NU180 | NU180 Nursing and Healthcare II | NCLEX
Style Midterm v3 | Questions with Correct Answers
and Expert Explanation for Each Question | Galen
1. A nurse is delegating tasks to an Unlicensed Assistive Personnel (UAP). Which task is
most appropriate for the nurse to delegate?
A. Assisting a stable patient with a bed bath.
B. Performing a sterile dressing change on a central line.
C. Evaluating a patient’s response to pain medication.
D. Teaching a patient how to use an incentive spirometer.
Correct Answer: A
Expert Explanation: The nurse should only delegate tasks that are routine and do
not require clinical judgment to UAPs. Assisting with activities of daily living for a
stable patient falls within the UAP’s scope. Assessment, teaching, and complex
sterile procedures must be performed by the registered nurse.
2. A patient refuses a life-saving blood transfusion due to religious beliefs. The nurse
supports the patient’s decision. Which ethical principle is being demonstrated?
A. Beneficence
B. Autonomy
C. Justice
,D. Nonmaleficence
Correct Answer: B
Expert Explanation: Autonomy refers to the right of patients to make their own
healthcare decisions. Supporting a patient’s refusal of treatment, even if life-saving,
honors their self-determination. The nurse must respect this choice regardless of
personal opinions or professional goals.
3. The nurse is using the SBAR tool to communicate with a physician. Which
information belongs in the ‘Background’ section?
A. ‘I am calling because the patient’s blood pressure has dropped.’
B. ‘The patient has a history of congestive heart failure and was admitted yesterday.’
C. ‘I suggest we increase the IV fluid rate to 125 mL/hr.’
D. ‘The patient is currently alert but appears pale and diaphoretic.’
Correct Answer: B
Expert Explanation: The ‘Background’ section of SBAR provides the context and
history leading up to the current situation. Option B describes the patient’s medical
history and admission status. Option A is the Situation, Option D is the Assessment,
and Option C is the Recommendation.
,4. A nurse observes a colleague documenting a medication administration before
actually giving the drug. What is the priority action by the nurse?
A. Report the incident to the Board of Nursing immediately.
B. Discuss the observation with the colleague privately.
C. Document the colleague’s behavior in the patient’s chart.
D. Notify the charge nurse or nurse manager.
Correct Answer: D
Expert Explanation: Falsifying documentation is a serious legal and safety issue
that must be reported through the appropriate chain of command. The nurse
manager is responsible for investigating and taking disciplinary action. Reporting
directly to the manager ensures patient safety is prioritized while following
institutional policy.
5. Which patient should the nurse assess first after receiving the change-of-shift
report?
A. A patient with a blood glucose of 140 mg/dL who is requesting breakfast.
B. A patient with a chest tube who is suddenly experiencing shortness of breath and
trachea deviation.
C. A patient who had an abdominal surgery 4 hours ago and reports pain of 6/10.
, D. A patient with chronic obstructive pulmonary disease (COPD) with an SpO2 of
91% on room air.
Correct Answer: B
Expert Explanation: Tracheal deviation and sudden shortness of breath are signs
of a tension pneumothorax, which is a life-threatening emergency. Using the ABC
(Airway, Breathing, Circulation) framework, this patient requires immediate
intervention. The other patients are stable or have non-emergent needs compared
to an obstructed airway or collapsed lung.
6. A nurse is explaining the ‘Safe Harbor’ law to a new graduate. What is the primary
purpose of this law in nursing practice?
A. To provide a process for nurses to protect their license when asked to perform an
unsafe task.
B. To protect the nurse from civil lawsuits filed by patients.
C. To ensure that patients receive free healthcare in emergency situations.
D. To allow nurses to work in multiple states without getting a new license.
Correct Answer: A
Expert Explanation: Safe Harbor is a peer-review process that allows a nurse to
request protection from employer retaliation when they believe a task is unsafe. It
Style Midterm v3 | Questions with Correct Answers
and Expert Explanation for Each Question | Galen
1. A nurse is delegating tasks to an Unlicensed Assistive Personnel (UAP). Which task is
most appropriate for the nurse to delegate?
A. Assisting a stable patient with a bed bath.
B. Performing a sterile dressing change on a central line.
C. Evaluating a patient’s response to pain medication.
D. Teaching a patient how to use an incentive spirometer.
Correct Answer: A
Expert Explanation: The nurse should only delegate tasks that are routine and do
not require clinical judgment to UAPs. Assisting with activities of daily living for a
stable patient falls within the UAP’s scope. Assessment, teaching, and complex
sterile procedures must be performed by the registered nurse.
2. A patient refuses a life-saving blood transfusion due to religious beliefs. The nurse
supports the patient’s decision. Which ethical principle is being demonstrated?
A. Beneficence
B. Autonomy
C. Justice
,D. Nonmaleficence
Correct Answer: B
Expert Explanation: Autonomy refers to the right of patients to make their own
healthcare decisions. Supporting a patient’s refusal of treatment, even if life-saving,
honors their self-determination. The nurse must respect this choice regardless of
personal opinions or professional goals.
3. The nurse is using the SBAR tool to communicate with a physician. Which
information belongs in the ‘Background’ section?
A. ‘I am calling because the patient’s blood pressure has dropped.’
B. ‘The patient has a history of congestive heart failure and was admitted yesterday.’
C. ‘I suggest we increase the IV fluid rate to 125 mL/hr.’
D. ‘The patient is currently alert but appears pale and diaphoretic.’
Correct Answer: B
Expert Explanation: The ‘Background’ section of SBAR provides the context and
history leading up to the current situation. Option B describes the patient’s medical
history and admission status. Option A is the Situation, Option D is the Assessment,
and Option C is the Recommendation.
,4. A nurse observes a colleague documenting a medication administration before
actually giving the drug. What is the priority action by the nurse?
A. Report the incident to the Board of Nursing immediately.
B. Discuss the observation with the colleague privately.
C. Document the colleague’s behavior in the patient’s chart.
D. Notify the charge nurse or nurse manager.
Correct Answer: D
Expert Explanation: Falsifying documentation is a serious legal and safety issue
that must be reported through the appropriate chain of command. The nurse
manager is responsible for investigating and taking disciplinary action. Reporting
directly to the manager ensures patient safety is prioritized while following
institutional policy.
5. Which patient should the nurse assess first after receiving the change-of-shift
report?
A. A patient with a blood glucose of 140 mg/dL who is requesting breakfast.
B. A patient with a chest tube who is suddenly experiencing shortness of breath and
trachea deviation.
C. A patient who had an abdominal surgery 4 hours ago and reports pain of 6/10.
, D. A patient with chronic obstructive pulmonary disease (COPD) with an SpO2 of
91% on room air.
Correct Answer: B
Expert Explanation: Tracheal deviation and sudden shortness of breath are signs
of a tension pneumothorax, which is a life-threatening emergency. Using the ABC
(Airway, Breathing, Circulation) framework, this patient requires immediate
intervention. The other patients are stable or have non-emergent needs compared
to an obstructed airway or collapsed lung.
6. A nurse is explaining the ‘Safe Harbor’ law to a new graduate. What is the primary
purpose of this law in nursing practice?
A. To provide a process for nurses to protect their license when asked to perform an
unsafe task.
B. To protect the nurse from civil lawsuits filed by patients.
C. To ensure that patients receive free healthcare in emergency situations.
D. To allow nurses to work in multiple states without getting a new license.
Correct Answer: A
Expert Explanation: Safe Harbor is a peer-review process that allows a nurse to
request protection from employer retaliation when they believe a task is unsafe. It
