FLORIDA UNDERGROUND UTILITY
CONTRACTOR EXAMINATION
Here is a comprehensive set of 320 multiple-choice questions designed to
mirror the style, content, and difficulty of the NCLEX-RN (National Council
Licensure Examination for Registered Nurses). The questions are organized
by major content areas, numbered sequentially, and each includes the correct
answer and a detailed rationale.
### Fundamentals of Nursing (Questions 1-30)
1. A nurse is preparing to administer an enteral feeding to a client via a
nasogastric tube. Which of the following actions should the nurse take first?
A. Flush the tube with 30 mL of water.
B. Verify the placement of the tube.
C. Check the residual volume.
D. Elevate the head of the bed to 30 degrees.
Correct Answer: B. Verify the placement of the tube.
Rationale: Patient safety is the priority. Before any feeding or medication is
administered, the nurse must first confirm that the tube is in the stomach (not
the lungs) by checking the pH of aspirate or obtaining an X-ray confirmation.
While flushing, checking residuals, and elevating the HOB are important, they
are secondary to verifying placement to prevent aspiration pneumonia.
,2. A client is on strict bed rest. The nurse assesses for a potential complication
of immobility. Which finding is the earliest sign of a pressure ulcer?
A. Full-thickness skin loss.
B. Non-blanchable erythema.
C. A fluid-filled blister.
D. Eschar formation.
Correct Answer: B. Non-blanchable erythema.
Rationale: Non-blanchable erythema (redness that does not turn white when
pressed) is the first visual sign of Stage 1 pressure injury. It indicates reactive
hyperemia and tissue ischemia. Blisters and eschar indicate later stages (2, 3,
or 4).
3. A nurse is caring for a post-operative client who is using a Patient-
Controlled Analgesia (PCA) pump. Which assessment is the priority?
A. The client’s pain level on a 0-10 scale.
B. The patency of the IV site.
C. The client’s respiratory rate and depth.
D. The amount of medication remaining in the syringe.
Correct Answer: C. The client’s respiratory rate and depth.
Rationale: The most significant adverse effect of opioid analgesics (commonly
used in PCA pumps) is respiratory depression. While all options are
important, monitoring respiratory status is the priority nursing action to
prevent fatal overdose.
4. A nurse is preparing to insert an indwelling urinary catheter. Which
technique is essential for maintaining sterile technique?
A. Wearing sterile gloves only.
B. Using sterile water to inflate the balloon.
,C. Keeping the catheter in the sterile field at all times.
D. Cleaning the meatus with an antiseptic solution from the anus towards the
meatus.
Correct Answer: C. Keeping the catheter in the sterile field at all times.
Rationale: Maintaining the sterility of the catheter itself is the core principle of
sterile technique. While sterile gloves are necessary, a full sterile kit is used.
The balloon is inflated with sterile water, but maintaining the sterility of the
catheter is the direct action to prevent introducing pathogens. Cleaning should
be from the meatus outward, not the other way, to avoid spreading bacteria
from the anus.
5. The nurse is assessing a client’s pulse. Which pulse site is most commonly
used to assess the rate and rhythm in an adult?
A. Apical pulse
B. Radial pulse
C. Carotid pulse
D. Femoral pulse
Correct Answer: B. Radial pulse.
Rationale: The radial pulse is easily accessible at the wrist and is the standard
site for assessing the peripheral pulse rate and rhythm in routine
assessments.
6. A nurse is providing oral care to an unconscious client. Which action is most
important to prevent aspiration?
A. Using a hard-bristled toothbrush.
B. Positioning the client in a side-lying position.
C. Using a commercial mouthwash.
D. Applying petroleum jelly to the lips.
, Correct Answer: B. Positioning the client in a side-lying position.
Rationale: A side-lying position allows fluids and secretions to drain out of the
mouth by gravity, reducing the risk of aspiration into the lungs.
7. A client is prescribed a "clear liquid diet." Which of the following items is
appropriate for the nurse to provide?
A. Milk
B. Orange juice with pulp
C. Chicken broth
D. Cream of wheat
Correct Answer: C. Chicken broth.
Rationale: A clear liquid diet consists of liquids that are transparent at room
temperature. Milk, orange juice with pulp, and cream of wheat are not clear
liquids and are generally part of a full liquid or soft diet.
8. Which statement by a client indicates a correct understanding of the
purpose of using an incentive spirometer?
A. "It will help me cough up mucus."
B. "It will help prevent pneumonia."
C. "It will measure my oxygen level."
D. "It will expand my lungs."
Correct Answer: D. "It will expand my lungs."
Rationale: The incentive spirometer encourages deep breathing, which helps
inflate the alveoli and prevent atelectasis (lung collapse). It does not directly
remove mucus, measure oxygen, or treat pneumonia; it prevents the
conditions that lead to it.
