NP Skills & Procedures Exam – 150 Questions
With Answers and Rationales (2025/2026)
1. When preparing to insert a peripheral IV, the NP should select
which vein first?
A. Basilic vein
B. Dorsal metacarpal vein
C. Cephalic vein
D. Median antecubital vein
Rationale: Distal veins are used first to preserve proximal sites for
future access.
2. The correct angle for venipuncture with a peripheral IV catheter is:
A. 45 degrees
B. 30 degrees
C. 10–15 degrees
D. 60 degrees
Rationale: A shallow angle reduces risk of piercing through the vein.
3. During IM injection in the deltoid, the maximum volume is:
A. 5 mL
B. 1 mL
C. 3 mL
D. 4 mL
Rationale: The deltoid muscle safely accommodates only 1 mL in
adults.
,4. Which needle length is MOST appropriate for an adult
ventrogluteal IM injection?
A. ⅝ inch
B. ½ inch
C. 1–1.5 inches
D. 2 inches
Rationale: A 1–1.5-inch needle ensures muscle penetration in most
adults.
5. The NP is preparing to insert a urinary catheter in a female patient.
The correct technique is to:
A. Clean from side-to-side
B. Clean front to back
C. Clean back to front
D. Clean in circular motions
Rationale: Cleaning front to back prevents contamination from the
rectal area.
6. A key sign of infiltration at an IV site is:
A. Warmth
B. Red streaking
C. Pulsation
D. Coolness and swelling
Rationale: Infiltration occurs when IV fluid enters surrounding tissue,
causing cool swelling.
7. The preferred site for intradermal injection is the:
A. Deltoid
B. Inner forearm
C. Ventrogluteal area
D. Thigh
,Rationale: The inner forearm allows easy visualization for intradermal
bleb formation.
8. Which gauge needle is most appropriate for subcutaneous heparin
administration?
A. 20G
B. 22G
C. 25–27G
D. 18G
Rationale: Smaller needles reduce discomfort and bruising for SC
injections.
9. When performing suture removal, the NP should:
A. Cut the knot
B. Pull the knot through the skin
C. Cut close to the skin and remove suture away from incision
D. Pull both ends
Rationale: Cutting near the skin prevents the contaminated external
portion from entering tissue.
10. Before performing wound irrigation, the NP should ensure
irrigation pressure is approximately:
A. 2 psi
B. 20 psi
C. 8 psi
D. 25 psi
Rationale: 8 psi optimally removes debris without damaging tissue.
11. The correct method to measure blood pressure manually is to:
A. Inflate 50 mmHg above expected systolic
B. Inflate 20 mmHg above expected diastolic
, C. Inflate 20–30 mmHg above the expected systolic
D. Inflate until pulse disappears
Rationale: Inflating above systolic ensures accurate Korotkoff sound
detection.
12. When performing a sterile dressing change, the NP should:
A. Touch the inside of the sterile field
B. Only touch sterile items with sterile gloves
C. Touch the wound with gloved hands
D. Touch sterile items with clean hands
Rationale: Sterile technique requires maintaining sterility to prevent
infection.
13. A patient requires a nasogastric tube (NG) insertion. Which
position is correct?
A. Supine
B. Prone
C. High Fowler’s (sitting upright)
D. Trendelenburg
Rationale: Upright positioning prevents aspiration and facilitates tube
passage.
14. The best method to confirm NG tube placement is:
A. Visual inspection of aspirate
B. Listening to air insufflation
C. X-ray confirmation
D. pH testing only
Rationale: X-ray is the gold standard to ensure safe placement before
feeding.
15. When giving an IM injection, the NP should aspirate the syringe:
With Answers and Rationales (2025/2026)
1. When preparing to insert a peripheral IV, the NP should select
which vein first?
A. Basilic vein
B. Dorsal metacarpal vein
C. Cephalic vein
D. Median antecubital vein
Rationale: Distal veins are used first to preserve proximal sites for
future access.
2. The correct angle for venipuncture with a peripheral IV catheter is:
A. 45 degrees
B. 30 degrees
C. 10–15 degrees
D. 60 degrees
Rationale: A shallow angle reduces risk of piercing through the vein.
3. During IM injection in the deltoid, the maximum volume is:
A. 5 mL
B. 1 mL
C. 3 mL
D. 4 mL
Rationale: The deltoid muscle safely accommodates only 1 mL in
adults.
,4. Which needle length is MOST appropriate for an adult
ventrogluteal IM injection?
A. ⅝ inch
B. ½ inch
C. 1–1.5 inches
D. 2 inches
Rationale: A 1–1.5-inch needle ensures muscle penetration in most
adults.
5. The NP is preparing to insert a urinary catheter in a female patient.
The correct technique is to:
A. Clean from side-to-side
B. Clean front to back
C. Clean back to front
D. Clean in circular motions
Rationale: Cleaning front to back prevents contamination from the
rectal area.
6. A key sign of infiltration at an IV site is:
A. Warmth
B. Red streaking
C. Pulsation
D. Coolness and swelling
Rationale: Infiltration occurs when IV fluid enters surrounding tissue,
causing cool swelling.
7. The preferred site for intradermal injection is the:
A. Deltoid
B. Inner forearm
C. Ventrogluteal area
D. Thigh
,Rationale: The inner forearm allows easy visualization for intradermal
bleb formation.
8. Which gauge needle is most appropriate for subcutaneous heparin
administration?
A. 20G
B. 22G
C. 25–27G
D. 18G
Rationale: Smaller needles reduce discomfort and bruising for SC
injections.
9. When performing suture removal, the NP should:
A. Cut the knot
B. Pull the knot through the skin
C. Cut close to the skin and remove suture away from incision
D. Pull both ends
Rationale: Cutting near the skin prevents the contaminated external
portion from entering tissue.
10. Before performing wound irrigation, the NP should ensure
irrigation pressure is approximately:
A. 2 psi
B. 20 psi
C. 8 psi
D. 25 psi
Rationale: 8 psi optimally removes debris without damaging tissue.
11. The correct method to measure blood pressure manually is to:
A. Inflate 50 mmHg above expected systolic
B. Inflate 20 mmHg above expected diastolic
, C. Inflate 20–30 mmHg above the expected systolic
D. Inflate until pulse disappears
Rationale: Inflating above systolic ensures accurate Korotkoff sound
detection.
12. When performing a sterile dressing change, the NP should:
A. Touch the inside of the sterile field
B. Only touch sterile items with sterile gloves
C. Touch the wound with gloved hands
D. Touch sterile items with clean hands
Rationale: Sterile technique requires maintaining sterility to prevent
infection.
13. A patient requires a nasogastric tube (NG) insertion. Which
position is correct?
A. Supine
B. Prone
C. High Fowler’s (sitting upright)
D. Trendelenburg
Rationale: Upright positioning prevents aspiration and facilitates tube
passage.
14. The best method to confirm NG tube placement is:
A. Visual inspection of aspirate
B. Listening to air insufflation
C. X-ray confirmation
D. pH testing only
Rationale: X-ray is the gold standard to ensure safe placement before
feeding.
15. When giving an IM injection, the NP should aspirate the syringe:
