To take a wound swab for culture using the Levine technique, the nurse first cleans the wound with normal saline and then:

Rotates the swab with pressure over 1 cm2 of clean wound bed

Rolls the swab across the whole wound in a zigzag line without pressure

Dips the swab into the pus and slough collected on the dressing

Wipes the swab around the wound edge and the surrounding skin

A stage 1 pressure injury is described as:

Intact skin with non-blanchable redness

Partial-thickness loss with a shallow open base

Persistent maroon discoloration of intact skin

Full-thickness loss with fat visible

A seated patient's blood pressure is measured with the arm hanging down by her side. Compared with a reading at heart level, the result will most likely be:

Low for systolic and high for diastolic

Unchanged, as long as the cuff fits

Orthostatic (postural) hypotension is present when, within 3 minutes of standing, the systolic pressure falls by at least:

20 mmHg, or the diastolic by at least 10 mmHg

10 mmHg, or the diastolic by at least 5 mmHg

40 mmHg, or the diastolic by at least 25 mmHg

30 mmHg, or the diastolic by at least 20 mmHg

Noradrenaline is running through a forearm cannula while a central line is awaited. The nurse finds the area around the site cold, white, swollen and painful. What should the nurse do first?

Stop the infusion and aspirate before removing the cannula

Flush the cannula with saline to clear the drug from the vein quickly

Apply a warm compress and keep the infusion running

Remove the cannula at once and press firmly on the site

Assessment, vital signs and nursing procedures

52 Gulf Prometric RN (DHA, DOH, MOH, SCFHS) practice questions on Assessment, vital signs and nursing procedures, part of Fundamentals and Patient Safety. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
To take a wound swab for culture using the Levine technique, the nurse first cleans the wound with normal saline and then:
1. ARolls the swab across the whole wound in a zigzag line without pressure
2. BDips the swab into the pus and slough collected on the dressing
3. CWipes the swab around the wound edge and the surrounding skin
4. DRotates the swab with pressure over 1 cm2 of clean wound bed
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Answer: D · Rotates the swab with pressure over 1 cm2 of clean wound bed
The Levine technique samples the organisms in the tissue rather than on the surface. Loose exudate and debris are first rinsed away with saline so that surface colonisers are not cultured. The swab is then pressed and rotated over about 1 cm2 of viable tissue for about 5 seconds, until fluid is drawn up. Dressing contents, edges and slough mostly grow colonising bacteria.
- A: A light zigzag over the surface without pressure samples surface colonisers.
- B: Old exudate on the dressing grows colonisers, not the organism in the tissue.
- C: The edge and skin carry skin flora, which give a misleading result.
Question 2 · Easy
A stage 1 pressure injury is described as:
1. AIntact skin with non-blanchable redness
2. BPartial-thickness loss with a shallow open base
3. CPersistent maroon discoloration of intact skin
4. DFull-thickness loss with fat visible
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Answer: A · Intact skin with non-blanchable redness
Stage 1 is intact skin with a localised area of redness that does not blanch when pressed. In dark skin the redness may be hard to see, so warmth, firmness, pain or a colour different from the surrounding skin are also used. Purple or maroon colour points to deep tissue injury instead. The area is offloaded straight away, because stage 1 is fully reversible.
- B: This describes stage 2, where the epidermis and part of the dermis are lost.
- C: Maroon or purple discoloration of intact skin is a deep tissue pressure injury.
- D: This describes stage 3, a full-thickness wound.
Question 3 · Medium
A seated patient's blood pressure is measured with the arm hanging down by her side. Compared with a reading at heart level, the result will most likely be:
1. AFalsely high
2. BLow for systolic and high for diastolic
3. CUnchanged, as long as the cuff fits
4. DFalsely low
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Answer: A · Falsely high
The arm should be supported at the level of the heart. When the arm hangs below the heart, the hydrostatic pressure of the column of blood adds to the reading, so both systolic and diastolic values come out higher. An arm held above the heart gives falsely low values. An unsupported arm also raises the reading through muscle contraction.
- B: Arm position moves both values in the same direction, not in opposite ones.
- C: Arm height changes the reading even with a correctly sized cuff.
