NCAS Fundamentals 4 — Questions and Answers
Question 1: A nurse is preparing to administer blood products. Which IV solution is compatible with blood transfusions?
- Dextrose 5% in water (D5W)
- Normal saline (0.9% NaCl) (Correct answer)
- Lactated Ringer's solution
- Dextrose 5% in 0.45% NaCl
Correct answer: Normal saline (0.9% NaCl)
Only normal saline (0.9% NaCl) is compatible with blood products; dextrose solutions can cause hemolysis and Lactated Ringer's can cause clotting.
Question 2: A patient on bed rest develops sudden onset of calf pain, warmth, and swelling. The nurse suspects deep vein thrombosis (DVT). What is the priority intervention?
- Massage the affected leg to reduce swelling
- Elevate the leg and apply a warm compress
- Maintain bed rest and notify the physician immediately (Correct answer)
- Encourage the patient to ambulate to improve circulation
Correct answer: Maintain bed rest and notify the physician immediately
Suspected DVT requires immediate physician notification and bed rest to prevent embolization of the clot.
Question 3: When administering an intradermal injection for a tuberculin skin test (TST), which finding indicates correct technique?
- Blood appears in the syringe before injection
- A wheal or bleb forms at the injection site (Correct answer)
- The patient reports a burning sensation deep in the tissue
- No resistance is felt when pushing the plunger
Correct answer: A wheal or bleb forms at the injection site
A pale wheal or bleb at the injection site confirms the medication was deposited in the dermis rather than subcutaneous tissue.
Question 4: A nurse is teaching a patient about pursed-lip breathing. Which patient statement indicates understanding?
- 'I will inhale through pursed lips and exhale through my nose.'
- 'I will inhale through my nose and exhale slowly through puckered lips.' (Correct answer)
- 'I will breathe as fast as possible with lips pursed.'
- 'I will hold my breath for 10 seconds between each breath.'
Correct answer: 'I will inhale through my nose and exhale slowly through puckered lips.'
Pursed-lip breathing involves nasal inhalation followed by slow exhalation through puckered lips to slow respiratory rate and reduce air trapping.
Question 5: A patient's nasogastric tube has been ordered for continuous feedings. Which assessment finding requires immediate action?
- Gastric residual of 150 mL
- Tube feeding rate of 50 mL/hr
- Absent bowel sounds with abdominal distension (Correct answer)
- Blood glucose of 140 mg/dL
Correct answer: Absent bowel sounds with abdominal distension
Absent bowel sounds with abdominal distension may indicate an ileus or obstruction and requires immediate physician notification and tube feeding cessation.
Question 6: Which assessment finding is most consistent with dehydration in an adult patient?
- Bounding pulse, peripheral edema
- Poor skin turgor, concentrated urine, tachycardia (Correct answer)
- Bradycardia, hypertension, weight gain
- Crackles in lung bases, jugular vein distension
Correct answer: Poor skin turgor, concentrated urine, tachycardia
Dehydration presents with poor skin turgor, dark concentrated urine, and tachycardia as the body compensates for reduced circulating volume.
Question 7: A nurse prepares to collect a midstream clean-catch urine specimen. Which instruction to the patient is correct?
- 'Void the entire stream into the specimen container.'
- 'Start urinating, stop briefly, then collect the middle portion.' (Correct answer)
- 'Collect the first few drops of urine in the container.'
- 'Refrigerate the urine for 2 hours before bringing it to the lab.'
Correct answer: 'Start urinating, stop briefly, then collect the middle portion.'
The midstream technique discards the initial urine stream to flush urethral organisms, then collects the middle portion for accurate culture results.
NCAS Fundamentals 4
A nurse is preparing to administer blood products.
Which IV solution is compatible with blood transfusions?