Nursing A Concept Based Approach
to Learning
1. A nurse is caring for a patient with impaired gas exchange. Which assessment
finding would be most concerning?
A. Normal breath sounds and regular respiratory rate
B. O2 saturation level of 98% on room air
C. Labored breathing with accessory muscle use
D. Capillary refill of less than 2 seconds
Answer: C. Labored breathing with accessory muscle use
2. In understanding infection prevention, which of the following is the best method
to prevent the spread of infection?
A. Wearing gloves only when blood or bodily fluids are present
B. Using hand sanitizer after removing gloves
C. Changing gloves between patients, but not washing hands
D. Hand washing with soap and water
Answer: D. Hand washing with soap and water
3. Which of the following best describes the nurse’s role in patient-centered care?
A. Prioritizing physician orders
B. Maintaining a strict daily routine for each patient
C. Involving the patient in the decision-making process
D. Avoiding family involvement in patient care
Answer: C. Involving the patient in the decision-making process
4. When performing a pain assessment, which of the following is most important?
A. The patient’s self-report of pain intensity
B. Observing the patient’s vital signs
C. Noting the time of the last pain medication dose
D. Documenting the type of medication administered
Answer: A. The patient’s self-report of pain intensity
,5. Which intervention is most appropriate for a patient at risk of falling?
A. Keep bed in the high position with side rails up
B. Apply physical restraints when the patient is left alone
C. Ensure the call light is within reach at all times
D. Encourage the patient to ambulate without assistance
Answer: C. Ensure the call light is within reach at all times6. A nurse is reviewing the
medication list of a patient with hypertension. Which of the following medications
would the nurse question?
A. Lisinopril
B. Amlodipine
C. Metformin
D. Losartan
Answer: C. Metformin
(Metformin is primarily used for diabetes, not hypertension.)
7. During a shift handoff, a nurse reports a patient’s condition as “stable.” What does
this most likely mean?
A. The patient has no health concerns
B. The patient’s vital signs are within normal limits and consistent
C. The patient is ready for discharge
D. The patient has no need for further monitoring
Answer: B. The patient’s vital signs are within normal limits and consistent
8. Which of the following is the priority assessment for a patient who has recently
been diagnosed with diabetes mellitus?
A. Measuring capillary blood glucose
B. Inspecting the patient’s skin for wounds
C. Assessing the patient’s food preferences
D. Monitoring the patient’s intake and output
Answer: A. Measuring capillary blood glucose
,9. When a patient is experiencing shortness of breath, which is the most appropriate
initial nursing intervention?
A. Encourage the patient to ambulate to increase circulation
B. Place the patient in a high-Fowler’s position
C. Administer prescribed pain medication
D. Reduce fluid intake to prevent edema
Answer: B. Place the patient in a high-Fowler’s position
(This position helps improve lung expansion and ease breathing.)
10. Which type of isolation precaution is appropriate for a patient with active
tuberculosis?
A. Droplet precautions
B. Airborne precautions
C. Contact precautions
D. Standard precautions
Answer: B. Airborne precautions
11. A patient reports they have not had a bowel movement in 3 days. Which nursing
intervention would be most appropriate?
A. Encourage a diet low in fiber
B. Instruct the patient to increase water intake
C. Suggest bed rest to relieve discomfort
D. Decrease physical activity
Answer: B. Instruct the patient to increase water intake
12. When educating a patient on the prevention of pressure ulcers, the nurse should
emphasize which of the following?
A. Changing positions at least every two hours
B. Maintaining a low-protein diet
C. Keeping the skin dry by avoiding moisturizers
D. Limiting fluid intake to avoid skin breakdown
Answer: A. Changing positions at least every two hours
, 13. A nurse notes that a patient receiving IV fluids has developed crackles in the
lungs. Which action should the nurse take first?
A. Stop the IV fluids immediately
B. Reposition the patient to a lying flat position
C. Decrease the flow rate and assess the patient’s respiratory status
D. Notify the healthcare provider without further assessment
Answer: C. Decrease the flow rate and assess the patient’s respiratory status
14. When assessing a patient’s nutritional status, which of the following is most
indicative of protein deficiency?
A. Muscle wasting
B. Edema
C. Hyperglycemia
D. Tachycardia
Answer: A. Muscle wasting
15. Which principle of therapeutic communication should a nurse use when talking
with a patient about their feelings?
A. Giving advice based on the nurse’s opinion
B. Using closed-ended questions for quick responses
C. Asking open-ended questions to encourage sharing
D. Minimizing expressions of empathy to remain objective
Answer: C. Asking open-ended questions to encourage sharing16. Which of the
following would be the highest priority for a nurse when caring for a patient
experiencing acute pain?
A. Positioning the patient for comfort
B. Encouraging distraction techniques like watching TV
C. Administering prescribed pain medication
D. Documenting the pain level in the patient’s record
Answer: C. Administering prescribed pain medication
(Pain management is a priority to help alleviate the patient’s acute discomfort.)
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