# NR 224 Fundamentals of Nursing Final Examination Success
Blueprint | Comprehensive Practice Questions with Detailed
Rationales | Updated 2026 Edition
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**Question 1**
A nurse is preparing to insert a nasogastric tube for a patient with a bowel obstruction. Which action
should the nurse take to facilitate tube insertion?
A. Have the patient hyperextend the neck during insertion
B. Instruct the patient to swallow small sips of water while advancing the tube
C. Advance the tube rapidly to minimize gagging
D. Use a lubricant that contains lidocaine to numb the throat
💫ANSWER✔️✔️: B. Instruct the patient to swallow small sips of water while advancing the tube
💫RATIONALE✔️✔️: Swallowing water closes the epiglottis and facilitates passage of the tube into the
esophagus; hyperextension should be avoided to prevent tracheal placement.
---
**Question 2**
A patient with a history of falls is being discharged home. Which nursing intervention is most important
to include in the discharge plan?
A. Install grab bars in the bathroom and shower
B. Place scatter rugs throughout the home for traction
C. Encourage the patient to wear socks without grip to slide feet easily
D. Remove all nightlights to improve sleep quality
,💫ANSWER✔️✔️: A. Install grab bars in the bathroom and shower
💫RATIONALE✔️✔️: Grab bars provide stability and reduce fall risk in high-risk areas; scatter rugs and lack
of proper lighting increase fall risk.
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**Question 3**
A nurse is assessing a patient's peripheral intravenous (IV) site and notes swelling, coolness, and pallor
around the insertion site. The IV infusion is infusing slowly. What complication should the nurse
suspect?
A. Phlebitis
B. Infiltration
C. Air embolism
D. Catheter embolism
💫ANSWER✔️✔️: B. Infiltration
💫RATIONALE✔️✔️: Swelling, coolness, and pallor with slow infusion indicate infiltration where fluid leaks
into surrounding tissue; phlebitis would show redness and warmth.
---
**Question 4**
A patient is receiving continuous enteral nutrition via a nasogastric tube. What is the priority nursing
action to prevent aspiration?
A. Keep the head of the bed elevated 30 to 45 degrees
B. Flush the tube with 50 mL of water every shift
C. Check gastric residual volumes every 12 hours
D. Change the feeding bag and tubing every 72 hours
,💫ANSWER✔️✔️: A. Keep the head of the bed elevated 30 to 45 degrees
💫RATIONALE✔️✔️: Elevating the head of the bed reduces the risk of regurgitation and aspiration;
residual checks should be done more frequently.
---
**Question 5**
A patient with diabetes mellitus has a blood glucose level of 45 mg/dL and is unconscious. Which
intervention should the nurse implement first?
A. Administer 50% dextrose IV push
B. Give the patient 4 ounces of orange juice
C. Administer glucagon intramuscularly
D. Place the patient in the recovery position
💫ANSWER✔️✔️: A. Administer 50% dextrose IV push
💫RATIONALE✔️✔️: For an unconscious patient with severe hypoglycemia, IV dextrose is the first-line
treatment; oral carbohydrates cannot be given to an unconscious patient.
---
**Question 6**
A nurse is caring for a patient with a stage III pressure injury. Which wound care intervention is most
appropriate?
A. Apply a dry gauze dressing to promote wound drying
B. Use a hydrocolloid dressing to maintain a moist environment
C. Apply an alginate dressing to manage moderate to heavy exudate
D. Use a transparent film dressing to allow wound visualization
, 💫ANSWER✔️✔️: C. Apply an alginate dressing to manage moderate to heavy exudate
💫RATIONALE✔️✔️: Stage III pressure injuries often have significant exudate; alginate dressings absorb
excess drainage while maintaining moisture balance.
---
**Question 7**
A patient is prescribed warfarin for atrial fibrillation. Which laboratory value should the nurse monitor to
evaluate the therapeutic effect of this medication?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT) and International Normalized Ratio (INR)
C. Platelet count
D. Bleeding time
💫ANSWER✔️✔️: B. Prothrombin time (PT) and International Normalized Ratio (INR)
💫RATIONALE✔️✔️: PT and INR are used to monitor warfarin therapy; aPTT is used for heparin
monitoring.
---
**Question 8**
A patient who is 2 days post-operative from abdominal surgery reports sharp pain and a popping
sensation in the incision area. Upon assessment, the nurse notes a loop of bowel protruding through the
incision. What is the priority nursing action?
