NU 301 Unit 1 Exam (PDF) | (Updated) NCLEX-Style
Fundamentals of Nursing Questions — 195 Questions
Section 1: Foundations of Nursing Practice (Questions 1-20)
1 A nurse is caring for a patient with chronic pain who requests a non-pharmacological intervention. Which
theoretical framework best supports the nurse's decision to incorporate guided imagery and relaxation
techniques into the care plan?
A) Orem's Self-Care Deficit Theory
B) Roy's Adaptation Model
C) Neuman's Systems Model
D) Peplau's Interpersonal Relations Theory
Answer: B
Rationale: Roy's Adaptation Model focuses on helping patients adapt to stressors through coping mechanisms,
including cognitive and behavioral strategies like guided imagery. Orem's theory emphasizes self-care deficits, not
adaptation. Neuman's model addresses system stability but not specifically non-pharmacological interventions.
Peplau's theory centers on nurse-patient relationships, not adaptation.
2 A nursing student is preparing a presentation on evidence-based practice (EBP). Which sequence correctly
represents the steps of EBP as applied to a clinical question?
A) Ask a clinical question, acquire the evidence, appraise the evidence, apply the evidence, assess the outcome
B) Acquire the evidence, ask a clinical question, appraise the evidence, apply the evidence, assess the outcome
C) Ask a clinical question, appraise the evidence, acquire the evidence, apply the evidence, assess the outcome
D) Appraise the evidence, ask a clinical question, acquire the evidence, apply the evidence, assess the outcome
Answer: A
Rationale: The correct EBP sequence is: Ask, Acquire, Appraise, Apply, Assess. This ensures that the clinical
question drives the search for evidence, which is then critically appraised before application. The other options
either start with acquisition or appraisal, which is illogical.
3 A nurse is documenting care for a patient who refused a prescribed medication. Which entry best demonstrates
legal and ethical documentation standards?
A) Patient refused medication due to personal beliefs. Provider notified.
B) Patient stated 'I don't want to take that pill.' Medication not given.
C) Patient refused amoxicillin 500 mg PO at 0900. Provider Dr. Smith notified at 0910. Patient's reason: 'I think I
am allergic.'
D) Medication held per patient request. No further action taken.
Answer: C
Rationale: Proper documentation includes the specific medication, dose, time, provider notification, and the patient's
exact reason, which is objective and complete. Option A includes interpretation ('personal beliefs'). Option B lacks
provider notification. Option D fails to specify medication or provider notification.
4 A nurse is delegating tasks to a licensed practical nurse (LPN) and a nursing assistant (NA). Which task should
the nurse delegate to the LPN?
A) Administering a blood transfusion
B) Assessing a patient's lung sounds
,C) Inserting a urinary catheter
D) Feeding a patient with dysphagia
Answer: C
Rationale: Inserting a urinary catheter is within the LPN scope of practice in most states, as it is a technical skill.
Administering blood transfusions and assessing lung sounds require registered nurse (RN) critical thinking.
Feeding a patient with dysphagia may be delegated to NA with training, but catheter insertion is more appropriate
for LPN.
5 A nurse is providing discharge teaching to a patient with a new diagnosis of heart failure. Which statement by
the patient indicates a need for further teaching?
A) I will weigh myself daily and call the clinic if I gain 2 pounds in a day.
B) I should limit my sodium intake to less than 2 grams per day.
C) I can take ibuprofen for joint pain as needed.
D) I will rest frequently and gradually increase activity.
Answer: C
Rationale: NSAIDs like ibuprofen can cause fluid retention and worsen heart failure; they should be avoided. Daily
weights, sodium restriction, and gradual activity are appropriate. The patient needs further teaching about
medication safety.
6 A nurse is using the nursing process to develop a care plan for a patient with pneumonia. Which step involves
analyzing data to identify health problems?
A) Assessment
B) Diagnosis
C) Planning
D) Implementation
Answer: B
Rationale: The diagnosis phase involves analyzing assessment data to identify actual or potential health problems.
Assessment is data collection. Planning sets goals, and implementation is carrying out interventions.
7 A nurse is caring for a patient who is a Jehovah's Witness and refuses a blood transfusion. The nurse respects
the patient's decision. Which ethical principle is the nurse demonstrating?
A) Beneficence
B) Nonmaleficence
C) Autonomy
D) Justice
Answer: C
Rationale: Autonomy respects the patient's right to make their own healthcare decisions, even if the decision is
against medical advice. Beneficence is doing good, nonmaleficence is avoiding harm, and justice is fairness. Here,
the nurse supports the patient's choice.
8 A nurse is reviewing a patient's medication reconciliation. The patient is prescribed warfarin and also takes
over-the-counter ginkgo biloba. What is the nurse's priority action?
A) Discontinue the ginkgo biloba immediately.
