• 1.

Which of the following patients is at most risk for pressure ulcers?

o A.

An 80-year old lady who just had a hip replacement and is on bed rest

o B.

A 5-year old child in traction for a fractured femur

o C.

A 95-year old Alzheimer's patient who roams around the facility

o D.

A 22-year old patient suffering from a spinal cord injury confined to a wheel chair

Correct Answer
A. An 80-year old lady who just had a hip replacement and is on bed rest

Explanation
Older individuals with orthopedic injuries are mostly immobile and made worse by decreased
sensory abilities.
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• 2.
A nurse notes the following orders on the care plan of a patient on enteric isolation
with a decubitus ulcer. Which of the following orders should the nurse question or
ask clarification?

o A.

Assess wound measurement once a week

o B.

Use a mask when changing heavily soiled linen

 o C.

Restrict visitors

o D.

Educate patient on how to take care of wounds.

Correct Answer
C. Restrict visitors

Explanation
Enteric isolation refers to the avoidance of any contact with bodily fluids of a patient due to
pathogens or chemotherapy treatment that can be transmitted via these fluids. Provided visitors
observe the right contact precautions, there is no reason to restrict them from seeing the
patient.
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• 3.
As a nurse, what is the most proper way to remove a gown?

o A.

Touch the outside of the gown only

o B.

Touch the inside of the gown only

o C.

Remove gown outside a patient's room

o D.

Ask another person to remove it for you.

Correct Answer
B. Touch the inside of the gown only
 Explanation
The nurse should take off the gown by shrugging it off the shoulders and rolling it up with the
gloves touching only the inside of the gown.
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• 4.
After a hip surgery, a 68-year old patient needed a Foley catheter. Laboratory examination
revealed that she developed Pseudomonas aeruginosa urinary tract infection. Based on this
patient's medical history, the nurse would suspect that this is probably a(n):

o A.

Superinfection

o B.

Autoimmune response

o C.

Antibiotic resistance response.

o D.

Nosocomial infection

Correct Answer
D. Nosocomial infection

Explanation
Pseudomonas aeruginosa is a common bacterium that can cause disease in animals, including
humans. It is found in soil, water, skin flora, and most man-made environments throughout the
world. Because it thrives on most surfaces, this bacterium is also found on and in medical
equipment, including catheters, causing cross-infection in hospitals and clinics. A nosocomial
infection is an infection acquired during a hospital stay or as a consequence of a medical
intervention (urinary catheter)
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• 5.
 A nurse is caring for a patient with a low White Blood Cell count, has prostate cancer, and
has been receiving chemotherapy for the past 5 months. Which of the following should be
implemented for this patient?

o A.

There should be no raw fruits, flowers or vegetables in his room

o B.

Patient should not receive any injections at this time

o C.

Patient should use mask when transported through the hospital

o D.

Protective isolation

Correct Answer(s)
A. There should be no raw fruits, flowers or vegetables in his room
C. Patient should use mask when transported through the hospital
D. Protective isolation

Explanation
With a low WBC count, the patient's immunity is also low needing protective isolation
precaution. Due to low immunity, a patient needs to wear a mask for his protection when
transported within the hospital. Fresh fruits, vegetables, and flowers may increase the risk of
infection for this patient. Avoiding injections however belongs to hemorrhagic (bleeding)
precautions.
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• 6.
During a bed bath, a chance for infection is best reduced by:

o A.

Change water after washing each leg.

 o B.

Using separate wash clothes for each eye

o C.

Thoroughly rinse and dry all skin folds.

o D.

Use clean gloves before starting the bath

Correct Answer
B. Using separate wash clothes for each eye

Explanation
Using separate wash clothes for each eye prevents spread of organisms from one eye to
another. It is the best answer. Rinsing and drying skin folds reduce skin irritation more than
prevent infection. Use of clean gloves is protective and part of a standard precaution. There is
no need to change water after washing each leg.
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• 7.
If a patient says that he has an urge to defecate after the nurse begins to administer a tap-
water enema, what should the nurse do?

o A.

Adjust tube location while maintaining fluid fow

o B.

Lower enema bag while instructing patient to breathe deeply

o C.

