,Hondros College NUR 150 Fundamental
Concepts of Practical Nursing I Exam 4 Practice
Pack 2026–2027 | Questions, Answers &
Rationales
Q1. A nurse is caring for a client who is 6 hours postoperative following abdominal surgery.
The client's dressing is saturated with bright red blood, and the nurse notes a heart rate of
122 beats per minute and a blood pressure of 88/54 mm Hg. Which action should the nurse
take first?
A. Reinforce the dressing with additional gauze
B. Apply direct pressure to the wound and notify the provider
C. Administer prescribed IV pain medication
D. Document the findings and reassess in 30 minutes
Correct Answer: B. Apply direct pressure to the wound and notify the provider
Rationale: The client is exhibiting signs of hemorrhage and hypovolemic shock, including a
saturated dressing with bright red blood, tachycardia, and hypotension. The priority is to
apply direct pressure to the bleeding site to control hemorrhage and notify the provider
immediately for further intervention. Reinforcing the dressing without pressure does not
control bleeding. Administering pain medication is secondary to controlling hemorrhage.
Documenting and reassessing in 30 minutes would delay life-saving intervention.
Key Takeaway: Postoperative bleeding plus shock signs means pressure and provider now.
Q2. A nurse is preparing to perform a sterile dressing change on a client's surgical incision.
Which action demonstrates correct sterile technique?
A. Reaching over the sterile field to obtain supplies
B. Keeping the sterile field below waist level
C. Opening the sterile package away from the body and adding items without touching the
field
,D. Using a clean glove to touch the sterile dressing
Correct Answer: C. Opening the sterile package away from the body and adding items without
touching the field
Rationale: Sterile technique requires that the nurse avoid reaching over the sterile field, keep
the field above waist level, and add items without contaminating them. Using clean gloves to
touch a sterile dressing contaminates the field. Reaching over the field allows microorganisms
from the nurse's clothing or skin to fall into the field. Keeping the field below waist level
contaminates it because the waist and below are considered unsterile areas.
Key Takeaway: Sterile field stays above the waist and is never reached over.
Q3. A nurse is caring for a client who has a new colostomy. Which finding should the nurse
report to the provider immediately?
A. Stoma is pink and moist
B. Stoma is dark purple and dry
C. Small amount of bleeding when cleaning the stoma
D. Output is liquid immediately after surgery
Correct Answer: B. Stoma is dark purple and dry
Rationale: A healthy stoma should be pink to red and moist. A dark purple or black stoma
indicates ischemia or necrosis, which requires immediate notification of the provider. A small
amount of bleeding when cleaning the stoma is normal because the stoma is highly vascular.
Liquid output immediately after surgery is expected as the bowel adjusts. The nurse must
recognize the signs of a compromised stoma.
Key Takeaway: A healthy stoma is pink and moist; purple or black means trouble.
Q4. A nurse is preparing to administer oxygen to a client with chronic obstructive pulmonary
disease (COPD). Which oxygen delivery method is most appropriate?
A. Nasal cannula at 6 L/min
B. Simple face mask at 10 L/min
C. Venturi mask at 2 L/min
, D. Nonrebreather mask at 15 L/min
Correct Answer: C. Venturi mask at 2 L/min
Rationale: Clients with COPD rely on hypoxic drive to stimulate breathing. Administering high
levels of oxygen can suppress this drive and cause respiratory depression. The Venturi mask
delivers a precise, controlled oxygen concentration, allowing the nurse to titrate low levels of
oxygen, typically 24% to 28%, which is safe for clients with COPD. Nasal cannula at 6 L/min,
simple face mask at 10 L/min, and nonrebreather at 15 L/min deliver high concentrations that
could be dangerous.
Key Takeaway: For COPD, use a Venturi mask to give controlled low oxygen.
Q5. A nurse is collecting a wound specimen for culture. Which action should the nurse take?
A. Collect the specimen from the surface of the wound
B. Cleanse the wound with normal saline before collecting the specimen
C. Collect the specimen from the deepest part of the wound after cleaning
D. Swab the surrounding intact skin
Correct Answer: C. Collect the specimen from the deepest part of the wound after cleaning
Rationale: Wound culture specimens should be collected from the deepest part of the wound
after cleaning the surface to remove contaminants. Collecting from the surface or surrounding
skin yields inaccurate results because these areas contain normal flora. Cleansing with normal
saline before collecting is appropriate, but the specimen must come from deep within the
wound to identify the true pathogens. The nurse should use sterile technique and send the
specimen promptly.
Key Takeaway: Wound culture comes from deep inside after cleaning.
Q6. A nurse is assessing a client who is 2 days postoperative following a hip replacement. The
client reports calf pain and tenderness, and the nurse notes unilateral swelling of the left leg.
Which action should the nurse take first?