- D: A falsely low reading comes from an arm placed above heart level.
Question 4 · Easy
Orthostatic (postural) hypotension is present when, within 3 minutes of standing, the systolic pressure falls by at least:
1. A10 mmHg, or the diastolic by at least 5 mmHg
2. B20 mmHg, or the diastolic by at least 10 mmHg
3. C40 mmHg, or the diastolic by at least 25 mmHg
4. D30 mmHg, or the diastolic by at least 20 mmHg
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Answer: B · 20 mmHg, or the diastolic by at least 10 mmHg
Orthostatic hypotension is a sustained fall in systolic pressure of 20 mmHg or more, or in diastolic pressure of 10 mmHg or more, within 3 minutes of standing. The nurse measures lying (or sitting) first, then standing, and also notes the pulse and any dizziness. Common causes are hypovolaemia, antihypertensives, diuretics and autonomic neuropathy in diabetes. A positive result is a fall risk, so the patient is helped to rise slowly.
- A: Changes this small are normal posture adjustments and are below the agreed cut-off.
- C: Waiting for falls this large would miss nearly every clinically important case.
- D: These falls are larger than needed, so many patients at risk would be missed.
Question 5 · Hard
Noradrenaline is running through a forearm cannula while a central line is awaited. The nurse finds the area around the site cold, white, swollen and painful. What should the nurse do first?
1. AStop the infusion and aspirate before removing the cannula
2. BFlush the cannula with saline to clear the drug from the vein quickly
3. CApply a warm compress and keep the infusion running
4. DRemove the cannula at once and press firmly on the site
Show answerHide answer
Answer: A · Stop the infusion and aspirate before removing the cannula
Coldness and blanching around the site show that the vasoconstrictor has leaked into the tissues, which can cause necrosis. The infusion is stopped at once and as much drug as possible is aspirated through the cannula before it is removed. The doctor is told, the limb is elevated, and the antidote phentolamine is given by local injection if prescribed. Another line is needed for the vasopressor, since stopping it may drop the blood pressure.
- B: Flushing pushes more of the drug into the damaged tissue.
- C: Continuing the infusion lets more drug leak and widens the injury.
- D: Removing the cannula first loses the chance to draw back the leaked drug.
Question 6 · Medium
When choosing a site for a peripheral IV cannula in the arm, the nurse usually starts with:
1. AAny vein in the dominant arm, to keep the other free
2. BThe most distal suitable vein in the arm
3. CThe antecubital fossa, because the veins there are largest
4. DThe vein closest to the wrist on the inner side
Answer and explanation in LearnFree account
Question 7 · Medium
A pressure injury on the sacrum is a shallow open wound with a pink, moist base and no slough; nearby is an intact blister filled with clear fluid. This is classified as:
1. ADeep tissue pressure injury
2. BStage 2
3. CStage 1
4. DStage 3
Answer and explanation in LearnFree account
Question 8 · Medium
When cleaning a sutured surgical incision, the nurse should wipe:
1. AIn circles from the outer skin inward to the incision line
2. BBack and forth across the incision with the same swab
3. CAlong the incision, then outward, new swab each stroke
4. DFrom the outer skin towards the incision, using one swab
Answer and explanation in LearnFree account
Question 9 · Medium
A deep leg wound is producing a large amount of exudate that soaks through gauze within hours. Which dressing is most suitable?
1. ACalcium alginate
2. BThin hydrocolloid
3. CHydrogel
4. DTransparent film
Answer and explanation in LearnFree account
Question 10 · Medium
Why does the nurse first palpate the brachial or radial pulse while inflating the cuff before auscultating a blood pressure?
1. ATo count the pulse rate in the same minute
2. BTo avoid a falsely low systolic from an auscultatory gap
3. CTo warm the artery so that the sounds are louder
4. DTo check that the cuff is the right width for the upper arm
Answer and explanation in LearnFree account
Question 11 · Medium
A patient is receiving oxygen by nasal cannula. The family wants to burn bukhoor (incense on charcoal) at the bedside for him. What should the nurse explain?
1. AIncense is fine if the oxygen flow is set below 2 L/min
2. BIncense is allowed once the window is opened for ventilation
3. CIncense may be burned if the cylinder is turned away from the burner
4. DBurning incense near oxygen is a fire risk and is not allowed
Answer and explanation in LearnFree account
Question 12 · Easy
Deep, rapid, laboured breathing in a patient with diabetic ketoacidosis is called:
