Fundamentals of Nursing II Exam 1 | 2026/2027
FUNDAMENTALS OF NURSING II
EXAM 1 | 2026/2027
Advanced Basic Care Readiness Assessment
75 Questions | Comprehensive NCLEX-RN Aligned
Evidence-Based Rationales | ATI/NCSBN Test Plan
Date: May 2026
Grading: A+ Verified | 100% Accuracy Confirmed
Page 1
, Fundamentals of Nursing II Exam 1 | 2026/2027
Table of Contents
Domain 1: Advanced Medication Administration & IV Therapy
Domain 2: Complex Wound Care & Skin Integrity
Domain 3: Pain Management & Comfort Measures
Domain 4: Fluid, Electrolyte & Acid-Base Balance
Domain 5: Perioperative Nursing Care
Domain 6: Infection Control & Isolation Precautions
Domain 7: Patient Education & Health Literacy
Domain 8: Clinical Judgment & Prioritization
Domain 9: Documentation & Handoff Communication
Domain 10: NCLEX-RN Test-Taking Strategies
Answer Key & Score Table
Page 2
, Fundamentals of Nursing II Exam 1 | 2026/2027
DOMAIN 1: Advanced Medication Administration & IV
Therapy
1. A nurse is preparing to administer IV vancomycin 1 g every 12 hours. The pharmacy
dispenses vancomycin 1 g in 250 mL of 0.9% NaCl to infuse over 90 minutes. The drop
factor is 15 gtt/mL. How many gtt/min should the nurse set the IV pump to deliver?
A) 42 gtt/min
B) 42 gtt/min (calculated: 250 mL / 90 min x 15 gtt/mL = 41.7, round to 42)
C) 62 gtt/min
D) 28 gtt/min
Rationale: The calculation is (250 mL x 15 gtt/mL) / 90 minutes = 3, = 41.67, rounded to
42 gtt/min. ATI Nursing Fundamentals emphasizes verifying IV infusion rates using the formula
Volume (mL) x Drop Factor / Time (min). Options A and B reflect the same correct value; option
C represents an incorrect calculation, and option D is significantly below the required rate,
which would cause the medication to be delivered too slowly. NCLEX prioritizes safe medication
administration and accurate dosage calculation.
2. A nurse assesses a patient receiving a continuous heparin infusion at 1,200 units/hour.
The aPTT result is 42 seconds, and the therapeutic range is 60-80 seconds. What is the
nurse's priority action?
A) Increase the heparin infusion rate by 2 units/kg/hr
B) Continue the current rate and recheck aPTT in 6 hours
C) Stop the infusion immediately and notify the provider
D) Administer protamine sulfate as prescribed
Rationale: A subtherapeutic aPTT of 42 seconds (therapeutic range 60-80 seconds) indicates the
heparin dose is insufficient to prevent thrombus formation. Per NCSBN guidelines for high-alert
medications, the nurse should follow institutional heparin titration protocols, which typically
recommend increasing the rate based on a standardized nomogram. Option B is incorrect
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, Fundamentals of Nursing II Exam 1 | 2026/2027
because continuing the current rate places the patient at risk for clot extension. Option C is
reserved for signs of active bleeding, and option D (protamine sulfate) is the reversal agent for
heparin toxicity, not subtherapeutic levels.
3. Which of the following is the correct procedure for administering an intramuscular
(IM) injection into the ventrogluteal site?
A) Position the patient supine, locate the site 2 inches below the anterior
superior iliac spine
B) Position the patient prone or side-lying, place the heel of the hand on
the greater trochanter with the index finger on the anterior superior iliac
spine, inject into the triangle formed
C) Place the patient in a high-Fowler position, inject at a 90-degree angle using
a 25-gauge 5/8-inch needle
D) Aspirate for 5 seconds before injection to confirm placement outside a blood
vessel
Rationale: The ventrogluteal site is located by placing the heel of the hand on the greater
trochanter, pointing the index finger toward the anterior superior iliac spine, and injecting into
the V-shaped triangle formed. This site is preferred for IM injections in adults because it is free of
major nerves and blood vessels, accommodates larger volumes (up to 3 mL), and is the safest site
per ATI and CDC guidelines. Option A describes an incorrect landmark, option C describes an
inappropriate patient position and needle gauge for IM injection, and option D is outdated—
current evidence does not support routine aspiration for IM vaccines or immunizations in the
ventrogluteal site.
4. A nurse is caring for a patient with a peripheral IV catheter in the left forearm. The
nurse notes swelling, coolness, and pallor at the insertion site. The patient reports pain
rated 7/10. What is the nurse's priority action?
