NUR 320 Foundations of Nursing Exam #4 Summer 2025
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Free NUR 320 Foundations of Nursing Exam #4 Summer 2025 Questions
1. The nurse is preparing to administer 350 mg Acetaminophen PO every 6 hours PRN for mild pain. The nurse will ensure which order for the proper 6 rights of medication administration?
- right dose, right route, right medication, right indication, right time, right situation
- right day, right expiration date, right drug, right patient, right computer, right documentation
- right patient, right drug, right dose, right route, right time, right documentation
- right patient, right drug, right dose, right time, right hospital, right situation
Explanation
The six rights of medication administration ensure patient safety and prevent medication errors. They include:
1. Right patient – Verify identity using two identifiers (name and date of birth).
2. Right drug – Confirm the medication matches the provider’s order.
3. Right dose – Ensure the dosage is accurate and within safe limits.
4. Right route – Verify the correct method of administration (PO).
5. Right time – Administer at correct intervals (every 6 hours).
6. Right documentation – Record administration accurately and promptly after giving the medication.
These steps collectively safeguard against adverse drug events and uphold nursing accountability.
1. Right patient – Verify identity using two identifiers (name and date of birth).
2. Right drug – Confirm the medication matches the provider’s order.
3. Right dose – Ensure the dosage is accurate and within safe limits.
4. Right route – Verify the correct method of administration (PO).
5. Right time – Administer at correct intervals (every 6 hours).
6. Right documentation – Record administration accurately and promptly after giving the medication.
These steps collectively safeguard against adverse drug events and uphold nursing accountability.
2. A physician prescribes 3000 mL of D5W to be administered over 24 hours. A nurse determines that how many milliliters per hour will be administered to the client? (Round to the nearest whole number. Include units in your answer.)
- 100 mL/hr
- 115 mL/hr
- 125 mL/hr
- 150 mL/hr
Explanation
Formula and Calculation:
mL per hour=Total volume (mL) ÷ Total time (hr)
mL per hour=3000÷24
mL per hour=125 mL/hr
Final Answer:
The nurse should set the IV pump to 125 mL/hr.
mL per hour=Total volume (mL) ÷ Total time (hr)
mL per hour=3000÷24
mL per hour=125 mL/hr
Final Answer:
The nurse should set the IV pump to 125 mL/hr.
3. A client feels faint upon raising from the bed to walk to the bathroom and falls. After sitting on the floor for a few minutes, the client is helped to a standing position by the nurse. The client is able to walk to the bathroom and back to bed without further problems. After the client is safely back in bed, the nurse believes the client may have had an episode of orthostatic hypotension. How should the nurse assess for orthostatic hypotension?
- Measure the client's pulse only while the client is in the sitting and standing positions.
- Take the client's blood pressure when the client is in the lying and sitting positions.
- Measure the client's blood pressure while the client is in the lying and standing positions.
- Take the client's blood pressure while the client is in the lying, sitting, and standing positions.
Explanation
Orthostatic hypotension is assessed by measuring blood pressure and heart rate in three positions—lying, sitting, and standing. Readings are taken a few minutes apart to identify a drop in systolic pressure (≥20 mmHg) or diastolic pressure (≥10 mmHg) upon standing. This method accurately determines the body’s ability to regulate blood pressure with position changes and confirms orthostatic hypotension, which commonly causes dizziness or fainting upon standing.
4. There is a rectal suppository ordered for a client who hasn't had a bowel movement in 4 days. When gathering supplies for proper administration of a rectal suppository, what is important for the nurse to bring into the room?
- Rectal thermometer and probe covers.
- Sterile gloves and a yellow contact gown.
- A water soluble lubricant to administer the suppository.
- Multiple members of the team, including the UAP.
Explanation
A water-soluble lubricant is essential for the safe and comfortable administration of a rectal suppository. Lubrication minimizes friction, reduces trauma to rectal mucosa, and allows smooth insertion. Oil-based lubricants should not be used because they can affect medication absorption. Water-soluble lubricants dissolve easily and are safe for mucous membranes, ensuring proper placement and effectiveness of the suppository.
5. Nurse Note
0700 am:
An 87-year-old client is admitted to the ER with weakness and fatigue. The client has a history of type 1 diabetes, smoking, and coronary artery disease. The client is wheelchair-bound and states that they have a nurse visit them at home 3 times per day to help them get out of bed and assist with their medication.
0800 am:
The nurse completes a complete head-to-toe assessment and notes the following during the assessment of the integument. Non-blanchable redness and partial thickness tissue loss to the left heel.
Vital Signs
HR-95
SpAO2-98% room air
Blood glucose- 150
Pain - 0/10 on a scale of 0-10
Labs
WBC-27,000
Albumin- 12 g/L
H/H- 13.0/38
Based on the nurse’s note and the table provided, which Action To Take, Potential Condition, and Parameter to Monitor are correctly matched for this client’s current findings?
0700 am:
An 87-year-old client is admitted to the ER with weakness and fatigue. The client has a history of type 1 diabetes, smoking, and coronary artery disease. The client is wheelchair-bound and states that they have a nurse visit them at home 3 times per day to help them get out of bed and assist with their medication.
0800 am:
The nurse completes a complete head-to-toe assessment and notes the following during the assessment of the integument. Non-blanchable redness and partial thickness tissue loss to the left heel.
Vital Signs
HR-95
SpAO2-98% room air
Blood glucose- 150
Pain - 0/10 on a scale of 0-10
Labs
WBC-27,000
Albumin- 12 g/L
H/H- 13.0/38
Based on the nurse’s note and the table provided, which Action To Take, Potential Condition, and Parameter to Monitor are correctly matched for this client’s current findings?
