Nursing Fundamentals Comprehensive Final Exam
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Free Nursing Fundamentals Comprehensive Final Exam Questions
1.
The nurse is caring for a patient who does not speak English. The nurse is using an interpreter to explain procedures and to answer questions that the patient may have. In performing the education, what should the nurse do?
- A Direct questions to the interpreter to ask the patient
- B Leave the information with the interpreter and leave the room to allow uninterrupted communication
- C Look at the client when asking the questions
- D Ask the interpreter to summarize what was discussed after you leave the room, and tell the interpreter you will try to get back later in case there are questions
Explanation
Explanation
The Correct Answer is: C. Look at the client when asking the questions.
Looking directly at the client while speaking promotes respect, maintains therapeutic communication, and reinforces that the conversation is between the nurse and the patient—not the nurse and the interpreter. This preserves the nurse–patient relationship, encourages trust, and helps the client feel included despite the language barrier. The interpreter facilitates communication, but the nurse must engage directly with the patient.
The Correct Answer is: C. Look at the client when asking the questions.
Looking directly at the client while speaking promotes respect, maintains therapeutic communication, and reinforces that the conversation is between the nurse and the patient—not the nurse and the interpreter. This preserves the nurse–patient relationship, encourages trust, and helps the client feel included despite the language barrier. The interpreter facilitates communication, but the nurse must engage directly with the patient.
2.
Which aspect of restraint use can the nurse delegate to the nursing assistive personnel?
- A Assessing the client's status
- B Applying and removing the restraints
- C Evaluating the client's response to restraints
- D Determining the need for restraint
Explanation
Explanation
The Correct Answer is: B. Applying and removing the restraints.
Nursing assistive personnel may apply or remove restraints only after the nurse has completed the assessment, determined the need, obtained an order, and provided clear instructions. This task is considered a technical skill rather than a nursing judgment. Delegating application and removal supports workflow while maintaining safety, as the nurse continues to hold responsibility for monitoring, evaluating, and documenting the client’s condition.
The Correct Answer is: B. Applying and removing the restraints.
Nursing assistive personnel may apply or remove restraints only after the nurse has completed the assessment, determined the need, obtained an order, and provided clear instructions. This task is considered a technical skill rather than a nursing judgment. Delegating application and removal supports workflow while maintaining safety, as the nurse continues to hold responsibility for monitoring, evaluating, and documenting the client’s condition.
3.
A nurse is preparing a presentation on healthy nutrition for a group of adults. Which of the following would be correct to include: (Select all that apply – You will choose 4 of the 8 options)
- A "Carbohydrates should be your main source of energy as the body digests them more easily and quickly than proteins or lipids."
- B "You should try to eat about the same amount of carbohydrates, proteins and lipids in a day."
- C "If you are vegetarian, you will be getting plenty of complete proteins in your diet."
- D "Fiber helps prevent constipation, helps you feel full longer so prevents overeating and it can help prevent some condition like diverticulosis or diabetes ."
- E "Proteins help us move, build and repair body tissue, function in the immune system and act as enzymes."
- F "Protein is found in very few body tissues so you don't need to eat it every day."
- G "Lipids are needed in very limited amounts and all forms of them will cause heart disease so use care when eating them."
- H "Lipids are needed to absorb the fat-soluble vitamins, provide essential fatty acids, help us maintain our body temperature and help form some hormones."
Explanation
Explanation
The Correct Answers are:
A. "Carbohydrates should be your main source of energy as the body digests them more easily and quickly than proteins or lipids."
D. "Fiber helps prevent constipation, helps you feel full longer so prevents overeating and it can help prevent some condition like diverticulosis or diabetes."
E. "Proteins help us move, build and repair body tissue, function in the immune system and act as enzymes."
H. "Lipids are needed to absorb the fat-soluble vitamins, provide essential fatty acids, help us maintain our body temperature and help form some hormones."
A. "Carbohydrates should be your main source of energy as the body digests them more easily and quickly than proteins or lipids."
