Penn State University
LANIF • 152 SRUN
PSU
★
College of Nursing
MAKING LIFE BETTER
EST. 1855
NURS 251 — Final Examination
CO M P R E H E N S I V E R E V I E W : D O CU M E N TAT I O N , M O B I L I TY, S K I N , I N F E C T I O N , E D U C AT I O N , M E D S ,
E L I M I N AT I O N , A G I N G , S L E E P, PA I N & CO M M U N I C AT I O N
INSTITUTION Penn State University — College of COURSE CODE NURS 251
Nursing
PROGRAM Bachelor of Science in Nursing (BSN) ACADEMIC YEAR
EXAM TITLE Final Examination — Comprehensive TOTAL QUESTIONS 125 Questions
Review
ACCREDITATION MSCHE — Middle States Commission on FORMAT Multiple Choice — Select the Single Best
Higher Education Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question based on NURS 251 course content.
▸ Questions cover documentation, mobility, integumentary, infection control, patient education, medication administration,
elimination, aging, sleep, pain, communication, and nursing process.
▸ Correct answers and clinical rationales appear below each question for examination review.
▸ All content aligns with Penn State University BSN curriculum and MSCHE accreditation standards.
SECTION I — COMPREHENSIVE FINAL EXAMINATION Questions 1 – 125
1. What is one of the most common root causes responsible for sentinel events in healthcare?
A. Equipment malfunction
B. Critical communication failure
C. Staffing shortages
D. Patient non-compliance
CORRECT ANSWER B — Critical communication failure
RATIONALE The Joint Commission consistently identifies communication failure as the leading root cause of sentinel
events (unexpected death or serious physical/psychological injury). Communication breakdowns occur
during handoffs, between disciplines, during transitions of care, and in emergency situations. This is why
standardized communication tools (SBAR, TeamSTEPPS, CUS/two-challenge rule) are mandated — they
structure communication to reduce errors. Effective communication is a cornerstone of patient safety and a
Joint Commission National Patient Safety Goal.
, 2. What is the definition of documentation in healthcare?
A. Verbal sharing of patient information between nurses
B. Written or typed communication — a permanent record of patient information and care
C. A billing tool used exclusively for reimbursement
D. An informal note-taking system for personal use
CORRECT ANSWER B — Written or typed communication, permanent record of patient information and care
RATIONALE Documentation is the permanent, legal record of patient care. It serves multiple purposes: communication
between providers, legal documentation (admissible in court), quality assurance, reimbursement
justification, research, and education. The medical record provides information about the current encounter
and can be referred to in the future. The cornerstone of safe care delivery is clear, accurate, and up-to-date
patient documentation. Documentation must be factual, objective, timely, and complete.
3. What is the SBAR communication template and what does each letter represent?
A. Scan, Brief, Assess, Report
B. Situation, Background, Assessment, Recommendation — with I-SBAR-R adding Identify and Readback
C. Subjective, Background, Analysis, Response
D. Safety, Briefing, Action, Review
CORRECT ANSWER B — Situation, Background, Assessment, Recommendation (I-SBAR-R adds Identify and Readback)
RATIONALE SBAR is the standardized communication framework adopted nationally to improve patient safety during
handoffs and urgent communications. I-SBAR-R components: Identify (who you are calling about and who
you are), Situation (what is happening now), Background (circumstances leading up to this), Assessment
(what you think the problem is), Recommendation (what should be done), Readback (read back the order to
verify accuracy). The CUS (two-challenge rule) complements SBAR: "I am Concerned, I am Uncomfortable,
this is a Safety issue." TeamSTEPPS is the broader teamwork training system. Structured communication
prevents the critical communication failures that cause sentinel events.
4. What is a key principle of objectivity in nursing documentation?
A. Use general terms that could apply to any patient
B. Be specific, accurate, and descriptive — especially important for psychosocial and mental health issues
C. Include personal opinions about the patient's behavior
D. Document only positive findings
CORRECT ANSWER B — Be specific, accurate, and descriptive — especially important for psychosocial and mental health
issues
RATIONALE Objective documentation describes observable, measurable facts without interpretation or judgment.
Example: WRONG — "Patient was inappropriate when taking medication." RIGHT — "Patient refused
medication, stated, 'I don't want that crap and you can't make me take it.' Face red, fists clenched, walked to
room and slammed door." The objective version provides exact quotes, observable behaviors, and
measurable details that allow any reader to draw their own conclusions. This is legally defensible and
clinically useful. Other documentation principles: accuracy (2 cm × 1 cm abrasion on left medial knee, not
"small abrasion"), conciseness (appetite 100% rather than "ate a very good breakfast"), and organization
(follow a logical order, such as head-to-toe).
