DOH Nursing Nursing Fundamentals & Patient Care 3 — Questions and Answers
Question 1: What is the correct technique for obtaining a mid-stream clean-catch urine specimen?
- Clean the urethral meatus, begin urinating, then collect mid-stream in a sterile container (Correct answer)
- Collect the first stream of urine directly into the container
- Use a catheter for all urine culture specimens
- Collect urine at any point during voiding into any clean container
Correct answer: Clean the urethral meatus, begin urinating, then collect mid-stream in a sterile container
Mid-stream clean-catch minimizes contamination from periurethral flora. Cleansing the meatus removes surface bacteria; discarding the initial stream flushes the urethra; collecting mid-stream captures bladder urine.
Question 2: A nurse is preparing to insert a nasogastric tube. What is the most reliable method to confirm correct placement?
- X-ray confirmation (Correct answer)
- Auscultation of air insufflation over epigastrium
- pH testing of aspirate alone
- Visual inspection of the tube's exit point at the nostril
Correct answer: X-ray confirmation
X-ray is the gold standard for confirming NG tube placement as it directly visualizes the tube position. Auscultation alone is unreliable. pH testing is a useful bedside check but not definitive without X-ray confirmation.
Question 3: Which ethical principle requires a nurse to keep a patient's information confidential?
- Fidelity and veracity (Correct answer)
- Beneficence
- Non-maleficence
- Justice
Correct answer: Fidelity and veracity
Fidelity refers to faithfulness to duties and promises, which includes maintaining confidentiality. Veracity means truth-telling. Together they support honest, trustworthy nurse-patient relationships. Confidentiality is a legal and ethical obligation.
Question 4: What is the normal range for adult respiratory rate?
- 12–20 breaths per minute (Correct answer)
- 8–10 breaths per minute
- 22–26 breaths per minute
- 30–35 breaths per minute
Correct answer: 12–20 breaths per minute
A normal adult respiratory rate is 12–20 breaths per minute. Bradypnea is <12/min and tachypnea is >20/min. Respiratory rate is a sensitive early indicator of clinical deterioration.
Question 5: A patient who is NPO (nothing by mouth) is receiving IV fluids. Which observation indicates adequate hydration?
- Urine output ≥30 mL/hr, moist mucous membranes (Correct answer)
- Concentrated dark urine and dry lips
- Blood pressure drop of 20 mmHg on standing
- Heart rate of 110 beats per minute
Correct answer: Urine output ≥30 mL/hr, moist mucous membranes
Adequate hydration is reflected by sufficient urine output (≥30 mL/hr), moist mucous membranes, stable vital signs, and normal skin turgor. Dark concentrated urine and tachycardia suggest dehydration.
Question 6: When providing oral hygiene to an unconscious patient, what is the most important safety measure?
- Position the patient on their side to prevent aspiration (Correct answer)
- Use a soft toothbrush with fluoride toothpaste
- Perform oral care every 8 hours only
- Wear sterile gloves throughout the procedure
Correct answer: Position the patient on their side to prevent aspiration
Positioning the unconscious patient on their side (lateral position) allows fluid and secretions to drain out rather than into the airway, preventing aspiration pneumonia — the primary risk during oral care for unconscious patients.
DOH Nursing Nursing Fundamentals & Patient Care 3
What is the correct technique for obtaining a mid-stream clean-catch urine specimen?