- Position the client to remove pressure off of bony extremity – Atelectasis – Blood Glucose
- Call the healthcare provider – Blood clot – Oxygen saturation
- Massage any reddened areas on the client’s body – Pressure injury – WBC count
- Position the client to remove pressure off of bony extremity – Pressure injury – WBC count
Explanation
The client’s left heel shows non-blanchable redness and partial-thickness tissue loss, consistent with a pressure injury. The appropriate nursing action is to remove pressure from bony prominences to prevent further tissue breakdown. Monitoring the WBC count is essential because an elevated value (27,000) indicates a potential infection associated with the wound. Relieving pressure and closely observing for infection are the top nursing priorities in this scenario.
6. When caring for clients with pressure injuries, it is important to know what stage the wound is before wound care can begin. What two things prevent a pressure injury from being stageable and healing?
- Odor & Discharge
- Depth & Redness
- Size & Shape
- Eschar or Slough
Explanation
Eschar (dead, leathery tissue) and slough (yellow or white stringy tissue) prevent accurate staging and delay healing of a pressure injury. These tissues cover the wound bed, obscuring its depth and extent of damage. Until they are removed through debridement, the true stage cannot be determined, and healing cannot progress effectively because necrotic tissue impedes new cell growth and increases infection risk.
7. A client diagnosed with terminal cancer asks the nurse what the criteria is for hospice care. Which information should the nurse share with the client?
- It is for those expected to live less than 6 months.
- It is for those needing assistance with pain management.
- It is for those having a terminal illness, such as cancer.
- It is for those with completion of an advance directive.
Explanation
Hospice care is specifically designed for clients who have a life expectancy of 6 months or less as certified by a healthcare provider. The focus of hospice is on comfort, dignity, and quality of life rather than curative treatment. It provides comprehensive support for both the client and family through pain control, emotional support, and end-of-life care planning, aligning care goals with the client’s wishes and comfort.
8. An 87-year-old client suffered a fall while at home and sustained a right hip fracture. As the client awaits surgery, the healthcare provider (HCP) orders strict bedrest. To prevent complications of immobility, the nurse will complete the following interventions. Select all that apply. One, some, or all options may be correct.
- Teach the client to reposition while in bed every 2 hours.
- Insert an indwelling urinary catheter.
- Encourage the client to consume a diet rich in protein prior to being NPO for surgery.
- Administer an anti-diarrheal.
- Teach the client to use an incentive spirometer as often as they are able every hour.
Explanation
A. Teach the client to reposition while in bed every 2 hours.
Frequent repositioning prevents pressure injuries and promotes circulation in immobile clients. Turning every 2 hours reduces tissue ischemia, a major complication of immobility in bedbound elderly patients.
C. Encourage the client to consume a diet rich in protein prior to being NPO for surgery.
Protein promotes tissue repair and healing, strengthens muscles, and maintains immune function. A high-protein diet before surgery helps minimize muscle wasting and supports recovery after surgical repair.
E. Teach the client to use an incentive spirometer as often as they are able every hour.
Using an incentive spirometer helps prevent atelectasis and pneumonia by promoting lung expansion and improving oxygenation during immobility. It’s a key intervention to maintain respiratory function preoperatively.
Frequent repositioning prevents pressure injuries and promotes circulation in immobile clients. Turning every 2 hours reduces tissue ischemia, a major complication of immobility in bedbound elderly patients.
C. Encourage the client to consume a diet rich in protein prior to being NPO for surgery.
Protein promotes tissue repair and healing, strengthens muscles, and maintains immune function. A high-protein diet before surgery helps minimize muscle wasting and supports recovery after surgical repair.
E. Teach the client to use an incentive spirometer as often as they are able every hour.
Using an incentive spirometer helps prevent atelectasis and pneumonia by promoting lung expansion and improving oxygenation during immobility. It’s a key intervention to maintain respiratory function preoperatively.
9. At time of death, which of the following tasks cannot be delegated to the assistive personnel (AP)?
- Changing the bedding and client's gown.
- Asking the family about organ and tissue donation.
- Helping to wash and prepare the body.
- Performing oral care on a client's dentures.
Explanation
Discussing or asking about organ and tissue donation is a highly sensitive and legally regulated process that must be handled by the registered nurse (RN) or a designated healthcare professional trained in organ procurement procedures. It requires clinical judgment, emotional sensitivity, and adherence to hospital policies and state laws. This conversation involves ethical considerations and should never be delegated to assistive personnel.
10. A 14-year-old client was recently diagnosed with type 1 diabetes. The client is prescribed 10 units of regular insulin and 15 units of NPH insulin each morning. How should the nurse instruct this client to give themself the prescribed doses of insulin?
- "First draw up the NPH insulin; then draw up the regular insulin in the same syringe."
- "First draw up and administer the regular insulin, then draw up and administer the NPH insulin."
- "First draw up and administer the NPH insulin. Wait at least 15 minutes; then draw up and administer the regular insulin."
- "First draw up the regular insulin; then draw up the NPH insulin in the same syringe."
Explanation
When mixing insulins, regular (clear) insulin is always drawn up before NPH (cloudy) insulin to prevent contaminating the regular insulin vial with intermediate-acting insulin. The phrase “clear before cloudy” helps nurses and clients remember the correct sequence. This ensures accurate dosing and maintains insulin effectiveness. Both insulins can then be administered together in one injection, minimizing the number of injections needed.
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