LANIF • 152 SRUN
PSU
★
College of Nursing
MAKING LIFE BETTER
EST. 1855
NURS 251 — Final Examination
CO M P R E H E N S I V E R E V I E W : D O CU M E N TAT I O N , M O B I L I TY, S K I N , I N F E C T I O N , E D U C AT I O N , M E D S ,
E L I M I N AT I O N , A G I N G , S L E E P, PA I N & CO M M U N I C AT I O N
INSTITUTION Penn State University — College of COURSE CODE NURS 251
Nursing
PROGRAM Bachelor of Science in Nursing (BSN) ACADEMIC YEAR
EXAM TITLE Final Examination — Comprehensive TOTAL QUESTIONS 125 Questions
Review
ACCREDITATION MSCHE — Middle States Commission on FORMAT Multiple Choice — Select the Single Best
Higher Education Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question based on NURS 251 course content.
▸ Questions cover documentation, mobility, integumentary, infection control, patient education, medication administration,
elimination, aging, sleep, pain, communication, and nursing process.
▸ Correct answers and clinical rationales appear below each question for examination review.
▸ All content aligns with Penn State University BSN curriculum and MSCHE accreditation standards.
SECTION I — COMPREHENSIVE FINAL EXAMINATION Questions 1 – 125
1. What is one of the most common root causes responsible for sentinel events in healthcare?
A. Equipment malfunction
B. Critical communication failure
C. Staffing shortages
D. Patient non-compliance
CORRECT ANSWER B — Critical communication failure
RATIONALE The Joint Commission consistently identifies communication failure as the leading root cause of sentinel
events (unexpected death or serious physical/psychological injury). Communication breakdowns occur
during handoffs, between disciplines, during transitions of care, and in emergency situations. This is why
standardized communication tools (SBAR, TeamSTEPPS, CUS/two-challenge rule) are mandated — they
structure communication to reduce errors. Effective communication is a cornerstone of patient safety and a
Joint Commission National Patient Safety Goal.
, 2. What is the definition of documentation in healthcare?
A. Verbal sharing of patient information between nurses
B. Written or typed communication — a permanent record of patient information and care
C. A billing tool used exclusively for reimbursement
D. An informal note-taking system for personal use
CORRECT ANSWER B — Written or typed communication, permanent record of patient information and care
RATIONALE Documentation is the permanent, legal record of patient care. It serves multiple purposes: communication
between providers, legal documentation (admissible in court), quality assurance, reimbursement
justification, research, and education. The medical record provides information about the current encounter
and can be referred to in the future. The cornerstone of safe care delivery is clear, accurate, and up-to-date
patient documentation. Documentation must be factual, objective, timely, and complete.
3. What is the SBAR communication template and what does each letter represent?
A. Scan, Brief, Assess, Report
B. Situation, Background, Assessment, Recommendation — with I-SBAR-R adding Identify and Readback
C. Subjective, Background, Analysis, Response
D. Safety, Briefing, Action, Review
CORRECT ANSWER B — Situation, Background, Assessment, Recommendation (I-SBAR-R adds Identify and Readback)
RATIONALE SBAR is the standardized communication framework adopted nationally to improve patient safety during
handoffs and urgent communications. I-SBAR-R components: Identify (who you are calling about and who
you are), Situation (what is happening now), Background (circumstances leading up to this), Assessment
(what you think the problem is), Recommendation (what should be done), Readback (read back the order to
verify accuracy). The CUS (two-challenge rule) complements SBAR: "I am Concerned, I am Uncomfortable,
this is a Safety issue." TeamSTEPPS is the broader teamwork training system. Structured communication
prevents the critical communication failures that cause sentinel events.
4. What is a key principle of objectivity in nursing documentation?
A. Use general terms that could apply to any patient
B. Be specific, accurate, and descriptive — especially important for psychosocial and mental health issues
C. Include personal opinions about the patient's behavior
D. Document only positive findings
CORRECT ANSWER B — Be specific, accurate, and descriptive — especially important for psychosocial and mental health
issues
RATIONALE Objective documentation describes observable, measurable facts without interpretation or judgment.
Example: WRONG — "Patient was inappropriate when taking medication." RIGHT — "Patient refused
medication, stated, 'I don't want that crap and you can't make me take it.' Face red, fists clenched, walked to
room and slammed door." The objective version provides exact quotes, observable behaviors, and
measurable details that allow any reader to draw their own conclusions. This is legally defensible and
clinically useful. Other documentation principles: accuracy (2 cm × 1 cm abrasion on left medial knee, not
"small abrasion"), conciseness (appetite 100% rather than "ate a very good breakfast"), and organization
(follow a logical order, such as head-to-toe).
