NR 224 Final Exam | Chamberlain University | Fundamentals Nursing Comprehensive Exam | Complete Test with Verified Questions and Answers with Detailed Rationales | Nursing Skills, Safety, Infection Control, Clinical Judgment | Get HighScore | Instant Down

INSTANT DOWNLOAD — GET HIGHSCORE on the NR 224 Final Exam at Chamberlain University with this comprehensive fundamentals nursing test bank, developed to reflect the latest NGN standards . This resource features verified questions and answers with detailed rationales in multiple-choice, select-all-that-apply (SATA), ordered response, and clinical judgment formats aligned with Chamberlain's NR224 Final Exam blueprint. It covers all essential nursing skills and concepts required to achieve a top score on the cumulative final examination, including: Infection Control & Prevention – Chain of infection (infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host); Standard Precautions (hand hygiene, PPE, safe injection practices); Transmission-Based Precautions (Contact: MRSA, VRE, C. diff — gown and gloves; Droplet: influenza, pertussis, meningitis — mask; Airborne: TB, measles, chickenpox — N95 respirator, negative pressure room); C. difficile spore management requires soap and water (alcohol-based hand rub ineffective); Hand hygiene indications (5 Moments: before patient contact, before clean/aseptic procedure, after body fluid exposure, after patient contact, after contact with patient surroundings); Sterile technique (surgical asepsis principles, sterile field within line of sight, 1-inch border considered contaminated, donning sterile gloves); PPE donning order (gown → mask → eyewear → gloves) and doffing order (gloves → gown → eyewear → mask) . Safety & Mobility – Fall prevention (Morse Fall Scale, Hendrich II Fall Risk Model, bed/chair alarms, low beds, floor mats, hourly rounding, call light within reach, non-skid footwear); Physical restraints (last resort, two-finger clearance between restraint and skin, remove every 2 hours for ROM and skin assessment, secure to bed frame NOT side rails, never use for staff convenience); Chemical restraints (medication used for discipline or convenience, not part of standard treatment); Assistive devices: cane (hold on strong side, advance with weak leg); walker (advance, step into, advance); crutch gaits (two-point, three-point, four-point, swing-to, swing-through); Transfer techniques (stand pivot, sliding board, mechanical lift, two-person transfer); Body mechanics for healthcare providers (wide base of support, lift with legs, keep load close, avoid twisting, friction-reducing devices); Complications of immobility (DVT — SCDs/compression devices, anticoagulants; pneumonia — incentive spirometry, deep breathing; pressure ulcers — repositioning q2h, pressure redistribution surfaces; constipation — increased fluids/fiber, stool softeners; contractures — ROM exercises) . Vital Signs & Physical Assessment – Temperature measurement (oral: sublingual pocket, wait 15 minutes after hot/cold liquids or smoking; rectal: most accurate, 0.5-1.0°F higher, contraindicated in neutropenia, cardiac patients, diarrhea; axillary: least accurate, 0.5-1.0°F lower; tympanic: infrared, pull ear up/back for adults; temporal artery: scan forehead); Normal ranges: oral 97.6-99.6°F (36.4-37.6°C); Pulse assessment (rate: newborn 80-150, infant 80-150, child 70-120, adult 60-100; rhythm: regular vs. irregular; amplitude: 0 absent, 1+ thready/weak, 2+ normal/brisk, 3+ bounding); Respirations (rate: newborn 30-60, infant 25-40, child 20-30, adult 12-20; depth: shallow, normal, deep; rhythm: regular vs. irregular; effort: unlabored vs. labored with accessory muscles); Blood pressure (Korotkoff sounds: Phase I first clear tapping = systolic, Phase II swishing, Phase III rhythmic tapping, Phase IV muffling, Phase V silence = diastolic in adults; proper cuff size: bladder width 40% arm circumference, length 80% arm circumference; too small = falsely elevated, too large = falsely low; patient positioning: sitting with back supported, feet flat, arm at heart level); Pain assessment (PQRST: Provocation/Palliation, Quality, Region/Radiation, Severity, Timing; pain scales: numeric 0-10, Wong-Baker FACES, FLACC for infants/nonverbal, PAINAD for dementia, CPOT for ICU) . Hygiene & Personal Care – Bed bath technique (ensure privacy, warm water, change water after peri care); Perineal care (female: front to back to prevent UTI; male: retract foreskin if uncircumcised, clean tip, replace foreskin); Oral care for conscious patients (soft toothbrush, fluoride toothpaste, brush teeth and tongue, floss); Oral care for unconscious patients (side-lying position to prevent aspiration, padded tongue blade, minimal fluid, suction if needed); Denture care (remove at night, store in labeled cup with water, brush with denture brush, not toothbrush); Hair care (comb daily, wash as needed, no tangling); Nail care (file straight across, do not cut for diabetic or peripheral vascular