CHAMBERLAIN UNIVERSITY | COLLEGE OF NURSING
NR 224 Exam 1: The Real Test Results
Fundamentals of Nursing | Summer 2026/2027 | Verified Questions and Answers with Rationales
FORMAT
TOTAL QUESTIONS TIME LIMIT PASSING SCORE
Single best answer
75 90 minutes 80% (60 of 75 correct)
(A-D)
Examination Instructions
Select the single best answer (A through D) for each of the 75 items. The verified answer and a detailed rationale follow every
item for immediate review and remediation.
Content is aligned with the Chamberlain University NR 224 Fundamentals of Nursing Exam 1 blueprint and 2026/2027 testing
standards; all distractors represent common examination pitfalls.
Cognitive distribution: 25% recall, 50% application, and 25% analysis; approximately 75% of items are scenario-based,
including clinical judgment scenarios.
Target score for readiness: at least 60 of 75 correct (80%) within the 90-minute testing window.
Examination Blueprint
Section Questions Content Focus
Assessment types, inspection, palpation, percussion, and auscultation
Section 1: Health Assessment and sequences, normal and abnormal findings across body systems, pain
1-16 (16 Q)
Physical Examination assessment scales, ABCDE primary survey, and documentation of
assessment data
Temperature, pulse, respiration, and blood pressure measurement
Section 2: Vital Signs and techniques, normal ranges across the lifespan, factors affecting vital
17-32 (16 Q)
Measurements signs, pain as the fifth vital sign, oxygen saturation monitoring, and
standard dosage and household conversions
Chain of infection components, hand hygiene, standard and
transmission-based precautions with mnemonic-based identification
Section 3: Infection Prevention and
33-47 (15 Q) (Mrs. Wee, Spiderman, My chicken has TB), PPE donning and doffing
Control
sequences, sterile technique, and healthcare-associated infection
prevention
EMR and EHR documentation, HIPAA privacy, National Patient Safety
Section 4: Patient Safety and Fall Goals, fall risk assessment tools and interventions, restraint alternatives
48-61 (14 Q)
Prevention and application, fire safety (RACE and PASS), medication safety, the
nursing process, and error reporting systems
Bathing and skin care, oral hygiene and denture care, back massage,
foot and nail care, pressure injury prevention and Braden Scale
Section 5: Hygiene and Personal Care 62-75 (14 Q)
assessment, body mechanics, positioning and mobility aids, and
therapeutic communication during personal care activities
Chamberlain University | NR 224 Fundamentals of Nursing 1
,NR 224 Exam 1: The Real Test Results Summer 2026/2027
Section 1: Health Assessment and Physical Examination Questions 1-16
Assessment types, inspection, palpation, percussion, and auscultation sequences, normal and abnormal findings across body systems, pain assessment
scales, ABCDE primary survey, and documentation of assessment data
Q1: A patient arrives at the ambulatory clinic stating, 'I have had shortness of breath for three days.' The electronic
record documents a complete head-to-toe assessment from a visit six months ago. Which type of assessment should
the nurse perform first at today's visit?
A. A comprehensive assessment repeating every system from head to toe
B. A focused assessment concentrating on the respiratory system and related findings [CORRECT]
C. An emergency assessment beginning with the ABCDE survey and rapid intervention
D. A follow-up assessment limited to reviewing the prior chart notes only
Correct Answer: B
Rationale: A focused assessment is a problem-centered examination limited to the system related to the chief complaint
and is appropriate when a comprehensive baseline database already exists. A full head-to-toe comprehensive assessment is
reserved for admission or annual examinations and would delay care for the active problem. An emergency assessment is
used only for life-threatening situations, and reviewing old notes alone produces no current assessment data.
Q2: During the morning assessment, a nurse is preparing to examine the abdomen of a patient admitted with
abdominal distention. Which sequence should the nurse use?
A. Inspection, palpation, percussion, auscultation
B. Auscultation, inspection, palpation, percussion
C. Inspection, auscultation, percussion, palpation [CORRECT]
D. Percussion, palpation, auscultation, inspection
Correct Answer: C
Rationale: The abdominal assessment sequence is inspection, auscultation, percussion, and palpation. Auscultation is
moved ahead of the touching techniques because percussion and palpation stimulate the bowel and can alter or falsely
increase bowel sounds. The traditional inspection-palpation-percussion-auscultation order used for other body regions is a
classic pitfall and is incorrect for the abdomen.
Q3: The nurse educator asks a student why auscultation precedes percussion and palpation during an abdominal
examination. Which response by the student is correct?
A. 'Touching the abdomen stimulates peristalsis and can change the bowel sounds before they are
auscultated.' [CORRECT]
B. 'Auscultation first allows the patient to become comfortable with being touched.'
C. 'Stethoscope placement must be mapped before anatomic landmarks are identified.'
D. 'Percussion should always be the last technique performed on any body region.'
Correct Answer: A
Rationale: Percussion and palpation mechanically stimulate peristalsis, which can artificially change bowel sounds and
produce misleading data, so auscultation comes first to capture a true baseline. Comfort and familiarity are not the rationale
for the sequence. Anatomic landmarks are established by inspection, and percussion is never the final technique on the
abdomen.
