WGU D445 Intermediate Nursing Skills
Objective Assessment -Solved
1. A nurse is preparing to insert a peripheral IV catheter in an adult patient. Which
action should the nurse take first?
A. Apply the tourniquet
B. Select the smallest available catheter
C. Verify the patient's identity and explain the procedure
D. Insert the catheter bevel-down
ANSWER: C. Verify the patient's identity and explain the procedure
2. A patient receiving a peripheral IV infusion develops swelling, coolness, and
pallor around the insertion site. Which complication does the nurse suspect?
A. Phlebitis
B. Infiltration
C. Infection
D. Hematoma
ANSWER: B. Infiltration
3. Which finding is most characteristic of phlebitis at a peripheral IV site?
A. Cool, pale skin
B. Edema without pain
C. Warmth, redness, and tenderness along the vein
D. Absence of blood return
ANSWER: C. Warmth, redness, and tenderness along the vein
4. A nurse is preparing to administer packed red blood cells. Which IV solution is
compatible with blood products?
A. Dextrose 5% in water
B. Lactated Ringer's
C. 0.9% sodium chloride
D. 0.45% sodium chloride
ANSWER: C. 0.9% sodium chloride
5. Shortly after a blood transfusion begins, the patient reports chills, low back pain,
and feeling suddenly unwell. What is the nurse's priority action?
A. Slow the transfusion
B. Stop the transfusion
C. Administer acetaminophen
D. Recheck the patient's temperature in 30 minutes
ANSWER: B. Stop the transfusion
6. After stopping a suspected blood transfusion reaction, which action should the
nurse take next?
A. Flush the tubing with the blood product
,B. Remove the IV catheter immediately
C. Maintain IV access with appropriate normal saline using new tubing
D. Restart the transfusion at a slower rate
ANSWER: C. Maintain IV access with appropriate normal saline using new tubing
7. A patient receiving an IV infusion suddenly develops dyspnea, cough, and
crackles. Which complication should the nurse suspect?
A. Fluid overload
B. Infiltration
C. Phlebitis
D. Local infection
ANSWER: A. Fluid overload
8. Which assessment finding requires the nurse to intervene immediately in a
patient with an artificial airway?
A. Small amount of clear secretions
B. Oxygen saturation of 98%
C. Sudden difficulty breathing with absent airflow
D. Mild throat irritation
ANSWER: C. Sudden difficulty breathing with absent airflow
9. A nurse is suctioning a patient with a tracheostomy. Which practice is
appropriate?
A. Apply suction continuously while inserting the catheter
B. Limit each suction pass to an appropriate short duration
C. Suction routinely every 15 minutes regardless of assessment
D. Use sterile water as the routine suction lubricant
ANSWER: B. Limit each suction pass to an appropriate short duration
10. Before suctioning a patient who has an artificial airway, the nurse should
primarily assess:
A. Bowel sounds
B. Need for suctioning and respiratory status
C. Urine color
D. Peripheral pulses only
ANSWER: B. Need for suctioning and respiratory status
11. Which finding most strongly suggests inadequate oxygenation?
A. Pink nail beds
B. Restlessness and altered mental status
C. Respiratory rate of 16/min
D. Warm skin
ANSWER: B. Restlessness and altered mental status
12. A postoperative patient suddenly develops shortness of breath, chest pain, and
tachycardia. Which complication should the nurse suspect?
A. Atelectasis
B. Pulmonary embolism
, C. Constipation
D. Urinary retention
ANSWER: B. Pulmonary embolism
13. Which intervention is most appropriate for reducing the risk of postoperative
atelectasis?
A. Restrict oral fluids
B. Encourage incentive spirometry and deep breathing
C. Maintain strict bed rest
D. Avoid coughing
ANSWER: B. Encourage incentive spirometry and deep breathing
14. A patient reports increasing incisional pain several hours after surgery. Which
assessment is most important?
A. Favorite food
B. Incision appearance and vital signs
C. Sleep preference
D. Hearing ability
ANSWER: B. Incision appearance and vital signs
15. Which finding is most concerning for wound dehiscence?
A. Mild incisional tenderness
B. Small amount of serous drainage
C. Separation of wound edges
D. Mild bruising
ANSWER: C. Separation of wound edges
16. A postoperative abdominal wound suddenly separates and bowel is visible.
What should the nurse do first?
A. Push the organs back into the abdomen
B. Cover the area with sterile dressings moistened with sterile saline
C. Apply a dry adhesive dressing tightly
D. Have the patient stand
ANSWER: B. Cover the area with sterile dressings moistened with sterile saline
17. Which finding is an early indication of pressure-related tissue injury?
A. Non-blanchable erythema
B. Thick eschar
C. Exposed bone
D. Purulent drainage
ANSWER: A. Non-blanchable erythema
18. Which intervention best helps prevent pressure injuries in an immobile patient?
A. Massage reddened bony prominences
B. Reposition the patient regularly and reduce pressure
C. Keep the patient in one position
D. Use donut-shaped devices routinely
ANSWER: B. Reposition the patient regularly and reduce pressure
Objective Assessment -Solved
1. A nurse is preparing to insert a peripheral IV catheter in an adult patient. Which
action should the nurse take first?
