PNLE PRACTICE QUESTIONS: D.

No specific order, its up to the nurse for her own convenience

PERIOPERATIVE NURSING
Rationale:
A client asks the nurse what a third-degree laceration is. She was informed  Gloves are put on the non-dominant hand first and then the
that she had one. The nurse explains that this is: dominant hand. Simply because humans tend to use the dominant
A. That extended their anal sphincter hand first before the non-dominant hand. Out of 10 humans that
B. Through the skin and into the muscles will put on their sterile gloves, 8 of them will put the gloves on
C. That involves anterior rectal wall their non-dominant hand first.
D. That extends through the perineal muscle
77. As the scrubbed nurse, when should you apply the goggles, shoe cap,
Rationale: and mask prior to the operation?
Third degree laceration involves all in the second-degree laceration and the A. Immediately after entering the sterile field
external sphincter of the rectum. Choices B, C, and D are under the second- B. After surgical hand scrub
degree laceration. C. Before surgical hand scrub
D. Before entering the sterile field

73. The nurse is to insert an NG Tube when suddenly, she accidentally dips
the end of the tube in the client’s glass containing distilled drinking water
which is definitely not sterile. As a nurse, what should you do?
A. Don’t mind the incident, continue to insert the NG Tube.
B. Obtain a new NG Tube for the client.
C. Disinfect the NG Tube before reinserting it again.
D. Ask your senior nurse what to do.
Rationale:
 The digestive tract is not sterile, and therefore, simple errors like
this would not cause harm to the patient. NG Tube need not be
sterile and so is colostomy and rectal tubes. Clean technique is
sufficient during NGT and colostomy care.
Rationale:
 The nurse should put his goggles, cap, and mask prior to washing
the hands. If he washes his hands prior to putting all these
equipment, he must wash his hands again as the said equipment
are unsterile.
78. Which of the following should the nurse do when applying gloves prior
to a surgical procedure?
A. Slipping gloved hand with all fingers when picking up the second glove.
B. Grasping the first glove by inserting four fingers, with thumbs up
underneath the cuff.
C. Putting the gloves into the dominant hand first.
D. Adjust only the fitting of the gloves after both gloves are on.

