UNIVERSITY OF CENTRAL FLORIDA
Course Code: NUR3028
Instructor:
Date: 2026
FINAL EXAM – ESSENTIALS OF NURSING PRACTICE
A 68-year-old patient with congestive heart failure (CHF) is admitted with
worsening dyspnea and edema. The nurse notes peripheral edema and
jugular venous distension. Which nursing intervention takes priority? a)
Encourage a high-sodium diet b) Administer prescribed diuretics and monitor
fluid status c) Limit fluid intake to 500 mL/day without provider order d) Assist
with ambulation immediately after admission
Answer: b) Administer prescribed diuretics and monitor fluid status
Rationale: In CHF exacerbation, diuretics reduce fluid overload. Monitoring
fluid balance is essential to avoid volume depletion or worsening edema.
Sodium restriction is typical but not encouraged as a high-sodium diet. Early
ambulation may not be tolerated.
A postoperative patient demonstrates a sudden drop in oxygen saturation,
tachypnea, and anxiety. What is the most appropriate initial nursing
assessment? a) Check peripheral pulses and capillary refill b) Assess the
possibility of pulmonary embolism c) Administer prescribed pain medication
d) Document vital signs and continue routine care
Answer: b) Assess the possibility of pulmonary embolism Rationale:
Sudden hypoxia and tachypnea post-op are red flags for pulmonary
embolism. Prompt assessment and intervention are critical to prevent
mortality.
When caring for a diabetic patient with a foot ulcer, which nursing action best
prevents infection? a) Cover the ulcer with a dry dressing and avoid cleaning
b) Teach the patient to soak feet daily in hot water c) Inspect the ulcer for
signs of infection and perform sterile dressing changes d) Encourage the
patient to walk frequently to promote circulation
1
,Answer: c) Inspect the ulcer for signs of infection and perform sterile
dressing changes Rationale: Infection prevention requires vigilant wound
assessment and aseptic technique during dressing changes. Soaking and
frequent walking could worsen the wound.
In a patient receiving IV potassium chloride infusion, which sign indicates a
potentially dangerous complication? a) Absence of urine output b) Slight
redness at IV insertion site c) Mild headache d) Gradual decrease in heart
rate
Answer: a) Absence of urine output Rationale: Potassium is excreted
renally. Anuria can cause hyperkalemia, leading to arrhythmias and cardiac
arrest. IV site redness is less critical and headache is nonspecific.
A nurse is preparing for a sterile dressing change on a central venous
catheter site. Which step is crucial for maintaining sterility? a) Wearing sterile
gloves before removing the old dressing b) Performing hand hygiene after
gloving c) Applying the new dressing immediately without skin antisepsis d)
Touching only the outer edges of the new dressing while applying
Answer: a) Wearing sterile gloves before removing the old dressing
Rationale: Sterile gloves are required to prevent contamination. Skin
antisepsis before dressing application is mandatory. Hand hygiene is before
gloving. Touching only edges helps maintain sterility.
True/False
A nursing care plan for a patient with acute pain should be developed only
after the pain has resolved. Answer: False Rationale: Pain assessment and
management are ongoing. Care plans should be developed as soon as pain
is identified to ensure timely intervention.
Administering opioids to patients with chronic pain always results in
addiction. Answer: False Rationale: Addiction risk is lower when opioids are
appropriately prescribed and monitored for chronic pain management.
The Glasgow Coma Scale is used to assess neurological function and helps
determine the severity of brain injury. Answer: True Rationale: The GCS
assesses eye-opening, verbal response, and motor response to classify
injury severity and monitor neurological status.
When performing tracheostomy care, sterile technique must be used to
prevent infection. Answer: True Rationale: Tracheostomy care requires
sterile technique to minimize risk of respiratory infection and complications.
The recommended compression to ventilation ratio for adult CPR is 15:2.
2
,Answer: False Rationale: Current guidelines recommend 30 compressions
to 2 ventilations for adult CPR.
Fill in the Blank
The process of evaluating a patient's response to nursing interventions is
called __________. Answer: evaluation Rationale: Evaluation is the final
step in the nursing process, assessing outcomes and effectiveness.
The term __________ refers to the unintended and harmful events that occur
as a result of medical care. Answer: adverse event Rationale: Adverse
events are incidents causing harm due to healthcare interventions.
The __________ lab value is most important to monitor in a patient receiving
warfarin therapy. Answer: INR (International Normalized Ratio) Rationale:
INR guides warfarin dosing by measuring blood coagulation.
A nurse documents a patient's inability to swallow as __________. Answer:
dysphagia Rationale: Dysphagia is medical terminology for difficulty
swallowing.
The acronym SBAR in nursing communication stands for Situation,
Background, Assessment, and __________. Answer: Recommendation
Rationale: SBAR standardizes communication during handoffs and urgent
situations.
