CLINICAL NURSING SKILLS AND
TECHNIQUES 10TH EDITION
COMPREHENSIVE FINAL PAPER 2026
QUESTIONS WITH ANSWERS GRADED A+
⩥ A nurse aspirates a small amount of fluid from a client's nasogastric
tube. The nurse determines that the tube is in the intestines based on the
aspirate being which color?
Straw-colored
Tan
Off-white
Green. Answer: Straw-colored
Rationale:Gastric fluid can be green with particles, off-white, or brown
if old blood is present. Intestinal aspirate tends to look clear or straw-
colored to a deep golden yellow color. Also, intestinal aspirate may be
greenish brown if stained with bile. Respiratory or tracheobronchial
fluid is usually off-white to tan and may be tinged with mucus.
⩥ A nurse has just received a client's laboratory results and is reviewing
them. Which finding should the nurse recognize as an indication of
malnutrition or malabsorption?
Hemoglobin (Hgb) 11.3 g/dL (113 g/L)
Hematocrit (Hct) 56% (0.56)
Serum albumin 2.8 g/dL (28 g/L)
,Creatinine 1.9 mg/dL (168 μmol/L) Answer: Serum albumin 2.8 g/dL
(28 g/L)
Rationale:Normal serum albumin is 3.3 to 5 g/dL (33 to 50 g/L).
Decreased albumin indicates malnutrition or malabsorption. Decreased
Hgb indicates anemia. Increased creatinine indicates dehydration.
Increased Hct indicates dehydration.
⩥ A nurse has just inserted a nasogastric tube in a client. Which method
is most reliable for verifying the correct placement of the tube?
Confirmation that pH of the aspirate is less than 5.5
Off-white fluid aspirated
Green fluid with particles aspirated
Radiographic confirmation of position Answer: Radiographic
confirmation of position
Rationale:Radiographic (x-ray) examination is the only reliable method
to determine accurate tube placement. In the absence of an x-ray, pH
testing is predicative of correct placement. Although visualization of
aspirated contents can help confirm correct placement of the tube, this
method is not as reliable as an x-ray.
⩥ The nurse is deaccessing the implanted port of a client's central
venous access device (CVAD). After removing the dressing and tape
from the needle, what action would the nurse perform next?
Unclamp the extension tubing and flush with 10 mL heparin.
,Unclamp the extension tubing and flush with a minimum of 5 mL
normal saline.
Clean the end cap on the extension tubing and insert the heparin-filled
syringe.
Clean the end cap on the extension tubing and insert the saline-filled
syringe. Answer: removing, carefully, all the tape securing the needle in
place
Rationale: When deaccessing an implanted port, the nurse would put on
clean gloves, stabilize the port with the nondominant hand, and then
gently pull back the transparent dressing, beginning with the edges and
proceeding around the edge of the dressing, carefully removing all the
tape securing the needle in place
⩥ How would the nurse care for the access site after removing the
needle from the implanted port of a central venous access device
(CVAD)?
Apply steady pressure to the site with an antimicrobial wipe.
Allow the site to air dry before applying a transparent dressing.
Apply a sterile bandage after wiping the site with an alcohol wipe.
Apply gentle pressure to the site with a gauze square. Answer: Apply
gentle pressure to the site with a gauze square.
Rationale:The nurse would apply gentle pressure with gauze on the
insertion site and apply a commercial adhesive bandage over the port if
any oozing occurs. Otherwise, a dressing is not necessary. Using an
antimicrobial wipe to apply pressure is not recommended, because it
, may cause burning. Gentle pressure controls bleeding. The site should
not be allowed to air dry
⩥ A nurse is caring for a client with a central venous access device
(CVAD) whose implanted port will not be used for a long period of time.
What action will the nurse take to maintain patency of the port?
Flush with heparin solution
Place a sterile dressing over the port
Apply firm pressure after deaccessing the port
Flush with normal saline solution Answer: Flush with heparin solution
Rationale:Implanted ports should be "locked" with a heparin solution
(100 U/mL) before removal of an access needle and/or for periodic
access and flushing to prevent clotting and maintain patency. Flushing
with a saline solution is done to remove substances from the well of the
port. Gentle pressure should be applied after removing the needle to
prevent bleeding and a small adhesive bandage may be applied if oozing
continues. Otherwise a dressing is not necessary.
