NUR155 / NUR 155 Test 4 (2026/2027): Foundations of Nursing - Galen Comprehensive Examination
NUR155 / NUR 155 TEST 4 (LATEST ):
FOUNDATIONS OF NURSING - GALEN
Galen College of Nursing • Foundations of Nursing • NCLEX-PN/RN Test Plan • QSEN Competencies
Total Questions: 100 | Cognitive Mix: 20% Recall, 50% Application, 30% Analysis | 75% Scenario-based, 25% Direct Knowledge | 20
Priority-Setting • 15 Pharmacology • 10 Infection Control & Safety
Section 1: Safety & Infection Control
Q1: A nurse is caring for a client with suspected tuberculosis. Which link in the chain of infection is interrupted
when the client is placed in a negative-pressure airborne isolation room with the door kept closed at all times?
A. Portal of exit, by containing organisms expelled during coughing
B. Mode of transmission, by preventing airborne droplet nuclei from reaching susceptible hosts *[CORRECT]*
C. Infectious agent, by directly killing Mycobacterium tuberculosis organisms in the air
D. Susceptible host, by boosting the immune response of staff and visitors
Correct Answer: B
Rationale: Airborne isolation with negative pressure interrupts the MODE OF TRANSMISSION by ensuring contaminated air
does not flow out of the room, preventing infectious droplet nuclei from reaching susceptible hosts. The infectious agent itself is
not killed by isolation alone (option C is incorrect). Portal-of-exit controls (masks on the patient) and susceptible-host protections
(employee N95 fit-testing) operate on different links (A and D are wrong). This aligns with NUR 155 chain-of-infection content
and the CDC Guideline for Isolation Precautions.
Q2: According to CDC and WHO hand-hygiene guidelines, which action by the nurse requires hand hygiene with
soap and water (rather than alcohol-based hand rub)?
A. After removing gloves following a routine vital signs assessment
B. Before donning sterile gloves for a dressing change
C. After providing care to a client with confirmed Clostridioides difficile infection *[CORRECT]*
D. After touching the bed rails of a client on contact precautions for MRSA
Correct Answer: C
Rationale: C. difficile produces spores that alcohol-based hand rubs cannot kill; soap-and-water mechanical friction is required
after caring for a C. difficile patient. Alcohol-based hand rub is appropriate for the other scenarios because there is no
spore-forming organism involved. This reflects CDC hand-hygiene recommendations and the NUR 155 medical-asepsis
curriculum.
NUR 155 Foundations of Nursing - Galen College of Nursing Page 1
,NUR155 / NUR 155 Test 4 (2026/2027): Foundations of Nursing - Galen Comprehensive Examination
Q3: A nurse is preparing to draw blood from a client with an unknown infectious status. Which personal
protective equipment (PPE) is required under Standard Precautions?
A. Sterile gloves, gown, and face shield for every blood draw
B. Gloves only, plus a face shield if splashing of blood or body fluids is anticipated *[CORRECT]*
C. N95 respirator and eye protection for all client contact
D. Gown, gloves, and surgical mask for routine venipuncture
Correct Answer: B
Rationale: Standard Precautions require gloves for any contact with blood or body fluids, and a face shield/mask + gown must be
added only when splashing is reasonably anticipated. An N95 respirator is reserved for known or suspected airborne pathogens
such as TB or measles (option C is incorrect). Sterile gloves are not indicated for a routine venipuncture (option A is incorrect),
and a full gown/mask ensemble is not required for a routine blood draw without splash risk (option D is incorrect). This is
consistent with OSHA Bloodborne Pathogens Standard and NUR 155 content.
Q4: Four clients require airborne infection isolation rooms. The nurse has only one negative-pressure AIIR
available. Which client must be assigned to the AIIR first?
