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CMSA practice questions

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Question 1Patient Care and Clinical Fundamentals

A patient is found unresponsive, not breathing, and without a palpable pulse. According to basic life support principles, which action should be initiated first?

  1. Begin high-quality chest compressions Correct answer.
  2. Check a blood glucose level
  3. Apply an automated external defibrillator
  4. Deliver two rescue breaths

Explanation

In cardiac arrest, circulation support takes priority, so chest compressions should begin immediately once unresponsiveness and absent breathing/pulse are confirmed. Compressions maintain perfusion to the brain and heart until defibrillation or advanced care is available.

Question 2Patient Care and Clinical Fundamentals

When performing adult chest compressions, which combination of rate and depth reflects current resuscitation guidance?

  1. 100 to 120 per minute with about 5 cm depth Correct answer.
  2. 60 to 80 per minute with 1 cm depth
  3. 140 to 160 per minute with about 8 cm depth
  4. 80 to 100 per minute with about 2 cm depth

Explanation

High-quality adult compressions are delivered at 100 to 120 per minute with a depth of approximately 5 cm (2 inches). This rate and depth optimize cardiac output while limiting injury.

Question 3Patient Care and Clinical Fundamentals

A patient with a known severe penicillin allergy requires an antibiotic. Which prescribing decision is most appropriate?

  1. Prescribe a structurally unrelated alternative such as a macrolide Correct answer.
  2. Prescribe penicillin with an antihistamine premedication
  3. Prescribe amoxicillin at a reduced dose
  4. Prescribe cephalexin without further assessment

Explanation

For a documented severe penicillin allergy, the safest approach is to select an antibiotic from an unrelated class. Cephalosporins carry some cross-reactivity risk and require careful assessment rather than routine substitution.

Question 4Patient Care and Clinical Fundamentals

Which finding most strongly suggests that a patient is experiencing hypovolemic shock?

  1. Widened pulse pressure with slowed capillary refill
  2. Tachycardia with narrow pulse pressure and cool clammy skin Correct answer.
  3. Warm flushed skin with bradycardia
  4. Bounding pulses with hypertension

Explanation

Hypovolemic shock classically presents with compensatory tachycardia, narrowed pulse pressure, cool clammy extremities, and delayed capillary refill. These reflect reduced circulating volume and sympathetic compensation.

Question 5Patient Care and Clinical Fundamentals

A patient reports crushing substernal chest pain radiating to the left arm. Which initial action is most appropriate?

  1. Administer a large meal to test for reflux
  2. Encourage ambulation to assess symptom change
  3. Schedule an outpatient stress test for next week
  4. Obtain a 12-lead ECG and initiate monitoring Correct answer.

Explanation

Chest pain with a cardiac pattern requires prompt 12-lead ECG and continuous monitoring to identify ischemia or infarction. Early detection guides time-sensitive reperfusion decisions.

Question 6Patient Care and Clinical Fundamentals

Which parameter is the most reliable single indicator of adequate oxygenation during resuscitation?

  1. Capillary refill time
  2. Pulse oximetry reading alone
  3. Arterial blood gas measurement of oxygenation Correct answer.
  4. Skin temperature

Explanation

Arterial blood gas analysis directly measures oxygenation and ventilation, making it the most reliable indicator among the listed options. Pulse oximetry alone can be misleading in poor perfusion states.

Question 7Patient Care and Clinical Fundamentals

A patient with type 1 diabetes presents with confusion, diaphoresis, and tremor. Capillary glucose is 3.1 mmol/L (56 mg/dL). What is the priority intervention?

  1. Withhold all intake and recheck in one hour
  2. Provide a fast-acting oral carbohydrate if able to swallow Correct answer.
  3. Administer a diuretic
  4. Administer intravenous insulin

Explanation

Hypoglycemia with intact swallowing is treated with fast-acting oral carbohydrate to rapidly raise glucose. If the patient cannot swallow safely, intravenous dextrose or glucagon is used instead.

Question 8Patient Care and Clinical Fundamentals

Which assessment finding is most consistent with an acute ischemic stroke rather than hypoglycemia?

