HESI FUNDAMENTALS PRACTICE TEST 2026/2027 | 100%
Correct Answers with Complete Solutions | NCLEX-RN
Aligned | Foundational Nursing | Clinical Judgment | Pass
Guaranteed - A+ Graded
Domain 1: Safe & Effective Care Environment (25 Questions)
Q1: A nurse is caring for a patient with Clostridioides difficile (C. diff) infection who has
fecal incontinence. Which infection control precautions are required when entering the
room?
A. Standard precautions only with alcohol-based hand sanitizer
B. Contact precautions with soap and water hand hygiene
C. Droplet precautions with surgical mask and eye protection
D. Airborne precautions with N95 respirator
Correct Answer: B [CORRECT]
Rationale: C. difficile requires Contact Precautions due to fecal-oral transmission via
contact with contaminated surfaces or equipment. Critically, alcohol-based hand
sanitizers are ineffective against C. diff spores, making soap and water hand hygiene
mandatory for mechanical removal of spores. Standard precautions alone (Option A)
are insufficient for this multidrug-resistant organism. Droplet (Option C) and Airborne
(Option D) precautions are inappropriate as C. diff is not transmitted via respiratory
,routes. The nurse must also wear a gown and gloves for room entry, use dedicated
equipment, and ensure thorough environmental cleaning with sporicidal agents.
Q2: A nurse discovers a fire in a patient's room. The patient has been rescued from
immediate danger. What is the nurse's next priority action using the RACE protocol?
A. Confine the fire by closing doors and windows
B. Activate the fire alarm and notify others
C. Extinguish the fire with the nearest appropriate extinguisher
D. Evacuate patients from adjacent rooms
Correct Answer: B [CORRECT]
Rationale: RACE stands for Rescue, Alarm, Confine, Extinguish/Evacuate. After ensuring
patient rescue (R), the immediate priority is Alarm (A) - activating the fire alarm system
to alert the facility, summon the fire department, and initiate the emergency response
plan. This ensures rapid deployment of fire suppression resources and facility-wide
awareness. Confinement (Option A) follows alarm activation to limit fire spread.
Extinguishment (Option C) is only attempted if the fire is small, contained, and the nurse
is trained (using PASS: Pull, Aim, Squeeze, Sweep). Evacuation (Option D) depends on
fire location and facility protocol but follows initial alarm and assessment.
,Q3: A patient with dementia attempts to remove their nasogastric tube and intravenous
line. The physician orders wrist restraints. Which action by the nurse demonstrates safe
restraint application?
A. Securing restraints to the bed frame to prevent falling
B. Applying restraints tightly to prevent any movement
C. Ensuring two fingers can fit between restraint and wrist, and securing to bed frame
(movable part)
D. Removing restraints every 2 hours for range of motion and circulation checks
Correct Answer: D [CORRECT]
Rationale: Restraint safety requires release every 2 hours for range of motion exercises,
circulation checks, nutrition/hydration, and toileting needs to prevent neurovascular
injury, contractures, and complications. Restraints should never be secured to bed rails
(Option A - risk of strangulation with rail movement) or applied too tightly (Option B -
causes nerve damage and impaired circulation). Two-finger fit (Option C) is correct for
application tightness, but securing to bed frame is incorrect; restraints should secure to
bed frame (movable part) only if specifically designed for that purpose, though bed rail
attachment is never appropriate. Restraints are last resort after less restrictive
alternatives fail, require physician orders, and mandate frequent monitoring and
documentation.
Q4: A nurse is applying a physical restraint to an agitated patient. According to the Joint
Commission and CMS regulations, which documentation is required?
, A. Patient's consent for restraint application
B. Physician's order obtained within 1 hour of application for non-emergency use
C. Family notification within 24 hours of restraint application
D. Documentation of restraint alternatives attempted or considered
Correct Answer: D [CORRECT]
Rationale: Documentation must demonstrate that less restrictive alternatives were
attempted or considered before restraint application, justifying the necessity of restraint
use. This includes interventions like redirection, environmental modifications, family
presence, or medication. Physician orders for restraints (Option B) are required before
application (or within 1 hour for emergencies), but the rationale for necessity is the
critical documentation element. Competent patient consent (Option A) is not required
for restraints used for safety, though informed refusal must be addressed. Family
notification (Option C) should occur promptly, not within 24 hours. Continuous
monitoring, regular reassessment, and discontinuation at earliest possible time are also
required.
Q5: A nurse is caring for a patient on fall precautions. Which intervention is most
effective for preventing falls in a patient with orthostatic hypotension?
