Chamberlain University
LANIF 422 RN
★ ★
College of Nursing & Public Health
C
C A R E • CO M P E T E N C E • CO N F I D E N C E
EST. 1889
NR 224 — Fundamentals of Nursing
F I N A L E X A M : CO M P R E H E N S I V E R E V I E W — I N F E C T I O N CO N T R O L , N U T R I T I O N ,
E L I M I N AT I O N , W O U N D C A R E & S A F E TY
INSTITUTION Chamberlain University — COURSE NR 224 – Fundamentals of
College of Nursing & Public Nursing
Health
EXAM VERSION Latest Update TOTAL QUESTIONS 25 Q&A with Clinical Rationale
FORMAT Multiple Choice – Select the GRADE A – 100% Correct Verified
Single Best Answer Answers
FINAL EXAMINATION STUDY GUIDE
▸ This document contains verified Q&A for NR 224 Fundamentals of Nursing Final Exam (2026/2027 Update).
▸ Covers infection control (C. diff precautions, chain of infection, PPE order), bowel elimination (Valsalva maneuver,
fecal impaction, enema administration, Guaiac test, constipating/laxative foods), NG tube insertion measurement,
BMI ranges, nutritional kcal values, therapeutic diets, water/fat-soluble vitamins, six rights of medication
administration, medication order types, wound healing (tissue types, intentions, pressure ulcer stages), urinary
incontinence types, oxygen therapy for COPD, normal vital signs, infectious process stages, nursing process steps,
and HIPAA.
▸ Each answer includes clinical rationale based on evidence-based practice and Chamberlain University nursing
curriculum standards.
▸ Use this guide to prepare for the final exam and for clinical application in foundational nursing practice.
SECTION I — INFECTION CONTROL Q1–Q2
1. What is the most effective method to prevent the transfer of Clostridium difficile (C. diff)?
CORRECT ANSWER: Hand hygiene with soap and water is effective to physically remove C. difficile spores
from the hands.
RATIONALE: Alcohol-based hand sanitizers do NOT kill C. diff spores. Soap and water mechanically removes spores.
C. diff requires Contact Precautions.
2. What is the Valsalva maneuver?
CORRECT ANSWER: Abnormal method used to assist in stool passage by exerting pressure to expel fecal
matter through voluntary contraction of abdominal muscles while maintaining forced expiration against a
closed airway.
RATIONALE: Normal passage of bowels should be painless, passing soft formed stool. Patients with cardiovascular
disease, glaucoma, increased ICP, or new surgical wound MUST avoid straining to pass stool due to risk of cardiac
dysrhythmia and high BP.
, SECTION II — BOWEL ELIMINATION Q3–Q7
3. What is fecal impaction and where does it occur?
CORRECT ANSWER: A collection of hardened feces in the rectum that cannot be expelled due to unrelieved
constipation. Occurs in the rectum.
RATIONALE: Least formed stool is in the ascending colon. Most formed stool is in the descending colon.
4. What position should the patient be in while administering an enema?
CORRECT ANSWER: Left Side-Lying or Sim's position.
RATIONALE: Left side allows enema solution to follow natural curve of sigmoid colon. Stop enema administration if
bleeding occurs, abdomen becomes rigid/distended, pain occurs, or resistance is felt.
5. Which enema solution is safest and why?
CORRECT ANSWER: Normal saline (isotonic solution) – does NOT create a danger for excess fluid absorption.
RATIONALE: Hypertonic solutions are contraindicated in dehydrated patients or young infants. Tap water is
hypotonic; should NOT be repeated due to risk of water toxicity or circulatory overload. Oil retention enema lubricates
rectum and softens stool. Soapsuds enema creates intestinal irritation; use with caution.
6. What is the Guaiac Fecal Occult Blood Test?
CORRECT ANSWER: Laboratory test used to measure microscopic amounts of blood in the feces (blood that
cannot be seen). Repeat at least three times while patient refrains from red meat, some raw vegetables,
vitamin C, aspirin, and NSAIDs (false positives).
RATIONALE: Used for colon cancer screening. For ova and parasites, stool MUST be warm (bacteriological changes
alter test results).
7. Which foods induce constipating vs. laxative effects?
CORRECT ANSWER: Constipating: cheese, lean meats, eggs, pasta. Laxative: fruits, vegetables, bran,
chocolate, alcohol, coffee.
RATIONALE: Cathartic suppositories (e.g., Dulcolax) are most effective due to stimulant effect on rectal mucosa.
Normal stoma: bright pink or brick red. Notify HCP if stoma is blue, purple, brown, or black (circulation problem).
SECTION III — NG TUBE & NUTRITION Q8–Q13
8. How does the nurse measure NG tube length for insertion?
CORRECT ANSWER: Tip of nose → earlobe → xiphoid process.
RATIONALE: Most reliable method of verification for NG tube placement is X-ray. Other methods: pH test (aspirate
and inspect color).
