NUR 320 Foundations of Nursing Exam #4 Summer 2025
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Free NUR 320 Foundations of Nursing Exam #4 Summer 2025 Questions
A nurse is preparing to administer a client’s medication. What is the nurse’s priority action to protect the client from a medication error?
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Checking the client's room number against the medication administration record.
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Reading medication labels at least 3 times before administering.
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Administering as many of the medications as possible at one time.
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Asking anxious family members to leave the room before giving a medication.
Explanation
1. When the medication is taken from storage,
2. When it is prepared, and
3. Before it is administered to the client.
Reading the label three times ensures the right medication, dose, route, and time are verified, reducing the risk of giving the wrong drug or dosage and promoting client safety.
A specific form of practice that is associated with a denomination, sect, or form of worship would be:
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Wellbeing
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Personality
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Spirituality
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Religion
Explanation
In healthcare, recognizing a client’s religious affiliation is important for providing culturally and spiritually competent care, such as honoring dietary restrictions, prayer rituals, or end-of-life practices.
The assistive personnel (AP) is caring for a dying client. Which action by the AP will cause the nurse to intervene?
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Keeping skin clean, dry, and moisturized.
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Elevating the head of the bed.
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Making the client eat.
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Assisting the client into a more comfortable position.
Explanation
Forcing or “making” a dying client eat is inappropriate and potentially harmful. As the body naturally begins to shut down, appetite and the ability to swallow decrease. Forcing food can cause choking, aspiration, or discomfort. End-of-life care focuses on comfort measures, respecting the client’s wishes, and relieving symptoms rather than promoting nutrition. The nurse should educate the AP that loss of appetite is a normal part of the dying process.
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.
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Teach the client to reposition while in bed every 2 hours.
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Insert an indwelling urinary catheter.
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Encourage the client to consume a diet rich in protein prior to being NPO for surgery.
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Administer an anti-diarrheal.
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Teach the client to use an incentive spirometer as often as they are able every hour.
Explanation
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.
The client appears to be very close to death. The nurse would anticipate which of the following physical symptoms to be associated with impending death? Select all that apply. One, some, or all options may be correct.
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Requests for a full meal
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Restlessness
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Non-labored breathing
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Confusion
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Cheyne-Stokes respirations
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Cool, mottled skin of the extremities
Explanation
In the active dying phase, declining cerebral perfusion, hypoxia, and metabolic derangements (e.g., hypercapnia, acidosis) commonly produce restlessness or terminal agitation. Patients may fidget, pull at linens, or attempt to get out of bed. Addressing reversible contributors—urinary retention, pain, hypoxia, or unmanaged symptoms—while providing calm reassurance and minimizing environmental stimuli are key nursing actions.
D. Confusion
Fluctuations in consciousness and cognition arise from reduced oxygen delivery to the brain, systemic inflammation, and organ failure–related toxin accumulation (e.g., uremia). Confusion, disorientation, and altered sleep–wake cycles are typical. Nursing care emphasizes frequent reorientation, low-stimulation surroundings, and family presence. Evaluate for treatable causes (pain, hypoglycemia, urinary retention), but prioritize comfort and safety.
E. Cheyne-Stokes respirations
This waxing–waning pattern with cycles of apnea followed by progressively deeper respirations reflects dysregulation of the respiratory center as CO₂ responsiveness changes near end of life. Episodes may persist or lengthen as death approaches. Interventions focus on comfort: positioning for ease of breathing, gentle mouth care, and, when appropriate, low-dose opioids or anxiolytics for dyspnea-related distress.
F. Cool, mottled skin of the extremities
Peripheral vasoconstriction and falling cardiac output shunt blood to vital organs, causing coolness, cyanosis, and mottling (livedo reticularis) in feet, hands, and knees. Capillary refill often prolongs. Nursing care includes warm, light blankets (avoid overheating), frequent skin checks, gentle repositioning for comfort, and protecting fragile skin from shear and pressure.
A client in critical condition is conscious, panicking, and questioning if they are going to survive. The MOST appropriate therapeutic response from the nurse would be:
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"I will call your physician NOW. There are medicines that can help you."
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"I understand you are anxious; I will stay right here by your side."
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"I promise you'll be fine. You're working with the best ER team in town."
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"You aren't going to die. I promise that everything is ok."
Explanation
This statement is therapeutic and supportive, acknowledging the client’s fear and providing emotional reassurance without giving false promises. By expressing understanding and a commitment to stay, the nurse conveys empathy, calm presence, and trust — essential for reducing anxiety in a panicking, critically ill client. This promotes psychological safety and emotional stability in a life-threatening situation.
A nurse on a busy step-down floor has finished the head-to-toe assessment on a client. The nurse is ready to perform medication administration and knows that documentation of medications happens when?
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You can delegate medication documentation if you are too busy.
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After the medication is administered.
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Whenever you get time to sit down and document.
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Within 2–4 hours of giving the medications.
Explanation
Medication documentation must occur immediately after administration to ensure accuracy, maintain patient safety, and comply with legal and institutional requirements. Recording medications before giving them is unsafe and unethical, while delaying documentation increases the risk of medication errors, duplication, or omissions. Accurate, timely documentation provides a clear record of care and supports continuity between providers, safeguarding both the nurse and the client.
A 22-year-old client was newly diagnosed with type 1 diabetes. The nurse will instruct the client to utilize the following methods to administer the subcutaneous insulin injection of 20 units NPH once daily.
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50-unit syringe, 25-gauge, 5/8 inch needle, administered at a 90-degree angle
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3 mL syringe, 18-gauge, 2-inch needle, administered at a 90-degree angle
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50-unit syringe, 20-gauge, 1.5-inch needle, administered at a 45-degree angle
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1 mL syringe, 25-gauge, 5/8 inch needle, administered at a 45-degree angle
Explanation
Insulin is administered subcutaneously using an insulin syringe specifically calibrated in units. For a 20-unit NPH dose, a 50-unit insulin syringe ensures accurate measurement. The recommended 25-gauge, 5/8 inch needle allows for comfortable subcutaneous delivery, and a 90-degree angle is appropriate for clients with adequate subcutaneous tissue. This technique ensures proper insulin absorption from the fatty tissue into the bloodstream for effective glucose control.
The nurse on a busy medical/surgical floor is providing client care. The nurse knows which syringe is the safest to use when pushing medication through an IV line?
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Tuberculin
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Leur-lock
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Insulin
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Non Leur-lock
Explanation
A Leur-lock syringe is the safest option for administering medications through an IV line because it features a secure, threaded connection between the syringe and the needle or IV tubing. This locking mechanism prevents accidental disconnection or medication leakage during administration, ensuring safety and accurate delivery of the prescribed dose into the intravenous system. Leur-lock syringes are the standard for IV medication administration in hospital settings.
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?
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"First draw up the NPH insulin; then draw up the regular insulin in the same syringe."
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"First draw up and administer the regular insulin, then draw up and administer the NPH insulin."
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"First draw up and administer the NPH insulin. Wait at least 15 minutes; then draw up and administer the regular insulin."
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"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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