NURS 104L FUNDAMENTALS OF
NURSING SKILLS LAB - WEEK 14
COMPREHENSIVE FINAL REVIEW
1. When preparing to administer a subcutaneous injection to an average-sized adult, which
needle length and angle of insertion should the nurse select?
A. 1 to 1.5 inch needle at a 90-degree angle
B. 1/2 inch needle at a 15-degree angle
C. 3/8 to 5/8 inch needle at a 45 to 90-degree angle
D. 1.5 inch needle at a 45-degree angle
Answer: C
Conceptual Explanation: Subcutaneous injections are typically administered using a 25-
to 27-gauge, 3/8 to 5/8 inch needle. The angle of insertion is 45 to 90 degrees depending
on the amount of subcutaneous tissue present.
2. A nurse is preparing to suction a patient with a tracheostomy. Which action by the nurse
would be considered a break in sterile technique?
A. Applying suction while inserting the catheter into the airway
B. Pre-oxygenating the patient with 100% oxygen before starting
,C. Using a sterile glove on the dominant hand to handle the catheter
D. Limiting the suctioning pass to no more than 10 to 15 seconds
Answer: A
Conceptual Explanation: Suction should never be applied during insertion as it causes
trauma to the tracheal mucosa and depletes oxygen. Suction is only applied intermittently
while withdrawing the catheter.
3. The nurse is assessing a patient’s radial pulse and finds it to be irregular. What is the most
appropriate follow-up action?
A. Assess the apical pulse for one full minute
B. Document the finding and check again in 4 hours
C. Use a Doppler to find the pedal pulse
D. Administer a PRN dose of digoxin
Answer: A
Conceptual Explanation: If a peripheral pulse is irregular, the nurse must assess the
apical pulse for a full 60 seconds to obtain an accurate rate and identify the nature of the
irregularity (pulse deficit).
4. A patient has an order for NPH and Regular insulin. Which sequence is correct when mixing
these two medications in one syringe?
A. Withdraw Regular first, then NPH, without injecting air into the vials
, B. Withdraw NPH, withdraw Regular, inject air into both vials
C. Inject air into Regular, withdraw Regular, inject air into NPH, withdraw NPH
D. Inject air into NPH, inject air into Regular, withdraw Regular, withdraw NPH
Answer: D
Conceptual Explanation: The correct sequence (Clear to Cloudy) is: Air in NPH, Air in
Regular, Withdraw Regular (clear), Withdraw NPH (cloudy). This prevents contaminating
the short-acting (Regular) insulin with the long-acting (NPH) insulin.
5. Which landmark is used to identify the ventrogluteal site for an intramuscular injection?
A. The acromion process and the axillary line
B. The greater trochanter, the anterior superior iliac spine, and the iliac crest
C. The posterior superior iliac spine and the gluteal fold
D. One handbreadth above the knee and one handbreadth below the greater trochanter
Answer: B
Conceptual Explanation: The ventrogluteal site is located by placing the palm over the
greater trochanter, the index finger on the anterior superior iliac spine, and the middle
finger spreading toward the iliac crest.
6. The nurse is performing a sterile dressing change. If a sterile item touches the 1-inch border
of the sterile field, the nurse should:
A. Consider the item and the field contaminated and start over
NURSING SKILLS LAB - WEEK 14
COMPREHENSIVE FINAL REVIEW
1. When preparing to administer a subcutaneous injection to an average-sized adult, which
needle length and angle of insertion should the nurse select?
A. 1 to 1.5 inch needle at a 90-degree angle
B. 1/2 inch needle at a 15-degree angle
C. 3/8 to 5/8 inch needle at a 45 to 90-degree angle
D. 1.5 inch needle at a 45-degree angle
Answer: C
Conceptual Explanation: Subcutaneous injections are typically administered using a 25-
to 27-gauge, 3/8 to 5/8 inch needle. The angle of insertion is 45 to 90 degrees depending
on the amount of subcutaneous tissue present.
2. A nurse is preparing to suction a patient with a tracheostomy. Which action by the nurse
would be considered a break in sterile technique?
A. Applying suction while inserting the catheter into the airway
B. Pre-oxygenating the patient with 100% oxygen before starting
,C. Using a sterile glove on the dominant hand to handle the catheter
D. Limiting the suctioning pass to no more than 10 to 15 seconds
Answer: A
Conceptual Explanation: Suction should never be applied during insertion as it causes
trauma to the tracheal mucosa and depletes oxygen. Suction is only applied intermittently
while withdrawing the catheter.
3. The nurse is assessing a patient’s radial pulse and finds it to be irregular. What is the most
appropriate follow-up action?
A. Assess the apical pulse for one full minute
B. Document the finding and check again in 4 hours
C. Use a Doppler to find the pedal pulse
D. Administer a PRN dose of digoxin
Answer: A
Conceptual Explanation: If a peripheral pulse is irregular, the nurse must assess the
apical pulse for a full 60 seconds to obtain an accurate rate and identify the nature of the
irregularity (pulse deficit).
4. A patient has an order for NPH and Regular insulin. Which sequence is correct when mixing
these two medications in one syringe?
A. Withdraw Regular first, then NPH, without injecting air into the vials
, B. Withdraw NPH, withdraw Regular, inject air into both vials
C. Inject air into Regular, withdraw Regular, inject air into NPH, withdraw NPH
D. Inject air into NPH, inject air into Regular, withdraw Regular, withdraw NPH
Answer: D
Conceptual Explanation: The correct sequence (Clear to Cloudy) is: Air in NPH, Air in
Regular, Withdraw Regular (clear), Withdraw NPH (cloudy). This prevents contaminating
the short-acting (Regular) insulin with the long-acting (NPH) insulin.
5. Which landmark is used to identify the ventrogluteal site for an intramuscular injection?
A. The acromion process and the axillary line
B. The greater trochanter, the anterior superior iliac spine, and the iliac crest
C. The posterior superior iliac spine and the gluteal fold
D. One handbreadth above the knee and one handbreadth below the greater trochanter
Answer: B
Conceptual Explanation: The ventrogluteal site is located by placing the palm over the
greater trochanter, the index finger on the anterior superior iliac spine, and the middle
finger spreading toward the iliac crest.
6. The nurse is performing a sterile dressing change. If a sterile item touches the 1-inch border
of the sterile field, the nurse should:
A. Consider the item and the field contaminated and start over
