Community College of Baltimore County
School of Nursing
NURSING 129 — Fundamentals of Nursing
Exam 1 Practice Examination | 2026/2027
INSTRUCTIONS
50 Questions | 90 Minutes | Passing Score: 75–78%
Single-best-answer and Select-All-That-Apply (SATA) items | NGN-Aligned
Choose the best answer for each question. SATA items have multiple correct responses.
Domain Q1–8 Q9–15 Q16– Q23– Q29– Total
22 28 50
Points 8 7 7 6 22 50
, CCBC Nursing 129 — Exam 1 Practice Examination | 2026/2027
NURSING PROCESS & CLINICAL JUDGMENT
1. A nurse is using the nursing process to care for a patient admitted with heart failure. After
collecting data, the nurse identifies that the patient has edema in the lower extremities,
shortness of breath on exertion, and a weight gain of 5 pounds in 2 days. Which step of the
nursing process is the nurse performing?
A. Assessment
B. Diagnosis
C. Planning
D. Implementation
Correct Answer: A
Rationale: The nurse is performing the assessment phase by collecting and analyzing patient data. The
assessment phase involves gathering subjective and objective data to establish a baseline and identify
patient needs. The data collected (edema, shortness of breath, weight gain) are all assessment findings that
will later be used to formulate nursing diagnoses.
2. According to Tanner's Model of Clinical Judgment, which phase involves noticing subtle
changes in a patient's condition that may signal a developing complication?
A. Noticing
B. Interpreting
C. Responding
D. Reflecting
Correct Answer: A
Rationale: Tanner's Model begins with "noticing," which involves detecting subtle, sometimes unexpected
changes in a patient's condition. This requires clinical knowledge, pattern recognition, and attentiveness to
deviations from expected findings. Noticing is the foundation upon which the subsequent phases of
interpreting, responding, and reflecting are built.
3. A nurse formulates the following nursing diagnosis for a patient post-operative abdominal
surgery: "Risk for Infection related to surgical incision." Which type of nursing diagnosis is
this?
A. Actual diagnosis
B. Risk diagnosis
C. Health promotion diagnosis
D. Syndrome diagnosis
Correct Answer: B
Rationale: This is a risk diagnosis because it identifies a potential problem that the patient does not
currently experience but is vulnerable to developing. Risk nursing diagnoses are written in the format
"Risk for [Problem] related to [Contributing Factors]." An actual diagnosis describes a problem that
1
, CCBC Nursing 129 — Exam 1 Practice Examination | 2026/2027
already exists, a health promotion diagnosis focuses on enhancing well-being, and a syndrome diagnosis
describes a cluster of actual or risk diagnoses.
4. Which statement accurately reflects the NCSBN Clinical Judgment Measurement Model
(CJMM)?
A. It consists of four layers: Recognize Cues, Analyze Cues, Generate Solutions, and
Evaluate Outcomes.
B. It replaces the traditional nursing process entirely.
C. It is used only for graduate-level nursing education.
D. It focuses exclusively on pharmacological knowledge assessment.
Correct Answer: A
Rationale: The NCSBN CJMM consists of four layers: Recognize Cues, Analyze Cues, Generate Solutions,
and Evaluate Outcomes. This framework guides the development of Next Generation NCLEX (NGN) items
and assesses clinical judgment skills across all levels of nursing education. It complements rather than
replaces the nursing process, applies to both pre-licensure and graduate education, and encompasses all
domains of nursing knowledge.
5. During the evaluation phase of the nursing process, a nurse determines that a patient's
expected outcome has not been met after implementing a bowel regimen. What is the nurse's
most appropriate next action?
A. Discontinue the care plan since the outcome was not achieved.
B. Modify the interventions and revise the care plan as needed.
C. Document the failure and transfer care to another nurse.
D. Wait another 48 hours before reassessing the patient.
Correct Answer: B
Rationale: When expected outcomes are not achieved, the nurse should modify the plan of care by
reassessing the patient, revising diagnoses if necessary, changing or adding interventions, and setting new
realistic goals. The nursing process is a continuous, dynamic cycle rather than a linear sequence.
Discontinuing the plan, transferring care, or simply waiting without action does not support the patient's
needs.
6. A nurse is caring for a patient with dehydration. The nurse notices that the patient's oral
mucosa is dry, skin turgor is poor, and urine output is decreased. In the CJMM, which layer is
the nurse performing?
