NR 226 FINAL EXAM
FUNDAMENTALS: PATIENT CARE
Comprehensive Practice • 2026/2027 Edition • 100 Questions
NR 226 FINAL EXAM
FUNDAMENTALS: PATIENT CARE COMPREHENSIVE PRACTICE (2026/2027
EDITION)
This comprehensive practice examination is aligned with the Chamberlain University NR-226
Fundamentals: Patient Care course objectives and the current NCLEX-RN® test plan, emphasizing
health promotion, rehabilitative patient care, and the nursing process. It contains 100
multiple-choice questions across eight sections, each with a complete rationale. Coverage reflects
the exam cognitive mix: approximately 30% recall, 50% application, and 20% analysis, with ≈75%
scenario-based items and ≈25% direct-knowledge items. Each question offers four options (A–D)
with exactly one correct response.
Section Topic Questions
Section 1 Nursing Process & Clinical Judgment – ADPIE, Prioritization, Delegation 14
Section 2 Fluid & Electrolyte Balance – Sodium, Potassium, Calcium, Magnesium, Phosphorus,
22 IV Solutions
Section 3 Acid-Base Balance – ABG Interpretation (ROME), Respiratory/Metabolic Imbalances
9
Section 4 Grief, Loss, & End-of-Life Care – Types of Loss, Grieving Stages, Disenfranchised
14 Grief, Postmortem Care
Section 5 Basic Care & Comfort – Pressure Injury Staging, Post-Operative Care, IV Therapy,
14 Tube Feeding
Section 6 Ethical & Legal Principles – Informed Consent, Autonomy, Beneficence, Nonmaleficence,
9 Justice
Section 7 Professional Communication – Therapeutic Communication, Cultural Considerations,
9 Collaboration
Section 8 Integrated Case Studies – Complex Patient Scenarios 9
TOTAL 100
How to use this exam: Work through the sections in order, marking your answers. Each item shows
four options (A–D) with exactly one correct response, followed by the answer and a rationale. A
consolidated answer key appears at the end for quick scoring.
,NR 226 FINAL EXAM — FUNDAMENTALS: PATIENT CARE Comprehensive Practice (2026/2027)
Section 1: Nursing Process & Clinical Judgment – ADPIE, Prioritization, Delegation
Q1: Which is the FIRST step of the nursing process?
A. Assessment [CORRECT]
B. Diagnosis
C. Planning
D. Implementation
Correct Answer: A
Rationale: Assessment (data collection) always comes first and guides all other steps.
Q2: The correct order of the nursing process is:
A. Assessment, Diagnosis, Planning, Implementation, Evaluation [CORRECT]
B. Diagnosis, Assessment, Planning, Evaluation, Implementation
C. Planning, Assessment, Diagnosis, Implementation, Evaluation
D. Implementation, Assessment, Diagnosis, Planning, Evaluation
Correct Answer: A
Rationale: ADPIE is the standard sequence of the nursing process.
Q3: Which step of the nursing process determines whether the plan of care needs revision?
A. Evaluation [CORRECT]
B. Assessment
C. Diagnosis
D. Implementation
Correct Answer: A
Rationale: Evaluation compares outcomes to goals to decide if the plan should continue or be revised.
Q4: A nurse writes the outcome: 'Patient will ambulate 50 feet by discharge.' This activity occurs during
which step?
A. Planning [CORRECT]
B. Assessment
C. Diagnosis
D. Evaluation
Correct Answer: A
Rationale: Setting measurable goals/outcomes is part of planning.
Q5: Objective data are BEST defined as:
A. findings that can be observed or measured by the nurse [CORRECT]
B. the patient's stated feelings
C. information reported by family
D. the patient's pain description
Correct Answer: A
Rationale: Objective data are observable/measurable (vital signs, lung sounds); subjective data are reported.
Q6: Which is an example of objective data?
A. Blood pressure 150/90 mmHg [CORRECT]
B. "I feel nauseated"
C. "My head hurts"
D. "I am anxious"
Correct Answer: A
Rationale: A measured blood pressure is objective; reported feelings are subjective.
