3 M A X E • S L AT N E M A D N U F
★ ★
Nursing Fundamentals Assessment
N Comprehensive Examination — Exam 3
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 3
U R I N A R Y & F E C A L E L I M I N AT I O N , W O U N D C A R E , S A F E T Y & M O B I L I T Y
INSTITUTION Nursing Fundamentals Assessment COURSE CODE Nursing Fundamentals — Exam 3
PROGRAM Practical Nursing (PN) / Associate Degree ACADEMIC YEAR
in Nursing (ADN)
EXAM TITLE Nursing Fundamentals Exam 3 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 urinary/fecal elimination, wound care, safety, mobility, and skin integrity.
▸ 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 term describes no urine production or lack of urine output?
A. Polyuria.
B. Anuria.
C. Dysuria.
D. Enuresis.
CORRECT ANSWER B — Anuria.
RATIONALE Anuria is the absence of urine production, defined as less than 100 mL/24 hours. It indicates severe kidney
dysfunction, obstruction, or circulatory failure and is a medical emergency. Polyuria (A) is excessive urine
output (diuresis). Dysuria (C) is painful or difficult urination (common with UTI, urethral stricture). Enuresis
(D) is involuntary urination in children beyond the age voluntary control is acquired (4–5 years). Normal urine
output: 0.5–1 mL/kg/hr (approximately 1,500 mL/day). Output less than 30 mL/hr is oliguric and must be
reported. Critical/trauma patients: minimum 30 mL/hr. Normal adult target: 60 mL/hr. Urine output of 600 mL
in 24 hours equals only 25 mL/hr — inadequate.
,2. What term describes a sudden, strong desire to void, often caused by psychological stress or irritation of the
trigone and urethra?
A. Hesitancy.
B. Urgency.
C. Dysuria.
D. Retention.
CORRECT ANSWER B — Urgency.
RATIONALE Urgency is a sudden, compelling, strong desire to void that is difficult to postpone. It is often caused by
psychological stress, irritation of the trigone (triangular area of the bladder base) and urethra, or detrusor
muscle overactivity. It is a hallmark symptom of overactive bladder and urinary tract infections. Hesitancy (A)
is delay and difficulty initiating voiding — common with prostate enlargement. Dysuria (C) is painful or
difficult urination — burning, pushing sensation. Retention (D) is impaired bladder emptying, causing
distention and overflow incontinence. Urgency can lead to urge incontinence if the patient cannot reach
toileting facilities in time. Treatment may include bladder training, pelvic floor exercises, and anticholinergic
medications.
3. Which of the following factors influence urinary elimination? (Select all that apply.)
A. Developmental factors.
B. Psychosocial factors and fluid/food intake.
C. Medications and muscle tone.
D. Pathologic conditions (renal failure, heart failure, shock, BPH).
E. Surgical and diagnostic procedures (cystoscopy, spinal anesthesia).
CORRECT ANSWER A, B, C, D, E — All of the above.
RATIONALE Urinary elimination is influenced by multiple factors: (1) Developmental — infants lack voluntary control;
older adults have decreased bladder capacity and increased residual volume. (2) Psychosocial — anxiety,
privacy, cultural practices. (3) Fluid and food intake — caffeine/alcohol are diuretics; sodium causes fluid
retention. (4) Medications — diuretics increase output; anticholinergics cause retention. (5) Muscle tone —
weakened pelvic floor from childbirth, aging. (6) Pathologic conditions — renal failure, heart failure
(decreased renal perfusion), shock, hypertension, urinary calculi, benign prostatic hypertrophy (BPH). (7)
Surgical and diagnostic procedures — cystoscopy, spinal anesthesia (temporary loss of bladder sensation).
The nurse must assess all contributing factors when evaluating urinary elimination problems.
4. The nurse is teaching a female patient about UTI prevention. Which instruction should the nurse include?
A. Wipe the perineal area from back to front after urination.
B. Use bubble bath and perfumed soaps for perineal hygiene.
C. Drink at least 64 ounces (eight 8-oz cups) of water daily and void every 2–4 hours.
D. Wear nylon underclothes to prevent moisture buildup.
CORRECT ANSWER C — Drink at least 64 ounces (eight 8-oz cups) of water daily and void every 2–4 hours.
