NSG 3130 Exam 4 | Fundamental Concepts
& Skills II
NURSING PRACTICE EXAM (2026/2027) - GALEN COLLEGE
(1) A nurse is preparing to initiate a blood transfusion. Which solution is the only fluid
compatible with blood products?
A. Lactated Ringer's
B. 0.45% Sodium Chloride
C. 0.9% Sodium Chloride (Normal Saline)
D. 5% Dextrose in Water (D5W)
CORRECT ANSWER: C
Clinical Skill Rationale: 0.9% Sodium Chloride is the only fluid compatible with blood. Other
solutions can cause hemolysis or clotting within the IV line.
(2) A client receiving a blood transfusion begins to experience chills, fever, and lower
back pain. What is the nurse's immediate priority?
A. Slow the infusion rate.
B. Stop the transfusion and disconnect the tubing at the hub.
C. Administer diphenhydramine.
D. Re-check the client's ID band.
CORRECT ANSWER: B
Clinical Skill Rationale: These are signs of a hemolytic transfusion reaction. The nurse must
stop the transfusion immediately and keep the line open with new Normal Saline tubing to
maintain IV access for emergency meds.
,(3) While performing tracheostomy care, which action by the nurse maintains sterile
technique?
A. Cleaning the inner cannula with tap water.
B. Using sterile gloves to handle the inner cannula and sterile supplies.
C. Cutting a standard gauze pad to fit around the stoma.
D. Suctioning the airway before and after cleaning the site.
CORRECT ANSWER: B
Clinical Skill Rationale: Tracheostomy care is a sterile procedure. Inner cannulas must be
handled with sterile gloves. Gauze should never be cut (loose fibers can be inhaled); pre-cut
drain sponges must be used.
(4) What is the maximum amount of time a nurse should apply suction during
tracheostomy suctioning?
A. 5 seconds
B. 10-15 seconds
C. 30 seconds
D. As long as it takes to clear the airway
CORRECT ANSWER: B
Clinical Skill Rationale: Suctioning should be limited to 10-15 seconds per pass to prevent
hypoxia and vagal stimulation, which can cause bradycardia.
,(5) The nurse notes continuous bubbling in the water-seal chamber of a client's chest
tube drainage system. How should the nurse interpret this?
A. It is a normal finding.
B. The client's lung has fully expanded.
C. There is an air leak in the system.
D. The suction is turned up too high.
CORRECT ANSWER: C
Clinical Skill Rationale: Intermittent bubbling is normal (during expiration), but continuous
bubbling in the water-seal chamber indicates an air leak either in the system or from the
client's lung.
(6) If a chest tube becomes accidentally disconnected from the drainage unit, what is
the nurse's immediate action?
A. Clamp the tube close to the client's chest.
B. Submerge the end of the tube in 1-2 inches of sterile water.
C. Tape the tube to the client's bedsheet.
D. Cover the site with a dry gauze dressing.
CORRECT ANSWER: B
Clinical Skill Rationale: Submerging the tube in sterile water creates a temporary water seal,
preventing air from entering the pleural space while a new system is prepared.
, (7) A nurse is caring for a client with a surgical wound that has eviscerated. Which
action is the priority?
A. Attempt to push the organs back into the abdomen.
B. Cover the protruding organs with sterile towels moistened with sterile normal saline.
C. Place the client in a high-Fowler's position.
D. Leave the wound open to air.
CORRECT ANSWER: B
Clinical Skill Rationale: Evisceration is a surgical emergency. The organs must be kept moist
and sterile to prevent necrosis and infection. The nurse should also place the client in low-
Fowler's with knees flexed.
(8) When performing a venipuncture, at what angle should the nurse insert the needle?
A. 5 to 10 degrees
B. 15 to 30 degrees
C. 45 to 60 degrees
D. 90 degrees
CORRECT ANSWER: B
Clinical Skill Rationale: An angle of 15-30 degrees is standard for venipuncture to ensure
the needle enters the vein without going through the back wall.
(9) Which is the most reliable method for verifying the initial placement of a
nasogastric (NG) tube?
A. Aspirating gastric contents and checking pH.
B. Auscultating a 'whoosh' of air in the epigastrium.
C. Obtaining a chest X-ray.
D. Observing for bubbles when the tube end is placed in water.
CORRECT ANSWER: C
Clinical Skill Rationale: Radiographic verification (X-ray) is the gold standard for confirming
correct NG tube placement before medications or feedings are initiated.
