4 M A X E • S L AT N E M A D N U F
★ ★
Nursing Fundamentals Assessment
N Comprehensive Examination — Exam 4
EST. 2026
E XC E L L E N C E I N N U RS I N G E D U C AT I O N
Fundamentals of Nursing — Exam 4
S E X U A L I T Y, S P I R I T U A L I T Y, F LU I D & E L E C T R O LY T E S , I V T H E R A P Y & B LO O D T R A N S F U S I O N
INSTITUTION Nursing Fundamentals Assessment COURSE CODE Nursing Fundamentals — Exam 4
PROGRAM Practical Nursing (PN) / Associate Degree ACADEMIC YEAR
in Nursing (ADN)
EXAM TITLE Nursing Fundamentals Exam 4 TOTAL QUESTIONS 60 Questions
COURSE TITLE Fundamentals of Nursing FORMAT Multiple Choice / Select All That Apply /
Ordered Response / Fill-in
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise instructed.
▸ Select all that apply questions are indicated — choose every correct option.
▸ Questions cover sexuality, spirituality, fluid/electrolytes, IV therapy, and blood transfusion.
▸ Correct answers and clinical rationales appear below each question for review purposes.
▸ All content reflects current evidence-based nursing practice.
SECTION I — FUNDAMENTALS OF NURSING COMPREHENSIVE Questions 1 –
EXAMINATION 60
1. The nurse is providing education on STIs to adolescents. Which statement indicates that further teaching is
needed?
A. "A vaccine is available to reduce infection from certain types of human papillomavirus."
B. "I should be screened for an STI after I am with a new partner."
C. "I know I'm not infected if I don't have any symptoms such as discharge or sores."
D. "A viral infection such as herpes or human papillomavirus cannot be treated with antibiotics."
CORRECT ANSWER C — "I know I'm not infected if I don't have any symptoms such as discharge or sores."
RATIONALE This statement indicates a need for further teaching because the majority of STIs have FEW if any symptoms
— an individual can be infected and infectious without knowing it. This is why regular screenings in all
sexually active individuals are essential, regardless of symptoms. The other statements are correct: (A) HPV
vaccine (Gardasil) protects against certain cancer-causing HPV types. (B) Screening after new partners is
recommended. (D) Viral infections (herpes, HPV) are not treated with antibiotics — antibiotics treat bacterial
STIs (chlamydia, gonorrhea, syphilis). The nurse must correct this misconception and emphasize that
asymptomatic STIs can still cause serious long-term complications (infertility, PID, increased HIV risk).
,2. According to Erikson's theory of psychosocial development, what is the major developmental task of adolescence?
A. Adjusting to dramatic changes in body image (Identity vs. Role Confusion).
B. Developing hypothetical reasoning skills.
C. Establishing the capacity for an intimate love relationship.
D. Learning to make good choices and avoid risk-taking behaviors.
CORRECT ANSWER A — Adjusting to dramatic changes in body image (Identity vs. Role Confusion).
RATIONALE Erikson's stage for adolescents (12–18 years) is Identity vs. Role Confusion. The major developmental task is
forming a coherent sense of self and personal identity. Adolescents are preoccupied with their changing
bodies and how their bodies appear to others — body image is central to identity formation. Option B
describes Piaget's formal operational stage (cognitive development, not psychosocial). Option C describes
Erikson's Intimacy vs. Isolation (early adulthood). Option D is a safety concern — risk-taking behaviors are the
primary cause of unintentional injury (the most common cause of death in adolescents), but this is not
Erikson's developmental task. The nurse should support healthy identity exploration while providing accurate
health information.
3. A 25-year-old female has several bruises in various stages of healing. The nurse suspects possible sexual abuse.
What is the nurse's first action?
A. Refer the patient to a sexual counselor.
B. Ask the patient to describe how she got the bruises in a private, nonjudgmental manner.
C. Report the abuse immediately to the proper authorities.
D. Tell the patient about the safe house for women.
CORRECT ANSWER B — Ask the patient to describe how she got the bruises in a private, nonjudgmental manner.
