Staff Nurse interview questions and answers

Assess the risk on admission with a tool such as the Braden scale and reassess regularly. Change the patient's position at least every two hours, or as often as the care plan says, and use a pressure-relieving mattress for high-risk patients. Use a draw sheet to lift rather than drag, to avoid shearing, keep the heels off the bed, and keep the head end no higher than needed.

Inspect the skin over bony areas like the sacrum, heels, hips and elbows at every turn. Keep the skin clean and dry, manage incontinence promptly, and support nutrition and fluids. If you see redness that doesn't fade when pressed, record it and report it at once, because that is the first stage of a pressure ulcer.

Fowler's position, sitting up with the head end raised (semi-Fowler's at about 30 to 45 degrees, high Fowler's higher), eases breathing, helps feeding and lowers the risk of aspiration. Supine, lying flat on the back, is used for examinations and some procedures. Prone is lying face down. Lateral is lying on the side, used for comfort and pressure relief, and the recovery position for an unconscious patient who is breathing.

Sims' position, left side with the upper knee bent, is used for enemas and rectal examination. Lithotomy, on the back with legs raised in supports, is for gynaecological procedures and delivery. Mention that tilting a patient head-down for shock is no longer routinely recommended; raising the legs is preferred where appropriate.

Intake is everything that goes in: oral fluids, IV fluids, IV medicines given in volume, and nasogastric or tube feeds. Output is everything that comes out: urine, vomit, drain contents, nasogastric aspirate and liquid stools. Measure each accurately in millilitres, record it on the chart as it happens rather than from memory, and total it over 24 hours or as ordered.

The balance shows whether the patient is dehydrated or overloaded, which matters in heart and kidney disease, after surgery and in patients on IV fluids. Report a low urine output at once; for an adult, less than 0.5 mL per kg per hour is a warning sign. Also look at the patient: thirst, dry tongue, swelling or breathlessness.

Confirm the tube's position before every feed and every medicine, and after coughing or vomiting. First check the external length mark against what was recorded at insertion. Then aspirate and test the aspirate with pH paper: a pH of 5.5 or below indicates the stomach in most hospital policies. If you can't get aspirate or the pH is higher, don't feed; inform the doctor, as an X-ray may be needed. The old method of pushing air and listening with a stethoscope is not reliable and should not be used.

During the feed, keep the patient's head raised to at least 30 to 45 degrees and for a while afterwards, flush the tube with water before and after, and record the feed.

First find out why: pain, fear of the stitches opening, dizziness, nausea, or worry about the drains and lines. Explain simply why moving early matters: it lowers the risk of blood clots, chest infection and constipation, and helps recovery.

Make it easier. Give pain relief as prescribed before mobilising, secure the drains and catheter, and go in stages: sit up, then sit on the edge of the bed with the legs hanging, and check for dizziness before standing. Stay with the patient and get a second person if needed. If they still refuse, respect it, try again later, and record it and inform the doctor or physiotherapist.

The basic five are the right patient, right drug, right dose, right route and right time. Most hospitals now add more: right documentation, right reason, right response (checking that the medicine worked and watching for side effects), the patient's right to refuse, and right education, telling the patient what they are taking.

In practice, identify the patient with two identifiers, such as name and hospital number, checked against the wristband, never by bed number. Check the medicine against the prescription three times: when taking it out, when preparing it, and at the bedside. Check allergies before the first dose. Record it immediately after giving it, never before. If anything is unclear, stop and ask before giving.

Use desired dose divided by the dose you have, times the volume: 500 ÷ 250 × 5 mL = 10 mL.

For a drip, drops per minute = volume in mL × drop factor ÷ time in minutes. For 1000 mL over 8 hours with a 20 drops per mL set: 1000 × 20 ÷ 480 = about 42 drops per minute. With a micro-drip set, which gives 60 drops per mL, the drops per minute equal the mL per hour. On an infusion pump you set mL per hour instead: 1000 ÷ 8 = 125 mL per hour.

Always check the drop factor on the set's packet, and get a second nurse to check calculations for children and high-alert medicines.

Isotonic fluids have about the same concentration as blood, so they stay mainly in the blood vessels and expand the circulating volume. Examples are 0.9% normal saline and Ringer's lactate, used in dehydration, blood loss and during surgery. 5% dextrose is isotonic in the bag, but once the glucose is used it acts like free water.

Hypotonic fluids, such as 0.45% saline, move water into the cells; they are used for cellular dehydration and must be avoided where there is a risk of brain swelling. Hypertonic fluids, such as 3% saline, draw water out of the cells, and are given only under close monitoring for specific conditions. Watch every patient on IV fluids for overload: breathlessness, swelling and crackles in the lungs.

Suspect anaphylaxis and act at once. Stop the infusion immediately but keep the IV line, call for help and inform the doctor, or call the emergency team. Check airway, breathing and circulation, give oxygen, and lay the patient flat with the legs raised, or sitting up if breathing is difficult. Keep the emergency trolley ready; intramuscular adrenaline is the first-line treatment and is given as ordered or under the hospital's anaphylaxis protocol. Monitor pulse, blood pressure and oxygen saturation closely.