A. Apply the tourniquet
B. Select the smallest available catheter
C. Verify the patient's identity and explain the procedure
D. Insert the catheter bevel-down
ANSWER: C. Verify the patient's identity and explain the procedure
2. A patient receiving a peripheral IV infusion develops swelling, coolness, and
pallor around the insertion site. Which complication does the nurse suspect?
A. Phlebitis
B. Infiltration
C. Infection
D. Hematoma
ANSWER: B. Infiltration
3. Which finding is most characteristic of phlebitis at a peripheral IV site?
A. Cool, pale skin
B. Edema without pain
C. Warmth, redness, and tenderness along the vein
D. Absence of blood return
ANSWER: C. Warmth, redness, and tenderness along the vein
4. A nurse is preparing to administer packed red blood cells. Which IV solution is
compatible with blood products?
A. Dextrose 5% in water
B. Lactated Ringer's
C. 0.9% sodium chloride
D. 0.45% sodium chloride
ANSWER: C. 0.9% sodium chloride
5. Shortly after a blood transfusion begins, the patient reports chills, low back pain,
and feeling suddenly unwell. What is the nurse's priority action?
A. Slow the transfusion
B. Stop the transfusion
C. Administer acetaminophen
D. Recheck the patient's temperature in 30 minutes
ANSWER: B. Stop the transfusion
6. After stopping a suspected blood transfusion reaction, which action should the
nurse take next?
A. Flush the tubing with the blood product
,B. Remove the IV catheter immediately
C. Maintain IV access with appropriate normal saline using new tubing
D. Restart the transfusion at a slower rate
ANSWER: C. Maintain IV access with appropriate normal saline using new tubing
7. A patient receiving an IV infusion suddenly develops dyspnea, cough, and
crackles. Which complication should the nurse suspect?
A. Fluid overload
B. Infiltration
C. Phlebitis
D. Local infection
ANSWER: A. Fluid overload
8. Which assessment finding requires the nurse to intervene immediately in a
patient with an artificial airway?
A. Small amount of clear secretions
B. Oxygen saturation of 98%
C. Sudden difficulty breathing with absent airflow
D. Mild throat irritation
ANSWER: C. Sudden difficulty breathing with absent airflow
9. A nurse is suctioning a patient with a tracheostomy. Which practice is
appropriate?
A. Apply suction continuously while inserting the catheter
B. Limit each suction pass to an appropriate short duration
C. Suction routinely every 15 minutes regardless of assessment
D. Use sterile water as the routine suction lubricant
ANSWER: B. Limit each suction pass to an appropriate short duration
10. Before suctioning a patient who has an artificial airway, the nurse should
primarily assess:
A. Bowel sounds
B. Need for suctioning and respiratory status
C. Urine color
D. Peripheral pulses only
ANSWER: B. Need for suctioning and respiratory status
11. Which finding most strongly suggests inadequate oxygenation?
A. Pink nail beds
B. Restlessness and altered mental status
C. Respiratory rate of 16/min
D. Warm skin
ANSWER: B. Restlessness and altered mental status
12. A postoperative patient suddenly develops shortness of breath, chest pain, and
tachycardia. Which complication should the nurse suspect?
A. Atelectasis
B. Pulmonary embolism
, C. Constipation
D. Urinary retention
ANSWER: B. Pulmonary embolism
13. Which intervention is most appropriate for reducing the risk of postoperative
atelectasis?
A. Restrict oral fluids
B. Encourage incentive spirometry and deep breathing
C. Maintain strict bed rest
D. Avoid coughing
ANSWER: B. Encourage incentive spirometry and deep breathing
14. A patient reports increasing incisional pain several hours after surgery. Which
assessment is most important?
A. Favorite food
B. Incision appearance and vital signs
C. Sleep preference
D. Hearing ability
ANSWER: B. Incision appearance and vital signs
15. Which finding is most concerning for wound dehiscence?
A. Mild incisional tenderness
B. Small amount of serous drainage
C. Separation of wound edges
D. Mild bruising
ANSWER: C. Separation of wound edges
16. A postoperative abdominal wound suddenly separates and bowel is visible.
What should the nurse do first?
A. Push the organs back into the abdomen
B. Cover the area with sterile dressings moistened with sterile saline
C. Apply a dry adhesive dressing tightly
D. Have the patient stand
ANSWER: B. Cover the area with sterile dressings moistened with sterile saline
17. Which finding is an early indication of pressure-related tissue injury?
A. Non-blanchable erythema
B. Thick eschar
C. Exposed bone
D. Purulent drainage
ANSWER: A. Non-blanchable erythema
18. Which intervention best helps prevent pressure injuries in an immobile patient?
A. Massage reddened bony prominences
B. Reposition the patient regularly and reduce pressure
C. Keep the patient in one position
D. Use donut-shaped devices routinely
ANSWER: B. Reposition the patient regularly and reduce pressure