RATIONALE The nurse's FIRST action when abuse is suspected is to conduct a private, sensitive interview — asking the
patient directly about the bruises in a safe, nonjudgmental environment. This allows the patient to disclose if
abuse is occurring. For competent adults, reporting to authorities (C) requires patient consent unless the
patient is a minor, elderly, or disabled (mandatory reporting). Referring to a counselor (A) or providing
information about a safe house (D) may be appropriate AFTER the patient discloses and expresses readiness
for those resources. The nurse must: ensure privacy, use therapeutic communication, avoid judgmental
language, document objective findings, and provide information about resources. For children, elders, and
vulnerable adults, reporting is mandatory regardless of patient consent.
4. A 26-year-old pregnant woman has purulent vaginal discharge, burning with urination, and urinary frequency. The
nurse suspects:
A. She should be tested for HIV.
B. She may have an STI such as chlamydia.
C. She is experiencing normal signs of pregnancy.
D. She needs education on proper perineal hygiene.
CORRECT ANSWER B — She may have an STI such as chlamydia.
RATIONALE Purulent vaginal discharge, dysuria (burning with urination), and urinary frequency are classic signs of an STI
— chlamydia and gonorrhea are the most common bacterial STIs presenting with these symptoms.
Chlamydia is especially important to diagnose and treat during pregnancy because it can cause preterm
labor, premature rupture of membranes, and neonatal conjunctivitis/pneumonia during vaginal delivery.
These are NOT normal pregnancy signs (C) — normal pregnancy may cause increased vaginal discharge
(leukorrhea) but it is typically thin, white, and non-irritating, without burning or frequency. HIV testing (A) is
recommended for all pregnant women but is not specifically indicated by these symptoms alone. Perineal
hygiene education (D) does not address the likely infection. The patient needs STI testing (nucleic acid
amplification test — NAAT) and prompt antibiotic treatment to prevent complications.
, 5. A new graduate nurse wants to enhance comfort in discussing sexual issues with patients. Which actions are
appropriate? (Select all that apply.)
A. Clarifying personal values related to sexuality.
B. Role playing discussion of sexual concerns with another nurse.
C. Attending a conference to enhance knowledge about sexuality.
D. Avoiding discussion of sexual concerns until after completing orientation.
CORRECT ANSWER A, B, C — Clarifying personal values; Role playing; Attending educational conferences.
RATIONALE Strategies to enhance comfort with sexuality discussions: (A) Clarifying personal values — the nurse must
understand their own beliefs and biases about sexuality to avoid imposing them on patients. (B) Role playing
— practicing discussions with a colleague builds confidence and communication skills. (C) Continuing
education — conferences and workshops increase knowledge and provide evidence-based approaches. (D) is
incorrect — avoiding discussions until orientation is complete delays essential patient care; sexuality is an
integral part of holistic nursing assessment and should be addressed from the beginning. Additional
strategies: using a nonjudgmental approach, beginning with permission ("Is it okay if I ask you some
questions about your sexual health?"), using open-ended questions, and being aware of the patient's cultural
background and developmental stage.
6. The nurse is gathering a sexual history from a 68-year-old man in a nursing home. What is important for the nurse
to keep in mind?
A. Older adults are usually not part of a sexual minority group.
B. Older adults sometimes do not reveal intimate details.
C. Older men and women lose their interest in sex.
D. Older adults in nursing homes do not usually participate in sexual activity.
CORRECT ANSWER B — Older adults sometimes do not reveal intimate details.
RATIONALE Older adults may be reluctant to discuss sexual concerns due to generational norms, embarrassment, or fear
of judgment. The nurse must create a safe, private, nonjudgmental environment and ask permission before
discussing sexual topics. The other options are myths: (A) Older adults CAN be part of sexual minority groups
(LGBTQ+). (C) Many older adults maintain sexual interest and activity — sexuality continues throughout the
lifespan, though the response cycle may slow. (D) Older adults in nursing homes DO participate in sexual
activity — facilities should respect residents' rights to sexual expression and privacy. Factors determining
sexual activity in older adults include: present health status, past and present life satisfaction, and status of
intimate relationships. The nurse should assess sexual health as part of holistic care for patients of ALL ages.
