WGU D445 – Intermediate Nursing Skills
Exam Questions and Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf.
1. A nurse is preparing to administer an intermittent IV antibiotic
through a peripheral IV catheter. Which action should the nurse
perform first?
A. Adjust the IV infusion rate
B. Administer the medication immediately
C. Flush the IV catheter with normal saline to assess patency
D. Disconnect the primary IV tubing permanently
Correct Answer: C. Flush the IV catheter with normal saline to assess
patency
Rationale: Assessing catheter patency before medication administration
ensures the IV is functional and reduces the risk of infiltration,
extravasation, or medication administration into surrounding tissues.
Verifying patency is a priority safety intervention before delivering any
IV medication.
, 2. A nurse is caring for a client receiving enteral nutrition through a
nasogastric tube. Which intervention best reduces the risk of
aspiration?
A. Place the client flat during feedings
B. Check bowel sounds every shift only
C. Maintain the head of the bed at 30–45 degrees during and after
feeding
D. Flush the tube only once daily
Correct Answer: C. Maintain the head of the bed at 30–45 degrees
during and after feeding
Rationale: Elevating the head of the bed significantly decreases the
likelihood of gastric contents entering the respiratory tract. This position
should be maintained during feeding and for at least 30–60 minutes
afterward to minimize aspiration risk.
3. Which assessment finding indicates infiltration of a peripheral IV
site?
A. Warmth and redness along the vein
B. Coolness, swelling, and discomfort at the insertion site
C. Blood return with flushing
D. Rapid infusion without resistance
Correct Answer: B. Coolness, swelling, and discomfort at the insertion
site
Rationale: Infiltration occurs when non-vesicant fluid leaks into
surrounding tissues. Typical findings include edema, cool skin,
,discomfort, and slowed infusion. Warmth and redness are more
consistent with phlebitis.
4. A nurse is reinforcing teaching about incentive spirometer use
following abdominal surgery. Which client statement indicates
understanding?
A. "I'll use it only if I feel short of breath."
B. "I'll inhale slowly and deeply to raise the indicator."
C. "I should exhale forcefully into the device."
D. "I only need to use it once each day."
Correct Answer: B. "I'll inhale slowly and deeply to raise the
indicator."
Rationale: The incentive spirometer encourages slow, deep inhalation to
expand alveoli, improve ventilation, and prevent postoperative
atelectasis. Frequent use throughout the day is recommended.
5. Which finding requires immediate intervention during a blood
transfusion?
A. Temperature increase of 0.2°F (0.1°C)
B. Mild fatigue
C. Chills, fever, and low back pain
D. Increased appetite
Correct Answer: C. Chills, fever, and low back pain
, Rationale: Fever, chills, and low back pain are classic signs of an acute
hemolytic transfusion reaction. The nurse should stop the transfusion
immediately, maintain IV access with normal saline, notify the provider,
and follow facility protocol.
6. A nurse is performing tracheostomy care. Which solution is
commonly used to clean the stoma according to facility policy?
A. Sterile saline
B. Hydrogen peroxide only
C. Alcohol
D. Chlorhexidine mouthwash
Correct Answer: A. Sterile saline
Rationale: Sterile saline is commonly used to clean the tracheostomy
site because it effectively removes secretions while minimizing tissue
irritation. Hydrogen peroxide may be used in some facilities if diluted
but should not replace saline unless indicated by policy.
7. A nurse is caring for a client with a chest tube connected to a
water-seal drainage system. Continuous bubbling in the water-seal
chamber most likely indicates:
A. Normal lung expansion
B. An air leak
C. Adequate suction
Exam Questions and Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf.
1. A nurse is preparing to administer an intermittent IV antibiotic
through a peripheral IV catheter. Which action should the nurse
perform first?
A. Adjust the IV infusion rate
B. Administer the medication immediately
C. Flush the IV catheter with normal saline to assess patency
D. Disconnect the primary IV tubing permanently
Correct Answer: C. Flush the IV catheter with normal saline to assess
patency
Rationale: Assessing catheter patency before medication administration
ensures the IV is functional and reduces the risk of infiltration,
extravasation, or medication administration into surrounding tissues.
Verifying patency is a priority safety intervention before delivering any
IV medication.
, 2. A nurse is caring for a client receiving enteral nutrition through a
nasogastric tube. Which intervention best reduces the risk of
aspiration?
A. Place the client flat during feedings
B. Check bowel sounds every shift only
C. Maintain the head of the bed at 30–45 degrees during and after
feeding
D. Flush the tube only once daily
Correct Answer: C. Maintain the head of the bed at 30–45 degrees
during and after feeding
Rationale: Elevating the head of the bed significantly decreases the
likelihood of gastric contents entering the respiratory tract. This position
should be maintained during feeding and for at least 30–60 minutes
afterward to minimize aspiration risk.
3. Which assessment finding indicates infiltration of a peripheral IV
site?
A. Warmth and redness along the vein
B. Coolness, swelling, and discomfort at the insertion site
C. Blood return with flushing
D. Rapid infusion without resistance
Correct Answer: B. Coolness, swelling, and discomfort at the insertion
site
Rationale: Infiltration occurs when non-vesicant fluid leaks into
surrounding tissues. Typical findings include edema, cool skin,
,discomfort, and slowed infusion. Warmth and redness are more
consistent with phlebitis.
4. A nurse is reinforcing teaching about incentive spirometer use
following abdominal surgery. Which client statement indicates
understanding?
A. "I'll use it only if I feel short of breath."
B. "I'll inhale slowly and deeply to raise the indicator."
C. "I should exhale forcefully into the device."
D. "I only need to use it once each day."
Correct Answer: B. "I'll inhale slowly and deeply to raise the
indicator."
Rationale: The incentive spirometer encourages slow, deep inhalation to
expand alveoli, improve ventilation, and prevent postoperative
atelectasis. Frequent use throughout the day is recommended.
5. Which finding requires immediate intervention during a blood
transfusion?
A. Temperature increase of 0.2°F (0.1°C)
B. Mild fatigue
C. Chills, fever, and low back pain
D. Increased appetite
Correct Answer: C. Chills, fever, and low back pain
, Rationale: Fever, chills, and low back pain are classic signs of an acute
hemolytic transfusion reaction. The nurse should stop the transfusion
immediately, maintain IV access with normal saline, notify the provider,
and follow facility protocol.
6. A nurse is performing tracheostomy care. Which solution is
commonly used to clean the stoma according to facility policy?
A. Sterile saline
B. Hydrogen peroxide only
C. Alcohol
D. Chlorhexidine mouthwash
Correct Answer: A. Sterile saline
Rationale: Sterile saline is commonly used to clean the tracheostomy
site because it effectively removes secretions while minimizing tissue
irritation. Hydrogen peroxide may be used in some facilities if diluted
but should not replace saline unless indicated by policy.
7. A nurse is caring for a client with a chest tube connected to a
water-seal drainage system. Continuous bubbling in the water-seal
chamber most likely indicates:
A. Normal lung expansion
B. An air leak
C. Adequate suction
