Penn State University
LANIF • 152 SRUN
PSU Ross and Carol Nese College of Nursing
MAKING LIFE BETTER
EST. 1855
NURS 251 — Fundamentals of Nursing Practice
F I N A L E X A M I N AT I O N • N U R S I N G P R O C E SS , S A F E TY, CO M M U N I C AT I O N , PA I N & W O U N D C A R E
INSTITUTION Penn State University — College of COURSE CODE NURS 251
Nursing
PROGRAM Bachelor of Science in Nursing (B.S.N.) ACADEMIC YEAR
EXAM TITLE Fundamentals of Nursing — Final TOTAL QUESTIONS 30 Questions
Examination
FORMAT Multiple Choice & Select-All-That-Apply
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless "Select All That Apply" is indicated.
▸ Questions cover safe patient handling, fall prevention, therapeutic communication, pain assessment and management, wound
care, infection control, and the nursing process.
▸ Pay close attention to the differences between medical and nursing diagnoses, types of pain (nociceptive vs. neuropathic),
wound drainage types, and isolation precautions.
▸ Correct answers and detailed rationales appear below each question for final exam preparation.
SECTION I — SAFETY, COMMUNICATION, PAIN, WOUNDS & NURSING Questions 1 –
PROCESS 30
1. Which of the following is a safe patient handling principle for patients who can assist with movement?
A. Keep the feet close together and lift with the back
B. Use a wide base of support, lower the center of gravity, face the direction of movement, and divide balanced activity
between arms and legs
C. Twist at the waist when turning to move the patient efficiently
D. Use only upper body strength to pull the patient
CORRECT ANSWER B — Wide base of support, lower center of gravity, face direction of movement, divide activity between
arms and legs
RATIONALE Safe patient handling principles protect both the patient and the healthcare worker from injury. Key
principles: maintain a wide base of support for stability; lower your center of gravity (bend at the knees, not
the waist); keep the line of gravity within the base of support to maintain equilibrium; face the direction of
movement to prevent abnormal twisting of the spine; divide balanced activity between arms and legs to
reduce strain on any one muscle group; use leverage, rolling, turning, or pivoting rather than lifting (these
require less work); reduce friction between the object and the surface to require less force. For immobile
patients, transfer devices and lift teams should be used. Never twist at the waist, lift with the back, or rely
solely on upper body strength — these practices cause musculoskeletal injuries, the most common
occupational injury among nurses.
, 2. Which of the following is an intrinsic fall risk factor?
A. Unfamiliar environment
B. Intravenous devices and catheters
C. Confusion and delirium
D. Drains and tubes
CORRECT ANSWER C — Confusion and delirium
RATIONALE Fall risk factors are divided into intrinsic (patient-related) and extrinsic (environment-related). Intrinsic factors
originate within the patient: surgery, decreased mobility, confusion and delirium, and the patient's perceived
ability (overestimating capabilities). Extrinsic factors originate in the environment: unfamiliar environment,
drains/tubes, intravenous devices, and catheters. Falls are common both in and out of healthcare settings, are
more common in the elderly, result in pain, disability, and death, and account for 90% of all incident reports
in healthcare facilities. Fall prevention strategies include: keeping side rails up, ensuring all items are within
the patient's reach, instructing the patient to always ask for assistance getting out of bed, and clearly
identifying the patient as a fall risk. Restraints should NOT be ordered PRN (as needed) — this is never
appropriate.
3. When using a restrictive device (restraint), how often should the nurse assess circulation of the restrained limb?
A. Every 2 hours
B. Every 4 hours
C. Every 15 minutes
D. Once per shift
CORRECT ANSWER C — Every 15 minutes
RATIONALE When restraints are in use, strict safety protocols must be followed: Assess circulation of the restrained limb
every 15 minutes (check pulses, capillary refill, skin color, temperature, and sensation distal to the restraint).
Offer food, fluids, and toileting every 2 hours. Remove restraints and perform range of motion (ROM) exercises
at regular intervals. Assess skin under restraints for breakdown. Reposition the patient every 2 hours.
Restraints may be chemical (medications) or physical (devices). Restraints CANNOT be ordered PRN — they
must have a specific provider order with a defined time limit. Restraints are used only as a last resort when
less restrictive alternatives have failed and the patient poses a danger to self or others. Alternatives to
restraints should always be attempted first.
4. What does SOLER stand for in active listening?
A. Speak, Observe, Listen, Evaluate, Respond
B. Sit squarely, Open posture, Lean forward, Eye contact, Relax
C. Stop, Look, Engage, Reflect
D. Summarize, Listen, Observe, Evaluate, Report
CORRECT ANSWER B — Sit squarely facing the client, Observe an open posture, Lean forward, Establish eye contact, Relax
RATIONALE SOLER is a mnemonic for the nonverbal components of active listening, a therapeutic communication
technique: S = Sit SQUARELY facing the client (conveys attention and involvement); O = Observe an OPEN
posture (arms and legs uncrossed — conveys approachability); L = LEAN forward toward the client (conveys
interest and engagement); E = Establish EYE contact (conveys attention and respect — be mindful of cultural
variations); R = RELAX (conveys calmness and confidence, putting the client at ease). Therapeutic
communication characteristics include empathy, respect, genuineness, concreteness, and appropriate
confrontation. Communication is an exchange of information, ideas, and feelings requiring interpretation,
sensitivity, imagination, and active participation. Key components: referent (motivates communication),
sender/receiver, message, channels, feedback, interpersonal variables, and environment.