Carbohydrates are the body’s preferred energy source because they break down quickly into glucose. They fuel the brain, muscles, and organs and are more efficiently used for energy than proteins or fats. A healthy diet typically includes carbohydrates as the major energy-providing nutrient, ideally from high-fiber, whole-food sources. D. "Fiber helps prevent constipation, helps you feel full longer so prevents overeating and it can help prevent some condition like diverticulosis or diabetes."
Fiber adds bulk to stool to prevent constipation, helps stabilize blood sugar, and promotes satiety, reducing overeating. It also lowers cholesterol and reduces the risk of diverticulosis. Adequate fiber is a key component of a healthy diet and supports both digestive and metabolic health.
E. "Proteins help us move, build and repair body tissue, function in the immune system and act as enzymes."
Proteins are essential structural and functional molecules. They repair tissues, build muscle, form antibodies, create enzymes and hormones, and support immune functioning. Without daily protein intake, muscle loss, poor healing, and immune compromise may occur.
H. "Lipids are needed to absorb the fat-soluble vitamins, provide essential fatty acids, help us maintain our body temperature and help form some hormones."
Lipids are crucial for absorbing vitamins A, D, E, and K. They provide essential fatty acids that the body cannot produce, help regulate temperature by providing insulation, and form the basis of many hormones. Lipids support brain function, cell structure, and overall health when consumed in proper amounts.
The Correct Answers are:
A. "Carbohydrates should be your main source of energy as the body digests them more easily and quickly than proteins or lipids."
D. "Fiber helps prevent constipation, helps you feel full longer so prevents overeating and it can help prevent some condition like diverticulosis or diabetes."
E. "Proteins help us move, build and repair body tissue, function in the immune system and act as enzymes."
H. "Lipids are needed to absorb the fat-soluble vitamins, provide essential fatty acids, help us maintain our body temperature and help form some hormones."
A. "Carbohydrates should be your main source of energy as the body digests them more easily and quickly than proteins or lipids."
Carbohydrates are the body’s preferred energy source because they break down quickly into glucose. They fuel the brain, muscles, and organs and are more efficiently used for energy than proteins or fats. A healthy diet typically includes carbohydrates as the major energy-providing nutrient, ideally from high-fiber, whole-food sources. D. "Fiber helps prevent constipation, helps you feel full longer so prevents overeating and it can help prevent some condition like diverticulosis or diabetes."
Fiber adds bulk to stool to prevent constipation, helps stabilize blood sugar, and promotes satiety, reducing overeating. It also lowers cholesterol and reduces the risk of diverticulosis. Adequate fiber is a key component of a healthy diet and supports both digestive and metabolic health.
E. "Proteins help us move, build and repair body tissue, function in the immune system and act as enzymes."
Proteins are essential structural and functional molecules. They repair tissues, build muscle, form antibodies, create enzymes and hormones, and support immune functioning. Without daily protein intake, muscle loss, poor healing, and immune compromise may occur.
H. "Lipids are needed to absorb the fat-soluble vitamins, provide essential fatty acids, help us maintain our body temperature and help form some hormones."
Lipids are crucial for absorbing vitamins A, D, E, and K. They provide essential fatty acids that the body cannot produce, help regulate temperature by providing insulation, and form the basis of many hormones. Lipids support brain function, cell structure, and overall health when consumed in proper amounts.
4.
A client with a history of vitamin D deficiency who is complaining of palpitations, irritability, numbness and tingling in the hands, toes and lips, restlessness and confusion. The client has a positive Chvostek's sign. This client is most likely experiencing
- A Hypocalcemia
- B Hypernatremia
- C Hypokalemia
- D Hyperchloremia
Explanation
Explanation
The Correct Answer is: A. Hypocalcemia.
A positive Chvostek’s sign, combined with numbness, tingling, irritability, confusion, and neuromuscular excitability, is classic for hypocalcemia. Vitamin D deficiency further supports this diagnosis because Vitamin D is required for calcium absorption. Low calcium levels cause muscle spasms, paresthesias, and increased neuromuscular irritability, explaining the client’s symptoms. Hypocalcemia affects cardiac conduction as well, contributing to palpitations and neurological disturbances.
The Correct Answer is: A. Hypocalcemia.