A. Apply a warm, moist sterile dressing over the protruding bowel
B. Gently push the bowel back into the abdominal cavity
C. Cover the wound with a sterile saline-moistened dressing and notify the surgeon
Blueprint | Comprehensive Practice Questions with Detailed
Rationales | Updated 2026 Edition
---
**Question 1**
A nurse is preparing to insert a nasogastric tube for a patient with a bowel obstruction. Which action
should the nurse take to facilitate tube insertion?
A. Have the patient hyperextend the neck during insertion
B. Instruct the patient to swallow small sips of water while advancing the tube
C. Advance the tube rapidly to minimize gagging
D. Use a lubricant that contains lidocaine to numb the throat
💫ANSWER✔️✔️: B. Instruct the patient to swallow small sips of water while advancing the tube
💫RATIONALE✔️✔️: Swallowing water closes the epiglottis and facilitates passage of the tube into the
esophagus; hyperextension should be avoided to prevent tracheal placement.
---
**Question 2**
A patient with a history of falls is being discharged home. Which nursing intervention is most important
to include in the discharge plan?
A. Install grab bars in the bathroom and shower
B. Place scatter rugs throughout the home for traction
C. Encourage the patient to wear socks without grip to slide feet easily
D. Remove all nightlights to improve sleep quality
,💫ANSWER✔️✔️: A. Install grab bars in the bathroom and shower
💫RATIONALE✔️✔️: Grab bars provide stability and reduce fall risk in high-risk areas; scatter rugs and lack
of proper lighting increase fall risk.
---
**Question 3**
A nurse is assessing a patient's peripheral intravenous (IV) site and notes swelling, coolness, and pallor
around the insertion site. The IV infusion is infusing slowly. What complication should the nurse
suspect?
A. Phlebitis
B. Infiltration
C. Air embolism
D. Catheter embolism
💫ANSWER✔️✔️: B. Infiltration
💫RATIONALE✔️✔️: Swelling, coolness, and pallor with slow infusion indicate infiltration where fluid leaks
into surrounding tissue; phlebitis would show redness and warmth.
---
**Question 4**
A patient is receiving continuous enteral nutrition via a nasogastric tube. What is the priority nursing
action to prevent aspiration?
A. Keep the head of the bed elevated 30 to 45 degrees
B. Flush the tube with 50 mL of water every shift
C. Check gastric residual volumes every 12 hours
D. Change the feeding bag and tubing every 72 hours
,💫ANSWER✔️✔️: A. Keep the head of the bed elevated 30 to 45 degrees
💫RATIONALE✔️✔️: Elevating the head of the bed reduces the risk of regurgitation and aspiration;
residual checks should be done more frequently.
---
**Question 5**
A patient with diabetes mellitus has a blood glucose level of 45 mg/dL and is unconscious. Which
intervention should the nurse implement first?
A. Administer 50% dextrose IV push
B. Give the patient 4 ounces of orange juice
C. Administer glucagon intramuscularly
D. Place the patient in the recovery position
💫ANSWER✔️✔️: A. Administer 50% dextrose IV push
💫RATIONALE✔️✔️: For an unconscious patient with severe hypoglycemia, IV dextrose is the first-line
treatment; oral carbohydrates cannot be given to an unconscious patient.
---
**Question 6**
A nurse is caring for a patient with a stage III pressure injury. Which wound care intervention is most
appropriate?
A. Apply a dry gauze dressing to promote wound drying
B. Use a hydrocolloid dressing to maintain a moist environment
C. Apply an alginate dressing to manage moderate to heavy exudate
D. Use a transparent film dressing to allow wound visualization
, 💫ANSWER✔️✔️: C. Apply an alginate dressing to manage moderate to heavy exudate
💫RATIONALE✔️✔️: Stage III pressure injuries often have significant exudate; alginate dressings absorb
excess drainage while maintaining moisture balance.
---
**Question 7**
A patient is prescribed warfarin for atrial fibrillation. Which laboratory value should the nurse monitor to
evaluate the therapeutic effect of this medication?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT) and International Normalized Ratio (INR)
C. Platelet count
D. Bleeding time
💫ANSWER✔️✔️: B. Prothrombin time (PT) and International Normalized Ratio (INR)
💫RATIONALE✔️✔️: PT and INR are used to monitor warfarin therapy; aPTT is used for heparin
monitoring.
---
**Question 8**
A patient who is 2 days post-operative from abdominal surgery reports sharp pain and a popping
sensation in the incision area. Upon assessment, the nurse notes a loop of bowel protruding through the
incision. What is the priority nursing action?
A. Apply a warm, moist sterile dressing over the protruding bowel
B. Gently push the bowel back into the abdominal cavity
C. Cover the wound with a sterile saline-moistened dressing and notify the surgeon