Afterwards, record the reaction, the drug and the actions taken, mark the allergy clearly on the chart and wristband, and report it as an adverse drug reaction through the hospital's pharmacovigilance system.

High-alert medicines are those that can cause serious harm if given wrongly, even though errors with them may not be more common. Examples are insulin, heparin and other anticoagulants, concentrated potassium chloride and other concentrated electrolytes, opioids, sedatives, chemotherapy and neuromuscular blocking agents.

Precautions: an independent double check by a second nurse before giving, using an infusion pump, and writing "units" in full rather than "U". Concentrated potassium chloride is never given as an IV push; it is always diluted and infused slowly, and stored separately from other vials. Keep look-alike and sound-alike medicines apart and labelled, and check the patient's blood sugar or clotting results before the dose where needed.

Introduce yourself and make sure there is privacy. Ask what they already know and what worries them, because the fear is often about something specific. Then explain in simple words, in their language if possible: what will be done, why, what they will feel, how long it takes, and what happens afterwards. Avoid medical terms, or explain them.

Check understanding by asking them to say it back in their own words, rather than asking "Understood?". Answer questions honestly; don't say "It won't hurt at all" if it will. Stay with them during the procedure if you can, and use an interpreter or a family member's help when there's a language barrier, while respecting the patient's privacy.

Informed consent is a patient's voluntary agreement to a procedure after being told what it is, why it's needed, its risks and benefits, and the alternatives, including not having it. The doctor doing the procedure is responsible for explaining it and taking consent. The patient must be an adult with the capacity to decide; for a child, a parent or guardian consents.

The nurse checks that the signed consent form is in the file before the procedure, that the patient's identity and the procedure match, and that the patient actually understood. Nurses often witness the signature. If the patient seems unsure, has new questions or wants to withdraw, stop and inform the doctor; consent can be withdrawn at any time.

Stay calm and take them aside, away from other patients. Listen without interrupting, then acknowledge their worry: "I can see you're very worried about your father. Let me find out what's happening right now." Often the anger comes from fear and not knowing.

Check the patient yourself first, in case he really needs urgent attention, then contact the doctor and give the family a realistic time instead of a vague "soon". Go back and update them even if there's a delay. Don't argue or blame colleagues. If the situation becomes threatening, call security and inform the nursing supervisor. Record the concern and what was done.

Don't lie and don't give a diagnosis you're not authorised to give. Sit down, make time, and find out what he already knows and fears: "What have the doctors told you so far? What's worrying you?" Acknowledge his feelings, then be honest about your role: "These are important questions, and the doctor should go through the results with you. I'll ask them to talk to you today." Then inform the doctor straight away.

When the news is given, ideally be present, because patients turn to nurses afterwards. Many hospitals follow a structured approach such as SPIKES for breaking bad news. Afterwards, check on him, listen, and offer support from counselling or palliative care.

The five moments are: before touching a patient, before a clean or aseptic procedure, after a risk of exposure to body fluids, after touching a patient, and after touching the patient's surroundings, such as the bed rails or monitor, even if you didn't touch the patient.

Use alcohol-based hand rub for most moments; it takes about 20 to 30 seconds. Wash with soap and water, for about 40 to 60 seconds, when hands are visibly dirty, after contact with body fluids, and when caring for patients with infections such as Clostridioides difficile, which hand rub doesn't kill. Gloves don't replace hand hygiene: clean your hands before putting them on and after taking them off.

Under the Bio-Medical Waste Management Rules, 2016, waste is separated at the point where it is generated into colour-coded containers. Yellow is for anatomical waste, soiled dressings and cotton, expired medicines and some chemical and laboratory waste; it goes for incineration. Red is for contaminated recyclable plastic such as IV sets, tubing, catheters, urine bags, gloves and syringes without needles. The white, translucent puncture-proof container is for sharps: needles, blades and syringes with fixed needles. Blue, a cardboard box with blue marking, is for glassware such as broken vials and ampoules, and metal implants.

Never recap needles, never sort waste later by hand, and follow the chart displayed in your ward.

Disinfection kills most harmful microorganisms but not necessarily bacterial spores; it is used for surfaces and for items that touch intact skin or mucous membranes. Sterilisation destroys all microorganisms, including spores, and is needed for anything that enters sterile tissue or the bloodstream, such as surgical instruments.

The autoclave sterilises with steam under pressure, commonly at 121°C for 15 minutes or more, or at 134°C for a shorter cycle. To check it, there are chemical indicators, such as indicator tape that changes colour on each pack, the Bowie-Dick test for air removal in pre-vacuum autoclaves, and biological indicators with heat-resistant spores, which give the strongest proof. Check the pack's indicator and expiry before opening it.

Let the wound bleed gently under running water, wash it with soap and water, and don't squeeze it hard, scrub it or put the finger in your mouth. Don't use bleach or strong antiseptics. For a splash in the eyes or mouth, rinse with plenty of water.

