NR 224 Fundamentals of Nursing Final Exam
NGN-Aligned Chamberlain University Actual
Exam 2026/2027 with Detailed Rationales |
Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
TABLE OF CONTENTS
● Section 1: Clinical Judgment Measurement Model (CJMM) – NGN-Aligned (Questions 1–8)
● Section 2: Safety & Infection Control (Questions 9–16)
● Section 3: Basic Care & Comfort (Questions 17–23)
● Section 4: Health Assessment & Vital Signs (Questions 24–29)
● Section 5: Pharmacology & Medication Administration (Questions 30–36)
● Section 6: Therapeutic Communication & Patient Education (Questions 37–40)
● Section 7: Legal & Ethical Issues in Nursing Practice (Questions 41–44)
● Section 8: Documentation & Reporting (Questions 45–47)
● Section 9: Fluid, Electrolyte, & Acid-Base Balance (Questions 48–52)
● Section 10: Oxygenation & Airway Management (Questions 53–57)
● Section 11: Pain Management & Non-Pharmacological Interventions (Questions 58–61)
● Section 12: Perioperative Care & Surgical Asepsis (Questions 62–65)
● Section 13: Developmental Considerations Across the Lifespan (Questions 66–68)
● Section 14: Cultural Competence & Spiritual Care (Questions 69–71)
● Section 15: Delegation, Prioritization, & Time Management (Questions 72–75)
,SECTION 1: Clinical Judgment Measurement Model (CJMM) –
NGN-Aligned (Questions 1–8)
Q1: A nurse enters a patient's room and observes the client is diaphoretic, has a respiratory rate of
28 breaths/min, and is clutching their chest. The nurse reviews the chart and notes the client
received a new blood pressure medication 2 hours ago. Which action best demonstrates the
analyzing cues phase of the Clinical Judgment Measurement Model?
A. Immediately call the rapid response team and begin CPR
B. Document the findings and notify the provider in 30 minutes
C. <span style="background-color: green">
D. Ask the client to rate their pain on a scale of 0 to 10
Correct Answer: C
Rationale: The analyzing cues phase of the NCSBN CJMM requires the nurse to interpret and make
sense of recognized data by identifying patterns and relationships among cues. Option C
demonstrates this by linking the client's physiological presentation (diaphoresis, tachypnea, chest
discomfort) to the recent medication administration, forming a clinical hypothesis about a potential
adverse drug reaction. Option A represents taking action without adequate analysis, which
bypasses critical thinking. Option B delays necessary intervention and fails to analyze the urgency
of the situation. Option D represents collecting additional data (recognizing cues) rather than
analyzing existing information. Chamberlain NR 224 students must master this phase to avoid
premature conclusions and unsafe interventions on the NGN.
,Q2: A 72-year-old postoperative client has the following assessment findings: oxygen saturation
89% on room air, temperature 38.2°C (100.8°F), diminished breath sounds in the right lower lobe,
and refusal to use the incentive spirometer. Using the CJMM, which hypothesis should the nurse
prioritize?
A. The client is experiencing anxiety related to hospitalization
B. <span style="background-color: green">
C. The client requires immediate discharge planning education
D. The client is demonstrating normal postoperative healing
Correct Answer: B
Rationale: Prioritizing hypotheses within the CJMM framework requires the nurse to determine
which potential explanation poses the greatest threat to patient safety based on current evidence.
The combination of hypoxemia, low-grade fever, diminished breath sounds, and noncompliance
with pulmonary hygiene strongly supports atelectasis with impaired gas exchange as the most
life-threatening hypothesis. Option A may be a contributing factor but does not address the
immediate physiological threat. Option C is inappropriate given the acute clinical presentation.
Option D is incorrect because these findings are not consistent with normal postoperative recovery.
NGN-style questions require students to prioritize physiological stability using Maslow's hierarchy
and the ABC framework.
Q3: A nurse is caring for a client with heart failure who has 3+ pitting edema in the lower
extremities, reports a 3-pound weight gain in 2 days, and has crackles auscultated bilaterally at the
lung bases. The nurse generates the following solutions. Which action represents the highest
priority solution before implementing interventions?
, A. Restrict the client's fluid intake to 1,000 mL per day independently
B. <span style="background-color: green">
C. Elevate the client's legs above heart level for 30 minutes
D. Teach the client about low-sodium diet choices
Correct Answer: B
Rationale: Generating solutions in the CJMM requires the nurse to identify evidence-based, legally
appropriate, and prioritized interventions that require provider collaboration when outside
independent nursing scope. Option B is correct because adjusting diuretic therapy is a dependent
nursing function requiring a provider's order; the nurse must advocate for the client by
communicating clinical findings. Option A is outside the nurse's independent scope and could
cause harm without medical direction. Option C may provide temporary comfort but does not
address the underlying fluid overload. Option D is important but secondary to acute physiological
stabilization. Chamberlain students must recognize that generating solutions includes
understanding scope of practice boundaries on the NGN.
Q4: After implementing a turn schedule for a client with impaired mobility, the nurse returns 2 hours
later and finds a new 2-cm reddened area on the client's coccyx that blanches with pressure.
Which CJMM phase is the nurse demonstrating when comparing this finding to the baseline skin
assessment?
