NR 224 FUNDAMENTALS OF NURSING EXAM 2: FOUNDATIONS OF NURSING:
FUNDAMENTAL SKILLS AND CONCEPTS | CHAMBERLAIN | 2026/2027 | 50
QUESTIONS | DETAILED RATIONALES | MULTIPLE-CHOICE – GRADED A+
INSTRUCTIONS
Select the single best answer for each question.
Each question has one correct answer and three plausible distractors.
Questions focus on medication administration, safety, elimination, perioperative care, nutrition, fluid
balance, oxygenation, and pain management.
Assume standard adult parameters unless otherwise specified.
SECTION I: MEDICATION ADMINISTRATION & SAFETY (Questions 1–8)
Q1 (NR224-Ex2-01). The nurse is preparing to administer an oral medication to a patient who has difficulty
swallowing tablets. The medication is a sustained-release capsule. Which action should the nurse take?
A) Open the capsule and sprinkle the contents over applesauce (if safe to do so)
B) Crush the capsule and mix it with water
C) Withhold the medication and notify the provider
D) Place the capsule in the patient's mouth without water
Answer: C
Rationale: Sustained-release medications should NOT be crushed or opened because doing so can cause a
rapid release of the entire dose, leading to toxicity. The nurse should withhold the medication and notify the
provider for an alternative formulation (e.g., liquid, different medication). Option D is unsafe due to
swallowing difficulty.
Reference: Potter PA, Perry AG, Stockert PA, Hall AM. Fundamentals of Nursing. 11th ed. Elsevier; 2023.
,NR 224 FUNDAMENTALS OF NURSING EXAM 2: FOUNDATIONS OF NURSING:
FUNDAMENTAL SKILLS AND CONCEPTS | CHAMBERLAIN | 2026/2027 | 50
QUESTIONS | DETAILED RATIONALES | MULTIPLE-CHOICE – GRADED A+
Bloom Level: Evaluation
Q2 (NR224-Ex2-02). The nurse is administering an intramuscular (IM) injection to a 2-year-old child. Which
site is most appropriate?
A) Vastus lateralis muscle
B) Ventrogluteal muscle
C) Dorsogluteal muscle
D) Deltoid muscle
Answer: A
Rationale: The vastus lateralis is the preferred IM injection site for infants and young children because it is a
large, well-developed muscle with no major nerves or blood vessels. The ventrogluteal (B) is used for older
children and adults. The dorsogluteal (C) is avoided due to sciatic nerve risk. The deltoid (D) is too small for a
2-year-old.
Reference: Potter PA, Perry AG, Stockert PA, Hall AM. Fundamentals of Nursing. 11th ed. Elsevier; 2023.
Bloom Level: Application
Q3 (NR224-Ex2-03). The nurse is administering a subcutaneous injection of enoxaparin (Lovenox). Which
action is correct?
A) Do not aspirate and do not massage the site
B) Aspirate before injecting to ensure needle is not in a vessel
C) Massage the site to promote absorption
D) Use a 22-gauge, 1.5-inch needle
,NR 224 FUNDAMENTALS OF NURSING EXAM 2: FOUNDATIONS OF NURSING:
FUNDAMENTAL SKILLS AND CONCEPTS | CHAMBERLAIN | 2026/2027 | 50
QUESTIONS | DETAILED RATIONALES | MULTIPLE-CHOICE – GRADED A+
Answer: A
Rationale: For enoxaparin (low molecular weight heparin), aspiration is not recommended because it can
cause hematoma. Massage (C) is also contraindicated as it can cause bruising. A smaller gauge needle (25-27
gauge, 3/8 to 5/8 inch) is used for subcutaneous injections (D is incorrect).
Reference: Potter PA, Perry AG, Stockert PA, Hall AM. Fundamentals of Nursing. 11th ed. Elsevier; 2023.
