150-Question NP Skills Exam: Test
Your Clinical Expertise ANSWERS
AND RATIONALE
2025/2026
1. Which of the following is the correct initial step before performing
a sterile procedure?
a) Don sterile gloves
b) Wash hands thoroughly
c) Prepare sterile field
d) Open sterile instruments
b) Wash hands thoroughly
Rationale: Hand hygiene is the most important first step in preventing
infection before any sterile procedure.
2. When inserting a Foley catheter in an adult female, how far
should the catheter be advanced after urine return?
a) 1–2 cm
b) 2–3 cm
c) 5–7 cm
d) 10–12 cm
c) 5–7 cm
Rationale: Advancing 5–7 cm ensures the catheter is fully within the
bladder to prevent dislodgement and leakage.
3. What is the appropriate gauge needle for a subcutaneous insulin
injection?
a) 18–20G
, b) 21–23G
c) 25–30G
d) 14–16G
c) 25–30G
Rationale: Thin needles (25–30G) reduce pain and tissue trauma for
subcutaneous injections like insulin.
4. During phlebotomy, which of the following sites is preferred for
venipuncture?
a) Dorsal hand veins
b) Basilic vein
c) Cephalic vein
d) Median cubital vein
d) Median cubital vein
Rationale: The median cubital vein is superficial, stable, and less
painful, making it the preferred site.
5. Which antiseptic solution is most appropriate for skin preparation
prior to central line insertion?
a) 70% isopropyl alcohol
b) Povidone-iodine
c) Chlorhexidine
d) Hydrogen peroxide
c) Chlorhexidine
Rationale: Chlorhexidine is preferred due to superior efficacy in
reducing catheter-related bloodstream infections.
6. How often should wound dressings be changed for a clean, non-
infected surgical incision?
a) Every 4 hours
b) Daily or per protocol
, c) Every 12 hours
d) Weekly
b) Daily or per protocol
Rationale: Routine daily dressing changes reduce infection risk;
frequency may vary based on institutional protocol.
7. What is the correct technique for a sterile glove donning?
a) Touch the outside of the glove with your bare hand
b) Touch the inside of the glove only
c) Touch both sides of the glove
d) No need to touch any part
b) Touch the inside of the glove only
Rationale: Only the inside of the glove is touched to maintain sterility
of the outside.
8. When performing a lumbar puncture, the patient should be
positioned:
a) Supine with legs straight
b) Sitting upright, flexed forward
c) Lying prone
d) Standing upright
b) Sitting upright, flexed forward
Rationale: Flexion of the spine opens the intervertebral spaces for
easier needle insertion.
9. What is the most important indicator of correct endotracheal
tube placement?
a) Chest X-ray
b) Bilateral breath sounds and ETCO₂ detection
c) Observation of chest rise only
d) Tube length at the lip
, b) Bilateral breath sounds and ETCO₂ detection
Rationale: Clinical assessment with breath sounds and end-tidal CO₂
ensures proper tube placement immediately at bedside.
10. For a peripheral IV insertion, the recommended angle of
needle insertion is:
a) 10–15°
b) 20–30°
c) 45°
d) 60°
b) 20–30°
Rationale: A 20–30° angle allows vein entry without puncturing the
posterior wall.
11. When performing CPR, what is the recommended
compression rate for adults?
a) 60–80/min
b) 80–100/min
c) 100–120/min
d) 120–140/min
c) 100–120/min
Rationale: High-quality compressions at 100–120/min optimize
cardiac output during CPR.
12. During a sterile dressing change, what is the correct
sequence of cleaning a wound?
a) Center to periphery
b) Periphery to center
c) Top to bottom
d) Bottom to top
Your Clinical Expertise ANSWERS
AND RATIONALE
2025/2026
1. Which of the following is the correct initial step before performing
a sterile procedure?
a) Don sterile gloves
b) Wash hands thoroughly
c) Prepare sterile field
d) Open sterile instruments
b) Wash hands thoroughly
Rationale: Hand hygiene is the most important first step in preventing
infection before any sterile procedure.
2. When inserting a Foley catheter in an adult female, how far
should the catheter be advanced after urine return?
a) 1–2 cm
b) 2–3 cm
c) 5–7 cm
d) 10–12 cm
c) 5–7 cm
Rationale: Advancing 5–7 cm ensures the catheter is fully within the
bladder to prevent dislodgement and leakage.
3. What is the appropriate gauge needle for a subcutaneous insulin
injection?
a) 18–20G
, b) 21–23G
c) 25–30G
d) 14–16G
c) 25–30G
Rationale: Thin needles (25–30G) reduce pain and tissue trauma for
subcutaneous injections like insulin.
4. During phlebotomy, which of the following sites is preferred for
venipuncture?
a) Dorsal hand veins
b) Basilic vein
c) Cephalic vein
d) Median cubital vein
d) Median cubital vein
Rationale: The median cubital vein is superficial, stable, and less
painful, making it the preferred site.
5. Which antiseptic solution is most appropriate for skin preparation
prior to central line insertion?
a) 70% isopropyl alcohol
b) Povidone-iodine
c) Chlorhexidine
d) Hydrogen peroxide
c) Chlorhexidine
Rationale: Chlorhexidine is preferred due to superior efficacy in
reducing catheter-related bloodstream infections.
6. How often should wound dressings be changed for a clean, non-
infected surgical incision?
a) Every 4 hours
b) Daily or per protocol
, c) Every 12 hours
d) Weekly
b) Daily or per protocol
Rationale: Routine daily dressing changes reduce infection risk;
frequency may vary based on institutional protocol.
7. What is the correct technique for a sterile glove donning?
a) Touch the outside of the glove with your bare hand
b) Touch the inside of the glove only
c) Touch both sides of the glove
d) No need to touch any part
b) Touch the inside of the glove only
Rationale: Only the inside of the glove is touched to maintain sterility
of the outside.
8. When performing a lumbar puncture, the patient should be
positioned:
a) Supine with legs straight
b) Sitting upright, flexed forward
c) Lying prone
d) Standing upright
b) Sitting upright, flexed forward
Rationale: Flexion of the spine opens the intervertebral spaces for
easier needle insertion.
9. What is the most important indicator of correct endotracheal
tube placement?
a) Chest X-ray
b) Bilateral breath sounds and ETCO₂ detection
c) Observation of chest rise only
d) Tube length at the lip
, b) Bilateral breath sounds and ETCO₂ detection
Rationale: Clinical assessment with breath sounds and end-tidal CO₂
ensures proper tube placement immediately at bedside.
10. For a peripheral IV insertion, the recommended angle of
needle insertion is:
a) 10–15°
b) 20–30°
c) 45°
d) 60°
b) 20–30°
Rationale: A 20–30° angle allows vein entry without puncturing the
posterior wall.
11. When performing CPR, what is the recommended
compression rate for adults?
a) 60–80/min
b) 80–100/min
c) 100–120/min
d) 120–140/min
c) 100–120/min
Rationale: High-quality compressions at 100–120/min optimize
cardiac output during CPR.
12. During a sterile dressing change, what is the correct
sequence of cleaning a wound?
a) Center to periphery
b) Periphery to center
c) Top to bottom
d) Bottom to top
