Chamberlain NR224 Fundamentals Skills
Exam Prep Questions And Well Graded
Solutions
With Rationales Updated 2026-2027
Master your NR224 Fundamentals Skills exams at Chamberlain University with this ultimate study
resource. This comprehensive guide features premium multiple-choice questions with verified
answers and detailed nursing process rationales. Perfect for Exam 1, the Mastery Exam, and the
Comprehensive Final. Cover critical topics like surgical asepsis, vital signs, oxygenation devices,
wound care staging, and patient safety. Elevate your test scores and pass your nursing check-offs
with ease
1. A nurse is preparing to perform hand hygiene after providing care to a client who has
Clostridioides difficile. Which of the following methods should the nurse use?
a) Cleanse hands with an alcohol-based hand rub
b) Wash hands thoroughly with antimicrobial soap and water
c) Wipe hands with a chlorhexidine gluconate cloth
d) Rinse hands with sterile saline solution
b) Wash hands thoroughly with antimicrobial soap and water
Rationale: Clostridioides difficile forms spores that are highly resistant to alcohol-
based rubs. Physical friction with soap and running water is required to mechanically
rinse the spores off the skin.
2. A nurse is donning personal protective equipment (PPE) before entering an airborne
precaution room. Which of the following items must the nurse put on last?
a) Gown
b) N95 respirator
c) Face shield
d) Gloves
d) Gloves
Rationale: The standard sequence for donning PPE is gown, mask/respirator,
goggles/face shield, and then gloves. The gloves must be put on last so they can be
extended to cover the cuffs of the gown.
3. A nurse enters a client's room and finds a small fire burning in the wastebasket.
Which of the following actions should the nurse take first?
a) Open the window to let the smoke escape
b) Pull the fire alarm pin at the closest station
c) Remove the client from the room to a safe area
d) Smother the fire with a wet bath blanket
c) Remove the client from the room to a safe area
Rationale: The RACE acronym for fire safety stands for Rescue, Alarm, Confine, and
Extinguish/Evacuate. The priority action is always to rescue and move clients away
from immediate danger.
4. A nurse is planning care for a client who is at high risk for falls. Which of the
following interventions should the nurse include in the plan?
a) Keep all four side rails raised on the bed at all times
b) Place the bed in its highest position for easier exit
1|Page
, c) Complete a fall risk assessment tool once every week
d) Maintain the bed in its lowest position with wheels locked
d) Maintain the bed in its lowest position with wheels locked
Rationale: Keeping the bed in its lowest position reduces the distance of a potential
fall, and locking the wheels prevents the bed from moving when the client attempts
to stand. Raising four side rails is considered a physical restraint.
5. A nurse is caring for an older adult client who is alert but confused. The client
repeatedly attempts to get out of bed independently. Which of the following
alternatives to restraints should the nurse implement first?
a) Place a electronic bed alarm mattress pad under the client
b) Administer a mild sedative ordered on a PRN basis
c) Apply a soft waist belt while the client sits in bed
d) Request a prescription for a 1-to-1 continuous sitter
a) Place a electronic bed alarm mattress pad under the client
Rationale: Restraint alternatives should always be attempted before resorting to
physical or chemical restraints. A bed alarm provides an immediate audio alert to
staff when the client shifts weight to exit, allowing for prompt intervention.
6. A nurse is performing an admission assessment on a new client. Which of the
following activities represents the "Assessment" phase of the nursing process?
a) Formulating a nursing diagnosis of Impaired Skin Integrity
b) Measuring the client's bilateral lower extremity blood pressure
c) Documenting that the client's pain decreased after medication
d) Establishing a goal that the client will walk 50 feet by tomorrow
b) Measuring the client's bilateral lower extremity blood pressure
Rationale: Assessment involves the systematic collection of objective and subjective
data regarding the client's health status. Measuring vital signs is an objective
assessment technique.
7. A nurse writes the following target outcome for a client: "Client will ambulate 100 feet
down the hallway with a walker." Which of the following components is missing from
this SMART goal?
a) Specific behavior
b) Measurable criteria
c) Time-bound element
d) Realistic expectation
c) Time-bound element
Rationale: A SMART goal must be Specific, Measurable, Attainable, Realistic, and
Time-bound. This outcome states what and how the client will perform, but fails to
define a target timeframe (e.g., "by day 3 of hospitalization").
8. A nurse administers an analgesic to a client reporting pain rated 8 on a scale of 0 to
10. One hour later, the nurse returns and asks the client to rate their pain again.
Which phase of the nursing process is the nurse executing?
a) Evaluation
b) Analysis
c) Implementation
d) Planning
a) Evaluation
Rationale: The evaluation phase involves comparing the client's current health status
or responses against the established goals and interventions to determine if the
nursing actions were effective.
