NU 301 Unit 6 Exam (PDF) | (Updated) NCLEX-Style
Fundamentals of Nursing Questions — 200 Questions and
Answers Already Graded A+ Premium Exam Tested And
Verified
Subject Area Fundamentals of Nursing
Description This exam assesses advanced understanding of core nursing concepts including
pharmacology, infection control, fluid and electrolyte balance, perioperative care,
and patient safety. Questions require synthesis of knowledge across multiple
domains and application to complex clinical scenarios.
Expected Grade A+
Total Questions 200
Duration 3 hours
Learning Outcomes 1. Apply evidence-based practice to pharmacological and non-pharmacological
interventions
2. Analyze patient data to prioritize nursing actions and prevent complications
3. Integrate principles of infection control, safety, and therapeutic communication
in diverse settings
Accreditation Aligns with AACN Essentials and NCLEX-RN test plan standards for US
baccalaureate nursing programs
Page 1
,1. A patient with a history of chronic obstructive pulmonary disease (COPD) is
receiving oxygen via nasal cannula at 2 L/min. The nurse notes that the patient's
respiratory rate has decreased from 22 to 10 breaths per minute, and the patient
appears drowsy. Which of the following should the nurse prioritize?
A. Increase the oxygen flow rate to 4 L/min to improve oxygenation
B. Reduce the oxygen flow rate to 1 L/min and monitor the patient's respiratory status
C. Administer naloxone per protocol for suspected opioid-induced respiratory depression
D. Prepare for immediate endotracheal intubation
Answer: B. Reduce the oxygen flow rate to 1 L/min and monitor the patient's
respiratory status
In patients with COPD, hypoxic drive is the primary stimulus for breathing. High
oxygen levels can suppress this drive, leading to hypoventilation and respiratory
acidosis. Reducing oxygen flow and monitoring is appropriate. Increasing oxygen
would worsen the condition. Naloxone is not indicated without evidence of opioid use.
Intubation is a last resort.
2. A nurse is preparing to administer a blood transfusion to a patient with a history
of multiple transfusions. Which of the following actions is most important to prevent
a transfusion reaction?
A. Pre-medicate with acetaminophen and diphenhydramine
B. Use a leukocyte-reduced blood product
C. Verify the patient's identity with two identifiers and cross-check with blood product
D. Administer the blood through a peripheral IV with a 20-gauge needle
Answer: B. Use a leukocyte-reduced blood product
Leukocyte-reduced blood products decrease the risk of febrile non-hemolytic
transfusion reactions, especially in patients with prior transfusions. Pre-medication
may reduce symptoms but does not prevent the reaction. Verification is crucial but does
not specifically prevent reactions. Needle size affects flow, not reaction risk.
Page 2
,3. A patient with heart failure is receiving furosemide 40 mg IV push. The nurse
notes that the patient's urine output over the last hour is 50 mL. Which of the
following laboratory values should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum magnesium
D. Serum calcium
Answer: B. Serum potassium
Furosemide is a loop diuretic that increases excretion of sodium, water, and potassium.
Hypokalemia is a common adverse effect that can lead to cardiac arrhythmias. While
sodium and magnesium may also be affected, potassium is the most critical to monitor
due to its cardiac implications.
4. A nurse is assessing a patient who has been on bed rest for 3 days. The patient
reports sudden onset of dyspnea and chest pain. Vital signs: BP 100/60, HR 110, RR
28, SpO2 88% on room air. Which of the following actions should the nurse take
first?
A. Administer oxygen via non-rebreather mask
B. Notify the healthcare provider immediately
C. Elevate the head of the bed to 45 degrees
D. Apply compression stockings
Answer: A. Administer oxygen via non-rebreather mask
The patient's symptoms are concerning for pulmonary embolism. The priority is to
correct hypoxemia; administering high-flow oxygen is the first step. Elevating the head
of the bed may improve breathing but does not address oxygenation directly. Notifying
the provider is important but secondary to oxygen. Compression stockings are
preventive, not acute.
Page 3
, 5. A nurse is teaching a patient about self-administration of enoxaparin. Which of
the following statements by the patient indicates a need for further teaching?
A. I will inject the medication into my abdomen
B. I should rotate injection sites between left and right sides
C. I will rub the injection site after administering the medication
D. I will hold the skin fold until the needle is fully inserted
Answer: C. I will rub the injection site after administering the medication
Rubbing the injection site after administering enoxaparin can cause bruising and
hematoma formation. Patients should be instructed to apply gentle pressure without
rubbing. The other statements are correct: abdominal injection, site rotation, and
maintaining skin fold are appropriate techniques.
6. A nurse is caring for a patient with a surgical wound that is draining purulent
fluid. The wound culture reveals methicillin-resistant Staphylococcus aureus
(MRSA). Which of the following precautions should the nurse implement?
A. Standard precautions only
B. Contact precautions
C. Droplet precautions
D. Airborne precautions
Answer: B. Contact precautions
MRSA is transmitted via direct contact with contaminated skin or surfaces. Contact
precautions, including gown and gloves, are required. Standard precautions alone are
insufficient. Droplet and airborne precautions are for respiratory pathogens.
7. A nurse is evaluating a patient's fluid balance. The patient's intake was 1500 mL,
output was 800 mL, and insensible losses are estimated at 400 mL. What is the
patient's fluid balance?
A. Positive 300 mL
B. Negative 300 mL
C. Positive 700 mL
D. Negative 700 mL
Answer: A. Positive 300 mL
Fluid balance = intake - (output + insensible losses) = 1500 - (800 + 400) = 1500 - 1200 =
+300 mL. A positive balance indicates retention.