Then report it at once to the nurse in charge and the infection control team, and fill in the incident report. The source patient's status for HIV, hepatitis B and hepatitis C is assessed, with consent, and you are assessed too. If HIV post-exposure prophylaxis is advised, it should start as soon as possible, ideally within two hours and not later than 72. Your hepatitis B vaccination status is checked, and follow-up tests are arranged.

Report it to the infection control nurse, who can confirm whether it's an outbreak and check the cultures. Then review how catheters are handled against the prevention bundle: insert a catheter only when there's a clear reason, insert it with aseptic technique, keep it a closed system, keep the bag below the bladder and off the floor, avoid kinks, empty the bag with a clean container for each patient, and give daily perineal care.

The most effective step is reviewing every day whether each catheter is still needed and asking the doctor to remove it as soon as possible. Audit practice on the ward, retrain staff where gaps are found, and track the infection rate afterwards.

Write it accurately, objectively and on time. Record what you saw, did and measured, not opinions: "Patient refused lunch, said he felt nauseated" rather than "Patient uncooperative." Each entry has the date and time, your name, signature and designation. Write clearly, use only the abbreviations your hospital approves, and leave no blank spaces.

If you make a mistake, draw a single line through it so it can still be read, write the correction, and sign and date it. Never use correction fluid, overwrite or tear out pages, and never write an entry before the care is given, such as a medicine not yet given. A common saying in nursing is "if it isn't documented, it wasn't done", and in a legal case that is how it is treated.

SBAR stands for Situation, Background, Assessment and Recommendation. It's a structured way to communicate about a patient, for handovers and calls, so nothing important is missed.

For example: "Doctor, this is [name], staff nurse in ward 4. Situation: Mr [name] in bed 12 has a blood pressure of 88/50 and a pulse of 120. Background: he's on day one after abdominal surgery and on IV fluids; at 6 pm his BP was 120/80. Assessment: his drain has collected 300 mL of blood in two hours and he's pale and sweating. I'm worried he's bleeding. Recommendation: please come and see him now. Do you want any tests sent or fluids changed meanwhile?" Read back any verbal orders.

Follow the nursing process: assessment, nursing diagnosis, planning, implementation and evaluation. From the assessment, write a nursing diagnosis as the problem, its cause and the evidence, for example "acute pain related to the surgical incision, as shown by a pain score of 7 out of 10 and guarding".

Then set a measurable goal with a time frame: "pain score below 3 within one hour of analgesia". List the interventions with the reason for each: assess pain regularly with a pain scale, give prescribed analgesia, position for comfort, teach the patient to support the wound when coughing. Finally evaluate whether the goal was met and revise the plan. Update it as the patient's condition changes.

Keep it short and about nursing. "I completed my BSc Nursing from [college] in [year] and I'm registered with the [state] Nursing Council. During my clinical postings I worked in medical, surgical, paediatric and ICU wards at [hospital], and I was most comfortable in [area], where I [specific skill, such as handling post-operative patients or monitoring]. I've also done a BLS course. I'm looking for a staff nurse role where I can build strong clinical skills in a busy hospital."

Mention your registration and any certificates, such as BLS. If you're experienced, say which units you've worked in, the patient load and any responsibilities, like being in charge of a shift.

Give a sincere reason, with a moment that made it real. "I wanted a career where I could help people directly every day. When my grandmother was in hospital, I saw how much the nurses' care and explanations meant to our family, and that made me choose nursing. During my training, caring for a patient through a long recovery confirmed it for me."

If nursing wasn't your first choice, you don't have to pretend it was; explain what made you commit to it since. Avoid giving going abroad or job security as your main reason, even if they matter to you.

Patients need care around the clock, so hospitals need a clear answer. "Yes. I understand nursing means night duties and rotating shifts, and I managed them during my internship. I plan my sleep and meals around the roster, and my family supports it."

If you have a genuine limitation, say so honestly and ask about the rotation policy, rather than agreeing now and refusing duties later. You can also show you understand why this matters: the night shift has fewer staff, so every nurse on it has to be reliable.

Patient safety comes first. "I'd make sure the patient is safe: check them and inform the doctor immediately so the effect can be assessed and treated. I'd speak to my colleague calmly and encourage them to report it with me. Then I'd make sure it is reported to the nurse in charge and through the hospital's incident reporting system."

Explain why: "Hiding an error can harm the patient, and reporting helps the hospital find what caused it, such as a confusing label or a workload problem, so it isn't repeated." Show that you'd also report your own mistakes, and that the aim is to fix the system, not to blame a colleague.

Prioritise by how urgent and unstable each patient is. Anything threatening airway, breathing or circulation comes first: a patient who is breathless, has a falling blood pressure or chest pain. Next are time-critical tasks such as a due antibiotic, insulin with a meal, or a patient going for surgery. Routine care can follow.

Ask for help early: inform the in-charge, ask a colleague to cover one task, and delegate non-nursing tasks to the ward assistant within their role. Give a quick word to the patients who must wait. For example: "One patient's oxygen saturation dropped while another wanted pain relief, so I went to the first and asked my colleague to assess the second's pain.