1. AKussmaul respiration
2. BBiot respiration
3. CApneustic breathing
4. DCheyne-Stokes respiration
Answer and explanation in LearnFree account
Question 13 · Medium
A nurse leaves the tourniquet on for 3 minutes and asks the patient to keep clenching and pumping the fist while she finds a vein. Which result is most likely to be falsely raised?
1. APotassium
2. BGlucose
3. CSodium
4. DChloride
Answer and explanation in LearnFree account
Question 14 · Medium
On the second day of an infusion, the patient's cannula site is red and painful along the vein and slightly swollen; the infusion runs freely. What should the nurse do?
1. ARemove the cannula and resite it in another limb
2. BFlush the cannula with saline to clear the vein
3. CSlow the infusion and apply a tighter dressing
4. DLeave it in place and recheck at the end of the shift
Answer and explanation in LearnFree account
Question 15 · Medium
To irrigate a wound at a pressure that cleans it without damaging new tissue, the nurse uses:
1. AA pressurised bag of saline at 300 mmHg
2. BA 35 mL syringe with a 19-gauge needle or cannula
3. CA 5 mL syringe with a 25-gauge needle
4. DA 60 mL bulb syringe with no tip attached
Answer and explanation in LearnFree account
Question 16 · Hard
A 54-year-old man is brought in after a road traffic crash. He opens his eyes only when his trapezius is squeezed, speaks random words but no sentences, and pulls his arm away from the painful stimulus. What is his Glasgow Coma Scale score?
1. A11
2. B6
3. C8
4. D9
Answer and explanation in LearnFree account
Question 17 · Hard
Four surgical patients are on the ward on day 1 after surgery. Which patient should the nurse assess first? A: temperature 37.8 °C, pulse 88/min, RR 16/min, alert B: pulse 118/min, RR 28/min, BP 98/58 mmHg, newly confused C: BP 152/90 mmHg, pulse 96/min, pain 6/10, alert D: COPD, SpO2 92% on room air (baseline 91-93%), RR 18/min
1. APatient A
2. BPatient D (COPD)
3. CPatient C
4. DPatient B
Answer and explanation in LearnFree account
Question 18 · Medium
Using the common estimate for a nasal cannula, a patient receiving oxygen at 3 L/min gets an inspired oxygen concentration of about:
1. A28%
2. B32%
3. C40%
4. D24%
Answer and explanation in LearnFree account
Question 19 · Hard
A 79-year-old woman was to receive 1,000 mL of normal saline over 8 hours, but the pump was set wrongly and 900 mL ran in 2 hours. She is now breathless, with crackles at both lung bases, distended neck veins, BP 168/94 mmHg and SpO2 89%. What should the nurse do first?
1. AContinue the remaining fluid at the original rate
2. BLay her flat with her legs raised on pillows
3. CRemove the cannula and apply a pressure dressing
4. DSlow it to keep the vein open and sit her up
Answer and explanation in LearnFree account
Question 20 · Hard
A doctor orders 1,000 mL of normal saline over 8 hours. The giving set delivers 20 drops/mL and no pump is available. What drip rate should the nurse set?
1. A21 drops/min
2. B125 drops/min
3. C42 drops/min
4. D63 drops/min
Answer and explanation in LearnFree account
Question 21 · Easy
When inserting a peripheral IV cannula, the needle is advanced through the skin bevel up at an angle of about:
1. A70-80 degrees
2. B10-30 degrees
3. C90 degrees exactly
4. D45-60 degrees
Answer and explanation in LearnFree account
Question 22 · Medium
After a percutaneous liver biopsy, the patient is positioned for several hours:
1. AProne, with a pillow under the abdomen
2. BOn the left side, with the head of the bed flat
3. CIn high Fowler's position, with both legs hanging down
4. DOn the right side, pillow under the costal margin
Answer and explanation in LearnFree account
Question 23 · Medium
A patient has used a nasal cannula for 5 days. Which area should the nurse check closely for a device-related pressure injury?
1. AThe back of the neck
2. BThe tops of the ears under the tubing
3. CThe bridge of the nose
4. DThe inner cheeks
Answer and explanation in LearnFree account
Question 24 · Easy
After removing a peripheral IV cannula, the nurse inspects the catheter mainly to confirm that:
1. ANo blood remains inside the catheter lumen
2. BThe cannula was the same gauge written in the notes
3. CThe dressing date matches the documented insertion date
4. DThe tip is intact and no fragment was left in the vein
Answer and explanation in LearnFree account
Question 25 · Medium
For a thoracentesis, the nurse helps the alert patient into which position?
1. ASitting up, leaning forward over a bedside table
2. BSupine, with the arm of the affected side above the head
3. CLying on the unaffected side, knees drawn to the chest
4. DProne, with the head of the bed tilted down
Answer and explanation in LearnFree account