Reassure patient that discomfort would be gone shortly

o D.
 Immediately discontinue procedure to allow patient bowel evacuation.

Correct Answer
B. Lower enema bag while instructing patient to breathe deeply

Explanation
This may delay the patient's urge to defecate. Maintaining fluid flow increases patient's urge.
Patient is likely to lose control of his bowels if nurse does not adjust flow rate. Discontinuing
intervention is done if prescribed amount of fluid has been given
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• 8.
A Nurse is changing a patient's pressure ulcer dressing using a sterile technique. Which of
the following is incorrect?

o A.

Remove old dressing with sterile gloves

o B.

Irrigate wound from top to bottom

o C.

Pack the wound with a sterile cotton swab

o D.

Tape dressing to allow patient movement

Correct Answer
A. Remove old dressing with sterile gloves

Explanation
Old dressings should be removed with clean gloves and not sterile gloves. Irrigating wound
from top to bottom is a correct procedure and so are the other two interventions.
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• 9.
 A nurse is suctioning secretions from a patient's nasal artificial airway. The nurse applies
suction for no longer than:

o A.

3 seconds

o B.

10 seconds

o C.

30 seconds

o D.

1 minute

Correct Answer
B. 10 seconds

Explanation
3 seconds is not enough. More than thirty seconds is too long to keep a patient from normal
breathing. 10 seconds allows the nurse to remove secretions effectively and not interrupt the
patient's normal breathing pattern for a long time.
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• 10.
When caring for a cancer patient who also has aids, which protective measure should be
used?

o A.

None

o B.

Glove, gown and mask

 o C.

Gloves

o D.

Standard precaution

Correct Answer
D. Standard precaution

Explanation
AIDS and CANCER without other complications do not require more than standard
precautions.
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• 11.
A nonspecific body defense "against infection"

o A.

Phagocytes

o B.

Inflammatory process

o C.

Antibodies

o D.

Cellular immunity

Correct Answer
B. Inflammatory process

Explanation
The inflammatory process is a nonspecific body because it is a process. Phagocytes and
 Antibodies are specific agents that defend the body against foreign elements. Cellular immunity
refers to a cellular quality.
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• 12.
A foreign protein that invades the body is called:

o A.

Antigen

o B.

Interferon

o C.

Complement

o D.

Antibody

Correct Answer
A. Antigen

Explanation
In immunology, an antigen is a substance that evokes the production of one or more antibodies.
Each antibody binds to a specific antigen by way of an interaction similar to the fit between a
lock and a key. The substance may be from the external environment or formed within the
body. The immune system will try to destroy or neutralize any antigen that is recognized as a
foreign and potentially harmful invader.
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• 13.
Immunity obtained as a result of experiencing an illness is known as:

o A.

Active natural immunity

 o B.

Passive natural immunity

o C.

Active acquired immunity

o D.

Passive acquired immunity

Correct Answer
C. Active acquired immunity

Explanation
Active immunity results from the development of antibodies in response to an antigen, as from
exposure to an infectious disease or through vaccination. Passive immunity results from the
transmission of antibodies, as from mother to fetus through the placenta or by the injection of
antiserum. Acquired when it is introduced to our system from external factors. Natural are
intrinsic factors within our system.
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• 14.
As a result of sharing a needle with an HIV-positive person (Person A). Person B becomes
infected. In the chain of infection before a person, B became infected, what was the
reservoir?

o A.

Person A

o B.

Person B

o C.

The dirty needle

o D.
 The hole made by inserting the needle into Person B's skin

Correct Answer
A. Person A

Explanation
Person A is the originator of the disease.
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• 15.
After receiving a flu shot from the city hall for free, a patient developed shingles. It was
learned later that one of the nurses who handled the syringes used for that day had
shingles. It seems that the patient got the shingles through which fomite?

o A.

The nurse who handled the syringes.

o B.

The syringe

o C.

The city hall

o D.

The person who administered the flu shot

Correct Answer
B. The syringe

Explanation
fomite is non-living; vector is living; both are vehicles for the transmission of pathogens
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• 16.
Which of the following illustrates microorganism transmission via droplet contact?

o A.
 Infected wound drainage contacts the nurse's hands

o B.