Bloom Level: Application
Q4 (NR224-Ex2-04). The nurse is preparing to administer ear drops to a 4-year-old child. Which action is
correct?
A) Pull the pinna down and back
B) Pull the pinna up and back
C) Pull the pinna straight back
D) Do not pull the pinna at all
Answer: A
Rationale: For a child under 3 years, the pinna should be pulled down and back to straighten the ear canal. For
adults and older children, the pinna is pulled up and back (B). Pulling straight back (C) or not pulling (D) is
incorrect.
Reference: Potter PA, Perry AG, Stockert PA, Hall AM. Fundamentals of Nursing. 11th ed. Elsevier; 2023.
Bloom Level: Application
, NR 224 FUNDAMENTALS OF NURSING EXAM 2: FOUNDATIONS OF NURSING:
FUNDAMENTAL SKILLS AND CONCEPTS | CHAMBERLAIN | 2026/2027 | 50
QUESTIONS | DETAILED RATIONALES | MULTIPLE-CHOICE – GRADED A+
Q5 (NR224-Ex2-05). The nurse is preparing to administer an intradermal injection for a tuberculin skin test.
Which site is most appropriate?
A) Inner forearm
B) Deltoid muscle
C) Vastus lateralis
D) Upper back
Answer: A
Rationale: The inner forearm is the preferred site for intradermal injections because the skin is thin and
hairless, making it easy to visualize the wheal. The deltoid (B) and vastus lateralis (C) are used for IM
injections. The upper back (D) is not typically used for intradermal injections.
Reference: Potter PA, Perry AG, Stockert PA, Hall AM. Fundamentals of Nursing. 11th ed. Elsevier; 2023.
Bloom Level: Comprehension
Q6 (NR224-Ex2-06). The nurse is preparing to administer eye drops. Which action is correct to prevent
systemic absorption?
A) Apply gentle pressure to the nasolacrimal duct (inner canthus) for 1-2 minutes
B) Have the patient close their eyes tightly after instillation
C) Instill the drops onto the cornea
D) Have the patient tilt their head back and look down
Answer: A
FUNDAMENTAL SKILLS AND CONCEPTS | CHAMBERLAIN | 2026/2027 | 50
QUESTIONS | DETAILED RATIONALES | MULTIPLE-CHOICE – GRADED A+
INSTRUCTIONS
Select the single best answer for each question.
Each question has one correct answer and three plausible distractors.
Questions focus on medication administration, safety, elimination, perioperative care, nutrition, fluid
balance, oxygenation, and pain management.
Assume standard adult parameters unless otherwise specified.
SECTION I: MEDICATION ADMINISTRATION & SAFETY (Questions 1–8)
Q1 (NR224-Ex2-01). The nurse is preparing to administer an oral medication to a patient who has difficulty
swallowing tablets. The medication is a sustained-release capsule. Which action should the nurse take?
A) Open the capsule and sprinkle the contents over applesauce (if safe to do so)
B) Crush the capsule and mix it with water
C) Withhold the medication and notify the provider
D) Place the capsule in the patient's mouth without water
Answer: C
Rationale: Sustained-release medications should NOT be crushed or opened because doing so can cause a
rapid release of the entire dose, leading to toxicity. The nurse should withhold the medication and notify the
provider for an alternative formulation (e.g., liquid, different medication). Option D is unsafe due to
swallowing difficulty.
Reference: Potter PA, Perry AG, Stockert PA, Hall AM. Fundamentals of Nursing. 11th ed. Elsevier; 2023.
,NR 224 FUNDAMENTALS OF NURSING EXAM 2: FOUNDATIONS OF NURSING:
FUNDAMENTAL SKILLS AND CONCEPTS | CHAMBERLAIN | 2026/2027 | 50
QUESTIONS | DETAILED RATIONALES | MULTIPLE-CHOICE – GRADED A+
Bloom Level: Evaluation
Q2 (NR224-Ex2-02). The nurse is administering an intramuscular (IM) injection to a 2-year-old child. Which
site is most appropriate?
