RPN Clinical Skills 2 — Questions and Answers
Question 1: When performing a sterile dressing change, which action would break sterile technique?
- Placing sterile supplies on the sterile field
- Reaching over the sterile field to retrieve an item (Correct answer)
- Opening sterile packages away from the sterile field
- Wearing sterile gloves when touching the wound
Correct answer: Reaching over the sterile field to retrieve an item
Reaching over a sterile field contaminates it because non-sterile clothing or ungloved arms pass over sterile items.
Question 2: A patient's blood pressure is 88/52 mmHg. What is the correct mean arterial pressure (MAP)?
- 64 mmHg (Correct answer)
- 70 mmHg
- 57 mmHg
- 60 mmHg
Correct answer: 64 mmHg
MAP = (SBP + 2×DBP) / 3 = (88 + 2×52) / 3 = 192 / 3 = 64 mmHg.
Question 3: Which catheter size (French) is most appropriate for a routine urinary catheterization of an adult female?
- 8 Fr
- 14–16 Fr (Correct answer)
- 20–22 Fr
- 24 Fr
Correct answer: 14–16 Fr
A 14–16 Fr catheter is standard for routine adult female urinary catheterization, balancing drainage and patient comfort.
Question 4: During a subcutaneous insulin injection, the nurse aspirates before injecting. Which statement is correct?
- Aspiration is required to prevent IV injection
- Aspiration is no longer recommended for subcutaneous injections (Correct answer)
- Aspiration prevents lipodystrophy
- Aspiration confirms needle placement in subcutaneous fat
Correct answer: Aspiration is no longer recommended for subcutaneous injections
Current evidence and nursing guidelines no longer recommend aspiration before subcutaneous injections because the injection sites lack large blood vessels.
Question 5: A patient is placed in the Trendelenburg position. Which clinical situation is this position CONTRAINDICATED?
- Hypovolemic shock while awaiting IV access
- Postural drainage of lower lobes
- Increased intracranial pressure (Correct answer)
- Hip replacement surgery
Correct answer: Increased intracranial pressure
Trendelenburg increases venous return to the head, which raises intracranial pressure and is dangerous in patients with head injury or ICP elevation.
Question 6: When inserting a nasogastric tube, the nurse asks the patient to swallow. At which landmark should advancement PAUSE to allow swallowing?
- At the nose
- At the nasopharynx / back of throat (Correct answer)
- At the carina
- At the xiphoid process
Correct answer: At the nasopharynx / back of throat
Pausing at the nasopharynx and asking the patient to swallow helps guide the tube into the esophagus rather than the trachea.
Question 7: A nurse is preparing to administer a medication via metered-dose inhaler (MDI) with a spacer. What is the correct sequence?
- Shake, exhale fully, actuate then inhale slowly, hold 10 seconds (Correct answer)
- Actuate, exhale, then inhale rapidly without holding
- Inhale first, then actuate, then hold 5 seconds
- Shake, inhale rapidly, actuate simultaneously, no hold needed
Correct answer: Shake, exhale fully, actuate then inhale slowly, hold 10 seconds
Shaking disperses the medication, exhaling empties the lungs, slow inhalation during actuation deposits medication in the airways, and a 10-second breath hold maximizes deposition.
RPN Clinical Skills 2
When performing a sterile dressing change, which action would break sterile technique?