Page 2 of 19
, NR 226 FINAL EXAM — FUNDAMENTALS: PATIENT CARE Comprehensive Practice (2026/2027)
Q7: A nurse uses Maslow's hierarchy to prioritize care. Which need is addressed FIRST?
A. Airway patency and oxygenation [CORRECT]
B. Self-esteem
C. Social interaction
D. Education about diet
Correct Answer: A
Rationale: Physiologic needs such as airway/oxygen take priority over higher-level needs.
Q8: Which task can the nurse appropriately delegate to unlicensed assistive personnel (UAP)?
A. Recording intake and output [CORRECT]
B. Initial assessment of a new admission
C. Teaching insulin administration
D. Developing the nursing diagnosis
Correct Answer: A
Rationale: UAPs can record I&O; assessment, teaching, and diagnosis are nursing responsibilities.
Q9: Before delegating a task to a UAP, the nurse must FIRST:
A. verify that the UAP understands the task and its expected outcome [CORRECT]
B. leave the unit
C. obtain physician permission
D. complete all other tasks
Correct Answer: A
Rationale: The nurse retains accountability and must confirm the UAP's competence and understanding.
Q10: A patient's IV is running behind schedule. The nurse should:
A. recalculate the rate and adjust the infusion within safe parameters [CORRECT]
B. run the IV wide open
C. bolus the remaining volume rapidly
D. ignore the schedule
Correct Answer: A
Rationale: The nurse recalculates and safely adjusts the rate; bolusing can cause fluid overload.
Q11: A nurse identifies the problem 'Risk for falls related to unsteady gait.' This statement is an
example of a:
A. nursing diagnosis [CORRECT]
B. medical diagnosis
C. goal
D. physician order
Correct Answer: A
Rationale: Risk-for diagnoses are nursing diagnoses describing potential problems.
Q12: The difference between a medical diagnosis and a nursing diagnosis is that a nursing diagnosis:
A. describes the patient's response to health problems [CORRECT]
B. identifies a disease process
C. is made by the physician
D. requires surgical treatment
Correct Answer: A
Rationale: Nursing diagnoses focus on human responses; medical diagnoses name diseases.
Page 3 of 19
FUNDAMENTALS: PATIENT CARE
Comprehensive Practice • 2026/2027 Edition • 100 Questions
NR 226 FINAL EXAM
FUNDAMENTALS: PATIENT CARE COMPREHENSIVE PRACTICE (2026/2027
EDITION)
This comprehensive practice examination is aligned with the Chamberlain University NR-226
Fundamentals: Patient Care course objectives and the current NCLEX-RN® test plan, emphasizing
health promotion, rehabilitative patient care, and the nursing process. It contains 100
multiple-choice questions across eight sections, each with a complete rationale. Coverage reflects
the exam cognitive mix: approximately 30% recall, 50% application, and 20% analysis, with ≈75%
scenario-based items and ≈25% direct-knowledge items. Each question offers four options (A–D)
with exactly one correct response.
Section Topic Questions
Section 1 Nursing Process & Clinical Judgment – ADPIE, Prioritization, Delegation 14
Section 2 Fluid & Electrolyte Balance – Sodium, Potassium, Calcium, Magnesium, Phosphorus,
22 IV Solutions
Section 3 Acid-Base Balance – ABG Interpretation (ROME), Respiratory/Metabolic Imbalances
9
Section 4 Grief, Loss, & End-of-Life Care – Types of Loss, Grieving Stages, Disenfranchised
14 Grief, Postmortem Care
Section 5 Basic Care & Comfort – Pressure Injury Staging, Post-Operative Care, IV Therapy,
14 Tube Feeding
Section 6 Ethical & Legal Principles – Informed Consent, Autonomy, Beneficence, Nonmaleficence,
9 Justice
Section 7 Professional Communication – Therapeutic Communication, Cultural Considerations,
9 Collaboration
Section 8 Integrated Case Studies – Complex Patient Scenarios 9
TOTAL 100
How to use this exam: Work through the sections in order, marking your answers. Each item shows
four options (A–D) with exactly one correct response, followed by the answer and a rationale. A
consolidated answer key appears at the end for quick scoring.