⩥ The nurse is deaccessing the implanted port of a client's central
venous access device (CVAD) following chemotherapy. Which action
would be appropriate?
removing the sterile dressing with a quick pulling motion
stabilizing the port with the dominant hand
removing, carefully, all the tape securing the needle in place
TECHNIQUES 10TH EDITION
COMPREHENSIVE FINAL PAPER 2026
QUESTIONS WITH ANSWERS GRADED A+
⩥ A nurse aspirates a small amount of fluid from a client's nasogastric
tube. The nurse determines that the tube is in the intestines based on the
aspirate being which color?
Straw-colored
Tan
Off-white
Green. Answer: Straw-colored
Rationale:Gastric fluid can be green with particles, off-white, or brown
if old blood is present. Intestinal aspirate tends to look clear or straw-
colored to a deep golden yellow color. Also, intestinal aspirate may be
greenish brown if stained with bile. Respiratory or tracheobronchial
fluid is usually off-white to tan and may be tinged with mucus.
⩥ A nurse has just received a client's laboratory results and is reviewing
them. Which finding should the nurse recognize as an indication of
malnutrition or malabsorption?
Hemoglobin (Hgb) 11.3 g/dL (113 g/L)
Hematocrit (Hct) 56% (0.56)
Serum albumin 2.8 g/dL (28 g/L)
,Creatinine 1.9 mg/dL (168 μmol/L) Answer: Serum albumin 2.8 g/dL
(28 g/L)
Rationale:Normal serum albumin is 3.3 to 5 g/dL (33 to 50 g/L).
Decreased albumin indicates malnutrition or malabsorption. Decreased
Hgb indicates anemia. Increased creatinine indicates dehydration.
Increased Hct indicates dehydration.
⩥ A nurse has just inserted a nasogastric tube in a client. Which method
is most reliable for verifying the correct placement of the tube?
Confirmation that pH of the aspirate is less than 5.5
Off-white fluid aspirated
Green fluid with particles aspirated
Radiographic confirmation of position Answer: Radiographic
confirmation of position
Rationale:Radiographic (x-ray) examination is the only reliable method
to determine accurate tube placement. In the absence of an x-ray, pH
testing is predicative of correct placement. Although visualization of
aspirated contents can help confirm correct placement of the tube, this
method is not as reliable as an x-ray.
⩥ The nurse is deaccessing the implanted port of a client's central
venous access device (CVAD). After removing the dressing and tape
from the needle, what action would the nurse perform next?
Unclamp the extension tubing and flush with 10 mL heparin.
,Unclamp the extension tubing and flush with a minimum of 5 mL
normal saline.
Clean the end cap on the extension tubing and insert the heparin-filled
syringe.
Clean the end cap on the extension tubing and insert the saline-filled
syringe. Answer: removing, carefully, all the tape securing the needle in
place
Rationale: When deaccessing an implanted port, the nurse would put on
clean gloves, stabilize the port with the nondominant hand, and then
gently pull back the transparent dressing, beginning with the edges and
proceeding around the edge of the dressing, carefully removing all the
tape securing the needle in place
⩥ How would the nurse care for the access site after removing the
needle from the implanted port of a central venous access device
(CVAD)?
Apply steady pressure to the site with an antimicrobial wipe.
Allow the site to air dry before applying a transparent dressing.
Apply a sterile bandage after wiping the site with an alcohol wipe.
Apply gentle pressure to the site with a gauze square. Answer: Apply
gentle pressure to the site with a gauze square.
Rationale:The nurse would apply gentle pressure with gauze on the
insertion site and apply a commercial adhesive bandage over the port if
any oozing occurs. Otherwise, a dressing is not necessary. Using an
antimicrobial wipe to apply pressure is not recommended, because it
, may cause burning. Gentle pressure controls bleeding. The site should
not be allowed to air dry
⩥ A nurse is caring for a client with a central venous access device
(CVAD) whose implanted port will not be used for a long period of time.
What action will the nurse take to maintain patency of the port?
Flush with heparin solution
Place a sterile dressing over the port
Apply firm pressure after deaccessing the port
Flush with normal saline solution Answer: Flush with heparin solution
Rationale:Implanted ports should be "locked" with a heparin solution
(100 U/mL) before removal of an access needle and/or for periodic
access and flushing to prevent clotting and maintain patency. Flushing
with a saline solution is done to remove substances from the well of the
port. Gentle pressure should be applied after removing the needle to
prevent bleeding and a small adhesive bandage may be applied if oozing
continues. Otherwise a dressing is not necessary.
⩥ The nurse is deaccessing the implanted port of a client's central
venous access device (CVAD) following chemotherapy. Which action
would be appropriate?
removing the sterile dressing with a quick pulling motion
stabilizing the port with the dominant hand
removing, carefully, all the tape securing the needle in place