A virus is transmitted through sexual intercourse

o C.

Microorganisms contact a person's nasal mucus when someone coughs nearby

o D.

Contaminated stethoscope touches a client's skin

Correct Answer
C. Microorganisms contact a person's nasal mucus when someone coughs nearby

Explanation
Droplet contact suggests particles transmitted through air at a closer distance.
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• 17.
An individual who is more likely than others to acquire an infection is a(n):

o A.

Vector

o B.

Reservoir

o C.

Fomite

o D.

Susceptible host
 Correct Answer
D. Susceptible host

Explanation
Vector and fomite are both vehicles of transmission. RESERVOIR is a place within which
microorganisms can thrive and reproduce. For example, microorganisms thrive in human
beings, animals, and inanimate objects such as water, table tops, and doorknobs.

SUSCEPTIBLE HOST is a person who cannot resist a microorganism invading the body,
multiplying, and resulting in infection. The host is susceptible to the disease, lacking immunity
or physical resistance to overcome the invasion by the pathogenic microorganism.
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• 18.
A government agency concerned with disease prevention. They track and manage infectious
diseases at the national level.

o A.

Centers for Disease Control and Prevention

o B.

World Health Organization

o C.

Department of Health and Human Services

o D.

National Institute for Occupational Safety and Health

Correct Answer
A. Centers for Disease Control and Prevention

Explanation
The correct answer is Centers for Disease Control and Prevention. This government agency is
responsible for tracking and managing infectious diseases at the national level. They work to
prevent the spread of diseases and provide guidance and resources to healthcare
professionals and the public.
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• 19.
Which of the following has the highest possibility of contaminating a sterile field?

o A.

The nurse diverts her head from the sterile field when talking

o B.

The nurse turns her back on the sterile field

o C.

The nurse holds her sterile gloved hands above waist level

o D.

The nurses reaches around a sterile field

Correct Answer
B. The nurse turns her back on the sterile field

Explanation
When the nurse turns her back on the sterile field, there is no way to see what is happening.
When the nurse diverts her head from the sterile field, nothing is broken. The nurse should
normally position her sterile gloved hands above waist level. The nurse cannot reach across a
sterile field. She needs to reach around and walk if needed
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• 20.
Which of the following situations require that gown, mask, and gloves be worn by all persons
entering the room.

o A.

Contact isolation

o B.
 Enteric precaution

o C.

Strict isolation

o D.

Universal precaution

Correct Answer
C. Strict isolation

Explanation
Strict isolation is used for diseases spread through the air and in some cases by contact.
Patients must be placed in isolation to prevent the spread of infectious diseases. Those who
are kept in strict isolation are often kept in a special room at the facility designed for that
purpose. Such rooms are equipped with a special lavatory and care giving equipment, and a
sink and waste disposal are provided for workers upon leaving the area.
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• 21.
Which of the following clients require a private room.

o A.

A client who has an infected abdominal incision

o B.

A client who has a kidney infection

o C.

A client who has a hepatitis B and is incontinent

o D.

A client who is bed bound and has an infected decubitus ulcer

 Correct Answer
C. A client who has a hepatitis B and is incontinent

Explanation
Hepatitis B is contagious. The rest of the choices are not.
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• 22.
A nurse comes in a patient's room wearing gloves, gown, and mask. When she gets out of
the room, what should she remove first.

o A.

Gown

o B.

Gloves

o C.

Mask

o D.

The order is not important

Correct Answer
B. Gloves

Explanation
Since the gloves are the most infected piece of the PPE after caring for a patient, it should be
the first one to be discarded.
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• 23.
After exposure to bloodborne pathogens, what should a nurse do next?

o A.

Begin a post-exposure prophylaxis within 24 hours

 o B.

Require the source individual to be tested for HIV/hepatitis

o C.

Test the exposed person for hepatitis immunity

o D.

Complete an injury report if the exposure requires treatment

Correct Answer
C. Test the exposed person for hepatitis immunity

Explanation
This is according to CDC protocol
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• 24.
Which of the following are considered universal precautions?

o A.

Wear clean gloves when touching body fluids

o B.

Wear sterile gloves when touching body secretions

o C.