2|Page
,9. A nurse is caring for a client who is in contact precautions. When removing PPE
upon exiting the room, which item should the nurse remove first?
a) Mask
b) Gown
c) Gloves
d) Goggles
c) Gloves
Rationale: According to standard CDC sequences, gloves are considered the most
heavily contaminated item and should be removed first to prevent contaminating the
nurse's hands during the removal of other PPE.
10. A nurse is preparing a sterile field for a dressing change. Which of the following
actions by the nurse violates surgical asepsis?
a) Opening the outermost flap of the sterile kit wrapper away from the body
b) Placing a sterile package of 4x4 gauze onto the center of the field
c) Reaching across the open sterile field to pick up a container of saline
d) Keeping the entire sterile field within the direct line of sight
c) Reaching across the open sterile field to pick up a container of saline
Rationale: Reaching across a sterile field introduces the risk of micro-organisms
dropping from the nurse's unsterile sleeves or arms onto the field, contaminating it.
Clean objects must never pass directly over a sterile field.
11. A nurse is preparing to transfer a client from the bed to a chair. Which of the
following biomechanical principles should the nurse use to prevent musculoskeletal
injury?
a) Keep the feet close together to create a narrow base of support
b) Bend at the waist to leverage the strength of the back muscles
c) Hold the client at arm's length away from the body during the pivot
d) Flex the knees and hips to utilize the strong muscles of the legs
d) Flex the knees and hips to utilize the strong muscles of the legs
Rationale: Bending at the knees and hips centers the work on the quadriceps and
gluteal muscles rather than the smaller muscles of the lower back, reducing the risk
of strain.
12. A nurse is caring for a client who is placed on droplet precautions. Which of the
following personal protective equipment is required when entering the room?
a) An N95 respirator mask
b) A standard surgical mask
c) A full body chemical fluid gown
d) Sterile surgical gloves
b) A standard surgical mask
Rationale: Droplet precautions protect against pathogens transmitted by large-
particle droplets that travel short distances (3 to 6 feet). A standard surgical mask is
required for entry.
13. A nurse is reviewing standard precautions with a newly licensed nurse. Which of the
following statements indicates an understanding of the training?
a) "Standard precautions are only necessary when a client has a known infection."
b) "I should wear gloves whenever there is potential contact with bodily fluids."
c) "Standard precautions require wearing a protective gown for all client contacts."
d) "I must wash my hands with soap and water after every single patient interaction."
b) "I should wear gloves whenever there is potential contact with bodily
fluids."
Rationale: Standard precautions apply to all clients receiving care in hospitals,
3|Page
, regardless of their diagnosis. They dictate using gloves whenever contact with blood,
bodily fluids, non-intact skin, or mucous membranes is anticipated.
14. A nurse is performing a skin assessment on a client and notes an area of localized,
intact skin over the sacrum that is red and does not blanch when pressed. How
should the nurse document this stage of pressure injury?
a) Stage 1
b) Stage 2
c) Stage 3
d) Deep tissue pressure injury
a) Stage 1
Rationale: A stage 1 pressure injury is characterized by localized, intact skin
featuring non-blanchable erythema (redness that does not turn white when briefly
pressed).
15. A nurse is caring for a client who is completely immobile and confined to bed. To
prevent the development of pressure injuries, how often should the nurse reposition
the client?
a) Every 4 hours
b) Every 2 hours
c) Once per shift
d) Every 30 minutes
b) Every 2 hours
Rationale: Repositioning a bedbound client at least every 2 hours is the standard
evidence-based nursing intervention used to relieve prolonged tissue capillary
pressure over bony prominences.
16. A nurse is completing an incident/variance report after a client fell while ambulating.
Which of the following actions should the nurse perform regarding documentation?
a) Document in the client's medical chart that an incident report was completed
b) Include the specific incident report tracking number within the nursing progress
notes
c) Record a factual, objective description of the event directly into the client's chart
d) Put a copy of the completed incident report into the client's paper chart folder
c) Record a factual, objective description of the event directly into the client's
chart
Rationale: The clinical medical record must contain a strictly factual, objective
account of what happened to the client. The incident report itself is an internal quality
improvement tool and should never be mentioned or included in the legal medical
record.
17. A nurse is assessing a surgical wound and notes thick, yellow-green drainage with a
foul odor. How should the nurse describe this type of exudate in the documentation?
a) Serous
b) Sanguineous
c) Serosanguineous
d) Purulent
d) Purulent
Rationale: Purulent exudate is thick, opaque, and varies in color from yellow to
green. It consists of dead cells, tissue debris, and bacteria, indicating the presence
of an infection.