A. Recognizing cues
B. Analyzing cues
C. Generating solutions
NGN-Aligned Chamberlain University Actual
Exam 2026/2027 with Detailed Rationales |
Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
TABLE OF CONTENTS
● Section 1: Clinical Judgment Measurement Model (CJMM) – NGN-Aligned (Questions 1–8)
● Section 2: Safety & Infection Control (Questions 9–16)
● Section 3: Basic Care & Comfort (Questions 17–23)
● Section 4: Health Assessment & Vital Signs (Questions 24–29)
● Section 5: Pharmacology & Medication Administration (Questions 30–36)
● Section 6: Therapeutic Communication & Patient Education (Questions 37–40)
● Section 7: Legal & Ethical Issues in Nursing Practice (Questions 41–44)
● Section 8: Documentation & Reporting (Questions 45–47)
● Section 9: Fluid, Electrolyte, & Acid-Base Balance (Questions 48–52)
● Section 10: Oxygenation & Airway Management (Questions 53–57)
● Section 11: Pain Management & Non-Pharmacological Interventions (Questions 58–61)
● Section 12: Perioperative Care & Surgical Asepsis (Questions 62–65)
● Section 13: Developmental Considerations Across the Lifespan (Questions 66–68)
● Section 14: Cultural Competence & Spiritual Care (Questions 69–71)
● Section 15: Delegation, Prioritization, & Time Management (Questions 72–75)
,SECTION 1: Clinical Judgment Measurement Model (CJMM) –
NGN-Aligned (Questions 1–8)
Q1: A nurse enters a patient's room and observes the client is diaphoretic, has a respiratory rate of
28 breaths/min, and is clutching their chest. The nurse reviews the chart and notes the client
received a new blood pressure medication 2 hours ago. Which action best demonstrates the
analyzing cues phase of the Clinical Judgment Measurement Model?
A. Immediately call the rapid response team and begin CPR
B. Document the findings and notify the provider in 30 minutes
C. <span style="background-color: green">
D. Ask the client to rate their pain on a scale of 0 to 10
Correct Answer: C
Rationale: The analyzing cues phase of the NCSBN CJMM requires the nurse to interpret and make
sense of recognized data by identifying patterns and relationships among cues. Option C
demonstrates this by linking the client's physiological presentation (diaphoresis, tachypnea, chest
discomfort) to the recent medication administration, forming a clinical hypothesis about a potential
adverse drug reaction. Option A represents taking action without adequate analysis, which
bypasses critical thinking. Option B delays necessary intervention and fails to analyze the urgency
of the situation. Option D represents collecting additional data (recognizing cues) rather than
analyzing existing information. Chamberlain NR 224 students must master this phase to avoid
premature conclusions and unsafe interventions on the NGN.
,Q2: A 72-year-old postoperative client has the following assessment findings: oxygen saturation
89% on room air, temperature 38.2°C (100.8°F), diminished breath sounds in the right lower lobe,
and refusal to use the incentive spirometer. Using the CJMM, which hypothesis should the nurse
prioritize?
A. The client is experiencing anxiety related to hospitalization
B. <span style="background-color: green">
C. The client requires immediate discharge planning education
D. The client is demonstrating normal postoperative healing
Correct Answer: B
Rationale: Prioritizing hypotheses within the CJMM framework requires the nurse to determine
which potential explanation poses the greatest threat to patient safety based on current evidence.
The combination of hypoxemia, low-grade fever, diminished breath sounds, and noncompliance
with pulmonary hygiene strongly supports atelectasis with impaired gas exchange as the most
life-threatening hypothesis. Option A may be a contributing factor but does not address the
immediate physiological threat. Option C is inappropriate given the acute clinical presentation.
Option D is incorrect because these findings are not consistent with normal postoperative recovery.
NGN-style questions require students to prioritize physiological stability using Maslow's hierarchy
and the ABC framework.
Q3: A nurse is caring for a client with heart failure who has 3+ pitting edema in the lower
extremities, reports a 3-pound weight gain in 2 days, and has crackles auscultated bilaterally at the
lung bases. The nurse generates the following solutions. Which action represents the highest
priority solution before implementing interventions?
, A. Restrict the client's fluid intake to 1,000 mL per day independently
B. <span style="background-color: green">
C. Elevate the client's legs above heart level for 30 minutes
D. Teach the client about low-sodium diet choices
Correct Answer: B
Rationale: Generating solutions in the CJMM requires the nurse to identify evidence-based, legally
appropriate, and prioritized interventions that require provider collaboration when outside
independent nursing scope. Option B is correct because adjusting diuretic therapy is a dependent
nursing function requiring a provider's order; the nurse must advocate for the client by
communicating clinical findings. Option A is outside the nurse's independent scope and could
cause harm without medical direction. Option C may provide temporary comfort but does not
address the underlying fluid overload. Option D is important but secondary to acute physiological
stabilization. Chamberlain students must recognize that generating solutions includes
understanding scope of practice boundaries on the NGN.
Q4: After implementing a turn schedule for a client with impaired mobility, the nurse returns 2 hours
later and finds a new 2-cm reddened area on the client's coccyx that blanches with pressure.
Which CJMM phase is the nurse demonstrating when comparing this finding to the baseline skin
assessment?
A. Recognizing cues
B. Analyzing cues
C. Generating solutions
