1. Which of the following is the most important aspect of infection control in a healthcare
setting?
A. Hand hygiene
B. Wearing gloves
C. Using disinfectant wipes
D. Wearing a mask
Answer: A. Hand hygiene
Rationale: Proper hand hygiene is the most effective way to prevent the spread of infections in
healthcare settings. It eliminates microorganisms from the hands and is essential in breaking the
chain of infection.
2. A nurse is caring for a patient who is postoperative and is at risk for deep vein
thrombosis (DVT). Which of the following actions is most appropriate to prevent DVT?
A. Applying compression stockings
B. Encouraging deep breathing exercises
C. Encouraging the patient to remain in bed
D. Administering a stool softener
Answer: A. Applying compression stockings
Rationale: Compression stockings help reduce the risk of DVT by improving venous return and
preventing blood from pooling in the legs.
3. Which of the following is an appropriate intervention for a patient with impaired skin
integrity?
A. Change the dressing every 12 hours
B. Keep the wound moist to promote healing
C. Avoid turning the patient to prevent further damage
D. Apply a heating pad to the affected area
Answer: B. Keep the wound moist to promote healing
Rationale: Keeping the wound moist (while preventing infection) can speed up healing and
reduce scarring. It also supports the natural healing process by promoting cellular migration and
tissue regeneration.
4. A patient is receiving morphine for pain management. Which of the following side effects
should the nurse monitor for?
,A. Diarrhea
B. Bradycardia
C. Hypertension
D. Respiratory depression
Answer: D. Respiratory depression
Rationale: Morphine is an opioid analgesic that can suppress the respiratory center in the brain,
leading to respiratory depression, which can be life-threatening if not monitored closely.
5. A nurse is educating a patient with diabetes about the importance of foot care. Which of
the following instructions should the nurse include?
A. Wash feet with hot water and dry them thoroughly
B. Avoid trimming toenails to prevent injury
C. Wear tight-fitting shoes to support the feet
D. Check feet daily for cuts, blisters, or redness
Answer: D. Check feet daily for cuts, blisters, or redness
Rationale: Proper foot care is essential for patients with diabetes to prevent infection and
complications. Checking feet regularly helps identify early signs of problems like ulcers or
infections.
6. A nurse is caring for a patient who has a urinary catheter in place. Which of the
following is the best method for preventing catheter-associated urinary tract infections
(CAUTIs)?
A. Ensure the catheter is properly secured to the patient's thigh
B. Perform hand hygiene before and after handling the catheter
C. Change the catheter every 48 hours
D. Irrigate the catheter with sterile saline
Answer: B. Perform hand hygiene before and after handling the catheter
Rationale: Hand hygiene is the most important measure for preventing the spread of infections,
including CAUTIs. It is crucial to follow aseptic technique and maintain proper hygiene during
catheter care.
7. When performing a physical assessment on an elderly patient, the nurse should focus on
which of the following?
, A. Assessing for early signs of confusion or delirium
B. Focusing only on vital signs and organ function
C. Avoiding discussions about lifestyle and health history
D. Ignoring minor complaints, as they are common in aging
Answer: A. Assessing for early signs of confusion or delirium
Rationale: Older adults are at increased risk for confusion or delirium, often due to infections,
medications, or other health changes. Early detection can help prevent further complications.
8. A patient is receiving a blood transfusion. The nurse notices signs of an allergic reaction.
Which of the following is the first action the nurse should take?
A. Stop the transfusion immediately
B. Administer epinephrine
C. Notify the healthcare provider
D. Assess vital signs and temperature
Answer: A. Stop the transfusion immediately
Rationale: The first step in managing an allergic reaction to a blood transfusion is to stop the
transfusion. This minimizes further exposure to the allergen and allows for proper treatment of
the reaction.
9. A nurse is administering an intramuscular (IM) injection. Which of the following is the
correct technique?
A. Inject the medication slowly at a 30-degree angle
B. Use the dorsogluteal site for most injections
C. Pull the skin taut and insert the needle at a 90-degree angle
D. Aspirate the syringe after insertion to check for blood return
Answer: C. Pull the skin taut and insert the needle at a 90-degree angle
Rationale: IM injections are typically administered at a 90-degree angle to the skin. Pulling the
skin taut helps prevent tissue damage and ensures proper needle insertion.
10. A nurse is planning care for a patient with hypertension. Which of the following
interventions should be included in the plan?
A. Encourage a high-sodium diet
B. Monitor blood pressure regularly
setting?
