APEX-STYLE MOCK EXAM – 150 ORIGINAL
PRACTICE QUESTIONS WITH VERIFIED ANSWERS
& RATIONALES
SECTION 1: FUNDAMENTALS & SAFETY (Questions 1–
25)
Question 1
A nurse is caring for a client who is confused and trying to pull out their IV
line. The nurse obtains a prescription for wrist restraints. Which action is
correct when applying the restraints?
A) Secure the restraints tightly to prevent the client from removing the IV
line
B) Attach the restraints to the bed's side rails
C) Allow room for two fingers to fit between the client's skin and the
restraints
D) Document the client's response every 4 hours
Answer: C) Allow room for two fingers to fit between the client's
skin and the restraints
Rationale: Restraints must be applied loosely enough for two fingers to fit
between the restraint and skin to prevent circulatory impairment. They
should be secured to a part of the bed frame that moves with the client, not
to side rails. Assessment must occur at least every 2 hours.
,Question 2
A nurse discovers sparks coming from an IV pump. Which action should the
nurse take FIRST?
A) Activate the fire alarm
B) Unplug the IV pump from the electrical outlet
C) Extinguish the sparks with a fire extinguisher
D) Label the pump as broken
Answer: B) Unplug the IV pump from the electrical outlet
Rationale: The RACE sequence for fire safety begins with Rescue (removing
clients), then Alarm. However, immediately unplugging the source of sparks
eliminates the hazard. The priority when an electrical device malfunctions is
to disconnect it from the power source.
Question 3
A nurse is caring for a client with Clostridioides difficile (C. diff). Which
infection control precaution is most important?
A) Airborne precautions with N95 respirator
B) Droplet precautions with surgical mask
C) Contact precautions with soap and water hand hygiene
D) Standard precautions only
Answer: C) Contact precautions with soap and water hand hygiene
Rationale: C. diff is spread by contact with spores. Alcohol-based hand
sanitizers are not effective against C. diff spores, so hand hygiene must be
performed with soap and water. Contact precautions (gown and gloves) are
required.
Question 4
The nurse is preparing a sterile field for a dressing change. The nurse
accidentally touches the edge of the sterile field. What should the nurse do?
A) Continue as the edge is part of the sterile field
B) Discard the contaminated setup and prepare a new sterile field
C) Place a new sterile drape over the contaminated area
D) Cleanse the contaminated area with alcohol
,Answer: B) Discard the contaminated setup and prepare a new
sterile field
*Rationale: The edges of a sterile field are considered contaminated (1-inch
or 2.5 cm border). Once contamination occurs, sterility is compromised, and
the entire setup must be replaced.*
Question 5
The nurse is performing hand hygiene. Which action demonstrates correct
technique?
A) Wash hands with soap and water for at least 5 seconds
B) Use alcohol-based hand rub for visibly soiled hands
C) Vigorously rub all surfaces of the hands for at least 20 seconds
D) Rinse hands with warm water before applying soap
Answer: C) Vigorously rub all surfaces of the hands for at least 20
seconds
*Rationale: Effective handwashing requires at least 20 seconds of vigorous
friction covering all hand surfaces. Soap and water, not alcohol-based hand
rub, should be used when hands are visibly soiled.*
Question 6
Which client is at highest risk for developing a pressure injury?
A) A client who ambulates independently twice daily
B) An immobile client with inadequate nutrition
C) A client on a regular diet with no deficits
D) A client who uses a walker
Answer: B) An immobile client with inadequate nutrition
Rationale: Immobility creates unrelieved pressure on bony prominences.
Poor nutrition, specifically protein-calorie malnutrition, impairs tissue
integrity and wound healing, greatly increasing the risk of pressure injury
development.
, Question 7
A nurse is providing oral care to an unconscious client. What is the most
important action to prevent aspiration?
A) Use a foam swab instead of a toothbrush
B) Place the client in a side-lying position with the head turned
C) Use half-strength hydrogen peroxide solution
D) Rinse the client's mouth with a large amount of water
Answer: B) Place the client in a side-lying position with the head
turned
Rationale: Positioning the client on their side with the head turned allows
fluid to drain out of the mouth by gravity, preventing aspiration. Water
should not be used in large volumes in an unconscious client due to the
absent gag reflex.
Question 8
A client reports difficulty sleeping in the hospital. Which intervention should
the nurse implement first?
A) Administer a prescribed sedative
B) Offer a back rub and create a quiet environment
C) Suggest the client exercise before bedtime
D) Keep the television on for background noise
Answer: B) Offer a back rub and create a quiet environment
Rationale: Non-pharmacological interventions should be attempted first. A
back rub promotes relaxation, and minimizing noise and light supports
natural sleep patterns.
Question 9
The nurse is performing a bed bath. At what temperature should the bath
water be maintained?