CONTRACTOR EXAMINATION
Here is a comprehensive set of 320 multiple-choice questions designed to
mirror the style, content, and difficulty of the NCLEX-RN (National Council
Licensure Examination for Registered Nurses). The questions are organized
by major content areas, numbered sequentially, and each includes the correct
answer and a detailed rationale.
### Fundamentals of Nursing (Questions 1-30)
1. A nurse is preparing to administer an enteral feeding to a client via a
nasogastric tube. Which of the following actions should the nurse take first?
A. Flush the tube with 30 mL of water.
B. Verify the placement of the tube.
C. Check the residual volume.
D. Elevate the head of the bed to 30 degrees.
Correct Answer: B. Verify the placement of the tube.
Rationale: Patient safety is the priority. Before any feeding or medication is
administered, the nurse must first confirm that the tube is in the stomach (not
the lungs) by checking the pH of aspirate or obtaining an X-ray confirmation.
While flushing, checking residuals, and elevating the HOB are important, they
are secondary to verifying placement to prevent aspiration pneumonia.
,2. A client is on strict bed rest. The nurse assesses for a potential complication
of immobility. Which finding is the earliest sign of a pressure ulcer?
A. Full-thickness skin loss.
B. Non-blanchable erythema.
C. A fluid-filled blister.
D. Eschar formation.
Correct Answer: B. Non-blanchable erythema.
Rationale: Non-blanchable erythema (redness that does not turn white when
pressed) is the first visual sign of Stage 1 pressure injury. It indicates reactive
hyperemia and tissue ischemia. Blisters and eschar indicate later stages (2, 3,
or 4).
3. A nurse is caring for a post-operative client who is using a Patient-
Controlled Analgesia (PCA) pump. Which assessment is the priority?
A. The client’s pain level on a 0-10 scale.
B. The patency of the IV site.
C. The client’s respiratory rate and depth.
D. The amount of medication remaining in the syringe.
Correct Answer: C. The client’s respiratory rate and depth.
Rationale: The most significant adverse effect of opioid analgesics (commonly
used in PCA pumps) is respiratory depression. While all options are
important, monitoring respiratory status is the priority nursing action to
prevent fatal overdose.
4. A nurse is preparing to insert an indwelling urinary catheter. Which
technique is essential for maintaining sterile technique?
A. Wearing sterile gloves only.
B. Using sterile water to inflate the balloon.
,C. Keeping the catheter in the sterile field at all times.
D. Cleaning the meatus with an antiseptic solution from the anus towards the
meatus.
Correct Answer: C. Keeping the catheter in the sterile field at all times.
Rationale: Maintaining the sterility of the catheter itself is the core principle of
sterile technique. While sterile gloves are necessary, a full sterile kit is used.
The balloon is inflated with sterile water, but maintaining the sterility of the
catheter is the direct action to prevent introducing pathogens. Cleaning should
be from the meatus outward, not the other way, to avoid spreading bacteria
from the anus.
5. The nurse is assessing a client’s pulse. Which pulse site is most commonly
used to assess the rate and rhythm in an adult?
A. Apical pulse
B. Radial pulse
C. Carotid pulse
D. Femoral pulse
Correct Answer: B. Radial pulse.
Rationale: The radial pulse is easily accessible at the wrist and is the standard
site for assessing the peripheral pulse rate and rhythm in routine
assessments.
6. A nurse is providing oral care to an unconscious client. Which action is most
important to prevent aspiration?
A. Using a hard-bristled toothbrush.
B. Positioning the client in a side-lying position.
C. Using a commercial mouthwash.
D. Applying petroleum jelly to the lips.
, Correct Answer: B. Positioning the client in a side-lying position.
Rationale: A side-lying position allows fluids and secretions to drain out of the
mouth by gravity, reducing the risk of aspiration into the lungs.
7. A client is prescribed a "clear liquid diet." Which of the following items is
appropriate for the nurse to provide?
A. Milk
B. Orange juice with pulp
C. Chicken broth
D. Cream of wheat
Correct Answer: C. Chicken broth.
Rationale: A clear liquid diet consists of liquids that are transparent at room
temperature. Milk, orange juice with pulp, and cream of wheat are not clear
liquids and are generally part of a full liquid or soft diet.
8. Which statement by a client indicates a correct understanding of the
purpose of using an incentive spirometer?
A. "It will help me cough up mucus."
B. "It will help prevent pneumonia."
C. "It will measure my oxygen level."
D. "It will expand my lungs."
Correct Answer: D. "It will expand my lungs."
Rationale: The incentive spirometer encourages deep breathing, which helps
inflate the alveoli and prevent atelectasis (lung collapse). It does not directly
remove mucus, measure oxygen, or treat pneumonia; it prevents the
conditions that lead to it.
