1
NR226 FINAL EXAM REVIEW STUDY GUIDE Actual
Exam 2026/2027 Complete Questions and Verified Answers
with Detailed Rationales Fundamentals Patient Care Grade
A Pass Guaranteed - A+ Graded
SECTION 1: FOUNDATIONS OF NURSING PRACTICE (Questions 1-20)
Q1: A nurse is caring for a postoperative patient who is refusing to get out of bed despite
ambulation orders. The nurse tells the patient, "If you don't get up and walk, you'll develop
pneumonia and blood clots." This statement is an example of which ethical dilemma?
A. Beneficence
B. Nonmaleficence
C. Paternalism
D. Coercion [CORRECT]
Correct Answer: D
Rationale: Coercion involves using threats or intimidation to force a patient to comply with
treatment. The nurse is threatening negative consequences to manipulate the patient's decision.
Beneficence is doing good, nonmaleficence is avoiding harm, and paternalism is making
decisions for patients without necessarily using threats.
Q2: A nurse administers the wrong medication to a patient but the patient suffers no harm. This is
an example of which type of legal issue?
A. Intentional tort
B. Malpractice
C. Negligence [CORRECT]
D. Assault
Correct Answer: C
Rationale: Negligence is the failure to act as a reasonably prudent person would under similar
circumstances. Administering the wrong medication constitutes professional negligence
(malpractice) even without harm, but negligence is the broader legal category. Intentional torts
require intent, and assault involves threatening harm without actual touching.
Q3: Which component of the nursing process involves determining whether patient goals have
been met and modifying the care plan if necessary?
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A. Assessment
B. Planning
C. Implementation
D. Evaluation [CORRECT]
Correct Answer: D
Rationale: Evaluation is the final step of the nursing process where the nurse reassesses the
patient, compares findings to expected outcomes, and determines if goals were met. If goals are
not met, the nurse revises the diagnosis, goals, or interventions. Assessment involves data
collection, planning involves setting goals, and implementation involves performing
interventions.
Q4: A patient with terminal cancer asks the nurse to help end their life. According to the ANA
Code of Ethics, which principle guides the nurse's response?
A. Justice requires providing equal care to all patients
B. Fidelity requires keeping promises to patients
C. Nonmaleficence prohibits nurses from participating in assisted suicide [CORRECT]
D. Autonomy requires honoring all patient requests
Correct Answer: C
Rationale: The ANA Code of Ethics explicitly prohibits nurses from participating in assisted
suicide. While autonomy is important, it does not supersede the ethical principle of
nonmaleficence (do no harm) and legal prohibitions. The nurse should provide comfort care and
psychosocial support instead.
Q5: A nurse shares patient information with a colleague in the hospital cafeteria where others can
overhear. This violates which legal requirement?
A. Informed consent
B. HIPAA Privacy Rule [CORRECT]
C. Advance directive
D. Patient Self-Determination Act
Correct Answer: B
Rationale: The HIPAA Privacy Rule requires protected health information (PHI) to be discussed
only in private settings where unauthorized individuals cannot overhear. Discussing patient
information in public areas like cafeterias violates patient confidentiality. Informed consent
,3
involves treatment permission, advance directives involve end-of-life decisions, and the PSDA
ensures patients are informed about advance directives.
Q6: Which nursing action demonstrates critical thinking when a postoperative patient reports
sudden chest pain?
A. Immediately administer the PRN pain medication
B. Notify the physician without further assessment
C. Assess the patient's vital signs, oxygen saturation, and pain characteristics before intervening
[CORRECT]
D. Document the complaint and continue with routine care
Correct Answer: C
Rationale: Critical thinking involves systematic analysis of a situation before acting. The nurse
must first assess the patient thoroughly to determine if this is cardiac, pulmonary, or
musculoskeletal pain before selecting interventions. Administering pain medication or notifying
the physician without assessment could delay appropriate treatment for a life-threatening
condition.
Q7: A living will is an example of which type of advance directive?
