Admission Transfer and Discharge (Most important MCQs)

Q1. A nurse is admitting an unconscious patient brought from the emergency department without relatives. Which action is the PRIORITY before administering prescribed medications?

A. Assess financial consent status B. Assign the patient to a general ward C. Apply an identification band with temporary identifiers D. Send belongings to the security office

Correct Answer: C. Apply an identification band with temporary identifiers

Rationale: Correct patient identification is the first priority to prevent medication and treatment errors. Temporary identifiers must be used until formal identification is confirmed.

Q2. During admission of a patient with severe dyspnea, which nursing action should be performed FIRST?

A. Complete detailed nursing history B. Record patient valuables C. Assess airway and oxygen saturation D. Explain hospital visiting policy

Correct Answer: C. Assess airway and oxygen saturation

Rationale: Airway and breathing take priority according to ABC principles. Stabilization precedes routine admission procedures.

Q3. A conscious patient refuses admission despite medical advice. What is the MOST appropriate nursing action?

A. Force the patient to stay for observation B. Inform security immediately C. Explain risks and document informed refusal D. Ask relatives to sign consent forcibly

Correct Answer: C. Explain risks and document informed refusal

Rationale: Competent adults have the legal right to refuse treatment. Nurses must ensure informed refusal is documented appropriately.

Q4. A patient with cervical spine injury is being transferred from stretcher to bed. Which technique is MOST appropriate?

A. One nurse transfer method B. Logrolling with spinal alignment maintained C. Pulling patient by upper limbs D. Semi-Fowler’s assisted transfer

Correct Answer: B. Logrolling with spinal alignment maintained

Rationale: Logrolling prevents spinal movement and further neurological injury during transfer.

Q5. During transfer from ICU to ward, the nurse forgets to communicate the patient’s allergy status. This represents failure of:

A. Biomedical waste segregation B. Infection prevention protocol C. Continuity of care D. Bed-making procedure

Correct Answer: C. Continuity of care

Rationale: Effective handoff communication ensures continuity and safety of patient care during transitions.

Q6. Which statement by a patient with heart failure indicates EFFECTIVE discharge teaching?

A. “I will stop medications once symptoms improve.” B. “I will weigh myself daily.” C. “Salt intake does not affect my condition.” D. “Follow-up visits are unnecessary if I feel well.”

Correct Answer: B. “I will weigh myself daily.”

Rationale: Daily weight monitoring helps detect fluid retention early in heart failure patients.

Q7. A patient with pulmonary tuberculosis is admitted to the medical ward. Which room placement is MOST appropriate?

A. Positive-pressure room B. Isolation room with negative pressure C. Shared room near nursing station D. Standard ward cubicle

Correct Answer: B. Isolation room with negative pressure

Rationale: Airborne infections like tuberculosis require negative-pressure isolation to prevent spread.

Q8. Which documentation entry by the nurse is MOST appropriate during patient transfer?

A. “Patient transferred safely.” B. “Condition stable.” C. “Transferred to ward at 10:30 AM with oxygen at 2 L/min; receiving nurse informed.” D. “Patient looked comfortable during transfer.”

Correct Answer: C

Rationale: Accurate documentation should be objective, complete, timed, and specific.

Q9. During transfer, a patient suddenly develops respiratory distress. What should the nurse do FIRST?

A. Continue transfer quickly B. Inform relatives immediately C. Stop transfer and assess airway D. Complete transfer documentation

Correct Answer: C. Stop transfer and assess airway

Rationale: Immediate patient stabilization takes priority over transfer completion.

Q10. Discharge planning for a stroke patient should BEGIN:

A. On the day of discharge B. After physician rounds C. At the time of admission D. After physiotherapy consultation

Correct Answer: C. At the time of admission

Rationale: Early discharge planning improves continuity of care and reduces readmission risk.

Q11. During admission, the nurse discovers that the prescribed antihypertensive medication differs from the medicine the patient takes at home. What is the MOST appropriate nursing action?

A. Administer both medications together B. Omit all antihypertensive drugs C. Clarify the discrepancy with the physician D. Ask the patient to decide which drug to take

Correct Answer: C. Clarify the discrepancy with the physician

Rationale: Medication reconciliation prevents medication errors during transitions of care by verifying accurate medication information.

Q12. Before transferring a patient from bed to wheelchair, which assessment is MOST essential?

A. Favorite sitting position B. Ability to bear weight C. Number of visitors present D. Meal preference

Correct Answer: B. Ability to bear weight

Rationale: Assessing mobility and weight-bearing ability prevents falls and transfer injuries.

