1. What is the primary purpose of the nursing process? A) To diagnose
medical conditions B) To provide a systematic approach to patient care C) To
document medical procedures D) To implement physician orders ANSWER :
B - The nursing process provides a systematic, organized approach to delivering
individualized patient care.
2. Which of the following is the correct order of the nursing process? A)
Planning, Assessment, Implementation, Diagnosis, Evaluation B) Assessment,
Diagnosis, Planning, Implementation, Evaluation C) Diagnosis, Assessment,
Planning, Implementation, Evaluation D) Assessment, Planning, Diagnosis,
Implementation, Evaluation ANSWER : B - The correct sequence is
Assessment, Diagnosis, Planning, Implementation, and Evaluation (ADPIE).
3. A patient refuses medication. What is the nurse's best action? A)
Administer the medication anyway B) Document the refusal and notify the
physician C) Tell the patient they must take it D) Skip documentation since it
wasn't given ANSWER : B - Document the refusal and notify the physician to
ensure proper care continuation.
4. What is the most important action before administering any medication?
A) Check the medication room B) Verify patient identity using two identifiers
C) Ask the patient if they want the medication D) Check the medication cart
ANSWER : B - Two patient identifiers must be verified to ensure patient
safety.
5. Which vital sign change requires immediate attention? A) Temperature of
98.6°F B) Blood pressure of 180/110 mmHg C) Pulse of 72 bpm D)
Respirations of 16/min ANSWER : B - A blood pressure of 180/110 mmHg
indicates hypertensive crisis requiring immediate intervention.
,6. What is the proper technique for handwashing? A) Wash for at least 5
seconds B) Wash for at least 15-20 seconds with soap and water C) Use hand
sanitizer only D) Rinse hands briefly under water ANSWER : B - Proper
handwashing requires at least 15-20 seconds with soap and water.
7. When should standard precautions be used? A) Only with diagnosed
infectious patients B) Only in the operating room C) With all patients at all
times D) Only when drawing blood ANSWER : C - Standard precautions
should be used with all patients to prevent infection transmission.
8. What is the correct site for intramuscular injection in adults? A) Deltoid,
ventrogluteal, vastus lateralis B) Abdomen only C) Forearm D) Dorsogluteal
only ANSWER : A - Deltoid, ventrogluteal, and vastus lateralis are appropriate
IM injection sites for adults.
9. A patient's Glasgow Coma Scale score is 8. What does this indicate? A)
Normal consciousness B) Mild impairment C) Severe impairment/coma D)
Brain death ANSWER : C - A GCS score of 8 or less indicates severe
impairment or coma.
10. What is the priority nursing diagnosis for a patient with difficulty
breathing? A) Anxiety B) Impaired gas exchange C) Activity intolerance D)
Knowledge deficit ANSWER : B - Impaired gas exchange is the priority as it
addresses the ABC priority (Airway, Breathing, Circulation).
11. Which patient position facilitates breathing? A) Prone B) Trendelenburg
C) Fowler's or Semi-Fowler's D) Supine ANSWER : C - Fowler's or Semi-
Fowler's position promotes lung expansion and easier breathing.
12. What is the normal range for adult heart rate? A) 40-60 bpm B) 60-100
bpm C) 100-120 bpm D) 120-140 bpm ANSWER : B - Normal adult heart rate
is 60-100 beats per minute.
13. Which action prevents pressure ulcers? A) Keep patient in one position
B) Reposition patient every 2 hours C) Avoid using pillows D) Keep skin moist
ANSWER : B - Repositioning every 2 hours reduces pressure and prevents
ulcer formation.
14. What is the first step in wound care? A) Apply antibiotic ointment B)
Hand hygiene C) Apply dressing D) Document findings ANSWER : B - Hand
hygiene is always the first step to prevent infection.
15. A patient has a temperature of 101.5°F. What is the appropriate
intervention? A) No action needed B) Administer antipyretics as ordered and
,monitor C) Apply heating blanket D) Restrict all fluids ANSWER : B - Fever
requires antipyretic administration and continued monitoring.
16. What does HIPAA protect? A) Patient's medical equipment B) Patient's
health information privacy C) Hospital finances D) Nursing licenses ANSWER
: B - HIPAA protects patient health information privacy and confidentiality.