LANIF • 152 SRUN
PSU Ross and Carol Nese College of Nursing
MAKING LIFE BETTER
EST. 1855
NURS 251 — Fundamentals of Nursing Practice
F I N A L E X A M I N AT I O N • N U R S I N G P R O C E SS , S A F E TY, CO M M U N I C AT I O N , PA I N & W O U N D C A R E
INSTITUTION Penn State University — College of COURSE CODE NURS 251
Nursing
PROGRAM Bachelor of Science in Nursing (B.S.N.) ACADEMIC YEAR
EXAM TITLE Fundamentals of Nursing — Final TOTAL QUESTIONS 30 Questions
Examination
FORMAT Multiple Choice & Select-All-That-Apply
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless "Select All That Apply" is indicated.
▸ Questions cover safe patient handling, fall prevention, therapeutic communication, pain assessment and management, wound
care, infection control, and the nursing process.
▸ Pay close attention to the differences between medical and nursing diagnoses, types of pain (nociceptive vs. neuropathic),
wound drainage types, and isolation precautions.
▸ Correct answers and detailed rationales appear below each question for final exam preparation.
SECTION I — SAFETY, COMMUNICATION, PAIN, WOUNDS & NURSING Questions 1 –
PROCESS 30
1. Which of the following is a safe patient handling principle for patients who can assist with movement?
A. Keep the feet close together and lift with the back
B. Use a wide base of support, lower the center of gravity, face the direction of movement, and divide balanced activity
between arms and legs
C. Twist at the waist when turning to move the patient efficiently
D. Use only upper body strength to pull the patient
CORRECT ANSWER B — Wide base of support, lower center of gravity, face direction of movement, divide activity between
arms and legs
RATIONALE Safe patient handling principles protect both the patient and the healthcare worker from injury. Key
principles: maintain a wide base of support for stability; lower your center of gravity (bend at the knees, not
the waist); keep the line of gravity within the base of support to maintain equilibrium; face the direction of
movement to prevent abnormal twisting of the spine; divide balanced activity between arms and legs to
reduce strain on any one muscle group; use leverage, rolling, turning, or pivoting rather than lifting (these
require less work); reduce friction between the object and the surface to require less force. For immobile
patients, transfer devices and lift teams should be used. Never twist at the waist, lift with the back, or rely
solely on upper body strength — these practices cause musculoskeletal injuries, the most common
occupational injury among nurses.
, 2. Which of the following is an intrinsic fall risk factor?
A. Unfamiliar environment
B. Intravenous devices and catheters
C. Confusion and delirium
D. Drains and tubes
CORRECT ANSWER C — Confusion and delirium
RATIONALE Fall risk factors are divided into intrinsic (patient-related) and extrinsic (environment-related). Intrinsic factors
originate within the patient: surgery, decreased mobility, confusion and delirium, and the patient's perceived
ability (overestimating capabilities). Extrinsic factors originate in the environment: unfamiliar environment,
drains/tubes, intravenous devices, and catheters. Falls are common both in and out of healthcare settings, are
more common in the elderly, result in pain, disability, and death, and account for 90% of all incident reports
in healthcare facilities. Fall prevention strategies include: keeping side rails up, ensuring all items are within
the patient's reach, instructing the patient to always ask for assistance getting out of bed, and clearly
identifying the patient as a fall risk. Restraints should NOT be ordered PRN (as needed) — this is never
appropriate.
3. When using a restrictive device (restraint), how often should the nurse assess circulation of the restrained limb?
A. Every 2 hours
B. Every 4 hours
C. Every 15 minutes
D. Once per shift
CORRECT ANSWER C — Every 15 minutes
RATIONALE When restraints are in use, strict safety protocols must be followed: Assess circulation of the restrained limb
every 15 minutes (check pulses, capillary refill, skin color, temperature, and sensation distal to the restraint).
Offer food, fluids, and toileting every 2 hours. Remove restraints and perform range of motion (ROM) exercises
at regular intervals. Assess skin under restraints for breakdown. Reposition the patient every 2 hours.
Restraints may be chemical (medications) or physical (devices). Restraints CANNOT be ordered PRN — they
must have a specific provider order with a defined time limit. Restraints are used only as a last resort when
less restrictive alternatives have failed and the patient poses a danger to self or others. Alternatives to
restraints should always be attempted first.
4. What does SOLER stand for in active listening?
A. Speak, Observe, Listen, Evaluate, Respond
B. Sit squarely, Open posture, Lean forward, Eye contact, Relax
C. Stop, Look, Engage, Reflect
D. Summarize, Listen, Observe, Evaluate, Report
CORRECT ANSWER B — Sit squarely facing the client, Observe an open posture, Lean forward, Establish eye contact, Relax
RATIONALE SOLER is a mnemonic for the nonverbal components of active listening, a therapeutic communication
technique: S = Sit SQUARELY facing the client (conveys attention and involvement); O = Observe an OPEN
posture (arms and legs uncrossed — conveys approachability); L = LEAN forward toward the client (conveys
interest and engagement); E = Establish EYE contact (conveys attention and respect — be mindful of cultural
variations); R = RELAX (conveys calmness and confidence, putting the client at ease). Therapeutic
communication characteristics include empathy, respect, genuineness, concreteness, and appropriate
confrontation. Communication is an exchange of information, ideas, and feelings requiring interpretation,
sensitivity, imagination, and active participation. Key components: referent (motivates communication),
sender/receiver, message, channels, feedback, interpersonal variables, and environment.