Q13. A patient insists on leaving the hospital against medical advice. Which nursing action is BEST?

A. Hide the patient’s belongings B. Inform the patient about possible complications and document the event C. Refuse to remove IV cannula D. Call police immediately

Correct Answer: B. Inform the patient about possible complications and document the event

Rationale: Patients have the right to leave against medical advice if competent. Nurses must provide education and proper documentation.

Q14. A newly admitted patient reports chest pain and sweating. Which action by the nurse has PRIORITY?

A. Complete nursing admission form B. Check insurance details C. Assess pain characteristics and vital signs D. Explain hospital rules

Correct Answer: C. Assess pain characteristics and vital signs

Rationale: Chest pain may indicate a life-threatening cardiac emergency requiring immediate assessment.

Q15. During admission, the patient gives jewelry to the nurse for safekeeping. What is the MOST appropriate action?

A. Keep jewelry in uniform pocket B. Ask another patient to witness storage C. Document valuables according to hospital policy D. Place jewelry under patient pillow

Correct Answer: C. Document valuables according to hospital policy

Rationale: Proper documentation prevents legal disputes and ensures accountability for patient belongings.

Q16. A patient receiving oxygen therapy is transferred to radiology. Which action is MOST important?

A. Remove oxygen during transport B. Ensure portable oxygen cylinder is functional C. Delay transfer until next shift D. Transport without monitoring equipment

Correct Answer: B. Ensure portable oxygen cylinder is functional

Rationale: Maintaining oxygen therapy during transfer prevents hypoxia and respiratory compromise.

Q17. Which instruction is MOST important before discharge of a patient receiving anticoagulant therapy?

A. Increase intake of sharp foods B. Use a soft toothbrush and electric razor C. Stop medication when bruising occurs D. Avoid all physical activity permanently

Correct Answer: B. Use a soft toothbrush and electric razor

Rationale: Anticoagulants increase bleeding risk; injury prevention measures are essential.

Q18. A patient with MRSA infection is transferred to another unit. Which nursing action is MOST appropriate?

A. Remove isolation precautions before transfer B. Inform receiving unit about required precautions C. Delay transfer indefinitely D. Cover infection status in documentation

Correct Answer: B. Inform receiving unit about required precautions

Rationale: Communication of infection-control precautions prevents cross-contamination and ensures continuity of isolation measures.

Q19. Which discharged patient requires the HIGHEST priority follow-up?

A. Young adult with mild gastritis B. Elderly patient using sedative medications and living alone C. Stable patient after appendectomy D. Patient discharged after minor dressing change

Correct Answer: B. Elderly patient using sedative medications and living alone

Rationale: Elderly patients on sedatives are at high risk for falls and injury after discharge.

Q20. Which nursing activity related to patient transfer can be delegated to trained assistive personnel?

A. Assessing neurological status B. Explaining transfer risks C. Transporting stable patient with supervision D. Evaluating patient response after transfer

Correct Answer: C. Transporting stable patient with supervision

Rationale: Stable patient transport may be delegated, but assessment and evaluation remain the nurse’s responsibility.

Q21. A nurse is preparing a patient for transfer to the intensive care unit. Which information is MOST important to communicate to the receiving nurse?

A. Patient’s favorite food B. Recent changes in vital signs C. Number of hospital visitors D. Time of last bed bath

Correct Answer: B. Recent changes in vital signs

Rationale: Communication of current clinical status ensures continuity and safety of patient care during transfer.

Q22. Which patient should the nurse admit FIRST?

A. Stable patient with scheduled cataract surgery B. Patient with mild fever and sore throat C. Patient with severe respiratory distress D. Patient awaiting routine diagnostic tests

Correct Answer: C. Patient with severe respiratory distress

Rationale: Airway and breathing problems require immediate attention according to prioritization principles.

Q23. During discharge teaching, which statement by the patient indicates NEED for further teaching?

A. “I will complete my antibiotic course.” B. “I will keep follow-up appointments.” C. “I can stop medications once I feel better.” D. “I will report unusual symptoms immediately.”

Correct Answer: C. “I can stop medications once I feel better.”

Rationale: Premature discontinuation of medication may worsen disease and increase complications.

Q24. Which action is MOST appropriate before transferring a patient to the operating room?

A. Remove identification band B. Verify informed consent C. Delay preoperative checklist D. Keep dentures in place

Correct Answer: B. Verify informed consent

Rationale: Consent must be verified before surgical procedures to ensure legal and ethical compliance.

Q25. A patient becomes dizzy while being transferred from bed to wheelchair. What should the nurse do FIRST?