  1. Generalized tremor with normal glucose
  2. Gradual onset over several weeks
  3. Unilateral facial droop and arm weakness of sudden onset Correct answer.
  4. Bilateral symmetric weakness improving after glucose administration

Explanation

Acute ischemic stroke typically produces sudden focal deficits such as unilateral facial droop and limb weakness. Hypoglycemia more often causes diffuse symptoms that resolve with glucose correction.

Question 9Patient Care and Clinical Fundamentals

A patient is in respiratory distress with an oxygen saturation of 86% on room air. Which initial intervention is most appropriate?

  1. Administer a sedative to reduce anxiety
  2. Apply supplemental oxygen and monitor response Correct answer.
  3. Encourage exercise to improve lung expansion
  4. Restrict fluids and observe

Explanation

Significant hypoxemia warrants immediate supplemental oxygen with reassessment of saturation and work of breathing. Correcting hypoxemia is the priority before other measures.

Question 10Patient Care and Clinical Fundamentals

Which infection control practice most directly prevents transmission of pathogens via a patient's cough?

  1. Wearing gloves for all contact
  2. Using a shared stethoscope between patients
  3. Applying droplet precautions with a surgical mask Correct answer.
  4. Placing the patient in a negative-pressure room for all coughs

Explanation

Droplet precautions, including a surgical mask for the patient during transport and appropriate staff protection, reduce transmission of respiratory droplets from coughing. Negative-pressure rooms are reserved for airborne pathogens.

Question 11Patient Care and Clinical Fundamentals

A patient with a suspected tension pneumothorax has worsening hypotension and tracheal deviation. What is the most appropriate immediate action?

  1. Obtain a chest radiograph before any treatment
  2. Perform emergency needle decompression Correct answer.
  3. Start oral antibiotics
  4. Administer a bronchodilator

Explanation

Tension pneumothorax is a life-threatening emergency requiring immediate needle decompression without waiting for imaging. Delay can lead to cardiovascular collapse.

Question 12Patient Care and Clinical Fundamentals

Which laboratory value is most useful for rapidly assessing the severity of dehydration in an acutely ill patient?

  1. Platelet count
  2. Serum calcium
  3. Serum creatinine and blood urea nitrogen Correct answer.
  4. Thyroid-stimulating hormone

Explanation

Elevated creatinine and blood urea nitrogen, especially a raised BUN-to-creatinine ratio, help assess dehydration and renal perfusion. These markers support volume-status evaluation in acute illness.

Question 13Patient Care and Clinical Fundamentals

A patient receiving intravenous fluids develops crackles, dyspnea, and jugular venous distension. What is the most likely explanation?

  1. Anaphylaxis
  2. Fluid overload Correct answer.
  3. Hypoglycemia
  4. Hypovolemia

Explanation

Crackles, dyspnea, and jugular venous distension during IV therapy suggest fluid overload with pulmonary congestion. Reducing or stopping fluids and reassessing is indicated.

Question 14Patient Care and Clinical Fundamentals

Which action best reduces the risk of wrong-site surgery?

  1. Relying on memory of the surgical schedule
  2. Confirming the site with the patient and marking it before the procedure Correct answer.
  3. Reviewing the consent form after the incision
  4. Asking a family member to confirm by telephone

Explanation

Wrong-site events are prevented by verifying identity, procedure, and site with the patient when possible, plus preoperative marking and team verification. These steps create redundant safety checks.

Question 15Patient Care and Clinical Fundamentals

A patient is prescribed warfarin and reports new bruising and dark stools. Which finding is most concerning for a bleeding complication?

  1. A slightly elevated temperature
  2. Mild constipation
  3. A normal platelet count
  4. An elevated international normalized ratio Correct answer.

Explanation

An elevated INR in a patient on warfarin with bruising and dark stools suggests excessive anticoagulation and gastrointestinal bleeding. Prompt evaluation and possible reversal are needed.

Question 16Patient Care and Clinical Fundamentals

Which route of medication administration is most appropriate for a patient in anaphylaxis with severe hypotension?