27 more Assessment, vital signs and nursing procedures questions

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Assessment, vital signs and nursing procedures

To take a wound swab for culture using the Levine technique, the nurse first cleans the wound with normal saline and then:

A stage 1 pressure injury is described as:

A seated patient's blood pressure is measured with the arm hanging down by her side. Compared with a reading at heart level, the result will most likely be:

Orthostatic (postural) hypotension is present when, within 3 minutes of standing, the systolic pressure falls by at least:

Noradrenaline is running through a forearm cannula while a central line is awaited. The nurse finds the area around the site cold, white, swollen and painful. What should the nurse do first?

When choosing a site for a peripheral IV cannula in the arm, the nurse usually starts with:

A pressure injury on the sacrum is a shallow open wound with a pink, moist base and no slough; nearby is an intact blister filled with clear fluid. This is classified as:

When cleaning a sutured surgical incision, the nurse should wipe:

A deep leg wound is producing a large amount of exudate that soaks through gauze within hours. Which dressing is most suitable?

Why does the nurse first palpate the brachial or radial pulse while inflating the cuff before auscultating a blood pressure?

A patient is receiving oxygen by nasal cannula. The family wants to burn bukhoor (incense on charcoal) at the bedside for him. What should the nurse explain?

Deep, rapid, laboured breathing in a patient with diabetic ketoacidosis is called:

A nurse leaves the tourniquet on for 3 minutes and asks the patient to keep clenching and pumping the fist while she finds a vein. Which result is most likely to be falsely raised?

On the second day of an infusion, the patient's cannula site is red and painful along the vein and slightly swollen; the infusion runs freely. What should the nurse do?

To irrigate a wound at a pressure that cleans it without damaging new tissue, the nurse uses:

A 54-year-old man is brought in after a road traffic crash. He opens his eyes only when his trapezius is squeezed, speaks random words but no sentences, and pulls his arm away from the painful stimulus. What is his Glasgow Coma Scale score?

Using the common estimate for a nasal cannula, a patient receiving oxygen at 3 L/min gets an inspired oxygen concentration of about:

A 79-year-old woman was to receive 1,000 mL of normal saline over 8 hours, but the pump was set wrongly and 900 mL ran in 2 hours. She is now breathless, with crackles at both lung bases, distended neck veins, BP 168/94 mmHg and SpO2 89%. What should the nurse do first?

A doctor orders 1,000 mL of normal saline over 8 hours. The giving set delivers 20 drops/mL and no pump is available. What drip rate should the nurse set?

When inserting a peripheral IV cannula, the needle is advanced through the skin bevel up at an angle of about:

After a percutaneous liver biopsy, the patient is positioned for several hours:

A patient has used a nasal cannula for 5 days. Which area should the nurse check closely for a device-related pressure injury?

After removing a peripheral IV cannula, the nurse inspects the catheter mainly to confirm that:

For a thoracentesis, the nurse helps the alert patient into which position?