NSG 3130 Fundamentals II Exam 2026/2027 | 300 Practice Questions,
Correct Answers & Detailed Rationales | Complete Nursing Study
Guide
Question 1
A nurse is caring for a patient who is on strict bed rest. Which nursing
intervention is the most effective in preventing the formation of deep
vein thrombosis (DVT)?
• A. Placing pillows under the patient's knees
• B. Massaging the calf muscles twice daily
• C. Encouraging active foot and ankle exercises hourly while awake
• D. Restricting fluid intake to minimize frequent urination
Correct Answer: C. Encouraging active foot and ankle exercises hourly
while awake
Detailed Rationale: Active foot and ankle exercises (such as ankle
pumps and circles) engage the calf muscle pump, promoting venous
return and preventing stasis of blood, which is a primary contributor to
DVT formation. Placing pillows directly under knees can compress the
popliteal artery/vein and increase venous stasis. Massaging calves is
strictly contraindicated because it can dislodge an existing, unsuspected
thrombus, leading to a pulmonary embolism.
Question 2
A healthcare provider orders a 24-hour urine collection for a patient
evaluating renal function. Which instruction must the nurse give the
patient regarding the collection process?
, • A. Save the first morning urine void on Day 1 as the start of the
specimen collection.
• B. Discard the first morning urine void on Day 1, then collect all
subsequent urine for 24 hours including the first void of Day 2.
• C. Keep the urine specimen at room temperature throughout the
24-hour period.
• D. Collect only the midstream portion of each voiding throughout
the 24 hours.
Correct Answer: B. Discard the first morning urine void on Day 1, then
collect all subsequent urine for 24 hours including the first void of Day
2.
Detailed Rationale: The 24-hour collection begins after the patient
voids and discards the first urine specimen in the morning. This ensures
that the collection starts with an empty bladder containing no residual
urine from the night before. All urine produced over the next 24
hours—ending with the first morning void on the following day—must
be collected and kept refrigerated or on ice to prevent bacterial growth
and chemical breakdown.
Question 3
A nurse is preparing to administer an intramuscular (IM) injection to an
adult patient who is receiving a 3 mL volume of medication. Which
anatomical site is the safest and most preferred choice for this volume?
• A. Deltoid muscle
• B. Ventrogluteal site
• C. Vastus lateralis site
, • D. Dorsogluteal site
Correct Answer: B. Ventrogluteal site
Detailed Rationale: The ventrogluteal site is the preferred and safest
site for IM injections in adults, especially for volumes up to 3 mL. It
provides a deep, large muscle mass away from major nerves (such as
the sciatic nerve) and large blood vessels. The deltoid muscle is
recommended only for small volumes (≤ 1 mL). The dorsogluteal site is
no longer recommended due to proximity to the sciatic nerve and
superior gluteal artery.
Question 4
A patient with a stage 2 pressure injury on the sacrum requires a
dressing change. Which dressing type is most appropriate for a clean,
stage 2 pressure injury with minimal exudate?
• A. Hydrocolloid dressing
• B. Alginate dressing
• C. Wet-to-dry gauze dressing
• D. Enzymatic debriding ointment with dry gauze
Correct Answer: A. Hydrocolloid dressing
Detailed Rationale: Hydrocolloid dressings maintain a moist wound-
healing environment, protect partial-thickness wounds (Stage 2
pressure injuries) from friction and external contamination, and are
appropriate for wounds with light to moderate exudate. Alginate
dressings are designed for heavy exudate. Wet-to-dry dressings cause
mechanical autolytic debridement and can damage newly granulating
tissue.
, Question 5
A patient with chronic obstructive pulmonary disease (COPD) is
receiving oxygen via nasal cannula. Why must the nurse exercise
caution when increasing the oxygen flow rate above 2 L/min for this
patient?
• A. High oxygen concentrations irritate the nasal mucosa and cause
epistaxis.
• B. High oxygen concentrations can suppress the hypoxic
respiratory drive in hypercapnic patients.
• C. It increases the risk of oxygen toxicity within 30 minutes.
• D. It causes hyperventilation and metabolic alkalosis.
Correct Answer: B. High oxygen concentrations can suppress the
hypoxic respiratory drive in hypercapnic patients.
Detailed Rationale: Patients with severe COPD often have chronically
elevated arterial carbon dioxide levels (PaCO2 ) and rely on low oxygen
levels (PaO2 ) as their primary stimulus (hypoxic drive) to breathe.
Supplying high oxygen levels can increase arterial oxygen levels,
abolishing this drive, which can lead to hypoventilation, respiratory
depression, and severe carbon dioxide narcosis.
Question 6
When measuring a patient's blood pressure, the nurse chooses a cuff
where the inflatable bladder width covers 20% of the patient's upper
arm circumference. What effect will this cuff size have on the blood
pressure reading?
