, NU 136: Fundamentals of Nursing Final
Exam Questions and Answers with
Rationale 2026/2027 Update
Question 1
A nurse is preparing to administer surgical staple removal for a
postoperative abdominal incision on day ten. Which intervention
is essential for safe staple removal?
A. Remove all staples simultaneously in a single swift
motion.
B. Use a sterile staple extractor, removing every other staple
first while inspecting the incision to ensure adequate wound
healing and approximation before removing the remaining
staples.
C. Pull staples out forcefully with bare fingers.
D. Apply strong liquid adhesive over the staples before
extraction.
Correct Answer: B. Use a sterile staple extractor, removing
every other staple first while inspecting the incision to
ensure adequate wound healing and approximation before
removing the remaining staples.
Expert Rationale: Removing surgical staples requires caution
to prevent wound dehiscence. Removing every other staple first
verifies that the underlying tissue is securely healed and closed
before the rest are extracted.
,Question 2
A nurse is caring for a client on the first postoperative day
following open abdominal surgery. Which nursing intervention
is most effective in preventing pulmonary complications such as
atelectasis?
A. Enforce strict continuous bed rest with zero movement for
seven days.
B. Assist the client with regular incentive spirometry, deep
breathing exercises, early ambulation, and frequent position
changes.
C. Administer high-dose cough suppressants around the
clock.
D. Restrict oral fluid intake completely.
Correct Answer: B. Assist the client with regular incentive
spirometry, deep breathing exercises, early ambulation, and
frequent position changes.
Expert Rationale: Anesthesia, surgical pain, and immobility
promote alveolar collapse and mucus retention. Incentive
spirometry expands alveoli, promotes deep breathing, and
coupled with early ambulation, significantly reduces pulmonary
complications.
Question 3
A physician order prescribes amoxicillin oral suspension 250
milligrams by mouth every eight hours. The pharmacy supplies
amoxicillin oral suspension labeled 125 milligrams per 5
, milliliters. How many milliliters should the nurse administer per
dose?
A. 5 milliliters
B. 10 milliliters
C. 15 milliliters
D. 2.5 milliliters
Correct Answer: B. 10 milliliters
Expert Rationale: Using the formula dose ordered divided by
dose available multiplied by volume: 250 milligrams divided by
125 milligrams multiplied by 5 milliliters equals 10 milliliters.
Question 4
A nurse enters a client room and notices that the peripheral
intravenous site in the left forearm is swollen, cool to the touch,
pale, and leaking fluid around the insertion site, while the
infusion has slowed significantly. How should the nurse
interpret and manage this finding?
A. The intravenous line is patent; continue the infusion as
ordered.
B. The intravenous line has infiltrated. The nurse must
immediately stop the infusion, disconnect the tubing,
remove the catheter, elevate the extremity, and apply a
warm or cold compress according to institutional policy
and the type of fluid infused.
Exam Questions and Answers with
Rationale 2026/2027 Update
Question 1
A nurse is preparing to administer surgical staple removal for a
postoperative abdominal incision on day ten. Which intervention
is essential for safe staple removal?
A. Remove all staples simultaneously in a single swift
motion.
B. Use a sterile staple extractor, removing every other staple
first while inspecting the incision to ensure adequate wound
healing and approximation before removing the remaining
staples.
C. Pull staples out forcefully with bare fingers.
D. Apply strong liquid adhesive over the staples before
extraction.
Correct Answer: B. Use a sterile staple extractor, removing
every other staple first while inspecting the incision to
ensure adequate wound healing and approximation before
removing the remaining staples.
Expert Rationale: Removing surgical staples requires caution
to prevent wound dehiscence. Removing every other staple first
verifies that the underlying tissue is securely healed and closed
before the rest are extracted.
,Question 2
A nurse is caring for a client on the first postoperative day
following open abdominal surgery. Which nursing intervention
is most effective in preventing pulmonary complications such as
atelectasis?
A. Enforce strict continuous bed rest with zero movement for
seven days.
B. Assist the client with regular incentive spirometry, deep
breathing exercises, early ambulation, and frequent position
changes.
C. Administer high-dose cough suppressants around the
clock.
D. Restrict oral fluid intake completely.
Correct Answer: B. Assist the client with regular incentive
spirometry, deep breathing exercises, early ambulation, and
frequent position changes.
Expert Rationale: Anesthesia, surgical pain, and immobility
promote alveolar collapse and mucus retention. Incentive
spirometry expands alveoli, promotes deep breathing, and
coupled with early ambulation, significantly reduces pulmonary
complications.
Question 3
A physician order prescribes amoxicillin oral suspension 250
milligrams by mouth every eight hours. The pharmacy supplies
amoxicillin oral suspension labeled 125 milligrams per 5
, milliliters. How many milliliters should the nurse administer per
dose?
A. 5 milliliters
B. 10 milliliters
C. 15 milliliters
D. 2.5 milliliters
Correct Answer: B. 10 milliliters
Expert Rationale: Using the formula dose ordered divided by
dose available multiplied by volume: 250 milligrams divided by
125 milligrams multiplied by 5 milliliters equals 10 milliliters.
Question 4
A nurse enters a client room and notices that the peripheral
intravenous site in the left forearm is swollen, cool to the touch,
pale, and leaking fluid around the insertion site, while the
infusion has slowed significantly. How should the nurse
interpret and manage this finding?
A. The intravenous line is patent; continue the infusion as
ordered.
B. The intravenous line has infiltrated. The nurse must
immediately stop the infusion, disconnect the tubing,
remove the catheter, elevate the extremity, and apply a
warm or cold compress according to institutional policy
and the type of fluid infused.