B) Advise the patient to stop ginkgo biloba and monitor for bleeding.
C) Document the supplement and notify the provider.
D) Administer vitamin K to counteract potential bleeding.
,Answer: C
Rationale: Ginkgo biloba can increase bleeding risk with warfarin. The nurse should document and notify the
provider for further evaluation. Discontinuing or advising to stop without provider order is outside nursing scope.
Vitamin K is not indicated without evidence of bleeding.
9 A nurse is implementing a fall prevention protocol for an older adult patient. Which intervention is most
effective in reducing fall risk?
A) Placing the bed in the highest position for easy transfer
B) Encouraging the patient to wear non-skid slippers when ambulating
C) Using a night light and keeping the call light within reach
D) Applying soft wrist restraints during the night
Answer: C
Rationale: Night lights and accessible call lights improve visibility and enable the patient to call for assistance,
reducing fall risk. Bed should be in lowest position. Non-skid slippers are good but not as effective as
environmental modifications. Restraints increase risk of injury and are not first-line.
10 A nurse is evaluating the effectiveness of a pain management plan for a patient with postoperative pain. Which
outcome indicates that the plan is effective?
A) The patient reports a pain score of 4 on a 0-10 scale 30 minutes after medication.
B) The patient is able to ambulate to the bathroom with assistance.
C) The patient requests pain medication every 4 hours as ordered.
D) The patient's vital signs are within normal limits.
Answer: B
Rationale: Effective pain management enables the patient to perform functional activities like ambulation. A pain
score of 4 may still be acceptable but functional ability is a better indicator. Requesting medication as ordered does
not indicate effectiveness. Vital signs can be normal even with pain.
11 A nursing student is preparing to administer a scheduled medication. The student is unsure about the dosage
calculation. Which action best reflects the principle of beneficence in this situation?
A) Administer the medication as prescribed, assuming the dose is correct.
B) Consult the drug reference and recalculate the dose before administering.
C) Ask another student to verify the calculation, then administer.
D) Document the uncertainty and administer the medication to avoid delay.
Answer: B
Rationale: Beneficence requires acting in the patient's best interest. Verifying the dose ensures safety and prevents
harm, which aligns with beneficence. Option A ignores potential error; C shifts responsibility without independent
verification; D prioritizes schedule over safety.
12 In the context of evidence-based practice (EBP), which hierarchy of evidence represents the strongest level for
guiding clinical decisions?
A) Systematic review of randomized controlled trials (RCTs)
B) Single randomized controlled trial
C) Cohort study
D) Expert opinion
Answer: A
Rationale: Systematic reviews of RCTs provide the highest level of evidence as they synthesize multiple
high-quality studies, reducing bias. Single RCTs (B) are strong but less robust; cohort studies (C) are observational;
, expert opinion (D) is the weakest.
13 A nurse is delegating a task to a licensed practical nurse (LPN). Which principle should guide the decision to
delegate?
A) The task is within the LPN's scope of practice and the nurse has assessed the patient's stability.
B) The task is complex but the LPN has performed it before.
C) The nurse is busy and the LPN is available.
D) The task requires ongoing assessment and critical thinking.
Answer: A
Rationale: Delegation must consider the delegatee's scope of practice and patient condition. A is correct: the task
must be within the LPN's scope and the patient stable. B is insufficient; C is inappropriate; D describes tasks that
should not be delegated.
14 A nurse is using the nursing process to plan care for a patient with pneumonia. Which step involves analyzing
data to identify health problems?
A) Assessment
B) Diagnosis
C) Planning
D) Implementation
Answer: B
Rationale: The diagnosis phase involves analyzing assessment data to identify nursing diagnoses. Assessment (A) is
data collection; Planning (C) sets goals; Implementation (D) is carrying out interventions.
15 Which ethical principle is most directly challenged when a patient refuses a life-saving blood transfusion due to
religious beliefs?
A) Autonomy
B) Beneficence
C) Nonmaleficence
D) Justice
Answer: A
Rationale: Autonomy respects the patient's right to make decisions, even if they conflict with medical advice.
Beneficence (doing good) and nonmaleficence (avoid harm) are important but must yield to autonomy when the
patient is competent. Justice (fairness) is less directly relevant.
16 A nurse is teaching a patient about managing hypertension. Which approach best demonstrates the use of the
Health Belief Model?
A) Emphasizing the severity of complications and the patient's susceptibility.
B) Providing a pamphlet with dietary recommendations.
C) Demonstrating how to use a home blood pressure monitor.
D) Encouraging the patient to ask questions.
Answer: A
Rationale: The Health Belief Model focuses on perceived susceptibility, severity, benefits, and barriers. Option A
addresses susceptibility and severity, key components. B, C, and D are educational strategies but do not specifically
apply the model's constructs.
17 A nurse is evaluating a patient's understanding of a low-sodium diet. Which outcome statement is written in
measurable terms?