18. A nurse is teaching a client about the use of a cane. The client has weakness on the
left side. Which of the following instructions should the nurse include?
a) Hold the cane in the left hand and move the right leg first
4|Page
Exam Prep Questions And Well Graded
Solutions
With Rationales Updated 2026-2027
Master your NR224 Fundamentals Skills exams at Chamberlain University with this ultimate study
resource. This comprehensive guide features premium multiple-choice questions with verified
answers and detailed nursing process rationales. Perfect for Exam 1, the Mastery Exam, and the
Comprehensive Final. Cover critical topics like surgical asepsis, vital signs, oxygenation devices,
wound care staging, and patient safety. Elevate your test scores and pass your nursing check-offs
with ease
1. A nurse is preparing to perform hand hygiene after providing care to a client who has
Clostridioides difficile. Which of the following methods should the nurse use?
a) Cleanse hands with an alcohol-based hand rub
b) Wash hands thoroughly with antimicrobial soap and water
c) Wipe hands with a chlorhexidine gluconate cloth
d) Rinse hands with sterile saline solution
b) Wash hands thoroughly with antimicrobial soap and water
Rationale: Clostridioides difficile forms spores that are highly resistant to alcohol-
based rubs. Physical friction with soap and running water is required to mechanically
rinse the spores off the skin.
2. A nurse is donning personal protective equipment (PPE) before entering an airborne
precaution room. Which of the following items must the nurse put on last?
a) Gown
b) N95 respirator
c) Face shield
d) Gloves
d) Gloves
Rationale: The standard sequence for donning PPE is gown, mask/respirator,
goggles/face shield, and then gloves. The gloves must be put on last so they can be
extended to cover the cuffs of the gown.
3. A nurse enters a client's room and finds a small fire burning in the wastebasket.
Which of the following actions should the nurse take first?
a) Open the window to let the smoke escape
b) Pull the fire alarm pin at the closest station
c) Remove the client from the room to a safe area
d) Smother the fire with a wet bath blanket
c) Remove the client from the room to a safe area
Rationale: The RACE acronym for fire safety stands for Rescue, Alarm, Confine, and
Extinguish/Evacuate. The priority action is always to rescue and move clients away
from immediate danger.
4. A nurse is planning care for a client who is at high risk for falls. Which of the
following interventions should the nurse include in the plan?
a) Keep all four side rails raised on the bed at all times
b) Place the bed in its highest position for easier exit
1|Page
, c) Complete a fall risk assessment tool once every week
d) Maintain the bed in its lowest position with wheels locked
d) Maintain the bed in its lowest position with wheels locked
Rationale: Keeping the bed in its lowest position reduces the distance of a potential
fall, and locking the wheels prevents the bed from moving when the client attempts
to stand. Raising four side rails is considered a physical restraint.
5. A nurse is caring for an older adult client who is alert but confused. The client
repeatedly attempts to get out of bed independently. Which of the following
alternatives to restraints should the nurse implement first?
a) Place a electronic bed alarm mattress pad under the client
b) Administer a mild sedative ordered on a PRN basis
c) Apply a soft waist belt while the client sits in bed
d) Request a prescription for a 1-to-1 continuous sitter
a) Place a electronic bed alarm mattress pad under the client
Rationale: Restraint alternatives should always be attempted before resorting to
physical or chemical restraints. A bed alarm provides an immediate audio alert to
staff when the client shifts weight to exit, allowing for prompt intervention.
6. A nurse is performing an admission assessment on a new client. Which of the
following activities represents the "Assessment" phase of the nursing process?
a) Formulating a nursing diagnosis of Impaired Skin Integrity
b) Measuring the client's bilateral lower extremity blood pressure
c) Documenting that the client's pain decreased after medication
d) Establishing a goal that the client will walk 50 feet by tomorrow
b) Measuring the client's bilateral lower extremity blood pressure
Rationale: Assessment involves the systematic collection of objective and subjective
data regarding the client's health status. Measuring vital signs is an objective
assessment technique.
7. A nurse writes the following target outcome for a client: "Client will ambulate 100 feet
down the hallway with a walker." Which of the following components is missing from
this SMART goal?
a) Specific behavior
b) Measurable criteria
c) Time-bound element
d) Realistic expectation
c) Time-bound element
Rationale: A SMART goal must be Specific, Measurable, Attainable, Realistic, and
Time-bound. This outcome states what and how the client will perform, but fails to
define a target timeframe (e.g., "by day 3 of hospitalization").
8. A nurse administers an analgesic to a client reporting pain rated 8 on a scale of 0 to
10. One hour later, the nurse returns and asks the client to rate their pain again.
Which phase of the nursing process is the nurse executing?
a) Evaluation
b) Analysis
c) Implementation
d) Planning
a) Evaluation
Rationale: The evaluation phase involves comparing the client's current health status
or responses against the established goals and interventions to determine if the
nursing actions were effective.