74. All of the following are principle of SURGICAL ASEPSIS except: Rationale:
A. Microorganism travels to moist surfaces faster than with dry surfaces.  The nurse should only adjust fitting of the gloves when they are
B. When in doubt about the sterility of an object, consider it not sterile. both on the hands. Not doing so will break the sterile technique.
C. Once the skin has been sterilized, considered it sterile.  Only 4 fingers are slipped when picking up the second gloves. You
D. If you can reach the object by overreaching, just move around the sterile cannot slip all of your fingers as the cuff is limited and the thumb
field to pick it rather than reaching for it. would not be able to enter the cuff.
 The first glove is grasp by simply picking it up with the first 2
Rationale: fingers and a thumb in a pinching motion.
 Human skin is impossible to be sterilized. It contains normal flora  Gloves are put on the non-dominant hand first.
of microorganism. A, B, and D are all correct.
79. Which gloves should you remove first?
75. Which of the following is true in SURGICAL ASEPSIS? A. The glove of the non-dominant hand
A. Autoclaved linens and gowns are considered sterile for about 4 months as B. The glove of the dominant hand
long as the bagging is intact. C. The glove of the left hand
B. Surgical technique is a sole effort of each nurse. D. Order in removing the gloves is unnecessary
C. Sterile conscience, is the best method to enhance sterile technique.
D. If a scrubbed person leaves the area of the sterile field, he/she must do Rationale:
handwashing and gloving again, but the gown need not be changed.  Gloves are worn in the non-dominant hand first and is removed
also from the non-dominant hand first. Simply because in 10
Rationale: people removing gloves, 8 of them will use the dominant hand
 Sterile conscience or the moral imperative of a nurse to be honest first and remove the gloves of the non-dominant hand.
in practicing sterile technique is the best method to enhance
sterile technique. 80. Before a surgical procedure, give the sequence on applying the
 Autoclaved linens are considered sterile only within 2 weeks even protective items listed below:
if the bagging is intact. 1. Eye wear or goggles
 Surgical technique is a team effort of each nurse. 2. Cap
 If a scrubbed person leaves the sterile field and area, he must do 3. Mask
the process all over again. 4. Gloves
5. Gown
76. In putting sterile gloves, which should be gloved first? A. 3,2,1,5,4
A. The dominant hand B. 3,2,1,4,5
B. The non-dominant hand C. 2,3,1,5,4
C. The left hand D. 2,3,1,4,5
Rationale:
 The nurse should use CaMEy Hand and Body Lotion.
o Ca = Cap
o M = mask
o Ey = eye goggles
o The nurse will do handwashing and then,
o Hand = gloves
o Body = gown
81. In removing protective devices, which should be the exact sequence?
1. Eye wear or goggles
2. Cap
3. Mask
4. Gloves
5. Gown
A. 4,3,5,1,2
B. 2,3,1,5,4
C. 5,4,3,2,1
D. 1,2,3,4,5
Rationale:
 When the nurse is about to remove his protective devices, he will
remove the GLOVES first followed by the MASK and GOWN then
other devices like CAP, SHOE COVER, etc. This is to prevent
contamination of hair, neck, and face area.
82. In pouring a plain NSS into a receptacle located in a sterile field, how
high should the nurse hold the bottle above the receptacle?
A. 1 inch
B. 3 inches
C. 6 inches
D. 10 inches
Rationale:
 Even if you do not know the answer to this question, you can
answer it correctly by imagining.
 If you pour the NSS into a receptacle 1 to 3 inches above it,
chances are the mouth of the NSS bottle would dip into the
receptacle as you fill it, making it contaminated.
 If you pour the NSS into a receptacle 10 inches about it, that is too
high, chances are as you pour the NSS, most will spill out because
the force will be too much for the buoyant force to handle. It will
also be difficult to pour something precisely into a receptacle as
the height increases between the receptacle and the bottle.
 6 inches is not too low nor too high.
83. The tip of the sterile forceps is considered sterile. It is used to
manipulate the objects in the sterile field using the non-sterile hands. How
should the nurse hold a sterile forcep?
A. The tip should always be lower than the handle.
B. The tip should always be above the handle.
C. The handle and the tip should be at the same level.
D. The handle should point downward and the tip always upward.
Rationale:
 A sterile forcep is usually dipped into a disinfectant or germicidal
solution. Imagine, if the tip is HIGHER than the handle, the
solution will go into the handle and into your hands and as you
use the forcep, you will eventually lower its tip making the
solution in your hand go back into the tip thus contaminating the