A. Continue transfer quickly B. Return patient safely to bed C. Ask patient to walk independently D. Leave patient seated alone

Correct Answer: B. Return patient safely to bed

Rationale: Preventing falls and ensuring patient safety are the immediate priorities.

Q26. Which discharge instruction is MOST important for a patient with newly diagnosed diabetes mellitus?

A. “Avoid all exercise permanently.” B. “Take insulin only when symptoms occur.” C. “Monitor blood glucose regularly.” D. “Skip meals after insulin administration.”

Correct Answer: C. “Monitor blood glucose regularly.”

Rationale: Regular glucose monitoring helps maintain glycemic control and prevents complications.

Q27. During admission assessment, which finding requires IMMEDIATE reporting?

A. Temperature 37.2°C B. Blood pressure 84/50 mmHg C. Mild anxiety D. Decreased appetite

Correct Answer: B. Blood pressure 84/50 mmHg

Rationale: Hypotension may indicate shock or hemodynamic instability requiring urgent intervention.

Q28. Which nursing action helps prevent infection during patient transfer?

A. Reusing contaminated gloves B. Ignoring isolation precautions C. Performing hand hygiene before and after transfer D. Sharing equipment without cleaning

Correct Answer: C. Performing hand hygiene before and after transfer

Rationale: Hand hygiene is the most effective method to reduce healthcare-associated infections.

Q29. A patient scheduled for discharge asks the nurse about medication side effects. Which response is BEST?

A. “Read the medicine label later.” B. “Side effects are not important.” C. “Let me explain common side effects and precautions.” D. “Ask the pharmacist after discharge.”

Correct Answer: C. “Let me explain common side effects and precautions.”

Rationale: Patient education regarding medications is an essential nursing responsibility during discharge planning.

Q30. Which patient transfer requires the MOST assistance?

A. Young adult with minor ankle sprain B. Alert patient with stable vital signs C. Elderly postoperative patient with weakness D. Patient walking independently

Correct Answer: C. Elderly postoperative patient with weakness

Rationale: Weak postoperative elderly patients are at increased risk for falls and injury during transfer.

Q31. Which nursing action is MOST important when admitting a confused elderly patient?

A. Leave side rails down for independence B. Place patient near exit door C. Assess fall risk immediately D. Avoid asking orientation questions

Correct Answer: C. Assess fall risk immediately

Rationale: Confused elderly patients are at high risk for falls and injury; early assessment improves safety.

Q32. A patient is transferred from ICU with a central venous catheter. Which action by the receiving nurse is PRIORITY?

A. Remove the catheter immediately B. Assess catheter site and IV infusions C. Delay assessment until physician rounds D. Disconnect IV fluids during transfer

Correct Answer: B. Assess catheter site and IV infusions

Rationale: Central line assessment prevents complications such as infection, infiltration, and interruption of therapy.

Q33. Which discharge instruction is MOST important for a patient after cataract surgery?

A. Rub eyes frequently B. Avoid heavy lifting and straining C. Stop eye drops if vision improves D. Sleep without eye protection

Correct Answer: B. Avoid heavy lifting and straining

Rationale: Straining increases intraocular pressure and may impair postoperative healing.

Q34. During transfer, a patient’s oxygen saturation suddenly falls to 82%. What should the nurse do FIRST?

A. Continue transport rapidly B. Assess airway and oxygen delivery system C. Document event after transfer D. Ask family members to calm the patient

Correct Answer: B. Assess airway and oxygen delivery system

Rationale: Immediate assessment and correction of airway or oxygen problems are essential to prevent hypoxia.

Q35. Which action by the nurse violates patient confidentiality during admission?

A. Discussing patient care with assigned healthcare team B. Providing information with patient consent C. Sharing patient diagnosis loudly in public hallway D. Documenting care in medical record

Correct Answer: C. Sharing patient diagnosis loudly in public hallway

Rationale: Confidential patient information must not be disclosed in public areas.

Q36. Which patient is MOST appropriate for discharge?

A. Patient with uncontrolled bleeding B. Patient with unstable vital signs C. Patient able to understand discharge instructions D. Patient requiring emergency surgery

Correct Answer: C. Patient able to understand discharge instructions

Rationale: Safe discharge requires clinical stability and understanding of post-discharge care.

Q37. A nurse receives a transfer report stating, “Patient is stable.” Which additional information is MOST necessary?

A. Patient’s favorite television program B. Current medications and allergies C. Dietary preference only D. Number of previous admissions

Correct Answer: B. Current medications and allergies

Rationale: Medication and allergy information is critical for safe continuity of care.