2|Page
,9. A nurse is caring for a client who is in contact precautions. When removing PPE
upon exiting the room, which item should the nurse remove first?
a) Mask
b) Gown
c) Gloves
d) Goggles
c) Gloves
Rationale: According to standard CDC sequences, gloves are considered the most
heavily contaminated item and should be removed first to prevent contaminating the
nurse's hands during the removal of other PPE.
10. A nurse is preparing a sterile field for a dressing change. Which of the following
actions by the nurse violates surgical asepsis?
a) Opening the outermost flap of the sterile kit wrapper away from the body
b) Placing a sterile package of 4x4 gauze onto the center of the field
c) Reaching across the open sterile field to pick up a container of saline
d) Keeping the entire sterile field within the direct line of sight
c) Reaching across the open sterile field to pick up a container of saline
Rationale: Reaching across a sterile field introduces the risk of micro-organisms
dropping from the nurse's unsterile sleeves or arms onto the field, contaminating it.
Clean objects must never pass directly over a sterile field.
11. A nurse is preparing to transfer a client from the bed to a chair. Which of the
following biomechanical principles should the nurse use to prevent musculoskeletal
injury?
a) Keep the feet close together to create a narrow base of support
b) Bend at the waist to leverage the strength of the back muscles
c) Hold the client at arm's length away from the body during the pivot
d) Flex the knees and hips to utilize the strong muscles of the legs
d) Flex the knees and hips to utilize the strong muscles of the legs
Rationale: Bending at the knees and hips centers the work on the quadriceps and
gluteal muscles rather than the smaller muscles of the lower back, reducing the risk
of strain.
12. A nurse is caring for a client who is placed on droplet precautions. Which of the
following personal protective equipment is required when entering the room?
a) An N95 respirator mask
b) A standard surgical mask
c) A full body chemical fluid gown
d) Sterile surgical gloves
b) A standard surgical mask
Rationale: Droplet precautions protect against pathogens transmitted by large-
particle droplets that travel short distances (3 to 6 feet). A standard surgical mask is
required for entry.
13. A nurse is reviewing standard precautions with a newly licensed nurse. Which of the
following statements indicates an understanding of the training?
a) "Standard precautions are only necessary when a client has a known infection."
b) "I should wear gloves whenever there is potential contact with bodily fluids."
c) "Standard precautions require wearing a protective gown for all client contacts."
d) "I must wash my hands with soap and water after every single patient interaction."
b) "I should wear gloves whenever there is potential contact with bodily
fluids."
Rationale: Standard precautions apply to all clients receiving care in hospitals,
3|Page
, regardless of their diagnosis. They dictate using gloves whenever contact with blood,
bodily fluids, non-intact skin, or mucous membranes is anticipated.
14. A nurse is performing a skin assessment on a client and notes an area of localized,
intact skin over the sacrum that is red and does not blanch when pressed. How
should the nurse document this stage of pressure injury?
a) Stage 1
b) Stage 2
c) Stage 3
d) Deep tissue pressure injury
a) Stage 1
Rationale: A stage 1 pressure injury is characterized by localized, intact skin
featuring non-blanchable erythema (redness that does not turn white when briefly
pressed).
15. A nurse is caring for a client who is completely immobile and confined to bed. To
prevent the development of pressure injuries, how often should the nurse reposition
the client?
a) Every 4 hours
b) Every 2 hours
c) Once per shift
d) Every 30 minutes
b) Every 2 hours
Rationale: Repositioning a bedbound client at least every 2 hours is the standard
evidence-based nursing intervention used to relieve prolonged tissue capillary
pressure over bony prominences.
16. A nurse is completing an incident/variance report after a client fell while ambulating.
Which of the following actions should the nurse perform regarding documentation?
a) Document in the client's medical chart that an incident report was completed
b) Include the specific incident report tracking number within the nursing progress
notes
c) Record a factual, objective description of the event directly into the client's chart
d) Put a copy of the completed incident report into the client's paper chart folder
c) Record a factual, objective description of the event directly into the client's
chart
Rationale: The clinical medical record must contain a strictly factual, objective
account of what happened to the client. The incident report itself is an internal quality
improvement tool and should never be mentioned or included in the legal medical
record.
17. A nurse is assessing a surgical wound and notes thick, yellow-green drainage with a
foul odor. How should the nurse describe this type of exudate in the documentation?
a) Serous
b) Sanguineous
c) Serosanguineous
d) Purulent
d) Purulent
Rationale: Purulent exudate is thick, opaque, and varies in color from yellow to
green. It consists of dead cells, tissue debris, and bacteria, indicating the presence
of an infection.
18. A nurse is teaching a client about the use of a cane. The client has weakness on the
left side. Which of the following instructions should the nurse include?
a) Hold the cane in the left hand and move the right leg first
4|Page