Wash hands before putting on gloves

o D.

Wear an eye mask only if not wearing glasses

o E.
 Wear a clean gown when changing a draining wound dressing

Correct Answer(s)
A. Wear clean gloves when touching body fluids
E. Wear a clean gown when changing a draining wound dressing

Explanation
the other choices which are not listed as universal precautions are either standard precautions
or sterile techniques.
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• 25.
The nurse is preparing to give oral care to an unconscious patient. How should the nurse
proceed?

o A.

Put the bed in high Fowler's position before beginning

o B.

Lower the head of the bed, and place the client in side-lying position.

o C.

Put the client in Fowler's position, then turn head to the side

o D.

Place the client supine with head lowered

Correct Answer
B. Lower the head of the bed, and place the client in side-lying position.

Explanation
For an unconscious patient, avoiding client aspiration or choking is of primary concern. The
side-lying position is the most appropriate position to do this.
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• 26.
For a client with tinea pedis, which nursing intervention would be the most appropriate?

o A.

Apply antiseptic to gauze, insert between affected toes and leave in place.

o B.

Dry feet well after bathing and allow to air dry. Apply clean stockings daily

o C.

Soak feet in warm water with epsom salts,then abrade with pumice stone

o D.

Apply salicylic acid followed by foot powder.

Correct Answer
B. Dry feet well after bathing and allow to air dry. Apply clean stockings daily

Explanation
Athlete's foot (also known as ringworm of the foot and tinea pedis is a fungal infection of the
skin that causes scaling, flaking, and itch of affected areas, is caused by fungi in the genus
Trichophyton. While it is typically transmitted in moist communal areas where people walk
barefoot, such as showers or bathhouses, the disease requires a warm moist environment,
such as the inside of a shoe, in order to incubate. Because of this the fungus only affects
approximately 0.75% of habitually (frequently) barefoot people. "B" is the best answer.
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• 27.
For a client confined to bed, which nursing activity is a part of the routine "hour of sleep"
care but not for "early morning" care?

o A.

Providing a back massage

o B.
 Providing a bed pan or urinal

o C.

Changing the linen

o D.

Washing the face and hands.

Correct Answer
A. Providing a back massage

Explanation
Providing a back massage is appropriate to enhance patient relaxation. It is a good intervention
to help the patient sleep and is not appropriate for early morning care since a patient needs to
be awakened at that time.
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• 28.
When providing perineal care for a female patient, the correct procedure is to wipe:

o A.

The area in concentric circular motions around the rectum

o B.

From the rectum toward the pubis

o C.

From the pubis toward the rectum

o D.

In concentric circles around the vaginal area

 Correct Answer
C. From the pubis toward the rectum

Explanation
Cleaning process is from in to out and from dirty to clean.
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• 29.
Which of the following shows the correct bed-making procedure?

o A.

Nurse shakes crumbs from the soiled linen before disposing it in the hamper

o B.

Nurse places clean linen on the bedside table of client in Bed A while making the bed
of the client in bed B.

o C.

The nurse wears sterile gloves while changing a client's bed linen

o D.

The nurse is careful not to bring soiled linens in contact with his uniform

Correct Answer
D. The nurse is careful not to bring soiled linens in contact with his uniform

Explanation
Shaking crumbs from linen could spread microorganisms. Using other devices not belonging to
the patient could create cross-contamination. There is no need to wear sterile gloves while
making the bed.
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• 30.
Which action shows a correct technique when doing eye care for a comatose patient?

o A.

The nurse cleans the eyes with saline solution, wiping from the inner canthus to the
outer canthus.
 o B.

Nurse cleans eyes with glucose solution and cotton balls

o C.

Nurse uses mineral oil into the lower lids to lubricate conjunctiva

o D.

If corneal reflex is absent, the nurse tapes saline soaked pads tightly over the eyes to
keep the eyes closed.

Correct Answer
A. The nurse cleans the eyes with saline solution, wiping from the inner canthus to the outer
canthus.

Explanation
Only "D" is, right. The rest are either irrelevant to eye care or a wrong technique
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• 31.
A female client refuses bath in the hospital unless they allow her to do it alone. Which of the
following might have influenced this client's hygienic practice?

o A.