Chamberlain University | NR 224 Fundamentals of Nursing 2
, NR 224 Exam 1: The Real Test Results Summer 2026/2027
Q4: Which action demonstrates correct inspection technique during a physical examination?
A. Palpating each area deeply before observing it
B. Quickly scanning two body regions at the same time to save time
C. Comparing findings only against textbook descriptions rather than the opposite side of the body
D. Providing adequate exposure and good lighting while observing each region systematically
[CORRECT]
Correct Answer: D
Rationale: Inspection requires adequate exposure, good lighting, and systematic, unhurried observation, frequently
comparing one side of the body with the other to evaluate symmetry. Palpation never precedes inspection of a region, and
rushing through two areas at once causes omissions. Bilateral comparison is a core strategy of accurate inspection rather than
relying on text descriptions alone.
Q5: While percussing the posterior thorax of an adult with pneumonia, the nurse hears short, soft, high-pitched, dull
notes over the right lower lobe where resonant lung sounds are expected. How should the nurse interpret this finding?
A. Hyperresonance consistent with trapped air and possible emphysema
B. Dullness consistent with fluid or solid material replacing air in the lung tissue [CORRECT]
C. Tympany consistent with a normally air-filled stomach
D. Resonance consistent with healthy, well-aerated lung tissue
Correct Answer: B
Rationale: A dull note over lung tissue means the normally air-filled parenchyma contains fluid or solid material, as occurs
with pneumonia consolidation, and the finding should be correlated with auscultation before documentation.
Hyperresonance indicates trapped air as in emphysema or pneumothorax, tympany is heard over air-filled structures such as
the gastric bubble, and resonance is the expected normal lung note.
Q6: A student nurse is examining a patient's abdomen and notes that the patient guards and reports pain in the right
lower quadrant. When should the student palpate this tender area?
A. First, to establish the baseline severity of the pain
B. Immediately after inspection to correlate the visual findings
C. At the same time as light palpation of the other quadrants
D. Last, after all other assessment techniques are completed [CORRECT]
Correct Answer: D
Rationale: Tender or painful areas are always palpated last so that guarding and pain do not interfere with the remainder of
the examination and the patient remains cooperative. Beginning with the painful area heightens guarding and distress, and
palpating it simultaneously with routine quadrant work contaminates the data collected from pain-free regions.
Chamberlain University | NR 224 Fundamentals of Nursing 3
NR 224 Exam 1: The Real Test Results
Fundamentals of Nursing | Summer 2026/2027 | Verified Questions and Answers with Rationales
FORMAT
TOTAL QUESTIONS TIME LIMIT PASSING SCORE
Single best answer
75 90 minutes 80% (60 of 75 correct)
(A-D)
Examination Instructions
Select the single best answer (A through D) for each of the 75 items. The verified answer and a detailed rationale follow every
item for immediate review and remediation.
Content is aligned with the Chamberlain University NR 224 Fundamentals of Nursing Exam 1 blueprint and 2026/2027 testing
standards; all distractors represent common examination pitfalls.
Cognitive distribution: 25% recall, 50% application, and 25% analysis; approximately 75% of items are scenario-based,
including clinical judgment scenarios.
Target score for readiness: at least 60 of 75 correct (80%) within the 90-minute testing window.
Examination Blueprint
Section Questions Content Focus
Assessment types, inspection, palpation, percussion, and auscultation
Section 1: Health Assessment and sequences, normal and abnormal findings across body systems, pain
1-16 (16 Q)
Physical Examination assessment scales, ABCDE primary survey, and documentation of
assessment data
Temperature, pulse, respiration, and blood pressure measurement
Section 2: Vital Signs and techniques, normal ranges across the lifespan, factors affecting vital
17-32 (16 Q)
Measurements signs, pain as the fifth vital sign, oxygen saturation monitoring, and
standard dosage and household conversions
Chain of infection components, hand hygiene, standard and
transmission-based precautions with mnemonic-based identification
Section 3: Infection Prevention and
33-47 (15 Q) (Mrs. Wee, Spiderman, My chicken has TB), PPE donning and doffing
Control
sequences, sterile technique, and healthcare-associated infection
prevention
EMR and EHR documentation, HIPAA privacy, National Patient Safety
Section 4: Patient Safety and Fall Goals, fall risk assessment tools and interventions, restraint alternatives
48-61 (14 Q)
Prevention and application, fire safety (RACE and PASS), medication safety, the
nursing process, and error reporting systems
Bathing and skin care, oral hygiene and denture care, back massage,
foot and nail care, pressure injury prevention and Braden Scale
Section 5: Hygiene and Personal Care 62-75 (14 Q)
assessment, body mechanics, positioning and mobility aids, and
therapeutic communication during personal care activities
Chamberlain University | NR 224 Fundamentals of Nursing 1
,NR 224 Exam 1: The Real Test Results Summer 2026/2027
Section 1: Health Assessment and Physical Examination Questions 1-16
Assessment types, inspection, palpation, percussion, and auscultation sequences, normal and abnormal findings across body systems, pain assessment
scales, ABCDE primary survey, and documentation of assessment data
Q1: A patient arrives at the ambulatory clinic stating, 'I have had shortness of breath for three days.' The electronic
record documents a complete head-to-toe assessment from a visit six months ago. Which type of assessment should
the nurse perform first at today's visit?