A. A client with Chickenpox (varicella) who is currently febrile with active lesions *[CORRECT]*
B. A client with pneumonia caused by Streptococcus pneumoniae
C. A client with a surgical site infection with methicillin-resistant Staphylococcus aureus (MRSA)
D. A client with Clostridioides difficile colitis with profuse diarrhea
Correct Answer: A
Rationale: Varicella (chickenpox) is transmitted by the AIRBORNE route and requires an AIIR; among these clients it is the only
one needing negative-pressure isolation. Pneumococcal pneumonia (B) requires standard precautions and possibly droplet if
mucotympanitis or meningitis is suspected, MRSA wound infection (C) requires CONTACT precautions, and C. difficile (D)
requires contact precautions with soap-and-water hand hygiene. Prioritizing the only true airborne pathogen is consistent with
CDC isolation precaution guidelines and the NUR 155 infection-control priority-setting framework.
Q5: A client on droplet precautions for influenza asks the nurse why visitors must wear a surgical mask within 3 to
6 feet of the bed. Which response by the nurse is most accurate?
A. "The mask prevents you from exhaling influenza virus into the room air."
B. Large respiratory droplets travel only short distances before settling, so a mask within 3 to 6 feet blocks
inoculation to the visitor's mucous membranes." *[CORRECT]*
C. "Droplet precautions are primarily used because the virus can survive on surfaces for weeks."
D. "The mask sterilizes the air you breathe so you cannot become infected."
Correct Answer: B
Rationale: Droplet transmission involves large respiratory particles (>5 µm) that travel only about 3 to 6 feet before settling; a
surgical mask protects the visitor's mucous membranes within that range. Airborne transmission requires an N95 respirator and an
AIIR (A describes a negative-pressure room concept, not a simple surgical mask). Option C describes contact transmission, and
option D falsely suggests the mask sterilizes the air. This is consistent with CDC transmission-based precaution guidelines and
NUR 155 infection-control content.
NUR 155 Foundations of Nursing - Galen College of Nursing Page 2
,NUR155 / NUR 155 Test 4 (2026/2027): Foundations of Nursing - Galen Comprehensive Examination
Q6: A nursing assistant is preparing to ambulate a client on contact precautions for a carbapenem-resistant
Enterobacteriaceae (CRE) colonization. Which PPE donning sequence is correct?
A. Gown → Mask → Gloves → Eye protection
B. Gown → Gloves → Mask → Eye protection
C. Gown → Mask → Eye protection → Gloves (gloves pulled over gown cuffs) *[CORRECT]*
D. Gloves → Gown → Mask → Eye protection
Correct Answer: C
Rationale: CDC PPE donning sequence is: gown first, then mask/respirator, then eye protection, then gloves last (with glove cuffs
pulled OVER gown cuffs to seal the wrist). Doffing is the reverse: gloves first, then eye protection, then gown, then mask. Option
A places gloves before eye protection (incorrect), option B omits proper glove-over-gown technique, and option D places gloves
before gown (incorrect). This reflects the CDC PPE donning/doffing sequence taught in NUR 155 medical and surgical asepsis
content.
Q7: A nurse is establishing a sterile field for a dressing change. Which observation, if made by the charge nurse,
would require intervention because the sterile field has been contaminated?
A. The nurse turns his back to the sterile field briefly to reach for additional supplies.
B. The nurse's gloved hands remain above waist level and within the visual field at all times.
C. Sterile items are dropped onto the field from a height of 6 inches without contacting the 1-inch unsterile border.
D. The sterile field has been opened and unused for 90 minutes; the nurse proceeds with the dressing change.
*[CORRECT]*
Correct Answer: D
Rationale: A sterile field is considered contaminated if it remains unattended or out of the nurse's view, if the 1-inch border is
touched, or if it has been open longer than the recommended time (most facilities specify a 30-minute limit when not in active use;
90 minutes requires re-establishment). Turning one's back on the field (A) also contaminates it; however, option D directly
describes a prolonged open time and is the clearest violation. Option B reflects correct technique and option C is acceptable as long
as the 1-inch border is avoided. This aligns with NUR 155 surgical-asepsis standards and AORN guidelines.
Q8: Which statement by a nursing student best demonstrates understanding of the difference between medical
asepsis and surgical asepsis?