Fundamentals of Nursing Questions — 195 Questions
Section 1: Foundations of Nursing Practice (Questions 1-20)
1 A nurse is caring for a patient with chronic pain who requests a non-pharmacological intervention. Which
theoretical framework best supports the nurse's decision to incorporate guided imagery and relaxation
techniques into the care plan?
A) Orem's Self-Care Deficit Theory
B) Roy's Adaptation Model
C) Neuman's Systems Model
D) Peplau's Interpersonal Relations Theory
Answer: B
Rationale: Roy's Adaptation Model focuses on helping patients adapt to stressors through coping mechanisms,
including cognitive and behavioral strategies like guided imagery. Orem's theory emphasizes self-care deficits, not
adaptation. Neuman's model addresses system stability but not specifically non-pharmacological interventions.
Peplau's theory centers on nurse-patient relationships, not adaptation.
2 A nursing student is preparing a presentation on evidence-based practice (EBP). Which sequence correctly
represents the steps of EBP as applied to a clinical question?
A) Ask a clinical question, acquire the evidence, appraise the evidence, apply the evidence, assess the outcome
B) Acquire the evidence, ask a clinical question, appraise the evidence, apply the evidence, assess the outcome
C) Ask a clinical question, appraise the evidence, acquire the evidence, apply the evidence, assess the outcome
D) Appraise the evidence, ask a clinical question, acquire the evidence, apply the evidence, assess the outcome
Answer: A
Rationale: The correct EBP sequence is: Ask, Acquire, Appraise, Apply, Assess. This ensures that the clinical
question drives the search for evidence, which is then critically appraised before application. The other options
either start with acquisition or appraisal, which is illogical.
3 A nurse is documenting care for a patient who refused a prescribed medication. Which entry best demonstrates
legal and ethical documentation standards?
A) Patient refused medication due to personal beliefs. Provider notified.
B) Patient stated 'I don't want to take that pill.' Medication not given.
C) Patient refused amoxicillin 500 mg PO at 0900. Provider Dr. Smith notified at 0910. Patient's reason: 'I think I
am allergic.'
D) Medication held per patient request. No further action taken.
Answer: C
Rationale: Proper documentation includes the specific medication, dose, time, provider notification, and the patient's
exact reason, which is objective and complete. Option A includes interpretation ('personal beliefs'). Option B lacks
provider notification. Option D fails to specify medication or provider notification.
4 A nurse is delegating tasks to a licensed practical nurse (LPN) and a nursing assistant (NA). Which task should
the nurse delegate to the LPN?
A) Administering a blood transfusion
B) Assessing a patient's lung sounds
,C) Inserting a urinary catheter
D) Feeding a patient with dysphagia
Answer: C
Rationale: Inserting a urinary catheter is within the LPN scope of practice in most states, as it is a technical skill.
Administering blood transfusions and assessing lung sounds require registered nurse (RN) critical thinking.
Feeding a patient with dysphagia may be delegated to NA with training, but catheter insertion is more appropriate
for LPN.
5 A nurse is providing discharge teaching to a patient with a new diagnosis of heart failure. Which statement by
the patient indicates a need for further teaching?
A) I will weigh myself daily and call the clinic if I gain 2 pounds in a day.
B) I should limit my sodium intake to less than 2 grams per day.
C) I can take ibuprofen for joint pain as needed.
D) I will rest frequently and gradually increase activity.
Answer: C
Rationale: NSAIDs like ibuprofen can cause fluid retention and worsen heart failure; they should be avoided. Daily
weights, sodium restriction, and gradual activity are appropriate. The patient needs further teaching about
medication safety.
6 A nurse is using the nursing process to develop a care plan for a patient with pneumonia. Which step involves
analyzing data to identify health problems?
A) Assessment
B) Diagnosis
C) Planning
D) Implementation
Answer: B
Rationale: The diagnosis phase involves analyzing assessment data to identify actual or potential health problems.
Assessment is data collection. Planning sets goals, and implementation is carrying out interventions.
7 A nurse is caring for a patient who is a Jehovah's Witness and refuses a blood transfusion. The nurse respects
the patient's decision. Which ethical principle is the nurse demonstrating?
A) Beneficence
B) Nonmaleficence
C) Autonomy
D) Justice
Answer: C
Rationale: Autonomy respects the patient's right to make their own healthcare decisions, even if the decision is
against medical advice. Beneficence is doing good, nonmaleficence is avoiding harm, and justice is fairness. Here,
the nurse supports the patient's choice.
8 A nurse is reviewing a patient's medication reconciliation. The patient is prescribed warfarin and also takes
over-the-counter ginkgo biloba. What is the nurse's priority action?
A) Discontinue the ginkgo biloba immediately.
B) Advise the patient to stop ginkgo biloba and monitor for bleeding.
