NU 136 • FUNDAMENTALS OF NURSING • STUDY RESOURCE
NU 136 EXAM 4
STUDY GUIDE (2026/2027)
Fundamentals of Nursing • Questions, Answers & Rationales
47 ORIGINAL PRACTICE QUESTIONS
How to Use This Guide
Answer each question before reviewing the answer and rationale. Focus on safety, priority
setting, clinical judgment, and the reason each distractor is less appropriate. These are original
educational practice questions—
Course coverage can vary by institution and instructor. Compare this guide with your syllabus,
class notes, and assigned readings.
High-Yield Topic Map
• Priority setting and recognition of acute deterioration
• Respiratory emergencies, aspiration prevention, and oxygen safety
• Medication safety, opioid toxicity, and error response
• Seizure precautions, stroke recognition, and fall prevention
• Infection prevention, aseptic technique, and occupational exposure
• Pressure injuries, wound emergencies, and postoperative care
• IV complications, transfusion reactions, and fluid/electrolyte concerns
• Nutrition, elimination, specimen collection, and ostomy assessment
• Therapeutic communication, informed consent, autonomy, and documentation
• Delegation, scope of practice, and professional accountability
NU 136 Exam 4 Study Guide | Original practice material • 2026/2027
, NU 136 • FUNDAMENTALS OF NURSING • STUDY RESOURCE
Practice Questions
Question 1. A nurse receives report on four clients. Which client should be
assessed first?
A. A client reporting incisional pain of 6/10 one hour after surgery
B. A client with new stridor after extubation
C. A client requesting assistance to the bathroom
D. A client whose discharge papers need clarification
Correct Answer: B
Detailed Rationale: Stridor can indicate acute upper-airway obstruction. Airway
compromise takes priority over pain, routine assistance, or discharge teaching.
Why the Other Options Are Incorrect
A. Pain requires assessment and treatment, but airway compromise is more urgent.
C. Mobility assistance matters, but it is not the first priority over possible airway obstruction.
D. Clarification can wait until immediate threats are addressed.
Key Clinical Concept: Airway and breathing emergencies
Question 2. A postoperative client suddenly becomes restless, tachypneic,
and has an oxygen saturation of 86%. What should the nurse do first?
A. Document the findings
B. Apply oxygen and rapidly assess respiratory status
C. Offer oral fluids
D. Encourage the client to sleep
Correct Answer: B
Detailed Rationale: Hypoxemia with acute respiratory changes requires immediate
intervention and assessment; activate emergency support according to the client's
condition and facility protocol.
Why the Other Options Are Incorrect
NU 136 Exam 4 Study Guide | Original practice material • 2026/2027
, NU 136 • FUNDAMENTALS OF NURSING • STUDY RESOURCE
A. Documentation follows urgent assessment and intervention.
C. Oral fluids do not correct hypoxemia and may be unsafe if respiratory distress is severe.
D. Rest does not address the immediate oxygenation problem.
Key Clinical Concept: Recognizing deterioration
Question 3. A client reports sudden chest pain and shortness of breath after a
long period of immobility. Which complication is the priority concern?
A. Constipation
B. Pulmonary embolism
C. Urinary retention
D. Pressure injury
Correct Answer: B
Detailed Rationale: Sudden dyspnea and chest pain in an immobile client can indicate
pulmonary embolism, a life-threatening emergency requiring rapid assessment and
escalation.
Why the Other Options Are Incorrect
A. Constipation does not explain the acute cardiopulmonary symptoms.
C. Urinary retention is not the priority explanation for sudden chest pain and dyspnea.
D. Pressure injury is a risk of immobility but does not typically cause this acute presentation.
Key Clinical Concept: Clinical warning signs
Question 4. A nurse finds a client difficult to arouse after receiving an opioid.
Respirations are 7/min. What is the priority action?
A. Give the next scheduled dose
B. Stimulate the client, support breathing, and summon urgent assistance
C. Offer a snack
D. Reassess in one hour
NU 136 Exam 4 Study Guide | Original practice material • 2026/2027
, NU 136 • FUNDAMENTALS OF NURSING • STUDY RESOURCE
Correct Answer: B
Detailed Rationale: Marked respiratory depression after an opioid is an emergency. Support
airway and ventilation, summon help, and follow protocol for naloxone and monitoring.
Why the Other Options Are Incorrect
A. Additional opioid could worsen respiratory depression.
C. Food does not reverse opioid toxicity and may create aspiration risk.
D. Waiting an hour is unsafe.
Key Clinical Concept: Opioid safety
Question 5. A client with diabetes is sweaty, shaky, and confused. The bedside
glucose is 52 mg/dL; the client is awake and can swallow. What should the
nurse do?
A. Give a fast-acting carbohydrate per protocol
B. Administer scheduled insulin
C. Restrict all oral intake
D. Encourage exercise
Correct Answer: A
Detailed Rationale: A conscious client who can swallow should receive a rapid-acting
carbohydrate according to hypoglycemia protocol, followed by reassessment and
additional treatment as indicated.
