NUR 104/NUR104 Exam 1 V2 | Foundations
of Nursing Q&A with Rationale | Fortis
College
1. A nurse is collecting data from a patient who reports localized pain and burning during
urination. Which step of the nursing process is the nurse performing?
A. Diagnosis
B. Assessment
C. Implementation
D. Evaluation
Correct Answer: B
Expert Explanation: The assessment phase involves the systematic collection of subjective
and objective data. In this scenario, the nurse is gathering information regarding the
patient’s symptoms and physical status. This foundational step is necessary to identify the
patient’s health needs before moving to diagnosis or planning.
2. Which historical figure is considered the founder of modern nursing and established the
first nursing philosophy based on health maintenance and restoration?
A. Clara Barton
B. Dorothea Dix
C. Florence Nightingale
,D. Harriet Tubman
Correct Answer: C
Expert Explanation: Florence Nightingale is recognized globally as the founder of modern
nursing practices. She developed the Environmental Theory which emphasizes the role of
the patient’s environment in their recovery. Her work during the Crimean War significantly
reduced mortality rates through sanitation and hygiene improvements.
3. According to Maslow’s Hierarchy of Needs, which patient finding requires the nurse’s
immediate priority?
A. The patient expresses a lack of self-worth.
B. The patient reports feeling unsafe in their neighborhood.
C. The patient states they feel lonely since their spouse passed.
D. The patient has an oxygen saturation of 88% on room air.
Correct Answer: D
Expert Explanation: Maslow’s hierarchy dictates that physiological needs must be met
before higher-level psychological needs. Oxygenation is a basic physiological requirement
for survival and takes precedence over safety, love, or esteem. Nurses use this framework
to prioritize care in clinical settings to ensure patient stability.
4. A nurse is practicing the ethical principle of autonomy. Which action by the nurse best
demonstrates this principle?
A. Ensuring the patient does not fall during the shift.
, B. Providing the patient with all the information needed to make an informed decision.
C. Treating all patients equally regardless of their background.
D. Keeping a promise to return to the room in 10 minutes.
Correct Answer: B
Expert Explanation: Autonomy refers to the patient’s right to make their own healthcare
decisions without coercion. By providing comprehensive information, the nurse empowers
the patient to exercise their self-determination. This principle is a cornerstone of the
informed consent process in the medical field.
5. Which of the following is considered ‘objective’ data during a physical assessment?
A. Patient states, ‘I feel dizzy when I stand up.’
B. Patient reports a pain level of 7 out of 10.
C. Patient describes a feeling of nausea.
D. Blood pressure reading of 150/92 mmHg.
Correct Answer: D
Expert Explanation: Objective data is observable and measurable information obtained
through physical examination or diagnostic tests. Blood pressure is a quantifiable value
that can be verified by another healthcare professional. Subjective data, conversely,
consists of the patient’s personal perceptions and feelings which cannot be directly
measured.
of Nursing Q&A with Rationale | Fortis
College
1. A nurse is collecting data from a patient who reports localized pain and burning during
urination. Which step of the nursing process is the nurse performing?
A. Diagnosis
B. Assessment
C. Implementation
D. Evaluation
Correct Answer: B
Expert Explanation: The assessment phase involves the systematic collection of subjective
and objective data. In this scenario, the nurse is gathering information regarding the
patient’s symptoms and physical status. This foundational step is necessary to identify the
patient’s health needs before moving to diagnosis or planning.
2. Which historical figure is considered the founder of modern nursing and established the
first nursing philosophy based on health maintenance and restoration?
A. Clara Barton
B. Dorothea Dix
C. Florence Nightingale
,D. Harriet Tubman
Correct Answer: C
Expert Explanation: Florence Nightingale is recognized globally as the founder of modern
nursing practices. She developed the Environmental Theory which emphasizes the role of
the patient’s environment in their recovery. Her work during the Crimean War significantly
reduced mortality rates through sanitation and hygiene improvements.
3. According to Maslow’s Hierarchy of Needs, which patient finding requires the nurse’s
immediate priority?
A. The patient expresses a lack of self-worth.
B. The patient reports feeling unsafe in their neighborhood.
C. The patient states they feel lonely since their spouse passed.
D. The patient has an oxygen saturation of 88% on room air.
Correct Answer: D
Expert Explanation: Maslow’s hierarchy dictates that physiological needs must be met
before higher-level psychological needs. Oxygenation is a basic physiological requirement
for survival and takes precedence over safety, love, or esteem. Nurses use this framework
to prioritize care in clinical settings to ensure patient stability.
4. A nurse is practicing the ethical principle of autonomy. Which action by the nurse best
demonstrates this principle?
A. Ensuring the patient does not fall during the shift.
, B. Providing the patient with all the information needed to make an informed decision.
C. Treating all patients equally regardless of their background.
D. Keeping a promise to return to the room in 10 minutes.
Correct Answer: B
Expert Explanation: Autonomy refers to the patient’s right to make their own healthcare
decisions without coercion. By providing comprehensive information, the nurse empowers
the patient to exercise their self-determination. This principle is a cornerstone of the
informed consent process in the medical field.
5. Which of the following is considered ‘objective’ data during a physical assessment?
A. Patient states, ‘I feel dizzy when I stand up.’
B. Patient reports a pain level of 7 out of 10.
C. Patient describes a feeling of nausea.
D. Blood pressure reading of 150/92 mmHg.
Correct Answer: D
Expert Explanation: Objective data is observable and measurable information obtained
through physical examination or diagnostic tests. Blood pressure is a quantifiable value
that can be verified by another healthcare professional. Subjective data, conversely,
consists of the patient’s personal perceptions and feelings which cannot be directly
measured.