  1. Topical
  2. Intramuscular epinephrine into the anterolateral thigh Correct answer.
  3. Subcutaneous
  4. Oral

Explanation

Intramuscular epinephrine into the anterolateral thigh is the first-line treatment for anaphylaxis because it rapidly reverses vasodilation and airway edema. Oral and topical routes are too slow or ineffective in shock.

Question 17Patient Care and Clinical Fundamentals

A patient with chronic obstructive pulmonary disease has an oxygen saturation target of 88% to 92%. Which action best reflects this goal?

  1. Target a saturation of 100%
  2. Administer the highest possible oxygen flow
  3. Titrate oxygen to the prescribed target range and monitor Correct answer.
  4. Withhold oxygen entirely

Explanation

In some patients with COPD and chronic hypercapnia, oxygen is titrated to a target range to avoid hyperoxia and worsening carbon dioxide retention. Monitoring guides safe adjustment.

Question 18Patient Care and Clinical Fundamentals

Which sign most reliably indicates that a patient has an obstructed airway?

  1. Mild sore throat
  2. Inability to speak or cough with silent chest movement Correct answer.
  3. Productive cough with clear sputum
  4. Bilateral leg edema

Explanation

Inability to speak or cough, especially with ineffective silent chest movement, indicates severe airway obstruction and requires immediate intervention. A productive cough suggests the airway is still patent.

Question 19Patient Care and Clinical Fundamentals

A patient has a new onset of unilateral leg swelling and pain after prolonged immobilization. Which condition should be suspected first?

  1. Deep vein thrombosis Correct answer.
  2. Gout
  3. Cellulitis of both legs
  4. Peripheral arterial occlusion

Explanation

Unilateral leg swelling and pain after immobilization raise suspicion for deep vein thrombosis. Prompt assessment and anticoagulation planning reduce the risk of pulmonary embolism.

Question 20Patient Care and Clinical Fundamentals

Which action is most important when preparing to administer a high-alert medication such as intravenous insulin?

  1. Independent double-check of dose and concentration before administration Correct answer.
  2. Delegation to an unlicensed assistant
  3. Rapid push administration to save time
  4. Adjusting the dose based on convenience rather than prescription

Explanation

High-alert medications require an independent double-check of dose, concentration, and pump settings to prevent harmful errors. This verification step is central to medication safety programs.

Question 21Patient Care and Clinical Fundamentals

Which finding best indicates that a patient's pain management plan should be reassessed?

  1. Decreased need for rescue analgesia
  2. Stable vital signs with improved comfort
  3. Ability to sleep through the night
  4. Reported pain score unchanged despite escalating doses Correct answer.

Explanation

Persistent pain despite escalating doses suggests the plan is ineffective or the diagnosis needs review. Reassessment should include etiology, modality, and safety considerations.

Question 22Patient Care and Clinical Fundamentals

A patient with a head injury has a declining level of consciousness. Which action is most appropriate?

  1. Delay reassessment until the next shift
  2. Perform serial neurologic assessments and escalate care Correct answer.
  3. Administer a sedative to promote rest
  4. Allow the patient to sleep without checks

Explanation

A declining level of consciousness after head injury may signal rising intracranial pressure or hemorrhage. Serial neurologic checks and escalation enable timely intervention.

Question 23Patient Care and Clinical Fundamentals

Which practice best supports a patient's informed consent before a procedure?

  1. Having a student sign on the patient's behalf
  2. Proceeding if the patient seems anxious
  3. Obtaining a signature without discussion
  4. Explaining risks, benefits, and alternatives in understandable terms Correct answer.

Explanation

Informed consent requires that the patient understands the risks, benefits, and alternatives before agreeing. Discussion in plain language supports autonomous decision-making.

Question 24Patient Care and Clinical Fundamentals

A patient is found with a blood glucose of 1.9 mmol/L (34 mg/dL) and is unable to swallow safely. Which intervention is most appropriate?

  1. Withhold treatment and monitor
  2. Administer intravenous dextrose or glucagon Correct answer.
  3. Start a low-carbohydrate diet
  4. Give oral glucose gel by mouth

Explanation

Severe hypoglycemia with an unsafe swallow requires parenteral therapy such as intravenous dextrose or intramuscular glucagon. Oral intake risks aspiration and is too slow.

