NUR 104 Midterm Exam Excelsior College
2025/2026 | Complete Exam with 180 Questions &
Correct Answers
NUR 104 Nursing Fundamentals Midterm Exam | Key Concepts: Basic Nursing Care, Health
Assessment, Infection Control, Safety, Pharmacology Basics, Communication, Patient
Education, and Professional Standards | Expert-Verified Q&A | Clinical & Exam-Ready
Introduction
This 2025/2026 NUR 104 Midterm Exam resource for Excelsior College contains 180 fully
verified questions with 100% correct answers, aligned with the latest curriculum and clinical
guidelines as of September 2025. The content covers fundamental nursing knowledge, including
patient assessment, vital signs, infection prevention, medication administration basics,
therapeutic communication, safety protocols, and patient-centered care. Questions are based on
current standards from Fundamentals of Nursing: The Art and Science of Person-Centered
Care (Taylor et al., 2019, updated editions), CDC infection control guidelines, Joint Commission
safety standards, and other contemporary nursing references. All answers are graded A+ with
detailed rationales to ensure exam readiness and reinforce clinical reasoning for Excelsior
College’s NUR 104 Nursing Fundamentals course.
Answer Format
Correct answers are highlighted in bold and green, with rationales explaining nursing
priorities, safe and effective practice, and clinical reasoning skills for NUR 104 midterm exam
success.
NUR 104 Midterm Exam Questions (1–180)
1. What is the priority nursing action when a patient reports sudden chest
pain?
a) Administer pain medication immediately
b) Perform a focused cardiac assessment
c) Document the complaint without assessment
d) Take vital signs and wait for physician orders
b) Perform a focused cardiac assessment
Rationale: Sudden chest pain may indicate a life-threatening condition like myocardial
infarction. A focused cardiac assessment (e.g., auscultation, pain characteristics, ECG
preparation) is the priority to guide interventions, per 2025 American Heart Association
guidelines.
,2. Which hand hygiene technique is most effective for preventing
healthcare-associated infections?
a) Wash hands for 10 seconds with water only
b) Use alcohol-based hand rub for 20 seconds
c) Dry hands with a reusable cloth towel
d) Wash hands without scrubbing between fingers
b) Use alcohol-based hand rub for 20 seconds
Rationale: Alcohol-based hand rub for at least 20 seconds is most effective for reducing
pathogens in healthcare settings when hands are not visibly soiled, per 2025 CDC infection
control guidelines.
3. What is the correct method for measuring an adult patient’s oral
temperature?
a) Place the thermometer in the posterior sublingual pocket
b) Hold the thermometer under the tongue for 10 seconds
c) Take the temperature immediately after the patient drinks water
d) Use a tympanic thermometer for oral readings
a) Place the thermometer in the posterior sublingual pocket
Rationale: The thermometer should be placed in the posterior sublingual pocket for accurate
oral temperature measurement, and the patient should not have consumed food or drink for at
least 15 minutes, per Fundamentals of Nursing (2025 standards).
4. Which action best promotes patient safety during ambulation?
a) Allow the patient to walk independently without assessment
b) Use a gait belt and assess mobility status
c) Ambulate the patient without assistive devices
d) Ignore fall risk assessment
b) Use a gait belt and assess mobility status
Rationale: Using a gait belt and assessing mobility status (e.g., balance, strength) prevents falls,
aligning with 2025 Joint Commission patient safety goals.
5. What is the priority nursing diagnosis for a patient with impaired gas
exchange due to pneumonia?
a) Risk for infection
b) Ineffective breathing pattern
c) Activity intolerance
d) Acute pain
b) Ineffective breathing pattern
Rationale: Ineffective breathing pattern is the priority for pneumonia, as it directly addresses
impaired gas exchange, a life-threatening issue, per NANDA-I 2025 nursing diagnoses.
6. Which medication administration right ensures the correct drug is
given?
a) Right time
b) Right medication
,c) Right route
d) Right dose
b) Right medication
Rationale: The right medication ensures the correct drug is administered, verified by checking
the order and label, per 2025 medication safety standards.
7. What is the appropriate action when a patient refuses a prescribed
medication?
a) Force the patient to take the medication
b) Document the refusal and notify the provider
c) Administer the medication later without consent
d) Ignore the refusal and proceed with care
b) Document the refusal and notify the provider
Rationale: Respecting patient autonomy requires documenting medication refusal and notifying
the provider to address concerns, per 2025 ethical nursing standards.
8. Which technique is correct for applying a nasal cannula for oxygen
therapy?
a) Place prongs facing downward in the nares
b) Secure the tubing over the ears and under the chin
c) Set flow rate without checking physician orders
d) Use adhesive tape to secure prongs in the nose
b) Secure the tubing over the ears and under the chin
Rationale: Proper nasal cannula application involves placing prongs upward in the nares and
securing tubing over the ears and under the chin for comfort and stability, per 2025 respiratory
care guidelines.