A. Keeping the bed in the lowest position with all side rails up
B. Instructing the patient to call for assistance before getting up, and implementing
gradual position changes
C. Applying wrist restraints to prevent the patient from getting up independently
D. Placing the call light on the overbed table
Correct Answers with Complete Solutions | NCLEX-RN
Aligned | Foundational Nursing | Clinical Judgment | Pass
Guaranteed - A+ Graded
Domain 1: Safe & Effective Care Environment (25 Questions)
Q1: A nurse is caring for a patient with Clostridioides difficile (C. diff) infection who has
fecal incontinence. Which infection control precautions are required when entering the
room?
A. Standard precautions only with alcohol-based hand sanitizer
B. Contact precautions with soap and water hand hygiene
C. Droplet precautions with surgical mask and eye protection
D. Airborne precautions with N95 respirator
Correct Answer: B [CORRECT]
Rationale: C. difficile requires Contact Precautions due to fecal-oral transmission via
contact with contaminated surfaces or equipment. Critically, alcohol-based hand
sanitizers are ineffective against C. diff spores, making soap and water hand hygiene
mandatory for mechanical removal of spores. Standard precautions alone (Option A)
are insufficient for this multidrug-resistant organism. Droplet (Option C) and Airborne
(Option D) precautions are inappropriate as C. diff is not transmitted via respiratory
,routes. The nurse must also wear a gown and gloves for room entry, use dedicated
equipment, and ensure thorough environmental cleaning with sporicidal agents.
Q2: A nurse discovers a fire in a patient's room. The patient has been rescued from
immediate danger. What is the nurse's next priority action using the RACE protocol?
A. Confine the fire by closing doors and windows
B. Activate the fire alarm and notify others
C. Extinguish the fire with the nearest appropriate extinguisher
D. Evacuate patients from adjacent rooms
Correct Answer: B [CORRECT]
Rationale: RACE stands for Rescue, Alarm, Confine, Extinguish/Evacuate. After ensuring
patient rescue (R), the immediate priority is Alarm (A) - activating the fire alarm system
to alert the facility, summon the fire department, and initiate the emergency response
plan. This ensures rapid deployment of fire suppression resources and facility-wide
awareness. Confinement (Option A) follows alarm activation to limit fire spread.
Extinguishment (Option C) is only attempted if the fire is small, contained, and the nurse
is trained (using PASS: Pull, Aim, Squeeze, Sweep). Evacuation (Option D) depends on
fire location and facility protocol but follows initial alarm and assessment.
,Q3: A patient with dementia attempts to remove their nasogastric tube and intravenous
line. The physician orders wrist restraints. Which action by the nurse demonstrates safe
restraint application?
A. Securing restraints to the bed frame to prevent falling
B. Applying restraints tightly to prevent any movement
C. Ensuring two fingers can fit between restraint and wrist, and securing to bed frame
(movable part)
D. Removing restraints every 2 hours for range of motion and circulation checks
Correct Answer: D [CORRECT]
Rationale: Restraint safety requires release every 2 hours for range of motion exercises,
circulation checks, nutrition/hydration, and toileting needs to prevent neurovascular
injury, contractures, and complications. Restraints should never be secured to bed rails
(Option A - risk of strangulation with rail movement) or applied too tightly (Option B -
causes nerve damage and impaired circulation). Two-finger fit (Option C) is correct for
application tightness, but securing to bed frame is incorrect; restraints should secure to
bed frame (movable part) only if specifically designed for that purpose, though bed rail
attachment is never appropriate. Restraints are last resort after less restrictive
alternatives fail, require physician orders, and mandate frequent monitoring and
documentation.
Q4: A nurse is applying a physical restraint to an agitated patient. According to the Joint
Commission and CMS regulations, which documentation is required?
, A. Patient's consent for restraint application
B. Physician's order obtained within 1 hour of application for non-emergency use
C. Family notification within 24 hours of restraint application
D. Documentation of restraint alternatives attempted or considered
Correct Answer: D [CORRECT]
Rationale: Documentation must demonstrate that less restrictive alternatives were
attempted or considered before restraint application, justifying the necessity of restraint
use. This includes interventions like redirection, environmental modifications, family
presence, or medication. Physician orders for restraints (Option B) are required before
application (or within 1 hour for emergencies), but the rationale for necessity is the
critical documentation element. Competent patient consent (Option A) is not required
for restraints used for safety, though informed refusal must be addressed. Family
notification (Option C) should occur promptly, not within 24 hours. Continuous
monitoring, regular reassessment, and discontinuation at earliest possible time are also
required.
Q5: A nurse is caring for a patient on fall precautions. Which intervention is most
effective for preventing falls in a patient with orthostatic hypotension?
A. Keeping the bed in the lowest position with all side rails up
B. Instructing the patient to call for assistance before getting up, and implementing
gradual position changes
C. Applying wrist restraints to prevent the patient from getting up independently
D. Placing the call light on the overbed table