Multiple Choice
Which physiological change is most associated with aging and impacts
medication metabolism? a) Increased hepatic enzyme activity b) Decreased
renal clearance c) Enhanced gastrointestinal motility d) Increased cardiac
output
Answer: b) Decreased renal clearance Rationale: Renal function declines
with age, reducing drug elimination and increasing toxicity risk.
What is the primary rationale for performing a health assessment using the
OLDCART method? a) To interpret laboratory values effectively b) To gather
systematic information about pain and symptoms c) To ensure medication
compliance d) To identify family history of genetic disorders
Answer: b) To gather systematic information about pain and symptoms
Rationale: OLDCART (Onset, Location, Duration, Character, Aggravating
factors, Relieving factors, Treatment) guides precise symptom history.
Which of the following indicates the nurse understands principles of cultural
competence? a) Assuming all patients prefer family involvement in decision-
3
, making b) Recognizing and respecting patient's cultural health beliefs c)
Applying one's own cultural norms universally d) Avoiding discussion of
culture to prevent bias
Answer: b) Recognizing and respecting patient's cultural health beliefs
Rationale: Cultural competence requires acknowledging and integrating
diverse beliefs into care planning.
In infection control, the principle of __________ refers to practices aimed at
preventing disease transmission by breaking the chain of infection. a)
sterilization b) asepsis c) disinfection d) isolation
Answer: b) asepsis Rationale: Asepsis encompasses techniques to
maintain a pathogen-free environment.
Which nursing diagnosis would be most appropriate for a patient
experiencing impaired gas exchange? a) Risk for ineffective airway
clearance b) Activity intolerance c) Ineffective breathing pattern d) Ineffective
gas exchange
Answer: d) Ineffective gas exchange Rationale: This diagnosis is specific to
oxygenation and CO2 elimination issues.
True/False
Patient confidentiality can legally be breached if information sharing protects
public health. Answer: True Rationale: Exceptions exist in laws requiring
reporting communicable diseases or threats to safety.
Hydration status can be reliably assessed solely by measuring blood
pressure. Answer: False Rationale: Hydration assessment requires multiple
parameters including mucous membranes, capillary refill, and serum labs.
The primary action of corticosteroids in inflammation is immunosuppression
and reducing inflammatory responses. Answer: True Rationale:
Corticosteroids modulate inflammation through multiple pathways but
suppress immune activity.
A positive Babinski reflex in adults indicates normal neurological function.
Answer: False Rationale: A positive Babinski in adults suggests
neurological pathology.
Hand hygiene remains the most effective method to prevent healthcare-
associated infections. Answer: True Rationale: Proper hand hygiene
significantly reduces cross-contamination and infection rates.
Fill in the Blank
4
Course Code: NUR3028
Instructor:
Date: 2026
FINAL EXAM – ESSENTIALS OF NURSING PRACTICE
A 68-year-old patient with congestive heart failure (CHF) is admitted with
worsening dyspnea and edema. The nurse notes peripheral edema and
jugular venous distension. Which nursing intervention takes priority? a)
Encourage a high-sodium diet b) Administer prescribed diuretics and monitor
fluid status c) Limit fluid intake to 500 mL/day without provider order d) Assist
with ambulation immediately after admission
Answer: b) Administer prescribed diuretics and monitor fluid status
Rationale: In CHF exacerbation, diuretics reduce fluid overload. Monitoring
fluid balance is essential to avoid volume depletion or worsening edema.
Sodium restriction is typical but not encouraged as a high-sodium diet. Early
ambulation may not be tolerated.
A postoperative patient demonstrates a sudden drop in oxygen saturation,
tachypnea, and anxiety. What is the most appropriate initial nursing
assessment? a) Check peripheral pulses and capillary refill b) Assess the
possibility of pulmonary embolism c) Administer prescribed pain medication
d) Document vital signs and continue routine care
Answer: b) Assess the possibility of pulmonary embolism Rationale:
Sudden hypoxia and tachypnea post-op are red flags for pulmonary
embolism. Prompt assessment and intervention are critical to prevent
mortality.
When caring for a diabetic patient with a foot ulcer, which nursing action best
prevents infection? a) Cover the ulcer with a dry dressing and avoid cleaning
b) Teach the patient to soak feet daily in hot water c) Inspect the ulcer for
signs of infection and perform sterile dressing changes d) Encourage the
patient to walk frequently to promote circulation
1
,Answer: c) Inspect the ulcer for signs of infection and perform sterile
dressing changes Rationale: Infection prevention requires vigilant wound
assessment and aseptic technique during dressing changes. Soaking and
frequent walking could worsen the wound.
In a patient receiving IV potassium chloride infusion, which sign indicates a
potentially dangerous complication? a) Absence of urine output b) Slight
redness at IV insertion site c) Mild headache d) Gradual decrease in heart
rate
Answer: a) Absence of urine output Rationale: Potassium is excreted
renally. Anuria can cause hyperkalemia, leading to arrhythmias and cardiac
arrest. IV site redness is less critical and headache is nonspecific.
