Chamberlain University
2 MAXE 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
E X A M 2 : M E D I C AT I O N A D M I N I ST R AT I O N , I M M O B I L I TY, S A F E TY & W O U N D H E A L I N G
INSTITUTION Chamberlain University — COURSE NR 224 – Fundamentals of
College of Nursing & Public Nursing
Health
EXAM VERSION Latest Update TOTAL QUESTIONS 48 Q&A with Clinical Rationale
FORMAT Multiple Choice – Select the GRADE A – 100% Correct Verified
Single Best Answer Answers
EXAMINATION STUDY GUIDE
▸ This document contains verified Q&A for NR 224 Fundamentals of Nursing Exam 2 (2026/2027 Update).
▸ Covers polypharmacy, pain modulation, pharmacokinetics (ADME), medication administration, injection
techniques, the six rights, fire safety (RACE/PULL), immobility complications by body system, and wound healing
by intention.
▸ Each answer includes clinical rationale based on evidence-based practice and Chamberlain University nursing
curriculum standards.
▸ Use this guide to prepare for the exam and for clinical application in foundational nursing practice.
SECTION I — PHARMACOLOGY FUNDAMENTALS & Q1–
PHARMACOKINETICS Q26
1. Which of the following indicates that an elderly client has been affected by polypharmacy?
CORRECT ANSWER: B. Medications are used to counteract side effects of currently prescribed medications.
RATIONALE: Polypharmacy often leads to prescribing cascade—using medications to treat side effects of other
medications. This increases the risk of adverse drug reactions and drug interactions in elderly patients. The BEERS
criteria help identify potentially inappropriate medications in older adults.
2. When caring for clients experiencing pain, a nurse should recognize that which of the following natural
substances decrease pain transmission? (Select all that apply.)
CORRECT ANSWER: B, D. Serotonin and endorphins decrease pain transmission.
RATIONALE: Endorphins are endogenous opioids that inhibit pain transmission in the central nervous system.
Serotonin is a neurotransmitter involved in descending pain modulation pathways. Substance P, bradykinin, and
histamine are pain-producing substances (algogenic).
, 3. You are caring for a patient who has diabetes complicated by kidney disease. You need to make a
detailed assessment when administering medications because this patient may experience problems
with which pharmacokinetic phase?
CORRECT ANSWER: D. Excretion
RATIONALE: Kidney disease impairs drug excretion, leading to medication accumulation. Accumulation can cause
toxicity and adverse effects. Dosage adjustment based on renal function is essential in patients with kidney disease.
4. A nurse is administering eardrops to an 8-year-old patient with an ear infection. How does the nurse
pull the patient's ear when administering the medication?
CORRECT ANSWER: D. Upward and outward
RATIONALE: For children over age 3, pull the pinna upward and outward to straighten the ear canal. This allows the
eardrops to reach the tympanic membrane. For children under age 3, pull downward and back.
5. A postoperative patient is receiving morphine sulfate via PCA. The nurse assesses that the patient's
respirations are depressed. The effects of the morphine sulfate can be classified as?
CORRECT ANSWER: D. Toxic
RATIONALE: Respiratory depression is an adverse effect and sign of opioid toxicity. This is beyond the desired
therapeutic effect of pain relief. Naloxone may be needed to reverse respiratory depression.
6. What term describes the time it takes for a medication to produce a response?
CORRECT ANSWER: A. Onset
RATIONALE: Onset of action is the time from administration to minimum effective concentration. Different routes
have different onset times (IV fastest, oral slowest). Onset affects clinical decision-making for pain management.
7. What term describes the point at which blood serum concentration is reached and maintained?
CORRECT ANSWER: B. Plateau
RATIONALE: Plateau (steady state) occurs when drug elimination equals drug absorption. It typically takes 4-5 half-
lives to reach steady state. Maintenance dosing aims to maintain plateau concentration.
8. What term describes the minimum blood serum concentration before the next scheduled dose?
CORRECT ANSWER: C. Trough
RATIONALE: Trough level is the lowest serum concentration before next dose. Trough levels are measured to avoid
toxicity (e.g., vancomycin, gentamicin). Trough levels guide dosing intervals for medications with narrow therapeutic
windows.
