BASIC CLINICAL NURSING SKILLS ACTUAL EXAM
QUESTIONS AND ANSWERS 2026 COMPLETE
VERIFIED SOLUTIONS
▶What is the first intervention that is appropriate for the nurse to perform
once a neonate has been delivered?
Thoroughly dry the neonate
Suction the mouth and nose
Measure APGAR score
Clamp the umbilical cord . Answer: Thoroughly dry the neonate
▶The nurse is giving discharge instructions to a patient with chronic
obstructive pulmonary disease - emphysema. Which response indicates
the patient understands the instructions?
I need to limit my fluids to prevent fluid overload.
I need to sleep with my feet elevated to prevent swelling.
I need to get the pneumococcal vaccine.
I need to avoid snacking between meals. . Answer: I need to get the
pneumococcal vaccine.
▶A patient, who has suffered deep, full-thickness (third degree) thermal
burns to the circumferential chest and abdomen, as well as burns of
varying depth to the upper extremities, has been transferred to your
emergency department from a small, rural community hospital. Ventilating
the intubated patient via bag-mask device is becoming increasingly difficult
and chest rise with ventilation is poor. The emergency nurse anticipates
which procedure?
Tracheostomy
Cricothyroidotomy
Escharotomy
Fasciotomy . Answer: Escharotomy
▶A patient presents to the ED with disorientation to time, place and person,
memory impairment, and personality changes for the past 6 days. This
patient is most likely exhibiting which psychosocial emergency?
Dementia
,Schizophrenia
Depression
Delirium . Answer: Delirium
▶A patient arrives with complaints of shortness of breath and a history of
asthma. The assessment reveals mild tachypnea, biphasic (expiratory and
inspiratory) wheezing, and use of accessory muscles. Peak expiratory flow
is 48% of personal best. What is the severity of this asthma exacerbation?
Severe
Moderate
Slight
Mild . Answer: Moderate
▶A hazard vulnerability analysis (HVA) was completed for a rural area ED.
One finding was that the electrical system was antiquated and could not
handle power outages with generator back-up. The director of emergency
preparedness acknowledged this issue and initiated a plan to ensure that
the electrical system received the necessary upgrades. What phase of
disaster preparedness is this related to?
Mitigation
Preparedness
Response
Recovery . Answer: Mitigation
▶A patient presents to the ED with complaints of right arm weakness, and
difficulty speaking. The symptoms started about 40 minutes ago and are
now improving. She said this happened yesterday too, but went away.
What is she experiencing?
Hemorrhagic stroke
Ischemic stroke
Bell's palsy
Transient ischemic attacks . Answer: Transient ischemic attacks
▶A 37-year-old female walks into the ED holding her abdomen. She is
writhing in pain. Her history includes vaginal bleeding for the past 6 days.
She soaked 5 sanitary pads in 2 hours. What is the most likely cause of the
heavy bleeding?
Uterine fibroids
Mittelschmerz
Pelvic inflammatory disease
, Bartholin cyst . Answer: Uterine fibroids
▶Wernicke-Korsakoff syndrome is characterized by which clinical
manifestations?
Ataxia, mental confusion, and ophthalmoplegia
Delirium tremens, hyperthermia, and disorientation
Tachycardia, tremors, and tachypnea
Hypothermia, muscle rigidity, and bradycardia . Answer: Ataxia, mental
confusion, and ophthalmoplegia
▶A 35-year-old man presents with complaints of stomach pain that comes
and goes for the past two weeks. The nurse asks additional questions
about the nature of this pain and finds that it is relieved with antacids and
he feels better after eating. The patient mentions that he had some similar
pain about two years ago, but it stopped after about a month and he never
sought care for it. This is most likely which type of gastrointestinal disorder?
Cholecystitis
Pancreatitis
Duodenal ulcer
Stress ulcer . Answer: Duodenal ulcer
▶Which immunoglobulin is responsible for Type 1 allergic responses?
IgA
IgE
IgG
IgM . Answer: IgE
▶A middle-aged male patient presents to the ED with complaint of fever.
He is awake, alert, and in no acute distress. On arrival, vital signs are BP
118/58 mm Hg, HR 112 beats/min, RR 20 breaths/min, SpO2 95%, T 38.8
C (101.9 F). His medical history includes human immunodeficiency virus
(HIV) and he is taking antiviral medications. Using a 5-level triage system,
this patient would be triaged as which acuity level?
Acuity Level 4 (non-urgent)
Acuity Level 2 (emergent)
Acuity Level 1 (life-threatening situation)
Acuity Level 3 (urgent) . Answer: Acuity Level 2 (emergent)
▶An 84-year-old male with a decreased level of consciousness presents to
the emergency department from a nursing home. The patient has a history
QUESTIONS AND ANSWERS 2026 COMPLETE
VERIFIED SOLUTIONS
▶What is the first intervention that is appropriate for the nurse to perform
once a neonate has been delivered?