LANIF 422 RN
★ ★
College of Nursing & Public Health
C
C A R E • CO M P E T E N C E • CO N F I D E N C E
EST. 1889
NR 224 — Fundamentals of Nursing
F I N A L E X A M : CO M P R E H E N S I V E R E V I E W — I N F E C T I O N CO N T R O L , N U T R I T I O N ,
E L I M I N AT I O N , W O U N D C A R E & S A F E TY
INSTITUTION Chamberlain University — COURSE NR 224 – Fundamentals of
College of Nursing & Public Nursing
Health
EXAM VERSION Latest Update TOTAL QUESTIONS 25 Q&A with Clinical Rationale
FORMAT Multiple Choice – Select the GRADE A – 100% Correct Verified
Single Best Answer Answers
FINAL EXAMINATION STUDY GUIDE
▸ This document contains verified Q&A for NR 224 Fundamentals of Nursing Final Exam (2026/2027 Update).
▸ Covers infection control (C. diff precautions, chain of infection, PPE order), bowel elimination (Valsalva maneuver,
fecal impaction, enema administration, Guaiac test, constipating/laxative foods), NG tube insertion measurement,
BMI ranges, nutritional kcal values, therapeutic diets, water/fat-soluble vitamins, six rights of medication
administration, medication order types, wound healing (tissue types, intentions, pressure ulcer stages), urinary
incontinence types, oxygen therapy for COPD, normal vital signs, infectious process stages, nursing process steps,
and HIPAA.
▸ Each answer includes clinical rationale based on evidence-based practice and Chamberlain University nursing
curriculum standards.
▸ Use this guide to prepare for the final exam and for clinical application in foundational nursing practice.
SECTION I — INFECTION CONTROL Q1–Q2
1. What is the most effective method to prevent the transfer of Clostridium difficile (C. diff)?
CORRECT ANSWER: Hand hygiene with soap and water is effective to physically remove C. difficile spores
from the hands.
RATIONALE: Alcohol-based hand sanitizers do NOT kill C. diff spores. Soap and water mechanically removes spores.
C. diff requires Contact Precautions.
2. What is the Valsalva maneuver?
CORRECT ANSWER: Abnormal method used to assist in stool passage by exerting pressure to expel fecal
matter through voluntary contraction of abdominal muscles while maintaining forced expiration against a
closed airway.
RATIONALE: Normal passage of bowels should be painless, passing soft formed stool. Patients with cardiovascular
disease, glaucoma, increased ICP, or new surgical wound MUST avoid straining to pass stool due to risk of cardiac
dysrhythmia and high BP.
, SECTION II — BOWEL ELIMINATION Q3–Q7
3. What is fecal impaction and where does it occur?
CORRECT ANSWER: A collection of hardened feces in the rectum that cannot be expelled due to unrelieved
constipation. Occurs in the rectum.
RATIONALE: Least formed stool is in the ascending colon. Most formed stool is in the descending colon.
4. What position should the patient be in while administering an enema?
CORRECT ANSWER: Left Side-Lying or Sim's position.
RATIONALE: Left side allows enema solution to follow natural curve of sigmoid colon. Stop enema administration if
bleeding occurs, abdomen becomes rigid/distended, pain occurs, or resistance is felt.
5. Which enema solution is safest and why?
CORRECT ANSWER: Normal saline (isotonic solution) – does NOT create a danger for excess fluid absorption.
RATIONALE: Hypertonic solutions are contraindicated in dehydrated patients or young infants. Tap water is
hypotonic; should NOT be repeated due to risk of water toxicity or circulatory overload. Oil retention enema lubricates
rectum and softens stool. Soapsuds enema creates intestinal irritation; use with caution.
6. What is the Guaiac Fecal Occult Blood Test?
CORRECT ANSWER: Laboratory test used to measure microscopic amounts of blood in the feces (blood that
cannot be seen). Repeat at least three times while patient refrains from red meat, some raw vegetables,
vitamin C, aspirin, and NSAIDs (false positives).
RATIONALE: Used for colon cancer screening. For ova and parasites, stool MUST be warm (bacteriological changes
alter test results).
7. Which foods induce constipating vs. laxative effects?
CORRECT ANSWER: Constipating: cheese, lean meats, eggs, pasta. Laxative: fruits, vegetables, bran,
chocolate, alcohol, coffee.
RATIONALE: Cathartic suppositories (e.g., Dulcolax) are most effective due to stimulant effect on rectal mucosa.
Normal stoma: bright pink or brick red. Notify HCP if stoma is blue, purple, brown, or black (circulation problem).
SECTION III — NG TUBE & NUTRITION Q8–Q13
8. How does the nurse measure NG tube length for insertion?
CORRECT ANSWER: Tip of nose → earlobe → xiphoid process.
RATIONALE: Most reliable method of verification for NG tube placement is X-ray. Other methods: pH test (aspirate
and inspect color).
