Clinical Competency

Click here for the Clinical Competency Booklet
INSTRUCTIONS:  Before completing the Clinical Competency Test you must read the Clinical Competency Resource Booklet
Contact Human Resources to request a printed copy of the booklet.

First and Last Name

Enteral Feeding

1. Under what circumstances may a client be a candidate for enteral nutrition?
2. Select the false statement regarding enteral feeding tubes:
3. How are feeding tubes measured?
4. Select the correct description of Gastrostomy type feeding tube:
5. Describe the possible complications related to receiving enteral feedings via nasogastric tube:
6. Describe the possible complications related to receiving enteral feedings via gastrostomy tube:
7. What is the correct order for starting an intermittent or bolus feeding:
8. What are the last steps when finishing a continuous drip enteral feeding:
9. What should be included when documenting an intermittent or continuous enteral feeding?
10. Select the correct process for a gastrostomy tube change:

Medication Administration

11. Which is NOT one of the 5 Rights of medication administration:
12. When a medication error or an adverse drug reaction occurs the nurse should notify the RN Supervisor of the incident immediately. What would be an example of a medication error:
13. What is the correct sequence for PO Medication Administration:
14. What is the correct steps for starting an enteral medication administration?
15. Select the correct procedure for an IM medication administration:
16. Which of the following sites are NOT considered an acceptable IM administration site:
17. When administering an IV medication, what is the maximum time frame in which a medication must be infused:
18. When drawing up a medication from an ampule or rubber topped vial what sort of needle should be used?
19. Prior to administering an IV medication what steps should be taken:
20. When infusing an IV medication what is the reasoning for selecting the Y site closest to the patient?
21. The following procedure describes an IV administration using which device?

Cleanse the container diaphragm used for medication insertion with alcohol, inject the medication into the bag/bottle or obtain a premixed bag/bottle, connect the administration tubing to the bag or bottle, cleanse the port closest to the IV insertion site with alcohol and connect the medication administration tubing to the main IV at the Y connector closest to the IV site, set the infusion rate to infuse the medication volume and flush over the desired time, start the infusion:
22. True or False.  If you need to cut a suppository it should be cut width-wise?
23. A patient should be placed in which position for a PR medication administration?
24. What is the maximum length needle that should be used for a subcutaneous medication administration?
25. What are the best sites that are considered an acceptable subcutaneous administration site:
26. The correct sequence for administering inhaled medications is:
27. Which device would be most appropriate when administering a nebulizer to a child under the age of 3?
28. When administering a dry powder inhaler which instruction should be given to the patient?
29. After administering an inhaled steroid what step should be completed?

Venous Access Device (VAD) Access and Flushing

30. Prior to accessing a VAD what steps should be completed?
31. When disinfecting the needleless connector of a VAD why is it important to allow the antiseptic to dry?
32. True or False:

When attaching the syringe to the needleless connector it is important to maintain the sterility of the syringe tip.
33. When flushing a VAD what type of fluid is recommended?
34. True or False:

Ability to aspirate a brisk blood return is not a good indicator that the line is patent
35. What could be indicated if resistance or sluggishness of flow is noted when flushing a VAD?
36. When disconnecting from a negative-pressure needleless connector when should the line be clamped?
37. When disconnecting from a positive-pressure needleless connector when should the line be clamped?
38. When disconnecting from a neutral-displacement needleless connector when should the line be clamped?
39. Why is it important to follow the correct clamping sequence based on the type of needleless connector used?

Urinary Catheterization

40. True or false:

Performing hand hygiene and gathering the necessary supplies prior to starting the procedure reduces the transmission of microorganisms and provides an organized approach to the transmission of microorganisms and provides an organized approach to the procedure.
41. Why is it important to select the appropriate size catheter for the patient?
42. In a female patient how should the patient be positioned?
43. In a male patient how should the sterile drape be placed?
44. True or false:

Sterile gloves should be applied prior to opening the necessary sterile supplies and placing a sterile towel between the female patients legs, or on top of the male patients thighs in order to prevent contamination.
45. True or false:

It is important to test the balloon by attaching the prefilled syringe of water to the secondary lumen balloon port of the catheter and inflating the balloon to ensure that the baloon is working and does not have any leaks
46. When catheterizing an uncircumcised male patient how far should the foreskin be withdrawn?
47. What are the correct steps for finishing a catherization?
48. How much of the catheter should be lubricated when catheterizing a male patient?
49. What process should be followed if the catheter is inadvertently placed in the vagina?

Seizure Precautions

50. Most breakthrough seizures are a result of what?
51. When should seizure precautions be implemented?
52. What action should be taken to prevent injury if the child should fall from the bed during a seizure?
53. If available, what equipment should be placed at the bedside to reduce the risk of aspiration in the postictal period?
54. If emergency medication is ordered what information should be reviewed?
55. If the patient begins to have a seizure what should be done first?
56. True or False: Most seizures will require intense airway intervention including bag-valve mask ventilation.
57. What position should a patient be placed in during the postictal stage?
58. True or False: It is important to keep the patient awake after a seizure so that you can monitor for any change in level of
59. It is important to document all seizure activity. What are 3 descriptions that should be documented?

Affecting Patient Outcomes

60. What does it mean to be outcome focused?
61. What are the 3 major steps that can be taken to affect patient outcomes?
62. True or false: Most interventions performed in the hospital cannot be safely performed at home.
63. What is the purpose of notifying the patient’s primary MD and the administrative RN of any changes in condition?
64. What factor most impacts whether or not an intervention is successful?
65. What is an example of an intervention that could be ordered if the patient is showing signs of infection?
66. What is an example of an intervention that could be ordered if the patient is showing signs of dehydration?
67. What should be considered if the patient begins to show early signs of respiratory distress?
68. If a life threatening emergency develops who should be called first?
69. If you have positively affected your patients outcome please let us know about it! How can you notify the Craig HomeCare office?