Q38. Which action is MOST appropriate before discharging a postoperative patient?

A. Remove all written instructions B. Assess understanding of wound care C. Encourage patient to skip follow-up visits D. Stop pain medications permanently

Correct Answer: B. Assess understanding of wound care

Rationale: Evaluating patient understanding ensures safe self-care after discharge.

Q39. During emergency admission, which nursing action takes PRIORITY?

A. Labeling patient belongings B. Completing insurance forms C. Stabilizing airway and circulation D. Explaining hospital menu options

Correct Answer: C. Stabilizing airway and circulation

Rationale: Immediate stabilization of life-threatening conditions is the highest priority.

Q40. Which transfer technique reduces risk of musculoskeletal injury to nurses?

A. Twisting while lifting patient B. Using proper body mechanics and assistive devices C. Pulling patient without assistance D. Lifting with back muscles only

Correct Answer: B. Using proper body mechanics and assistive devices

Rationale: Proper body mechanics prevent nurse injuries and improve patient safety.

Q41. A nurse is admitting a patient with suspected meningitis. Which action is MOST important initially?

A. Place the patient in droplet isolation B. Allow unrestricted visitors C. Delay assessment until physician arrives D. Transfer patient to shared ward immediately

Correct Answer: A. Place the patient in droplet isolation

Rationale: Meningitis may spread through respiratory droplets; immediate isolation reduces transmission risk.

Q42. Which statement by a nurse during discharge teaching is MOST appropriate?

A. “You do not need follow-up care if symptoms improve.” B. “Call the healthcare provider if symptoms worsen.” C. “Double your medication dose if pain increases.” D. “Stop medications once appetite improves.”

Correct Answer: B. “Call the healthcare provider if symptoms worsen.”

Rationale: Patients must know warning signs that require medical attention after discharge.

Q43. A patient is transferred from stretcher to bed. Which action by the nurse is BEST?

A. Lock wheels of bed and stretcher B. Keep wheels unlocked for flexibility C. Pull patient quickly without assistance D. Raise bed to maximum height for patient

Correct Answer: A. Lock wheels of bed and stretcher

Rationale: Locked wheels prevent movement and reduce fall risk during transfer.

Q44. Which admission finding requires IMMEDIATE intervention?

A. Mild headache B. Respiratory rate of 8/min C. Slight anxiety D. Dry lips

Correct Answer: B. Respiratory rate of 8/min

Rationale: Severe bradypnea may indicate respiratory depression requiring urgent intervention.

Q45. A discharged patient states, “I will take leftover antibiotics next time I feel sick.” Which response by the nurse is BEST?

A. “That is correct.” B. “Antibiotics should only be used as prescribed.” C. “Double the dose for faster recovery.” D. “Store antibiotics without labels.”

Correct Answer: B. “Antibiotics should only be used as prescribed.”

Rationale: Inappropriate antibiotic use increases resistance and treatment complications.

Q46. During transfer of a patient receiving IV fluids, the nurse notices swelling at the IV site. What should the nurse do FIRST?

A. Increase infusion rate B. Stop the IV infusion C. Ignore the swelling temporarily D. Continue transfer without assessment

Correct Answer: B. Stop the IV infusion

Rationale: Swelling may indicate infiltration; stopping infusion prevents tissue damage.

Q47. Which nursing action is MOST important before discharging a patient receiving insulin therapy?

A. Assess ability to self-administer insulin B. Encourage skipping meals C. Stop glucose monitoring permanently D. Advise insulin storage near heat source

Correct Answer: A. Assess ability to self-administer insulin

Rationale: Safe insulin administration skills are essential for diabetic self-management.

Q48. A nurse preparing to transfer a patient notices the identification band is missing. What should the nurse do FIRST?

A. Transfer patient immediately B. Create and verify a new identification band C. Ask another patient to identify the patient D. Delay all care indefinitely

Correct Answer: B. Create and verify a new identification band

Rationale: Accurate identification is essential before any transfer or treatment.

Q49. Which patient requires the HIGHEST priority discharge planning?

A. Young adult with minor illness B. Patient with chronic disability living alone C. Stable patient after diagnostic test D. Patient discharged after vaccination

Correct Answer: B. Patient with chronic disability living alone

Rationale: Patients with disabilities and limited support require coordinated discharge planning.

Q50. Which nursing action is appropriate when transferring a patient with seizure precautions?

A. Remove padded side rails B. Keep emergency equipment available C. Leave patient unattended during transfer D. Restrain patient routinely

Correct Answer: B. Keep emergency equipment available

Rationale: Emergency preparedness improves patient safety in patients at risk for seizures.

