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Foundations of Nursing Final Exam
Jersey College 2026 | Complete Study
Guide | Key Concepts & Topics | NCLEX
Fundamentals Review
Exam Structure:
Subject: Foundations of Nursing (Assessment, Fundamentals, Lifespan,
Pharmacology)
Source: Exam Preparation Material (Jersey College Nursing Program)
Format: Q & A with Rationales
1. Hypoxia
Correct Answer: deficiency in the amount of oxygen reaching the tissues
Rationale:
1. Hypoxia indicates inadequate tissue oxygenation, which can lead to
cellular damage.
2. It is a critical finding that requires immediate intervention (e.g.,
supplemental oxygen, airway management).
3. Nurses must recognize early signs like confusion, tachycardia,
cyanosis, and low pulse oximetry readings.
2. Auscultation
Correct Answer: to listen
Rationale:
1. Auscultation is a fundamental physical assessment skill using a
stethoscope.
2. It is used to assess heart, lung, and bowel sounds.
3. Proper technique requires a quiet environment and correct
placement of the stethoscope diaphragm or bell.
, 2|Page
3. Palpation
Correct Answer: an examination technique in which the examiner's hands
are used to feel the texture, size, consistency, and location of certain body
parts
Rationale:
1. Palpation provides tactile data about temperature, moisture, texture,
and tenderness.
2. It is used to assess pulses, edema, masses, and organ enlargement.
3. Light palpation precedes deep palpation to avoid causing pain or
discomfort.
4. Percussion
Correct Answer: tapping on a surface to determine the difference in the
density of the underlying structure
Rationale:
1. Percussion helps determine if an underlying area is filled with air,
fluid, or solid matter.
2. Different sounds (tympany, dullness, resonance) correspond to
different underlying tissues.
3. It is used to assess organ size, borders, and the presence of abnormal
fluid or air.
5. Piece of equipment is used to perform the Weber test and Rinne test
Correct Answer: Tuning Fork
Rationale:
1. A tuning fork is a simple instrument that vibrates at a specific
frequency.
2. In the Weber test, it assesses lateralization of sound (conductive vs.
sensorineural hearing loss).
3. In the Rinne test, it compares air conduction (AC) and bone
conduction (BC) of sound.
6. Weber's test and Rinne's test are performed in order to assess
Correct Answer: Sound Conduction (deafness)
Rationale:
1. These bedside tests screen for hearing deficits and differentiate
between types of hearing loss.
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2. Conductive hearing loss involves the outer/middle ear; sensorineural
involves the inner ear or auditory nerve.
3. Abnormal findings warrant referral for formal audiometric testing.
7. When assessing a "PT" eye, which instrument would the nurse use
to visualize the retina
Correct Answer: Ophthalmoscope
Rationale:
1. The ophthalmoscope allows visualization of the internal eye
structures, including the retina, optic disc, and blood vessels.
2. This assessment is part of a comprehensive neurological and sensory
exam.
3. Findings like papilledema (swollen optic disc) can indicate increased
intracranial pressure.
8. Ophthalmoscope
Correct Answer: instrument for examining the interior of the eye,
especially the retina
Rationale:
1. Mastery of the ophthalmoscope is essential for assessing diabetic
retinopathy, hypertension, and neurological conditions.
2. The exam is performed in a darkened room with the patient's pupil
dilated for best results.
3. Documentation includes observations of the optic disc, vessels,
macula, and any hemorrhages or exudates.
9. Percutaneous
Correct Answer: through the skin
Rationale:
1. This term describes routes of medication administration or
diagnostic procedures (e.g., percutaneous endoscopic gastrostomy -
PEG tube).
2. It implies a needle or catheter pierces the skin.
3. Aseptic technique is critical to prevent infection.
10. The nurse performs a comprehensive assessment of a newly
admitted client. What is the primary purpose of this admission
, 4|Page
assessment
Correct Answer: Identify baseline data
Rationale:
1. The initial assessment establishes a baseline against which all future
changes are measured.
2. It identifies immediate needs, risks, and priorities for care planning.
3. Comprehensive data includes physiological, psychological, social, and
spiritual dimensions.
11. Comprehensive assessment
Correct Answer: The comprehensive assessment is conducted when a
client first enters the health care setting to obtain baseline information that
can be used for comparison to later assessments.
Rationale:
1. This systematic head-to-toe assessment is a nursing responsibility.
2. It incorporates subjective (what the patient says) and objective (what
the nurse observes) data.
3. Findings guide the development of the patient's individualized care
plan.
12. When assessing the glossopharyngeal nerve, it is most important
for the nurse to implement which intervention
Correct Answer: The clients ability to swallow
Rationale:
1. Cranial Nerve IX (Glossopharyngeal) is responsible for the gag reflex
and swallowing.
2. Assessing swallow function is critical for patient safety, especially
before initiating oral intake.
3. Dysfunction increases the risk of aspiration pneumonia.
13. Cranial nerves
Correct Answer: 12 pairs of nerves that carry messages to and from the
brain
Rationale:
1. Cranial nerves originate from the brainstem and primarily serve the
head and neck.
