NURS 101L Fundamentals of Nursing Skills Lab - Week 10
Comprehensive Quiz 2026 |WCU
1. When inserting an indwelling urinary catheter in a female patient, which of
the following is the correct order for cleaning the labia with antiseptic swabs?
A. Clean from the clitoris toward the anus, starting with the labia majora on each side, then the labia minora,
and finally the meatus.
B. Clean the meatus directly, then both sides of the labia majora.
C. Clean in a circular motion around the meatus twice.
D. Clean from the anus toward the clitoris to ensure all bacteria are moved away from the vaginal opening.
Answer: A
Rationale: To maintain surgical asepsis and prevent CAUTI, cleaning must proceed from
the least contaminated area to the most contaminated (front to back), starting with the
outermost folds and moving inward to the meatus.
2. While inserting a nasogastric (NG) tube, the nurse notes the patient begins to
cough, gag, and turn blue. What is the priority action?
A. Continue advancing the tube quickly to reach the stomach.
B. Immediately withdraw the tube and allow the patient to recover.
C. Have the patient take small sips of water through a straw.
D. Rotate the tube 180 degrees and check the back of the throat.
Answer: B
Rationale: Signs of respiratory distress (coughing, cyanosis) indicate the tube has likely
entered the trachea. The nurse must remove the tube immediately to ensure airway
patency.
,3. A nurse is preparing a sterile field for a dressing change. Which action would
result in the contamination of the sterile field?
A. Opening the first flap of the sterile kit away from the body.
B. Dropping a sterile gauze pad onto the field from 6 inches above.
C. Placing a sterile bowl 0.5 inches from the edge of the sterile drape.
D. Keeping the sterile field within the line of sight at all times.
Answer: C
Rationale: A 1-inch (2.5 cm) border around the edges of a sterile field is considered
contaminated. Items placed within this margin are no longer sterile.
4. The nurse is measuring a patient for NG tube insertion. Which method is most
accurate for determining the length of the tube?
A. Measure the distance from the forehead to the sternal notch.
B. Measure from the bridge of the nose to the umbilicus.
C. Measure from the mouth to the earlobe, then to the xiphoid process.
D. Measure from the tip of the nose to the earlobe, then to the xiphoid process.
Answer: D
Rationale: The standard NEX measurement (Nose-Earlobe-Xiphoid) provides the most
reliable estimate for the distance required to reach the stomach.
5. Which clinical manifestation is the most reliable early indicator of an IV
infiltration?
A. Warmth and redness at the insertion site.
B. A red streak following the vein path.
C. Purulent drainage from the catheter hub.
D. Coolness of the skin and edema around the site.
Answer: D
Rationale: Infiltration occurs when non-vesicant fluid leaks into the tissue; this typically
causes the site to feel cool to the touch and appear swollen (edema).
, 6. When performing tracheostomy suctioning, what is the maximum amount of
time the nurse should apply suction?
A. 5 seconds
B. As long as it takes to clear all secretions
C. 20 to 30 seconds
D. 10 to 15 seconds
Answer: D
Rationale: Suctioning should be limited to 10-15 seconds to prevent hypoxia and vagal
stimulation, which can lead to bradycardia.
7. A patient is prescribed a 24-hour urine collection. How should the nurse begin
the collection process?
A. Discard the first morning void and record that time as the start.
B. Include the very first voiding of the morning in the container.
C. Start the collection with the second voiding and end exactly 12 hours later.
D. Collect only the midstream portion of every void for 24 hours.
Answer: A
Rationale: The 24-hour clock starts after the patient’s first void is discarded, ensuring that
the urine collected is produced exactly within the 24-hour window.
8. Which of the following is a primary nursing intervention to prevent Catheter-
Associated Urinary Tract Infections (CAUTI)?
A. Changing the catheter every 72 hours routinely.
B. Cleaning the perineal area with antiseptic wipes every 4 hours.
C. Irrigating the catheter with sterile saline twice daily.
D. Keeping the drainage bag below the level of the bladder at all times.
Answer: D
Rationale: Maintaining the drainage bag below the bladder prevents the backflow of
contaminated urine into the bladder, which is a major risk factor for CAUTI.
