Nursing Fundamentals Comprehensive Final Exam at Fox Valley Technical College
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Free Nursing Fundamentals Comprehensive Final Exam at Fox Valley Technical College Questions
The client with COPD (chronic obstructive pulmonary disease) tells the nurse, "I can feel the congestion in my lungs, and I cough a lot but I can't seem to bring anything up as my secretions are so thick." Which of the following actions should the nurse take to help the client to be able to eliminate/expectorate the tenacious (thick) bronchial secretions?
- A Maintain a semi - Fowler's position as much as possible
- B Administering oxygen via nasal cannula at 2L per minute
- C Helping the client select a low-salt diet
- D Encouraging the client to drink eight to ten 8-ounce glasses of water a day
Explanation
The Correct Answer is: D. Encouraging the client to drink eight to ten 8-ounce glasses of water a day.
Increasing fluid intake is the most effective action to thin thick bronchial secretions, making them easier to expectorate. Adequate hydration decreases mucus viscosity, improves airway clearance, reduces coughing effort, and supports better ventilation in COPD clients. Fluids directly target the cause of the problem—thick mucus—allowing the client to cough more productively and improve overall respiratory function.
A client on your unit is deteriorating, but remains alert and oriented. Three days after admission, you notice he seems depressed. He tells you, "I'm tired of being sick. I wish I could end it all." What is the most accurate way to document or record this data?
- A Client states, "I'm tired of being sick. I wish I could end it all."
- B Complains he is tired of being ill and wants to die.
- C Does not want to live any longer because he is sick of being ill.
- D Appears to be depressed, possibly suicidal.
Explanation
The Correct Answer is: A. Client states, "I'm tired of being sick. I wish I could end it all."
This is the most accurate documentation because it uses the client's exact words without interpretation or modification. Objective charting requires verbatim quotes when a client expresses suicidal thoughts. Recording the statement precisely ensures that the healthcare team receives clear, factual, and legally sound information for immediate safety planning and intervention.
The nurse is educating a client with Chronic Obstructive Pulmonary Disease about safety precautions for using oxygen at home. The nurse knows that the client understands the safety principles discussed when he says the following:
- A "Smoking is permitted when oxygen is in use."
- B "Fire extinguishers do not need to be stored in the home."
- C "I should avoid materials that generate static electricity."
- D "Acetone, oil, and alcohol are appropriate substances to use while wearing oxygen."
Explanation
The Correct Answer is: C. "I should avoid materials that generate static electricity."
Static electricity can ignite oxygen, creating a dangerous fire risk. Avoiding static-producing fabrics and materials is a correct and safe oxygen-therapy practice. This response shows the client understands essential oxygen precautions, including avoiding sparks, preventing friction, and maintaining a fire-safe environment. Oxygen supports combustion, so reducing ignition sources is critical for home safety.
Which of the following are effects of immobility on the body?
- A A sense of well-being, increased muscle strength, increased metabolic rate, and increased appetite.
- B Disuse osteoporosis, increased size and strength of muscles, diminished cardiac reserve, and increased metabolic rate.
- C Improved the appetite, increased the heart rate, decreased respiratory movement, and decreased metabolic rate.
- D Urinary stasis, anorexia, stiffness of the joints, and venous vasodilation and stasis.
Explanation
The Correct Answer is: D. Urinary stasis, anorexia, stiffness of the joints, and venous vasodilation and stasis.
These findings accurately describe the harmful physiological effects of immobility. When a client is immobile, urine does not drain effectively (urinary stasis), increasing infection risk. Appetite often decreases (anorexia). Joints stiffen due to lack of movement, and blood pools in the veins, leading to venous stasis and higher risk of deep-vein thrombosis. These are classic negative consequences of prolonged inactivity.
You are caring for an elderly patient that has fallen at home and has a fractured hip. The patient is oriented to person, place, and time. Which risk factors place this patient at risk for developing a pressure injury while hospitalized? (Select all that apply – you will choose 2 of the 4 options.)
- A Increase in pain sensation due to fall
- B Impaired mobility
- C Forces from friction and shear
- D Alteration in level of consciousness
Explanation
The Correct Answers are:
B. Impaired mobility
C. Forces from friction and shear
Explanation
B. Impaired mobility
A fractured hip significantly limits movement. When a client cannot reposition independently, pressure remains on bony prominences for prolonged periods, leading to tissue ischemia and breakdown. Elderly clients are at especially high risk due to decreased muscle mass, thinner skin, and reduced circulation. Impaired mobility is one of the strongest predictors of pressure injury development in hospitalized patients.
C. Forces from friction and shear
Friction and shear occur when the client is pulled up in bed or slides down in a semi-Fowler’s position. These forces damage superficial tissues and blood vessels, greatly increasing pressure injury risk. In a patient with limited mobility, these mechanical forces occur more frequently and with greater impact, making prevention essential.