Question 25Patient Care and Clinical Fundamentals

Which monitoring parameter best detects early deterioration in a postoperative patient?

  1. Trended vital signs including respiratory rate and oxygen saturation Correct answer.
  2. Single temperature reading at admission
  3. Patient-reported appetite
  4. Occasional blood pressure checks

Explanation

Trended vital signs, especially respiratory rate and oxygen saturation, detect early physiologic deterioration such as respiratory depression or sepsis. Trends are more informative than isolated readings.

Question 26Patient Care and Clinical Fundamentals

During a code blue, which rhythm requires immediate defibrillation rather than cardiopulmonary resuscitation alone?

  1. Sinus bradycardia
  2. Ventricular fibrillation Correct answer.
  3. Atrial fibrillation with a controlled rate
  4. First-degree atrioventricular block

Explanation

Ventricular fibrillation produces chaotic ventricular activity with no effective cardiac output, and it is a shockable rhythm in which early defibrillation is the definitive treatment. Organized rhythms with a pulse, even when abnormal in rate or conduction, are managed with medications, pacing, or observation rather than emergent defibrillation.

Question 27Patient Care and Clinical Fundamentals

A patient's radial pulse is weak and the systolic blood pressure is falling, but the patient is alert. Which finding would most strongly suggest that the patient is progressing toward decompensated shock?

  1. Narrowing pulse pressure with increasing heart rate Correct answer.
  2. Widening pulse pressure with bradycardia
  3. Increased urine output with stable mentation
  4. Warm extremities with bounding pulses

Explanation

In early compensated shock, tachycardia and peripheral vasoconstriction narrow the gap between systolic and diastolic pressures as the body tries to preserve perfusion to vital organs. A widening pulse pressure with bradycardia, warm bounding pulses, or improving urine output suggests the opposite trajectory.

Question 28Patient Care and Clinical Fundamentals

A patient with an indwelling urinary catheter has had no urine output for three hours. Which action should the nurse take first?

  1. Remove the catheter and begin intermittent catheterization
  2. Palpate the bladder and inspect the tubing for kinks or dislodgement Correct answer.
  3. Clamp the catheter and encourage oral fluids
  4. Irrigate the catheter with 50 mL of sterile saline

Explanation

Absent drainage is most often caused by mechanical obstruction such as a kink, dependent loop, or dislodgement, so the tubing and bladder should be assessed before any intervention. Irrigating, clamping, or removing the catheter without identifying the cause risks injury or unnecessary procedures.

Question 29Patient Care and Clinical Fundamentals

Which action best prevents ventilator-associated pneumonia in a patient receiving mechanical ventilation?

  1. Changing the ventilator circuit tubing every 24 hours
  2. Elevating the head of the bed to 30 to 45 degrees Correct answer.
  3. Keeping the patient supine to promote comfort
  4. Suctioning the airway on a fixed hourly schedule

Explanation

Semi-upright positioning reduces aspiration of oropharyngeal and gastric secretions, which is a key mechanism in the development of ventilator-associated pneumonia. Scheduled suctioning, routine circuit changes, and supine positioning do not prevent this complication and may increase risk.

Question 30Patient Care and Clinical Fundamentals

A patient with an acute exacerbation of asthma has a silent chest and rising carbon dioxide level. What does this finding indicate?

  1. Improvement in airflow obstruction
  2. Adequate response to bronchodilator therapy
  3. Mild bronchospasm that can be managed with oral medication
  4. Impending respiratory failure requiring urgent escalation Correct answer.

Explanation

A silent chest means airflow is so limited that wheezing can no longer be heard, and a rising carbon dioxide level signals failing ventilation. Together they indicate impending respiratory failure and require immediate escalation of care, including ventilatory support planning.

Question 31Patient Care and Clinical Fundamentals

Which intervention is most appropriate for a patient with a suspected cervical spine injury who requires airway management?

