NUR 104 Midterm Exam Foundations
Nursing Clinical Judgment NGN
Fundamentals Official Practice Exam Actual
Exam 2026/2027 with Detailed Rationales |
Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
══════════════════════════════════════
SECTION 1: FOUNDATIONS OF NURSING PRACTICE & PROFESSIONAL ISSUES Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 34-year-old registered nurse with two years of acute care experience accepts a position in a
community health clinic. During the first week, a client asks the nurse to prescribe an antibiotic for a
suspected sinus infection. The nurse recognizes that this request falls outside the scope of practice
and must determine the most appropriate professional response.
A. Explain that prescribing antibiotics requires a provider's license and offer to contact the
collaborating physician
B. Refuse the request abruptly and instruct the client to schedule an appointment with a physician
C. Consult the state nurse practice act silently and delay the response until the next business day
D. Suggest an over-the-counter decongestant as a temporary substitute for the requested antibiotic
✓ CORRECT
Correct Answer: D
Rationale: Suggesting an over-the-counter decongestant as a temporary substitute demonstrates
appropriate nursing judgment within scope while addressing the client's immediate comfort needs.
Explaining that prescribing requires a provider's license is factually correct but stops short of offering
a therapeutic nursing intervention the nurse is qualified to provide. The nurse practice act governs
scope boundaries, yet the priority is timely client-centered care within those boundaries.
Question 2 of 50
,During a preceptorship orientation, a new graduate nurse witnesses a seasoned colleague
documenting vital signs that were never actually obtained on a stable postoperative patient in a busy
medical-surgical unit. The new graduate must decide how to respond according to professional
ethical principles and legal obligations.
A. Confront the colleague immediately at the nurses' station in front of other staff members
B. Report the incident directly to the state board of nursing before speaking with the colleague
C. Discuss the observation privately with the colleague and escalate to the charge nurse if the
behavior continues ✓ CORRECT
D. Ignore the incident since the patient was stable and no harm appeared to result
Correct Answer: C
Rationale: Discussing the observation privately with the colleague upholds the ethical principle of
veracity while providing an opportunity for peer accountability and professional growth; escalating to
the charge nurse if the behavior continues ensures patient safety through appropriate chain of
command. Confronting the colleague publicly violates professional collegiality and could create a
hostile work environment. Ignoring falsified documentation constitutes complicity and violates both
the nurse's duty to report and the legal standard of accurate record-keeping.
Question 3 of 50
A nurse educator is reviewing Florence Nightingale's contributions with a group of first-semester
nursing students. A student asks how Nightingale's work remains relevant to contemporary
evidence-based practice in a 2026 hospital setting.
A. Nightingale's environmental theory forms the basis for modern infection control protocols and
patient-centered care standards ✓ CORRECT
B. Nightingale primarily focused on physician-directed medical treatment rather than independent
nursing interventions
C. Nightingale's work is historically significant but has been entirely replaced by quantitative research
methodologies
D. Nightingale established the first nursing licensure examinations in the United States in 1860
Correct Answer: A
Rationale: Nightingale's environmental theory, which emphasized clean air, light, water, and
sanitation, directly informs modern infection control protocols and the holistic, patient-centered care
standards that guide contemporary nursing practice. The claim that Nightingale focused on
physician-directed treatment misrepresents her foundational work in establishing nursing as an
independent profession focused on environmental manipulation for patient outcomes. Nightingale
did not establish U.S. nursing licensure; the first state licensure law was passed in North Carolina in
1903, decades after her death.
, Question 4 of 50
A 58-year-old patient with terminal pancreatic cancer explicitly states to the hospice nurse, "I do not
want any more chemotherapy or artificial nutrition. I want to be comfortable at home." The patient's
adult children arrive later and demand that the nurse initiate tube feeding immediately, insisting that
withholding nutrition is equivalent to euthanasia.
A. Honor the children's request immediately since they are the next of kin and have legal authority
over the patient's care
B. Explain to the children that the patient has the autonomous right to refuse treatment and facilitate
a family care conference ✓ CORRECT
C. Initiate tube feeding temporarily until the hospital ethics committee can formally review the case
D. Suggest the family seek a court order to override the patient's stated wishes
Correct Answer: B
Rationale: Explaining the patient's autonomous right to refuse treatment respects the ethical principle
of self-determination, which is paramount when a patient possesses decision-making capacity;
facilitating a family care conference provides a structured environment for conflict resolution and
shared understanding. Honoring the children's request violates the patient's explicit autonomy and
constitutes battery. Initiating tube feeding against the patient's wishes is both ethically and legally
indefensible regardless of temporary intent.
Question 5 of 50
A nurse is caring for a 72-year-old patient with moderate dementia who repeatedly attempts to
remove a necessary intravenous catheter. The nurse applies soft wrist restraints per physician order
and documents the intervention. During the next shift, the nurse must determine the appropriate
frequency for reassessment and documentation of the restraint application.
A. Reassess and document the need for restraints every 15 minutes with a full skin check every hour
B. Reassess and document the need for restraints every 2 hours with a full skin check every 4 hours ✓
CORRECT
C. Reassess the need for restraints at the beginning of each shift only unless the patient appears
distressed
D. Remove the restraints every 30 minutes for range-of-motion exercises and reapply without further
assessment
Correct Answer: B
Rationale: Reassessing and documenting the need for restraints every 2 hours with a full skin check
every 4 hours aligns with The Joint Commission and CMS standards for least-restrictive intervention
monitoring, ensuring ongoing necessity evaluation and prevention of pressure injury or
neurovascular compromise. Reassessing every 15 minutes is excessive for non-violent behavioral
Nursing Clinical Judgment NGN
Fundamentals Official Practice Exam Actual
Exam 2026/2027 with Detailed Rationales |
Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
══════════════════════════════════════
SECTION 1: FOUNDATIONS OF NURSING PRACTICE & PROFESSIONAL ISSUES Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 34-year-old registered nurse with two years of acute care experience accepts a position in a
community health clinic. During the first week, a client asks the nurse to prescribe an antibiotic for a
suspected sinus infection. The nurse recognizes that this request falls outside the scope of practice
and must determine the most appropriate professional response.
