Herzing University NSG 122 HESI Final Actual
Exam: Fundamental Concepts Practice
Questions with Verified Solutions
SECTION 1: BASIC NURSING SKILLS & ACTIVITIES OF DAILY LIVING
(Questions 1-19)
Hygiene & Personal Care
Q1. A nurse is preparing to perform hand hygiene before assisting with a sterile
dressing change. Which method is MOST effective for removing microorganisms?
A) Using alcohol-based hand rub for 15-20 seconds
B) Washing with soap and water for 40-60 seconds
C) Using antimicrobial soap for 2 minutes
D) Wearing sterile gloves without hand hygiene
Correct Answer: B
Rationale: When hands are visibly soiled or before sterile procedures, washing with soap
and water for 40-60 seconds is most effective per CDC guidelines. Alcohol-based rub
(A) is appropriate for routine decontamination when hands are not visibly soiled. Two
minutes (C) is excessive for routine hand hygiene. Gloves (D) are never a substitute for
hand hygiene.
,HESI Focus: Infection control principles distinguish between routine hand hygiene and
surgical/sterile preparation.
Clinical Application: Soap and water physically remove spores and certain organisms
that alcohol cannot eliminate.
Q2. When providing perineal care to a female patient, the nurse should cleanse the
perineal area using which technique?
A) Front to back, using a clean portion of the washcloth for each stroke
B) Back to front to ensure thorough cleaning
C) Circular motion from the anus outward
D) Side to side across the perineum
Correct Answer: A
Rationale: Front-to-back (urethra to anus) prevents fecal contamination of the urinary
meatus, reducing UTI risk. Using a clean portion of the cloth for each stroke prevents
recontamination. Back-to-front (B) and circular from anus (C) increase infection risk.
Side-to-side (D) is ineffective.
Infection Prevention: E. coli from the gastrointestinal tract is the most common cause
of UTIs; proper technique prevents introduction of pathogens.
Patient Dignity: Maintain privacy, explain procedure, and use warm water for comfort.
Q3. A patient with limited mobility has been in bed for three days. Which nursing
intervention is MOST important to prevent skin breakdown?
,A) Massage reddened bony prominences with lotion
B) Reposition the patient every 2 hours
C) Apply talcum powder to keep skin dry
D) Use donut-shaped cushions under the sacrum
Correct Answer: B
Rationale: Repositioning every 2 hours relieves pressure on bony prominences and is
the most effective pressure injury prevention strategy. Massage (A) can damage fragile
tissue. Talcum powder (C) can cause respiratory issues and caking. Donut cushions (D)
cause venous congestion and increase pressure injury risk.
Braden Scale: Assess mobility, activity, moisture, nutrition, friction/shear, and sensory
perception to determine risk level.
Evidence-Based Practice: 30-degree lateral positioning reduces sacral pressure
compared to 90-degree side-lying.
Q4. When assisting a patient with oral care who is unconscious, the nurse should place
the patient in which position?
A) Supine with head elevated 30 degrees
B) Side-lying with head turned toward the side
C) Trendelenburg position
D) High Fowler's position
Correct Answer: B
, Rationale: Side-lying with head turned allows secretions to drain from the mouth,
preventing aspiration. Supine (A) and Trendelenburg (C) increase aspiration risk. High
Fowler's (D) is contraindicated for unconscious patients who cannot maintain airway.
Aspiration Prevention: Use minimal water, avoid flossing (can cause bleeding), and use
sponge-tipped swabs or soft toothbrush.
Documentation: Record oral cavity condition, any lesions, bleeding, or unusual findings.
Mobility & Body Mechanics
Q5. When transferring a patient from bed to wheelchair, which action demonstrates
proper body mechanics?
A) Keeping feet close together for balance
B) Bending at the waist to reach the patient
C) Twisting at the waist while lifting
D) Using leg muscles and keeping back straight
Correct Answer: D
Rationale: Proper body mechanics include using large leg muscles (quadriceps,
hamstrings), maintaining neutral spine alignment, and avoiding twisting. Feet should be
shoulder-width apart (not close together, A). Bending at waist (B) and twisting (C) cause
back injury.
Ergonomics: Keep load close to center of gravity, use assistive devices (transfer belt,
mechanical lift), and get help for patients >35 lbs or unpredictable.
