Rn Learning System Fundamentals Practice Quiz 2 - claymation artwork

RN Learning System Fundamentals Practice Quiz 2

13 Questions 9 min
RN Learning System Fundamentals Practice Quiz 2 focuses on bedside fundamentals that drive safe daily care: infection control choices, oxygen therapy setup, mobility and fall prevention, basic med checks, and clear documentation. It rewards accurate prioritization of unstable findings and the safest first action. Nursing students, new graduate RNs, and bedside nurses can use it to sharpen clinical judgment.
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1You walk into a patient room and notice the bed is in the highest position after morning care, but the patient is alert and says they feel fine. What action is the priority to reduce immediate harm?
2Wearing clean gloves eliminates the need to perform hand hygiene after patient care.

True / False

3You are preparing to administer digoxin to an adult patient. What assessment is most important to complete immediately before giving the dose?
4A patient is diagnosed with influenza and has a frequent cough. Which transmission-based precautions are appropriate?
5After caring for a patient with suspected Clostridioides difficile infection, alcohol-based hand rub is preferred over soap and water.

True / False

6A patient is unsteady and needs to walk to the bathroom for the first time after surgery. What equipment best supports safe ambulation?
7You administer an ordered medication and the patient swallows it without difficulty. When should you document the administration?
8You are entering the room of a patient on contact precautions for a draining wound. What PPE is required on entry?
9Because oxygen is a medication, a nurse may still apply oxygen immediately in acute respiratory distress while obtaining or clarifying the order per facility protocol.

True / False

10You receive four call lights at the same time. Which patient should you assess first?
11A pulse oximeter suddenly reads 82% on a patient who is awake, speaking in full sentences, and does not look distressed. What should you do first?
12A PRN medication order still requires a current indication and reassessment of effect within an appropriate time for the route.

True / False

13A patient with type 1 diabetes is NPO for a procedure. The pre-procedure fingerstick glucose is 62 mg/dL (3.4 mmol/L), and a short-acting insulin dose is due per sliding scale. What is the best initial nursing action?
14A patient with an IV and a Foley catheter insists on walking to the bathroom alone. They are slightly dizzy when sitting up. What is the best nursing response?
15After removing gloves, you should perform hand hygiene before touching clean equipment such as a medication scanner or computer keyboard.

True / False

16A patient is on a simple face mask. You find the oxygen flowmeter set at 4 L/min, even though the provider order is for 8 L/min. What is the best immediate action?
17You are pulled in four directions at once. Which situation requires you to respond first?
18A patient arrives with fever, cough, and a rash, and the provider suspects measles. The patient is currently in a shared bay area. What should you do first to protect others?
19Charting "patient tolerated procedure well" is sufficient documentation after an invasive bedside procedure.

True / False

20You are preparing to suction a tracheostomy for visible secretions and coarse breath sounds. What nursing action best reduces suction-related hypoxia?
21You are covering four patients. Which one should you assess first?

High-Frequency Misses in RN Fundamentals: Priority, PPE, Med Checks, and Documentation

Missing the stem’s priority word

Many items hinge on a single modifier like first, best, immediate, or most important. If you answer the “most complete plan” instead of the “first action,” you will pick a safe but wrong option.

  • Fix: Rephrase the question in one sentence before you look at choices, using the exact priority word.

Skipping the safety sequence

Fundamentals questions often grade the safest next step, not the most advanced intervention.

  • Fix: Screen in order: immediate danger (falls, bleeding, disconnected oxygen), then ABCs, then acute change, then comfort and teaching.
  • Common trap: Calling the provider before correcting obvious hypoxia with positioning and oxygen per protocol.

Isolation and PPE mix-ups

  • Fix: Decide the route first (airborne, droplet, contact), then pick PPE and room setup that matches the route.
  • Common trap: Treating airborne pathogens like droplet, or forgetting eye protection when splash risk is in the stem.

Medication fundamentals errors

  • Fix: Match each medication class with its required pre-assessment (apical pulse, BP, RR, sedation scale, pain score) and document the reassessment time.
  • Common trap: Giving a PRN medication without confirming the indication and last dose time.

Charting that creates risk

  • Fix: Chart objective data, the intervention, and the patient response. Separate facts from interpretation.
  • Common trap: Vague phrases like “tolerated well” without a measurable reassessment (SpO2, pain score, lung sounds, gait stability).

Printable RN Fundamentals Quick Sheet: Prioritization, Infection Control, Oxygen, Mobility, and Core Charting

Print or save as PDF and keep this next to your notes for quick repetition before clinical, skills checkoffs, or proctored exams.

Rapid prioritization ladder (use in order)

  1. Immediate safety threats: active bleeding, fall risk, disconnected oxygen, acute mental status change with risk of harm, medication error in progress.
  2. ABCs: airway patency, work of breathing, oxygenation (SpO2 trend), circulation and perfusion (BP, HR, skin, urine output).
  3. Acute change: new confusion, new chest pain, sudden dyspnea, new hypotension, fever with rigors, rapidly worsening pain.
  4. Least stable first: unstable beats stable, post-op complication beats routine care, fresh admission beats discharge teaching.
  5. Then comfort and education: pain control, anxiety support, teaching, documentation cleanup.