17. Which assessment finding indicates fluid volume deficit? A) Edema B)
Crackles in lungs C) Decreased skin turgor D) Weight gain ANSWER : C -
Decreased skin turgor indicates dehydration/fluid volume deficit.
18. What is the appropriate needle gauge for blood transfusion? A) 25
gauge B) 18-20 gauge C) 27 gauge D) 30 gauge ANSWER : B - 18-20 gauge
needles allow adequate blood flow for transfusions.
19. A patient is NPO. What does this mean? A) Nothing by mouth B) No
physical activity C) Needs pain medication D) Neurological assessment needed
ANSWER : A - NPO (nil per os) means nothing by mouth.
20. What is the priority assessment for a postoperative patient? A) Pain
level B) Airway and breathing C) Bowel sounds D) Mobility ANSWER : B -
Airway and breathing are always priority assessments.
21. Which lab value indicates anemia? A) Elevated WBC B) Low
hemoglobin C) High platelet count D) Elevated glucose ANSWER : B - Low
hemoglobin indicates anemia.
22. What is the purpose of informed consent? A) To protect the hospital
legally B) To ensure patient understands procedure and gives voluntary
permission C) To document physician orders D) To bill insurance ANSWER :
B - Informed consent ensures patient understanding and voluntary agreement.
23. When should a nurse document care? A) At the end of the shift B) As
soon as possible after providing care C) Only when something goes wrong D)
Once per day ANSWER : B - Documentation should occur as soon as possible
after care is provided.
24. What is the correct method to dispose of needles? A) Recap and throw in
trash B) Place directly in sharps container without recapping C) Break needle
first D) Give to housekeeping ANSWER : B - Needles should be placed
directly in sharps containers without recapping.
25. A patient with diabetes has blood glucose of 45 mg/dL. What is the
priority action? A) Administer insulin B) Give glucose or simple carbohydrate
, C) Encourage exercise D) Do nothing, recheck in 4 hours ANSWER : B -
Blood glucose of 45 mg/dL is hypoglycemic; give glucose immediately.
26. What does "PRN" mean in medication orders? A) As needed B) Before
meals C) Twice daily D) Every night ANSWER : A - PRN means "as needed"
(pro re nata).
27. Which patient has the highest fall risk? A) 30-year-old postoperative
patient B) 85-year-old confused patient on sedatives C) 50-year-old with
appendicitis D) 25-year-old with pneumonia ANSWER : B - Elderly, confused
patients on sedatives have highest fall risk.
28. What is the therapeutic range for INR in patients on warfarin? A) 0.5-
1.0 B) 2.0-3.0 C) 5.0-7.0 D) 10.0-12.0 ANSWER : B - Therapeutic INR range
for warfarin is typically 2.0-3.0.
29. What is the correct technique for measuring blood pressure? A) Arm
above heart level, deflate cuff rapidly B) Arm at heart level, deflate cuff slowly
C) Any arm position, deflate quickly D) Arm below heart level ANSWER : B -
Arm should be at heart level with slow cuff deflation for accuracy.
30. Which intervention reduces surgical site infection? A) Shaving surgical
site the night before B) Administering prophylactic antibiotics as ordered C)
Keeping dressing moist D) Avoiding hand hygiene ANSWER : B -
Prophylactic antibiotics reduce surgical site infection risk.
31. What is the primary purpose of pain assessment? A) To determine if
patient is drug-seeking B) To guide effective pain management C) To satisfy
documentation requirements D) To compare patients ANSWER : B - Pain
assessment guides appropriate pain management interventions.
32. A patient is receiving IV fluids at 125 mL/hr. How much will infuse in 8
hours? A) 500 mL B) 750 mL C) 1000 mL D) 1250 mL ANSWER : C - 125
mL/hr × 8 hours = 1000 mL.
33. What is the primary function of the chain of command? A) To punish
nurses B) To provide structure for resolving issues and making decisions C) To
create more paperwork D) To avoid patient care ANSWER : B - Chain of
command provides structure for problem resolution and decision-making.
34. Which assessment indicates adequate tissue perfusion? A) Cool, pale
extremities B) Capillary refill < 3 seconds C) Weak peripheral pulses D)
Cyanotic nail beds ANSWER : B - Capillary refill less than 3 seconds
indicates adequate perfusion.
medical conditions B) To provide a systematic approach to patient care C) To
document medical procedures D) To implement physician orders ANSWER :
B - The nursing process provides a systematic, organized approach to delivering
individualized patient care.
