2 M A X E • S L AT N E M A D N U F
★ ★
Nursing Fundamentals Assessment
N Comprehensive Examination — Exam 2
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
Nursing Fundamentals — Exam 2
E T H I CS , L E G A L , D O C U M E N TAT I O N , O L D E R A D U LTS & N U R S I N G P R O C E S S
INSTITUTION Nursing Fundamentals Assessment COURSE CODE Nursing Fundamentals — Exam 2
PROGRAM Practical Nursing (PN) / Associate Degree ACADEMIC YEAR
in Nursing (ADN)
EXAM TITLE Nursing Fundamentals Exam 2 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 ethics, legal principles, documentation, older adult care, and the nursing process.
▸ Correct answers and clinical rationales appear below each question for review purposes.
▸ All content reflects current ANA standards, NPA, and evidence-based nursing practice.
SECTION I — FUNDAMENTALS OF NURSING COMPREHENSIVE Questions 1 –
EXAMINATION 50
1. How many patient identifiers are required before administering medications or performing procedures?
A. One.
B. Two.
C. Three.
D. None if you know the patient.
CORRECT ANSWER B — Two.
RATIONALE The Joint Commission requires at least TWO patient identifiers before administering medications, drawing
blood, performing procedures, or providing any treatment. Acceptable identifiers include: patient's name,
date of birth, medical record number, or telephone number. The patient's room number is NOT an acceptable
identifier (patients change rooms). This safety measure prevents errors — always verify identity, even if you
"know" the patient. The two identifiers must be checked against the patient's identification band and the
medication/treatment order.
,2. What does the acronym SMART stand for in goal setting?
A. Safe, Measurable, Achievable, Reliable, Timed.
B. Specific, Measurable, Attainable, Realistic, Timely.
C. Standard, Meaningful, Accurate, Relevant, Tested.
D. Subjective, Measurable, Assessable, Recorded, Timely.
CORRECT ANSWER B — Specific, Measurable, Attainable, Realistic, Timely.
RATIONALE SMART goals guide effective care planning: Specific (clearly defines what the patient will achieve — e.g.,
"ambulate 50 feet"), Measurable (can be objectively evaluated — distance, pain score), Attainable (achievable
given the patient's condition and resources), Realistic (relevant to the identified problem and within the
patient's capacity), and Timely (has a specific time frame — "by discharge," "within 1 hour"). All patient goals
should begin with "The patient will..." and be client-centered, singular, observable, and measurable. Goals are
established during the Planning phase of the nursing process.
3. What is the correct format for a NANDA-I nursing diagnosis?
A. Medical diagnosis related to nursing intervention.
B. Nursing diagnosis related to etiology as evidenced by signs and symptoms (PES format).
C. Patient goal related to nursing action.
D. Nursing intervention as evidenced by patient outcome.
CORRECT ANSWER B — Nursing diagnosis related to etiology as evidenced by signs and symptoms (PES format).
RATIONALE A NANDA-I approved nursing diagnosis follows the PES format: Problem (the nursing diagnosis label — e.g.,
"Impaired Skin Integrity") + Etiology (related to factors — e.g., "related to prolonged pressure over bony
prominence") + Signs/Symptoms (as evidenced by/AEB — e.g., "as evidenced by 3 cm stage 2 pressure ulcer
on sacrum"). Medical diagnoses identify disease processes; nursing diagnoses identify human responses.
Three types: Problem-Focused (current problem), Health Promotion (readiness for improvement), and Risk
(vulnerability to developing a problem — no "AEB" because signs haven't occurred yet).
4. Failure to obtain informed consent, except in emergencies, can be considered which intentional tort?
A. Assault.
B. Battery.
C. False imprisonment.
D. Defamation.
CORRECT ANSWER B — Battery.
RATIONALE Battery is the intentional, unauthorized touching of another person. Performing a procedure without
informed consent constitutes battery — even if the procedure was performed correctly and benefited the
patient. Informed consent requires disclosure of: risks, benefits, alternatives, and consequences of refusal.
Exceptions to informed consent: emergencies when the patient is unable to consent (implied consent), and
therapeutic privilege (withholding information if disclosure would cause serious psychological harm). Assault
is the THREAT of harmful contact — no physical contact required. Battery is the actual contact. The provider
performing the procedure is responsible for obtaining informed consent; the nurse may witness the
signature.
, 5. An unresponsive patient arrives in the emergency department. There is no family present and no advance directive.
What type of consent applies?
A. Expressed consent.
B. Implied consent.
C. Verbal consent.
D. No consent is needed.
CORRECT ANSWER B — Implied consent.