C) Document the supplement and notify the provider.
D) Administer vitamin K to counteract potential bleeding.
,Answer: C
Rationale: Ginkgo biloba can increase bleeding risk with warfarin. The nurse should document and notify the
provider for further evaluation. Discontinuing or advising to stop without provider order is outside nursing scope.
Vitamin K is not indicated without evidence of bleeding.
9 A nurse is implementing a fall prevention protocol for an older adult patient. Which intervention is most
effective in reducing fall risk?
A) Placing the bed in the highest position for easy transfer
B) Encouraging the patient to wear non-skid slippers when ambulating
C) Using a night light and keeping the call light within reach
D) Applying soft wrist restraints during the night
Answer: C
Rationale: Night lights and accessible call lights improve visibility and enable the patient to call for assistance,
reducing fall risk. Bed should be in lowest position. Non-skid slippers are good but not as effective as
environmental modifications. Restraints increase risk of injury and are not first-line.
10 A nurse is evaluating the effectiveness of a pain management plan for a patient with postoperative pain. Which
outcome indicates that the plan is effective?
A) The patient reports a pain score of 4 on a 0-10 scale 30 minutes after medication.
B) The patient is able to ambulate to the bathroom with assistance.
C) The patient requests pain medication every 4 hours as ordered.
D) The patient's vital signs are within normal limits.
Answer: B
Rationale: Effective pain management enables the patient to perform functional activities like ambulation. A pain
score of 4 may still be acceptable but functional ability is a better indicator. Requesting medication as ordered does
not indicate effectiveness. Vital signs can be normal even with pain.
11 A nursing student is preparing to administer a scheduled medication. The student is unsure about the dosage
calculation. Which action best reflects the principle of beneficence in this situation?
A) Administer the medication as prescribed, assuming the dose is correct.
B) Consult the drug reference and recalculate the dose before administering.
C) Ask another student to verify the calculation, then administer.
D) Document the uncertainty and administer the medication to avoid delay.
Answer: B
Rationale: Beneficence requires acting in the patient's best interest. Verifying the dose ensures safety and prevents
harm, which aligns with beneficence. Option A ignores potential error; C shifts responsibility without independent
verification; D prioritizes schedule over safety.
12 In the context of evidence-based practice (EBP), which hierarchy of evidence represents the strongest level for
guiding clinical decisions?
A) Systematic review of randomized controlled trials (RCTs)
B) Single randomized controlled trial
C) Cohort study
D) Expert opinion
Answer: A
Rationale: Systematic reviews of RCTs provide the highest level of evidence as they synthesize multiple
high-quality studies, reducing bias. Single RCTs (B) are strong but less robust; cohort studies (C) are observational;
, expert opinion (D) is the weakest.
13 A nurse is delegating a task to a licensed practical nurse (LPN). Which principle should guide the decision to
delegate?
A) The task is within the LPN's scope of practice and the nurse has assessed the patient's stability.
B) The task is complex but the LPN has performed it before.
C) The nurse is busy and the LPN is available.
D) The task requires ongoing assessment and critical thinking.
Answer: A
Rationale: Delegation must consider the delegatee's scope of practice and patient condition. A is correct: the task
must be within the LPN's scope and the patient stable. B is insufficient; C is inappropriate; D describes tasks that
should not be delegated.
14 A nurse is using the nursing process to plan care for a patient with pneumonia. Which step involves analyzing
data to identify health problems?
A) Assessment
B) Diagnosis
C) Planning
D) Implementation
Answer: B
Rationale: The diagnosis phase involves analyzing assessment data to identify nursing diagnoses. Assessment (A) is
data collection; Planning (C) sets goals; Implementation (D) is carrying out interventions.
15 Which ethical principle is most directly challenged when a patient refuses a life-saving blood transfusion due to
religious beliefs?
A) Autonomy
B) Beneficence
C) Nonmaleficence
D) Justice
Answer: A
Rationale: Autonomy respects the patient's right to make decisions, even if they conflict with medical advice.
Beneficence (doing good) and nonmaleficence (avoid harm) are important but must yield to autonomy when the
patient is competent. Justice (fairness) is less directly relevant.
16 A nurse is teaching a patient about managing hypertension. Which approach best demonstrates the use of the
Health Belief Model?
A) Emphasizing the severity of complications and the patient's susceptibility.
B) Providing a pamphlet with dietary recommendations.
C) Demonstrating how to use a home blood pressure monitor.
D) Encouraging the patient to ask questions.
Answer: A
Rationale: The Health Belief Model focuses on perceived susceptibility, severity, benefits, and barriers. Option A
addresses susceptibility and severity, key components. B, C, and D are educational strategies but do not specifically
apply the model's constructs.
17 A nurse is evaluating a patient's understanding of a low-sodium diet. Which outcome statement is written in
measurable terms?
