of confusion and restlessness [CORRECT]
D. A client with chronic osteoarthritis requesting PRN analgesic
Correct Answer: C — A client with a new onset of confusion and restlessness
Rationale: The acute vs. chronic framework prioritizes acute changes over chronic, stable conditions.
New-onset confusion and restlessness is an acute change that may indicate hypoxia, infection, medication
toxicity, or a neurological event, requiring immediate assessment. Chronic pain (option A), chronic
hypertension (option B), and chronic osteoarthritis (option D) are stable conditions that can wait. The nursing
process emphasizes that acute changes often signal clinical deterioration and require prompt evaluation.
Using SBAR for communication, the nurse would escalate concerns to the provider after gathering
assessment data.
Q6: A nurse is evaluating the effectiveness of a care plan for a client with impaired gas exchange. Which
finding best indicates that the goal has been met?
A. The client reports feeling less short of breath
B. The client's SpO2 is 95% on 2L oxygen via nasal cannula [CORRECT]
C. The client's respiratory rate is 22/min
Page 4