  1. Maintain manual in-line stabilization while opening the airway with a jaw-thrust maneuver Correct answer.
  2. Apply traction to the head to align the spine
  3. Place the patient in the recovery position and wait for imaging
  4. Perform a head-tilt chin-lift while the collar is removed

Explanation

Manual in-line stabilization with a jaw-thrust minimizes movement of the cervical spine during airway maneuvers in a patient with a suspected injury. Head-tilt chin-lift, traction, or repositioning without stabilization risks further spinal cord damage.

Question 32Patient Care and Clinical Fundamentals

A patient is admitted with severe vomiting and diarrhea. Which set of findings best indicates hypovolemia rather than a primary electrolyte disorder?

  1. Bradycardia, hypertension, and warm flushed skin
  2. Orthostatic hypotension, tachycardia, and decreased skin turgor Correct answer.
  3. Paresthesias with a normal heart rate and blood pressure
  4. Muscle weakness with normal vital signs

Explanation

Orthostatic hypotension, tachycardia, and decreased skin turgor are classic signs of reduced intravascular volume from gastrointestinal losses. The other findings are more consistent with electrolyte disturbances or other conditions and do not directly reflect volume depletion.

Question 33Patient Care and Clinical Fundamentals

A patient has a new colostomy with a dark, dusky stoma that feels cool. Which action is most appropriate?

  1. Irrigate the stoma with saline to improve color
  2. Notify the surgeon immediately for evaluation of stoma ischemia Correct answer.
  3. Apply a warm compress and reassess in the morning
  4. Document the finding as a normal postoperative change

Explanation

A dark, dusky, cool stoma suggests inadequate blood supply such as ischemia or necrosis and requires urgent surgical evaluation. Applying heat, irrigating, or documenting it as normal delays treatment and may worsen the outcome.

Question 34Patient Care and Clinical Fundamentals

Which action best reduces the risk of aspiration during oral medication administration for a patient with dysphagia?

  1. Give pills with a large volume of water while the patient talks
  2. Have the patient sit upright and use the safest consistency as determined by swallow evaluation
  3. Crush all medications and mix them with thin liquids Correct answer.
  4. Administer medications while the patient is lying flat

Explanation

An upright position and a consistency matched to the patient's assessed swallow safety reduce the likelihood of aspiration. Crushing all medications is unsafe because some are extended-release or enteric-coated, and lying flat or talking during swallowing increases aspiration risk.

Question 35Patient Care and Clinical Fundamentals

A patient receiving a blood transfusion develops fever, chills, and flank pain shortly after the infusion begins. What is the priority action?

  1. Stop the transfusion and maintain intravenous access with normal saline Correct answer.
  2. Slow the transfusion and continue to monitor
  3. Administer an antihistamine and continue the transfusion
  4. Increase the rate to finish the unit quickly

Explanation

Fever, chills, and flank pain suggest an acute hemolytic transfusion reaction, which requires immediately stopping the transfusion and keeping intravenous access with saline. Continuing or increasing the infusion would expose the patient to more incompatible blood, and antihistamines do not treat hemolysis.

Question 36Patient Care and Clinical Fundamentals

Which finding is most consistent with an acute compartment syndrome in a patient with a casted forearm fracture?

  1. Numbness that improves with loosening the cast
  2. Pain out of proportion to the injury that worsens with passive stretch Correct answer.
  3. Pulselessness as the earliest sign
  4. Pain that resolves with elevation of the limb

Explanation

Pain out of proportion to the injury and pain with passive stretch are the earliest and most reliable signs of compartment syndrome. Pulselessness is a late finding, and improvement with elevation or loosening alone does not exclude the condition.

Question 37Patient Care and Clinical Fundamentals

Which action best supports safe administration of a medication that has a high risk of harm if given in error?

  1. Delegate the administration to an unlicensed assistant
  2. Document after administration without a pre-administration check
  3. Administer it rapidly to minimize the time at the bedside
  4. Verify the indication, dose, and rate with a second qualified clinician before administration Correct answer.