2 MAXE 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
E X A M 2 : M E D I C AT I O N A D M I N I ST R AT I O N , I M M O B I L I TY, S A F E TY & W O U N D H E A L I N G
INSTITUTION Chamberlain University — COURSE NR 224 – Fundamentals of
College of Nursing & Public Nursing
Health
EXAM VERSION Latest Update TOTAL QUESTIONS 48 Q&A with Clinical Rationale
FORMAT Multiple Choice – Select the GRADE A – 100% Correct Verified
Single Best Answer Answers
EXAMINATION STUDY GUIDE
▸ This document contains verified Q&A for NR 224 Fundamentals of Nursing Exam 2 (2026/2027 Update).
▸ Covers polypharmacy, pain modulation, pharmacokinetics (ADME), medication administration, injection
techniques, the six rights, fire safety (RACE/PULL), immobility complications by body system, and wound healing
by intention.
▸ Each answer includes clinical rationale based on evidence-based practice and Chamberlain University nursing
curriculum standards.
▸ Use this guide to prepare for the exam and for clinical application in foundational nursing practice.
SECTION I — PHARMACOLOGY FUNDAMENTALS & Q1–
PHARMACOKINETICS Q26
1. Which of the following indicates that an elderly client has been affected by polypharmacy?
CORRECT ANSWER: B. Medications are used to counteract side effects of currently prescribed medications.
RATIONALE: Polypharmacy often leads to prescribing cascade—using medications to treat side effects of other
medications. This increases the risk of adverse drug reactions and drug interactions in elderly patients. The BEERS
criteria help identify potentially inappropriate medications in older adults.
2. When caring for clients experiencing pain, a nurse should recognize that which of the following natural
substances decrease pain transmission? (Select all that apply.)
CORRECT ANSWER: B, D. Serotonin and endorphins decrease pain transmission.
RATIONALE: Endorphins are endogenous opioids that inhibit pain transmission in the central nervous system.
Serotonin is a neurotransmitter involved in descending pain modulation pathways. Substance P, bradykinin, and
histamine are pain-producing substances (algogenic).
, 3. You are caring for a patient who has diabetes complicated by kidney disease. You need to make a
detailed assessment when administering medications because this patient may experience problems
with which pharmacokinetic phase?
CORRECT ANSWER: D. Excretion
RATIONALE: Kidney disease impairs drug excretion, leading to medication accumulation. Accumulation can cause
toxicity and adverse effects. Dosage adjustment based on renal function is essential in patients with kidney disease.
4. A nurse is administering eardrops to an 8-year-old patient with an ear infection. How does the nurse
pull the patient's ear when administering the medication?
CORRECT ANSWER: D. Upward and outward
RATIONALE: For children over age 3, pull the pinna upward and outward to straighten the ear canal. This allows the
eardrops to reach the tympanic membrane. For children under age 3, pull downward and back.
5. A postoperative patient is receiving morphine sulfate via PCA. The nurse assesses that the patient's
respirations are depressed. The effects of the morphine sulfate can be classified as?
CORRECT ANSWER: D. Toxic
RATIONALE: Respiratory depression is an adverse effect and sign of opioid toxicity. This is beyond the desired
therapeutic effect of pain relief. Naloxone may be needed to reverse respiratory depression.
6. What term describes the time it takes for a medication to produce a response?
CORRECT ANSWER: A. Onset
RATIONALE: Onset of action is the time from administration to minimum effective concentration. Different routes
have different onset times (IV fastest, oral slowest). Onset affects clinical decision-making for pain management.
7. What term describes the point at which blood serum concentration is reached and maintained?
CORRECT ANSWER: B. Plateau
RATIONALE: Plateau (steady state) occurs when drug elimination equals drug absorption. It typically takes 4-5 half-
lives to reach steady state. Maintenance dosing aims to maintain plateau concentration.
8. What term describes the minimum blood serum concentration before the next scheduled dose?
CORRECT ANSWER: C. Trough
RATIONALE: Trough level is the lowest serum concentration before next dose. Trough levels are measured to avoid
toxicity (e.g., vancomycin, gentamicin). Trough levels guide dosing intervals for medications with narrow therapeutic
windows.