Q51. Which action is MOST important when admitting a patient with suicidal ideation?

A. Leave the patient alone for privacy B. Remove potentially harmful objects from the environment C. Encourage the patient to sleep immediately D. Delay mental status assessment

Correct Answer: B. Remove potentially harmful objects from the environment

Rationale: Patient safety is the priority in suicidal patients; harmful objects must be removed to prevent self-harm.

Q52. During discharge teaching, which statement by the patient indicates CORRECT understanding of hypertension management?

A. “I will stop medication once blood pressure becomes normal.” B. “I should monitor my blood pressure regularly.” C. “Salt restriction is unnecessary.” D. “Missed doses should always be doubled.”

Correct Answer: B. “I should monitor my blood pressure regularly.”

Rationale: Regular monitoring helps evaluate effectiveness of treatment and control hypertension.

Q53. A nurse is transferring a postoperative patient who suddenly reports severe chest pain. What is the PRIORITY nursing action?

A. Continue transfer rapidly B. Stop transfer and assess the patient immediately C. Inform housekeeping staff D. Complete transfer documentation first

Correct Answer: B. Stop transfer and assess the patient immediately

Rationale: Sudden chest pain may indicate a life-threatening emergency requiring immediate assessment.

Q54. Which nursing action BEST prevents falls during patient transfer?

A. Encourage patient to stand quickly B. Keep floor dry and clutter-free C. Ask patient to walk without assistance D. Transfer patient in dim lighting

Correct Answer: B. Keep floor dry and clutter-free

Rationale: Environmental safety reduces fall risk during movement and transfer.

Q55. Which patient statement indicates NEED for further discharge teaching after myocardial infarction?

A. “I will take medications as prescribed.” B. “I should gradually increase activity.” C. “I can resume smoking if I feel better.” D. “I will attend follow-up appointments.”

Correct Answer: C. “I can resume smoking if I feel better.”

Rationale: Smoking increases cardiovascular risk and must be avoided after myocardial infarction.

Q56. During admission, a patient reports allergy to penicillin. What is the MOST appropriate nursing action?

A. Ignore the allergy until physician arrives B. Document allergy clearly in medical records C. Remove allergy information later D. Ask family members to remember it

Correct Answer: B. Document allergy clearly in medical records

Rationale: Accurate allergy documentation prevents medication-related adverse reactions.

Q57. A patient with stroke is being discharged home. Which referral is MOST important?

A. Travel agency referral B. Home health and rehabilitation services C. Restaurant dietary consultation only D. Cosmetic counseling services

Correct Answer: B. Home health and rehabilitation services

Rationale: Stroke patients often require continued rehabilitation and support for recovery.

Q58. Which nursing action is MOST appropriate when transferring a patient with a urinary catheter?

A. Raise drainage bag above bladder level B. Keep drainage bag below bladder level C. Disconnect catheter tubing routinely D. Clamp catheter during transport unnecessarily

Correct Answer: B. Keep drainage bag below bladder level

Rationale: Keeping the drainage bag below bladder level prevents urine backflow and infection.

Q59. During discharge planning, which patient has the HIGHEST risk for readmission?

A. Patient with good family support B. Patient who understands medications clearly C. Patient with multiple chronic illnesses and poor support D. Patient attending regular follow-up visits

Correct Answer: C. Patient with multiple chronic illnesses and poor support

Rationale: Complex illnesses combined with inadequate support increase readmission risk.

Q60. Which action by the nurse demonstrates proper body mechanics during transfer?

A. Twisting while lifting B. Keeping feet apart and bending knees C. Lifting with straight knees D. Pulling patient with arms only

Correct Answer: B. Keeping feet apart and bending knees

Rationale: Proper body mechanics reduce risk of musculoskeletal injury to healthcare workers.

Q61. Which action is MOST important before transferring a patient receiving blood transfusion?

A. Stop transfusion without assessment B. Verify blood group and patient identity C. Remove identification band D. Transfer patient without monitoring

Correct Answer: B. Verify blood group and patient identity

Rationale: Verification prevents fatal transfusion reactions caused by patient or blood mismatch.

Q62. A patient scheduled for discharge says, “I cannot afford my medications.” Which nursing action is BEST?

A. Ignore the statement B. Notify the healthcare team and social services C. Tell the patient to stop treatment D. Delay discharge indefinitely without planning

Correct Answer: B. Notify the healthcare team and social services

Rationale: Financial barriers may affect treatment adherence and require interdisciplinary support.

Q63. During admission assessment, which finding requires IMMEDIATE nursing intervention?