A. "Medical asepsis eliminates all microorganisms including spores; surgical asepsis only reduces organisms."
B. "Medical asepsis reduces the number of microorganisms through hand hygiene and cleaning; surgical asepsis
eliminates all microorganisms, including spores, through sterilization." *[CORRECT]*
C. "Both medical and surgical asepsis use identical techniques and achieve the same level of cleanliness."
D. "Surgical asepsis is only used in the operating room; medical asepsis is only used on medical-surgical units."
Correct Answer: B
Rationale: Medical asepsis (clean technique) reduces the number of microorganisms through hand hygiene, environmental
cleaning, and barrier use; surgical asepsis (sterile technique) eliminates ALL microorganisms including spores via sterilization.
Options A, C, and D are incorrect inversions or generalizations. This reflects foundational NUR 155 content on principles of
asepsis.
NUR 155 Foundations of Nursing - Galen College of Nursing Page 3
, NUR155 / NUR 155 Test 4 (2026/2027): Foundations of Nursing - Galen Comprehensive Examination
Q9: A nurse sustains a needlestick injury while recapping a used insulin syringe from a client with hepatitis B.
Which action should the nurse take FIRST?
A. Complete an incident report and notify the supervisor within 24 hours.
B. Wash the puncture site thoroughly with soap and water, then follow facility exposure-control protocol.
*[CORRECT]*
C. Bleed the wound by squeezing the puncture site to express contaminated blood.
D. Apply povidone-iodine to the site and continue working until the shift ends.
Correct Answer: B
Rationale: The first action after a needlestick exposure is to wash the site thoroughly with soap and water (and flush mucous
membranes), then immediately initiate the facility's exposure-control protocol including rapid HIV/hepatitis serology, prophylactic
medication consideration, and supervisor notification. Squeezing the wound to express blood (C) is no longer recommended
because it can force contaminants deeper. Completing the incident report (A) is necessary but follows immediate first aid, and
continuing to work untreated (D) is unsafe. This reflects the OSHA Bloodborne Pathogens Standard and NUR 155 sharps-injury
protocol.
Q10: A fire occurs in a client's room while the client is on 4 L/min of oxygen via nasal cannula. Using the RACE
fire-safety mnemonic, which action should the nurse perform FIRST?
A. Extinguish the fire using a Class A fire extinguisher.
B. Activate the fire alarm pull station in the hallway.
C. Rescue the client by removing them from the room and turning off the oxygen source. *[CORRECT]*
D. Confine the fire by closing all doors and windows.
Correct Answer: C
Rationale: RACE stands for Rescue → Alarm → Confine → Extinguish/Evacuate; the nurse's first action is to RESCUE the client
from immediate danger and simultaneously shut off the oxygen source because oxygen supports combustion. Pulling the alarm (B)
follows rescue, confining the fire by closing doors (D) follows alarm activation, and extinguishing (A) is the final step using PASS
(Pull, Aim, Squeeze, Sweep). This sequence aligns with the NFPA fire-safety standards and NUR 155 environmental-safety
content.
Q11: Which client is at greatest risk for a healthcare-associated infection (HAI) and warrants the most aggressive
infection-prevention measures?
A. A 38-year-old client with a closed fracture of the right tibia in a cast.
B. A 72-year-old client with a central venous catheter, broad-spectrum antibiotics, and a urinary catheter in place
for 7 days. *[CORRECT]*
C. A 50-year-old client receiving IV fluids via a peripheral saline lock for less than 24 hours.
D. A 25-year-old postpartum client with an episiotomy.
Correct Answer: B
Rationale: The 72-year-old client has multiple major HAI risk factors: invasive central line (CLABSI risk), prolonged urinary
catheter (CAUTI risk), broad-spectrum antibiotics (C. difficile and fungal overgrowth), and advanced age. The other clients have
fewer and less critical risk factors. This aligns with the CDC HAI prevention guidance and NUR 155 content on host susceptibility,
invasive devices, and antimicrobial stewardship.