A. Durable power of attorney for healthcare
B. Instructional directive [CORRECT]
C. POLST form
D. Do Not Resuscitate order
Correct Answer: B
Rationale: A living will is an instructional directive that specifies which life-sustaining
treatments a patient wants or does not want in specific circumstances. A durable power of
attorney for healthcare designates a surrogate decision-maker. POLST forms are physician orders
for specific interventions, and DNR orders address resuscitation status only.
Q8: Which element is NOT required for valid informed consent?
A. Disclosure of information
B. Patient capacity
C. Witness signature by a family member [CORRECT]
D. Voluntary agreement
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Correct Answer: C
Rationale: Informed consent requires disclosure of information, patient capacity to understand,
and voluntary agreement without coercion. While a witness signature is often required, it does
not need to be a family member—typically a healthcare professional or neutral party witnesses to
verify the patient signed voluntarily. Family members may have conflicts of interest.
Q9: A nurse researcher is developing a study question using the PICOT format. What does the
"T" represent?
A. Type of study design
B. Time frame [CORRECT]
C. Target population
D. Treatment intervention
Correct Answer: B
Rationale: PICOT stands for Population, Intervention, Comparison, Outcome, and Time. The
time component specifies the duration of the study or when outcomes will be measured. This
framework helps develop focused, searchable clinical questions for evidence-based practice.
Q10: Which scope of practice issue occurs when a nurse performs a task requiring physician
delegation without proper authorization?
A. Negligence
B. Malpractice
C. Scope of practice violation [CORRECT]
D. Breach of fiduciary duty
Correct Answer: C
Rationale: Performing tasks beyond one's legal scope of practice without proper authorization
constitutes a scope of practice violation. This differs from negligence (failure to perform
appropriately) or malpractice (professional negligence). Nurses must work within their state
nurse practice act and institutional policies.
Q11: A patient with diabetes refuses insulin, stating, "I don't believe in taking medications."
Which response demonstrates therapeutic communication?
A. "You need insulin to live, so you really should take it."
B. "Tell me more about your concerns regarding insulin therapy." [CORRECT]
C. "Your doctor knows what's best for you."
NR226 FINAL EXAM REVIEW STUDY GUIDE Actual
Exam 2026/2027 Complete Questions and Verified Answers
with Detailed Rationales Fundamentals Patient Care Grade
A Pass Guaranteed - A+ Graded
SECTION 1: FOUNDATIONS OF NURSING PRACTICE (Questions 1-20)
Q1: A nurse is caring for a postoperative patient who is refusing to get out of bed despite
ambulation orders. The nurse tells the patient, "If you don't get up and walk, you'll develop
pneumonia and blood clots." This statement is an example of which ethical dilemma?
A. Beneficence
B. Nonmaleficence
C. Paternalism
D. Coercion [CORRECT]
Correct Answer: D
Rationale: Coercion involves using threats or intimidation to force a patient to comply with
treatment. The nurse is threatening negative consequences to manipulate the patient's decision.
Beneficence is doing good, nonmaleficence is avoiding harm, and paternalism is making
decisions for patients without necessarily using threats.
Q2: A nurse administers the wrong medication to a patient but the patient suffers no harm. This is
an example of which type of legal issue?
A. Intentional tort
B. Malpractice
C. Negligence [CORRECT]
D. Assault
Correct Answer: C
Rationale: Negligence is the failure to act as a reasonably prudent person would under similar
circumstances. Administering the wrong medication constitutes professional negligence
(malpractice) even without harm, but negligence is the broader legal category. Intentional torts
require intent, and assault involves threatening harm without actual touching.
Q3: Which component of the nursing process involves determining whether patient goals have
been met and modifying the care plan if necessary?
,2
A. Assessment
B. Planning
C. Implementation
D. Evaluation [CORRECT]
Correct Answer: D
Rationale: Evaluation is the final step of the nursing process where the nurse reassesses the
patient, compares findings to expected outcomes, and determines if goals were met. If goals are
not met, the nurse revises the diagnosis, goals, or interventions. Assessment involves data
collection, planning involves setting goals, and implementation involves performing
interventions.
