NU180 | NU180 Nursing and Healthcare II | NCLEX
Style Final Exam v1 | Questions with Correct
Answers and Expert Explanation for Each Question
| Galen
1. A nurse is caring for a client who is scheduled for an elective surgery. The client
expresses uncertainty about the procedure. Which action should the nurse take first?
A. Ask the client to sign the informed consent form immediately.
B. Notify the surgeon that the client has questions about the procedure.
C. Provide a detailed explanation of the surgical risks and benefits.
D. Reassure the client that the surgeon is highly experienced and capable.
Correct Answer: B
Expert Explanation: It is the surgeon’s legal responsibility to provide a detailed
explanation of the risks and benefits of a procedure. The nurse’s role in informed
consent is to witness the signature and ensure the client understands the
information provided. By notifying the surgeon, the nurse ensures the client’s right
to informed autonomy is protected.
2. A nurse is teaching a group of older adults about home safety. Which of the
following instructions should the nurse include to prevent falls?
A. Use area rugs in hallways to provide better traction.
,B. Install grab bars in the bathroom near the toilet and shower.
C. Keep the house dimly lit at night to promote better sleep cycles.
D. Place frequently used items on the top shelf of the pantry.
Correct Answer: B
Expert Explanation: Grab bars provide essential support for older adults with
decreased balance or strength during transitions in the bathroom. Area rugs are a
significant tripping hazard and should be removed rather than added. Adequate
lighting and placing items within easy reach are also critical strategies to minimize
the risk of falls.
3. Which of the following actions by the nurse demonstrates the ethical principle of
beneficence?
A. Respecting a patient’s right to refuse a life-saving blood transfusion.
B. Providing a patient with the requested pain medication on time.
C. Telling a patient the truth about a terminal diagnosis even if it is difficult.
D. Ensuring that all patients on the unit receive equal access to resources.
Correct Answer: B
Expert Explanation: Beneficence refers to the duty to do good and act in the best
interest of the patient. Providing pain relief directly promotes the patient’s well-
,being and alleviates suffering. While the other options represent autonomy,
veracity, and justice, timely medication administration is a primary example of
doing good.
4. A nurse is preparing to administer an intramuscular injection to an adult client.
Which site is most recommended for large volume injections to avoid nerve damage?
A. Dorsogluteal site
B. Vastus lateralis
C. Deltoid muscle
D. Ventrogluteal site
Correct Answer: D
Expert Explanation: The ventrogluteal site is the preferred location for
intramuscular injections in adults because it is away from major nerves and blood
vessels. It provides a large muscle mass that can accommodate larger volumes of
medication safely. The dorsogluteal site is no longer recommended due to the high
risk of hitting the sciatic nerve.
5. A nurse is monitoring a client for complications of immobility. Which of the
following findings should the nurse identify as a sign of deep vein thrombosis (DVT)?
A. Bilateral pitting edema in the lower extremities.
B. Pale, cool skin on the affected foot with a weak pedal pulse.
, C. Unilateral swelling, redness, and warmth in the calf.
D. Decreased sensation and tingling in the toes of both feet.
Correct Answer: C
Expert Explanation: DVT typically presents with localized signs such as unilateral
swelling, tenderness, and warmth in the affected limb. Bilateral edema is more often
associated with systemic issues like heart failure. The nurse must promptly report
these findings to prevent the potential complication of a pulmonary embolism.
6. Which step of the nursing process involves the nurse determining if the client’s
goals have been met?
A. Assessment
B. Evaluation
C. Implementation
D. Planning
Correct Answer: B
Expert Explanation: The evaluation phase is the final step where the nurse
compares the client’s current status with the desired outcomes. This process allows
the nurse to determine if the interventions were successful or if the care plan needs
Style Final Exam v1 | Questions with Correct
Answers and Expert Explanation for Each Question
| Galen
1. A nurse is caring for a client who is scheduled for an elective surgery. The client
expresses uncertainty about the procedure. Which action should the nurse take first?
A. Ask the client to sign the informed consent form immediately.
B. Notify the surgeon that the client has questions about the procedure.
C. Provide a detailed explanation of the surgical risks and benefits.
D. Reassure the client that the surgeon is highly experienced and capable.
Correct Answer: B
Expert Explanation: It is the surgeon’s legal responsibility to provide a detailed
explanation of the risks and benefits of a procedure. The nurse’s role in informed
consent is to witness the signature and ensure the client understands the
information provided. By notifying the surgeon, the nurse ensures the client’s right
to informed autonomy is protected.
2. A nurse is teaching a group of older adults about home safety. Which of the
following instructions should the nurse include to prevent falls?
A. Use area rugs in hallways to provide better traction.
,B. Install grab bars in the bathroom near the toilet and shower.
C. Keep the house dimly lit at night to promote better sleep cycles.
D. Place frequently used items on the top shelf of the pantry.
Correct Answer: B
Expert Explanation: Grab bars provide essential support for older adults with
decreased balance or strength during transitions in the bathroom. Area rugs are a
significant tripping hazard and should be removed rather than added. Adequate
lighting and placing items within easy reach are also critical strategies to minimize
the risk of falls.
3. Which of the following actions by the nurse demonstrates the ethical principle of
beneficence?
A. Respecting a patient’s right to refuse a life-saving blood transfusion.
B. Providing a patient with the requested pain medication on time.
C. Telling a patient the truth about a terminal diagnosis even if it is difficult.
D. Ensuring that all patients on the unit receive equal access to resources.
Correct Answer: B
Expert Explanation: Beneficence refers to the duty to do good and act in the best
interest of the patient. Providing pain relief directly promotes the patient’s well-
,being and alleviates suffering. While the other options represent autonomy,
veracity, and justice, timely medication administration is a primary example of
doing good.
4. A nurse is preparing to administer an intramuscular injection to an adult client.
Which site is most recommended for large volume injections to avoid nerve damage?
A. Dorsogluteal site
B. Vastus lateralis
C. Deltoid muscle
D. Ventrogluteal site
Correct Answer: D
Expert Explanation: The ventrogluteal site is the preferred location for
intramuscular injections in adults because it is away from major nerves and blood
vessels. It provides a large muscle mass that can accommodate larger volumes of
medication safely. The dorsogluteal site is no longer recommended due to the high
risk of hitting the sciatic nerve.
5. A nurse is monitoring a client for complications of immobility. Which of the
following findings should the nurse identify as a sign of deep vein thrombosis (DVT)?
A. Bilateral pitting edema in the lower extremities.
B. Pale, cool skin on the affected foot with a weak pedal pulse.
, C. Unilateral swelling, redness, and warmth in the calf.
D. Decreased sensation and tingling in the toes of both feet.
Correct Answer: C
Expert Explanation: DVT typically presents with localized signs such as unilateral
swelling, tenderness, and warmth in the affected limb. Bilateral edema is more often
associated with systemic issues like heart failure. The nurse must promptly report
these findings to prevent the potential complication of a pulmonary embolism.
6. Which step of the nursing process involves the nurse determining if the client’s
goals have been met?
A. Assessment
B. Evaluation
C. Implementation
D. Planning
Correct Answer: B
Expert Explanation: The evaluation phase is the final step where the nurse
compares the client’s current status with the desired outcomes. This process allows
the nurse to determine if the interventions were successful or if the care plan needs
