Fundamentals HESI Exit Exam Actual Exam 2026/2027 |
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Safe & Effective Care Environment – Delegation, Ethics, Legal, Infection Control
Q1: A patient with a methicillin-resistant Staphylococcus aureus (MRSA) infection is
placed on contact precautions. The nurse is preparing to collect a sputum specimen.
Which personal protective equipment (PPE) is essential to don before entering the
room?
A. N95 respirator mask
B. Gown and gloves
C. Face shield and surgical mask
D. Sterile gown and clean gloves
Correct Answer: B
Rationale: Contact precautions require the use of a gown and gloves to prevent direct
contact with the patient and contaminated surfaces, as MRSA spreads primarily via
skin-to-skin contact or touching contaminated objects.
Q2: The nurse receives a new admission and notes that the patient has a "Do Not
Resuscitate" (DNR) order in their chart. The patient’s daughter approaches the nurse
frantically and says, "You have to do everything if dad stops breathing!" What is the
nurse’s best initial response?
A. "I’m sorry, but the legal document states we cannot perform CPR."
B. "Let’s step into the conference room to discuss your father’s wishes and the orders in
place."
C. "Your father signed this paper, so we must follow it whether you like it or not."
D. "I will call the doctor to see if the order can be cancelled right now."
Correct Answer: B
Rationale: The nurse must show empathy and provide clear communication while
addressing the family’s concerns; discussing the specifics of the order and the patient’s
wishes in a private setting is the most appropriate action.
Q3: Which task is most appropriate for the nurse to delegate to an unlicensed assistive
personnel (UAP) working on a medical-surgical unit?
A. Measuring the output of a patient who just returned from hemodialysis
B. Administering a dose of a stool softener to a stable patient
C. Performing a sterile dressing change on a central line site
D. Educating a patient on how to use a incentive spirometer
Correct Answer: A
,Rationale: Measuring intake and output is a standard care task that falls within the
scope of practice for a UAP; the other options require assessment skills, sterile
technique, or patient education that must be performed by a licensed nurse.
Q4: A nurse is preparing to administer a controlled substance via IV push. Which safety
measure is most critical to prevent medication errors and maintain legal standards?
A. Asking a colleague to double-check the dosage and calculation
B. Checking the patient's ID band after administering the medication
C. Preparing the medication at the bedside in front of the patient
D. Documenting the administration prior to giving the drug
Correct Answer: A
Rationale: Facility protocols and legal standards typically require an independent
double-check of controlled substances by a second licensed nurse to ensure the right
drug and dose are given, preventing potentially lethal errors.
Q5: The nurse is caring for a patient who speaks limited English and needs to sign a
consent form for surgery. An interpreter is available via video call. How should the nurse
proceed?
A. Ask the patient’s teenage son to translate to save time
B. Use the interpreter to explain the procedure and verify understanding before signing
C. Have the patient sign the form and rely on the doctor to explain later
D. Translate the key points themselves using simple medical terms
Correct Answer: B
Rationale: Using a qualified medical interpreter ensures accurate communication of
risks and benefits; family members should be avoided due to potential misinterpretation
and conflicts of interest.
Q6: A patient throws a water pitcher at the nurse, narrowly missing their head. The
nurse documents the incident. Which action is required regarding the documentation?
A. Document only the objective facts, including the patient’s quote
B. Include personal opinions about the patient’s mental state
C. Do not document the incident since no injury occurred
D. Blame the nursing assistant for provoking the patient
Correct Answer: A
Rationale: Legal documentation must be objective, factual, and include specific details
about the event and the patient's behavior without including subjective opinions or
blaming others.
Q7: The nurse is performing hand hygiene. Which moment in the "Five Moments for
Hand Hygiene" is most critical to prevent cross-contamination between patients?
A. Before touching a patient
, B. After touching a patient
C. After body fluid exposure risk
D. Before clean/aseptic procedure
Correct Answer: A
B. B
C. C
D. D
Correct Answer: A
Rationale: While all moments are important, hand hygiene immediately before touching
a patient is the primary defense against transmitting pathogens from the environment or
healthcare worker's hands to the vulnerable patient.
Q8: A patient in isolation for Clostridioides difficile (C. diff) requires a blood pressure
check. The nurse finds the blood pressure cuff machine is broken in the room. What is
the correct action?
A. Bring the hallway machine into the room, clean it before leaving
B. Use a manual sphygmomanometer dedicated to the room only
C. Take the machine out of the room and wipe it with alcohol
D. Borrow a machine from the neighboring room
Correct Answer: B
Rationale: C. diff spores are not killed by alcohol; equipment should ideally be dedicated
to the room to prevent spreading spores, or cleaned with bleach-based products,
making the dedicated equipment the safest choice.
Q9: A nurse is supervising a float nurse who is not familiar with the unit. The float nurse
asks to take a patient assignment that includes a patient receiving a blood transfusion.
What is the charge nurse’s best response?
A. "Sure, as long as you know how to monitor for reactions."
B. "No, I cannot assign a patient with an unstable blood transfusion to a float nurse."
C. "I will assign you that patient, but I will check on you every 5 minutes."
D. "Take this other patient instead; they are stable and just need discharge teaching."
Correct Answer: D
Rationale: Assignment decisions should be based on patient stability and the nurse's
competency; assigning a float nurse to a stable patient with predictable needs ensures
safe care.
Q10: [Scenario] The charge nurse is making assignments for the shift. There is one
LPN and three UAPs on staff. Which patient should the charge nurse assign to the
LPN?