NUR 155 Foundations of Nursing - Galen College of Nursing Page 4
NUR155 / NUR 155 TEST 4 (LATEST ):
FOUNDATIONS OF NURSING - GALEN
Galen College of Nursing • Foundations of Nursing • NCLEX-PN/RN Test Plan • QSEN Competencies
Total Questions: 100 | Cognitive Mix: 20% Recall, 50% Application, 30% Analysis | 75% Scenario-based, 25% Direct Knowledge | 20
Priority-Setting • 15 Pharmacology • 10 Infection Control & Safety
Section 1: Safety & Infection Control
Q1: A nurse is caring for a client with suspected tuberculosis. Which link in the chain of infection is interrupted
when the client is placed in a negative-pressure airborne isolation room with the door kept closed at all times?
A. Portal of exit, by containing organisms expelled during coughing
B. Mode of transmission, by preventing airborne droplet nuclei from reaching susceptible hosts *[CORRECT]*
C. Infectious agent, by directly killing Mycobacterium tuberculosis organisms in the air
D. Susceptible host, by boosting the immune response of staff and visitors
Correct Answer: B
Rationale: Airborne isolation with negative pressure interrupts the MODE OF TRANSMISSION by ensuring contaminated air
does not flow out of the room, preventing infectious droplet nuclei from reaching susceptible hosts. The infectious agent itself is
not killed by isolation alone (option C is incorrect). Portal-of-exit controls (masks on the patient) and susceptible-host protections
(employee N95 fit-testing) operate on different links (A and D are wrong). This aligns with NUR 155 chain-of-infection content
and the CDC Guideline for Isolation Precautions.
Q2: According to CDC and WHO hand-hygiene guidelines, which action by the nurse requires hand hygiene with
soap and water (rather than alcohol-based hand rub)?
A. After removing gloves following a routine vital signs assessment
B. Before donning sterile gloves for a dressing change
C. After providing care to a client with confirmed Clostridioides difficile infection *[CORRECT]*
D. After touching the bed rails of a client on contact precautions for MRSA
Correct Answer: C
Rationale: C. difficile produces spores that alcohol-based hand rubs cannot kill; soap-and-water mechanical friction is required
after caring for a C. difficile patient. Alcohol-based hand rub is appropriate for the other scenarios because there is no
spore-forming organism involved. This reflects CDC hand-hygiene recommendations and the NUR 155 medical-asepsis
curriculum.
NUR 155 Foundations of Nursing - Galen College of Nursing Page 1
,NUR155 / NUR 155 Test 4 (2026/2027): Foundations of Nursing - Galen Comprehensive Examination
Q3: A nurse is preparing to draw blood from a client with an unknown infectious status. Which personal
protective equipment (PPE) is required under Standard Precautions?
A. Sterile gloves, gown, and face shield for every blood draw
B. Gloves only, plus a face shield if splashing of blood or body fluids is anticipated *[CORRECT]*
C. N95 respirator and eye protection for all client contact
D. Gown, gloves, and surgical mask for routine venipuncture
Correct Answer: B
Rationale: Standard Precautions require gloves for any contact with blood or body fluids, and a face shield/mask + gown must be
added only when splashing is reasonably anticipated. An N95 respirator is reserved for known or suspected airborne pathogens
such as TB or measles (option C is incorrect). Sterile gloves are not indicated for a routine venipuncture (option A is incorrect),
and a full gown/mask ensemble is not required for a routine blood draw without splash risk (option D is incorrect). This is
consistent with OSHA Bloodborne Pathogens Standard and NUR 155 content.
Q4: Four clients require airborne infection isolation rooms. The nurse has only one negative-pressure AIIR
available. Which client must be assigned to the AIIR first?