★ ★
Nursing Fundamentals Assessment
N Comprehensive Examination — Exam 4
EST. 2026
E XC E L L E N C E I N N U RS I N G E D U C AT I O N
Fundamentals of Nursing — Exam 4
S E X U A L I T Y, S P I R I T U A L I T Y, F LU I D & E L E C T R O LY T E S , I V T H E R A P Y & B LO O D T R A N S F U S I O N
INSTITUTION Nursing Fundamentals Assessment COURSE CODE Nursing Fundamentals — Exam 4
PROGRAM Practical Nursing (PN) / Associate Degree ACADEMIC YEAR
in Nursing (ADN)
EXAM TITLE Nursing Fundamentals Exam 4 TOTAL QUESTIONS 60 Questions
COURSE TITLE Fundamentals of Nursing FORMAT Multiple Choice / Select All That Apply /
Ordered Response / Fill-in
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise instructed.
▸ Select all that apply questions are indicated — choose every correct option.
▸ Questions cover sexuality, spirituality, fluid/electrolytes, IV therapy, and blood transfusion.
▸ Correct answers and clinical rationales appear below each question for review purposes.
▸ All content reflects current evidence-based nursing practice.
SECTION I — FUNDAMENTALS OF NURSING COMPREHENSIVE Questions 1 –
EXAMINATION 60
1. The nurse is providing education on STIs to adolescents. Which statement indicates that further teaching is
needed?
A. "A vaccine is available to reduce infection from certain types of human papillomavirus."
B. "I should be screened for an STI after I am with a new partner."
C. "I know I'm not infected if I don't have any symptoms such as discharge or sores."
D. "A viral infection such as herpes or human papillomavirus cannot be treated with antibiotics."
CORRECT ANSWER C — "I know I'm not infected if I don't have any symptoms such as discharge or sores."
RATIONALE This statement indicates a need for further teaching because the majority of STIs have FEW if any symptoms
— an individual can be infected and infectious without knowing it. This is why regular screenings in all
sexually active individuals are essential, regardless of symptoms. The other statements are correct: (A) HPV
vaccine (Gardasil) protects against certain cancer-causing HPV types. (B) Screening after new partners is
recommended. (D) Viral infections (herpes, HPV) are not treated with antibiotics — antibiotics treat bacterial
STIs (chlamydia, gonorrhea, syphilis). The nurse must correct this misconception and emphasize that
asymptomatic STIs can still cause serious long-term complications (infertility, PID, increased HIV risk).
,2. According to Erikson's theory of psychosocial development, what is the major developmental task of adolescence?
A. Adjusting to dramatic changes in body image (Identity vs. Role Confusion).
B. Developing hypothetical reasoning skills.
C. Establishing the capacity for an intimate love relationship.
D. Learning to make good choices and avoid risk-taking behaviors.
CORRECT ANSWER A — Adjusting to dramatic changes in body image (Identity vs. Role Confusion).
RATIONALE Erikson's stage for adolescents (12–18 years) is Identity vs. Role Confusion. The major developmental task is
forming a coherent sense of self and personal identity. Adolescents are preoccupied with their changing
bodies and how their bodies appear to others — body image is central to identity formation. Option B
describes Piaget's formal operational stage (cognitive development, not psychosocial). Option C describes
Erikson's Intimacy vs. Isolation (early adulthood). Option D is a safety concern — risk-taking behaviors are the
primary cause of unintentional injury (the most common cause of death in adolescents), but this is not
Erikson's developmental task. The nurse should support healthy identity exploration while providing accurate
health information.
3. A 25-year-old female has several bruises in various stages of healing. The nurse suspects possible sexual abuse.
What is the nurse's first action?
A. Refer the patient to a sexual counselor.
B. Ask the patient to describe how she got the bruises in a private, nonjudgmental manner.
C. Report the abuse immediately to the proper authorities.
D. Tell the patient about the safe house for women.
CORRECT ANSWER B — Ask the patient to describe how she got the bruises in a private, nonjudgmental manner.
