FUNDAMENTALS HESI PRACTICE EXAM 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 client with Clostridioides difficile infection. Which action by
the nursing assistant requires immediate intervention by the nurse?
A. Wearing gloves while emptying the bedside commode
B. Placing a blood pressure cuff on the client's arm
C. Wearing a gown and gloves while providing perineal care [CORRECT]
D. Using alcohol-based hand sanitizer after removing gloves [CORRECT]
Correct Answer: D
Rationale: C. difficile is a spore-forming organism that is not killed by alcohol-based
hand sanitizers. The nursing assistant must wash hands with soap and water after
removing gloves. While wearing a gown and gloves for perineal care (Option C) is
appropriate, the critical error is using alcohol sanitizer (Option D), which is ineffective
against C. difficile spores. Option A is appropriate—gloves are required for contact with
body fluids. Option B is acceptable if proper hand hygiene follows. The nurse must
intervene immediately to ensure proper hand washing technique to prevent
transmission.
,Q2: A client with dementia is attempting to climb out of bed despite being at high risk
for falls. The provider orders wrist restraints. What is the nurse's priority action?
A. Apply the restraints immediately to prevent injury
B. Assess the client's unmet needs and attempt less restrictive interventions first
[CORRECT]
C. Document the provider's order and apply restraints
D. Ask the family to sit with the client continuously
Correct Answer: B
Rationale: The least restrictive intervention principle requires nurses to assess and
address underlying causes of behavior before applying restraints. The client may be
hungry, in pain, need to use the bathroom, or be confused about location. Restraints
require a face-to-face provider assessment within 1 hour, a specific order with duration,
and must be the least restrictive means of protection. Options A and C violate this
principle. Option D places burden on family and doesn't address immediate safety
needs. Documentation, monitoring, and frequent reassessment are required once
restraints are applied.
Q3: A nurse discovers a medication error where a client received the wrong dose of
medication. The client is stable with no adverse effects. What is the nurse's first action?
A. Complete an incident report
,B. Notify the provider and assess the client thoroughly [CORRECT]
C. Document the error in the medical record
D. Tell the client what happened
Correct Answer: B
Rationale: Client safety is the priority. The nurse must first notify the provider and
conduct a thorough assessment to determine if interventions are needed. Incident
reports (Option A) are completed after client is stable and are not placed in the medical
record. Documentation (Option C) should be factual without admitting fault or using
words like "error" or "mistake." Option D requires appropriate timing and context; the
client should be informed but not before ensuring safety and following institutional
protocol. The incident report is for quality improvement and risk management, not for
disciplinary action.
Q4: A nurse is preparing to administer chemotherapy to a client. Which personal
protective equipment (PPE) is required when handling the medication?
A. Gloves only
B. Gloves and gown
C. Double gloves, gown, and face shield [CORRECT]
D. Standard gloves and mask
Correct Answer: C
, Rationale: Chemotherapy agents are hazardous drugs requiring special handling. OSHA
and ONS guidelines require double chemotherapy-tested gloves (outer gloves changed
every 30 minutes or when torn), a disposable impermeable gown with closed front and
tight cuffs, and face/eye protection (face shield or goggles with mask) to prevent
exposure to splashes. Option A is insufficient. Option B lacks eye protection. Option D
uses standard rather than chemotherapy-tested gloves and lacks gown protection. A
spill kit and proper disposal in hazardous waste containers are also required.
Q5: During a fire emergency on the unit, a nurse is caring for a client on ventilator
support who cannot be ambulated. What is the priority action?
A. Call the fire department
B. Move the client to a safe area using a stretcher or wheelchair with portable oxygen
[CORRECT]
C. Extinguish the fire if it is small
D. Close the doors and wait for help
Correct Answer: B
Rationale: The RACE acronym guides fire response: Rescue (move clients in immediate
danger), Alarm (pull fire alarm), Confine (close doors), Extinguish/Evacuate. For a
ventilator-dependent client, the nurse must rescue the client first, ensuring continued
oxygenation with portable O2 during transport. Option A (alarm) should be done
simultaneously if possible, but client rescue takes precedence. Option C is only for
small, contained fires with proper equipment. Option D abandons the client. Knowing
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 client with Clostridioides difficile infection. Which action by
the nursing assistant requires immediate intervention by the nurse?