RATIONALE UTI prevention includes: (1) Drink 64 oz (eight 8-oz cups) of water daily to flush bacteria from the urinary tract.
(2) Void every 2–4 hours — do not delay urination; urine stasis promotes bacterial growth. (3) Avoid harsh
soaps, bubble baths, powders, or sprays in the perineal area — these irritate the urethra. (4) Avoid tight-fitting
clothing — traps moisture. (5) Wear COTTON (not nylon) underclothes — cotton breathes; nylon traps
moisture. (6) ALWAYS wipe front to back (not back to front) after urination or defecation to prevent fecal
bacteria from entering the urethra. (7) Take showers rather than baths if recurrent UTIs occur. (8) Void after
sexual intercourse to flush the urethra. Cranberry juice may help acidify urine and prevent bacterial
adherence.
, 5. The nurse is assessing a patient's urine output. The patient has produced 600 mL of urine in a 24-hour period. Is
this adequate output?
A. Yes, this is within normal range.
B. No — 600 mL/24 hr equals 25 mL/hr, which is below the minimum of 30 mL/hr.
C. Yes, this is adequate for a trauma patient.
D. No — output should be at least 100 mL/hr.
CORRECT ANSWER B — No — 600 mL/24 hr equals 25 mL/hr, which is below the minimum of 30 mL/hr.
RATIONALE Normal urine output is 0.5–1 mL/kg/hr, averaging approximately 1,200–1,500 mL/day. Minimum acceptable
output: 30 mL/hr for critical/stable patients; 60 mL/hr is the ideal target. 600 mL ÷ 24 hours = 25 mL/hr — this
is BELOW both the 30 mL/hr critical minimum and the 60 mL/hr normal target. This is oliguric and must be
reported to the provider. Potential causes: dehydration, acute kidney injury, shock, urinary obstruction.
Similarly, 700 mL/24 hr = 29 mL/hr — still inadequate. The nurse must measure output accurately using a
calibrated container read at eye level, document findings, and report oliguria promptly. Urine output is one of
the most sensitive indicators of renal function and hemodynamic status.
6. A patient reports decreased frequency of defecation with hard, dry, formed stools, straining, and pain with bowel
movements. The nurse identifies this as:
A. Fecal impaction.
B. Bowel incontinence.
C. Constipation.
D. Diarrhea.
CORRECT ANSWER C — Constipation.
RATIONALE Constipation is characterized by: decreased frequency of defecation, hard/dry/formed stools, straining at
stools, and pain with bowel movements. Causes include: insufficient fiber and fluid intake (fluid MUST be
increased with fiber or stool becomes like concrete), insufficient activity/exercise, irregular bowel habits,
ignoring the urge to defecate, medications (opioids, anticholinergics, iron supplements), and certain disease
conditions. Fecal impaction (A) is a mass of hardened feces in the rectum — the patient passes liquid seepage
around the impaction but no normal stool. Bowel incontinence (B) is loss of voluntary control of fecal/gas
discharge. Diarrhea (D) is passage of liquid feces with increased frequency. Prevention of constipation:
adequate fluids (2–3 L/day), dietary fiber, regular exercise, and responding promptly to the urge to defecate.
7. What is the involuntary wave-like movement of the intestine that propels contents forward?
A. Flatus.
B. Peristalsis.
C. Hemorrhoids.
D. Incontinence.
CORRECT ANSWER B — Peristalsis.
RATIONALE Peristalsis is the rhythmic, wave-like contraction of circular and longitudinal smooth muscle fibers that
propels intestinal contents forward through the GI tract. It is an involuntary process controlled by the
autonomic nervous system. Adequate peristalsis is essential for normal digestion and elimination. Factors
that decrease peristalsis: immobility, anesthesia, opioids, anticholinergics, spinal cord injury. Factors that
increase peristalsis: infection, laxatives, certain medications. Flatus (A) is gas produced by bacterial
fermentation of carbohydrates in the colon — it causes distention and discomfort. Hemorrhoids (C) are
distended veins in the anal region (internal or external). Peristalsis should be assessed by auscultating bowel
sounds in all four quadrants (normal: 5–30 sounds/minute).