A. Massage the affected calf
B. Apply warm compresses to the leg
C. Notify the provider and maintain bed rest
Concepts of Practical Nursing I Exam 4 Practice
Pack 2026–2027 | Questions, Answers &
Rationales
Q1. A nurse is caring for a client who is 6 hours postoperative following abdominal surgery.
The client's dressing is saturated with bright red blood, and the nurse notes a heart rate of
122 beats per minute and a blood pressure of 88/54 mm Hg. Which action should the nurse
take first?
A. Reinforce the dressing with additional gauze
B. Apply direct pressure to the wound and notify the provider
C. Administer prescribed IV pain medication
D. Document the findings and reassess in 30 minutes
Correct Answer: B. Apply direct pressure to the wound and notify the provider
Rationale: The client is exhibiting signs of hemorrhage and hypovolemic shock, including a
saturated dressing with bright red blood, tachycardia, and hypotension. The priority is to
apply direct pressure to the bleeding site to control hemorrhage and notify the provider
immediately for further intervention. Reinforcing the dressing without pressure does not
control bleeding. Administering pain medication is secondary to controlling hemorrhage.
Documenting and reassessing in 30 minutes would delay life-saving intervention.
Key Takeaway: Postoperative bleeding plus shock signs means pressure and provider now.
Q2. A nurse is preparing to perform a sterile dressing change on a client's surgical incision.
Which action demonstrates correct sterile technique?
A. Reaching over the sterile field to obtain supplies
B. Keeping the sterile field below waist level
C. Opening the sterile package away from the body and adding items without touching the
field
,D. Using a clean glove to touch the sterile dressing
Correct Answer: C. Opening the sterile package away from the body and adding items without
touching the field
Rationale: Sterile technique requires that the nurse avoid reaching over the sterile field, keep
the field above waist level, and add items without contaminating them. Using clean gloves to
touch a sterile dressing contaminates the field. Reaching over the field allows microorganisms
from the nurse's clothing or skin to fall into the field. Keeping the field below waist level
contaminates it because the waist and below are considered unsterile areas.
Key Takeaway: Sterile field stays above the waist and is never reached over.
Q3. A nurse is caring for a client who has a new colostomy. Which finding should the nurse
report to the provider immediately?
A. Stoma is pink and moist
B. Stoma is dark purple and dry
C. Small amount of bleeding when cleaning the stoma
D. Output is liquid immediately after surgery
Correct Answer: B. Stoma is dark purple and dry
Rationale: A healthy stoma should be pink to red and moist. A dark purple or black stoma
indicates ischemia or necrosis, which requires immediate notification of the provider. A small
amount of bleeding when cleaning the stoma is normal because the stoma is highly vascular.
Liquid output immediately after surgery is expected as the bowel adjusts. The nurse must
recognize the signs of a compromised stoma.
Key Takeaway: A healthy stoma is pink and moist; purple or black means trouble.
Q4. A nurse is preparing to administer oxygen to a client with chronic obstructive pulmonary
disease (COPD). Which oxygen delivery method is most appropriate?
A. Nasal cannula at 6 L/min
B. Simple face mask at 10 L/min
C. Venturi mask at 2 L/min
, D. Nonrebreather mask at 15 L/min
Correct Answer: C. Venturi mask at 2 L/min
Rationale: Clients with COPD rely on hypoxic drive to stimulate breathing. Administering high
levels of oxygen can suppress this drive and cause respiratory depression. The Venturi mask
delivers a precise, controlled oxygen concentration, allowing the nurse to titrate low levels of
oxygen, typically 24% to 28%, which is safe for clients with COPD. Nasal cannula at 6 L/min,
simple face mask at 10 L/min, and nonrebreather at 15 L/min deliver high concentrations that
could be dangerous.
Key Takeaway: For COPD, use a Venturi mask to give controlled low oxygen.
Q5. A nurse is collecting a wound specimen for culture. Which action should the nurse take?
A. Collect the specimen from the surface of the wound
B. Cleanse the wound with normal saline before collecting the specimen
C. Collect the specimen from the deepest part of the wound after cleaning
D. Swab the surrounding intact skin
Correct Answer: C. Collect the specimen from the deepest part of the wound after cleaning
Rationale: Wound culture specimens should be collected from the deepest part of the wound
after cleaning the surface to remove contaminants. Collecting from the surface or surrounding
skin yields inaccurate results because these areas contain normal flora. Cleansing with normal
saline before collecting is appropriate, but the specimen must come from deep within the
wound to identify the true pathogens. The nurse should use sterile technique and send the
specimen promptly.
Key Takeaway: Wound culture comes from deep inside after cleaning.
Q6. A nurse is assessing a client who is 2 days postoperative following a hip replacement. The
client reports calf pain and tenderness, and the nurse notes unilateral swelling of the left leg.
Which action should the nurse take first?
A. Massage the affected calf
B. Apply warm compresses to the leg
C. Notify the provider and maintain bed rest
