# 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 administer a medication to a patient with dysphagia. Which action should the
nurse take first?
A. Crush all medications and mix with applesauce
B. Request a liquid formulation of the medication
C. Assess the patient's ability to swallow safely
D. Place the medication in the patient's mouth with water
💫ANSWER✔️✔️: C. Assess the patient's ability to swallow safely
💫RATIONALE✔️✔️: Assessment is the priority before any intervention; determining swallow safety
prevents aspiration and guides appropriate medication administration.
---
**Question 2**
A patient with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of 88% on room
air. Which oxygen delivery device should the nurse use?
A. Non-rebreather mask at 15 L/min
B. Venturi mask at 24% FiO2
C. Nasal cannula at 2 L/min
D. Simple face mask at 6 L/min
,💫ANSWER✔️✔️: C. Nasal cannula at 2 L/min
💫RATIONALE✔️✔️: Low-flow oxygen via nasal cannula is appropriate for COPD patients to prevent
respiratory drive suppression; saturation should be maintained at 88-92%.
---
**Question 3**
A nurse is assessing a patient's wound and notes the edges are approximated and there is no drainage.
Which phase of wound healing is the patient most likely in?
A. Hemostasis
B. Inflammatory phase
C. Proliferative phase
D. Maturation phase
💫ANSWER✔️✔️: D. Maturation phase
💫RATIONALE✔️✔️: Approximation of wound edges without drainage indicates the final maturation
phase where collagen remodeling occurs; healing is nearly complete.
---
**Question 4**
A patient is prescribed metoprolol for hypertension. Which assessment finding should the nurse report
to the provider before administration?
A. Blood pressure of 118/76 mmHg
B. Heart rate of 52 beats per minute
C. Respiratory rate of 16 breaths per minute
D. Temperature of 98.6°F
,💫ANSWER✔️✔️: B. Heart rate of 52 beats per minute
💫RATIONALE✔️✔️: Metoprolol is a beta-blocker that can cause bradycardia; a heart rate below 60
requires holding the medication and notifying the provider.
---
**Question 5**
A patient is receiving total parenteral nutrition (TPN). Which nursing action is essential to prevent
infection?
A. Change the TPN tubing every 24 hours
B. Monitor blood glucose levels twice daily
C. Weigh the patient daily
D. Infuse the TPN through a peripheral IV site
💫ANSWER✔️✔️: A. Change the TPN tubing every 24 hours
💫RATIONALE✔️✔️: TPN is a hypertonic solution that supports bacterial growth; tubing and filter should
be changed every 24 hours to prevent infection.
---
**Question 6**
A patient with a history of falls is being discharged. Which intervention should the nurse prioritize in the
discharge plan?
A. Encourage the patient to wear reading glasses at all times
B. Remove throw rugs and ensure adequate lighting
C. Limit the patient's ambulation to reduce fall risk
D. Keep the patient's bed in the highest position for ease of transfer
, 💫ANSWER✔️✔️: B. Remove throw rugs and ensure adequate lighting
💫RATIONALE✔️✔️: Removing tripping hazards and ensuring lighting are evidence-based fall prevention
strategies; limiting mobility is not recommended.
---
**Question 7**
A nurse is preparing to insert an indwelling urinary catheter. Which action maintains sterile technique?
A. Place the sterile field on the patient's bedside table
B. Open the catheter kit with sterile gloves
C. Use the sterile drape with the shiny side down
D. Clean the meatus with a back-and-forth motion
💫ANSWER✔️✔️: C. Use the sterile drape with the shiny side down
💫RATIONALE✔️✔️: The sterile drape should have the shiny side down to prevent slippage; cleansing
should be front-to-back and sterile gloves are used for the procedure.
---
**Question 8**
A patient with diabetes mellitus has a blood glucose level of 65 mg/dL and is conscious. Which
intervention should the nurse implement first?
A. Administer glucagon intramuscularly
B. Give the patient 4 ounces of orange juice
C. Provide the patient with a peanut butter sandwich
D. Administer 50% dextrose IV push
Blueprint | Comprehensive Practice Questions with Detailed
Rationales | Updated 2026 Edition
---
**Question 1**
A nurse is preparing to administer a medication to a patient with dysphagia. Which action should the
nurse take first?
