College Exams & Notes

Master your nursing exams with comprehensive practice questions and detailed explanations

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QUESTION #1
Fundamentals of Nursing Exam 4 Fundamentals
In caring for a dying patient, what is an appropriate nursing action to increase family involvement?
A Insisting that all bedside care be performed by the family
B Demonstrating care and supporting family participation
C Expecting the family to consistently perform the patients ADLs
D Refusing all assistance from the family to decrease family stress

Explanations

A
Insisting that the family perform all care places unnecessary burden and stress on them. Family involvement should be encouraged, not forced.
B
The nurse should model compassionate care while allowing family members to participate as they feel comfortable. This supports coping and maintains dignity for the patient.
C
Expecting families to consistently perform ADLs may overwhelm them emotionally and physically. Participation should be voluntary and guided by the nurse.
D
Refusing family assistance prevents meaningful involvement and may increase feelings of helplessness. Families often benefit from being included in care.
Family involvement at end of life should be encouraged through support, education, and choice. On exams, select answers that promote compassionate inclusion without placing demands on family members.
QUESTION #2
Fundamentals of Nursing Exam 4 Fundamentals
Which of the following scenarios accurately describes when palliative care is provided?
A Only in the homes of the terminally ill
B For any chronic illness that requires symptom control
C For cancer patients only in their last weeks of life
D Only in hospital settings based on the seriousness of the illness

Explanations

A
Palliative care is not limited to home care or terminal illness. It may be provided in multiple settings and at various stages of disease.
B
Palliative care focuses on symptom management and quality of life for patients with chronic or serious illnesses. It can be provided alongside curative treatment.
C
Palliative care is not restricted to cancer patients or end-of-life care. This description more closely aligns with hospice care.
D
Palliative care is not limited to hospital settings. It can be delivered in outpatient clinics, long-term care facilities, or at home.
Palliative care is appropriate at any stage of a serious or chronic illness and focuses on symptom relief and quality of life. On exams, remember that palliative care is broader than hospice and is not limited to end-of-life care.
QUESTION #3
Fundamentals of Nursing Exam 4 Fundamentals
Which statement is true regarding advance care planning and advance directives?
A Advance care planning applies only when the person is dying.
B Advance care planning should be done by family members of people who are incompetent.
C Discussion of advance care planning is a nursing responsibility.
D Advance directives should be kept in a safety deposit box until the person dies.

Explanations

A
Advance care planning should occur early and can be done by any competent adult, not only those who are dying. It is a proactive process.
B
Advance care planning is completed by competent individuals themselves, not by family members unless legal authority exists. The goal is to honor the patient’s wishes.
C
Nurses play a key role in initiating and facilitating discussions about advance care planning. This supports informed decision-making and patient autonomy.
D
Advance directives should be easily accessible in the medical record or with the patient. Keeping them in a safety deposit box limits their usefulness.
Advance care planning promotes patient autonomy and should occur before a health crisis. On exams, remember that nurses are responsible for educating and encouraging patients to discuss advance directives.
QUESTION #4
Fundamentals of Nursing Exam 4 Fundamentals
The nurse has been caring for a patient who has just died. What is the preferred outcome in caring for the body after death?
A Make sure that the body is sent to the morgue within an hour after death.
B Have the family members participate in the bathing and dressing of the deceased.
C Notify in person or by phone all family and team members immediately after the patient’s death
D Demonstrate respect for the body and provide a clean, peaceful impression of the deceased for the family.

Explanations

A
Timely transport is necessary but is not the primary goal of postmortem care. Respect and dignity take priority.
B
Family participation may be offered but should never be assumed or required. Preferences vary among families and cultures.
C
Notification is an important task but is not the desired outcome of postmortem care. The focus is on the condition and presentation of the body.
D
Postmortem care prioritizes dignity, respect, and a peaceful appearance for family members. This supports the grieving process.
The primary goal of postmortem care is to preserve dignity and respect for the deceased. On exams, choose outcomes that focus on compassion, cultural sensitivity, and family support rather than tasks or timelines.
QUESTION #5
Fundamentals of Nursing Exam 4 Fundamentals
The grandmother of two children, 8 and 10 years of age, has died. Their mother asks the nurse what she should do about her children attending the funeral. What is the nurse’s best response?
A “Take them to the funeral—they need closure. Many children attend funerals in today’s society.”
B “Do not take them to the funeral—they are too young to be exposed to the emotions that are demonstrated at funerals.”
C “Talk to your children about how they feel about attending the funeral and encourage them to ask questions and talk about their concerns.”
D “Talk to your children about what your mother meant to you and how much she cared for them, and then see if they really want to attend the funeral.”