RATIONALE Implied consent is the legal/ethical assumption that an unresponsive patient would consent to emergency
life-saving treatment if they were able. It applies when: (1) the patient is unconscious or otherwise unable to
consent, (2) a true emergency exists, and (3) there is no known advance directive refusing treatment. Under
EMTALA (Emergency Medical Treatment and Active Labor Act), any patient presenting to the ED must be
screened and stabilized before transfer — regardless of ability to pay or consent status. The patient should be
treated, not left untreated. Expressed consent is verbal or written agreement by a competent patient.
6. A patient states they are DNR, but no signed DNR paperwork can be found. What should the nurse do?
A. Treat the patient as DNR based on their verbal statement.
B. Initiate full resuscitation efforts — only signed DNR paperwork is valid.
C. Ask the family what they think the patient would want.
D. Wait until the patient's primary provider arrives to decide.
CORRECT ANSWER B — Initiate full resuscitation efforts — only signed DNR paperwork is valid.
RATIONALE A DNR (Do Not Resuscitate) order is valid ONLY when properly signed and documented in the medical record.
A patient's verbal statement alone is insufficient — without written documentation, the nurse must initiate
full resuscitation. If the patient later produces the signed DNR, it becomes effective immediately. Advance
directives include: Living Will (specifies treatment wishes), Durable Power of Attorney for Healthcare
(designates a decision-maker), and DNR orders. These documents speak for the patient when they cannot
speak for themselves. Without an advance directive or DPOA, the spouse, adult child, or parent is consulted —
never a neighbor.
7. Which ethical principle is defined as "taking positive action to help patients"?
A. Autonomy.
B. Beneficence.
C. Nonmaleficence.
D. Justice.
CORRECT ANSWER B — Beneficence.
RATIONALE Beneficence is the ethical duty to "do good" — actively promoting the patient's welfare and well-being. It goes
beyond simply avoiding harm (nonmaleficence) to taking positive actions that benefit the patient. Examples:
pre-medicating before painful procedures, providing comfort measures, advocating for needed services. The
ANA Code of Ethics is based on 9 principles, with 4 key principles: Advocacy (applying skills/knowledge to
benefit another), Responsibility (following through on obligations), Accountability (answering for one's
actions), and Confidentiality (respecting privacy). Autonomy is freedom from external control (right to self-
determination). Justice is fairness in resource distribution. Fidelity is keeping promises.
★ ★
Nursing Fundamentals Assessment
N Comprehensive Examination — Exam 2
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
Nursing Fundamentals — Exam 2
E T H I CS , L E G A L , D O C U M E N TAT I O N , O L D E R A D U LTS & N U R S I N G P R O C E S S
INSTITUTION Nursing Fundamentals Assessment COURSE CODE Nursing Fundamentals — Exam 2
PROGRAM Practical Nursing (PN) / Associate Degree ACADEMIC YEAR
in Nursing (ADN)
EXAM TITLE Nursing Fundamentals Exam 2 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 ethics, legal principles, documentation, older adult care, and the nursing process.
▸ Correct answers and clinical rationales appear below each question for review purposes.
▸ All content reflects current ANA standards, NPA, and evidence-based nursing practice.
SECTION I — FUNDAMENTALS OF NURSING COMPREHENSIVE Questions 1 –
EXAMINATION 50
1. How many patient identifiers are required before administering medications or performing procedures?
A. One.
B. Two.
C. Three.
D. None if you know the patient.
CORRECT ANSWER B — Two.
RATIONALE The Joint Commission requires at least TWO patient identifiers before administering medications, drawing
blood, performing procedures, or providing any treatment. Acceptable identifiers include: patient's name,
date of birth, medical record number, or telephone number. The patient's room number is NOT an acceptable
identifier (patients change rooms). This safety measure prevents errors — always verify identity, even if you
"know" the patient. The two identifiers must be checked against the patient's identification band and the
medication/treatment order.
,2. What does the acronym SMART stand for in goal setting?
A. Safe, Measurable, Achievable, Reliable, Timed.
B. Specific, Measurable, Attainable, Realistic, Timely.
C. Standard, Meaningful, Accurate, Relevant, Tested.
D. Subjective, Measurable, Assessable, Recorded, Timely.
CORRECT ANSWER B — Specific, Measurable, Attainable, Realistic, Timely.
RATIONALE SMART goals guide effective care planning: Specific (clearly defines what the patient will achieve — e.g.,
"ambulate 50 feet"), Measurable (can be objectively evaluated — distance, pain score), Attainable (achievable
given the patient's condition and resources), Realistic (relevant to the identified problem and within the
patient's capacity), and Timely (has a specific time frame — "by discharge," "within 1 hour"). All patient goals
should begin with "The patient will..." and be client-centered, singular, observable, and measurable. Goals are
established during the Planning phase of the nursing process.
