1 MAXE · 422 RN
★ ★
C College of Nursing & Public Health
EST. 1889
EXTRAORDINARY CARE. EXTRAORDINARY NURSES.
NR224 EXAM 1
F U N DA M E N TA LS O F N U RS I N G — CO M P R E H E N S I V E E X A M I N AT I O N
INSTITUTION Chamberlain University COURSE CODE NR 224
PROGRAM Bachelor of Science in Nursing — ACADEMIC YEAR
BSN
EXAM TITLE NR224 EXAM 1 TOTAL QUESTIONS 80 Questions
COURSE TITLE Fundamentals of Nursing FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise instructed.
▸ Select all that apply questions are indicated and may have more than one correct answer.
▸ Content covers critical thinking, nursing process, infection control, vital signs, mobility, and patient
safety.
▸ Correct answers and evidence-based rationales appear below each question.
▸ All content reflects current nursing practice standards and NCLEX-style question formatting.
, SECTION I — NR224: FUNDAMENTALS OF NURSING —
Questions 1 – 80
EXAM 1
1. 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 then checks the condition of
the site where the IV catheter enters the patient's skin. After the nurse readjusts the flow
rate, the infusion begins at the correct rate. This is an example of:
A. Inference
B. Diagnostic reasoning
C. Competency
D. Problem solving
CORRECT ANSWER D — Problem solving
RATIONALE Problem solving involves identifying an issue (IV not infusing), systematically
assessing potential causes (pain, regulator, tubing position, connections, site
condition), and implementing a solution (readjusting the flow rate) that resolves
the problem. The nurse moved through a logical sequence to identify and correct
the problem. Diagnostic reasoning involves forming a nursing diagnosis from
assessment data, which was not the primary action here. Inference is drawing a
conclusion from evidence, which is only one component. Competency is a general
attribute, not the specific cognitive process demonstrated.
,2. The nurse sits down to talk with a patient who lost her sister 2 weeks ago. The patient
reports she is unable to sleep, feels very fatigued during the day, and is having trouble at
work. The nurse asks her to clarify the type of trouble. The patient explains she can't
concentrate or even solve simple problems. The nurse records the results of the
assessment, describing the patient as having ineffective coping. This is an example of:
A. Diagnostic reasoning
B. Competency
C. Inference
D. Problem solving
CORRECT ANSWER A — Diagnostic reasoning
RATIONALE Diagnostic reasoning is the process of collecting assessment data (sleep
disturbance, fatigue, work difficulty, concentration problems), clustering cues,
and formulating a nursing diagnosis (ineffective coping). The nurse gathered
subjective and objective data, analyzed the pattern, and assigned a diagnostic
label that directs nursing care. Problem solving focuses on resolving a specific
problem rather than forming a diagnostic conclusion. Inference is drawing a
conclusion from data — a component of diagnostic reasoning but not the
complete process demonstrated here.
, 3. A patient on a surgical unit develops sudden shortness of breath and a drop in BP. The
staff respond, but the patient dies 30 minutes later. The manager on the nursing unit calls
the staff involved in the emergency response together. The staff discusses what occurred
over the 30 minute time frame, the actions taken, and whether other steps should have
been implemented. The nurses in this situation are:
A. Problem solving
B. Showing humility
C. Conducting reflective practice
D. Exercising responsibility
CORRECT ANSWER C — Conducting reflective practice
RATIONALE Reflective practice involves reviewing a clinical experience, analyzing actions
taken, considering alternative approaches, and learning from the situation to
improve future practice. The staff discussion of what occurred, actions taken, and
whether other steps should have been implemented is the essence of reflective
practice — a structured debriefing that promotes professional growth. Problem
solving focuses on finding solutions to active problems. Showing humility and
exercising responsibility may be components of the reflective process but do not
capture the full activity described.