Galen College of Nursing NU 136 Exam 5 Actual
Practice Questions: Comprehensive Assessment
with Complete Verified Solutions
SECTION 1: INFECTION CONTROL & ASEPSIS (Questions 1-15)
Q1: A nurse is preparing to change a sterile dressing on a post-operative abdominal
wound. After performing hand hygiene, what is the NEXT appropriate step in
maintaining aseptic technique?
A. Apply sterile gloves immediately
B. Open the sterile dressing kit on a clean, dry surface
C. Clean the wound from the center outward
D. Assess the wound appearance and drainage
Correct Answer: B
Rationale: The correct sequence for sterile dressing change is: 1) Hand hygiene, 2)
Prepare sterile field (open supplies without contamination), 3) Apply sterile gloves, 4)
Remove old dressing, 5) Assess and clean wound, 6) Apply new dressing. Opening
sterile supplies before gloving prevents contaminating gloves while handling outer
packaging. Assessing the wound (D) occurs after removing the old dressing. Cleaning
(C) requires sterile gloves. Applying gloves (A) before opening supplies risks
contamination.
,Clinical Judgment: This tests procedural sequencing and understanding that sterile
technique requires environmental preparation before personal protection.
QSEN Competency: Safety - Minimizes risk of harm to patients through system
effectiveness and individual performance.
Q2: A patient with active pulmonary tuberculosis is being transported to the radiology
department for a chest X-ray. Which precaution must be maintained during transport?
A. Surgical mask on patient, staff wear N95 respirators
B. Patient in negative pressure room, no transport needed
C. Staff wear surgical masks, patient requires no mask
D. Gown and gloves for all staff, patient mask optional
Correct Answer: A
Rationale: Tuberculosis requires airborne precautions. The infectious patient must wear
a surgical mask during transport to prevent expelling droplet nuclei into the
environment. Healthcare workers require N95 respirators (or higher-level protection like
PAPR) because TB bacilli are small enough to pass through surgical masks. Negative
pressure rooms (B) contain the patient in the room but don't address transport. Surgical
masks for staff (C) are insufficient. Gown and gloves (D) are contact precautions, not
airborne.
Clinical Connection: TB is the classic example of airborne transmission; understanding
this distinction is critical for infection control and occupational safety.
,Q3: A nurse enters a patient's room and observes the patient coughing forcefully
without covering their mouth. The patient has been diagnosed with influenza 24 hours
ago. What is the nurse's immediate action?
A. Apply a mask to the patient and leave the room
B. Instruct the patient to cover coughs and provide tissues
C. Don PPE before approaching the patient
D. Transfer patient to negative pressure room
Correct Answer: B
Rationale: Immediate patient education about respiratory hygiene (covering coughs,
using tissues, hand hygiene) is the first response. This empowers the patient and
reduces transmission risk. While the nurse will need PPE (C) for prolonged contact,
immediate behavioral intervention takes precedence. Masking the patient (A) is
appropriate but education is more sustainable. Negative pressure (D) is unnecessary for
influenza (droplet precautions, not airborne).
Nursing Process: Assessment → Immediate intervention (education) → Protective
measures.
Q4: Select-All-That-Apply: Which actions demonstrate proper hand hygiene according to
CDC guidelines? (Select all that apply)
A. Using alcohol-based hand rub when hands are visibly clean
B. Washing with soap and water for at least 15 seconds
C. Applying hand sanitizer to cover all surfaces of hands
, D. Drying hands with a paper towel before using hand sanitizer
E. Removing rings and watches before handwashing
F. Turning off faucet with bare hands after rinsing
Correct Answers: A, C, E
Rationale:
● A is CORRECT: Alcohol-based hand rub (ABHR) is preferred for routine
decontamination when hands are not visibly soiled.
● C is CORRECT: Approximately 3 mL of sanitizer should cover all hand surfaces
(palms, backs, fingers, fingertips, thumbs, wrists).
● E is CORRECT: Jewelry harbors microorganisms and prevents thorough cleaning;
removal is essential.
● B is INCORRECT: Soap and water washing requires 20 seconds (not 15); 15
seconds is the minimum for ABHR application.
● D is INCORRECT: Hands must be completely dry before ABHR application is
irrelevant—ABHR is used instead of washing, not after.
● F is INCORRECT: Faucets should be turned off with a paper towel to prevent
recontamination.
Evidence-Based Practice: CDC Hand Hygiene Guidelines (2023) emphasize ABHR for
most clinical situations, with soap/water required for C. difficile, norovirus, and visibly
soiled hands.
Q5: A nurse is caring for a patient with a wound infected with methicillin-resistant
Staphylococcus aureus (MRSA). Which PPE is required when changing the wound
dressing?