A) 90°F to 95°F (32°C to 35°C)
B) 105°F to 115°F (40.6°C to 46.1°C)
C) 110°F to 115°F (43.3°C to 46.1°C)
D) 120°F to 125°F (48.9°C to 51.7°C)
PRACTICE QUESTIONS WITH VERIFIED ANSWERS
& RATIONALES
SECTION 1: FUNDAMENTALS & SAFETY (Questions 1–
25)
Question 1
A nurse is caring for a client who is confused and trying to pull out their IV
line. The nurse obtains a prescription for wrist restraints. Which action is
correct when applying the restraints?
A) Secure the restraints tightly to prevent the client from removing the IV
line
B) Attach the restraints to the bed's side rails
C) Allow room for two fingers to fit between the client's skin and the
restraints
D) Document the client's response every 4 hours
Answer: C) Allow room for two fingers to fit between the client's
skin and the restraints
Rationale: Restraints must be applied loosely enough for two fingers to fit
between the restraint and skin to prevent circulatory impairment. They
should be secured to a part of the bed frame that moves with the client, not
to side rails. Assessment must occur at least every 2 hours.
,Question 2
A nurse discovers sparks coming from an IV pump. Which action should the
nurse take FIRST?
A) Activate the fire alarm
B) Unplug the IV pump from the electrical outlet
C) Extinguish the sparks with a fire extinguisher
D) Label the pump as broken
Answer: B) Unplug the IV pump from the electrical outlet
Rationale: The RACE sequence for fire safety begins with Rescue (removing
clients), then Alarm. However, immediately unplugging the source of sparks
eliminates the hazard. The priority when an electrical device malfunctions is
to disconnect it from the power source.
Question 3
A nurse is caring for a client with Clostridioides difficile (C. diff). Which
infection control precaution is most important?
A) Airborne precautions with N95 respirator
B) Droplet precautions with surgical mask
C) Contact precautions with soap and water hand hygiene
D) Standard precautions only
Answer: C) Contact precautions with soap and water hand hygiene
Rationale: C. diff is spread by contact with spores. Alcohol-based hand
sanitizers are not effective against C. diff spores, so hand hygiene must be
performed with soap and water. Contact precautions (gown and gloves) are
required.
Question 4
The nurse is preparing a sterile field for a dressing change. The nurse
accidentally touches the edge of the sterile field. What should the nurse do?
A) Continue as the edge is part of the sterile field
B) Discard the contaminated setup and prepare a new sterile field
C) Place a new sterile drape over the contaminated area
D) Cleanse the contaminated area with alcohol
,Answer: B) Discard the contaminated setup and prepare a new
sterile field
*Rationale: The edges of a sterile field are considered contaminated (1-inch
or 2.5 cm border). Once contamination occurs, sterility is compromised, and
the entire setup must be replaced.*
Question 5
The nurse is performing hand hygiene. Which action demonstrates correct
technique?
A) Wash hands with soap and water for at least 5 seconds
B) Use alcohol-based hand rub for visibly soiled hands
C) Vigorously rub all surfaces of the hands for at least 20 seconds
D) Rinse hands with warm water before applying soap
Answer: C) Vigorously rub all surfaces of the hands for at least 20
seconds
*Rationale: Effective handwashing requires at least 20 seconds of vigorous
friction covering all hand surfaces. Soap and water, not alcohol-based hand
rub, should be used when hands are visibly soiled.*
Question 6
Which client is at highest risk for developing a pressure injury?
A) A client who ambulates independently twice daily
B) An immobile client with inadequate nutrition
C) A client on a regular diet with no deficits
D) A client who uses a walker
Answer: B) An immobile client with inadequate nutrition
Rationale: Immobility creates unrelieved pressure on bony prominences.
Poor nutrition, specifically protein-calorie malnutrition, impairs tissue
integrity and wound healing, greatly increasing the risk of pressure injury
development.
, Question 7
A nurse is providing oral care to an unconscious client. What is the most
important action to prevent aspiration?
A) Use a foam swab instead of a toothbrush
B) Place the client in a side-lying position with the head turned
C) Use half-strength hydrogen peroxide solution
D) Rinse the client's mouth with a large amount of water
Answer: B) Place the client in a side-lying position with the head
turned
Rationale: Positioning the client on their side with the head turned allows
fluid to drain out of the mouth by gravity, preventing aspiration. Water
should not be used in large volumes in an unconscious client due to the
absent gag reflex.
Question 8
A client reports difficulty sleeping in the hospital. Which intervention should
the nurse implement first?
A) Administer a prescribed sedative
B) Offer a back rub and create a quiet environment
C) Suggest the client exercise before bedtime
D) Keep the television on for background noise
Answer: B) Offer a back rub and create a quiet environment
Rationale: Non-pharmacological interventions should be attempted first. A
back rub promotes relaxation, and minimizing noise and light supports
natural sleep patterns.
Question 9
The nurse is performing a bed bath. At what temperature should the bath
water be maintained?
A) 90°F to 95°F (32°C to 35°C)
B) 105°F to 115°F (40.6°C to 46.1°C)
C) 110°F to 115°F (43.3°C to 46.1°C)
D) 120°F to 125°F (48.9°C to 51.7°C)