A. A patient admitted yesterday with rule-out stroke needing neuro checks every hour
B. A patient receiving total parenteral nutrition (TPN) via central line
Latest Version | Real Exam Questions & Correct Answers |
Pass Guaranteed - A+ Graded
Safe & Effective Care Environment – Delegation, Ethics, Legal, Infection Control
Q1: A patient with a methicillin-resistant Staphylococcus aureus (MRSA) infection is
placed on contact precautions. The nurse is preparing to collect a sputum specimen.
Which personal protective equipment (PPE) is essential to don before entering the
room?
A. N95 respirator mask
B. Gown and gloves
C. Face shield and surgical mask
D. Sterile gown and clean gloves
Correct Answer: B
Rationale: Contact precautions require the use of a gown and gloves to prevent direct
contact with the patient and contaminated surfaces, as MRSA spreads primarily via
skin-to-skin contact or touching contaminated objects.
Q2: The nurse receives a new admission and notes that the patient has a "Do Not
Resuscitate" (DNR) order in their chart. The patient’s daughter approaches the nurse
frantically and says, "You have to do everything if dad stops breathing!" What is the
nurse’s best initial response?
A. "I’m sorry, but the legal document states we cannot perform CPR."
B. "Let’s step into the conference room to discuss your father’s wishes and the orders in
place."
C. "Your father signed this paper, so we must follow it whether you like it or not."
D. "I will call the doctor to see if the order can be cancelled right now."
Correct Answer: B
Rationale: The nurse must show empathy and provide clear communication while
addressing the family’s concerns; discussing the specifics of the order and the patient’s
wishes in a private setting is the most appropriate action.
Q3: Which task is most appropriate for the nurse to delegate to an unlicensed assistive
personnel (UAP) working on a medical-surgical unit?
A. Measuring the output of a patient who just returned from hemodialysis
B. Administering a dose of a stool softener to a stable patient
C. Performing a sterile dressing change on a central line site
D. Educating a patient on how to use a incentive spirometer
Correct Answer: A
,Rationale: Measuring intake and output is a standard care task that falls within the
scope of practice for a UAP; the other options require assessment skills, sterile
technique, or patient education that must be performed by a licensed nurse.
Q4: A nurse is preparing to administer a controlled substance via IV push. Which safety
measure is most critical to prevent medication errors and maintain legal standards?
A. Asking a colleague to double-check the dosage and calculation
B. Checking the patient's ID band after administering the medication
C. Preparing the medication at the bedside in front of the patient
D. Documenting the administration prior to giving the drug
Correct Answer: A
Rationale: Facility protocols and legal standards typically require an independent
double-check of controlled substances by a second licensed nurse to ensure the right
drug and dose are given, preventing potentially lethal errors.
Q5: The nurse is caring for a patient who speaks limited English and needs to sign a
consent form for surgery. An interpreter is available via video call. How should the nurse
proceed?
A. Ask the patient’s teenage son to translate to save time
B. Use the interpreter to explain the procedure and verify understanding before signing
C. Have the patient sign the form and rely on the doctor to explain later
D. Translate the key points themselves using simple medical terms
Correct Answer: B
Rationale: Using a qualified medical interpreter ensures accurate communication of
risks and benefits; family members should be avoided due to potential misinterpretation
and conflicts of interest.
Q6: A patient throws a water pitcher at the nurse, narrowly missing their head. The
nurse documents the incident. Which action is required regarding the documentation?
A. Document only the objective facts, including the patient’s quote
B. Include personal opinions about the patient’s mental state
C. Do not document the incident since no injury occurred
D. Blame the nursing assistant for provoking the patient
Correct Answer: A
Rationale: Legal documentation must be objective, factual, and include specific details
about the event and the patient's behavior without including subjective opinions or
blaming others.
Q7: The nurse is performing hand hygiene. Which moment in the "Five Moments for
Hand Hygiene" is most critical to prevent cross-contamination between patients?
A. Before touching a patient
, B. After touching a patient
C. After body fluid exposure risk
D. Before clean/aseptic procedure
Correct Answer: A
B. B
C. C
D. D
Correct Answer: A
Rationale: While all moments are important, hand hygiene immediately before touching
a patient is the primary defense against transmitting pathogens from the environment or
healthcare worker's hands to the vulnerable patient.
Q8: A patient in isolation for Clostridioides difficile (C. diff) requires a blood pressure
check. The nurse finds the blood pressure cuff machine is broken in the room. What is
the correct action?
A. Bring the hallway machine into the room, clean it before leaving
B. Use a manual sphygmomanometer dedicated to the room only
C. Take the machine out of the room and wipe it with alcohol
D. Borrow a machine from the neighboring room
Correct Answer: B
Rationale: C. diff spores are not killed by alcohol; equipment should ideally be dedicated
to the room to prevent spreading spores, or cleaned with bleach-based products,
making the dedicated equipment the safest choice.
Q9: A nurse is supervising a float nurse who is not familiar with the unit. The float nurse
asks to take a patient assignment that includes a patient receiving a blood transfusion.
What is the charge nurse’s best response?
A. "Sure, as long as you know how to monitor for reactions."
B. "No, I cannot assign a patient with an unstable blood transfusion to a float nurse."
C. "I will assign you that patient, but I will check on you every 5 minutes."
D. "Take this other patient instead; they are stable and just need discharge teaching."
Correct Answer: D
Rationale: Assignment decisions should be based on patient stability and the nurse's
competency; assigning a float nurse to a stable patient with predictable needs ensures
safe care.
Q10: [Scenario] The charge nurse is making assignments for the shift. There is one
LPN and three UAPs on staff. Which patient should the charge nurse assign to the
LPN?
A. A patient admitted yesterday with rule-out stroke needing neuro checks every hour
B. A patient receiving total parenteral nutrition (TPN) via central line
