NR 226: Fundamentals of Patient Care - Exam 2 (2026/2027 Update)
Chamberlain
1. A nurse is preparing to administer an intramuscular (IM) injection. Which site
is the preferred location for medications that are thick or larger in volume?
A. Deltoid
B. Dorsogluteal
C. Ventrogluteal
D. Vastus Lateralis
Answer: C
Rationale: The ventrogluteal site is the preferred and safest site for all adults, children, and
infants, especially for large volumes and viscous medications, because it is deep and away
from major nerves and blood vessels.
2. Which of the following is the first action a nurse should take after realizing a
medication error has occurred?
A. Notify the healthcare provider.
B. Complete an incident report.
C. Assess the patient’s condition.
D. Inform the nurse manager.
Answer: C
Rationale: The priority is always patient safety. The nurse must first assess the patient for
any adverse effects before notifying the provider or documenting the incident.
,3. A nurse is mixing NPH and regular insulin in one syringe. Which insulin should
be drawn up first?
A. NPH insulin (cloudy)
B. Regular insulin (clear)
C. It does not matter which is drawn first.
D. They should never be mixed in the same syringe.
Answer: B
Rationale: To prevent contaminating the clear (short-acting) insulin with the cloudy
(longer-acting) insulin, the clear (Regular) insulin must always be drawn into the syringe
first.
4. When administering an intradermal injection, at what angle should the
needle be inserted?
A. 90 degrees
B. 45 degrees
C. 5 to 15 degrees
D. 30 degrees
Answer: C
Rationale: Intradermal injections are given into the dermis, just under the epidermis,
requiring a very shallow angle of 5 to 15 degrees.
5. A patient is experiencing dysphagia. Which intervention should the nurse
implement to prevent aspiration during feeding?
A. Place food on the unaffected side of the mouth.
B. Encourage the patient to use a straw for all liquids.
C. Have the patient lie flat during meals.
D. Instruct the patient to tilt their head back while swallowing.
Answer: A
, Rationale: Placing food on the unaffected side of the mouth allows for better control and
chewing, reducing the risk of aspiration. Straws should be avoided and the head should be
tilted forward (chin-tuck).
6. Which assessment finding is indicative of a Stage 2 pressure injury?
A. Non-blanchable erythema of intact skin.
B. Partial-thickness loss of dermis presenting as a shallow open ulcer.
C. Full-thickness skin loss with visible adipose tissue.
D. Full-thickness tissue loss with exposed bone or muscle.
Answer: B
Rationale: Stage 2 pressure injuries involve partial-thickness loss of the dermis, often
appearing as a shallow open ulcer with a red-pink wound bed or an intact/ruptured serum-
filled blister.
7. What is the primary purpose of using the Z-track method for intramuscular
injections?
A. To ensure the medication reaches the bone.
B. To reduce pain during the needle insertion.
C. To increase the speed of medication absorption.
D. To prevent medication from leaking into the subcutaneous tissue.
Answer: D
Rationale: The Z-track method seals the medication within the muscle tissue and prevents
it from tracking back into the subcutaneous layer, which reduces irritation and staining.
Chamberlain
1. A nurse is preparing to administer an intramuscular (IM) injection. Which site
is the preferred location for medications that are thick or larger in volume?
A. Deltoid
B. Dorsogluteal
C. Ventrogluteal
D. Vastus Lateralis
Answer: C
Rationale: The ventrogluteal site is the preferred and safest site for all adults, children, and
infants, especially for large volumes and viscous medications, because it is deep and away
from major nerves and blood vessels.
2. Which of the following is the first action a nurse should take after realizing a
medication error has occurred?
A. Notify the healthcare provider.
B. Complete an incident report.
C. Assess the patient’s condition.
D. Inform the nurse manager.
Answer: C
Rationale: The priority is always patient safety. The nurse must first assess the patient for
any adverse effects before notifying the provider or documenting the incident.
,3. A nurse is mixing NPH and regular insulin in one syringe. Which insulin should
be drawn up first?
A. NPH insulin (cloudy)
B. Regular insulin (clear)
C. It does not matter which is drawn first.
D. They should never be mixed in the same syringe.
Answer: B
Rationale: To prevent contaminating the clear (short-acting) insulin with the cloudy
(longer-acting) insulin, the clear (Regular) insulin must always be drawn into the syringe
first.
4. When administering an intradermal injection, at what angle should the
needle be inserted?
A. 90 degrees
B. 45 degrees
C. 5 to 15 degrees
D. 30 degrees
Answer: C
Rationale: Intradermal injections are given into the dermis, just under the epidermis,
requiring a very shallow angle of 5 to 15 degrees.
5. A patient is experiencing dysphagia. Which intervention should the nurse
implement to prevent aspiration during feeding?
A. Place food on the unaffected side of the mouth.
B. Encourage the patient to use a straw for all liquids.
C. Have the patient lie flat during meals.
D. Instruct the patient to tilt their head back while swallowing.
Answer: A
, Rationale: Placing food on the unaffected side of the mouth allows for better control and
chewing, reducing the risk of aspiration. Straws should be avoided and the head should be
tilted forward (chin-tuck).
6. Which assessment finding is indicative of a Stage 2 pressure injury?
A. Non-blanchable erythema of intact skin.
B. Partial-thickness loss of dermis presenting as a shallow open ulcer.
C. Full-thickness skin loss with visible adipose tissue.
D. Full-thickness tissue loss with exposed bone or muscle.
Answer: B
Rationale: Stage 2 pressure injuries involve partial-thickness loss of the dermis, often
appearing as a shallow open ulcer with a red-pink wound bed or an intact/ruptured serum-
filled blister.
7. What is the primary purpose of using the Z-track method for intramuscular
injections?
A. To ensure the medication reaches the bone.
B. To reduce pain during the needle insertion.
C. To increase the speed of medication absorption.
D. To prevent medication from leaking into the subcutaneous tissue.
Answer: D
Rationale: The Z-track method seals the medication within the muscle tissue and prevents
it from tracking back into the subcutaneous layer, which reduces irritation and staining.