sterile area of the forcep. To prevent this, the tip should always be
lower than the handle. In situation questions like this, imagination
is very important.
68. Which of the following should the nurse AVOID doing in preventing
spread of infection?
A. Recapping the needle before disposal to prevent injuries.
B. Never pointing a needle towards a body part.
C. Using only Standard precaution to AIDS patients.
D. Do not give fresh and uncooked fruits and vegetables to Mr. Gatchie, with
neutropenia.
Rationale:
 Never recap needles. They are directly disposed in a puncture
proof container after used. Recapping the needles could cause
injury to the nurse and spread of infections.
 B, C, and D are all appropriate. Standard precaution is sufficient
for an HIV patient. A client with neutropenia (low levels of
neutrophils) are not given fresh and uncooked fruits and
vegetables for even the non-infective organisms are found in
these foods which could cause severe infection on an
immunocompromised patient.
85. When performing surgical hand scrub, which of the following nursing
action is required to prevent contamination?
1. Keep fingernail short, clean, and with nail polish
2. Open faucet with knee or foot control
3. Keep hands above the elbow when washing and rinsing
4. Wear cap, mask, shoe cover after you scrubbed
A. 1,2
B. 2,3
C. 1,2,3
D. 2,3,4
Rationale:
 Cap, mask, and shoe cover are worn BEFORE scrubbing.
86. When removing gloves, which of the following is an inappropriate
nursing action?
A. Wash gloved hand first
B. Peel off gloves inside out
C. Use glove to glove skin to skin technique
D. Remove mask and gown before removing gloves
Rationale:
 Gloves are the dirtiest protective item nurses are wearing and
therefore, the first to be removed to prevent spread of
microorganism as you remove the mask and gown.
33. Also known as STERILE TECHNIQUE.
A. Surgical Asepsis
B. Medical Asepsis
C. Sepsis
D. Asepsis
A substance usually intended for use on inanimate objects, that destroys
pathogens but not the spores.
A. Sterilization
B. Disinfectant
C. Antiseptic
D. Autoclave
Rationale:
Disinfectants are used on inanimate objects while Antiseptic are intended for
use on persons and other living things. Both can kill and inhibit growth of
microorganism but cannot kill their spores. That is when autoclaving or
steam under pressure gets in. Autoclaving can kill almost ALL type of
microorganism including their spores.
36. This is a process of removing pathogens but not their spores.
A. Sterilization
B. Autoclaving
C. Disinfection
D. Medical asepsis
Rationale:
Both A and B are capable on killing spores.
Autoclaving or steam under pressure
 A form of STERILIZATON
Disinfection
 is the PROCESS of removing pathogens but not their spores.
Medical Asepsis
 a PRACTICE designed to minimize or reduce the transfer of
pathogens.
3. In handwashing by medical asepsis, hands are held
A. Above the elbow, the hands must always be above the waist
B. Above the elbow, the hands are cleaner than the elbow
C. Below the elbow, medical asepsis does not require hands to be above the
waist
D. Below the elbow, hands are dirtier than the lower arms
Rationale:
In medical asepsis, hands are held BELOW the elbow because hands are
dirtier than the elbow and therefore, to limit contamination of the lower
arm, the hands should always be below the elbow.
In surgical asepsis, nurses are required to keep the hands above the waist.
A. Equipment with small lumen is easier to clean than those with small
lumen.
B. Sterilization is the complete destruction of all viable microorganism
including spores.
C. Some organisms are easily destroyed, while other, with coagulated protein
requires longer time.
D. The number of organisms is directly proportional to the length of time
required for sterilization.
Rationale:
Equipment with LARGE LUMEN is easier to clean than those with small
lumen. B, C, and D are all correct.
58. Karlita asked you, how long should she boil her glass baby bottle in
water? You correctly answered her by saying:
A. The minimum time for boiling articles is 5 minutes
B. Boil the glass baby bottle and other articles for at least 10 minutes
C. For boiling to be effective, a minimum of 15 minutes is required
D. It doesn’t matter how long you boil the articles, as long as the water
reached 100 degrees Celsius.
Rationale:
Boiling is the most common and east expensive method of sterilization used
in home. For it to be effective, you should boil articles for at least 15 minutes.
59. This type of disinfection is best done in sterilizing drugs, foods, and
other things that are required to be sterilized before taken in by the human
body
A. Boiling water
B. Gas sterilization
C. Steam under pressure
D. Radiation