RATIONALE The nurse's FIRST action when abuse is suspected is to conduct a private, sensitive interview — asking the
patient directly about the bruises in a safe, nonjudgmental environment. This allows the patient to disclose if
abuse is occurring. For competent adults, reporting to authorities (C) requires patient consent unless the
patient is a minor, elderly, or disabled (mandatory reporting). Referring to a counselor (A) or providing
information about a safe house (D) may be appropriate AFTER the patient discloses and expresses readiness
for those resources. The nurse must: ensure privacy, use therapeutic communication, avoid judgmental
language, document objective findings, and provide information about resources. For children, elders, and
vulnerable adults, reporting is mandatory regardless of patient consent.
4. A 26-year-old pregnant woman has purulent vaginal discharge, burning with urination, and urinary frequency. The
nurse suspects:
A. She should be tested for HIV.
B. She may have an STI such as chlamydia.
C. She is experiencing normal signs of pregnancy.
D. She needs education on proper perineal hygiene.
CORRECT ANSWER B — She may have an STI such as chlamydia.
RATIONALE Purulent vaginal discharge, dysuria (burning with urination), and urinary frequency are classic signs of an STI
— chlamydia and gonorrhea are the most common bacterial STIs presenting with these symptoms.
Chlamydia is especially important to diagnose and treat during pregnancy because it can cause preterm
labor, premature rupture of membranes, and neonatal conjunctivitis/pneumonia during vaginal delivery.
These are NOT normal pregnancy signs (C) — normal pregnancy may cause increased vaginal discharge
(leukorrhea) but it is typically thin, white, and non-irritating, without burning or frequency. HIV testing (A) is
recommended for all pregnant women but is not specifically indicated by these symptoms alone. Perineal
hygiene education (D) does not address the likely infection. The patient needs STI testing (nucleic acid
amplification test — NAAT) and prompt antibiotic treatment to prevent complications.
, 5. A new graduate nurse wants to enhance comfort in discussing sexual issues with patients. Which actions are
appropriate? (Select all that apply.)
A. Clarifying personal values related to sexuality.
B. Role playing discussion of sexual concerns with another nurse.
C. Attending a conference to enhance knowledge about sexuality.
D. Avoiding discussion of sexual concerns until after completing orientation.
CORRECT ANSWER A, B, C — Clarifying personal values; Role playing; Attending educational conferences.
RATIONALE Strategies to enhance comfort with sexuality discussions: (A) Clarifying personal values — the nurse must
understand their own beliefs and biases about sexuality to avoid imposing them on patients. (B) Role playing
— practicing discussions with a colleague builds confidence and communication skills. (C) Continuing
education — conferences and workshops increase knowledge and provide evidence-based approaches. (D) is
incorrect — avoiding discussions until orientation is complete delays essential patient care; sexuality is an
integral part of holistic nursing assessment and should be addressed from the beginning. Additional
strategies: using a nonjudgmental approach, beginning with permission ("Is it okay if I ask you some
questions about your sexual health?"), using open-ended questions, and being aware of the patient's cultural
background and developmental stage.
6. The nurse is gathering a sexual history from a 68-year-old man in a nursing home. What is important for the nurse
to keep in mind?
A. Older adults are usually not part of a sexual minority group.
B. Older adults sometimes do not reveal intimate details.
C. Older men and women lose their interest in sex.
D. Older adults in nursing homes do not usually participate in sexual activity.
CORRECT ANSWER B — Older adults sometimes do not reveal intimate details.
RATIONALE Older adults may be reluctant to discuss sexual concerns due to generational norms, embarrassment, or fear
of judgment. The nurse must create a safe, private, nonjudgmental environment and ask permission before
discussing sexual topics. The other options are myths: (A) Older adults CAN be part of sexual minority groups
(LGBTQ+). (C) Many older adults maintain sexual interest and activity — sexuality continues throughout the
lifespan, though the response cycle may slow. (D) Older adults in nursing homes DO participate in sexual
activity — facilities should respect residents' rights to sexual expression and privacy. Factors determining
sexual activity in older adults include: present health status, past and present life satisfaction, and status of
intimate relationships. The nurse should assess sexual health as part of holistic care for patients of ALL ages.