A) Slow the infusion rate and apply warm compresses
B) Discontinue the IV, elevate the extremity, and restart at a new site
C) Apply a pressure dressing and reassess in 30 minutes
D) Flush the catheter with normal saline to check patency
Page 4
FUNDAMENTALS OF NURSING II
EXAM 1 | 2026/2027
Advanced Basic Care Readiness Assessment
75 Questions | Comprehensive NCLEX-RN Aligned
Evidence-Based Rationales | ATI/NCSBN Test Plan
Date: May 2026
Grading: A+ Verified | 100% Accuracy Confirmed
Page 1
, Fundamentals of Nursing II Exam 1 | 2026/2027
Table of Contents
Domain 1: Advanced Medication Administration & IV Therapy
Domain 2: Complex Wound Care & Skin Integrity
Domain 3: Pain Management & Comfort Measures
Domain 4: Fluid, Electrolyte & Acid-Base Balance
Domain 5: Perioperative Nursing Care
Domain 6: Infection Control & Isolation Precautions
Domain 7: Patient Education & Health Literacy
Domain 8: Clinical Judgment & Prioritization
Domain 9: Documentation & Handoff Communication
Domain 10: NCLEX-RN Test-Taking Strategies
Answer Key & Score Table
Page 2
, Fundamentals of Nursing II Exam 1 | 2026/2027
DOMAIN 1: Advanced Medication Administration & IV
Therapy
1. A nurse is preparing to administer IV vancomycin 1 g every 12 hours. The pharmacy
dispenses vancomycin 1 g in 250 mL of 0.9% NaCl to infuse over 90 minutes. The drop
factor is 15 gtt/mL. How many gtt/min should the nurse set the IV pump to deliver?
A) 42 gtt/min
B) 42 gtt/min (calculated: 250 mL / 90 min x 15 gtt/mL = 41.7, round to 42)
C) 62 gtt/min
D) 28 gtt/min
Rationale: The calculation is (250 mL x 15 gtt/mL) / 90 minutes = 3, = 41.67, rounded to
42 gtt/min. ATI Nursing Fundamentals emphasizes verifying IV infusion rates using the formula
Volume (mL) x Drop Factor / Time (min). Options A and B reflect the same correct value; option
C represents an incorrect calculation, and option D is significantly below the required rate,
which would cause the medication to be delivered too slowly. NCLEX prioritizes safe medication
administration and accurate dosage calculation.
2. A nurse assesses a patient receiving a continuous heparin infusion at 1,200 units/hour.
The aPTT result is 42 seconds, and the therapeutic range is 60-80 seconds. What is the
nurse's priority action?
A) Increase the heparin infusion rate by 2 units/kg/hr
B) Continue the current rate and recheck aPTT in 6 hours
C) Stop the infusion immediately and notify the provider
D) Administer protamine sulfate as prescribed
Rationale: A subtherapeutic aPTT of 42 seconds (therapeutic range 60-80 seconds) indicates the
heparin dose is insufficient to prevent thrombus formation. Per NCSBN guidelines for high-alert
medications, the nurse should follow institutional heparin titration protocols, which typically
recommend increasing the rate based on a standardized nomogram. Option B is incorrect
Page 3
, Fundamentals of Nursing II Exam 1 | 2026/2027
because continuing the current rate places the patient at risk for clot extension. Option C is
reserved for signs of active bleeding, and option D (protamine sulfate) is the reversal agent for
heparin toxicity, not subtherapeutic levels.
3. Which of the following is the correct procedure for administering an intramuscular
(IM) injection into the ventrogluteal site?
A) Position the patient supine, locate the site 2 inches below the anterior
superior iliac spine
B) Position the patient prone or side-lying, place the heel of the hand on
the greater trochanter with the index finger on the anterior superior iliac
spine, inject into the triangle formed
C) Place the patient in a high-Fowler position, inject at a 90-degree angle using
a 25-gauge 5/8-inch needle
D) Aspirate for 5 seconds before injection to confirm placement outside a blood
vessel
Rationale: The ventrogluteal site is located by placing the heel of the hand on the greater
trochanter, pointing the index finger toward the anterior superior iliac spine, and injecting into
the V-shaped triangle formed. This site is preferred for IM injections in adults because it is free of
major nerves and blood vessels, accommodates larger volumes (up to 3 mL), and is the safest site
per ATI and CDC guidelines. Option A describes an incorrect landmark, option C describes an
inappropriate patient position and needle gauge for IM injection, and option D is outdated—
current evidence does not support routine aspiration for IM vaccines or immunizations in the
ventrogluteal site.
4. A nurse is caring for a patient with a peripheral IV catheter in the left forearm. The
nurse notes swelling, coolness, and pallor at the insertion site. The patient reports pain
rated 7/10. What is the nurse's priority action?
A) Slow the infusion rate and apply warm compresses
B) Discontinue the IV, elevate the extremity, and restart at a new site
C) Apply a pressure dressing and reassess in 30 minutes
D) Flush the catheter with normal saline to check patency
Page 4