2. Which of the following is the correct order of the nursing process? A)
Planning, Assessment, Implementation, Diagnosis, Evaluation B) Assessment,
Diagnosis, Planning, Implementation, Evaluation C) Diagnosis, Assessment,
Planning, Implementation, Evaluation D) Assessment, Planning, Diagnosis,
Implementation, Evaluation ANSWER : B - The correct sequence is
Assessment, Diagnosis, Planning, Implementation, and Evaluation (ADPIE).
3. A patient refuses medication. What is the nurse's best action? A)
Administer the medication anyway B) Document the refusal and notify the
physician C) Tell the patient they must take it D) Skip documentation since it
wasn't given ANSWER : B - Document the refusal and notify the physician to
ensure proper care continuation.
4. What is the most important action before administering any medication?
A) Check the medication room B) Verify patient identity using two identifiers
C) Ask the patient if they want the medication D) Check the medication cart
ANSWER : B - Two patient identifiers must be verified to ensure patient
safety.
5. Which vital sign change requires immediate attention? A) Temperature of
98.6°F B) Blood pressure of 180/110 mmHg C) Pulse of 72 bpm D)
Respirations of 16/min ANSWER : B - A blood pressure of 180/110 mmHg
indicates hypertensive crisis requiring immediate intervention.
,6. What is the proper technique for handwashing? A) Wash for at least 5
seconds B) Wash for at least 15-20 seconds with soap and water C) Use hand
sanitizer only D) Rinse hands briefly under water ANSWER : B - Proper
handwashing requires at least 15-20 seconds with soap and water.
7. When should standard precautions be used? A) Only with diagnosed
infectious patients B) Only in the operating room C) With all patients at all
times D) Only when drawing blood ANSWER : C - Standard precautions
should be used with all patients to prevent infection transmission.
8. What is the correct site for intramuscular injection in adults? A) Deltoid,
ventrogluteal, vastus lateralis B) Abdomen only C) Forearm D) Dorsogluteal
only ANSWER : A - Deltoid, ventrogluteal, and vastus lateralis are appropriate
IM injection sites for adults.
9. A patient's Glasgow Coma Scale score is 8. What does this indicate? A)
Normal consciousness B) Mild impairment C) Severe impairment/coma D)
Brain death ANSWER : C - A GCS score of 8 or less indicates severe
impairment or coma.
10. What is the priority nursing diagnosis for a patient with difficulty
breathing? A) Anxiety B) Impaired gas exchange C) Activity intolerance D)
Knowledge deficit ANSWER : B - Impaired gas exchange is the priority as it
addresses the ABC priority (Airway, Breathing, Circulation).
11. Which patient position facilitates breathing? A) Prone B) Trendelenburg
C) Fowler's or Semi-Fowler's D) Supine ANSWER : C - Fowler's or Semi-
Fowler's position promotes lung expansion and easier breathing.
12. What is the normal range for adult heart rate? A) 40-60 bpm B) 60-100
bpm C) 100-120 bpm D) 120-140 bpm ANSWER : B - Normal adult heart rate
is 60-100 beats per minute.
13. Which action prevents pressure ulcers? A) Keep patient in one position
B) Reposition patient every 2 hours C) Avoid using pillows D) Keep skin moist
ANSWER : B - Repositioning every 2 hours reduces pressure and prevents
ulcer formation.
14. What is the first step in wound care? A) Apply antibiotic ointment B)
Hand hygiene C) Apply dressing D) Document findings ANSWER : B - Hand
hygiene is always the first step to prevent infection.
15. A patient has a temperature of 101.5°F. What is the appropriate
intervention? A) No action needed B) Administer antipyretics as ordered and
,monitor C) Apply heating blanket D) Restrict all fluids ANSWER : B - Fever
requires antipyretic administration and continued monitoring.
16. What does HIPAA protect? A) Patient's medical equipment B) Patient's
health information privacy C) Hospital finances D) Nursing licenses ANSWER
: B - HIPAA protects patient health information privacy and confidentiality.