9. What is the primary purpose of using standard precautions in patient
care?
a) Protect only the healthcare provider
b) Prevent transmission of infectious agents
c) Apply only to patients with known infections
d) Eliminate the need for hand hygiene
b) Prevent transmission of infectious agents
Rationale: Standard precautions are used for all patients to prevent transmission of infectious
agents, including hand hygiene and personal protective equipment, per 2025 CDC guidelines.
10. Which communication technique is most effective for a patient with
hearing impairment?
a) Speak loudly and quickly
b) Face the patient and speak clearly
c) Avoid eye contact during conversation
d) Use medical jargon to explain care
b) Face the patient and speak clearly
, Rationale: Facing the patient and speaking clearly facilitates lip-reading and understanding for
patients with hearing impairment, per 2025 therapeutic communication standards.
11. What is the correct position for a patient receiving a nasogastric tube
feeding?
a) Supine with head flat
b) Fowler’s position at 30–45 degrees
c) Prone position
d) Trendelenburg position
b) Fowler’s position at 30–45 degrees
Rationale: Fowler’s position at 30–45 degrees reduces the risk of aspiration during nasogastric
tube feeding, per 2025 enteral nutrition guidelines.
12. Which vital sign finding requires immediate nursing intervention?
a) Blood pressure of 120/80 mmHg
b) Pulse rate of 110 beats per minute
c) Respiratory rate of 16 breaths per minute
d) Temperature of 98.6°F (37°C)
b) Pulse rate of 110 beats per minute
Rationale: A pulse rate of 110 beats per minute indicates tachycardia, which may signal a
serious condition requiring immediate assessment and intervention, per 2025 vital sign
protocols.
13. What is the appropriate action when preparing to administer an
intramuscular injection?
a) Use a 25-gauge needle for all injections
b) Verify the medication and patient identity
c) Inject without aspirating the syringe
d) Administer in the same site repeatedly
b) Verify the medication and patient identity
Rationale: Verifying the medication and patient identity ensures safety and prevents errors, per
2025 medication administration standards.
14. What is a key principle of patient-centered care?
a) Ignore patient preferences
b) Incorporate patient values and preferences
c) Use provider-driven decisions only
d) Avoid family involvement
b) Incorporate patient values and preferences
Rationale: Patient-centered care emphasizes incorporating patient values and preferences to
promote individualized care, per 2025 nursing practice standards.
15. Which action is appropriate when caring for a patient with a urinary
catheter?
a) Keep the drainage bag above the bladder level
b) Secure the catheter to prevent pulling
2025/2026 | Complete Exam with 180 Questions &
Correct Answers
NUR 104 Nursing Fundamentals Midterm Exam | Key Concepts: Basic Nursing Care, Health
Assessment, Infection Control, Safety, Pharmacology Basics, Communication, Patient
Education, and Professional Standards | Expert-Verified Q&A | Clinical & Exam-Ready
Introduction
This 2025/2026 NUR 104 Midterm Exam resource for Excelsior College contains 180 fully
verified questions with 100% correct answers, aligned with the latest curriculum and clinical
guidelines as of September 2025. The content covers fundamental nursing knowledge, including
patient assessment, vital signs, infection prevention, medication administration basics,
therapeutic communication, safety protocols, and patient-centered care. Questions are based on
current standards from Fundamentals of Nursing: The Art and Science of Person-Centered
Care (Taylor et al., 2019, updated editions), CDC infection control guidelines, Joint Commission
safety standards, and other contemporary nursing references. All answers are graded A+ with
detailed rationales to ensure exam readiness and reinforce clinical reasoning for Excelsior
College’s NUR 104 Nursing Fundamentals course.
Answer Format
Correct answers are highlighted in bold and green, with rationales explaining nursing
priorities, safe and effective practice, and clinical reasoning skills for NUR 104 midterm exam
success.
NUR 104 Midterm Exam Questions (1–180)
1. What is the priority nursing action when a patient reports sudden chest
pain?
a) Administer pain medication immediately
b) Perform a focused cardiac assessment
c) Document the complaint without assessment
d) Take vital signs and wait for physician orders
b) Perform a focused cardiac assessment
Rationale: Sudden chest pain may indicate a life-threatening condition like myocardial
infarction. A focused cardiac assessment (e.g., auscultation, pain characteristics, ECG
preparation) is the priority to guide interventions, per 2025 American Heart Association
guidelines.
,2. Which hand hygiene technique is most effective for preventing
healthcare-associated infections?
a) Wash hands for 10 seconds with water only
b) Use alcohol-based hand rub for 20 seconds
c) Dry hands with a reusable cloth towel
d) Wash hands without scrubbing between fingers
b) Use alcohol-based hand rub for 20 seconds
Rationale: Alcohol-based hand rub for at least 20 seconds is most effective for reducing
pathogens in healthcare settings when hands are not visibly soiled, per 2025 CDC infection
control guidelines.