A. A client with Chickenpox (varicella) who is currently febrile with active lesions *[CORRECT]*
B. A client with pneumonia caused by Streptococcus pneumoniae
C. A client with a surgical site infection with methicillin-resistant Staphylococcus aureus (MRSA)
D. A client with Clostridioides difficile colitis with profuse diarrhea
Correct Answer: A
Rationale: Varicella (chickenpox) is transmitted by the AIRBORNE route and requires an AIIR; among these clients it is the only
one needing negative-pressure isolation. Pneumococcal pneumonia (B) requires standard precautions and possibly droplet if
mucotympanitis or meningitis is suspected, MRSA wound infection (C) requires CONTACT precautions, and C. difficile (D)
requires contact precautions with soap-and-water hand hygiene. Prioritizing the only true airborne pathogen is consistent with
CDC isolation precaution guidelines and the NUR 155 infection-control priority-setting framework.
Q5: A client on droplet precautions for influenza asks the nurse why visitors must wear a surgical mask within 3 to
6 feet of the bed. Which response by the nurse is most accurate?
A. "The mask prevents you from exhaling influenza virus into the room air."
B. Large respiratory droplets travel only short distances before settling, so a mask within 3 to 6 feet blocks
inoculation to the visitor's mucous membranes." *[CORRECT]*
C. "Droplet precautions are primarily used because the virus can survive on surfaces for weeks."
D. "The mask sterilizes the air you breathe so you cannot become infected."
Correct Answer: B
Rationale: Droplet transmission involves large respiratory particles (>5 µm) that travel only about 3 to 6 feet before settling; a
surgical mask protects the visitor's mucous membranes within that range. Airborne transmission requires an N95 respirator and an
AIIR (A describes a negative-pressure room concept, not a simple surgical mask). Option C describes contact transmission, and
option D falsely suggests the mask sterilizes the air. This is consistent with CDC transmission-based precaution guidelines and
NUR 155 infection-control content.
NUR 155 Foundations of Nursing - Galen College of Nursing Page 2
,NUR155 / NUR 155 Test 4 (2026/2027): Foundations of Nursing - Galen Comprehensive Examination
Q6: A nursing assistant is preparing to ambulate a client on contact precautions for a carbapenem-resistant
Enterobacteriaceae (CRE) colonization. Which PPE donning sequence is correct?
A. Gown → Mask → Gloves → Eye protection
B. Gown → Gloves → Mask → Eye protection
C. Gown → Mask → Eye protection → Gloves (gloves pulled over gown cuffs) *[CORRECT]*
D. Gloves → Gown → Mask → Eye protection
Correct Answer: C
Rationale: CDC PPE donning sequence is: gown first, then mask/respirator, then eye protection, then gloves last (with glove cuffs
pulled OVER gown cuffs to seal the wrist). Doffing is the reverse: gloves first, then eye protection, then gown, then mask. Option
A places gloves before eye protection (incorrect), option B omits proper glove-over-gown technique, and option D places gloves
before gown (incorrect). This reflects the CDC PPE donning/doffing sequence taught in NUR 155 medical and surgical asepsis
content.
Q7: A nurse is establishing a sterile field for a dressing change. Which observation, if made by the charge nurse,
would require intervention because the sterile field has been contaminated?
A. The nurse turns his back to the sterile field briefly to reach for additional supplies.
B. The nurse's gloved hands remain above waist level and within the visual field at all times.
C. Sterile items are dropped onto the field from a height of 6 inches without contacting the 1-inch unsterile border.
D. The sterile field has been opened and unused for 90 minutes; the nurse proceeds with the dressing change.
*[CORRECT]*
Correct Answer: D
Rationale: A sterile field is considered contaminated if it remains unattended or out of the nurse's view, if the 1-inch border is
touched, or if it has been open longer than the recommended time (most facilities specify a 30-minute limit when not in active use;
90 minutes requires re-establishment). Turning one's back on the field (A) also contaminates it; however, option D directly
describes a prolonged open time and is the clearest violation. Option B reflects correct technique and option C is acceptable as long
as the 1-inch border is avoided. This aligns with NUR 155 surgical-asepsis standards and AORN guidelines.
Q8: Which statement by a nursing student best demonstrates understanding of the difference between medical
asepsis and surgical asepsis?