A. Gloves only
B. Gloves and gown
Practice Questions: Comprehensive Assessment
with Complete Verified Solutions
SECTION 1: INFECTION CONTROL & ASEPSIS (Questions 1-15)
Q1: A nurse is preparing to change a sterile dressing on a post-operative abdominal
wound. After performing hand hygiene, what is the NEXT appropriate step in
maintaining aseptic technique?
A. Apply sterile gloves immediately
B. Open the sterile dressing kit on a clean, dry surface
C. Clean the wound from the center outward
D. Assess the wound appearance and drainage
Correct Answer: B
Rationale: The correct sequence for sterile dressing change is: 1) Hand hygiene, 2)
Prepare sterile field (open supplies without contamination), 3) Apply sterile gloves, 4)
Remove old dressing, 5) Assess and clean wound, 6) Apply new dressing. Opening
sterile supplies before gloving prevents contaminating gloves while handling outer
packaging. Assessing the wound (D) occurs after removing the old dressing. Cleaning
(C) requires sterile gloves. Applying gloves (A) before opening supplies risks
contamination.
,Clinical Judgment: This tests procedural sequencing and understanding that sterile
technique requires environmental preparation before personal protection.
QSEN Competency: Safety - Minimizes risk of harm to patients through system
effectiveness and individual performance.
Q2: A patient with active pulmonary tuberculosis is being transported to the radiology
department for a chest X-ray. Which precaution must be maintained during transport?
A. Surgical mask on patient, staff wear N95 respirators
B. Patient in negative pressure room, no transport needed
C. Staff wear surgical masks, patient requires no mask
D. Gown and gloves for all staff, patient mask optional
Correct Answer: A
Rationale: Tuberculosis requires airborne precautions. The infectious patient must wear
a surgical mask during transport to prevent expelling droplet nuclei into the
environment. Healthcare workers require N95 respirators (or higher-level protection like
PAPR) because TB bacilli are small enough to pass through surgical masks. Negative
pressure rooms (B) contain the patient in the room but don't address transport. Surgical
masks for staff (C) are insufficient. Gown and gloves (D) are contact precautions, not
airborne.
Clinical Connection: TB is the classic example of airborne transmission; understanding
this distinction is critical for infection control and occupational safety.
,Q3: A nurse enters a patient's room and observes the patient coughing forcefully
without covering their mouth. The patient has been diagnosed with influenza 24 hours
ago. What is the nurse's immediate action?
A. Apply a mask to the patient and leave the room
B. Instruct the patient to cover coughs and provide tissues
C. Don PPE before approaching the patient
D. Transfer patient to negative pressure room
Correct Answer: B
Rationale: Immediate patient education about respiratory hygiene (covering coughs,
using tissues, hand hygiene) is the first response. This empowers the patient and
reduces transmission risk. While the nurse will need PPE (C) for prolonged contact,
immediate behavioral intervention takes precedence. Masking the patient (A) is
appropriate but education is more sustainable. Negative pressure (D) is unnecessary for
influenza (droplet precautions, not airborne).
Nursing Process: Assessment → Immediate intervention (education) → Protective
measures.
Q4: Select-All-That-Apply: Which actions demonstrate proper hand hygiene according to
CDC guidelines? (Select all that apply)
A. Using alcohol-based hand rub when hands are visibly clean
B. Washing with soap and water for at least 15 seconds
C. Applying hand sanitizer to cover all surfaces of hands
, D. Drying hands with a paper towel before using hand sanitizer
E. Removing rings and watches before handwashing
F. Turning off faucet with bare hands after rinsing
Correct Answers: A, C, E
Rationale:
● A is CORRECT: Alcohol-based hand rub (ABHR) is preferred for routine
decontamination when hands are not visibly soiled.
● C is CORRECT: Approximately 3 mL of sanitizer should cover all hand surfaces
(palms, backs, fingers, fingertips, thumbs, wrists).
● E is CORRECT: Jewelry harbors microorganisms and prevents thorough cleaning;
removal is essential.
● B is INCORRECT: Soap and water washing requires 20 seconds (not 15); 15
seconds is the minimum for ABHR application.
● D is INCORRECT: Hands must be completely dry before ABHR application is
irrelevant—ABHR is used instead of washing, not after.
● F is INCORRECT: Faucets should be turned off with a paper towel to prevent
recontamination.
Evidence-Based Practice: CDC Hand Hygiene Guidelines (2023) emphasize ABHR for
most clinical situations, with soap/water required for C. difficile, norovirus, and visibly
soiled hands.
Q5: A nurse is caring for a patient with a wound infected with methicillin-resistant
Staphylococcus aureus (MRSA). Which PPE is required when changing the wound
dressing?
A. Gloves only
B. Gloves and gown