Comprehensive Quiz 2026 |WCU
1. When inserting an indwelling urinary catheter in a female patient, which of
the following is the correct order for cleaning the labia with antiseptic swabs?
A. Clean from the clitoris toward the anus, starting with the labia majora on each side, then the labia minora,
and finally the meatus.
B. Clean the meatus directly, then both sides of the labia majora.
C. Clean in a circular motion around the meatus twice.
D. Clean from the anus toward the clitoris to ensure all bacteria are moved away from the vaginal opening.
Answer: A
Rationale: To maintain surgical asepsis and prevent CAUTI, cleaning must proceed from
the least contaminated area to the most contaminated (front to back), starting with the
outermost folds and moving inward to the meatus.
2. While inserting a nasogastric (NG) tube, the nurse notes the patient begins to
cough, gag, and turn blue. What is the priority action?
A. Continue advancing the tube quickly to reach the stomach.
B. Immediately withdraw the tube and allow the patient to recover.
C. Have the patient take small sips of water through a straw.
D. Rotate the tube 180 degrees and check the back of the throat.
Answer: B
Rationale: Signs of respiratory distress (coughing, cyanosis) indicate the tube has likely
entered the trachea. The nurse must remove the tube immediately to ensure airway
patency.
,3. A nurse is preparing a sterile field for a dressing change. Which action would
result in the contamination of the sterile field?
A. Opening the first flap of the sterile kit away from the body.
B. Dropping a sterile gauze pad onto the field from 6 inches above.
C. Placing a sterile bowl 0.5 inches from the edge of the sterile drape.
D. Keeping the sterile field within the line of sight at all times.
Answer: C
Rationale: A 1-inch (2.5 cm) border around the edges of a sterile field is considered
contaminated. Items placed within this margin are no longer sterile.
4. The nurse is measuring a patient for NG tube insertion. Which method is most
accurate for determining the length of the tube?
A. Measure the distance from the forehead to the sternal notch.
B. Measure from the bridge of the nose to the umbilicus.
C. Measure from the mouth to the earlobe, then to the xiphoid process.
D. Measure from the tip of the nose to the earlobe, then to the xiphoid process.
Answer: D
Rationale: The standard NEX measurement (Nose-Earlobe-Xiphoid) provides the most
reliable estimate for the distance required to reach the stomach.
5. Which clinical manifestation is the most reliable early indicator of an IV
infiltration?
A. Warmth and redness at the insertion site.
B. A red streak following the vein path.
C. Purulent drainage from the catheter hub.
D. Coolness of the skin and edema around the site.
Answer: D
Rationale: Infiltration occurs when non-vesicant fluid leaks into the tissue; this typically
causes the site to feel cool to the touch and appear swollen (edema).
, 6. When performing tracheostomy suctioning, what is the maximum amount of
time the nurse should apply suction?
A. 5 seconds
B. As long as it takes to clear all secretions
C. 20 to 30 seconds
D. 10 to 15 seconds
Answer: D
Rationale: Suctioning should be limited to 10-15 seconds to prevent hypoxia and vagal
stimulation, which can lead to bradycardia.
7. A patient is prescribed a 24-hour urine collection. How should the nurse begin
the collection process?
A. Discard the first morning void and record that time as the start.
B. Include the very first voiding of the morning in the container.
C. Start the collection with the second voiding and end exactly 12 hours later.
D. Collect only the midstream portion of every void for 24 hours.
Answer: A
Rationale: The 24-hour clock starts after the patient’s first void is discarded, ensuring that
the urine collected is produced exactly within the 24-hour window.
8. Which of the following is a primary nursing intervention to prevent Catheter-
Associated Urinary Tract Infections (CAUTI)?
A. Changing the catheter every 72 hours routinely.
B. Cleaning the perineal area with antiseptic wipes every 4 hours.
C. Irrigating the catheter with sterile saline twice daily.
D. Keeping the drainage bag below the level of the bladder at all times.
Answer: D
Rationale: Maintaining the drainage bag below the bladder prevents the backflow of
contaminated urine into the bladder, which is a major risk factor for CAUTI.