A nurse is preparing for a sterile dressing change on a central venous
catheter site. Which step is crucial for maintaining sterility? a) Wearing sterile
gloves before removing the old dressing b) Performing hand hygiene after
gloving c) Applying the new dressing immediately without skin antisepsis d)
Touching only the outer edges of the new dressing while applying
Answer: a) Wearing sterile gloves before removing the old dressing
Rationale: Sterile gloves are required to prevent contamination. Skin
antisepsis before dressing application is mandatory. Hand hygiene is before
gloving. Touching only edges helps maintain sterility.
True/False
A nursing care plan for a patient with acute pain should be developed only
after the pain has resolved. Answer: False Rationale: Pain assessment and
management are ongoing. Care plans should be developed as soon as pain
is identified to ensure timely intervention.
Administering opioids to patients with chronic pain always results in
addiction. Answer: False Rationale: Addiction risk is lower when opioids are
appropriately prescribed and monitored for chronic pain management.
The Glasgow Coma Scale is used to assess neurological function and helps
determine the severity of brain injury. Answer: True Rationale: The GCS
assesses eye-opening, verbal response, and motor response to classify
injury severity and monitor neurological status.
When performing tracheostomy care, sterile technique must be used to
prevent infection. Answer: True Rationale: Tracheostomy care requires
sterile technique to minimize risk of respiratory infection and complications.
The recommended compression to ventilation ratio for adult CPR is 15:2.
2
,Answer: False Rationale: Current guidelines recommend 30 compressions
to 2 ventilations for adult CPR.
Fill in the Blank
The process of evaluating a patient's response to nursing interventions is
called __________. Answer: evaluation Rationale: Evaluation is the final
step in the nursing process, assessing outcomes and effectiveness.
The term __________ refers to the unintended and harmful events that occur
as a result of medical care. Answer: adverse event Rationale: Adverse
events are incidents causing harm due to healthcare interventions.
The __________ lab value is most important to monitor in a patient receiving
warfarin therapy. Answer: INR (International Normalized Ratio) Rationale:
INR guides warfarin dosing by measuring blood coagulation.
A nurse documents a patient's inability to swallow as __________. Answer:
dysphagia Rationale: Dysphagia is medical terminology for difficulty
swallowing.
The acronym SBAR in nursing communication stands for Situation,
Background, Assessment, and __________. Answer: Recommendation
Rationale: SBAR standardizes communication during handoffs and urgent
situations.
Multiple Choice
Which physiological change is most associated with aging and impacts
medication metabolism? a) Increased hepatic enzyme activity b) Decreased
renal clearance c) Enhanced gastrointestinal motility d) Increased cardiac
output
Answer: b) Decreased renal clearance Rationale: Renal function declines
with age, reducing drug elimination and increasing toxicity risk.
What is the primary rationale for performing a health assessment using the
OLDCART method? a) To interpret laboratory values effectively b) To gather
systematic information about pain and symptoms c) To ensure medication
compliance d) To identify family history of genetic disorders
Answer: b) To gather systematic information about pain and symptoms
Rationale: OLDCART (Onset, Location, Duration, Character, Aggravating
factors, Relieving factors, Treatment) guides precise symptom history.
Which of the following indicates the nurse understands principles of cultural
competence? a) Assuming all patients prefer family involvement in decision-
3
, making b) Recognizing and respecting patient's cultural health beliefs c)
Applying one's own cultural norms universally d) Avoiding discussion of
culture to prevent bias
Answer: b) Recognizing and respecting patient's cultural health beliefs
Rationale: Cultural competence requires acknowledging and integrating
diverse beliefs into care planning.
In infection control, the principle of __________ refers to practices aimed at
preventing disease transmission by breaking the chain of infection. a)
sterilization b) asepsis c) disinfection d) isolation
Answer: b) asepsis Rationale: Asepsis encompasses techniques to
maintain a pathogen-free environment.
Which nursing diagnosis would be most appropriate for a patient
experiencing impaired gas exchange? a) Risk for ineffective airway
clearance b) Activity intolerance c) Ineffective breathing pattern d) Ineffective
gas exchange
Answer: d) Ineffective gas exchange Rationale: This diagnosis is specific to
oxygenation and CO2 elimination issues.
True/False
Patient confidentiality can legally be breached if information sharing protects
public health. Answer: True Rationale: Exceptions exist in laws requiring
reporting communicable diseases or threats to safety.
Hydration status can be reliably assessed solely by measuring blood
pressure. Answer: False Rationale: Hydration assessment requires multiple
parameters including mucous membranes, capillary refill, and serum labs.
The primary action of corticosteroids in inflammation is immunosuppression
and reducing inflammatory responses. Answer: True Rationale:
Corticosteroids modulate inflammation through multiple pathways but
suppress immune activity.
A positive Babinski reflex in adults indicates normal neurological function.
Answer: False Rationale: A positive Babinski in adults suggests
neurological pathology.
Hand hygiene remains the most effective method to prevent healthcare-
associated infections. Answer: True Rationale: Proper hand hygiene
significantly reduces cross-contamination and infection rates.
Fill in the Blank
4