Foundations of Nursing Final Exam
Jersey College 2026 | Complete Study
Guide | Key Concepts & Topics | NCLEX
Fundamentals Review
Exam Structure:
Subject: Foundations of Nursing (Assessment, Fundamentals, Lifespan,
Pharmacology)
Source: Exam Preparation Material (Jersey College Nursing Program)
Format: Q & A with Rationales
1. Hypoxia
Correct Answer: deficiency in the amount of oxygen reaching the tissues
Rationale:
1. Hypoxia indicates inadequate tissue oxygenation, which can lead to
cellular damage.
2. It is a critical finding that requires immediate intervention (e.g.,
supplemental oxygen, airway management).
3. Nurses must recognize early signs like confusion, tachycardia,
cyanosis, and low pulse oximetry readings.
2. Auscultation
Correct Answer: to listen
Rationale:
1. Auscultation is a fundamental physical assessment skill using a
stethoscope.
2. It is used to assess heart, lung, and bowel sounds.
3. Proper technique requires a quiet environment and correct
placement of the stethoscope diaphragm or bell.
, 2|Page
3. Palpation
Correct Answer: an examination technique in which the examiner's hands
are used to feel the texture, size, consistency, and location of certain body
parts
Rationale:
1. Palpation provides tactile data about temperature, moisture, texture,
and tenderness.
2. It is used to assess pulses, edema, masses, and organ enlargement.
3. Light palpation precedes deep palpation to avoid causing pain or
discomfort.
4. Percussion
Correct Answer: tapping on a surface to determine the difference in the
density of the underlying structure
Rationale:
1. Percussion helps determine if an underlying area is filled with air,
fluid, or solid matter.
2. Different sounds (tympany, dullness, resonance) correspond to
different underlying tissues.
3. It is used to assess organ size, borders, and the presence of abnormal
fluid or air.
5. Piece of equipment is used to perform the Weber test and Rinne test
Correct Answer: Tuning Fork
Rationale:
1. A tuning fork is a simple instrument that vibrates at a specific
frequency.
2. In the Weber test, it assesses lateralization of sound (conductive vs.
sensorineural hearing loss).
3. In the Rinne test, it compares air conduction (AC) and bone
conduction (BC) of sound.
6. Weber's test and Rinne's test are performed in order to assess
Correct Answer: Sound Conduction (deafness)
Rationale:
1. These bedside tests screen for hearing deficits and differentiate
between types of hearing loss.
, 3|Page
2. Conductive hearing loss involves the outer/middle ear; sensorineural
involves the inner ear or auditory nerve.
3. Abnormal findings warrant referral for formal audiometric testing.
7. When assessing a "PT" eye, which instrument would the nurse use
to visualize the retina
Correct Answer: Ophthalmoscope
Rationale:
1. The ophthalmoscope allows visualization of the internal eye
structures, including the retina, optic disc, and blood vessels.
2. This assessment is part of a comprehensive neurological and sensory
exam.
3. Findings like papilledema (swollen optic disc) can indicate increased
intracranial pressure.
8. Ophthalmoscope
Correct Answer: instrument for examining the interior of the eye,
especially the retina
Rationale:
1. Mastery of the ophthalmoscope is essential for assessing diabetic
retinopathy, hypertension, and neurological conditions.
2. The exam is performed in a darkened room with the patient's pupil
dilated for best results.
3. Documentation includes observations of the optic disc, vessels,
macula, and any hemorrhages or exudates.
9. Percutaneous
Correct Answer: through the skin
Rationale:
1. This term describes routes of medication administration or
diagnostic procedures (e.g., percutaneous endoscopic gastrostomy -
PEG tube).
2. It implies a needle or catheter pierces the skin.
3. Aseptic technique is critical to prevent infection.
10. The nurse performs a comprehensive assessment of a newly
admitted client. What is the primary purpose of this admission
, 4|Page
assessment
Correct Answer: Identify baseline data
Rationale:
1. The initial assessment establishes a baseline against which all future
changes are measured.
2. It identifies immediate needs, risks, and priorities for care planning.
3. Comprehensive data includes physiological, psychological, social, and
spiritual dimensions.
11. Comprehensive assessment
Correct Answer: The comprehensive assessment is conducted when a
client first enters the health care setting to obtain baseline information that
can be used for comparison to later assessments.
Rationale:
1. This systematic head-to-toe assessment is a nursing responsibility.
2. It incorporates subjective (what the patient says) and objective (what
the nurse observes) data.
3. Findings guide the development of the patient's individualized care
plan.
12. When assessing the glossopharyngeal nerve, it is most important
for the nurse to implement which intervention
Correct Answer: The clients ability to swallow
Rationale:
1. Cranial Nerve IX (Glossopharyngeal) is responsible for the gag reflex
and swallowing.
2. Assessing swallow function is critical for patient safety, especially
before initiating oral intake.
3. Dysfunction increases the risk of aspiration pneumonia.
13. Cranial nerves
Correct Answer: 12 pairs of nerves that carry messages to and from the
brain
Rationale:
1. Cranial nerves originate from the brainstem and primarily serve the
head and neck.
