S L AT N E M A D N U F • 4 M A X E
★ ★
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
Exam 4 — Fundamentals of Nursing
M E D I C AT I O N A D M I N I S T R AT I O N , P E R I O P E R AT I V E C A R E , M O B I L I T Y & PA I N M A N A G E M E N T
INSTITUTION Nursing Fundamentals Assessment COURSE CODE Exam 4 — Fundamentals of Nursing
PROGRAM Practical Nursing (PN) / Associate Degree ACADEMIC YEAR
in Nursing (ADN)
EXAM TITLE Exam 4 — Fundamentals of Nursing TOTAL QUESTIONS 50 Questions
COURSE TITLE Fundamentals of Nursing FORMAT Multiple Choice — Select the Single Best
Answer
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 medication administration, perioperative care, mobility, self-care, and pain management.
▸ 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 50
1. What are the three classifications of medications?
A. Oral, topical, injectable.
B. Chemical, clinical, therapeutic.
C. Prescription, over-the-counter, controlled.
D. Generic, brand, compounded.
CORRECT ANSWER B — Chemical, clinical, therapeutic.
RATIONALE Medications are classified by three broad categories: Chemical classification (based on the drug's chemical
structure and properties), Clinical classification (based on the drug's therapeutic use or clinical indication —
e.g., antihypertensives, antibiotics, analgesics), and Therapeutic classification (based on what condition the
drug treats — e.g., antidiabetic, antidepressant). These classifications help organize the vast number of
medications into meaningful groups for study, prescription, and clinical use. Medications can also be
described by their preparation forms: solid (capsule, tablet, spansule, powder), liquid (elixir, emulsion,
suspension, syrup, tincture), semisolid (cream, gel, ointment, paste), and specialized (suppository,
transdermal patch, lozenge). The nurse must understand medication classifications to safely administer
drugs, anticipate effects and side effects, and educate patients. The FDA regulates medication manufacture,
sale, and effectiveness.
,2. A medication that has a coating causing drug absorption in the intestines rather than the stomach to prevent
stomach irritation is called:
A. Spansule.
B. Enteric-coated.
C. Lozenge.
D. Elixir.
CORRECT ANSWER B — Enteric-coated.
RATIONALE Enteric-coated medications have a special coating that resists dissolution in the acidic environment of the
stomach — the drug is released in the alkaline environment of the small intestine. Purposes: (1) Prevents
gastric irritation from medications that are harsh on the stomach mucosa (e.g., aspirin, NSAIDs). (2) Protects
the drug from destruction by stomach acid (some drugs are inactivated by gastric acid). (3) Delays onset of
action until the drug reaches the intestines. ENTERIC-COATED TABLETS MUST NEVER BE CRUSHED OR
CHEWED — crushing destroys the protective coating, causing the drug to be released in the stomach (losing
the protective benefit) and altering absorption. A spansule (A) is a time-release capsule that dissolves slowly
for prolonged effect. A lozenge (troche) (C) is held in the mouth to dissolve. An elixir (D) is a liquid preparation
with an alcohol base. The nurse must know which medications cannot be crushed — including enteric-coated,
extended-release, and sublingual formulations.
3. What are the six rights of medication administration?
A. Right patient, medication, dose, route, time, documentation.
B. Right assessment, diagnosis, planning, implementation, evaluation.
C. Right task, circumstance, person, direction, supervision.
D. Right to refuse, right to privacy, right to information.
CORRECT ANSWER A — Right patient, medication, dose, route, time, documentation.
RATIONALE The Six Rights of Medication Administration (PMDRTD): (1) Right PATIENT — verify with two identifiers (name,
DOB, medical record number). (2) Right MEDICATION — check label three times against the MAR. (3) Right
DOSE — calculate accurately; have another nurse check if uncertain. (4) Right ROUTE — as prescribed; the
same drug may have different effects by different routes. (5) Right TIME — administer within 30 minutes of
scheduled time; know which medications must be given at exact times. (6) Right DOCUMENTATION — record
AFTER administration (never before); include time, route, dose, site (for injections), and patient response.
Additional rights often included: right reason, right to refuse, right assessment, right evaluation. The nurse
must NEVER administer a medication prepared by another nurse. If a patient refuses a medication, the nurse's
first action is to attempt to clarify the concern through education. If the patient still refuses, document the
refusal and notify the provider. Controlled substances require a second RN to witness discarding of any
wasted portion.
, 4. A medication order that must be carried out immediately is classified as:
A. PRN.
B. Routine (standing).
C. Stat.
D. One-time.
CORRECT ANSWER C — Stat.