54. The suggested time per hand on handwashing using the time method is Rationale:
A. 5 to 10 seconds each hand Imagine foods and drugs that are being sterilized by a boiling water, ethylene
B. 10 to 15 seconds each hand oxide gas and autoclave or steam under pressure, they will be inactivated by
C. 15 to 30 seconds each hand these methods.
D. 30 to 60 seconds each hand  Ethylene oxide gas used in gas sterilization is TOXIC to humans.
 Boiling the food will alter its consistency and nutrients.
Rationale:  Autoclaving the food is never performed.
Each hands requires at least 15 to 30 seconds of handwashing to effectively  Radiation using microwave oven or ionizing radiation penetrates
remove transient microorganisms. to foods and drugs thus, sterilizing them.
55. The minimum time in washing each hand should never be below 61. Which of the following is not true in implementing medical asepsis?
A. 5 seconds A. Wash hand before and after patient contact
B. 10 seconds B. Keep soiled linens from touching the clothing
C. 15 seconds C. Shake the linens to remove dust
D. 30 seconds D. Practice good hygiene

Rationale: Rationale:
According to Kozier, the minimum time required for washing each hand is 10 NEVER shake the linens. Once soiled, fold it inwards clean surface out.
seconds and should not be lower than that. Shaking the linen will further spread pathogens that has been harbored by
56. How many ml of liquid soap is recommended for handwashing the fabric.
procedure?
A. 1-2 ml 62. Which of the following is true about autoclaving or steam under
B. 2-3 ml pressure?
C. 2-4 ml A. All kinds of microorganism and their spores are destroyed by autoclave
D. 5-10 ml machine.
B. The autoclaved instruments can be used for 1 month considering the bags
Rationale: are still intact.
2-4 ml or 1 tsp/5 ml of liquid soap is recommended for handwashing C. The instruments are put into unlocked position, on their hinge, during the
procedure. autoclave.
57. Which of the following is not true about sterilization, cleaning, and D. Autoclaving different kinds of metals at one time is advisable.
disinfection?
Rationale:
  Metals with locks, like clamps and scissors should be UNLOCKED in A. In specially marked BIO HAZARD container.
order to minimized stiffening caused by autoclave to the hinges of B. Yellow trashcan
these metals. C. Black trashcan
 NOT ALL microorganisms are destroyed by autoclaving. There are D. Leeches are brought back to the culture room, they are not thrown away
recently discovered microorganism that is invulnerable to extreme for they are reusable.
heat. Autoclaved instruments are to be used within 2 weeks.
 Only the same type of metals should be autoclaved as this will Rationale:
affect alteration in plating of these metals. Leeches, in leech therapy or LEECH PHLEBOTOMY are to be disposed on a BIO
HAZARD container. They are never reused as this could cause transfer of
63. Which of the following is true about masks? infection. These leeches are hospital grown and not the usual leeches found
A. Mask should only cover the nose. in swamps.
B. Mask functions better if they are wet with alcohol.
C. Masks can provide durable protection even when worn for a long time and
after each and every patient care.
D. N95 mask or particulate masks can filter organism as small as 1
micromillimeter.

Rationale:
 Mask should cover both nose and mouth.
 Masks will not function optimally when wet.
 Masks should be worn not greater than 4 hours, as it will lose
effectiveness after 4 hours.

64. Where should you put a wet adult diaper?

A. Green trashcan
B. Black trashcan
C. Orange trashcan
D. Yellow trashcan

Rationale:
Infectious waste like blood and blood products, wet diapers, and dressings
are thrown in yellow trashcans.

65. Needles, scalpels, broken glass, and lancets are considered as injurious
wastes. As a nurse, it is correct to put them at disposal via a/an
A. Puncture proof container
B. Reused PET bottles
C. Black trashcan
D. Yellow trashcan with a tag “INJURIOUS WASTES”

Rationale:
Needles, scalpels, and other sharps are to be disposed in a puncture proof
container.

66. Miranda Priestly, an executive of RAMP magazine, was diagnosed with

cancer of the cervix. You noticed that the radioactive internal implant
protrudes to her vagina were supposedly, it should be in her cervix. What
should be your initial action?
A. Using a long forceps, push it back towards the cervix then call the
physician.
B. Wear gloves, remove it gently and place it on lead container.
C. Using a long forceps, remove it and place it on a lead container.
D. Call the physician, you are not allowed to touch, re-insert or remove it.

Rationale:
 A dislodged radioactive cervical implant in brachytherapy is to be
picked by a LONG FORCEP and stored in a LEAD CONTAINER in
order to prevent damage on the client’s normal tissue.
 Calling the physician is the second most appropriate action among
the choices.
 A nurse should never attempt to put it back nor, touch it with her
bare hands.

67. After leech therapy, where should you put the leeches?