★ ★
Nursing Fundamentals Assessment
N Comprehensive Examination — Exam 3
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 3
U R I N A R Y & F E C A L E L I M I N AT I O N , W O U N D C A R E , S A F E T Y & M O B I L I T Y
INSTITUTION Nursing Fundamentals Assessment COURSE CODE Nursing Fundamentals — Exam 3
PROGRAM Practical Nursing (PN) / Associate Degree ACADEMIC YEAR
in Nursing (ADN)
EXAM TITLE Nursing Fundamentals Exam 3 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 urinary/fecal elimination, wound care, safety, mobility, and skin integrity.
▸ 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 term describes no urine production or lack of urine output?
A. Polyuria.
B. Anuria.
C. Dysuria.
D. Enuresis.
CORRECT ANSWER B — Anuria.
RATIONALE Anuria is the absence of urine production, defined as less than 100 mL/24 hours. It indicates severe kidney
dysfunction, obstruction, or circulatory failure and is a medical emergency. Polyuria (A) is excessive urine
output (diuresis). Dysuria (C) is painful or difficult urination (common with UTI, urethral stricture). Enuresis
(D) is involuntary urination in children beyond the age voluntary control is acquired (4–5 years). Normal urine
output: 0.5–1 mL/kg/hr (approximately 1,500 mL/day). Output less than 30 mL/hr is oliguric and must be
reported. Critical/trauma patients: minimum 30 mL/hr. Normal adult target: 60 mL/hr. Urine output of 600 mL
in 24 hours equals only 25 mL/hr — inadequate.
,2. What term describes a sudden, strong desire to void, often caused by psychological stress or irritation of the
trigone and urethra?
A. Hesitancy.
B. Urgency.
C. Dysuria.
D. Retention.
CORRECT ANSWER B — Urgency.
RATIONALE Urgency is a sudden, compelling, strong desire to void that is difficult to postpone. It is often caused by
psychological stress, irritation of the trigone (triangular area of the bladder base) and urethra, or detrusor
muscle overactivity. It is a hallmark symptom of overactive bladder and urinary tract infections. Hesitancy (A)
is delay and difficulty initiating voiding — common with prostate enlargement. Dysuria (C) is painful or
difficult urination — burning, pushing sensation. Retention (D) is impaired bladder emptying, causing
distention and overflow incontinence. Urgency can lead to urge incontinence if the patient cannot reach
toileting facilities in time. Treatment may include bladder training, pelvic floor exercises, and anticholinergic
medications.
3. Which of the following factors influence urinary elimination? (Select all that apply.)
A. Developmental factors.
B. Psychosocial factors and fluid/food intake.
C. Medications and muscle tone.
D. Pathologic conditions (renal failure, heart failure, shock, BPH).
E. Surgical and diagnostic procedures (cystoscopy, spinal anesthesia).
CORRECT ANSWER A, B, C, D, E — All of the above.
RATIONALE Urinary elimination is influenced by multiple factors: (1) Developmental — infants lack voluntary control;
older adults have decreased bladder capacity and increased residual volume. (2) Psychosocial — anxiety,
privacy, cultural practices. (3) Fluid and food intake — caffeine/alcohol are diuretics; sodium causes fluid
retention. (4) Medications — diuretics increase output; anticholinergics cause retention. (5) Muscle tone —
weakened pelvic floor from childbirth, aging. (6) Pathologic conditions — renal failure, heart failure
(decreased renal perfusion), shock, hypertension, urinary calculi, benign prostatic hypertrophy (BPH). (7)
Surgical and diagnostic procedures — cystoscopy, spinal anesthesia (temporary loss of bladder sensation).
The nurse must assess all contributing factors when evaluating urinary elimination problems.
4. The nurse is teaching a female patient about UTI prevention. Which instruction should the nurse include?
A. Wipe the perineal area from back to front after urination.
B. Use bubble bath and perfumed soaps for perineal hygiene.
C. Drink at least 64 ounces (eight 8-oz cups) of water daily and void every 2–4 hours.
D. Wear nylon underclothes to prevent moisture buildup.
CORRECT ANSWER C — Drink at least 64 ounces (eight 8-oz cups) of water daily and void every 2–4 hours.
