Nurse Exam 1 Practice Test Actual 2026/2027 with
Detailed Rationales | 100% Verified | Pass Guaranteed –
A+ Graded
SECTION 1: IV Therapy Fundamentals & Vascular Access
(Questions 1–12)
Q1: A practical nurse is preparing to insert a peripheral IV catheter. Which vein is the
preferred site for initial venipuncture in an adult patient?
A. Basilic vein in the antecubital fossa
B. Cephalic vein in the dorsal hand
C. Median cubital vein in the forearm
D. Metacarpal vein in the thumb side of the hand
Correct Answer: C
Rationale: The median cubital vein in the forearm is the preferred initial site due to its
large diameter, superficial location, and reduced risk of nerve injury; it allows for
adequate blood flow and is easily accessible for catheter insertion.
Q2: A patient requires long-term IV therapy and the provider orders a peripherally
inserted central catheter (PICC). Which anatomical landmark serves as the insertion
site for a PICC line?
,A. Subclavian vein
B. Basilic or cephalic vein in the antecubital area
C. Internal jugular vein
D. Femoral vein
Correct Answer: B
Rationale: PICC lines are inserted through the basilic or cephalic veins in the
antecubital fossa and advanced until the catheter tip rests in the superior vena cava,
providing central venous access without the risks of direct central line insertion.
Q3: A practical nurse is selecting a catheter gauge for a patient receiving blood
transfusion. Which gauge is most appropriate?
A. 24 gauge
B. 22 gauge
C. 20 gauge
D. 18 gauge
Correct Answer: D
Rationale: An 18-gauge catheter is the minimum size recommended for blood
transfusion because larger diameters prevent hemolysis of red blood cells and allow
the thicker blood product to flow at an appropriate rate without excessive pressure.
Q4: Prior to IV insertion, the practical nurse applies a tourniquet 4–6 inches above
the intended venipuncture site. What is the maximum recommended time the
tourniquet should remain in place?
, A. 30 seconds
B. 1 minute
C. 2 minutes
D. 5 minutes
Correct Answer: B
Rationale: The tourniquet should remain in place no longer than 1 minute to prevent
hemoconcentration, hemolysis, and inaccurate laboratory results; prolonged
application can also cause patient discomfort and venous damage.
Q5: A practical nurse is preparing the skin for IV insertion. Which antiseptic solution
is most effective for site preparation and should be allowed to dry completely before
venipuncture?
A. 70% isopropyl alcohol
B. Povidone-iodine (Betadine)
C. Chlorhexidine gluconate 2% in 70% isopropyl alcohol
D. Hydrogen peroxide 3%
Correct Answer: C
Rationale: Chlorhexidine gluconate 2% in 70% isopropyl alcohol provides
broad-spectrum antimicrobial activity with residual effect; it must air dry completely
to ensure maximum antiseptic efficacy and prevent stinging upon catheter insertion.
Q6: A patient has a triple-lumen central venous catheter in place. Which lumen is
typically designated for blood draws and TPN administration?