Free SNLE Practice Questions With Answers & Explanations

✓ Correct answer: B. Gown, mask, goggles, gloves

The recommended donning sequence is gown first, then mask/respirator, then goggles or face shield, and gloves last so the glove cuffs can cover the gown sleeves. Donning gloves first (A, D) contaminates them while handling other equipment, and applying the mask before the gown (C) risks disturbing the mask's seal while pulling the gown over the head and shoulders.

Verified against: Potter & Perry, Fundamentals of Nursing — Infection Prevention and Control chapter (CDC donning sequence)

✓ Correct answer: B. Apical pulse of 54 beats per minute

Digoxin slows conduction through the AV node, so the apical pulse must be counted for a full minute before each dose; an adult rate below 60 beats per minute warrants withholding the drug and notifying the provider due to bradycardia and toxicity risk. The blood pressure (A) and respiratory rate (C) shown are within normal limits, and a potassium of 4.2 mEq/L (D) is normal — hypokalemia, not normokalemia, would increase digoxin toxicity risk.

Verified against: Lehne's Pharmacology for Nursing Care — cardiac glycosides chapter

✓ Correct answer: B. Deep, rapid respirations with a fruity breath odor

In DKA the body compensates for metabolic acidosis with Kussmaul respirations — deep, rapid breathing that blows off carbon dioxide — and exhaled ketones produce a characteristic fruity odor. Slow, shallow breathing (A) is not a compensatory pattern for acidosis, stridor (C) indicates upper-airway obstruction, and Cheyne-Stokes breathing (D) is associated with neurologic injury or end-stage heart failure rather than DKA.

Verified against: Brunner & Suddarth's Textbook of Medical-Surgical Nursing — diabetes complications chapter

✓ Correct answer: C. Massage the fundus until firm

A boggy fundus with heavy bleeding indicates uterine atony, the leading cause of early postpartum hemorrhage; the immediate nursing action is fundal massage to stimulate contraction, which often controls bleeding within moments. Notifying the provider (A) and administering uterotonics (B) follow if massage is ineffective, and delaying intervention to have the client void (D) is unsafe in the presence of active heavy bleeding, although a full bladder can contribute to displacement.

Verified against: Lowdermilk, Maternity & Women's Health Care — postpartum hemorrhage chapter

✓ Correct answer: C. A sunken anterior fontanel and decreased tear production

In infants, a sunken anterior fontanel together with decreased or absent tears, dry mucous membranes, and fewer wet diapers are classic indicators of dehydration. A flat fontanel (A), an adequate urine output of about six wet diapers per day (B), and brisk capillary refill under 2 seconds (D) are all normal findings that argue against significant fluid volume deficit.

Verified against: Hockenberry, Wong's Nursing Care of Infants and Children — fluid and electrolyte imbalance chapter

✓ Correct answer: B. A client 2 hours after thyroidectomy who has developed noisy, high-pitched breathing

High-pitched, noisy breathing (stridor) after thyroidectomy suggests airway compromise from laryngeal edema or hematoma and is an emergency; airway problems always take priority in the ABC framework. Incisional pain (A) is expected and important but not immediately life-threatening, delayed ambulation (C) is a mobility concern addressed during the shift, and discharge teaching (D) is the lowest-acuity need of the four.

Verified against: Brunner & Suddarth's Textbook of Medical-Surgical Nursing — thyroid surgery postoperative care; priority-setting frameworks

✓ Correct answer: C. Notify the surgeon that the client needs further explanation before consent

Obtaining informed consent — explaining the procedure, its risks, benefits, and alternatives — is the responsibility of the provider performing it; when a client indicates they do not understand, the nurse must contact the surgeon before the form is signed. Explaining the operation herself (A) exceeds the nurse's role in consent, having the client sign without understanding (B) invalidates the consent, and offering reassurance (D) dismisses the client's right to information.

Verified against: Potter & Perry, Fundamentals of Nursing — legal implications and informed consent chapter

✓ Correct answer: B. Discontinue the oxytocin infusion and reposition the client to her side

Late decelerations indicate uteroplacental insufficiency, so the nurse first stops the oxytocin (removing the stimulus for excessive contractions), turns the client to a lateral position to improve placental perfusion, and typically applies oxygen and increases IV fluids. Increasing oxytocin (A) worsens the insufficiency, continuing routine monitoring (C) ignores a nonreassuring pattern, and cesarean birth (D) is not the first-line intrauterine resuscitation step.

Verified against: Lowdermilk, Maternity & Women's Health Care — fetal assessment during labor chapter

✓ Correct answer: B. "Provide an early-morning deep-cough specimen, usually repeated on consecutive days."

AFB testing requires sputum from deep in the lungs, and early-morning specimens contain the overnight accumulation of secretions with the highest organism yield; collection is typically repeated on consecutive days to increase diagnostic sensitivity. Saliva (A) is not sputum and will be rejected, antiseptic mouthwash immediately before collection (C) can affect the specimen — rinsing with water is preferred — and a single afternoon sample (D) reduces the chance of detecting the bacilli.

Verified against: Brunner & Suddarth's Textbook of Medical-Surgical Nursing — tuberculosis section (diagnostic evaluation)

✓ Correct answer: A. Chewable aspirin

Chewable aspirin is given as early as possible in suspected myocardial infarction because it rapidly inhibits platelet aggregation and limits thrombus extension, improving survival. Ibuprofen (B) is not a substitute antiplatelet and can interfere with aspirin's effect, furosemide (C) is indicated for volume overload rather than initial ACS management, and insulin (D) addresses hyperglycemia, not the occluding clot.

Verified against: Brunner & Suddarth's Textbook of Medical-Surgical Nursing — acute coronary syndrome chapter

✓ Correct answer: A. B-type natriuretic peptide (BNP)

BNP is released by the ventricles in response to stretching from volume overload and elevated filling pressures, so an elevated level supports heart failure and helps distinguish cardiac from pulmonary causes of dyspnea. Amylase (B) reflects pancreatic disease, ALT (C) reflects hepatocellular injury, and an elevated white cell count (D) points to infection or inflammation rather than ventricular overload.

Verified against: Brunner & Suddarth's Textbook of Medical-Surgical Nursing — heart failure chapter (diagnostic findings)

✓ Correct answer: C. 31 drops per minute

The hourly rate is 1,000 mL divided by 8 hours, which equals 125 mL per hour; multiplying 125 mL by the drop factor of 15 gives 1,875 drops per hour, and dividing by 60 minutes yields about 31 drops per minute. The other options result from applying different drop factors — roughly 10, 12, and 20 drops per milliliter respectively — so using them with this tubing would deliver the fluid at the wrong rate.

Verified against: Potter & Perry, Fundamentals of Nursing — intravenous therapy section (calculating flow rates)