RATIONALE Medication order types: STAT — must be given IMMEDIATELY (within 5 minutes or as soon as possible). Used
for emergency situations. PRN (A) — given as needed; requires nursing judgment about when to administer
and documentation of effectiveness. Routine/Standing (B) — carried out for a specified number of days or
until cancelled by another order (e.g., "Digoxin 0.125 mg PO daily"). One-time (D) — given only once at a
specified time (e.g., preoperative antibiotic). Standing Protocol — written for medications to be administered
in specific situations with criteria clearly outlined (e.g., "Acetaminophen 650 mg PO for temperature >101°F").
Verbal orders are accepted only in emergencies — the nurse must read back the order for verification.
Telephone orders must be written in the medical record, read back, and signed by the provider within 24
hours. CPOE (Computerized Provider Order Entry) allows the provider to enter orders directly into the
computer, reducing errors. The nurse is responsible for safe interpretation of the order and must clarify any
unclear orders with the provider.
5. Schedule II controlled substances are characterized by:
A. Low abuse potential; no prescription required.
B. High abuse potential with severe physical or psychological dependence; accepted medical uses; prescription
required with no refills.
C. No accepted medical use; high abuse potential.
D. Low abuse potential; prescription may not be required; no refill limits.
CORRECT ANSWER B — High abuse potential with severe physical or psychological dependence; accepted medical uses;
prescription required with no refills.
RATIONALE Controlled substances are classified into five schedules by the Comprehensive Drug Abuse Prevention and
Control Act of 1970: Schedule I (C): highest abuse potential, NO accepted medical use (heroin, LSD, ecstasy) —
no prescription available. Schedule II (B): high abuse potential with severe physical or psychological
dependence; HAS accepted medical uses; prescription required with NO refills allowed (morphine,
oxycodone, fentanyl, amphetamines, cocaine, codeine). Schedule III: moderate abuse potential; prescription
required; limited quantities; 34-day supply limit (opioid/acetaminophen combinations like Tylenol #3,
anabolic steroids). Schedule IV: lower abuse potential; prescription required; up to 5 refills in 6 months
(benzodiazepines — diazepam, lorazepam). Schedule V (D): lowest abuse potential; may or may not require
prescription; some available OTC (cough syrup with codeine). When discarding a controlled substance, a
SECOND RN must witness and cosign. Controlled substances in home care must follow legal requirements for
storage, documentation, and disposal.
★ ★
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
Exam 4 — Fundamentals of Nursing
M E D I C AT I O N A D M I N I S T R AT I O N , P E R I O P E R AT I V E C A R E , M O B I L I T Y & PA I N M A N A G E M E N T
INSTITUTION Nursing Fundamentals Assessment COURSE CODE Exam 4 — Fundamentals of Nursing
PROGRAM Practical Nursing (PN) / Associate Degree ACADEMIC YEAR
in Nursing (ADN)
EXAM TITLE Exam 4 — Fundamentals of Nursing TOTAL QUESTIONS 50 Questions
COURSE TITLE Fundamentals of Nursing FORMAT Multiple Choice — Select the Single Best
Answer
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 medication administration, perioperative care, mobility, self-care, and pain management.
▸ 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 50
1. What are the three classifications of medications?
A. Oral, topical, injectable.
B. Chemical, clinical, therapeutic.
C. Prescription, over-the-counter, controlled.
D. Generic, brand, compounded.
CORRECT ANSWER B — Chemical, clinical, therapeutic.
RATIONALE Medications are classified by three broad categories: Chemical classification (based on the drug's chemical
structure and properties), Clinical classification (based on the drug's therapeutic use or clinical indication —
e.g., antihypertensives, antibiotics, analgesics), and Therapeutic classification (based on what condition the
drug treats — e.g., antidiabetic, antidepressant). These classifications help organize the vast number of
medications into meaningful groups for study, prescription, and clinical use. Medications can also be
described by their preparation forms: solid (capsule, tablet, spansule, powder), liquid (elixir, emulsion,
suspension, syrup, tincture), semisolid (cream, gel, ointment, paste), and specialized (suppository,
transdermal patch, lozenge). The nurse must understand medication classifications to safely administer
drugs, anticipate effects and side effects, and educate patients. The FDA regulates medication manufacture,
sale, and effectiveness.
,2. A medication that has a coating causing drug absorption in the intestines rather than the stomach to prevent
stomach irritation is called:
A. Spansule.
B. Enteric-coated.
C. Lozenge.
D. Elixir.
CORRECT ANSWER B — Enteric-coated.