Explanation

High-alert medications require independent double-checking of the indication, dose, and infusion rate by a second qualified clinician before administration to prevent harmful errors. Delegation to unlicensed staff, rapid administration, and skipping the pre-administration check all increase the risk of patient harm.

Question 38Patient Care and Clinical Fundamentals

A patient with a new tracheostomy has copious secretions and a rising carbon dioxide level. Which action is most appropriate?

  1. Remove the tracheostomy tube and provide bag-mask ventilation
  2. Increase the oxygen flow and wait for the next scheduled assessment
  3. Deflate the cuff to allow secretions to drain
  4. Suction the airway using sterile technique and assess for obstruction Correct answer.

Explanation

Copious secretions with rising carbon dioxide suggest airway obstruction or inadequate clearance, so suctioning with sterile technique and reassessing the airway is the priority. Deflating the cuff, simply increasing oxygen, or removing the tube without preparation risks aspiration or loss of the airway.

Question 39Patient Care and Clinical Fundamentals

A patient is receiving a continuous infusion of a medication that can cause hypotension. Which monitoring approach best detects an early adverse effect?

  1. Checking blood pressure and heart rate at defined intervals with prompt reassessment after rate changes Correct answer.
  2. Checking vital signs only at the end of the shift
  3. Documenting the infusion without vital sign monitoring
  4. Relying on the patient to report symptoms without scheduled checks

Explanation

Scheduled vital sign checks with reassessment after any rate or dose change allow early detection of hypotension and tachycardia before serious harm occurs. End-of-shift checks, symptom-only reporting, and documentation without monitoring delay recognition of deterioration.

Question 40Patient Care and Clinical Fundamentals

Which practice best supports a patient's ability to make an informed decision about a proposed procedure?

  1. Obtaining consent from a family member without the patient's involvement when the patient is alert
  2. Summarizing only the benefits to reduce anxiety
  3. Providing information about risks, benefits, and alternatives in a language and format the patient understands Correct answer.
  4. Having the patient sign the consent form before any discussion

Explanation

Informed consent requires that the patient understand the risks, benefits, and alternatives, which depends on communication in an accessible language and format. Signing before discussion, bypassing an alert patient, or omitting risks undermines the validity of consent.

Question 41Medical Asepsis, Infection Control, and Safety

A medication aide is preparing to give an oral dose to a client on contact precautions for a wound infection. Which action best reflects standard aseptic practice for this task?

  1. Perform hand hygiene, then don gloves before entering the room and remove them after the task Correct answer.
  2. Wear sterile gloves while pouring the medication into a disposable cup
  3. Keep the medication cup covered while transporting it to the room
  4. Sanitize the medication cart handle after each client contact

Explanation

Standard precautions require hand hygiene before and after client contact and glove use when touching body fluids or contaminated items; gloves are removed and hands cleaned after the task. Clean, non-sterile gloves are sufficient for routine oral medication administration. Hand hygiene is the single most important step and must bracket the task.

Question 42Medical Asepsis, Infection Control, and Safety

Which client situation requires the healthcare worker to use transmission-based precautions in addition to standard precautions?

  1. A client receiving intravenous antibiotics at home
  2. A client with a chronic dry cough from smoking
  3. A client with a healed surgical incision
  4. A client with an active Clostridioides difficile infection Correct answer.

Explanation

Clostridioides difficile requires contact precautions because spores persist on surfaces and are spread by hands and equipment. Standard precautions alone apply to healed incisions and routine medication administration. A chronic smoker's cough is not an infectious indication for transmission-based precautions.

Question 43Medical Asepsis, Infection Control, and Safety

What is the minimum recommended duration for scrubbing hands with soap and water during routine hand hygiene?

  1. At least 20 seconds Correct answer.
  2. At least 60 seconds
  3. At least 5 seconds
  4. At least 2 minutes

Explanation

Routine handwashing with soap and water should last about 20 seconds, covering all surfaces of the hands and wrists. Shorter times are insufficient to mechanically remove transient organisms. Prolonged times beyond 20 seconds are not required for routine hygiene.

Question 44Medical Asepsis, Infection Control, and Safety

A client is placed in airborne precautions for suspected pulmonary tuberculosis. Which action is essential when entering the room?