& Skills II
NURSING PRACTICE EXAM (2026/2027) - GALEN COLLEGE
(1) A nurse is preparing to initiate a blood transfusion. Which solution is the only fluid
compatible with blood products?
A. Lactated Ringer's
B. 0.45% Sodium Chloride
C. 0.9% Sodium Chloride (Normal Saline)
D. 5% Dextrose in Water (D5W)
CORRECT ANSWER: C
Clinical Skill Rationale: 0.9% Sodium Chloride is the only fluid compatible with blood. Other
solutions can cause hemolysis or clotting within the IV line.
(2) A client receiving a blood transfusion begins to experience chills, fever, and lower
back pain. What is the nurse's immediate priority?
A. Slow the infusion rate.
B. Stop the transfusion and disconnect the tubing at the hub.
C. Administer diphenhydramine.
D. Re-check the client's ID band.
CORRECT ANSWER: B
Clinical Skill Rationale: These are signs of a hemolytic transfusion reaction. The nurse must
stop the transfusion immediately and keep the line open with new Normal Saline tubing to
maintain IV access for emergency meds.
,(3) While performing tracheostomy care, which action by the nurse maintains sterile
technique?
A. Cleaning the inner cannula with tap water.
B. Using sterile gloves to handle the inner cannula and sterile supplies.
C. Cutting a standard gauze pad to fit around the stoma.
D. Suctioning the airway before and after cleaning the site.
CORRECT ANSWER: B
Clinical Skill Rationale: Tracheostomy care is a sterile procedure. Inner cannulas must be
handled with sterile gloves. Gauze should never be cut (loose fibers can be inhaled); pre-cut
drain sponges must be used.
(4) What is the maximum amount of time a nurse should apply suction during
tracheostomy suctioning?
A. 5 seconds
B. 10-15 seconds
C. 30 seconds
D. As long as it takes to clear the airway
CORRECT ANSWER: B
Clinical Skill Rationale: Suctioning should be limited to 10-15 seconds per pass to prevent
hypoxia and vagal stimulation, which can cause bradycardia.
,(5) The nurse notes continuous bubbling in the water-seal chamber of a client's chest
tube drainage system. How should the nurse interpret this?
A. It is a normal finding.
B. The client's lung has fully expanded.
C. There is an air leak in the system.
D. The suction is turned up too high.
CORRECT ANSWER: C
Clinical Skill Rationale: Intermittent bubbling is normal (during expiration), but continuous
bubbling in the water-seal chamber indicates an air leak either in the system or from the
client's lung.
(6) If a chest tube becomes accidentally disconnected from the drainage unit, what is
the nurse's immediate action?
A. Clamp the tube close to the client's chest.
B. Submerge the end of the tube in 1-2 inches of sterile water.
C. Tape the tube to the client's bedsheet.
D. Cover the site with a dry gauze dressing.
CORRECT ANSWER: B
Clinical Skill Rationale: Submerging the tube in sterile water creates a temporary water seal,
preventing air from entering the pleural space while a new system is prepared.
, (7) A nurse is caring for a client with a surgical wound that has eviscerated. Which
action is the priority?
A. Attempt to push the organs back into the abdomen.
B. Cover the protruding organs with sterile towels moistened with sterile normal saline.
C. Place the client in a high-Fowler's position.
D. Leave the wound open to air.
CORRECT ANSWER: B
Clinical Skill Rationale: Evisceration is a surgical emergency. The organs must be kept moist
and sterile to prevent necrosis and infection. The nurse should also place the client in low-
Fowler's with knees flexed.
(8) When performing a venipuncture, at what angle should the nurse insert the needle?
A. 5 to 10 degrees
B. 15 to 30 degrees
C. 45 to 60 degrees
D. 90 degrees
CORRECT ANSWER: B
Clinical Skill Rationale: An angle of 15-30 degrees is standard for venipuncture to ensure
the needle enters the vein without going through the back wall.
(9) Which is the most reliable method for verifying the initial placement of a
nasogastric (NG) tube?
A. Aspirating gastric contents and checking pH.
B. Auscultating a 'whoosh' of air in the epigastrium.
C. Obtaining a chest X-ray.
D. Observing for bubbles when the tube end is placed in water.
CORRECT ANSWER: C
Clinical Skill Rationale: Radiographic verification (X-ray) is the gold standard for confirming
correct NG tube placement before medications or feedings are initiated.