• A. The reading will be falsely low.
Correct Answers & Detailed Rationales | Complete Nursing Study
Guide
Question 1
A nurse is caring for a patient who is on strict bed rest. Which nursing
intervention is the most effective in preventing the formation of deep
vein thrombosis (DVT)?
• A. Placing pillows under the patient's knees
• B. Massaging the calf muscles twice daily
• C. Encouraging active foot and ankle exercises hourly while awake
• D. Restricting fluid intake to minimize frequent urination
Correct Answer: C. Encouraging active foot and ankle exercises hourly
while awake
Detailed Rationale: Active foot and ankle exercises (such as ankle
pumps and circles) engage the calf muscle pump, promoting venous
return and preventing stasis of blood, which is a primary contributor to
DVT formation. Placing pillows directly under knees can compress the
popliteal artery/vein and increase venous stasis. Massaging calves is
strictly contraindicated because it can dislodge an existing, unsuspected
thrombus, leading to a pulmonary embolism.
Question 2
A healthcare provider orders a 24-hour urine collection for a patient
evaluating renal function. Which instruction must the nurse give the
patient regarding the collection process?
, • A. Save the first morning urine void on Day 1 as the start of the
specimen collection.
• B. Discard the first morning urine void on Day 1, then collect all
subsequent urine for 24 hours including the first void of Day 2.
• C. Keep the urine specimen at room temperature throughout the
24-hour period.
• D. Collect only the midstream portion of each voiding throughout
the 24 hours.
Correct Answer: B. Discard the first morning urine void on Day 1, then
collect all subsequent urine for 24 hours including the first void of Day
2.
Detailed Rationale: The 24-hour collection begins after the patient
voids and discards the first urine specimen in the morning. This ensures
that the collection starts with an empty bladder containing no residual
urine from the night before. All urine produced over the next 24
hours—ending with the first morning void on the following day—must
be collected and kept refrigerated or on ice to prevent bacterial growth
and chemical breakdown.
Question 3
A nurse is preparing to administer an intramuscular (IM) injection to an
adult patient who is receiving a 3 mL volume of medication. Which
anatomical site is the safest and most preferred choice for this volume?
• A. Deltoid muscle
• B. Ventrogluteal site
• C. Vastus lateralis site
, • D. Dorsogluteal site
Correct Answer: B. Ventrogluteal site
Detailed Rationale: The ventrogluteal site is the preferred and safest
site for IM injections in adults, especially for volumes up to 3 mL. It
provides a deep, large muscle mass away from major nerves (such as
the sciatic nerve) and large blood vessels. The deltoid muscle is
recommended only for small volumes (≤ 1 mL). The dorsogluteal site is
no longer recommended due to proximity to the sciatic nerve and
superior gluteal artery.
Question 4
A patient with a stage 2 pressure injury on the sacrum requires a
dressing change. Which dressing type is most appropriate for a clean,
stage 2 pressure injury with minimal exudate?
• A. Hydrocolloid dressing
• B. Alginate dressing
• C. Wet-to-dry gauze dressing
• D. Enzymatic debriding ointment with dry gauze
Correct Answer: A. Hydrocolloid dressing
Detailed Rationale: Hydrocolloid dressings maintain a moist wound-
healing environment, protect partial-thickness wounds (Stage 2
pressure injuries) from friction and external contamination, and are
appropriate for wounds with light to moderate exudate. Alginate
dressings are designed for heavy exudate. Wet-to-dry dressings cause
mechanical autolytic debridement and can damage newly granulating
tissue.
, Question 5
A patient with chronic obstructive pulmonary disease (COPD) is
receiving oxygen via nasal cannula. Why must the nurse exercise
caution when increasing the oxygen flow rate above 2 L/min for this
patient?
• A. High oxygen concentrations irritate the nasal mucosa and cause
epistaxis.
• B. High oxygen concentrations can suppress the hypoxic
respiratory drive in hypercapnic patients.
• C. It increases the risk of oxygen toxicity within 30 minutes.
• D. It causes hyperventilation and metabolic alkalosis.
Correct Answer: B. High oxygen concentrations can suppress the
hypoxic respiratory drive in hypercapnic patients.
Detailed Rationale: Patients with severe COPD often have chronically
elevated arterial carbon dioxide levels (PaCO2 ) and rely on low oxygen
levels (PaO2 ) as their primary stimulus (hypoxic drive) to breathe.
Supplying high oxygen levels can increase arterial oxygen levels,
abolishing this drive, which can lead to hypoventilation, respiratory
depression, and severe carbon dioxide narcosis.
Question 6
When measuring a patient's blood pressure, the nurse chooses a cuff
where the inflatable bladder width covers 20% of the patient's upper
arm circumference. What effect will this cuff size have on the blood
pressure reading?
• A. The reading will be falsely low.
