Western Governors University
CCN: NURS 3126
Course Number: D453
Course Title: Advanced Nursing Skills
Exam: Final Assessment
Date:2026
A nurse is preparing to administer packed red blood cells to a postoperative patient with hemoglobin of 6.8
g/dL. Which action is the priority before initiating the transfusion?
A. Warm the blood in a microwave
B. Verify patient identity and blood compatibility with another licensed nurse
C. Administer medications through the same IV line
D. Infuse dextrose solution with the blood product
Correct Answer: B
Rationale: Accurate patient identification and compatibility verification are critical to prevent fatal transfusion
reactions.
---
1
,True or False: Central venous pressure monitoring helps evaluate right ventricular preload and fluid status.
Correct Answer: True
Rationale: Central venous pressure reflects venous return and right-sided cardiac filling pressures.
---
Fill in the blank: The nursing skill involving insertion of a tube into the trachea to maintain airway patency is
called endotracheal __________.
Correct Answer: intubation
Rationale: Endotracheal intubation secures the airway and facilitates ventilation.
---
A patient receiving total parenteral nutrition (TPN) suddenly develops dyspnea and chest pain during central
line dressing change. Which complication should the nurse suspect?
A. Air embolism
B. Hypoglycemia
C. Hypernatremia
D. Pleural effusion
Correct Answer: A
Rationale: Air embolism can occur during central venous catheter manipulation and may cause respiratory
distress and cardiovascular collapse.
2
,---
A nurse is caring for a patient with a chest tube connected to suction drainage. Continuous bubbling is observed
in the water-seal chamber. What is the nurse’s priority action?
A. Clamp the chest tube immediately
B. Assess the system for an air leak
C. Increase suction pressure
D. Remove the chest tube
Correct Answer: B
Rationale: Continuous bubbling in the water-seal chamber usually indicates an air leak requiring systematic
assessment.
---
True or False: Sterile technique is essential during urinary catheter insertion to reduce catheter-associated
urinary tract infections.
Correct Answer: True
Rationale: Maintaining sterility minimizes introduction of microorganisms into the urinary tract.
---
A patient receiving intravenous potassium chloride reports burning at the IV site. Which nursing action is most
appropriate?
3
, A. Increase the infusion rate
B. Assess IV patency and dilute infusion if prescribed
C. Administer potassium by IV push
D. Ignore the complaint if serum potassium is low
Correct Answer: B
Rationale: Potassium chloride is irritating to veins and may cause infiltration or phlebitis.
---
Fill in the blank: The advanced nursing procedure used to remove secretions from the airway through a catheter
is called __________ suctioning.
Correct Answer: endotracheal
Rationale: Endotracheal suctioning maintains airway patency in intubated patients.
---
A nurse is performing tracheostomy care for a patient receiving mechanical ventilation. Which action requires
immediate correction?
A. Using sterile technique
B. Hyperoxygenating before suctioning
C. Suctioning routinely for 30 seconds continuously
D. Assessing breath sounds after suctioning
4
CCN: NURS 3126
Course Number: D453
Course Title: Advanced Nursing Skills
Exam: Final Assessment
Date:2026
A nurse is preparing to administer packed red blood cells to a postoperative patient with hemoglobin of 6.8
g/dL. Which action is the priority before initiating the transfusion?
A. Warm the blood in a microwave
B. Verify patient identity and blood compatibility with another licensed nurse
C. Administer medications through the same IV line
D. Infuse dextrose solution with the blood product
Correct Answer: B
Rationale: Accurate patient identification and compatibility verification are critical to prevent fatal transfusion
reactions.
---
1
,True or False: Central venous pressure monitoring helps evaluate right ventricular preload and fluid status.
Correct Answer: True
Rationale: Central venous pressure reflects venous return and right-sided cardiac filling pressures.
---
Fill in the blank: The nursing skill involving insertion of a tube into the trachea to maintain airway patency is
called endotracheal __________.
Correct Answer: intubation
Rationale: Endotracheal intubation secures the airway and facilitates ventilation.
---
A patient receiving total parenteral nutrition (TPN) suddenly develops dyspnea and chest pain during central
line dressing change. Which complication should the nurse suspect?
A. Air embolism
B. Hypoglycemia
C. Hypernatremia
D. Pleural effusion
Correct Answer: A
Rationale: Air embolism can occur during central venous catheter manipulation and may cause respiratory
distress and cardiovascular collapse.
2
,---
A nurse is caring for a patient with a chest tube connected to suction drainage. Continuous bubbling is observed
in the water-seal chamber. What is the nurse’s priority action?
A. Clamp the chest tube immediately
B. Assess the system for an air leak
C. Increase suction pressure
D. Remove the chest tube
Correct Answer: B
Rationale: Continuous bubbling in the water-seal chamber usually indicates an air leak requiring systematic
assessment.
---
True or False: Sterile technique is essential during urinary catheter insertion to reduce catheter-associated
urinary tract infections.
Correct Answer: True
Rationale: Maintaining sterility minimizes introduction of microorganisms into the urinary tract.
---
A patient receiving intravenous potassium chloride reports burning at the IV site. Which nursing action is most
appropriate?
3
, A. Increase the infusion rate
B. Assess IV patency and dilute infusion if prescribed
C. Administer potassium by IV push
D. Ignore the complaint if serum potassium is low
Correct Answer: B
Rationale: Potassium chloride is irritating to veins and may cause infiltration or phlebitis.
---
Fill in the blank: The advanced nursing procedure used to remove secretions from the airway through a catheter
is called __________ suctioning.
Correct Answer: endotracheal
Rationale: Endotracheal suctioning maintains airway patency in intubated patients.
---
A nurse is performing tracheostomy care for a patient receiving mechanical ventilation. Which action requires
immediate correction?
A. Using sterile technique
B. Hyperoxygenating before suctioning
C. Suctioning routinely for 30 seconds continuously
D. Assessing breath sounds after suctioning
4