RATIONALE Enteric-coated medications have a special coating that resists dissolution in the acidic environment of the
stomach — the drug is released in the alkaline environment of the small intestine. Purposes: (1) Prevents
gastric irritation from medications that are harsh on the stomach mucosa (e.g., aspirin, NSAIDs). (2) Protects
the drug from destruction by stomach acid (some drugs are inactivated by gastric acid). (3) Delays onset of
action until the drug reaches the intestines. ENTERIC-COATED TABLETS MUST NEVER BE CRUSHED OR
CHEWED — crushing destroys the protective coating, causing the drug to be released in the stomach (losing
the protective benefit) and altering absorption. A spansule (A) is a time-release capsule that dissolves slowly
for prolonged effect. A lozenge (troche) (C) is held in the mouth to dissolve. An elixir (D) is a liquid preparation
with an alcohol base. The nurse must know which medications cannot be crushed — including enteric-coated,
extended-release, and sublingual formulations.
3. What are the six rights of medication administration?
A. Right patient, medication, dose, route, time, documentation.
B. Right assessment, diagnosis, planning, implementation, evaluation.
C. Right task, circumstance, person, direction, supervision.
D. Right to refuse, right to privacy, right to information.
CORRECT ANSWER A — Right patient, medication, dose, route, time, documentation.
RATIONALE The Six Rights of Medication Administration (PMDRTD): (1) Right PATIENT — verify with two identifiers (name,
DOB, medical record number). (2) Right MEDICATION — check label three times against the MAR. (3) Right
DOSE — calculate accurately; have another nurse check if uncertain. (4) Right ROUTE — as prescribed; the
same drug may have different effects by different routes. (5) Right TIME — administer within 30 minutes of
scheduled time; know which medications must be given at exact times. (6) Right DOCUMENTATION — record
AFTER administration (never before); include time, route, dose, site (for injections), and patient response.
Additional rights often included: right reason, right to refuse, right assessment, right evaluation. The nurse
must NEVER administer a medication prepared by another nurse. If a patient refuses a medication, the nurse's
first action is to attempt to clarify the concern through education. If the patient still refuses, document the
refusal and notify the provider. Controlled substances require a second RN to witness discarding of any
wasted portion.
, 4. A medication order that must be carried out immediately is classified as:
A. PRN.
B. Routine (standing).
C. Stat.
D. One-time.
CORRECT ANSWER C — Stat.
RATIONALE Medication order types: STAT — must be given IMMEDIATELY (within 5 minutes or as soon as possible). Used
for emergency situations. PRN (A) — given as needed; requires nursing judgment about when to administer
and documentation of effectiveness. Routine/Standing (B) — carried out for a specified number of days or
until cancelled by another order (e.g., "Digoxin 0.125 mg PO daily"). One-time (D) — given only once at a
specified time (e.g., preoperative antibiotic). Standing Protocol — written for medications to be administered
in specific situations with criteria clearly outlined (e.g., "Acetaminophen 650 mg PO for temperature >101°F").
Verbal orders are accepted only in emergencies — the nurse must read back the order for verification.
Telephone orders must be written in the medical record, read back, and signed by the provider within 24
hours. CPOE (Computerized Provider Order Entry) allows the provider to enter orders directly into the
computer, reducing errors. The nurse is responsible for safe interpretation of the order and must clarify any
unclear orders with the provider.
5. Schedule II controlled substances are characterized by:
A. Low abuse potential; no prescription required.
B. High abuse potential with severe physical or psychological dependence; accepted medical uses; prescription
required with no refills.
C. No accepted medical use; high abuse potential.
D. Low abuse potential; prescription may not be required; no refill limits.
CORRECT ANSWER B — High abuse potential with severe physical or psychological dependence; accepted medical uses;
prescription required with no refills.
RATIONALE Controlled substances are classified into five schedules by the Comprehensive Drug Abuse Prevention and
Control Act of 1970: Schedule I (C): highest abuse potential, NO accepted medical use (heroin, LSD, ecstasy) —
no prescription available. Schedule II (B): high abuse potential with severe physical or psychological
dependence; HAS accepted medical uses; prescription required with NO refills allowed (morphine,
oxycodone, fentanyl, amphetamines, cocaine, codeine). Schedule III: moderate abuse potential; prescription
required; limited quantities; 34-day supply limit (opioid/acetaminophen combinations like Tylenol #3,
anabolic steroids). Schedule IV: lower abuse potential; prescription required; up to 5 refills in 6 months
(benzodiazepines — diazepam, lorazepam). Schedule V (D): lowest abuse potential; may or may not require
prescription; some available OTC (cough syrup with codeine). When discarding a controlled substance, a
SECOND RN must witness and cosign. Controlled substances in home care must follow legal requirements for
storage, documentation, and disposal.