A. Recognize Cues
B. Analyze Cues
C. Generate Solutions
D. Evaluate Outcomes
Correct Answer: A
Rationale: The nurse is recognizing cues by observing and identifying relevant clinical findings (dry
mucosa, poor skin turgor, decreased urine output) that may indicate a clinical problem. Recognizing cues
2
School of Nursing
NURSING 129 — Fundamentals of Nursing
Exam 1 Practice Examination | 2026/2027
INSTRUCTIONS
50 Questions | 90 Minutes | Passing Score: 75–78%
Single-best-answer and Select-All-That-Apply (SATA) items | NGN-Aligned
Choose the best answer for each question. SATA items have multiple correct responses.
Domain Q1–8 Q9–15 Q16– Q23– Q29– Total
22 28 50
Points 8 7 7 6 22 50
, CCBC Nursing 129 — Exam 1 Practice Examination | 2026/2027
NURSING PROCESS & CLINICAL JUDGMENT
1. A nurse is using the nursing process to care for a patient admitted with heart failure. After
collecting data, the nurse identifies that the patient has edema in the lower extremities,
shortness of breath on exertion, and a weight gain of 5 pounds in 2 days. Which step of the
nursing process is the nurse performing?
A. Assessment
B. Diagnosis
C. Planning
D. Implementation
Correct Answer: A
Rationale: The nurse is performing the assessment phase by collecting and analyzing patient data. The
assessment phase involves gathering subjective and objective data to establish a baseline and identify
patient needs. The data collected (edema, shortness of breath, weight gain) are all assessment findings that
will later be used to formulate nursing diagnoses.
2. According to Tanner's Model of Clinical Judgment, which phase involves noticing subtle
changes in a patient's condition that may signal a developing complication?
A. Noticing
B. Interpreting
C. Responding
D. Reflecting
Correct Answer: A
Rationale: Tanner's Model begins with "noticing," which involves detecting subtle, sometimes unexpected
changes in a patient's condition. This requires clinical knowledge, pattern recognition, and attentiveness to
deviations from expected findings. Noticing is the foundation upon which the subsequent phases of
interpreting, responding, and reflecting are built.
3. A nurse formulates the following nursing diagnosis for a patient post-operative abdominal
surgery: "Risk for Infection related to surgical incision." Which type of nursing diagnosis is
this?
A. Actual diagnosis
B. Risk diagnosis
C. Health promotion diagnosis
D. Syndrome diagnosis
Correct Answer: B
Rationale: This is a risk diagnosis because it identifies a potential problem that the patient does not
currently experience but is vulnerable to developing. Risk nursing diagnoses are written in the format
"Risk for [Problem] related to [Contributing Factors]." An actual diagnosis describes a problem that
1
, CCBC Nursing 129 — Exam 1 Practice Examination | 2026/2027
already exists, a health promotion diagnosis focuses on enhancing well-being, and a syndrome diagnosis
describes a cluster of actual or risk diagnoses.
4. Which statement accurately reflects the NCSBN Clinical Judgment Measurement Model
(CJMM)?
A. It consists of four layers: Recognize Cues, Analyze Cues, Generate Solutions, and
Evaluate Outcomes.
B. It replaces the traditional nursing process entirely.
C. It is used only for graduate-level nursing education.
D. It focuses exclusively on pharmacological knowledge assessment.
Correct Answer: A
Rationale: The NCSBN CJMM consists of four layers: Recognize Cues, Analyze Cues, Generate Solutions,
and Evaluate Outcomes. This framework guides the development of Next Generation NCLEX (NGN) items
and assesses clinical judgment skills across all levels of nursing education. It complements rather than
replaces the nursing process, applies to both pre-licensure and graduate education, and encompasses all
domains of nursing knowledge.
5. During the evaluation phase of the nursing process, a nurse determines that a patient's
expected outcome has not been met after implementing a bowel regimen. What is the nurse's
most appropriate next action?
A. Discontinue the care plan since the outcome was not achieved.
B. Modify the interventions and revise the care plan as needed.
C. Document the failure and transfer care to another nurse.
D. Wait another 48 hours before reassessing the patient.
Correct Answer: B
Rationale: When expected outcomes are not achieved, the nurse should modify the plan of care by
reassessing the patient, revising diagnoses if necessary, changing or adding interventions, and setting new
realistic goals. The nursing process is a continuous, dynamic cycle rather than a linear sequence.
Discontinuing the plan, transferring care, or simply waiting without action does not support the patient's
needs.
6. A nurse is caring for a patient with dehydration. The nurse notices that the patient's oral
mucosa is dry, skin turgor is poor, and urine output is decreased. In the CJMM, which layer is
the nurse performing?
A. Recognize Cues
B. Analyze Cues
C. Generate Solutions
D. Evaluate Outcomes
Correct Answer: A
Rationale: The nurse is recognizing cues by observing and identifying relevant clinical findings (dry
mucosa, poor skin turgor, decreased urine output) that may indicate a clinical problem. Recognizing cues
2