Page 4
Fundamentals of Nursing Questions — 200 Questions and
Answers Already Graded A+ Premium Exam Tested And
Verified
Subject Area Fundamentals of Nursing
Description This exam assesses advanced understanding of core nursing concepts including
pharmacology, infection control, fluid and electrolyte balance, perioperative care,
and patient safety. Questions require synthesis of knowledge across multiple
domains and application to complex clinical scenarios.
Expected Grade A+
Total Questions 200
Duration 3 hours
Learning Outcomes 1. Apply evidence-based practice to pharmacological and non-pharmacological
interventions
2. Analyze patient data to prioritize nursing actions and prevent complications
3. Integrate principles of infection control, safety, and therapeutic communication
in diverse settings
Accreditation Aligns with AACN Essentials and NCLEX-RN test plan standards for US
baccalaureate nursing programs
Page 1
,1. A patient with a history of chronic obstructive pulmonary disease (COPD) is
receiving oxygen via nasal cannula at 2 L/min. The nurse notes that the patient's
respiratory rate has decreased from 22 to 10 breaths per minute, and the patient
appears drowsy. Which of the following should the nurse prioritize?
A. Increase the oxygen flow rate to 4 L/min to improve oxygenation
B. Reduce the oxygen flow rate to 1 L/min and monitor the patient's respiratory status
C. Administer naloxone per protocol for suspected opioid-induced respiratory depression
D. Prepare for immediate endotracheal intubation
Answer: B. Reduce the oxygen flow rate to 1 L/min and monitor the patient's
respiratory status
In patients with COPD, hypoxic drive is the primary stimulus for breathing. High
oxygen levels can suppress this drive, leading to hypoventilation and respiratory
acidosis. Reducing oxygen flow and monitoring is appropriate. Increasing oxygen
would worsen the condition. Naloxone is not indicated without evidence of opioid use.
Intubation is a last resort.
2. A nurse is preparing to administer a blood transfusion to a patient with a history
of multiple transfusions. Which of the following actions is most important to prevent
a transfusion reaction?
A. Pre-medicate with acetaminophen and diphenhydramine
B. Use a leukocyte-reduced blood product
C. Verify the patient's identity with two identifiers and cross-check with blood product
D. Administer the blood through a peripheral IV with a 20-gauge needle
Answer: B. Use a leukocyte-reduced blood product
Leukocyte-reduced blood products decrease the risk of febrile non-hemolytic
transfusion reactions, especially in patients with prior transfusions. Pre-medication
may reduce symptoms but does not prevent the reaction. Verification is crucial but does
not specifically prevent reactions. Needle size affects flow, not reaction risk.
Page 2
,3. A patient with heart failure is receiving furosemide 40 mg IV push. The nurse
notes that the patient's urine output over the last hour is 50 mL. Which of the
following laboratory values should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum magnesium
D. Serum calcium
Answer: B. Serum potassium
Furosemide is a loop diuretic that increases excretion of sodium, water, and potassium.
Hypokalemia is a common adverse effect that can lead to cardiac arrhythmias. While
sodium and magnesium may also be affected, potassium is the most critical to monitor
due to its cardiac implications.
4. A nurse is assessing a patient who has been on bed rest for 3 days. The patient
reports sudden onset of dyspnea and chest pain. Vital signs: BP 100/60, HR 110, RR
28, SpO2 88% on room air. Which of the following actions should the nurse take
first?
A. Administer oxygen via non-rebreather mask
B. Notify the healthcare provider immediately
C. Elevate the head of the bed to 45 degrees
D. Apply compression stockings
Answer: A. Administer oxygen via non-rebreather mask
The patient's symptoms are concerning for pulmonary embolism. The priority is to
correct hypoxemia; administering high-flow oxygen is the first step. Elevating the head
of the bed may improve breathing but does not address oxygenation directly. Notifying
the provider is important but secondary to oxygen. Compression stockings are
preventive, not acute.
Page 3
, 5. A nurse is teaching a patient about self-administration of enoxaparin. Which of
the following statements by the patient indicates a need for further teaching?
A. I will inject the medication into my abdomen
B. I should rotate injection sites between left and right sides
C. I will rub the injection site after administering the medication
D. I will hold the skin fold until the needle is fully inserted
Answer: C. I will rub the injection site after administering the medication
Rubbing the injection site after administering enoxaparin can cause bruising and
hematoma formation. Patients should be instructed to apply gentle pressure without
rubbing. The other statements are correct: abdominal injection, site rotation, and
maintaining skin fold are appropriate techniques.
6. A nurse is caring for a patient with a surgical wound that is draining purulent
fluid. The wound culture reveals methicillin-resistant Staphylococcus aureus
(MRSA). Which of the following precautions should the nurse implement?
A. Standard precautions only
B. Contact precautions
C. Droplet precautions
D. Airborne precautions
Answer: B. Contact precautions
MRSA is transmitted via direct contact with contaminated skin or surfaces. Contact
precautions, including gown and gloves, are required. Standard precautions alone are
insufficient. Droplet and airborne precautions are for respiratory pathogens.
7. A nurse is evaluating a patient's fluid balance. The patient's intake was 1500 mL,
output was 800 mL, and insensible losses are estimated at 400 mL. What is the
patient's fluid balance?
A. Positive 300 mL
B. Negative 300 mL
C. Positive 700 mL
D. Negative 700 mL
Answer: A. Positive 300 mL
Fluid balance = intake - (output + insensible losses) = 1500 - (800 + 400) = 1500 - 1200 =
+300 mL. A positive balance indicates retention.
Page 4