A positive Chvostek’s sign, combined with numbness, tingling, irritability, confusion, and neuromuscular excitability, is classic for hypocalcemia. Vitamin D deficiency further supports this diagnosis because Vitamin D is required for calcium absorption. Low calcium levels cause muscle spasms, paresthesias, and increased neuromuscular irritability, explaining the client’s symptoms. Hypocalcemia affects cardiac conduction as well, contributing to palpitations and neurological disturbances.
5.
While all of the following clinical manifestations are important to report to the primary health care provider when they occur, which would be the most important to report:
- A Anuria
- B Dysuria
- C Polyuria
- D Nocturia
Explanation
Explanation
The Correct Answer is: A. Anuria.
Anuria—defined as producing less than 50 mL of urine in 24 hours—is a medical emergency. It may indicate acute kidney injury, severe dehydration, urinary obstruction, or shock. Immediate evaluation and intervention are required to prevent permanent kidney damage and life-threatening complications. Because it signals a failure of renal function, anuria is the most urgent condition to report.
The Correct Answer is: A. Anuria.
Anuria—defined as producing less than 50 mL of urine in 24 hours—is a medical emergency. It may indicate acute kidney injury, severe dehydration, urinary obstruction, or shock. Immediate evaluation and intervention are required to prevent permanent kidney damage and life-threatening complications. Because it signals a failure of renal function, anuria is the most urgent condition to report.
6.
The quality and risk nurse in the local hospital is performing a hospital survey on Never Events or Serious Reportable Events. Which of the following statements would the nurse use to best describe this type of event?
- A "It involves only events in the operating room area involving the use of unsafe equipment."
- B "It is an event that can cause serious injury or death to a client that should never happen in a hospital."
- C "It is an analysis to try to understand the causes of events."
- D "It is a specific event that enables a hospital to maximize reimbursement from Medicare and Medicaid."
Explanation
Explanation
The Correct Answer is: B. "It is an event that can cause serious injury or death to a client that should never happen in a hospital."
Never Events are serious, preventable patient-safety incidents that result in significant harm or death and should never occur in a properly functioning healthcare environment. These include wrong-site surgeries, retained foreign objects, and severe medication errors. They indicate a breakdown in safety systems and require immediate reporting, investigation, and corrective action. This definition aligns with national patient-safety standards and regulatory guidelines.
The Correct Answer is: B. "It is an event that can cause serious injury or death to a client that should never happen in a hospital."
Never Events are serious, preventable patient-safety incidents that result in significant harm or death and should never occur in a properly functioning healthcare environment. These include wrong-site surgeries, retained foreign objects, and severe medication errors. They indicate a breakdown in safety systems and require immediate reporting, investigation, and corrective action. This definition aligns with national patient-safety standards and regulatory guidelines.
7.
Which of the following would be the most important piece of information to include in a change of shift report?
- A The vitals were all within normal limits
- B The chest X-ray from two days ago was normal
- C There were no changes in medication orders for the client
- D The Foley catheter was removed 5 hours ago and the client has not voided
Explanation
Explanation
The Correct Answer is: D. The Foley catheter was removed 5 hours ago and the client has not voided.
Failure to void within several hours after Foley catheter removal is clinically significant and may indicate urinary retention. This requires monitoring and potential intervention from the next nurse on shift. Timely reporting ensures continuity of care and prevents complications such as bladder distention or the need for re-catheterization. This information is time-sensitive, safety-related, and directly affects the plan of care.
The Correct Answer is: D. The Foley catheter was removed 5 hours ago and the client has not voided.
Failure to void within several hours after Foley catheter removal is clinically significant and may indicate urinary retention. This requires monitoring and potential intervention from the next nurse on shift. Timely reporting ensures continuity of care and prevents complications such as bladder distention or the need for re-catheterization. This information is time-sensitive, safety-related, and directly affects the plan of care.
8.
Unless complications develop, you know the wound will heal by:
- A Primary intention
- B Secondary intention
- C Delayed closure
- D Tertiary intention
Explanation
Explanation
The Correct Answer is: A. Primary intention.