Exam: Fundamental Concepts Practice
Questions with Verified Solutions
SECTION 1: BASIC NURSING SKILLS & ACTIVITIES OF DAILY LIVING
(Questions 1-19)
Hygiene & Personal Care
Q1. A nurse is preparing to perform hand hygiene before assisting with a sterile
dressing change. Which method is MOST effective for removing microorganisms?
A) Using alcohol-based hand rub for 15-20 seconds
B) Washing with soap and water for 40-60 seconds
C) Using antimicrobial soap for 2 minutes
D) Wearing sterile gloves without hand hygiene
Correct Answer: B
Rationale: When hands are visibly soiled or before sterile procedures, washing with soap
and water for 40-60 seconds is most effective per CDC guidelines. Alcohol-based rub
(A) is appropriate for routine decontamination when hands are not visibly soiled. Two
minutes (C) is excessive for routine hand hygiene. Gloves (D) are never a substitute for
hand hygiene.
,HESI Focus: Infection control principles distinguish between routine hand hygiene and
surgical/sterile preparation.
Clinical Application: Soap and water physically remove spores and certain organisms
that alcohol cannot eliminate.
Q2. When providing perineal care to a female patient, the nurse should cleanse the
perineal area using which technique?
A) Front to back, using a clean portion of the washcloth for each stroke
B) Back to front to ensure thorough cleaning
C) Circular motion from the anus outward
D) Side to side across the perineum
Correct Answer: A
Rationale: Front-to-back (urethra to anus) prevents fecal contamination of the urinary
meatus, reducing UTI risk. Using a clean portion of the cloth for each stroke prevents
recontamination. Back-to-front (B) and circular from anus (C) increase infection risk.
Side-to-side (D) is ineffective.
Infection Prevention: E. coli from the gastrointestinal tract is the most common cause
of UTIs; proper technique prevents introduction of pathogens.
Patient Dignity: Maintain privacy, explain procedure, and use warm water for comfort.
Q3. A patient with limited mobility has been in bed for three days. Which nursing
intervention is MOST important to prevent skin breakdown?
,A) Massage reddened bony prominences with lotion
B) Reposition the patient every 2 hours
C) Apply talcum powder to keep skin dry
D) Use donut-shaped cushions under the sacrum
Correct Answer: B
Rationale: Repositioning every 2 hours relieves pressure on bony prominences and is
the most effective pressure injury prevention strategy. Massage (A) can damage fragile
tissue. Talcum powder (C) can cause respiratory issues and caking. Donut cushions (D)
cause venous congestion and increase pressure injury risk.
Braden Scale: Assess mobility, activity, moisture, nutrition, friction/shear, and sensory
perception to determine risk level.
Evidence-Based Practice: 30-degree lateral positioning reduces sacral pressure
compared to 90-degree side-lying.
Q4. When assisting a patient with oral care who is unconscious, the nurse should place
the patient in which position?
A) Supine with head elevated 30 degrees
B) Side-lying with head turned toward the side
C) Trendelenburg position
D) High Fowler's position
Correct Answer: B
, Rationale: Side-lying with head turned allows secretions to drain from the mouth,
preventing aspiration. Supine (A) and Trendelenburg (C) increase aspiration risk. High
Fowler's (D) is contraindicated for unconscious patients who cannot maintain airway.
Aspiration Prevention: Use minimal water, avoid flossing (can cause bleeding), and use
sponge-tipped swabs or soft toothbrush.
Documentation: Record oral cavity condition, any lesions, bleeding, or unusual findings.
Mobility & Body Mechanics
Q5. When transferring a patient from bed to wheelchair, which action demonstrates
proper body mechanics?
A) Keeping feet close together for balance
B) Bending at the waist to reach the patient
C) Twisting at the waist while lifting
D) Using leg muscles and keeping back straight
Correct Answer: D
Rationale: Proper body mechanics include using large leg muscles (quadriceps,
hamstrings), maintaining neutral spine alignment, and avoiding twisting. Feet should be
shoulder-width apart (not close together, A). Bending at waist (B) and twisting (C) cause
back injury.
Ergonomics: Keep load close to center of gravity, use assistive devices (transfer belt,
mechanical lift), and get help for patients >35 lbs or unpredictable.