A. Blood glucose 92 mg/dL B. Oxygen saturation 84% C. Mild nausea D. Dry skin

Correct Answer: B. Oxygen saturation 84%

Rationale: Severe hypoxemia requires urgent assessment and oxygen support.

Q64. Which nursing action is MOST appropriate when transferring a patient with a chest tube?

A. Clamp the chest tube routinely during transport B. Keep drainage system below chest level C. Disconnect chest tube during transfer D. Raise drainage unit above patient chest

Correct Answer: B. Keep drainage system below chest level

Rationale: Proper positioning promotes drainage and prevents backflow into the pleural cavity.

Q65. Which discharge instruction is MOST important for a patient prescribed opioid analgesics?

A. “Take extra doses for severe sleepiness.” B. “Avoid driving while taking this medication.” C. “Mix medication with alcohol for better effect.” D. “Stop fluids completely.”

Correct Answer: B. “Avoid driving while taking this medication.”

Rationale: Opioids may cause sedation and impaired judgment, increasing accident risk.

Q66. During transfer, a patient becomes unresponsive. What should the nurse do FIRST?

A. Continue transfer to destination B. Assess responsiveness and airway C. Wait for physician before assessment D. Complete transfer paperwork

Correct Answer: B. Assess responsiveness and airway

Rationale: Immediate assessment of airway and responsiveness is critical during emergencies.

Q67. Which nursing action BEST protects patient privacy during admission?

A. Discuss medical history in crowded waiting area B. Close curtains and speak quietly during assessment C. Share patient diagnosis openly with visitors D. Leave medical records unattended

Correct Answer: B. Close curtains and speak quietly during assessment

Rationale: Maintaining confidentiality and privacy is an essential ethical responsibility.

Q68. Which patient is MOST suitable for discharge education using written instructions alone?

A. Patient with severe visual impairment B. Patient who cannot read C. Alert patient with good literacy skills D. Patient with acute confusion

Correct Answer: C. Alert patient with good literacy skills

Rationale: Written instructions are effective when the patient can read and understand them independently.

Q69. A nurse is preparing to transfer a patient with intravenous potassium infusion. Which action is MOST important?

A. Verify infusion rate before transfer B. Increase potassium infusion speed C. Disconnect infusion without order D. Allow infusion pump battery to remain uncharged

Correct Answer: A. Verify infusion rate before transfer

Rationale: Potassium administration errors can cause life-threatening cardiac complications.

Q70. Which nursing action is MOST appropriate during discharge of a patient with pulmonary tuberculosis?

A. Teach cough etiquette and medication adherence B. Stop medications once fever decreases C. Encourage sharing personal utensils D. Avoid follow-up sputum testing

Correct Answer: A. Teach cough etiquette and medication adherence

Rationale: Proper education reduces transmission risk and improves treatment success.

Q71. A patient with impaired mobility is being discharged home. Which intervention is MOST important to prevent falls?

A. Remove all hallway lighting B. Encourage use of loose rugs C. Teach use of assistive walking devices D. Advise wearing slippery footwear

Correct Answer: C. Teach use of assistive walking devices

Rationale: Proper use of assistive devices improves stability and reduces fall risk.

Q72. During admission, a patient suddenly develops seizures. What is the nurse’s PRIORITY action?

A. Insert object into patient’s mouth B. Restrain the patient tightly C. Protect the patient from injury D. Leave patient unattended

Correct Answer: C. Protect the patient from injury

Rationale: During seizures, patient safety and injury prevention are the primary priorities.

Q73. Which action is MOST important before transferring a patient to another department for diagnostic testing?

A. Remove patient identification band B. Verify patient identity and test order C. Send patient without medical record D. Delay transport unnecessarily

Correct Answer: B. Verify patient identity and test order

Rationale: Correct identification ensures the right patient receives the correct procedure.

Q74. Which discharge instruction is MOST important for a patient with heart failure?

A. “Increase salt intake daily.” B. “Monitor daily weight regularly.” C. “Stop medications when edema decreases.” D. “Avoid reporting shortness of breath.”

Correct Answer: B. “Monitor daily weight regularly.”

Rationale: Daily weight helps identify fluid retention and worsening heart failure early.

Q75. During transfer, which patient requires the HIGHEST priority monitoring?

A. Stable patient after dressing change B. Patient receiving vasoactive medications C. Ambulatory patient with mild fever D. Patient awaiting discharge paperwork

Correct Answer: B. Patient receiving vasoactive medications

Rationale: Vasoactive medications can rapidly affect hemodynamic stability and require close monitoring.

