COMPREHENSIVE ACTUAL EXAM – 420
QUESTIONS WITH ANSWERS AND RATIONALES
1. Infection Control
Hand hygiene: most important to prevent infection
Precautions: Standard for all; Transmission-based (airborne, droplet, contact)
PPE: Correct donning/doffing prevents contamination
2. Nursing Process
ADPIE: Assessment → Diagnosis → Planning → Implementation → Evaluation
Prioritize: ABCs (Airway, Breathing, Circulation)
Goals: Use SMART criteria
3. Patient Safety
Fall prevention: Assess risk, bed alarms, non-slip footwear
Medication & procedure safety: Verify 2 identifiers, environment safety
Error reporting: Document and follow protocol
4. Vital Signs & Assessment
Normal adult ranges:
o Temp: 36–38 °C / 96.8–100.4 °F
o Pulse: 60–100 bpm
o Resp: 12–20/min
o BP: 90––80 mmHg
o SpO₂: 95–100%
Assessment tips: Use correct technique, observe for abnormalities
5. Medication Administration
Five Rights: Patient, Drug, Dose, Route, Time
Key steps: Check allergies, verify labs, document response
Insulin: Rotate sites, clear before cloudy
PRN meds: Assess need before giving
6. Communication & Patient Education
Therapeutic communication: Active listening, empathy, clarity
Teach-back method: Confirms patient understanding
Adapt teaching: Literacy, language, cognitive deficits
Document: Content taught, patient response, follow-up
,Section 1: Infection Control – 70 Questions
1. What is the most effective way to prevent the spread of infections in a
healthcare setting?
A) Wearing gloves only
B) Hand hygiene
C) Using antibiotics routinely
D) Wearing a mask only
Answer: B – Hand hygiene
Rationale: Hand hygiene is the single most effective measure to prevent
transmission of pathogens.
2. Which precaution is required for a patient with tuberculosis?
A) Contact precautions
B) Airborne precautions
C) Droplet precautions
D) Standard precautions only
Answer: B – Airborne precautions
Rationale: TB is transmitted via airborne particles; an N95 mask and
negative-pressure room are needed.
3. A nurse should wear gloves when:
A) Touching intact skin
B) Handling blood, body fluids, or contaminated items
C) Feeding a patient
D) Performing vital signs
Answer: B – Handling blood, body fluids, or contaminated items
Rationale: Gloves prevent contact with potentially infectious materials.
,4. What is the correct order for removing PPE?
A) Gloves, goggles, gown, mask
B) Gown, gloves, goggles, mask
C) Gloves, gown, goggles, mask
D) Mask, gown, gloves, goggles
Answer: C – Gloves, gown, goggles, mask
Rationale: Removes the most contaminated items first to reduce the risk of
self-contamination.
5. Which isolation precaution is appropriate for Clostridioides difficile
infection?
A) Airborne
B) Droplet
C) Contact
D) Standard
Answer: C – Contact
Rationale: C. difficile spores spread via direct or indirect contact; gown and
gloves are required.
6. When should a nurse perform hand hygiene using soap and water
instead of alcohol-based sanitizer?
A) Before patient contact
B) After contact with C. difficile
C) After removing gloves
D) Before entering patient room
Answer: B – After contact with C. difficile
Rationale: Alcohol-based sanitizers are not effective against spores like C.
difficile; soap and water is required.
7. Which action demonstrates proper standard precautions?
A) Wearing gloves for all patient contact
B) Using PPE only when patients are symptomatic
, C) Hand hygiene, using PPE when exposure is possible, proper disposal of
sharps
D) Using antibiotics prophylactically
Answer: C – Hand hygiene, using PPE when exposure is possible, proper
disposal of sharps
Rationale: Standard precautions are applied to all patients to prevent
infection.
8. The nurse is caring for a patient with influenza. Which precaution should
be used?
A) Contact
B) Airborne
C) Droplet
D) Standard only
Answer: C – Droplet
Rationale: Influenza is transmitted via droplets from coughing or sneezing;
surgical mask within 3 feet is recommended.
9. What is the correct handwashing technique?
A) Rub hands under water for 5 seconds
B) Use only cold water
C) Lather with soap and scrub all surfaces for at least 20 seconds
D) Rinse and dry quickly
Answer: C – Lather with soap and scrub all surfaces for at least 20
seconds
Rationale: Proper handwashing includes all surfaces to remove pathogens
effectively.
10. When handling soiled linens, the nurse should:
A) Shake linens before placing them in hamper
B) Wear gloves and avoid touching clothing