3. What is the correct method for measuring an adult patient’s oral
temperature?
a) Place the thermometer in the posterior sublingual pocket
b) Hold the thermometer under the tongue for 10 seconds
c) Take the temperature immediately after the patient drinks water
d) Use a tympanic thermometer for oral readings
a) Place the thermometer in the posterior sublingual pocket
Rationale: The thermometer should be placed in the posterior sublingual pocket for accurate
oral temperature measurement, and the patient should not have consumed food or drink for at
least 15 minutes, per Fundamentals of Nursing (2025 standards).
4. Which action best promotes patient safety during ambulation?
a) Allow the patient to walk independently without assessment
b) Use a gait belt and assess mobility status
c) Ambulate the patient without assistive devices
d) Ignore fall risk assessment
b) Use a gait belt and assess mobility status
Rationale: Using a gait belt and assessing mobility status (e.g., balance, strength) prevents falls,
aligning with 2025 Joint Commission patient safety goals.
5. What is the priority nursing diagnosis for a patient with impaired gas
exchange due to pneumonia?
a) Risk for infection
b) Ineffective breathing pattern
c) Activity intolerance
d) Acute pain
b) Ineffective breathing pattern
Rationale: Ineffective breathing pattern is the priority for pneumonia, as it directly addresses
impaired gas exchange, a life-threatening issue, per NANDA-I 2025 nursing diagnoses.
6. Which medication administration right ensures the correct drug is
given?
a) Right time
b) Right medication
,c) Right route
d) Right dose
b) Right medication
Rationale: The right medication ensures the correct drug is administered, verified by checking
the order and label, per 2025 medication safety standards.
7. What is the appropriate action when a patient refuses a prescribed
medication?
a) Force the patient to take the medication
b) Document the refusal and notify the provider
c) Administer the medication later without consent
d) Ignore the refusal and proceed with care
b) Document the refusal and notify the provider
Rationale: Respecting patient autonomy requires documenting medication refusal and notifying
the provider to address concerns, per 2025 ethical nursing standards.
8. Which technique is correct for applying a nasal cannula for oxygen
therapy?
a) Place prongs facing downward in the nares
b) Secure the tubing over the ears and under the chin
c) Set flow rate without checking physician orders
d) Use adhesive tape to secure prongs in the nose
b) Secure the tubing over the ears and under the chin
Rationale: Proper nasal cannula application involves placing prongs upward in the nares and
securing tubing over the ears and under the chin for comfort and stability, per 2025 respiratory
care guidelines.
9. What is the primary purpose of using standard precautions in patient
care?
a) Protect only the healthcare provider
b) Prevent transmission of infectious agents
c) Apply only to patients with known infections
d) Eliminate the need for hand hygiene
b) Prevent transmission of infectious agents
Rationale: Standard precautions are used for all patients to prevent transmission of infectious
agents, including hand hygiene and personal protective equipment, per 2025 CDC guidelines.
10. Which communication technique is most effective for a patient with
hearing impairment?
a) Speak loudly and quickly
b) Face the patient and speak clearly
c) Avoid eye contact during conversation
d) Use medical jargon to explain care
b) Face the patient and speak clearly
, Rationale: Facing the patient and speaking clearly facilitates lip-reading and understanding for
patients with hearing impairment, per 2025 therapeutic communication standards.
11. What is the correct position for a patient receiving a nasogastric tube
feeding?
a) Supine with head flat
b) Fowler’s position at 30–45 degrees
c) Prone position
d) Trendelenburg position
b) Fowler’s position at 30–45 degrees
Rationale: Fowler’s position at 30–45 degrees reduces the risk of aspiration during nasogastric
tube feeding, per 2025 enteral nutrition guidelines.
12. Which vital sign finding requires immediate nursing intervention?
a) Blood pressure of 120/80 mmHg
b) Pulse rate of 110 beats per minute
c) Respiratory rate of 16 breaths per minute
d) Temperature of 98.6°F (37°C)
b) Pulse rate of 110 beats per minute
Rationale: A pulse rate of 110 beats per minute indicates tachycardia, which may signal a
serious condition requiring immediate assessment and intervention, per 2025 vital sign
protocols.
13. What is the appropriate action when preparing to administer an
intramuscular injection?
a) Use a 25-gauge needle for all injections
b) Verify the medication and patient identity
c) Inject without aspirating the syringe
d) Administer in the same site repeatedly
b) Verify the medication and patient identity
Rationale: Verifying the medication and patient identity ensures safety and prevents errors, per
2025 medication administration standards.
14. What is a key principle of patient-centered care?
a) Ignore patient preferences
b) Incorporate patient values and preferences
c) Use provider-driven decisions only
d) Avoid family involvement
b) Incorporate patient values and preferences
Rationale: Patient-centered care emphasizes incorporating patient values and preferences to
promote individualized care, per 2025 nursing practice standards.
15. Which action is appropriate when caring for a patient with a urinary
catheter?
a) Keep the drainage bag above the bladder level
b) Secure the catheter to prevent pulling