Environment

o B.

Personal preference

o C.

Culture

o D.

Religion
 Correct Answer
C. Culture

Explanation
Culture is the best answer.
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• 32.
To shave a client with a safety razor, the nurse should first:

o A.

Apply shaving cream to the face

o B.

Put lotion on the skin

o C.

Put on clean gloves

o D.

Shave in short, firm strokes

Correct Answer
C. Put on clean gloves

Explanation
Wearing gloves is standard precaution. Do it first
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• 33.
Which would be the best way to position a bedpan for a patient who is able to assist with the
procedure?

o A.

Ask patient to raise buttocks of the bed while nurse slides bedpan under him
 o B.

Assist patient to a sitting position on the bedpan on the side of the bed.

o C.

Ask patient to roll over and position the bed pan on his buttocks and have him roll over
onto it.

o D.

Ask patient to get out of bed and use a bedside commode.

Correct Answer
A. Ask patient to raise buttocks of the bed while nurse slides bedpan under him

Explanation
"A" is the best method. Sitting on the side of the bed could cause skin friction and run the risk
for bed sores. Rolling over is effective but it is not the easiest thing to do. The last choice does
not address the question focused on elimination while on the bed.
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• 34.
If a nurse is allowed to clip a patient's toenails, which one of the following techniques would
be recommended?

o A.

Clip nails as short as possible

o B.

Clip nails with square corners

o C.

Round off the edges of the nails

o D.

Clip the nails straight across.

 Correct Answer
D. Clip the nails straight across.

Explanation
Clipping the nails straight across is the best answer because it reduces the incidence of
ingrown toenails. Clipping as short as possible may be painful. Square corners may catch on
bed linens. Rounding off nails can predispose to ingrown nails.
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• 35.
A patient with a Stage III decubitus ulcer asks the nurse if the ulcer will leave a scar once it
heals. Which of the following is the most appropriate response?

o A.

"Sometimes there is a scar, sometimes there isn't"

o B.

"I don't think you should worry about that right now"

o C.

"Usually there is scar present with this type of healing"

o D.

"I think you should ask your doctor about that tomorrow"

Correct Answer
C. "Usually there is scar present with this type of healing"

Explanation
"C" is the best answer. Ulcer will fill in from the inside and upward which leaves a scar. A flip
flop answer is demeaning. Telling the patient not to worry does not recognize the patients need
to know. Asking the doctor is possible but the nurse is avoiding the answer.
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• 36.
Microorganisms
 o A.

Microscopic entities capable of carrying on a living process and are naturally present
in the human body, as well as the environment

o B.

They are always harmless

o C.

They are always harmful

o D.

The do not cause disease

Correct Answer
A. Microscopic entities capable of carrying on a living process and are naturally present in the
human body, as well as the environment

Explanation
Foundations, p. 266
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• 37.
Difference between Medical asepsis and Surgical Asepsis.

o A.

Medical Asepsis inhibits growth and spread of Pathogens. Surgical Asepsis destroys
microorganisms and spores

o B.

Surgical Asepsis inhibits growth and spread of Pathogens. Medical Asepsis destroys
microorganisms and spores

o C.
 They are equally used in any prevention control protocol

o D.

Medical asepsis is also known as sterile technique. Surgical asepsis is also clean
technique

Correct Answer
A. Medical Asepsis inhibits growth and spread of Pathogens. Surgical Asepsis destroys
microorganisms and spores

Explanation
Foundations, p. 267
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• 38.
Where do pathogens grow?

o A.

Reservoir

o B.

Infectious Agent

o C.

Host

o D.

Entrance or Exit

Correct Answer
A. Reservoir

Explanation
Foundations, page 267
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• 39.
 Which of the following statements about SPORES is not true?

o A.

A round body formed by bacterium when conditions are unfavorable for growth of
bacterium

o B.

Spore enlarges until it is as large as the bacterial cell and is surrounded by a capsule

o C.

Spores remain dormant until environmental conditions become favorable for growth

o D.

Spores normally die when exposed to excessively high temperatures

Correct Answer
D. Spores normally die when exposed to excessively high temperatures

Explanation
Foundations, page 268
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• 40.
Factors that determine a pathogen's ability to produce disease.

o A.

