NURS 104L Fundamentals of Nursing Skills Lab Comprehensive Final
Exam Study Guide 2026 |WCU
1. A nurse is performing hand hygiene. Which action is the most critical factor in
removing microorganisms during the hand-washing process?
A. The amount of soap used
B. The temperature of the water
C. The type of towel used for drying
D. Friction during rubbing
Answer: D
Rationale: Friction is the most effective component of hand hygiene because it physically
removes transient microbes from the skin’s surface.
2. When donning Personal Protective Equipment (PPE), which item should be
applied first according to standard CDC guidelines?
A. Gloves
B. Goggles or Face shield
C. Mask or Respirator
D. Gown
Answer: D
Rationale: The standard sequence for donning PPE is Gown, then Mask/Respirator, then
Goggles/Face Shield, and finally Gloves.
,3. A nurse is assessing a patient’s blood pressure using a cuff that is too narrow
for the patient’s arm circumference. What result should the nurse expect?
A. A falsely low reading
B. A reading that is only accurate for systolic
C. A falsely high reading
D. The cuff size does not affect the reading
Answer: C
Rationale: A cuff that is too small or narrow will provide a falsely high blood pressure
reading, while a cuff that is too large will provide a falsely low reading.
4. While assessing the apical pulse of a patient, where should the nurse place
the stethoscope?
A. Second intercostal space, right sternal border
B. Fourth intercostal space, left sternal border
C. Second intercostal space, left sternal border
D. Fifth intercostal space, midclavicular line
Answer: D
Rationale: The apical pulse (Point of Maximal Impulse) is best auscultated at the fifth
intercostal space at the left midclavicular line.
5. The nurse is preparing to administer NPH and Regular insulin in the same
syringe. Which step is correct?
A. Draw up the NPH insulin first
B. Inject air into the Regular insulin vial first
C. Draw up the Regular insulin first
D. Mixing these two insulins is contraindicated
Answer: C
Rationale: When mixing insulin, you draw ‘Clear before Cloudy’ (Regular before NPH) to
prevent contaminating the clear insulin with the long-acting NPH protein.
, 6. A patient is placed on Airborne Precautions. Which of the following is a
requirement for this type of isolation?
A. Surgical mask within 3 feet of the patient
B. Keeping the door open for ventilation
C. Negative pressure private room
D. Standard medical exam gloves only
Answer: C
Rationale: Airborne precautions require a private, negative-pressure airflow room and the
use of an N95 respirator.
7. What is the appropriate angle for an intradermal injection?
A. 45 degrees
B. 5 to 15 degrees
C. 90 degrees
D. 30 degrees
Answer: B
Rationale: Intradermal injections are administered into the dermis, just under the
epidermis, at a 5-15 degree angle with the bevel up.
8. When assessing the abdomen, in what order should the nurse perform the
physical assessment techniques?
A. Inspection, Auscultation, Percussion, Palpation
B. Inspection, Palpation, Percussion, Auscultation
C. Auscultation, Inspection, Palpation, Percussion
D. Palpation, Percussion, Auscultation, Inspection
Answer: A
Rationale: For the abdomen, auscultation is performed before percussion and palpation to
avoid stimulating bowel sounds and altering the natural findings.
Exam Study Guide 2026 |WCU
1. A nurse is performing hand hygiene. Which action is the most critical factor in
removing microorganisms during the hand-washing process?
A. The amount of soap used
B. The temperature of the water
C. The type of towel used for drying
D. Friction during rubbing
Answer: D
Rationale: Friction is the most effective component of hand hygiene because it physically
removes transient microbes from the skin’s surface.
2. When donning Personal Protective Equipment (PPE), which item should be
applied first according to standard CDC guidelines?
A. Gloves
B. Goggles or Face shield
C. Mask or Respirator
D. Gown
Answer: D
Rationale: The standard sequence for donning PPE is Gown, then Mask/Respirator, then
Goggles/Face Shield, and finally Gloves.
,3. A nurse is assessing a patient’s blood pressure using a cuff that is too narrow
for the patient’s arm circumference. What result should the nurse expect?
A. A falsely low reading
B. A reading that is only accurate for systolic
C. A falsely high reading
D. The cuff size does not affect the reading
Answer: C
Rationale: A cuff that is too small or narrow will provide a falsely high blood pressure
reading, while a cuff that is too large will provide a falsely low reading.
4. While assessing the apical pulse of a patient, where should the nurse place
the stethoscope?
A. Second intercostal space, right sternal border
B. Fourth intercostal space, left sternal border
C. Second intercostal space, left sternal border
D. Fifth intercostal space, midclavicular line
Answer: D
Rationale: The apical pulse (Point of Maximal Impulse) is best auscultated at the fifth
intercostal space at the left midclavicular line.
5. The nurse is preparing to administer NPH and Regular insulin in the same
syringe. Which step is correct?
A. Draw up the NPH insulin first
B. Inject air into the Regular insulin vial first
C. Draw up the Regular insulin first
D. Mixing these two insulins is contraindicated
Answer: C
Rationale: When mixing insulin, you draw ‘Clear before Cloudy’ (Regular before NPH) to
prevent contaminating the clear insulin with the long-acting NPH protein.
, 6. A patient is placed on Airborne Precautions. Which of the following is a
requirement for this type of isolation?
A. Surgical mask within 3 feet of the patient
B. Keeping the door open for ventilation
C. Negative pressure private room
D. Standard medical exam gloves only
Answer: C
Rationale: Airborne precautions require a private, negative-pressure airflow room and the
use of an N95 respirator.
7. What is the appropriate angle for an intradermal injection?
A. 45 degrees
B. 5 to 15 degrees
C. 90 degrees
D. 30 degrees
Answer: B
Rationale: Intradermal injections are administered into the dermis, just under the
epidermis, at a 5-15 degree angle with the bevel up.
8. When assessing the abdomen, in what order should the nurse perform the
physical assessment techniques?
A. Inspection, Auscultation, Percussion, Palpation
B. Inspection, Palpation, Percussion, Auscultation
C. Auscultation, Inspection, Palpation, Percussion
D. Palpation, Percussion, Auscultation, Inspection
Answer: A
Rationale: For the abdomen, auscultation is performed before percussion and palpation to
avoid stimulating bowel sounds and altering the natural findings.
