2026/2027 EXAM COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) WITH EXPLANATIONS
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(CHAMBERLAIN UNIVERSITY)
EXAM OVERVIEW & TEST STRUCTURE
NR 224 Fundamentals of Nursing Exam 3 covers foundational nursing concepts
including:
- Advanced Oxygenation and Respiratory Care
- Fluid, Electrolyte, and Acid-Base Balance
- Sleep and Rest
- Stress and Coping
- Loss, Grief, and Dying
- Sensory Alterations
- Self-Concept and Sexuality
- Spirituality and Culture
- Client Education
- Expanded Perioperative Nursing
- Legal and Ethical Concepts (Advanced)
SECTION 1: OXYGENATION & RESPIRATORY CARE (Questions 1–15)
QUESTION 1
A patient with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 88% on room air. The nurse should administer oxygen to maintain
the SpO2 in which target range?
A) 80-85%
B) 85-90%
C) 88-92%
D) 95-100%
ANSWER: C) 88-92%
RATIONALE: For patients with COPD, the target oxygen saturation is 88-92%.
These patients often have chronic CO2 retention and rely on a hypoxic
drive. High oxygen levels can eliminate this drive, leading to
hypoventilation, CO2 narcosis, and respiratory failure. SpO2 above 92% may
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,be harmful. The goal is adequate oxygenation without suppressing the
respiratory drive.
QUESTION 2
A nurse is assessing a patient with dyspnea. Which of the following is the
earliest sign of hypoxia?
A) Cyanosis
B) Restlessness and anxiety
C) Bradypnea
D) Hypotension
ANSWER: B) Restlessness and anxiety
RATIONALE: Restlessness and anxiety are early signs of hypoxia because the
brain is highly sensitive to decreased oxygen levels. Cyanosis is a late
sign and indicates severe hypoxia. Bradypnea and hypotension are also late
findings. The nurse must recognize subtle behavior changes as early
indicators of oxygenation problems.
QUESTION 3
A patient is receiving oxygen via a Venturi mask at 40%. Which statement about
the Venturi mask is correct?
A) It delivers a variable, non-precise FiO2
B) It delivers a precise FiO2 regardless of the patient's respiratory pattern
C) It delivers the highest FiO2 possible
D) It is used primarily for long-term oxygen therapy
ANSWER: B) It delivers a precise FiO2 regardless of the patient's respiratory
pattern
RATIONALE: The Venturi mask delivers a precise, fixed concentration of
oxygen (24-50%) that remains consistent regardless of the patient's
breathing pattern. This makes it ideal for patients with COPD who require
controlled oxygen. Non-rebreather masks deliver the highest FiO2 (up to 100%)
but are not precise.
QUESTION 4
A patient has just undergone a thoracentesis. Which assessment finding
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,requires immediate intervention?
A) Pain at the insertion site
B) Sudden onset of dyspnea and chest pain
C) Small amount of serous drainage
D) Heart rate of 88 beats/min
ANSWER: B) Sudden onset of dyspnea and chest pain
RATIONALE: Sudden dyspnea and chest pain after thoracentesis may indicate a
pneumothorax (collapsed lung) caused by the needle puncturing the lung
during the procedure. This is a serious complication requiring immediate
intervention. Pain at the insertion site, minimal serous drainage, and a
normal heart rate are expected findings.
QUESTION 5
A patient with pneumonia has a productive cough with thick, green sputum.
Which nursing intervention is most effective for mobilizing secretions?
A) Encourage the patient to cough forcefully
B) Administer a prescribed bronchodilator
C) Encourage increased oral fluid intake
D) Place the patient in a supine position
ANSWER: C) Encourage increased oral fluid intake
RATIONALE: Increased oral fluid intake (at least 2-3 L/day) thins respiratory
secretions, making them easier to mobilize and expectorate. Forceful
coughing can be fatiguing and less effective without hydration. Bronchodilators
open airways but do not thin secretions. Supine positioning impairs lung
expansion and secretion clearance.
QUESTION 6
Which of the following is a complication of oxygen therapy that the nurse
should monitor for in a patient receiving high-flow oxygen?
A) Oxygen-induced hypercapnia
B) Oxygen-induced hypoxemia
C) Oxygen-induced bradycardia
D) Oxygen-induced hypertension
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, ANSWER: A) Oxygen-induced hypercapnia
RATIONALE: High-flow oxygen can lead to oxygen-induced hypercapnia in
patients with chronic CO2 retention (e.g., COPD). The oxygen removes the
hypoxic drive, causing the patient to hypoventilate and retain CO2. This can
lead to confusion, lethargy, and respiratory acidosis. The nurse should
titrate oxygen to the lowest effective level.
QUESTION 7
A nurse is caring for a patient who is 2 days post-operative following
abdominal surgery. The patient is at risk for atelectasis. Which intervention
is most effective for preventing atelectasis?
A) Administering a bronchodilator
B) Encouraging use of the incentive spirometer every hour while awake
C) Placing the patient in the supine position
D) Restricting oral fluids to reduce secretion production
ANSWER: B) Encouraging use of the incentive spirometer every hour while awake
RATIONALE: Incentive spirometry promotes deep breathing and sustained
inspiration, which helps inflate alveoli and prevents atelectasis (lung
collapse). It is the most effective nursing intervention for preventing
post-operative atelectasis. Supine positioning worsens atelectasis, and
fluid restriction would thicken secretions.
QUESTION 8
A patient is being weaned from mechanical ventilation. Which assessment
finding indicates the patient is ready for extubation?
A) Spontaneous respirations with adequate tidal volume and negative inspiratory
force
B) Shallow, rapid respirations with decreased tidal volume
C) Inability to cough and clear secretions
D) Decreased level of consciousness
ANSWER: A) Spontaneous respirations with adequate tidal volume and negative
inspiratory force
RATIONALE: Successful weaning requires the patient to have spontaneous
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