LPN Skills Check-Offs: IV, NG, and Wound Vac 2026/2027 UPDATE
1. When initiating an IV infusion on an adult patient, which vein is generally
considered the best first choice to preserve the vein proximal to it?
A. Basilic vein in the upper arm
B. Cephalic vein in the forearm
C. Digital vein in the finger
D. Great saphenous vein in the leg
Answer: B
Rationale: The cephalic vein in the forearm is preferred. It is a large vein, and starting
distally (in the lower arm) preserves more proximal sites for future use.
2. Which measurement technique is used to determine the correct insertion
length for a nasogastric (NG) tube?
A. From the chin to the umbilicus
B. From the sternal notch to the earlobe, then to the nose
C. From the mouth to the stomach, plus 10 inches
D. From the tip of the nose to the earlobe, then to the xiphoid process
Answer: D
Rationale: The standard measurement for NG tube insertion is the distance from the tip of
the nose to the earlobe and then to the xiphoid process.
,3. A patient with a Wound Vac (NPWT) complains of increased pain at the site.
What is the nurse’s priority assessment?
A. Check for a leak in the seal
B. Increase the pressure setting
C. Turn off the suction immediately
D. Assess the wound for signs of infection or ischemia
Answer: D
Rationale: New or increased pain can indicate infection, ischemia, or excessive pressure,
requiring a direct assessment of the wound bed and surrounding tissue.
4. What is the correct angle of insertion for a peripheral IV catheter?
A. 45 to 60 degrees
B. 5 to 10 degrees
C. 90 degrees
D. 10 to 30 degrees
Answer: D
Rationale: The needle should be inserted at a 10- to 30-degree angle, depending on the
depth of the vein, to ensure it enters the lumen without piercing the back wall.
5. Which finding is most indicative of IV infiltration?
A. Cool skin and edema around the insertion site
B. Redness and warmth along the vein
C. Purulent drainage from the site
D. A palpable venous cord
Answer: A
Rationale: Infiltration occurs when non-vesicant fluid enters the subcutaneous tissue,
causing the skin to feel cool, blanched, and swollen.
, 6. Before administering a bolus feeding through an NG tube, what is the most
reliable bedside method to verify placement?
A. Auscultating air over the epigastrium
B. Asking the patient to speak
C. Checking the pH of aspirated gastric contents
D. Observing for respiratory distress
Answer: C
Rationale: While X-ray is the gold standard for initial placement, checking the pH (usually
<5) is the most reliable bedside method for subsequent verification.
7. During Wound Vac management, which type of foam is typically used to
promote granulation tissue in a deep wound?
A. White hydrophilic foam
B. Adhesive hydrocolloid
C. Silver-impregnated mesh
D. Black polyurethane foam
Answer: D
Rationale: Black foam (polyurethane) has larger pores and is most effective at stimulating
granulation tissue and wound contraction.
8. The nurse notices a ‘Leak Alarm’ on the Wound Vac machine. Which action
should be taken first?
A. Apply more transparent film over areas where air might be entering
B. Change the entire dressing
C. Silence the alarm and wait for the provider
D. Irrigate the tubing with normal saline
Answer: A
Rationale: Most leaks occur around the edges of the transparent dressing; smoothing or
adding more film to reinforce the seal is the first step.
1. When initiating an IV infusion on an adult patient, which vein is generally
considered the best first choice to preserve the vein proximal to it?
A. Basilic vein in the upper arm
B. Cephalic vein in the forearm
C. Digital vein in the finger
D. Great saphenous vein in the leg
Answer: B
Rationale: The cephalic vein in the forearm is preferred. It is a large vein, and starting
distally (in the lower arm) preserves more proximal sites for future use.
2. Which measurement technique is used to determine the correct insertion
length for a nasogastric (NG) tube?
A. From the chin to the umbilicus
B. From the sternal notch to the earlobe, then to the nose
C. From the mouth to the stomach, plus 10 inches
D. From the tip of the nose to the earlobe, then to the xiphoid process
Answer: D
Rationale: The standard measurement for NG tube insertion is the distance from the tip of
the nose to the earlobe and then to the xiphoid process.
,3. A patient with a Wound Vac (NPWT) complains of increased pain at the site.
What is the nurse’s priority assessment?
A. Check for a leak in the seal
B. Increase the pressure setting
C. Turn off the suction immediately
D. Assess the wound for signs of infection or ischemia
Answer: D
Rationale: New or increased pain can indicate infection, ischemia, or excessive pressure,
requiring a direct assessment of the wound bed and surrounding tissue.
4. What is the correct angle of insertion for a peripheral IV catheter?
A. 45 to 60 degrees
B. 5 to 10 degrees
C. 90 degrees
D. 10 to 30 degrees
Answer: D
Rationale: The needle should be inserted at a 10- to 30-degree angle, depending on the
depth of the vein, to ensure it enters the lumen without piercing the back wall.
5. Which finding is most indicative of IV infiltration?
A. Cool skin and edema around the insertion site
B. Redness and warmth along the vein
C. Purulent drainage from the site
D. A palpable venous cord
Answer: A
Rationale: Infiltration occurs when non-vesicant fluid enters the subcutaneous tissue,
causing the skin to feel cool, blanched, and swollen.
, 6. Before administering a bolus feeding through an NG tube, what is the most
reliable bedside method to verify placement?
A. Auscultating air over the epigastrium
B. Asking the patient to speak
C. Checking the pH of aspirated gastric contents
D. Observing for respiratory distress
Answer: C
Rationale: While X-ray is the gold standard for initial placement, checking the pH (usually
<5) is the most reliable bedside method for subsequent verification.
7. During Wound Vac management, which type of foam is typically used to
promote granulation tissue in a deep wound?
A. White hydrophilic foam
B. Adhesive hydrocolloid
C. Silver-impregnated mesh
D. Black polyurethane foam
Answer: D
Rationale: Black foam (polyurethane) has larger pores and is most effective at stimulating
granulation tissue and wound contraction.
8. The nurse notices a ‘Leak Alarm’ on the Wound Vac machine. Which action
should be taken first?
A. Apply more transparent film over areas where air might be entering
B. Change the entire dressing
C. Silence the alarm and wait for the provider
D. Irrigate the tubing with normal saline
Answer: A
Rationale: Most leaks occur around the edges of the transparent dressing; smoothing or
adding more film to reinforce the seal is the first step.