Providing culturally competent and congruent care involves:
- A Following standards plans of care for all clients to treat all the same
- B Provides care the fits the values and standards of the health care system
- C Learning about the client's culture and values to provide care that fits with their values, life patterns and beliefs
- D Knowing that the way that the nurse has always delivered care is the best way for care to be given as this is the superior culture who knows best
Explanation
The Correct Answer is: C. Learning about the client's culture and values to provide care that fits with their values, life patterns and beliefs.
Culturally competent and congruent care requires understanding and respecting the client’s unique cultural background, beliefs, and daily practices. This involves active learning, open communication, and tailoring care to align with the client’s worldview. It ensures that care is patient-centered, reduces cultural conflict, and supports trust, safety, and effective therapeutic relationships. This approach honors diversity and improves quality of care.
The nurse is caring for a Native American who has had recent surgery. In the patient's culture, it is a sign of weakness to complain of pain. In the nurse's culture, people who are having pain ask for pain medicine. The nurse has assumed that the patient has not been having pain and does not need medication because he has not complained of pain. What is the nurse doing?
- A Practicing discrimination by not giving the patient pain medicine
- B Striving to provide culturally congruent care by allowing the patient to suffer
- C Operating from an emic worldview of the patient's cultural beliefs
- D Utilizing cultural imposition by not asking the patient about his pain
Explanation
The Correct Answer is: D. Utilizing cultural imposition by not asking the patient about his pain.
Cultural imposition occurs when a healthcare provider assumes their own cultural norms are the correct or universal ones, failing to consider that the patient’s cultural values may differ. By assuming the patient has no pain simply because he has not verbally expressed it, the nurse is imposing her own cultural expectations instead of assessing the patient directly. This results in inadequate care and potential suffering because the nurse is not acknowledging cultural differences in expressing pain.
A nurse educator on a medical–surgical unit is reviewing isolation procedures and PPE usage with a group of new nurses. Which of the following correctly identifies the type of precautions or isolation needed for each situation? SATA.
- A Administering an IM vaccine to a patient – Standard precautions
- B Transferring a patient with a seeping infected rash from a gurney to the bed – Contact precautions
- C Performing clean wound care to an almost fully healed wound – Standard precautions
- D Assisting a client with infectious diarrhea to the bathroom – Contact precautions
Explanation
The Correct Answers are:
A. Administering an IM vaccine to a patient – Standard precautions
B. Transferring a patient with a seeping infected rash from a gurney to the bed – Contact precautions
C. Performing clean wound care to an almost fully healed wound – Standard precautions
D. Assisting a client with infectious diarrhea to the bathroom – Contact precautions
Explanation
A. Administering an IM vaccine to a patient – Standard precautions
IM injections are covered by standard precautions because they involve minimal exposure to bloodborne pathogens. Hand hygiene and gloves are sufficient. No airborne, droplet, or contact risks are present, making standard precautions the correct and evidence-based choice.
B. Transferring a patient with a seeping infected rash from a gurney to the bed – Contact precautions
A draining, infected rash is considered a moist wound with a high risk of spreading organisms through direct or indirect contact. Gloves and gown are required. Contact precautions prevent transmission of organisms such as MRSA, VRE, and wound infections.
C. Performing clean wound care to an almost fully healed wound – Standard precautions
A nearly healed wound has minimal drainage and low infection risk. Standard precautions—hand hygiene and gloves—are adequate. No additional PPE or special isolation is required unless active drainage or organism-specific precautions are involved.
D. Assisting a client with infectious diarrhea to the bathroom – Contact precautions
Infectious diarrhea spreads via the fecal–oral route and contaminates surfaces easily. Contact precautions (gown and gloves) are required to prevent spread of pathogens including C. difficile, Norovirus, and Rotavirus. Standard precautions alone are not enough for infectious diarrhea.
Pain is a universal experience. Which of the following descriptions is most accurate related to pain and pain management?
- A Caregivers should attempt to delay the administration of pain medications to prevent drug dependence
- B Pain is always a sign a physiological problem exists.
- C Pain is highly subjective and is whatever the client states it is.
- D Verbal reports of pain are not sufficient cause for treatment.
Explanation
The Correct Answer is: C. Pain is highly subjective and is whatever the client states it is.
Pain is defined by the client, not by objective findings. It is a subjective experience influenced by physical, psychological, cultural, and emotional factors. Because only the client can truly feel their pain, their self-report is the most accurate and reliable indicator. Effective pain management begins with accepting and respecting what the client says about their pain experience.
Which of the following approaches is essential when delivering culturally sensitive care?
- A A nonjudgmental attitude.
- B Detailed and complete knowledge of the client's culture
- C Fluency in the client's native language
- D Technical skill competence
Explanation
The Correct Answer is: A. A nonjudgmental attitude.
A nonjudgmental attitude is essential because it allows the nurse to approach clients with openness, respect, and cultural humility. This attitude supports therapeutic communication, reduces bias, and creates an environment in which clients feel comfortable expressing their beliefs and needs. Cultural sensitivity does not require mastery of every culture—it requires respect, curiosity, and the willingness to understand each client without imposing assumptions.
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