Strength of microorganism

o B.

Number of microorganisms

o C.

Effectiveness of a person's immune system

 o D.

Length of exposure to the microorganism

o E.

Shape of the microorganism

Correct Answer(s)
A. Strength of microorganism
B. Number of microorganisms
C. Effectiveness of a person's immune system
D. Length of exposure to the microorganism

Explanation
Foundations, page 268
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• 41.
Responsible for more diseases than any other organism.

o A.

Streptococcus bacterium

o B.

Staphylococcus aureus

o C.

Rocky Mountain

o D.

Clostridium

Correct Answer
A. Streptococcus bacterium

Explanation
Foundations, p. 269
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• 42.
Anthrax infection occurs in three forms. What are they?

o A.

Perineal

o B.

Inhalation

o C.

Gastrointestinal

o D.

Cutaneous

Correct Answer(s)
B. Inhalation
C. Gastrointestinal
D. Cutaneous

Explanation
Foundations, p. 269
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• 43.
Ways are which a bacterial infection is transmitted from person to person.

o A.

Person to person by direct contact

o B.

Indirect contact with articles contaminated with the pathogen

o C.
 Ingestion of contaminated food and drink

o D.

Inhalation of droplet nuclei

Correct Answer(s)
A. Person to person by direct contact
B. Indirect contact with articles contaminated with the pathogen
C. Ingestion of contaminated food and drink
D. Inhalation of droplet nuclei

Explanation
Foundations, p. 269
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• 44.
Considered by CDC to be one of a number of potential agents for use in biological terrorism.

o A.

Bacillus anthracis

o B.

Candida albicans

o C.

Tubercle bacillus

o D.

Escherichia coli

Correct Answer
A. Bacillus anthracis

Explanation
Foundations, p. 270
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• 45.
The smallest known agents to cause disease normally composed of either RNA or DNA.

o A.

Viruses

o B.

Bacteria

o C.

Fungi

o D.

Yeast

Correct Answer
A. Viruses

Explanation
Foundations, page 270
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• 46.
A patient suffering from a common cold asks, "What is going on with me?" Which of the
following is NOT AN APPROPRIATE RESPONSE?

o A.

There are no medicines that can cure the common cold

o B.

Let me give you an antibiotic to help relieve your symptoms

o C.
 The common cold is normally caused by virus

o D.

What you have is self limiting. It will run its course.

Correct Answer
B. Let me give you an antibiotic to help relieve your symptoms

Explanation
Foundations, p. 271
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• 47.
Which of the following is the proper order on the stages of an infectious process?

o A.

Convalescence, Incubation, Illness, Prodormal

o B.

Prodormal, Convalescence, Incubation, Illness

o C.

Incubation, Prodormal, Illness, Convalescence

o D.

Illness, Incubation, Prodormal, Convalescence

Correct Answer
C. Incubation, Prodormal, Illness, Convalescence

Explanation
p. 273
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• 48.
 Which of the following statements about Infection and Inflammation is true?

o A.

Infection and Inflammation share some common signs and symptoms

o B.

Inflammation always involve infection

o C.

Infection always involve inflammation

o D.

The signs of infection are the same signs of inflammation

Correct Answer
A. Infection and Inflammation share some common signs and symptoms

Explanation
Foundations p. 274
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• 49.
Which of the following are major sites for health-care-associated infections?

o A.

Urinary and Respiratory Tract

o B.

Blood Stream

o C.

Scalp and finger nails

o D.
 Surgical or Traumatic wounds

Correct Answer(s)
A. Urinary and Respiratory Tract
B. Blood Stream
D. Surgical or Traumatic wounds

Explanation
Foundations, p. 307
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• 50.
Personal Hygiene for Nurses.

o A.

Take a daily bath or shower

o B.

Wear a clean uniform daily

o C.

Keep fingernails short and clean

o D.

Use breath mints and perfume to smell pleasant

o E.

Wear the best make-up and jewelry to be pretty

Correct Answer(s)
A. Take a daily bath or shower
B. Wear a clean uniform daily
C. Keep fingernails short and clean

Explanation
Foundations, Box 18-3, page 436
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