NURS 300: Fundamentals of
Nursing Final Exam
Institution: School of Nursing
Date: April 1, 2026
Total Questions: 85
Instructions: Select the best answer for each question. Correct answers
are highlighted in bold with a rationale provided.
Section I: Safe & Effective Care Environment (Questions
1-15)
1. A nurse is preparing to administer a high-alert medication. According to the
2026 ISMP guidelines, which of the following actions is the priority?
a) Administering the medication via a programmable smart pump with a current
drug library.
b) Placing a "high-alert" sticker on the medication container.
c) Having a second licensed nurse perform an independent double-check of the
order and dose.
d) Asking the patient their name and date of birth.
Rationale: While all options are safety measures, the independent double-check by
two licensed professionals is the priority for high-alert medications (e.g., insulin,
heparin) to prevent catastrophic errors. Smart pumps (A) are a safeguard but require
correct programming. Identification (D) is standard for all medications.
2. A charge nurse is implementing a new telehealth monitoring system for post-
operative patients. Legally, what is the nurse’s primary responsibility regarding
this technology?
a) Ensuring the patient signs a waiver absolving the hospital of liability for
technological failures.
b) Maintaining the same standard of care as in an in-person visit, ensuring patient
, privacy under HIPAA.
c) Delegating the monitoring to unlicensed assistive personnel (UAP) to manage the
increased workload.
d) Discontinuing the program if the patient expresses discomfort with technology.
Rationale: The standard of care does not change with telehealth. Nurses must
ensure compliance with the Health Insurance Portability and Accountability Act
(HIPAA) and provide care equivalent to in-person visits.
3. A nurse is caring for a client who is confused and trying to remove their
peripheral IV. The provider orders restraints. Which action demonstrates proper
restraint use per 2026 CMS guidelines?
a) Applying wrist restraints and securing the ties to the side rail for quick release.
b) Documenting that the restraints are for the convenience of the staff to prevent
injury.
c) Obtaining a new written restraint order every 4 hours for an adult, specifying the
type and location.
d) Checking the restrained limb for circulation and skin integrity every 8 hours.
Rationale: CMS mandates that orders for restraints must be renewed every 4 hours
for adults (every 2 hours for children), must be in writing, and specify the type.
Restraints cannot be "prn." Ties must be secured to a movable part of the bed
frame, not the side rail (A). Checks must be done frequently (usually q1-2h, not q8h)
(D).
4. A nurse is using clinical decision support (CDS) software integrated into the
EHR. What is the primary purpose of this AI-driven tool in 2026?
a) To replace the nurse’s clinical judgment with algorithmic recommendations.
b) To generate automatic billing codes for procedures performed.
c) To provide evidence-based alerts for potential medication interactions or
deteriorating vital signs.
d) To schedule staffing assignments based on patient acuity.
Rationale: Clinical Decision Support (CDS) tools are designed to analyze data in real-
time to alert clinicians to potential risks (e.g., sepsis, drug interactions) to enhance,
not replace, clinical judgment.
5. A newly licensed nurse is reviewing delegation principles. Which task is
appropriate to delegate to a licensed practical/vocational nurse (LPN/LVN)?
a) Initial admission assessment for a patient with pneumonia.
b) Administration of IV push antiemetic to a post-operative patient.
c) Insertion of a nasogastric tube for gastric decompression.
d) Evaluation of the effectiveness of a pain management intervention.
Nursing Final Exam
Institution: School of Nursing
Date: April 1, 2026
Total Questions: 85
Instructions: Select the best answer for each question. Correct answers
are highlighted in bold with a rationale provided.
Section I: Safe & Effective Care Environment (Questions
1-15)
1. A nurse is preparing to administer a high-alert medication. According to the
2026 ISMP guidelines, which of the following actions is the priority?
a) Administering the medication via a programmable smart pump with a current
drug library.
b) Placing a "high-alert" sticker on the medication container.
c) Having a second licensed nurse perform an independent double-check of the
order and dose.
d) Asking the patient their name and date of birth.
Rationale: While all options are safety measures, the independent double-check by
two licensed professionals is the priority for high-alert medications (e.g., insulin,
heparin) to prevent catastrophic errors. Smart pumps (A) are a safeguard but require
correct programming. Identification (D) is standard for all medications.
2. A charge nurse is implementing a new telehealth monitoring system for post-
operative patients. Legally, what is the nurse’s primary responsibility regarding
this technology?
a) Ensuring the patient signs a waiver absolving the hospital of liability for
technological failures.
b) Maintaining the same standard of care as in an in-person visit, ensuring patient
, privacy under HIPAA.
c) Delegating the monitoring to unlicensed assistive personnel (UAP) to manage the
increased workload.
d) Discontinuing the program if the patient expresses discomfort with technology.
Rationale: The standard of care does not change with telehealth. Nurses must
ensure compliance with the Health Insurance Portability and Accountability Act
(HIPAA) and provide care equivalent to in-person visits.
3. A nurse is caring for a client who is confused and trying to remove their
peripheral IV. The provider orders restraints. Which action demonstrates proper
restraint use per 2026 CMS guidelines?
a) Applying wrist restraints and securing the ties to the side rail for quick release.
b) Documenting that the restraints are for the convenience of the staff to prevent
injury.
c) Obtaining a new written restraint order every 4 hours for an adult, specifying the
type and location.
d) Checking the restrained limb for circulation and skin integrity every 8 hours.
Rationale: CMS mandates that orders for restraints must be renewed every 4 hours
for adults (every 2 hours for children), must be in writing, and specify the type.
Restraints cannot be "prn." Ties must be secured to a movable part of the bed
frame, not the side rail (A). Checks must be done frequently (usually q1-2h, not q8h)
(D).
4. A nurse is using clinical decision support (CDS) software integrated into the
EHR. What is the primary purpose of this AI-driven tool in 2026?
a) To replace the nurse’s clinical judgment with algorithmic recommendations.
b) To generate automatic billing codes for procedures performed.
c) To provide evidence-based alerts for potential medication interactions or
deteriorating vital signs.
d) To schedule staffing assignments based on patient acuity.
Rationale: Clinical Decision Support (CDS) tools are designed to analyze data in real-
time to alert clinicians to potential risks (e.g., sepsis, drug interactions) to enhance,
not replace, clinical judgment.
5. A newly licensed nurse is reviewing delegation principles. Which task is
appropriate to delegate to a licensed practical/vocational nurse (LPN/LVN)?
a) Initial admission assessment for a patient with pneumonia.
b) Administration of IV push antiemetic to a post-operative patient.
c) Insertion of a nasogastric tube for gastric decompression.
d) Evaluation of the effectiveness of a pain management intervention.