17. Which assessment finding indicates fluid volume deficit? A) Edema B)
Crackles in lungs C) Decreased skin turgor D) Weight gain ANSWER : C -
Decreased skin turgor indicates dehydration/fluid volume deficit.
18. What is the appropriate needle gauge for blood transfusion? A) 25
gauge B) 18-20 gauge C) 27 gauge D) 30 gauge ANSWER : B - 18-20 gauge
needles allow adequate blood flow for transfusions.
19. A patient is NPO. What does this mean? A) Nothing by mouth B) No
physical activity C) Needs pain medication D) Neurological assessment needed
ANSWER : A - NPO (nil per os) means nothing by mouth.
20. What is the priority assessment for a postoperative patient? A) Pain
level B) Airway and breathing C) Bowel sounds D) Mobility ANSWER : B -
Airway and breathing are always priority assessments.
21. Which lab value indicates anemia? A) Elevated WBC B) Low
hemoglobin C) High platelet count D) Elevated glucose ANSWER : B - Low
hemoglobin indicates anemia.
22. What is the purpose of informed consent? A) To protect the hospital
legally B) To ensure patient understands procedure and gives voluntary
permission C) To document physician orders D) To bill insurance ANSWER :
B - Informed consent ensures patient understanding and voluntary agreement.
23. When should a nurse document care? A) At the end of the shift B) As
soon as possible after providing care C) Only when something goes wrong D)
Once per day ANSWER : B - Documentation should occur as soon as possible
after care is provided.
24. What is the correct method to dispose of needles? A) Recap and throw in
trash B) Place directly in sharps container without recapping C) Break needle
first D) Give to housekeeping ANSWER : B - Needles should be placed
directly in sharps containers without recapping.
25. A patient with diabetes has blood glucose of 45 mg/dL. What is the
priority action? A) Administer insulin B) Give glucose or simple carbohydrate
, C) Encourage exercise D) Do nothing, recheck in 4 hours ANSWER : B -
Blood glucose of 45 mg/dL is hypoglycemic; give glucose immediately.
26. What does "PRN" mean in medication orders? A) As needed B) Before
meals C) Twice daily D) Every night ANSWER : A - PRN means "as needed"
(pro re nata).
27. Which patient has the highest fall risk? A) 30-year-old postoperative
patient B) 85-year-old confused patient on sedatives C) 50-year-old with
appendicitis D) 25-year-old with pneumonia ANSWER : B - Elderly, confused
patients on sedatives have highest fall risk.
28. What is the therapeutic range for INR in patients on warfarin? A) 0.5-
1.0 B) 2.0-3.0 C) 5.0-7.0 D) 10.0-12.0 ANSWER : B - Therapeutic INR range
for warfarin is typically 2.0-3.0.
29. What is the correct technique for measuring blood pressure? A) Arm
above heart level, deflate cuff rapidly B) Arm at heart level, deflate cuff slowly
C) Any arm position, deflate quickly D) Arm below heart level ANSWER : B -
Arm should be at heart level with slow cuff deflation for accuracy.
30. Which intervention reduces surgical site infection? A) Shaving surgical
site the night before B) Administering prophylactic antibiotics as ordered C)
Keeping dressing moist D) Avoiding hand hygiene ANSWER : B -
Prophylactic antibiotics reduce surgical site infection risk.
31. What is the primary purpose of pain assessment? A) To determine if
patient is drug-seeking B) To guide effective pain management C) To satisfy
documentation requirements D) To compare patients ANSWER : B - Pain
assessment guides appropriate pain management interventions.
32. A patient is receiving IV fluids at 125 mL/hr. How much will infuse in 8
hours? A) 500 mL B) 750 mL C) 1000 mL D) 1250 mL ANSWER : C - 125
mL/hr × 8 hours = 1000 mL.
33. What is the primary function of the chain of command? A) To punish
nurses B) To provide structure for resolving issues and making decisions C) To
create more paperwork D) To avoid patient care ANSWER : B - Chain of
command provides structure for problem resolution and decision-making.
34. Which assessment indicates adequate tissue perfusion? A) Cool, pale
extremities B) Capillary refill < 3 seconds C) Weak peripheral pulses D)
Cyanotic nail beds ANSWER : B - Capillary refill less than 3 seconds
indicates adequate perfusion.