A) Vastus lateralis muscle
B) Ventrogluteal muscle
C) Dorsogluteal muscle
D) Deltoid muscle
Answer: A
Rationale: The vastus lateralis is the preferred IM injection site for infants and young children because it is a
large, well-developed muscle with no major nerves or blood vessels. The ventrogluteal (B) is used for older
children and adults. The dorsogluteal (C) is avoided due to sciatic nerve risk. The deltoid (D) is too small for a
2-year-old.
Reference: Potter PA, Perry AG, Stockert PA, Hall AM. Fundamentals of Nursing. 11th ed. Elsevier; 2023.
Bloom Level: Application
Q3 (NR224-Ex2-03). The nurse is administering a subcutaneous injection of enoxaparin (Lovenox). Which
action is correct?
A) Do not aspirate and do not massage the site
B) Aspirate before injecting to ensure needle is not in a vessel
C) Massage the site to promote absorption
D) Use a 22-gauge, 1.5-inch needle
,NR 224 FUNDAMENTALS OF NURSING EXAM 2: FOUNDATIONS OF NURSING:
FUNDAMENTAL SKILLS AND CONCEPTS | CHAMBERLAIN | 2026/2027 | 50
QUESTIONS | DETAILED RATIONALES | MULTIPLE-CHOICE – GRADED A+
Answer: A
Rationale: For enoxaparin (low molecular weight heparin), aspiration is not recommended because it can
cause hematoma. Massage (C) is also contraindicated as it can cause bruising. A smaller gauge needle (25-27
gauge, 3/8 to 5/8 inch) is used for subcutaneous injections (D is incorrect).
Reference: Potter PA, Perry AG, Stockert PA, Hall AM. Fundamentals of Nursing. 11th ed. Elsevier; 2023.
Bloom Level: Application
Q4 (NR224-Ex2-04). The nurse is preparing to administer ear drops to a 4-year-old child. Which action is
correct?
A) Pull the pinna down and back
B) Pull the pinna up and back
C) Pull the pinna straight back
D) Do not pull the pinna at all
Answer: A
Rationale: For a child under 3 years, the pinna should be pulled down and back to straighten the ear canal. For
adults and older children, the pinna is pulled up and back (B). Pulling straight back (C) or not pulling (D) is
incorrect.
Reference: Potter PA, Perry AG, Stockert PA, Hall AM. Fundamentals of Nursing. 11th ed. Elsevier; 2023.
Bloom Level: Application
, NR 224 FUNDAMENTALS OF NURSING EXAM 2: FOUNDATIONS OF NURSING:
FUNDAMENTAL SKILLS AND CONCEPTS | CHAMBERLAIN | 2026/2027 | 50
QUESTIONS | DETAILED RATIONALES | MULTIPLE-CHOICE – GRADED A+
Q5 (NR224-Ex2-05). The nurse is preparing to administer an intradermal injection for a tuberculin skin test.
Which site is most appropriate?
A) Inner forearm
B) Deltoid muscle
C) Vastus lateralis
D) Upper back
Answer: A
Rationale: The inner forearm is the preferred site for intradermal injections because the skin is thin and
hairless, making it easy to visualize the wheal. The deltoid (B) and vastus lateralis (C) are used for IM
injections. The upper back (D) is not typically used for intradermal injections.
Reference: Potter PA, Perry AG, Stockert PA, Hall AM. Fundamentals of Nursing. 11th ed. Elsevier; 2023.
Bloom Level: Comprehension
Q6 (NR224-Ex2-06). The nurse is preparing to administer eye drops. Which action is correct to prevent
systemic absorption?
A) Apply gentle pressure to the nasolacrimal duct (inner canthus) for 1-2 minutes
B) Have the patient close their eyes tightly after instillation
C) Instill the drops onto the cornea
D) Have the patient tilt their head back and look down
Answer: A