The image shows a wound that has been surgically closed with sutures. Wounds that are clean, have minimal tissue loss, and are well-approximated (edges brought together) heal by primary intention. This method promotes faster healing, minimal scarring, and lower risk of infection. Surgical incisions with sutures, staples, or adhesive strips are classic examples of wounds healing by primary intention.
The Correct Answer is: A. Primary intention.
The image shows a wound that has been surgically closed with sutures. Wounds that are clean, have minimal tissue loss, and are well-approximated (edges brought together) heal by primary intention. This method promotes faster healing, minimal scarring, and lower risk of infection. Surgical incisions with sutures, staples, or adhesive strips are classic examples of wounds healing by primary intention.
9.
What are some strategies a new nurse can use to develop skills in achieving cultural competence? (Select all that apply – you will choose 2 of the 4 options)
- A Read the literature and study nursing theories and principles pertaining to culture
- B Take advantage of as many opportunities as possible to interact with persons from diverse cultures
- C Recognize that persons from different cultures have different healthcare practices but for safety purposes, need to follow the same nursing plan of care for all people
- D Understand all the practices of all cultures worldwide so he can choose the best interventions
Explanation
Explanation
The Correct Answers are:
A. Read the literature and study nursing theories and principles pertaining to culture
B. Take advantage of as many opportunities as possible to interact with persons from diverse cultures
A. Read the literature and study nursing theories and principles pertaining to culture
Reading and studying culturally relevant theories helps nurses understand how cultural beliefs influence health behaviors, decision-making, communication styles, and expectations in healthcare. This foundational knowledge strengthens the nurse’s ability to assess, interpret, and respond to culturally diverse needs. It builds awareness, reduces bias, and equips the nurse to deliver culturally sensitive and individualized care. B. Take advantage of as many opportunities as possible to interact with persons from diverse cultures
Direct interaction with culturally diverse individuals helps nurses gain real-world experience, improve communication skills, and develop cultural humility. Exposure to different beliefs, practices, and perspectives enhances understanding and reduces assumptions. These practical encounters help the nurse build confidence, empathy, and respect for cultural differences in patient care.
The Correct Answers are:
A. Read the literature and study nursing theories and principles pertaining to culture
B. Take advantage of as many opportunities as possible to interact with persons from diverse cultures
A. Read the literature and study nursing theories and principles pertaining to culture
Reading and studying culturally relevant theories helps nurses understand how cultural beliefs influence health behaviors, decision-making, communication styles, and expectations in healthcare. This foundational knowledge strengthens the nurse’s ability to assess, interpret, and respond to culturally diverse needs. It builds awareness, reduces bias, and equips the nurse to deliver culturally sensitive and individualized care. B. Take advantage of as many opportunities as possible to interact with persons from diverse cultures
Direct interaction with culturally diverse individuals helps nurses gain real-world experience, improve communication skills, and develop cultural humility. Exposure to different beliefs, practices, and perspectives enhances understanding and reduces assumptions. These practical encounters help the nurse build confidence, empathy, and respect for cultural differences in patient care.
10.
A nurse is caring for a client whose spouse recently died. The client says, "I can't believe this happened. I keep expecting him to walk through the door." Considering the phase of grief this person is most likely in, which response by the nurse is most therapeutic?
- A "You just need to work on trying to accept that he's gone."
- B "It's normal to feel disbelief after such a loss."
- C "I promise you will start to feel better after a few weeks."
- D "You should focus on keeping yourself busy."
Explanation
Explanation
The Correct Answer is: B. "It's normal to feel disbelief after such a loss."
This response validates the client’s feelings and acknowledges that denial and disbelief are common during the early stages of grief. It demonstrates empathy, normalizes the client’s emotional response, and provides support without minimizing or challenging their expression. Therapeutic communication focuses on understanding, validating, and allowing the client to express grief safely at their own pace.
The Correct Answer is: B. "It's normal to feel disbelief after such a loss."
This response validates the client’s feelings and acknowledges that denial and disbelief are common during the early stages of grief. It demonstrates empathy, normalizes the client’s emotional response, and provides support without minimizing or challenging their expression. Therapeutic communication focuses on understanding, validating, and allowing the client to express grief safely at their own pace.
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