Q76. Which nursing action is MOST appropriate during discharge of a patient with asthma?

A. Teach proper inhaler technique B. Encourage exposure to smoke C. Stop rescue inhalers permanently D. Avoid discussing trigger factors

Correct Answer: A. Teach proper inhaler technique

Rationale: Correct inhaler use improves medication delivery and asthma control.

Q77. A nurse notices redness over a patient’s sacral area during admission assessment. What should the nurse do FIRST?

A. Ignore the finding temporarily B. Document and initiate pressure injury prevention measures C. Massage the reddened area vigorously D. Delay intervention until discharge

Correct Answer: B. Document and initiate pressure injury prevention measures

Rationale: Early intervention prevents progression of pressure injuries.

Q78. Which action is MOST appropriate when transferring a confused patient?

A. Leave patient unattended during transport B. Use safety precautions and close supervision C. Remove side rails during transfer D. Allow patient to ambulate alone

Correct Answer: B. Use safety precautions and close supervision

Rationale: Confused patients are at high risk for falls and accidental injury.

Q79. During discharge teaching, which patient statement indicates CORRECT understanding of wound care?

A. “I will wash hands before dressing changes.” B. “I will reuse old dressings repeatedly.” C. “I will stop antibiotics once pain decreases.” D. “I will touch wound with unclean hands.”

Correct Answer: A. “I will wash hands before dressing changes.”

Rationale: Hand hygiene reduces risk of wound infection.

Q80. Which nursing action is MOST important when admitting a patient with suspected stroke?

A. Delay neurological assessment B. Assess level of consciousness immediately C. Encourage excessive physical activity D. Postpone vital sign monitoring

Correct Answer: B. Assess level of consciousness immediately

Rationale: Neurological assessment helps identify severity and progression of stroke symptoms.

Q81. A patient is being discharged after abdominal surgery. Which instruction is MOST important regarding wound infection?

A. Report redness, swelling, or fever immediately. B. Apply powder directly on the incision daily. C. Touch the incision frequently to assess healing. D. Stop antibiotics once pain reduces.

Correct Answer: A. Report redness, swelling, or fever immediately.

Rationale: Early recognition of infection signs helps prevent serious postoperative complications.

Q82. During transfer of a patient on a cardiac monitor, which action is MOST appropriate?

A. Disconnect monitor alarms permanently B. Ensure monitor battery is functional C. Remove cardiac leads before transfer D. Ignore abnormal monitor readings

Correct Answer: B. Ensure monitor battery is functional

Rationale: Continuous cardiac monitoring is essential for detecting life-threatening arrhythmias during transfer.

Q83. Which patient requires IMMEDIATE admission assessment?

A. Patient with stable chronic arthritis B. Patient with sudden onset slurred speech C. Patient requesting dietary counseling D. Patient waiting for routine vaccination

Correct Answer: B. Patient with sudden onset slurred speech

Rationale: Slurred speech may indicate acute stroke requiring urgent evaluation.

Q84. Which discharge instruction is MOST important for a patient prescribed diuretics?

A. Take medication at bedtime only. B. Monitor weight and report swelling. C. Avoid fluid intake completely. D. Double the dose if urine output decreases.

Correct Answer: B. Monitor weight and report swelling.

Rationale: Monitoring fluid status helps evaluate effectiveness of diuretic therapy and detect complications.

Q85. During patient transfer, which action helps reduce anxiety?

A. Avoid explaining procedures B. Communicate clearly and reassure the patient C. Ignore patient questions D. Rush the transfer process

Correct Answer: B. Communicate clearly and reassure the patient

Rationale: Clear communication promotes patient comfort and cooperation during transfer.

Q86. Which nursing action is MOST appropriate when admitting a patient with severe burns?

A. Apply ice directly to burns B. Assess airway and breathing immediately C. Delay fluid assessment D. Cover burns with dry cotton only

Correct Answer: B. Assess airway and breathing immediately

Rationale: Burn patients are at risk for airway compromise due to inhalation injury.

Q87. Which statement by a patient indicates EFFECTIVE discharge teaching after knee replacement surgery?

A. I will avoid prescribed physiotherapy exercises. B. I will use assistive devices while walking. C. I can stop medications whenever pain decreases. D. I should remain on bed rest permanently.

Correct Answer: B. I will use assistive devices while walking.

Rationale: Assistive devices improve mobility and reduce fall risk after orthopedic surgery.

Q88. Which action is MOST important before transferring a patient receiving enteral feeding?