3. What is the correct format for a NANDA-I nursing diagnosis?
A. Medical diagnosis related to nursing intervention.
B. Nursing diagnosis related to etiology as evidenced by signs and symptoms (PES format).
C. Patient goal related to nursing action.
D. Nursing intervention as evidenced by patient outcome.
CORRECT ANSWER B — Nursing diagnosis related to etiology as evidenced by signs and symptoms (PES format).
RATIONALE A NANDA-I approved nursing diagnosis follows the PES format: Problem (the nursing diagnosis label — e.g.,
"Impaired Skin Integrity") + Etiology (related to factors — e.g., "related to prolonged pressure over bony
prominence") + Signs/Symptoms (as evidenced by/AEB — e.g., "as evidenced by 3 cm stage 2 pressure ulcer
on sacrum"). Medical diagnoses identify disease processes; nursing diagnoses identify human responses.
Three types: Problem-Focused (current problem), Health Promotion (readiness for improvement), and Risk
(vulnerability to developing a problem — no "AEB" because signs haven't occurred yet).
4. Failure to obtain informed consent, except in emergencies, can be considered which intentional tort?
A. Assault.
B. Battery.
C. False imprisonment.
D. Defamation.
CORRECT ANSWER B — Battery.
RATIONALE Battery is the intentional, unauthorized touching of another person. Performing a procedure without
informed consent constitutes battery — even if the procedure was performed correctly and benefited the
patient. Informed consent requires disclosure of: risks, benefits, alternatives, and consequences of refusal.
Exceptions to informed consent: emergencies when the patient is unable to consent (implied consent), and
therapeutic privilege (withholding information if disclosure would cause serious psychological harm). Assault
is the THREAT of harmful contact — no physical contact required. Battery is the actual contact. The provider
performing the procedure is responsible for obtaining informed consent; the nurse may witness the
signature.
, 5. An unresponsive patient arrives in the emergency department. There is no family present and no advance directive.
What type of consent applies?
A. Expressed consent.
B. Implied consent.
C. Verbal consent.
D. No consent is needed.
CORRECT ANSWER B — Implied consent.
RATIONALE Implied consent is the legal/ethical assumption that an unresponsive patient would consent to emergency
life-saving treatment if they were able. It applies when: (1) the patient is unconscious or otherwise unable to
consent, (2) a true emergency exists, and (3) there is no known advance directive refusing treatment. Under
EMTALA (Emergency Medical Treatment and Active Labor Act), any patient presenting to the ED must be
screened and stabilized before transfer — regardless of ability to pay or consent status. The patient should be
treated, not left untreated. Expressed consent is verbal or written agreement by a competent patient.
6. A patient states they are DNR, but no signed DNR paperwork can be found. What should the nurse do?
A. Treat the patient as DNR based on their verbal statement.
B. Initiate full resuscitation efforts — only signed DNR paperwork is valid.
C. Ask the family what they think the patient would want.
D. Wait until the patient's primary provider arrives to decide.
CORRECT ANSWER B — Initiate full resuscitation efforts — only signed DNR paperwork is valid.
RATIONALE A DNR (Do Not Resuscitate) order is valid ONLY when properly signed and documented in the medical record.
A patient's verbal statement alone is insufficient — without written documentation, the nurse must initiate
full resuscitation. If the patient later produces the signed DNR, it becomes effective immediately. Advance
directives include: Living Will (specifies treatment wishes), Durable Power of Attorney for Healthcare
(designates a decision-maker), and DNR orders. These documents speak for the patient when they cannot
speak for themselves. Without an advance directive or DPOA, the spouse, adult child, or parent is consulted —
never a neighbor.
7. Which ethical principle is defined as "taking positive action to help patients"?
A. Autonomy.
B. Beneficence.
C. Nonmaleficence.
D. Justice.
CORRECT ANSWER B — Beneficence.
RATIONALE Beneficence is the ethical duty to "do good" — actively promoting the patient's welfare and well-being. It goes
beyond simply avoiding harm (nonmaleficence) to taking positive actions that benefit the patient. Examples:
pre-medicating before painful procedures, providing comfort measures, advocating for needed services. The
ANA Code of Ethics is based on 9 principles, with 4 key principles: Advocacy (applying skills/knowledge to
benefit another), Responsibility (following through on obligations), Accountability (answering for one's
actions), and Confidentiality (respecting privacy). Autonomy is freedom from external control (right to self-
determination). Justice is fairness in resource distribution. Fidelity is keeping promises.