A. Crush all medications and mix with applesauce
B. Request a liquid formulation of the medication
C. Assess the patient's ability to swallow safely
D. Place the medication in the patient's mouth with water
💫ANSWER✔️✔️: C. Assess the patient's ability to swallow safely
💫RATIONALE✔️✔️: Assessment is the priority before any intervention; determining swallow safety
prevents aspiration and guides appropriate medication administration.
---
**Question 2**
A patient with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of 88% on room
air. Which oxygen delivery device should the nurse use?
A. Non-rebreather mask at 15 L/min
B. Venturi mask at 24% FiO2
C. Nasal cannula at 2 L/min
D. Simple face mask at 6 L/min
,💫ANSWER✔️✔️: C. Nasal cannula at 2 L/min
💫RATIONALE✔️✔️: Low-flow oxygen via nasal cannula is appropriate for COPD patients to prevent
respiratory drive suppression; saturation should be maintained at 88-92%.
---
**Question 3**
A nurse is assessing a patient's wound and notes the edges are approximated and there is no drainage.
Which phase of wound healing is the patient most likely in?
A. Hemostasis
B. Inflammatory phase
C. Proliferative phase
D. Maturation phase
💫ANSWER✔️✔️: D. Maturation phase
💫RATIONALE✔️✔️: Approximation of wound edges without drainage indicates the final maturation
phase where collagen remodeling occurs; healing is nearly complete.
---
**Question 4**
A patient is prescribed metoprolol for hypertension. Which assessment finding should the nurse report
to the provider before administration?
A. Blood pressure of 118/76 mmHg
B. Heart rate of 52 beats per minute
C. Respiratory rate of 16 breaths per minute
D. Temperature of 98.6°F
,💫ANSWER✔️✔️: B. Heart rate of 52 beats per minute
💫RATIONALE✔️✔️: Metoprolol is a beta-blocker that can cause bradycardia; a heart rate below 60
requires holding the medication and notifying the provider.
---
**Question 5**
A patient is receiving total parenteral nutrition (TPN). Which nursing action is essential to prevent
infection?
A. Change the TPN tubing every 24 hours
B. Monitor blood glucose levels twice daily
C. Weigh the patient daily
D. Infuse the TPN through a peripheral IV site
💫ANSWER✔️✔️: A. Change the TPN tubing every 24 hours
💫RATIONALE✔️✔️: TPN is a hypertonic solution that supports bacterial growth; tubing and filter should
be changed every 24 hours to prevent infection.
---
**Question 6**
A patient with a history of falls is being discharged. Which intervention should the nurse prioritize in the
discharge plan?
A. Encourage the patient to wear reading glasses at all times
B. Remove throw rugs and ensure adequate lighting
C. Limit the patient's ambulation to reduce fall risk
D. Keep the patient's bed in the highest position for ease of transfer
, 💫ANSWER✔️✔️: B. Remove throw rugs and ensure adequate lighting
💫RATIONALE✔️✔️: Removing tripping hazards and ensuring lighting are evidence-based fall prevention
strategies; limiting mobility is not recommended.
---
**Question 7**
A nurse is preparing to insert an indwelling urinary catheter. Which action maintains sterile technique?
A. Place the sterile field on the patient's bedside table
B. Open the catheter kit with sterile gloves
C. Use the sterile drape with the shiny side down
D. Clean the meatus with a back-and-forth motion
💫ANSWER✔️✔️: C. Use the sterile drape with the shiny side down
💫RATIONALE✔️✔️: The sterile drape should have the shiny side down to prevent slippage; cleansing
should be front-to-back and sterile gloves are used for the procedure.
---
**Question 8**
A patient with diabetes mellitus has a blood glucose level of 65 mg/dL and is conscious. Which
intervention should the nurse implement first?
A. Administer glucagon intramuscularly
B. Give the patient 4 ounces of orange juice
C. Provide the patient with a peanut butter sandwich
D. Administer 50% dextrose IV push