Thoroughly dry the neonate
Suction the mouth and nose
Measure APGAR score
Clamp the umbilical cord . Answer: Thoroughly dry the neonate
▶The nurse is giving discharge instructions to a patient with chronic
obstructive pulmonary disease - emphysema. Which response indicates
the patient understands the instructions?
I need to limit my fluids to prevent fluid overload.
I need to sleep with my feet elevated to prevent swelling.
I need to get the pneumococcal vaccine.
I need to avoid snacking between meals. . Answer: I need to get the
pneumococcal vaccine.
▶A patient, who has suffered deep, full-thickness (third degree) thermal
burns to the circumferential chest and abdomen, as well as burns of
varying depth to the upper extremities, has been transferred to your
emergency department from a small, rural community hospital. Ventilating
the intubated patient via bag-mask device is becoming increasingly difficult
and chest rise with ventilation is poor. The emergency nurse anticipates
which procedure?
Tracheostomy
Cricothyroidotomy
Escharotomy
Fasciotomy . Answer: Escharotomy
▶A patient presents to the ED with disorientation to time, place and person,
memory impairment, and personality changes for the past 6 days. This
patient is most likely exhibiting which psychosocial emergency?
Dementia
,Schizophrenia
Depression
Delirium . Answer: Delirium
▶A patient arrives with complaints of shortness of breath and a history of
asthma. The assessment reveals mild tachypnea, biphasic (expiratory and
inspiratory) wheezing, and use of accessory muscles. Peak expiratory flow
is 48% of personal best. What is the severity of this asthma exacerbation?
Severe
Moderate
Slight
Mild . Answer: Moderate
▶A hazard vulnerability analysis (HVA) was completed for a rural area ED.
One finding was that the electrical system was antiquated and could not
handle power outages with generator back-up. The director of emergency
preparedness acknowledged this issue and initiated a plan to ensure that
the electrical system received the necessary upgrades. What phase of
disaster preparedness is this related to?
Mitigation
Preparedness
Response
Recovery . Answer: Mitigation
▶A patient presents to the ED with complaints of right arm weakness, and
difficulty speaking. The symptoms started about 40 minutes ago and are
now improving. She said this happened yesterday too, but went away.
What is she experiencing?
Hemorrhagic stroke
Ischemic stroke
Bell's palsy
Transient ischemic attacks . Answer: Transient ischemic attacks
▶A 37-year-old female walks into the ED holding her abdomen. She is
writhing in pain. Her history includes vaginal bleeding for the past 6 days.
She soaked 5 sanitary pads in 2 hours. What is the most likely cause of the
heavy bleeding?
Uterine fibroids
Mittelschmerz
Pelvic inflammatory disease
, Bartholin cyst . Answer: Uterine fibroids
▶Wernicke-Korsakoff syndrome is characterized by which clinical
manifestations?
Ataxia, mental confusion, and ophthalmoplegia
Delirium tremens, hyperthermia, and disorientation
Tachycardia, tremors, and tachypnea
Hypothermia, muscle rigidity, and bradycardia . Answer: Ataxia, mental
confusion, and ophthalmoplegia
▶A 35-year-old man presents with complaints of stomach pain that comes
and goes for the past two weeks. The nurse asks additional questions
about the nature of this pain and finds that it is relieved with antacids and
he feels better after eating. The patient mentions that he had some similar
pain about two years ago, but it stopped after about a month and he never
sought care for it. This is most likely which type of gastrointestinal disorder?
Cholecystitis
Pancreatitis
Duodenal ulcer
Stress ulcer . Answer: Duodenal ulcer
▶Which immunoglobulin is responsible for Type 1 allergic responses?
IgA
IgE
IgG
IgM . Answer: IgE
▶A middle-aged male patient presents to the ED with complaint of fever.
He is awake, alert, and in no acute distress. On arrival, vital signs are BP
118/58 mm Hg, HR 112 beats/min, RR 20 breaths/min, SpO2 95%, T 38.8
C (101.9 F). His medical history includes human immunodeficiency virus
(HIV) and he is taking antiviral medications. Using a 5-level triage system,
this patient would be triaged as which acuity level?
Acuity Level 4 (non-urgent)
Acuity Level 2 (emergent)
Acuity Level 1 (life-threatening situation)
Acuity Level 3 (urgent) . Answer: Acuity Level 2 (emergent)
▶An 84-year-old male with a decreased level of consciousness presents to
the emergency department from a nursing home. The patient has a history