,NR 226 FINAL EXAM — FUNDAMENTALS: PATIENT CARE Comprehensive Practice (2026/2027)
Section 1: Nursing Process & Clinical Judgment – ADPIE, Prioritization, Delegation
Q1: Which is the FIRST step of the nursing process?
A. Assessment [CORRECT]
B. Diagnosis
C. Planning
D. Implementation
Correct Answer: A
Rationale: Assessment (data collection) always comes first and guides all other steps.
Q2: The correct order of the nursing process is:
A. Assessment, Diagnosis, Planning, Implementation, Evaluation [CORRECT]
B. Diagnosis, Assessment, Planning, Evaluation, Implementation
C. Planning, Assessment, Diagnosis, Implementation, Evaluation
D. Implementation, Assessment, Diagnosis, Planning, Evaluation
Correct Answer: A
Rationale: ADPIE is the standard sequence of the nursing process.
Q3: Which step of the nursing process determines whether the plan of care needs revision?
A. Evaluation [CORRECT]
B. Assessment
C. Diagnosis
D. Implementation
Correct Answer: A
Rationale: Evaluation compares outcomes to goals to decide if the plan should continue or be revised.
Q4: A nurse writes the outcome: 'Patient will ambulate 50 feet by discharge.' This activity occurs during
which step?
A. Planning [CORRECT]
B. Assessment
C. Diagnosis
D. Evaluation
Correct Answer: A
Rationale: Setting measurable goals/outcomes is part of planning.
Q5: Objective data are BEST defined as:
A. findings that can be observed or measured by the nurse [CORRECT]
B. the patient's stated feelings
C. information reported by family
D. the patient's pain description
Correct Answer: A
Rationale: Objective data are observable/measurable (vital signs, lung sounds); subjective data are reported.
Q6: Which is an example of objective data?
A. Blood pressure 150/90 mmHg [CORRECT]
B. "I feel nauseated"
C. "My head hurts"
D. "I am anxious"
Correct Answer: A
Rationale: A measured blood pressure is objective; reported feelings are subjective.
Page 2 of 19
, NR 226 FINAL EXAM — FUNDAMENTALS: PATIENT CARE Comprehensive Practice (2026/2027)
Q7: A nurse uses Maslow's hierarchy to prioritize care. Which need is addressed FIRST?
A. Airway patency and oxygenation [CORRECT]
B. Self-esteem
C. Social interaction
D. Education about diet
Correct Answer: A
Rationale: Physiologic needs such as airway/oxygen take priority over higher-level needs.
Q8: Which task can the nurse appropriately delegate to unlicensed assistive personnel (UAP)?
A. Recording intake and output [CORRECT]
B. Initial assessment of a new admission
C. Teaching insulin administration
D. Developing the nursing diagnosis
Correct Answer: A
Rationale: UAPs can record I&O; assessment, teaching, and diagnosis are nursing responsibilities.
Q9: Before delegating a task to a UAP, the nurse must FIRST:
A. verify that the UAP understands the task and its expected outcome [CORRECT]
B. leave the unit
C. obtain physician permission
D. complete all other tasks
Correct Answer: A
Rationale: The nurse retains accountability and must confirm the UAP's competence and understanding.
Q10: A patient's IV is running behind schedule. The nurse should:
A. recalculate the rate and adjust the infusion within safe parameters [CORRECT]
B. run the IV wide open
C. bolus the remaining volume rapidly
D. ignore the schedule
Correct Answer: A
Rationale: The nurse recalculates and safely adjusts the rate; bolusing can cause fluid overload.
Q11: A nurse identifies the problem 'Risk for falls related to unsteady gait.' This statement is an
example of a:
A. nursing diagnosis [CORRECT]
B. medical diagnosis
C. goal
D. physician order
Correct Answer: A
Rationale: Risk-for diagnoses are nursing diagnoses describing potential problems.
Q12: The difference between a medical diagnosis and a nursing diagnosis is that a nursing diagnosis:
A. describes the patient's response to health problems [CORRECT]
B. identifies a disease process
C. is made by the physician
D. requires surgical treatment
Correct Answer: A
Rationale: Nursing diagnoses focus on human responses; medical diagnoses name diseases.
Page 3 of 19