Why the Other Options Are Incorrect
B. Insulin can worsen hypoglycemia.
C. Oral intake is appropriate when the client is alert and can swallow safely.
D. Exercise can lower glucose further.
Key Clinical Concept: Hypoglycemia response
NU 136 Exam 4 Study Guide | Original practice material • 2026/2027
NU 136 EXAM 4
STUDY GUIDE (2026/2027)
Fundamentals of Nursing • Questions, Answers & Rationales
47 ORIGINAL PRACTICE QUESTIONS
How to Use This Guide
Answer each question before reviewing the answer and rationale. Focus on safety, priority
setting, clinical judgment, and the reason each distractor is less appropriate. These are original
educational practice questions—
Course coverage can vary by institution and instructor. Compare this guide with your syllabus,
class notes, and assigned readings.
High-Yield Topic Map
• Priority setting and recognition of acute deterioration
• Respiratory emergencies, aspiration prevention, and oxygen safety
• Medication safety, opioid toxicity, and error response
• Seizure precautions, stroke recognition, and fall prevention
• Infection prevention, aseptic technique, and occupational exposure
• Pressure injuries, wound emergencies, and postoperative care
• IV complications, transfusion reactions, and fluid/electrolyte concerns
• Nutrition, elimination, specimen collection, and ostomy assessment
• Therapeutic communication, informed consent, autonomy, and documentation
• Delegation, scope of practice, and professional accountability
NU 136 Exam 4 Study Guide | Original practice material • 2026/2027
, NU 136 • FUNDAMENTALS OF NURSING • STUDY RESOURCE
Practice Questions
Question 1. A nurse receives report on four clients. Which client should be
assessed first?
A. A client reporting incisional pain of 6/10 one hour after surgery
B. A client with new stridor after extubation
C. A client requesting assistance to the bathroom
D. A client whose discharge papers need clarification
Correct Answer: B
Detailed Rationale: Stridor can indicate acute upper-airway obstruction. Airway
compromise takes priority over pain, routine assistance, or discharge teaching.
Why the Other Options Are Incorrect
A. Pain requires assessment and treatment, but airway compromise is more urgent.
C. Mobility assistance matters, but it is not the first priority over possible airway obstruction.
D. Clarification can wait until immediate threats are addressed.
Key Clinical Concept: Airway and breathing emergencies
Question 2. A postoperative client suddenly becomes restless, tachypneic,
and has an oxygen saturation of 86%. What should the nurse do first?
A. Document the findings
B. Apply oxygen and rapidly assess respiratory status
C. Offer oral fluids
D. Encourage the client to sleep
Correct Answer: B
Detailed Rationale: Hypoxemia with acute respiratory changes requires immediate
intervention and assessment; activate emergency support according to the client's
condition and facility protocol.
Why the Other Options Are Incorrect
NU 136 Exam 4 Study Guide | Original practice material • 2026/2027
, NU 136 • FUNDAMENTALS OF NURSING • STUDY RESOURCE
A. Documentation follows urgent assessment and intervention.
C. Oral fluids do not correct hypoxemia and may be unsafe if respiratory distress is severe.
D. Rest does not address the immediate oxygenation problem.
Key Clinical Concept: Recognizing deterioration
Question 3. A client reports sudden chest pain and shortness of breath after a
long period of immobility. Which complication is the priority concern?
A. Constipation
B. Pulmonary embolism
C. Urinary retention
D. Pressure injury
Correct Answer: B
Detailed Rationale: Sudden dyspnea and chest pain in an immobile client can indicate
pulmonary embolism, a life-threatening emergency requiring rapid assessment and
escalation.
Why the Other Options Are Incorrect
A. Constipation does not explain the acute cardiopulmonary symptoms.
C. Urinary retention is not the priority explanation for sudden chest pain and dyspnea.
D. Pressure injury is a risk of immobility but does not typically cause this acute presentation.
Key Clinical Concept: Clinical warning signs
Question 4. A nurse finds a client difficult to arouse after receiving an opioid.
Respirations are 7/min. What is the priority action?
A. Give the next scheduled dose
B. Stimulate the client, support breathing, and summon urgent assistance
C. Offer a snack
D. Reassess in one hour
NU 136 Exam 4 Study Guide | Original practice material • 2026/2027
, NU 136 • FUNDAMENTALS OF NURSING • STUDY RESOURCE
Correct Answer: B
Detailed Rationale: Marked respiratory depression after an opioid is an emergency. Support
airway and ventilation, summon help, and follow protocol for naloxone and monitoring.
Why the Other Options Are Incorrect
A. Additional opioid could worsen respiratory depression.
C. Food does not reverse opioid toxicity and may create aspiration risk.
D. Waiting an hour is unsafe.
Key Clinical Concept: Opioid safety
Question 5. A client with diabetes is sweaty, shaky, and confused. The bedside
glucose is 52 mg/dL; the client is awake and can swallow. What should the
nurse do?
A. Give a fast-acting carbohydrate per protocol
B. Administer scheduled insulin
C. Restrict all oral intake
D. Encourage exercise
Correct Answer: A
Detailed Rationale: A conscious client who can swallow should receive a rapid-acting
carbohydrate according to hypoglycemia protocol, followed by reassessment and
additional treatment as indicated.
Why the Other Options Are Incorrect
B. Insulin can worsen hypoglycemia.
C. Oral intake is appropriate when the client is alert and can swallow safely.
D. Exercise can lower glucose further.
Key Clinical Concept: Hypoglycemia response
NU 136 Exam 4 Study Guide | Original practice material • 2026/2027