A. Wearing gloves while emptying the bedside commode
B. Placing a blood pressure cuff on the client's arm
C. Wearing a gown and gloves while providing perineal care [CORRECT]
D. Using alcohol-based hand sanitizer after removing gloves [CORRECT]
Correct Answer: D
Rationale: C. difficile is a spore-forming organism that is not killed by alcohol-based
hand sanitizers. The nursing assistant must wash hands with soap and water after
removing gloves. While wearing a gown and gloves for perineal care (Option C) is
appropriate, the critical error is using alcohol sanitizer (Option D), which is ineffective
against C. difficile spores. Option A is appropriate—gloves are required for contact with
body fluids. Option B is acceptable if proper hand hygiene follows. The nurse must
intervene immediately to ensure proper hand washing technique to prevent
transmission.
,Q2: A client with dementia is attempting to climb out of bed despite being at high risk
for falls. The provider orders wrist restraints. What is the nurse's priority action?
A. Apply the restraints immediately to prevent injury
B. Assess the client's unmet needs and attempt less restrictive interventions first
[CORRECT]
C. Document the provider's order and apply restraints
D. Ask the family to sit with the client continuously
Correct Answer: B
Rationale: The least restrictive intervention principle requires nurses to assess and
address underlying causes of behavior before applying restraints. The client may be
hungry, in pain, need to use the bathroom, or be confused about location. Restraints
require a face-to-face provider assessment within 1 hour, a specific order with duration,
and must be the least restrictive means of protection. Options A and C violate this
principle. Option D places burden on family and doesn't address immediate safety
needs. Documentation, monitoring, and frequent reassessment are required once
restraints are applied.
Q3: A nurse discovers a medication error where a client received the wrong dose of
medication. The client is stable with no adverse effects. What is the nurse's first action?
A. Complete an incident report
,B. Notify the provider and assess the client thoroughly [CORRECT]
C. Document the error in the medical record
D. Tell the client what happened
Correct Answer: B
Rationale: Client safety is the priority. The nurse must first notify the provider and
conduct a thorough assessment to determine if interventions are needed. Incident
reports (Option A) are completed after client is stable and are not placed in the medical
record. Documentation (Option C) should be factual without admitting fault or using
words like "error" or "mistake." Option D requires appropriate timing and context; the
client should be informed but not before ensuring safety and following institutional
protocol. The incident report is for quality improvement and risk management, not for
disciplinary action.
Q4: A nurse is preparing to administer chemotherapy to a client. Which personal
protective equipment (PPE) is required when handling the medication?
A. Gloves only
B. Gloves and gown
C. Double gloves, gown, and face shield [CORRECT]
D. Standard gloves and mask
Correct Answer: C
, Rationale: Chemotherapy agents are hazardous drugs requiring special handling. OSHA
and ONS guidelines require double chemotherapy-tested gloves (outer gloves changed
every 30 minutes or when torn), a disposable impermeable gown with closed front and
tight cuffs, and face/eye protection (face shield or goggles with mask) to prevent
exposure to splashes. Option A is insufficient. Option B lacks eye protection. Option D
uses standard rather than chemotherapy-tested gloves and lacks gown protection. A
spill kit and proper disposal in hazardous waste containers are also required.
Q5: During a fire emergency on the unit, a nurse is caring for a client on ventilator
support who cannot be ambulated. What is the priority action?
A. Call the fire department
B. Move the client to a safe area using a stretcher or wheelchair with portable oxygen
[CORRECT]
C. Extinguish the fire if it is small
D. Close the doors and wait for help
Correct Answer: B
Rationale: The RACE acronym guides fire response: Rescue (move clients in immediate
danger), Alarm (pull fire alarm), Confine (close doors), Extinguish/Evacuate. For a
ventilator-dependent client, the nurse must rescue the client first, ensuring continued
oxygenation with portable O2 during transport. Option A (alarm) should be done
simultaneously if possible, but client rescue takes precedence. Option C is only for
small, contained fires with proper equipment. Option D abandons the client. Knowing