A. "Medical asepsis eliminates all microorganisms including spores; surgical asepsis only reduces organisms."
B. "Medical asepsis reduces the number of microorganisms through hand hygiene and cleaning; surgical asepsis
eliminates all microorganisms, including spores, through sterilization." *[CORRECT]*
C. "Both medical and surgical asepsis use identical techniques and achieve the same level of cleanliness."
D. "Surgical asepsis is only used in the operating room; medical asepsis is only used on medical-surgical units."
Correct Answer: B
Rationale: Medical asepsis (clean technique) reduces the number of microorganisms through hand hygiene, environmental
cleaning, and barrier use; surgical asepsis (sterile technique) eliminates ALL microorganisms including spores via sterilization.
Options A, C, and D are incorrect inversions or generalizations. This reflects foundational NUR 155 content on principles of
asepsis.
NUR 155 Foundations of Nursing - Galen College of Nursing Page 3
, NUR155 / NUR 155 Test 4 (2026/2027): Foundations of Nursing - Galen Comprehensive Examination
Q9: A nurse sustains a needlestick injury while recapping a used insulin syringe from a client with hepatitis B.
Which action should the nurse take FIRST?
A. Complete an incident report and notify the supervisor within 24 hours.
B. Wash the puncture site thoroughly with soap and water, then follow facility exposure-control protocol.
*[CORRECT]*
C. Bleed the wound by squeezing the puncture site to express contaminated blood.
D. Apply povidone-iodine to the site and continue working until the shift ends.
Correct Answer: B
Rationale: The first action after a needlestick exposure is to wash the site thoroughly with soap and water (and flush mucous
membranes), then immediately initiate the facility's exposure-control protocol including rapid HIV/hepatitis serology, prophylactic
medication consideration, and supervisor notification. Squeezing the wound to express blood (C) is no longer recommended
because it can force contaminants deeper. Completing the incident report (A) is necessary but follows immediate first aid, and
continuing to work untreated (D) is unsafe. This reflects the OSHA Bloodborne Pathogens Standard and NUR 155 sharps-injury
protocol.
Q10: A fire occurs in a client's room while the client is on 4 L/min of oxygen via nasal cannula. Using the RACE
fire-safety mnemonic, which action should the nurse perform FIRST?
A. Extinguish the fire using a Class A fire extinguisher.
B. Activate the fire alarm pull station in the hallway.
C. Rescue the client by removing them from the room and turning off the oxygen source. *[CORRECT]*
D. Confine the fire by closing all doors and windows.
Correct Answer: C
Rationale: RACE stands for Rescue → Alarm → Confine → Extinguish/Evacuate; the nurse's first action is to RESCUE the client
from immediate danger and simultaneously shut off the oxygen source because oxygen supports combustion. Pulling the alarm (B)
follows rescue, confining the fire by closing doors (D) follows alarm activation, and extinguishing (A) is the final step using PASS
(Pull, Aim, Squeeze, Sweep). This sequence aligns with the NFPA fire-safety standards and NUR 155 environmental-safety
content.
Q11: Which client is at greatest risk for a healthcare-associated infection (HAI) and warrants the most aggressive
infection-prevention measures?
A. A 38-year-old client with a closed fracture of the right tibia in a cast.
B. A 72-year-old client with a central venous catheter, broad-spectrum antibiotics, and a urinary catheter in place
for 7 days. *[CORRECT]*
C. A 50-year-old client receiving IV fluids via a peripheral saline lock for less than 24 hours.
D. A 25-year-old postpartum client with an episiotomy.
Correct Answer: B
Rationale: The 72-year-old client has multiple major HAI risk factors: invasive central line (CLABSI risk), prolonged urinary
catheter (CAUTI risk), broad-spectrum antibiotics (C. difficile and fungal overgrowth), and advanced age. The other clients have
fewer and less critical risk factors. This aligns with the CDC HAI prevention guidance and NUR 155 content on host susceptibility,
invasive devices, and antimicrobial stewardship.
NUR 155 Foundations of Nursing - Galen College of Nursing Page 4
