# NR 224 Fundamentals of Nursing Final Examination Success
Blueprint | Comprehensive Practice Questions with Detailed
Rationales | Updated 2026 Edition
---
**Question 1**
A nurse is preparing to perform a sterile wound irrigation. Which action maintains sterility?
A. Pour the irrigating solution directly from the bottle onto the wound
B. Direct the flow of solution from the cleanest to the dirtiest area
C. Hold the syringe 1 inch above the wound
D. Use clean gloves for the procedure
💫ANSWER✔️✔️: B. Direct the flow of solution from the cleanest to the dirtiest area
💫RATIONALE✔️✔️: Directing irrigation from clean to dirty prevents contamination of clean areas; sterile
gloves and sterile solution are required for sterile irrigation.
---
**Question 2**
A patient with a history of chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy.
Which oxygen saturation target is appropriate for this patient?
A. 95-100%
B. 88-92%
C. 85-89%
D. 80-85%
💫ANSWER✔️✔️: B. 88-92%
,💫RATIONALE✔️✔️: For COPD patients, a target oxygen saturation of 88-92% is recommended to prevent
respiratory depression; higher levels can suppress the hypoxic drive.
---
**Question 3**
A nurse is assessing a patient who is 2 days post-operative. The patient has a temperature of 101.2°F
and purulent drainage from the surgical incision. What is the priority nursing action?
A. Administer prescribed antibiotics
B. Obtain a wound culture
C. Apply a sterile dressing
D. Notify the healthcare provider
💫ANSWER✔️✔️: B. Obtain a wound culture
💫RATIONALE✔️✔️: A wound culture should be obtained before initiating antibiotics to identify the
causative organism; the provider should be notified after the culture.
---
**Question 4**
A patient is prescribed enoxaparin for deep vein thrombosis prophylaxis. Which instruction should the
nurse provide?
A. "Administer the medication intramuscularly"
B. "Inject the medication into the abdomen"
C. "Massage the injection site after administration"
D. "Expect to have routine blood draws to monitor therapy"
💫ANSWER✔️✔️: B. "Inject the medication into the abdomen"
,💫RATIONALE✔️✔️: Enoxaparin is administered subcutaneously in the abdomen; injection sites should
not be massaged to prevent hematoma formation.
---
**Question 5**
A patient with a history of heart failure is experiencing dyspnea and orthopnea. Which nursing
intervention should be implemented first?
A. Administer supplemental oxygen
B. Place the patient in high Fowler's position
C. Administer prescribed diuretics
D. Assess the patient's lung sounds
💫ANSWER✔️✔️: D. Assess the patient's lung sounds
💫RATIONALE✔️✔️: Assessment is the priority; lung sounds provide essential data about fluid status and
guide subsequent interventions.
---
**Question 6**
A nurse is preparing to administer a medication via a nasogastric tube. Which medication should the
nurse question?
A. Enteric-coated tablets
B. Liquid medications
C. Crushed tablets
D. Dissolved medications
💫ANSWER✔️✔️: A. Enteric-coated tablets
, 💫RATIONALE✔️✔️: Enteric-coated and sustained-release medications should not be crushed or
administered via NG tube; other formulations are acceptable.
---
**Question 7**
A patient with a history of diabetes mellitus is admitted with a foot ulcer. Which assessment finding
indicates the patient is at risk for amputation?
A. Redness and warmth around the ulcer
B. Absence of pedal pulses
C. Serosanguineous drainage
D. Ulcer size of 2 cm
💫ANSWER✔️✔️: B. Absence of pedal pulses
💫RATIONALE✔️✔️: Absence of pedal pulses indicates severe peripheral arterial disease, which increases
the risk of poor wound healing and potential amputation.
---
**Question 8**
A nurse is caring for a patient with a tracheostomy. Which action is essential to maintain airway
patency?