  1. Wear a gown and gloves only
  2. Wear a face shield alone
  3. Wear a fit-tested N95 respirator Correct answer.
  4. Wear a standard surgical mask

Explanation

Airborne precautions require a fit-tested N95 or higher respirator because tiny droplet nuclei remain suspended and can be inhaled. A surgical mask does not provide an adequate seal against these particles. Gowns, gloves, and face shields do not filter inhaled air.

Question 45Medical Asepsis, Infection Control, and Safety

When should a healthcare worker remove personal protective equipment before leaving a client's room?

  1. Remove gloves in the room and the rest at the nurses' station
  2. Remove most PPE inside the room, with respirator removed last after leaving Correct answer.
  3. Remove PPE only after completing documentation
  4. Remove all PPE in the hallway outside the room

Explanation

PPE is generally removed inside the room to contain contamination, with the respirator removed after exiting and closing the door. Removing equipment in hallways or work areas contaminates clean zones. Gloves are removed first, followed by other items in a careful sequence.

Question 46Medical Asepsis, Infection Control, and Safety

A sharps container in a client's room is filled to the marked fill line. What is the appropriate action?

  1. Continue using the container until it physically overflows
  2. Recap needles tightly and place them in the regular trash
  3. Compress the contents to make room for more sharps
  4. Close and replace the container before it is overfilled Correct answer.

Explanation

Sharps containers must be replaced when they reach the fill line so that items cannot protrude and cause injury. Overfilling increases the risk of needlesticks for staff and housekeeping. Recapping or placing sharps in regular trash violates safe handling rules.

Question 47Medical Asepsis, Infection Control, and Safety

A nurse sustains a needlestick from a contaminated hollow-bore needle. Which action should occur first?

  1. Apply bleach directly to the puncture site
  2. Wash the site with soap and water and report the exposure immediately Correct answer.
  3. Squeeze the wound to express blood and apply a tight bandage
  4. Wait to see whether symptoms develop before reporting

Explanation

After a needlestick, the site should be washed with soap and water and the exposure reported promptly so post-exposure evaluation and prophylaxis can begin. Squeezing, caustic agents, and delay are not recommended. Rapid reporting is critical for timely HIV and hepatitis evaluation.

Question 48Medical Asepsis, Infection Control, and Safety

Which statement correctly describes the purpose of a surgical hand scrub before an invasive procedure?

  1. It replaces the need for sterile gowning
  2. It only removes visible dirt from the hands
  3. It reduces resident and transient flora on the hands and forearms for the duration of the procedure Correct answer.
  4. It sterilizes the hands completely so gloves are unnecessary

Explanation

A surgical scrub reduces both transient and resident microorganisms on hands and forearms to lower the risk of surgical site infection. It does not sterilize skin, and gloves and sterile gowns remain required. Removing visible soil alone would not achieve sustained antimicrobial effect.

Question 49Medical Asepsis, Infection Control, and Safety

A sterile field is set up on a table. Which action contaminates the field?

  1. Placing sterile instruments within the field's borders
  2. Opening sterile packages without touching the inner wrapper
  3. Reaching across the sterile field with a nonsterile arm Correct answer.
  4. Keeping the field in view above waist level

Explanation

Reaching over a sterile field with nonsterile clothing or arms contaminates it because the field must only contact sterile items. Placing sterile items within the border, keeping the field above waist level and in view, and careful package opening preserve sterility. Any break in technique requires the field to be considered contaminated.

Question 50Medical Asepsis, Infection Control, and Safety

A client on contact precautions for a draining wound is being transported to radiology. What is the appropriate practice?

  1. Cover the draining wound and have the client perform hand hygiene before transport Correct answer.
  2. Cancel the procedure until the wound stops draining
  3. Have the client wear a sterile gown during transport
  4. Remove all precautions during transport to reduce stigma

Explanation

For transport, the source of contamination should be contained, such as covering a draining wound, and the client should perform hand hygiene. Precautions are not abandoned merely for transport, and procedures need not be canceled for a contained wound. A sterile gown is not required for the client.