BSN225 Final Exam Actual Exam Style V1
| BSN 225 HESI RN Specialty
Fundamentals of Nursing Exam |
Nightingale
1. A nurse is caring for a patient who has a prescription for a clear liquid diet. Which of the
following food items should the nurse offer?
A. Vanilla pudding
B. Cream of chicken soup
C. Orange juice with pulp
D. Apple juice
Answer: D
Rationale: Clear liquid diets consist of foods that are liquid at room temperature and
transparent. Apple juice meets these criteria because it is see-through and lacks solids or
pulp. In contrast, pudding and cream soups are considered full liquids or soft foods.
2. When performing hand hygiene, how long should a nurse scrub their hands with soap and
water?
A. At least 5 seconds
B. Exactly 1 minute
C. At least 20 seconds
,D. Until the hands feel dry
Answer: C
Rationale: Effective handwashing requires friction and time to remove transient
microorganisms. The CDC recommends scrubbing for at least 20 seconds to ensure all
surfaces are cleaned. This duration is approximately the time it takes to sing the ‘Happy
Birthday’ song twice.
3. A nurse is preparing to administer an intramuscular injection. Which angle of insertion
should the nurse use?
A. 90 degrees
B. 30 degrees
C. 45 degrees
D. 15 degrees
Answer: A
Rationale: Intramuscular injections are designed to reach deep muscle tissue below the
subcutaneous layer. A 90-degree angle ensures the needle penetrates through the skin and
fat into the muscle. Using a shallower angle might result in the medication being deposited
in the subcutaneous tissue instead.
4. The nurse is using the RACE acronym for fire safety. What does the ‘E’ stand for?
A. Examine
, B. Exit
C. Evaluate
D. Extinguish
Answer: D
Rationale: RACE stands for Rescue, Alarm, Confine, and Extinguish/Evacuate. The ‘E’ refers
to extinguishing the fire if it is small and safe to do so. This standardized protocol helps
healthcare workers respond systematically to fire emergencies.
5. Which vital sign should the nurse prioritize for a patient who just returned from surgery?
A. Blood pressure
B. Temperature
C. Pain level
D. Respiratory rate
Answer: D
Rationale: Monitoring the respiratory rate is the highest priority due to the risk of
anesthesia-induced respiratory depression. Maintaining a patent airway and adequate
ventilation is the first step in the ABC (Airway, Breathing, Circulation) assessment. While
blood pressure and pain are important, they follow airway and breathing in terms of
urgency.
| BSN 225 HESI RN Specialty
Fundamentals of Nursing Exam |
Nightingale
1. A nurse is caring for a patient who has a prescription for a clear liquid diet. Which of the
following food items should the nurse offer?
A. Vanilla pudding
B. Cream of chicken soup
C. Orange juice with pulp
D. Apple juice
Answer: D
Rationale: Clear liquid diets consist of foods that are liquid at room temperature and
transparent. Apple juice meets these criteria because it is see-through and lacks solids or
pulp. In contrast, pudding and cream soups are considered full liquids or soft foods.
2. When performing hand hygiene, how long should a nurse scrub their hands with soap and
water?
A. At least 5 seconds
B. Exactly 1 minute
C. At least 20 seconds
,D. Until the hands feel dry
Answer: C
Rationale: Effective handwashing requires friction and time to remove transient
microorganisms. The CDC recommends scrubbing for at least 20 seconds to ensure all
surfaces are cleaned. This duration is approximately the time it takes to sing the ‘Happy
Birthday’ song twice.
3. A nurse is preparing to administer an intramuscular injection. Which angle of insertion
should the nurse use?
A. 90 degrees
B. 30 degrees
C. 45 degrees
D. 15 degrees
Answer: A
Rationale: Intramuscular injections are designed to reach deep muscle tissue below the
subcutaneous layer. A 90-degree angle ensures the needle penetrates through the skin and
fat into the muscle. Using a shallower angle might result in the medication being deposited
in the subcutaneous tissue instead.
4. The nurse is using the RACE acronym for fire safety. What does the ‘E’ stand for?
A. Examine
, B. Exit
C. Evaluate
D. Extinguish
Answer: D
Rationale: RACE stands for Rescue, Alarm, Confine, and Extinguish/Evacuate. The ‘E’ refers
to extinguishing the fire if it is small and safe to do so. This standardized protocol helps
healthcare workers respond systematically to fire emergencies.
5. Which vital sign should the nurse prioritize for a patient who just returned from surgery?
A. Blood pressure
B. Temperature
C. Pain level
D. Respiratory rate
Answer: D
Rationale: Monitoring the respiratory rate is the highest priority due to the risk of
anesthesia-induced respiratory depression. Maintaining a patent airway and adequate
ventilation is the first step in the ABC (Airway, Breathing, Circulation) assessment. While
blood pressure and pain are important, they follow airway and breathing in terms of
urgency.
