NR 224 FUNDAMENTALS FINAL
CERTIFICATION PAPER 2026 QUESTIONS
WITH SOLUTIONS GRADED A+
⩥ Which statement by the patient is an indication to use the Z-track
method? Answer: "The last shot like that turned my skin colors."
⩥ A 2-year-old child is ordered to have ear irrigation performed daily.
The nurse correctly performs the procedure by Answer: Pulling the
auricle down and back to straighten the ear canal.
⩥ A patient has an order to receive 10 units of U-50 insulin. The nurse is
using a U-100 syringe. How many units should the nurse draw up in the
syringe and administer? Answer: 20 units
⩥ A patient has an order to receive 20 units of U-50 insulin. The nurse is
using a U-100 syringe. How many units should the nurse draw up in the
syringe and administer? Answer: 0.4 mL
⩥ The patient is to receive phenytoin (Dilantin) at 0900. The nurse
knows that the ideal time to draw a trough level is Answer: 0830.
⩥ A patient who has been receiving intermittent chemotherapy through a
peripheral IV site is ordered to receive a high dose of vancomycin
,through the same vein. Why does this concern the nurse? Answer:
Chemotherapy is irritating to the vascular system and may cause the vein
to infiltrate.
⩥ A physician orders 1000 mL of normal saline to infuse at a rate of 50
mL/hr. The nurse plans on hanging a new bag at what time? Answer: 20
hours
⩥ The nurse is preparing to administer a 0.5-mL rabies vaccine into the
deltoid muscle of a patient. Which needle size is best for the procedure?
Answer: 25 gauge x 5/8 inch
⩥ The nurse knows that the purpose of aspiration on IM injections is to
Answer: Ensure proper placement of the needle.
⩥ The nurse is giving an IM injection. Upon aspiration, the nurse notices
blood return in the syringe. What should the nurse do? Answer:
Withdraw the needle and prepare the injection again.
⩥ The nurse is planning to administer a tuberculin test with a 27-gauge,
3/8-inch needle. The nurse should insert the needle at an angle of _____
degrees. Answer: 15
, ⩥ The nurse knows to assess for signs of medication toxicity within
older adults because of which physiological change? Answer: Reduced
glomerular filtration
⩥ A registered nurse interprets that a scribbled medication order reads
25 mg. The nurse administers 25 mg of the medication to a patient, and
then discovers that the dose was incorrectly interpreted and should have
been 15 mg. Who is ultimately responsible for the error? Answer: Nurse
⩥ A patient is to receive medication through a nasogastric tube. What is
the most important nursing action to ensure effective absorption?
Answer: Clamp suction for 30 to 60 minutes after medication
administration.
⩥ Aspirin is an analgesic, antipyretic, antiplatelet, and anti-inflammatory
agent. A physician writes for aspirin 650 mg every 4 to 6 hours prn:
febrile. For which patient would this order be appropriate? Answer: 62-
year-old female with pneumonia
⩥ A patient is in need of immediate pain relief for a severe headache.
The nurse knows that which medication will be absorbed the quickest?
Answer: Hydromorphone (Dilaudid) 4 mg IV
⩥ A drug requires a low pH to be metabolized. Knowing this, the nurse
anticipates that the medication will be administered by which route?
Answer: Oral
CERTIFICATION PAPER 2026 QUESTIONS
WITH SOLUTIONS GRADED A+
⩥ Which statement by the patient is an indication to use the Z-track
method? Answer: "The last shot like that turned my skin colors."
⩥ A 2-year-old child is ordered to have ear irrigation performed daily.
The nurse correctly performs the procedure by Answer: Pulling the
auricle down and back to straighten the ear canal.
⩥ A patient has an order to receive 10 units of U-50 insulin. The nurse is
using a U-100 syringe. How many units should the nurse draw up in the
syringe and administer? Answer: 20 units
⩥ A patient has an order to receive 20 units of U-50 insulin. The nurse is
using a U-100 syringe. How many units should the nurse draw up in the
syringe and administer? Answer: 0.4 mL
⩥ The patient is to receive phenytoin (Dilantin) at 0900. The nurse
knows that the ideal time to draw a trough level is Answer: 0830.
⩥ A patient who has been receiving intermittent chemotherapy through a
peripheral IV site is ordered to receive a high dose of vancomycin
,through the same vein. Why does this concern the nurse? Answer:
Chemotherapy is irritating to the vascular system and may cause the vein
to infiltrate.
⩥ A physician orders 1000 mL of normal saline to infuse at a rate of 50
mL/hr. The nurse plans on hanging a new bag at what time? Answer: 20
hours
⩥ The nurse is preparing to administer a 0.5-mL rabies vaccine into the
deltoid muscle of a patient. Which needle size is best for the procedure?
Answer: 25 gauge x 5/8 inch
⩥ The nurse knows that the purpose of aspiration on IM injections is to
Answer: Ensure proper placement of the needle.
⩥ The nurse is giving an IM injection. Upon aspiration, the nurse notices
blood return in the syringe. What should the nurse do? Answer:
Withdraw the needle and prepare the injection again.
⩥ The nurse is planning to administer a tuberculin test with a 27-gauge,
3/8-inch needle. The nurse should insert the needle at an angle of _____
degrees. Answer: 15
, ⩥ The nurse knows to assess for signs of medication toxicity within
older adults because of which physiological change? Answer: Reduced
glomerular filtration
⩥ A registered nurse interprets that a scribbled medication order reads
25 mg. The nurse administers 25 mg of the medication to a patient, and
then discovers that the dose was incorrectly interpreted and should have
been 15 mg. Who is ultimately responsible for the error? Answer: Nurse
⩥ A patient is to receive medication through a nasogastric tube. What is
the most important nursing action to ensure effective absorption?
Answer: Clamp suction for 30 to 60 minutes after medication
administration.
⩥ Aspirin is an analgesic, antipyretic, antiplatelet, and anti-inflammatory
agent. A physician writes for aspirin 650 mg every 4 to 6 hours prn:
febrile. For which patient would this order be appropriate? Answer: 62-
year-old female with pneumonia
⩥ A patient is in need of immediate pain relief for a severe headache.
The nurse knows that which medication will be absorbed the quickest?
Answer: Hydromorphone (Dilaudid) 4 mg IV
⩥ A drug requires a low pH to be metabolized. Knowing this, the nurse
anticipates that the medication will be administered by which route?
Answer: Oral