Explanations

A
Telling the parent what the children need removes choice and may not respect individual coping styles. Children should not be forced to attend.
B
Children at this age can understand death in an age-appropriate way and benefit from honest discussion. Avoiding the funeral altogether may increase confusion or fear.
C
Children should be allowed to express feelings, ask questions, and participate in decisions about attending the funeral. This supports healthy grieving.
D
Focusing on the adult’s feelings may influence the children’s decision rather than centering on their emotional needs. The priority is the children’s perspective.
Children should be given honest, age-appropriate information and allowed to express their feelings about death. On exams, choose responses that encourage communication, choice, and emotional expression rather than forcing or avoiding rituals.
QUESTION #6
Fundamentals of Nursing Exam 4 Fundamentals
The nurse has been caring for a 65-year-old male patient who has just died. In planning for follow-up bereavement care, the nurse knows that which person is at risk for disenfranchised grief?
A A daughter who lives in a different state
B The son who was with the patient when he died
C The estranged ex-wife of the patient who lives nearby
D The 16-year-old grandchild of the patient

Explanations

A
Distance does not invalidate a person’s grief, and a daughter’s loss is socially recognized. She is likely to receive support.
B
A son’s grief is expected and socially acknowledged, especially if he was present at death. This is not disenfranchised grief.
C
Disenfranchised grief occurs when a loss is not socially recognized or supported. An estranged ex-wife may grieve privately without acknowledgment or support.
D
A grandchild’s grief is recognized and supported, even though age may affect how it is expressed. This does not meet criteria for disenfranchised grief.
Disenfranchised grief occurs when a person’s loss is not openly acknowledged, socially validated, or supported. On exams, look for relationships that are hidden, estranged, or socially unrecognized.
QUESTION #7
Fundamentals of Nursing Exam 4 Fundamentals
The nurse is orienting new staff to a clinical unit that provides palliative care. A new employee asks what “grief” is exactly. Which statement indicates that the nurse has correctly defined grief?
A The emotional response to a loss
B The outward, social expression of a loss
C The depression felt after a loss
D The loss of a possession or loved one

Explanations

A
Grief refers to the internal emotional response experienced after a loss. It includes feelings such as sadness, anger, and longing.
B
The outward, social expression of loss is called mourning, not grief. This describes behaviors rather than internal feelings.
C
Depression may occur during grief but is not synonymous with it. Grief encompasses a broader range of emotions.
D
This describes the loss itself, not the emotional response to the loss. Grief occurs as a reaction to loss.
Grief is the internal emotional response to loss, while mourning is the outward expression of grief. On exams, distinguish clearly between loss, grief, and mourning.
QUESTION #8
Fundamentals of Nursing Exam 4 Fundamentals
While caring for a patient with advanced multiple sclerosis, the nurse is discussing the difference between hospice and palliative care. Which statement by the patient indicates understanding of the difference between hospice care and palliative care?
A “I will need to get hospice care if I want my symptoms controlled.”
B “I can have palliative care right now—even though I am not going to die anytime soon.”
C “My doctor has to make the decision if I have hospice care.
D “I can’t get any other treatments, even if they are experimental, if I choose palliative care.”

Explanations

A
Symptom control is provided in both hospice and palliative care. Hospice is not required to receive symptom management.
B
Palliative care can be provided at any stage of illness and alongside curative treatment. It is not limited to end-of-life care.
C
Hospice care decisions involve the patient and care team, not the physician alone. Patient choice is central.
D
Palliative care does not restrict other treatments. Patients may continue curative or experimental therapies.
Palliative care focuses on symptom relief and quality of life at any stage of serious illness. On exams, hospice care is reserved for end-of-life situations, while palliative care is not.
QUESTION #9
Fundamentals of Nursing Exam 4 Fundamentals
The patient who had a below-the-knee amputation 3 days ago complains of pain from the amputated extremity. Which response by the nurse best explains what the patient is experiencing?
A “Your phantom pain will subside when the brain realizes the lower extremity is no longer there.”
B “Your radiating pain will continue for months because the lower extremity is no longer there.”
C “You are suffering from referred pain, which you will always have, but it will lessen with time.”
D “You are experiencing psychogenic pain because loss of an extremity is an emotional loss.”

Explanations

A
Phantom pain occurs when the brain continues to perceive sensations from an amputated limb. This pain often decreases over time as the nervous system adapts.
B
Radiating pain spreads along nerve pathways and does not explain pain felt in an amputated limb. This description is inaccurate.
C
Referred pain is felt in a different area than its source, not in a limb that no longer exists. This does not describe post-amputation pain.
D
Phantom pain is neurologic, not psychogenic, and is not simply due to emotional loss. It is a real physiologic phenomenon.
Phantom limb pain is common after amputation and results from continued nerve signaling to the brain. On exams, associate post-amputation pain with neurologic causes rather than emotional or referred pain.
QUESTION #10
Fundamentals of Nursing Exam 4 Fundamentals
The endocrine system releases excessive hormones during episodes of acute pain. The nurse should monitor patients experiencing acute pain for which potential problem?
A Hyperglycemia
B Migraine headache
C Hypokalemia
D Diarrhea

Explanations

A
Acute pain triggers stress hormones such as cortisol and epinephrine, which increase blood glucose levels. This can result in stress-induced hyperglycemia.
B
Migraines are neurologic conditions and are not a direct endocrine response to acute pain.
C
Acute pain does not typically cause significant potassium shifts. Hypokalemia is not a common stress response.
D
Stress hormones tend to slow gastrointestinal activity rather than cause diarrhea. This is not a typical endocrine response to acute pain.
Acute pain activates the stress response, increasing cortisol and catecholines. On exams, associate acute pain with elevated blood glucose levels.