Q4: A patient with terminal cancer asks the nurse to help end their life. According to the ANA
Code of Ethics, which principle guides the nurse's response?
A. Justice requires providing equal care to all patients
B. Fidelity requires keeping promises to patients
C. Nonmaleficence prohibits nurses from participating in assisted suicide [CORRECT]
D. Autonomy requires honoring all patient requests
Correct Answer: C
Rationale: The ANA Code of Ethics explicitly prohibits nurses from participating in assisted
suicide. While autonomy is important, it does not supersede the ethical principle of
nonmaleficence (do no harm) and legal prohibitions. The nurse should provide comfort care and
psychosocial support instead.
Q5: A nurse shares patient information with a colleague in the hospital cafeteria where others can
overhear. This violates which legal requirement?
A. Informed consent
B. HIPAA Privacy Rule [CORRECT]
C. Advance directive
D. Patient Self-Determination Act
Correct Answer: B
Rationale: The HIPAA Privacy Rule requires protected health information (PHI) to be discussed
only in private settings where unauthorized individuals cannot overhear. Discussing patient
information in public areas like cafeterias violates patient confidentiality. Informed consent
,3
involves treatment permission, advance directives involve end-of-life decisions, and the PSDA
ensures patients are informed about advance directives.
Q6: Which nursing action demonstrates critical thinking when a postoperative patient reports
sudden chest pain?
A. Immediately administer the PRN pain medication
B. Notify the physician without further assessment
C. Assess the patient's vital signs, oxygen saturation, and pain characteristics before intervening
[CORRECT]
D. Document the complaint and continue with routine care
Correct Answer: C
Rationale: Critical thinking involves systematic analysis of a situation before acting. The nurse
must first assess the patient thoroughly to determine if this is cardiac, pulmonary, or
musculoskeletal pain before selecting interventions. Administering pain medication or notifying
the physician without assessment could delay appropriate treatment for a life-threatening
condition.
Q7: A living will is an example of which type of advance directive?
A. Durable power of attorney for healthcare
B. Instructional directive [CORRECT]
C. POLST form
D. Do Not Resuscitate order
Correct Answer: B
Rationale: A living will is an instructional directive that specifies which life-sustaining
treatments a patient wants or does not want in specific circumstances. A durable power of
attorney for healthcare designates a surrogate decision-maker. POLST forms are physician orders
for specific interventions, and DNR orders address resuscitation status only.
Q8: Which element is NOT required for valid informed consent?
A. Disclosure of information
B. Patient capacity
C. Witness signature by a family member [CORRECT]
D. Voluntary agreement
, 4
Correct Answer: C
Rationale: Informed consent requires disclosure of information, patient capacity to understand,
and voluntary agreement without coercion. While a witness signature is often required, it does
not need to be a family member—typically a healthcare professional or neutral party witnesses to
verify the patient signed voluntarily. Family members may have conflicts of interest.
Q9: A nurse researcher is developing a study question using the PICOT format. What does the
"T" represent?
A. Type of study design
B. Time frame [CORRECT]
C. Target population
D. Treatment intervention
Correct Answer: B
Rationale: PICOT stands for Population, Intervention, Comparison, Outcome, and Time. The
time component specifies the duration of the study or when outcomes will be measured. This
framework helps develop focused, searchable clinical questions for evidence-based practice.
Q10: Which scope of practice issue occurs when a nurse performs a task requiring physician
delegation without proper authorization?
A. Negligence
B. Malpractice
C. Scope of practice violation [CORRECT]
D. Breach of fiduciary duty
Correct Answer: C
Rationale: Performing tasks beyond one's legal scope of practice without proper authorization
constitutes a scope of practice violation. This differs from negligence (failure to perform
appropriately) or malpractice (professional negligence). Nurses must work within their state
nurse practice act and institutional policies.
Q11: A patient with diabetes refuses insulin, stating, "I don't believe in taking medications."
Which response demonstrates therapeutic communication?
A. "You need insulin to live, so you really should take it."
B. "Tell me more about your concerns regarding insulin therapy." [CORRECT]
C. "Your doctor knows what's best for you."