A. Change the tracheostomy ties daily
B. Suction the tracheostomy as needed
C. Deflate the cuff during tube care
D. Keep the humidifier turned off
💫ANSWER✔️✔️: B. Suction the tracheostomy as needed
Blueprint | Comprehensive Practice Questions with Detailed
Rationales | Updated 2026 Edition
---
**Question 1**
A nurse is preparing to perform a sterile wound irrigation. Which action maintains sterility?
A. Pour the irrigating solution directly from the bottle onto the wound
B. Direct the flow of solution from the cleanest to the dirtiest area
C. Hold the syringe 1 inch above the wound
D. Use clean gloves for the procedure
💫ANSWER✔️✔️: B. Direct the flow of solution from the cleanest to the dirtiest area
💫RATIONALE✔️✔️: Directing irrigation from clean to dirty prevents contamination of clean areas; sterile
gloves and sterile solution are required for sterile irrigation.
---
**Question 2**
A patient with a history of chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy.
Which oxygen saturation target is appropriate for this patient?
A. 95-100%
B. 88-92%
C. 85-89%
D. 80-85%
💫ANSWER✔️✔️: B. 88-92%
,💫RATIONALE✔️✔️: For COPD patients, a target oxygen saturation of 88-92% is recommended to prevent
respiratory depression; higher levels can suppress the hypoxic drive.
---
**Question 3**
A nurse is assessing a patient who is 2 days post-operative. The patient has a temperature of 101.2°F
and purulent drainage from the surgical incision. What is the priority nursing action?
A. Administer prescribed antibiotics
B. Obtain a wound culture
C. Apply a sterile dressing
D. Notify the healthcare provider
💫ANSWER✔️✔️: B. Obtain a wound culture
💫RATIONALE✔️✔️: A wound culture should be obtained before initiating antibiotics to identify the
causative organism; the provider should be notified after the culture.
---
**Question 4**
A patient is prescribed enoxaparin for deep vein thrombosis prophylaxis. Which instruction should the
nurse provide?
A. "Administer the medication intramuscularly"
B. "Inject the medication into the abdomen"
C. "Massage the injection site after administration"
D. "Expect to have routine blood draws to monitor therapy"
💫ANSWER✔️✔️: B. "Inject the medication into the abdomen"
,💫RATIONALE✔️✔️: Enoxaparin is administered subcutaneously in the abdomen; injection sites should
not be massaged to prevent hematoma formation.
---
**Question 5**
A patient with a history of heart failure is experiencing dyspnea and orthopnea. Which nursing
intervention should be implemented first?
A. Administer supplemental oxygen
B. Place the patient in high Fowler's position
C. Administer prescribed diuretics
D. Assess the patient's lung sounds
💫ANSWER✔️✔️: D. Assess the patient's lung sounds
💫RATIONALE✔️✔️: Assessment is the priority; lung sounds provide essential data about fluid status and
guide subsequent interventions.
---
**Question 6**
A nurse is preparing to administer a medication via a nasogastric tube. Which medication should the
nurse question?
A. Enteric-coated tablets
B. Liquid medications
C. Crushed tablets
D. Dissolved medications
💫ANSWER✔️✔️: A. Enteric-coated tablets
, 💫RATIONALE✔️✔️: Enteric-coated and sustained-release medications should not be crushed or
administered via NG tube; other formulations are acceptable.
---
**Question 7**
A patient with a history of diabetes mellitus is admitted with a foot ulcer. Which assessment finding
indicates the patient is at risk for amputation?
A. Redness and warmth around the ulcer
B. Absence of pedal pulses
C. Serosanguineous drainage
D. Ulcer size of 2 cm
💫ANSWER✔️✔️: B. Absence of pedal pulses
💫RATIONALE✔️✔️: Absence of pedal pulses indicates severe peripheral arterial disease, which increases
the risk of poor wound healing and potential amputation.
---
**Question 8**
A nurse is caring for a patient with a tracheostomy. Which action is essential to maintain airway
patency?
A. Change the tracheostomy ties daily
B. Suction the tracheostomy as needed
C. Deflate the cuff during tube care
D. Keep the humidifier turned off
💫ANSWER✔️✔️: B. Suction the tracheostomy as needed