Infection control essentials

  • Standard precautions: hand hygiene before and after contact, gloves for blood or body fluids, mask plus eye protection for splash or spray risk.
  • Contact precautions: gown and gloves on entry, dedicate equipment (stethoscope, BP cuff) if possible, clean high-touch surfaces.
  • Droplet precautions: surgical mask for close contact, patient wears a mask for transport.
  • Airborne precautions: fit-tested respirator (N95 or facility equivalent) and negative-pressure room if available, keep the door closed.

Oxygen therapy reminders

  • Nasal cannula: 1 to 6 L/min for mild hypoxemia, humidify per policy if higher flows or dryness.
  • Simple mask: keep at least 5 L/min to flush CO2.
  • Nonrebreather: high flow (often 10 to 15 L/min) for acute severe hypoxemia, ensure reservoir bag inflates and valves function.
  • Safety: no petroleum products, assess skin and mucosa, reassess SpO2 and work of breathing after changes.

Mobility and fall prevention

  • Before ambulation: check orthostatic symptoms, lines and drains, footwear, and need for gait belt or assistive device.
  • During ambulation: stand to the side and slightly behind, stop for dizziness, document distance, assistance level, and tolerance.

Documentation mini-template (high yield)

  • Assessment: objective findings (vitals, SpO2, lung sounds, neuro status).
  • Action: what you did and when (positioning, oxygen, meds, notification).
  • Response: measurable reassessment (new SpO2, pain score, RR, mental status).

Worked RN Fundamentals Scenarios: Choosing the Safest First Action Under Time Pressure

Scenario 1: Post-op hypoxia versus “call the provider”

A patient is 2 hours post-op with SpO2 88% on room air, RR 26, drowsy but arousable, and shallow breathing. The UAP reports the patient “seems sleepy.”

  1. Identify the priority cue: SpO2 is low with increased RR and shallow respirations. This is an ABC problem (oxygenation and ventilation).
  2. Pick the safest first action: Position the patient to improve ventilation (raise HOB) and apply oxygen per protocol, then reassess. This addresses hypoxia immediately.
  3. Do focused assessment while intervening: Check airway patency, lung sounds, sedation level, pain control, and recent opioid dosing. Verify pulse oximeter placement and waveform.
  4. Escalate based on response: If SpO2 stays low, work of breathing increases, or mental status worsens, activate rapid response per facility policy and notify the provider with objective data (SpO2 trend, RR, meds, interventions tried).
  5. Document like an RN: Baseline vitals and SpO2, interventions (positioning, oxygen device and flow), and the measurable response within minutes.

Scenario 2: PRN opioid administration with a missing pre-check

A patient requests IV opioid medication for 8/10 pain. The last dose was 1 hour ago, RR is 10, and the patient is difficult to arouse.

  1. Priority cue: Low RR and decreased arousability suggest respiratory depression risk.
  2. Best next step: Hold the opioid, stimulate and assess respiratory status, and follow policy for escalation and reversal if indicated. Pain control is not prioritized over breathing.

RN Learning System Fundamentals Practice Quiz 2 FAQ: Priority Logic, PPE Choices, Oxygen Safety, and Charting Decisions

How do I decide between ABCs and “least stable first” on fundamentals questions?

Start with immediate safety threats and ABCs because they can kill quickly. “Least stable first” helps after you confirm there is no airway, breathing, circulation, or active harm issue. If two patients both have stable ABCs, then rank by acuity, new symptoms, and concerning trends.

What is the quickest way to choose the right transmission-based precautions?

Match the organism to the route of spread before you pick PPE. Airborne requires a respirator and a closed door with negative pressure if available. Droplet requires a surgical mask for close contact. Contact requires gown and gloves on entry with dedicated equipment when possible. If the stem includes splash risk, add eye protection regardless of route.

On oxygen therapy items, what details most often separate correct from incorrect?

Look for safety and device function details. A simple mask must run at a minimum flow to prevent CO2 rebreathing. A nonrebreather must have an inflated reservoir bag and working valves. Prioritize reassessment after any change in device or flow, and chart SpO2 and work of breathing, not only “tolerated.”

What pre-assessments are most commonly expected before giving basic meds in fundamentals questions?

Expect a required check tied to adverse effects: apical pulse and BP for many cardiac meds, RR and sedation level for opioids, BP for antihypertensives, and pain score plus functional impact for analgesics. Also confirm timing of the last dose and the PRN indication. If a required assessment is missing in the stem, the safest answer is often to assess before giving.

How should I document an event like a near fall or sudden desaturation without writing risky charting?

Chart objective facts, your actions, and the patient response. Example structure: assessment findings (vitals, SpO2, mental status), the intervention (assist back to bed, oxygen applied, provider or rapid response notification), and measurable reassessment. Avoid blame, assumptions, and terms that imply conclusions like “noncompliant.” For more practice with fundamentals patterns, use Fundamentals Quiz 1 Review And Refresh.

Do fundamentals items include communication and delegation, or is it only skills and precautions?

They often include both. You may need to pick what to delegate to a UAP versus what requires RN assessment, or what to report using concise SBAR. If your misses involve handoffs, therapeutic responses, or conflict scenarios, add targeted practice with Nursing Communication Skills Practice Questions.

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