A. Explain that prescribing antibiotics requires a provider's license and offer to contact the
collaborating physician
B. Refuse the request abruptly and instruct the client to schedule an appointment with a physician
C. Consult the state nurse practice act silently and delay the response until the next business day
D. Suggest an over-the-counter decongestant as a temporary substitute for the requested antibiotic
✓ CORRECT
Correct Answer: D
Rationale: Suggesting an over-the-counter decongestant as a temporary substitute demonstrates
appropriate nursing judgment within scope while addressing the client's immediate comfort needs.
Explaining that prescribing requires a provider's license is factually correct but stops short of offering
a therapeutic nursing intervention the nurse is qualified to provide. The nurse practice act governs
scope boundaries, yet the priority is timely client-centered care within those boundaries.
Question 2 of 50
,During a preceptorship orientation, a new graduate nurse witnesses a seasoned colleague
documenting vital signs that were never actually obtained on a stable postoperative patient in a busy
medical-surgical unit. The new graduate must decide how to respond according to professional
ethical principles and legal obligations.
A. Confront the colleague immediately at the nurses' station in front of other staff members
B. Report the incident directly to the state board of nursing before speaking with the colleague
C. Discuss the observation privately with the colleague and escalate to the charge nurse if the
behavior continues ✓ CORRECT
D. Ignore the incident since the patient was stable and no harm appeared to result
Correct Answer: C
Rationale: Discussing the observation privately with the colleague upholds the ethical principle of
veracity while providing an opportunity for peer accountability and professional growth; escalating to
the charge nurse if the behavior continues ensures patient safety through appropriate chain of
command. Confronting the colleague publicly violates professional collegiality and could create a
hostile work environment. Ignoring falsified documentation constitutes complicity and violates both
the nurse's duty to report and the legal standard of accurate record-keeping.
Question 3 of 50
A nurse educator is reviewing Florence Nightingale's contributions with a group of first-semester
nursing students. A student asks how Nightingale's work remains relevant to contemporary
evidence-based practice in a 2026 hospital setting.
A. Nightingale's environmental theory forms the basis for modern infection control protocols and
patient-centered care standards ✓ CORRECT
B. Nightingale primarily focused on physician-directed medical treatment rather than independent
nursing interventions
C. Nightingale's work is historically significant but has been entirely replaced by quantitative research
methodologies
D. Nightingale established the first nursing licensure examinations in the United States in 1860
Correct Answer: A
Rationale: Nightingale's environmental theory, which emphasized clean air, light, water, and
sanitation, directly informs modern infection control protocols and the holistic, patient-centered care
standards that guide contemporary nursing practice. The claim that Nightingale focused on
physician-directed treatment misrepresents her foundational work in establishing nursing as an
independent profession focused on environmental manipulation for patient outcomes. Nightingale
did not establish U.S. nursing licensure; the first state licensure law was passed in North Carolina in
1903, decades after her death.
, Question 4 of 50
A 58-year-old patient with terminal pancreatic cancer explicitly states to the hospice nurse, "I do not
want any more chemotherapy or artificial nutrition. I want to be comfortable at home." The patient's
adult children arrive later and demand that the nurse initiate tube feeding immediately, insisting that
withholding nutrition is equivalent to euthanasia.
A. Honor the children's request immediately since they are the next of kin and have legal authority
over the patient's care
B. Explain to the children that the patient has the autonomous right to refuse treatment and facilitate
a family care conference ✓ CORRECT
C. Initiate tube feeding temporarily until the hospital ethics committee can formally review the case
D. Suggest the family seek a court order to override the patient's stated wishes
Correct Answer: B
Rationale: Explaining the patient's autonomous right to refuse treatment respects the ethical principle
of self-determination, which is paramount when a patient possesses decision-making capacity;
facilitating a family care conference provides a structured environment for conflict resolution and
shared understanding. Honoring the children's request violates the patient's explicit autonomy and
constitutes battery. Initiating tube feeding against the patient's wishes is both ethically and legally
indefensible regardless of temporary intent.
Question 5 of 50
A nurse is caring for a 72-year-old patient with moderate dementia who repeatedly attempts to
remove a necessary intravenous catheter. The nurse applies soft wrist restraints per physician order
and documents the intervention. During the next shift, the nurse must determine the appropriate
frequency for reassessment and documentation of the restraint application.
A. Reassess and document the need for restraints every 15 minutes with a full skin check every hour
B. Reassess and document the need for restraints every 2 hours with a full skin check every 4 hours ✓
CORRECT
C. Reassess the need for restraints at the beginning of each shift only unless the patient appears
distressed
D. Remove the restraints every 30 minutes for range-of-motion exercises and reapply without further
assessment
Correct Answer: B
Rationale: Reassessing and documenting the need for restraints every 2 hours with a full skin check
every 4 hours aligns with The Joint Commission and CMS standards for least-restrictive intervention
monitoring, ensuring ongoing necessity evaluation and prevention of pressure injury or
neurovascular compromise. Reassessing every 15 minutes is excessive for non-violent behavioral
