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This comprehensive 200-question practice set is designed for the NR 224
Fundamentals Exam, covering essential nursing concepts including
medication administration, sterile technique, wound care, vital signs
assessment, patient safety, fall prevention, fluid and electrolyte balance,
nutrition, elimination, mobility, and perioperative care. Every question is
completely unique, with no repetition of clinical scenarios, medications,
nursing procedures, or assessment findings. Each question includes four
multiple-choice options, a correct answer, and a detailed rationale explaining
the underlying nursing principle or priority action. This resource is intended
for supplemental exam preparation only and is not affiliated with or endorsed
by any specific nursing program. Use it to reinforce critical thinking and
identify knowledge gaps for exam success.
1. A nurse is preparing medications for a patient. The nurse checks the name of the
medication on the label with the name of the medication on the doctor's order. At
the bedside the nurse checks the patient's name against the medication order as
well. The nurse is following which critical thinking attitude?
A) Creativity
B) Humility
C) Responsibility
D) Fairness
Answer: C
Rationale: The nurse is demonstrating responsibility by systematically verifying
the medication against the order and confirming the patient's identity before
administration. Responsibility is a critical thinking attitude that involves following
through on obligations and being accountable for one's actions in patient care .
2. A nurse has seen many cancer patients struggle with pain management because
they are afraid of becoming addicted to the medicine. Pain control is a priority for
cancer care. By helping patients focus on their values and beliefs about pain
control, a nurse can best make clinical decisions. This is an example of:
,A) Creativity
B) Fairness
C) Clinical reasoning
D) Applying ethical criteria
Answer: D
Rationale: The nurse is applying ethical criteria by considering the patient's values,
beliefs, and perspective when making clinical decisions. Ethical reasoning
integrates the patient's rights, values, and preferences into care planning .
3. Which of the following describes a nurse's application of a specific knowledge
base during critical thinking? (Select all that apply.)
A) Initiative in reading current evidence from the literature
B) Application of nursing theory
C) Reviewing a policy and procedure manual
D) Considering a colleague's view of a patient's needs
E) Previous time caring for a specific group of patients
Answer: A, B, C, E
Rationale: A specific knowledge base includes reading current evidence, applying
nursing theory, reviewing policies and procedures, and drawing from previous
clinical experiences. Considering a colleague's view reflects collaboration, not the
nurse's own specific knowledge base .
4. A nurse is completing the following steps during her shift of care. Which are
steps of nursing assessment? (Select all that apply.)
A) Review of patient data in the medical record
B) Confirming a patient's self-report of abdominal pain by inspecting the abdomen
C) Reporting results of an ongoing assessment to a nurse working the next
scheduled shift
D) Analyzing a set of signs revealing lower leg weakness and unsteady gait with a
pattern of mobility alteration
E) Conducting an interview of a family caregiver
Answer: A, B, E
Rationale: Nursing assessment includes data collection through reviewing records,
physical examination, and interviewing patients and family caregivers. Analyzing
data and reporting findings are part of diagnosis and communication, not the
assessment step itself .
5. A nurse initiates a brief interview with a patient who has come to the medical
clinic because of self-reported hoarseness, sore throat, and chest congestion. The
nurse observes that the patient has a slumped posture and is using intercostal
,muscles to breathe. The nurse auscultates the patient's lungs and hears crackles in
the left lower lobe. The patient's respiratory rate is 20 per minute compared with an
average of 16 per minute during previous clinic visits. The patient tells the nurse,
"It is hard for me to get a breath." Which of the following data sets are examples of
subjective data? (Select all that apply.)
A) Heart rate of 20 per minute and chest congestion
B) Lung sounds revealing crackles and use of intercostal muscles to breathe
C) Patient statement, "It's hard for me to get a breath"
D) Patient self-report of hoarseness and sore throat
Answer: C, D
Rationale: Subjective data are information reported by the patient, including
symptoms and feelings such as difficulty breathing, hoarseness, and sore throat.
Objective data are measurable and observable, such as heart rate, lung sounds, and
use of accessory muscles .
6. A client is a chronic carrier of infection. To prevent the spread of the infection to
other clients or health care providers, the nurse emphasizes interventions that do
which of the following?
A) Eliminate the reservoir
B) Block the portal of exit from the reservoir
C) Block the portal of entry into the host
D) Decrease the susceptibility of the host
Answer: B
Rationale: Blocking the portal of exit from the reservoir prevents the organism
from reaching other persons. Since the carrier is the reservoir and the condition is
chronic, the reservoir cannot be eliminated. Blocking the portal of entry or
decreasing host susceptibility protects only one individual at a time .
7. Which is the most effective nursing action for controlling the spread of
infection?
A) Thorough hand hygiene
B) Wearing gloves and masks when providing direct client care
C) Implementing appropriate isolation precautions
D) Administering broad-spectrum prophylactic antibiotics
Answer: A
Rationale: Hands are frequently in contact with clients and equipment, making
them the most obvious source of transmission. Regular and routine hand hygiene is
the most effective way to prevent movement of potentially infective materials .
, 8. According to the 2025 AHA guideline, normal adult blood pressure is defined
as:
A) <120/80 mmHg
B) 120-129/<80 mmHg
C) <130/80 mmHg
D) 130-139/80-89 mmHg
Answer: A
Rationale: The 2025 AHA guideline defines normal adult blood pressure as
<120/80 mmHg. Elevated BP is defined as 120-129/<80 mmHg, which aligns with
a new prevention focus .
9. A nurse is instructing an assistive personnel about caring for a client who has a
low platelet count as a result of chemotherapy. Which instruction is the priority for
measuring vital signs for this client?
A) "Do not measure the client's temperature rectally."
B) "Count the client's radial pulse for 30 seconds and multiply it by 2."
C) "Do not let the client know you are counting her respirations."
D) "Let the client rest for 5 minutes before you measure her blood pressure."
Answer: A
Rationale: For a client with low platelet count (thrombocytopenia), the priority is
to avoid rectal trauma that could cause bleeding. The rectal route is contraindicated
due to the risk of injury and hemorrhage .
10. A nurse who is admitting a client who has a fractured femur obtains a blood
pressure reading of 140/94 mm Hg. The client denies any history of hypertension.
Which action should the nurse take first?
A) Request a prescription for an antihypertensive medication
B) Ask the client if she is having pain
C) Request a prescription for antianxiety medication
D) Return in 30 min to recheck the client's blood pressure
Answer: B
Rationale: Pain is a common cause of elevated blood pressure. Before assuming
hypertension, the nurse should first assess for contributing factors such as pain,
anxiety, or discomfort. The elevated reading may be temporary and related to the
client's acute injury .
11. While assessing a patient, the nurse observes the patient's IV line is not
infusing at the ordered rate. The nurse assesses the patient for pain at the IV site,
checks the flow regulator on the tubing, looks to see if the patient is lying on the
tubing, checks the point of connection between the tubing and the IV catheter, and