A. A comprehensive assessment repeating every system from head to toe
B. A focused assessment concentrating on the respiratory system and related findings [CORRECT]
C. An emergency assessment beginning with the ABCDE survey and rapid intervention
D. A follow-up assessment limited to reviewing the prior chart notes only
Correct Answer: B
Rationale: A focused assessment is a problem-centered examination limited to the system related to the chief complaint
and is appropriate when a comprehensive baseline database already exists. A full head-to-toe comprehensive assessment is
reserved for admission or annual examinations and would delay care for the active problem. An emergency assessment is
used only for life-threatening situations, and reviewing old notes alone produces no current assessment data.
Q2: During the morning assessment, a nurse is preparing to examine the abdomen of a patient admitted with
abdominal distention. Which sequence should the nurse use?
A. Inspection, palpation, percussion, auscultation
B. Auscultation, inspection, palpation, percussion
C. Inspection, auscultation, percussion, palpation [CORRECT]
D. Percussion, palpation, auscultation, inspection
Correct Answer: C
Rationale: The abdominal assessment sequence is inspection, auscultation, percussion, and palpation. Auscultation is
moved ahead of the touching techniques because percussion and palpation stimulate the bowel and can alter or falsely
increase bowel sounds. The traditional inspection-palpation-percussion-auscultation order used for other body regions is a
classic pitfall and is incorrect for the abdomen.
Q3: The nurse educator asks a student why auscultation precedes percussion and palpation during an abdominal
examination. Which response by the student is correct?
A. 'Touching the abdomen stimulates peristalsis and can change the bowel sounds before they are
auscultated.' [CORRECT]
B. 'Auscultation first allows the patient to become comfortable with being touched.'
C. 'Stethoscope placement must be mapped before anatomic landmarks are identified.'
D. 'Percussion should always be the last technique performed on any body region.'
Correct Answer: A
Rationale: Percussion and palpation mechanically stimulate peristalsis, which can artificially change bowel sounds and
produce misleading data, so auscultation comes first to capture a true baseline. Comfort and familiarity are not the rationale
for the sequence. Anatomic landmarks are established by inspection, and percussion is never the final technique on the
abdomen.
Chamberlain University | NR 224 Fundamentals of Nursing 2
, NR 224 Exam 1: The Real Test Results Summer 2026/2027
Q4: Which action demonstrates correct inspection technique during a physical examination?
A. Palpating each area deeply before observing it
B. Quickly scanning two body regions at the same time to save time
C. Comparing findings only against textbook descriptions rather than the opposite side of the body
D. Providing adequate exposure and good lighting while observing each region systematically
[CORRECT]
Correct Answer: D
Rationale: Inspection requires adequate exposure, good lighting, and systematic, unhurried observation, frequently
comparing one side of the body with the other to evaluate symmetry. Palpation never precedes inspection of a region, and
rushing through two areas at once causes omissions. Bilateral comparison is a core strategy of accurate inspection rather than
relying on text descriptions alone.
Q5: While percussing the posterior thorax of an adult with pneumonia, the nurse hears short, soft, high-pitched, dull
notes over the right lower lobe where resonant lung sounds are expected. How should the nurse interpret this finding?
A. Hyperresonance consistent with trapped air and possible emphysema
B. Dullness consistent with fluid or solid material replacing air in the lung tissue [CORRECT]
C. Tympany consistent with a normally air-filled stomach
D. Resonance consistent with healthy, well-aerated lung tissue
Correct Answer: B
Rationale: A dull note over lung tissue means the normally air-filled parenchyma contains fluid or solid material, as occurs
with pneumonia consolidation, and the finding should be correlated with auscultation before documentation.
Hyperresonance indicates trapped air as in emphysema or pneumothorax, tympany is heard over air-filled structures such as
the gastric bubble, and resonance is the expected normal lung note.
Q6: A student nurse is examining a patient's abdomen and notes that the patient guards and reports pain in the right
lower quadrant. When should the student palpate this tender area?
A. First, to establish the baseline severity of the pain
B. Immediately after inspection to correlate the visual findings
C. At the same time as light palpation of the other quadrants
D. Last, after all other assessment techniques are completed [CORRECT]
Correct Answer: D
Rationale: Tender or painful areas are always palpated last so that guarding and pain do not interfere with the remainder of
the examination and the patient remains cooperative. Beginning with the painful area heightens guarding and distress, and
palpating it simultaneously with routine quadrant work contaminates the data collected from pain-free regions.
Chamberlain University | NR 224 Fundamentals of Nursing 3