A. Lay patient flat during transfer B. Pause feeding and maintain tube safety C. Remove feeding tube routinely D. Ignore tube placement verification

Correct Answer: B. Pause feeding and maintain tube safety

Rationale: Preventing aspiration and tube dislodgement is essential during transfer.

Q89. During discharge planning, which factor has the GREATEST effect on patient compliance?

A. Complex medication schedules without explanation B. Clear understanding of treatment plan C. Absence of written instructions D. Limited patient involvement in decisions

Correct Answer: B. Clear understanding of treatment plan

Rationale: Patients are more likely to follow treatment plans they understand clearly.

Q90. Which nursing action demonstrates correct infection-control practice during admission?

A. Performing hand hygiene before patient contact B. Reusing contaminated gloves C. Sharing personal protective equipment D. Ignoring isolation signs

Correct Answer: A. Performing hand hygiene before patient contact

Rationale: Hand hygiene is the most effective measure to prevent healthcare-associated infections.

Q91. A patient with chronic obstructive pulmonary disease is being discharged. Which instruction is MOST important?

A. Avoid all vaccinations. B. Practice pursed-lip breathing techniques. C. Stop oxygen therapy abruptly. D. Remain indoors permanently.

Correct Answer: B. Practice pursed-lip breathing techniques.

Rationale: Pursed-lip breathing improves ventilation and reduces dyspnea in COPD patients.

Q92. During admission, which nursing action BEST promotes therapeutic communication?

A. Interrupting the patient frequently B. Using open-ended questions C. Avoiding eye contact completely D. Giving false reassurance

Correct Answer: B. Using open-ended questions

Rationale: Open-ended questions encourage patients to express concerns and provide detailed information.

Q93. Which action is MOST important before transferring a patient with spinal injury?

A. Flex the patient’s neck during movement B. Maintain spinal alignment throughout transfer C. Transfer patient without assistance D. Allow patient to sit unsupported

Correct Answer: B. Maintain spinal alignment throughout transfer

Rationale: Proper spinal alignment prevents worsening neurological injury.

Q94. Which patient statement indicates NEED for further discharge teaching regarding antibiotics?

A. I will complete the full prescribed course. B. I will not share antibiotics with others. C. I can stop antibiotics once symptoms disappear. D. I will report allergic reactions immediately.

Correct Answer: C. I can stop antibiotics once symptoms disappear.

Rationale: Antibiotics must be completed fully to prevent resistance and recurrence.

Q95. A nurse is transferring a patient with hypoglycemia. The patient suddenly becomes unconscious. What should the nurse do FIRST?

A. Continue transfer quickly B. Assess airway and blood glucose level C. Complete documentation immediately D. Leave patient temporarily for assistance

Correct Answer: B. Assess airway and blood glucose level

Rationale: Immediate assessment and correction of hypoglycemia are critical to prevent brain injury.

Q96. Which nursing action is MOST appropriate during discharge of a patient with epilepsy?

A. Teach importance of medication adherence B. Advise stopping medications after one seizure-free week C. Encourage sleep deprivation D. Recommend avoiding follow-up care

Correct Answer: A. Teach importance of medication adherence

Rationale: Consistent antiepileptic medication use helps prevent seizure recurrence.

Q97. During admission assessment, which finding requires URGENT reporting?

A. Heart rate 42/min with dizziness B. Mild fatigue after walking C. Slight decrease in appetite D. Occasional dry cough

Correct Answer: A. Heart rate 42/min with dizziness

Rationale: Symptomatic bradycardia may indicate serious cardiac compromise.

Q98. Which nursing action is MOST appropriate when transferring a patient with restraints?

A. Remove restraints without order B. Check circulation and safety during transfer C. Leave restrained patient unattended D. Tighten restraints excessively

Correct Answer: B. Check circulation and safety during transfer

Rationale: Patients in restraints require ongoing assessment to prevent injury and circulatory impairment.

Q99. Which discharge instruction is MOST important for a patient taking anticoagulants?

A. Report unusual bleeding immediately. B. Increase contact sports participation. C. Use hard-bristle toothbrushes. D. Take aspirin without consulting physician.

Correct Answer: A. Report unusual bleeding immediately.

Rationale: Anticoagulants increase bleeding risk; early reporting prevents severe complications.

Q100. Which nursing action is MOST important during emergency admission of an unconscious patient?

A. Obtain detailed occupational history immediately B. Stabilize airway, breathing, and circulation C. Arrange discharge teaching materials D. Complete nonurgent documentation first

Correct Answer: B. Stabilize airway, breathing, and circulation

Rationale: ABC stabilization is the highest priority during emergency care of unconscious patients.

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