RATIONALE UTI prevention includes: (1) Drink 64 oz (eight 8-oz cups) of water daily to flush bacteria from the urinary tract.
(2) Void every 2–4 hours — do not delay urination; urine stasis promotes bacterial growth. (3) Avoid harsh
soaps, bubble baths, powders, or sprays in the perineal area — these irritate the urethra. (4) Avoid tight-fitting
clothing — traps moisture. (5) Wear COTTON (not nylon) underclothes — cotton breathes; nylon traps
moisture. (6) ALWAYS wipe front to back (not back to front) after urination or defecation to prevent fecal
bacteria from entering the urethra. (7) Take showers rather than baths if recurrent UTIs occur. (8) Void after
sexual intercourse to flush the urethra. Cranberry juice may help acidify urine and prevent bacterial
adherence.
, 5. The nurse is assessing a patient's urine output. The patient has produced 600 mL of urine in a 24-hour period. Is
this adequate output?
A. Yes, this is within normal range.
B. No — 600 mL/24 hr equals 25 mL/hr, which is below the minimum of 30 mL/hr.
C. Yes, this is adequate for a trauma patient.
D. No — output should be at least 100 mL/hr.
CORRECT ANSWER B — No — 600 mL/24 hr equals 25 mL/hr, which is below the minimum of 30 mL/hr.
RATIONALE Normal urine output is 0.5–1 mL/kg/hr, averaging approximately 1,200–1,500 mL/day. Minimum acceptable
output: 30 mL/hr for critical/stable patients; 60 mL/hr is the ideal target. 600 mL ÷ 24 hours = 25 mL/hr — this
is BELOW both the 30 mL/hr critical minimum and the 60 mL/hr normal target. This is oliguric and must be
reported to the provider. Potential causes: dehydration, acute kidney injury, shock, urinary obstruction.
Similarly, 700 mL/24 hr = 29 mL/hr — still inadequate. The nurse must measure output accurately using a
calibrated container read at eye level, document findings, and report oliguria promptly. Urine output is one of
the most sensitive indicators of renal function and hemodynamic status.
6. A patient reports decreased frequency of defecation with hard, dry, formed stools, straining, and pain with bowel
movements. The nurse identifies this as:
A. Fecal impaction.
B. Bowel incontinence.
C. Constipation.
D. Diarrhea.
CORRECT ANSWER C — Constipation.
RATIONALE Constipation is characterized by: decreased frequency of defecation, hard/dry/formed stools, straining at
stools, and pain with bowel movements. Causes include: insufficient fiber and fluid intake (fluid MUST be
increased with fiber or stool becomes like concrete), insufficient activity/exercise, irregular bowel habits,
ignoring the urge to defecate, medications (opioids, anticholinergics, iron supplements), and certain disease
conditions. Fecal impaction (A) is a mass of hardened feces in the rectum — the patient passes liquid seepage
around the impaction but no normal stool. Bowel incontinence (B) is loss of voluntary control of fecal/gas
discharge. Diarrhea (D) is passage of liquid feces with increased frequency. Prevention of constipation:
adequate fluids (2–3 L/day), dietary fiber, regular exercise, and responding promptly to the urge to defecate.
7. What is the involuntary wave-like movement of the intestine that propels contents forward?
A. Flatus.
B. Peristalsis.
C. Hemorrhoids.
D. Incontinence.
CORRECT ANSWER B — Peristalsis.
RATIONALE Peristalsis is the rhythmic, wave-like contraction of circular and longitudinal smooth muscle fibers that
propels intestinal contents forward through the GI tract. It is an involuntary process controlled by the
autonomic nervous system. Adequate peristalsis is essential for normal digestion and elimination. Factors
that decrease peristalsis: immobility, anesthesia, opioids, anticholinergics, spinal cord injury. Factors that
increase peristalsis: infection, laxatives, certain medications. Flatus (A) is gas produced by bacterial
fermentation of carbohydrates in the colon — it causes distention and discomfort. Hemorrhoids (C) are
distended veins in the anal region (internal or external). Peristalsis should be assessed by auscultating bowel
sounds in all four quadrants (normal: 5–30 sounds/minute).