disease patients, soften with warm water, no metal files) . Skin Integrity & Wound Care – Pressure ulcer staging: Stage 1 (intact skin with nonblanchable erythema); Stage 2 (partial-thickness skin loss with exposed dermis, no fat visible); Stage 3 (full-thickness skin loss with visible adipose tissue); Stage 4 (full-thickness skin loss with exposed muscle, bone, tendon); Unstageable (slough/eschar covering wound bed); Deep Tissue Injury (persistent nonblanchable deep red, maroon, purple discoloration); Braden Scale (sensory perception, moisture, activity, mobility, nutrition, friction/shear; lower score = higher risk); Wound cleansing (center to outward, sterile normal saline, no hydrogen peroxide/iodine/povidone on granulating tissue); Dressing types (transparent, hydrocolloid, hydrogel, alginate, foam); Drain management (Jackson-Pratt, Hemovac — empty when full, measure output, maintain suction, secure to clothing) . Oxygenation & Respiratory Care – Oxygen delivery devices: nasal cannula (1-6 LPM, FiO2 24-44%); simple face mask (5-10 LPM, FiO2 35-55%); partial rebreather (6-11 LPM, FiO2 40-60%); non-rebreather (10-15 LPM, FiO2 60-95% — reservoir bag must remain inflated); Venturi mask (4-12 LPM, precise FiO2, best for COPD); high-flow nasal cannula HFNC (30-60 LPM, FiO2 up to 100%); Pulse oximetry (SpO2 95% normal, COPD target 88-92%); Incentive spirometry (post-op, deep breathing, splint incision); Tracheostomy care (routine every shift, clean inner cannula, replace with sterile technique, obturator at bedside); Tracheal suctioning (sterile technique for open system, pre-oxygenate, suction pressure 80-150 mmHg, apply suction only on withdrawal, maximum 10 seconds, limit 2-3 passes); CPAP and BiPAP (non-invasive positive pressure ventilation, prevent skin breakdown on bridge of nose, monitor for gastric distension) . Medication Administration – Six Rights of Medication Administration (Right patient, right medication, right dose, right route, right time, right documentation); Right patient verification (two identifiers: name, date of birth, MRN — NOT room number); Right dose calculation (desired ÷ have × quantity); Right routes: oral (PO), IM (intramuscular — 90° angle, sites: deltoid, vastus lateralis, ventrogluteal), SubQ (subcutaneous — 45-90° angle, sites: abdomen, outer arm, anterior thigh), ID (intradermal — 10-15° angle, small bleb), IV (intravenous); Z-track method (IM, displace skin laterally, release after needle withdrawal); Insulin administration (roll NPH, do NOT shake, draw regular before NPH, rotate sites within same anatomical area); IV therapy: peripheral IV (18-24 gauge, sites: forearm, hand, antecubital), CVC/PICC (central lines, sterile dressing change, flush with 10 mL syringe); IV complications (infiltration — cool, taut skin, stop infusion, elevate; phlebitis — red, warm, palpable cord, discontinue, warm compress; extravasation — vesicant infiltration, leave IV in, administer antidote) . Elimination – Urinary catheterization: indwelling Foley (sterile technique, secure to thigh, keep bag below bladder, empty q8h, meatal care daily); straight/intermittent catheter (in-and-out, clean or sterile technique); external catheters (condom catheter for males, no adhesive tape); CAUTI prevention (sterile insertion, maintain closed system, remove ASAP, avoid routine replacement); Bowel elimination: constipation (increased fiber, fluids, mobility, stool softeners, enemas); diarrhea (monitor I&O, skin care, replace fluids); fecal impaction (digital removal with order, lidocaine gel); ostomy care (colostomy (formed stool), ileostomy (liquid stool), urostomy (urine); pouching system, skin barrier, monitor stoma color: pink-red healthy, dusky/purple ischemia, black necrosis) . Nutrition & Hydration – Enteral nutrition: NG tube placement verification (aspirate pH 0-4, radiographic confirmation most accurate); feeding tube administration (HOB ≥30°, check residual q4-6h, flush before and after, room temperature formula); TPN (central line only, monitor glucose, sterile dressing change, abrupt discontinuation causes hypoglycemia); Dehydration: manifestations (dry mucous membranes, poor skin turgor, oliguria, concentrated urine, tachycardia, hypotension), interventions (oral fluids, IV fluids); Fluid overload: manifestations (crackles, JVD, edema, hypertension, weight gain), interventions (diuretics, fluid restriction, sodium restriction) . Fluids, Electrolytes, Acid-Base – Normal electrolyte ranges: Sodium 135-145 mEq/L, Potassium 3.5-5.0 mEq/L, Calcium 8.6-10.2 mg/dL; Hypokalemia (causes: diuretics, vomiting; manifestations: U waves, muscle weakness, hyporeflexia; treatment: oral/IV potassium, never IV push); Hyperkalemia (causes: renal failure, ACE inhibitors; manifestations: peaked T waves, weakness; treatment: calcium gluconate, insulin+glucose, Kayexalate, dialysis); Respiratory acidosis (pH↓ PaCO₂↑ — hypoventilation, treatment: improve ventilation); Respiratory alkalosis (pH↑ PaCO₂↓ — hyperventilation, treatment: reduce ventilation, rebreathe CO₂); Metabolic acidosis (pH↓ HCO₃↓ — DKA, diarrhea; treatment: treat underlying cause, sodium bicarbonate if severe); Metabolic alkalosis (pH↑ HCO₃↑ — vomiting, NG suction; treatment: replace fluids/electrolytes, acetazolamide) . Nursing Process & Documentation – ADPIE: Assessment (subjective vs. objective data), Diagnosis (nursing diagnosis vs. medical diagnosis, PES statement), Planning (SMART goals: Specific, Measurable, Attainable, Realistic, Timely), Implementation (independent, dependent, interdependent interventions), Evaluation (outcomes met, partially met, not met); Priority setting frameworks (ABCs: Airway, Breathing, Circulation; Maslow's Hierarchy of Needs: physiologic first, then safety, love/belonging, esteem, self-actualization; acute before chronic, unstable before stable); Delegation (five rights: right task, right circumstance, right person, right direction/communication, right supervision/evaluation; RN delegates to LPN and UAP, retains accountability; LPN stable predictable patients; UAP ADLs, vital signs, I&O); Documentation standards (objective, factual, timely, legible, complete, confidential; NEVER document ahead of time, NEVER alter record, NEVER mention incident report in patient chart); Incident reports (separate confidential system, focus on system improvement, not discipline) . Legal & Ethical Considerations – Informed consent (nurse witnesses signature, verifies understanding, notifies provider of questions; elements: diagnosis, procedure description, risks/benefits, alternatives, consequences of refusal); HIPAA (protected health information PHI, minimum necessary standard, TPO: Treatment, Payment, Operations, breach notification within 60 days for 500 individuals); Advance directives (living will: end-of-life treatment preferences; durable power of attorney for healthcare: appoints healthcare decision-maker; POLST/MOLST: portable medical orders; DNR/AND: do not resuscitate/allow natural death); Patient Self-Determination Act (facilities must inform patients of their rights to make healthcare decisions); Professional boundaries (avoid dual relationships, self-disclosure, gifts $5-$10, social media violations, never post patient information); Code of ethics (autonomy: right to self-determination; beneficence: do good; nonmaleficence: do no harm; justice: fair treatment; fidelity: keep promises; veracity: truthfulness) . Disaster & Emergency Preparedness – RACE: Rescue, Alarm, Contain, Extinguish; PASS: Pull, Aim, Squeeze, Sweep; Fire extinguisher classes: Class A (paper/wood/plastic — water, ABC), Class B (flammable liquids — CO₂, ABC, BC), Class C (electrical — CO₂, ABC, BC), Class D (combustible metals — dry powder), Class K (cooking oils/grease — wet chemical); Evacuation priorities: horizontal (same floor) before vertical (down stairs, never elevator except if designated evacuation elevator); Emergency preparedness plan (review annually, drills, role assignments) . Each question includes detailed rationales explaining the "why" behind every correct answer, reinforcing clinical judgment and NCLEX readiness. Pass your Chamberlain NR224 Final Exam with confidence on your first attempt. DOCUMENT ACCESS: This resource is available as an instant digital download (PDF) immediately upon purchase. Fully text-searchable, printable, and accessible anytime through your user account. 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NR 224 Final Exam Chamberlain University Fundamentals Nursing Comprehensive Exam Test Bank Verified Questions and Answers with Detailed Rationales Chamberlain NR224 Final Exam Study Guide Infection Control Chain of Infection Standard Precautions Contact Precautions Droplet Precautions Airborne Precautions N95 Respirator Negative Pressure Room C difficile Soap and Water Hand Hygiene Only 5 Moments of Hand Hygiene Before Patient Contact After Body Fluid Exposure After Patient Contact Sterile Technique Surgical Asepsis Sterile Field Donning Sterile Gloves PPE Donning Order Gown Mask Eye Protection Gloves Fall Prevention Morse Fall Scale Hendrich II Hourly Rounding Non-Skid Footwear Physical Restraint Two Fingers Remove Every 2 Hours Secure to Bed Frame Crutch Gaits Two-Point Three-Point Four-Point Swing-To Swing-Through Cane Placement Strong Side Advance with Weak Leg Complications of Immobility DVT Prevention SCDs Incentive Spirometry Normal Vital Signs Temperature Pulse Respiration Blood Pressure SpO2 Korotkoff Sounds Phase I Systolic Phase V Diastolic Blood Pressure Cuff Size Bladder Width 40% Arm Circumference Pain Assessment PQRST Numeric Pain Scale FACES FLACC PAINAD Pressure Injury Staging Stage 1 Nonblanchable Erythema Stage 2 Partial Thickness Stage 3 Full Thickness Fat Visible Stage 4 Muscle Bone Visible Braden Scale Pressure Ulcer Risk Assessment Wound Cleansing Center to Outward Normal Saline Oxygen Delivery Devices Nasal Cannula Non-Rebreather Venturi Mask HFNC Tracheostomy Care Obturator at Bedside Tracheal Suctionin