Trivium Clinical Skills and Procedures 2 — Questions and Answers
Question 1: When performing a sterile dressing change, what is the correct order of steps?
- Clean wound, open supplies, don gloves, assess
- Open supplies using sterile technique, don sterile gloves, then clean the wound (Correct answer)
- Don clean gloves, open supplies, then switch to sterile gloves
- Assess wound first, then gather all supplies barehanded
Correct answer: Open supplies using sterile technique, don sterile gloves, then clean the wound
Sterile supplies must be opened and the sterile field established before donning sterile gloves to maintain asepsis throughout the procedure.
Question 2: A patient's oxygen saturation drops to 88% on room air. What is the nurse's priority action?
- Notify the physician immediately
- Apply supplemental oxygen and reassess (Correct answer)
- Reposition the patient and wait 5 minutes
- Obtain an ABG sample first
Correct answer: Apply supplemental oxygen and reassess
Applying supplemental oxygen to correct hypoxia is the immediate priority before further assessment or physician notification.
Question 3: Which technique is used to confirm correct placement of a nasogastric tube before use?
- Inject air and listen for gurgling over the stomach with a stethoscope only
- Confirm by X-ray and check pH of aspirate (Correct answer)
- Pull back on the plunger to see fluid return
- Ask the patient to speak clearly
Correct answer: Confirm by X-ray and check pH of aspirate
X-ray confirmation combined with pH testing of gastric aspirate (pH ≤5.5) is the gold standard for verifying NG tube placement.
Question 4: When inserting a urinary catheter in a female patient, the nurse accidentally contaminates the catheter tip. What should be done?
- Wipe the tip with an antiseptic swab and proceed
- Insert the catheter anyway since the urethra is not sterile
- Obtain a new sterile catheter and restart the procedure (Correct answer)
- Rinse the catheter tip with sterile saline
Correct answer: Obtain a new sterile catheter and restart the procedure
Any contamination of the catheter requires replacing it with a new sterile one to prevent urinary tract infection.
Question 5: A nurse is preparing to administer a subcutaneous injection of insulin. Which site rotation principle applies?
- Rotate between different body regions each injection
- Use the same site every time for consistent absorption
- Rotate within one anatomical region to promote consistent absorption (Correct answer)
- Alternate arms only to minimize lipodystrophy
Correct answer: Rotate within one anatomical region to promote consistent absorption
Rotating within one anatomical region (e.g., the abdomen) ensures consistent insulin absorption rates compared to rotating between regions.
Question 6: Which action best prevents air embolism when discontinuing a central venous catheter?
- Remove quickly while the patient inhales deeply
- Have the patient perform Valsalva maneuver or hold breath during removal (Correct answer)
- Clamp the catheter before removal and remove during normal breathing
- Remove during expiration with the patient sitting upright
Correct answer: Have the patient perform Valsalva maneuver or hold breath during removal
Valsalva maneuver increases intrathoracic pressure, closing the venous lumen and preventing air from entering the bloodstream during CVC removal.
Question 7: When suctioning a tracheostomy, how long should each suction pass last?
- No more than 10–15 seconds (Correct answer)
- 20–30 seconds for effective clearance
- Up to 60 seconds if secretions are thick
- As long as secretions are returning
Correct answer: No more than 10–15 seconds
Each suction pass should not exceed 10–15 seconds to minimize hypoxia and mucosal trauma.
Trivium Clinical Skills and Procedures 2
When performing a sterile dressing change, what is the correct order of steps?