A. Hand hygiene
B. Wearing gloves
C. Using disinfectant wipes
D. Wearing a mask
Answer: A. Hand hygiene
Rationale: Proper hand hygiene is the most effective way to prevent the spread of infections in
healthcare settings. It eliminates microorganisms from the hands and is essential in breaking the
chain of infection.
2. A nurse is caring for a patient who is postoperative and is at risk for deep vein
thrombosis (DVT). Which of the following actions is most appropriate to prevent DVT?
A. Applying compression stockings
B. Encouraging deep breathing exercises
C. Encouraging the patient to remain in bed
D. Administering a stool softener
Answer: A. Applying compression stockings
Rationale: Compression stockings help reduce the risk of DVT by improving venous return and
preventing blood from pooling in the legs.
3. Which of the following is an appropriate intervention for a patient with impaired skin
integrity?
A. Change the dressing every 12 hours
B. Keep the wound moist to promote healing
C. Avoid turning the patient to prevent further damage
D. Apply a heating pad to the affected area
Answer: B. Keep the wound moist to promote healing
Rationale: Keeping the wound moist (while preventing infection) can speed up healing and
reduce scarring. It also supports the natural healing process by promoting cellular migration and
tissue regeneration.
4. A patient is receiving morphine for pain management. Which of the following side effects
should the nurse monitor for?
,A. Diarrhea
B. Bradycardia
C. Hypertension
D. Respiratory depression
Answer: D. Respiratory depression
Rationale: Morphine is an opioid analgesic that can suppress the respiratory center in the brain,
leading to respiratory depression, which can be life-threatening if not monitored closely.
5. A nurse is educating a patient with diabetes about the importance of foot care. Which of
the following instructions should the nurse include?
A. Wash feet with hot water and dry them thoroughly
B. Avoid trimming toenails to prevent injury
C. Wear tight-fitting shoes to support the feet
D. Check feet daily for cuts, blisters, or redness
Answer: D. Check feet daily for cuts, blisters, or redness
Rationale: Proper foot care is essential for patients with diabetes to prevent infection and
complications. Checking feet regularly helps identify early signs of problems like ulcers or
infections.
6. A nurse is caring for a patient who has a urinary catheter in place. Which of the
following is the best method for preventing catheter-associated urinary tract infections
(CAUTIs)?
A. Ensure the catheter is properly secured to the patient's thigh
B. Perform hand hygiene before and after handling the catheter
C. Change the catheter every 48 hours
D. Irrigate the catheter with sterile saline
Answer: B. Perform hand hygiene before and after handling the catheter
Rationale: Hand hygiene is the most important measure for preventing the spread of infections,
including CAUTIs. It is crucial to follow aseptic technique and maintain proper hygiene during
catheter care.
7. When performing a physical assessment on an elderly patient, the nurse should focus on
which of the following?
, A. Assessing for early signs of confusion or delirium
B. Focusing only on vital signs and organ function
C. Avoiding discussions about lifestyle and health history
D. Ignoring minor complaints, as they are common in aging
Answer: A. Assessing for early signs of confusion or delirium
Rationale: Older adults are at increased risk for confusion or delirium, often due to infections,
medications, or other health changes. Early detection can help prevent further complications.
8. A patient is receiving a blood transfusion. The nurse notices signs of an allergic reaction.
Which of the following is the first action the nurse should take?
A. Stop the transfusion immediately
B. Administer epinephrine
C. Notify the healthcare provider
D. Assess vital signs and temperature
Answer: A. Stop the transfusion immediately
Rationale: The first step in managing an allergic reaction to a blood transfusion is to stop the
transfusion. This minimizes further exposure to the allergen and allows for proper treatment of
the reaction.
9. A nurse is administering an intramuscular (IM) injection. Which of the following is the
correct technique?
A. Inject the medication slowly at a 30-degree angle
B. Use the dorsogluteal site for most injections
C. Pull the skin taut and insert the needle at a 90-degree angle
D. Aspirate the syringe after insertion to check for blood return
Answer: C. Pull the skin taut and insert the needle at a 90-degree angle
Rationale: IM injections are typically administered at a 90-degree angle to the skin. Pulling the
skin taut helps prevent tissue damage and ensures proper needle insertion.
10. A nurse is planning care for a patient with hypertension. Which of the following
interventions should be included in the plan?
A. Encourage a high-sodium diet
B. Monitor blood pressure regularly
