HESI FUNDAMENTALS EXAM –
QUESTIONS (SPRING 2023–2026
UPDATED)
1. A nurse is caring for a client on contact precautions for Clostridioides difficile.
Which action is essential when providing care?
A) Wear an N95 respirator
B) Use alcohol-based hand rub after glove removal
C) Perform hand hygiene with soap and water after glove removal
D) Place the client in a negative-pressure room
Rationale: C. diff spores are not killed by alcohol-based hand rub; soap and water
must be used for mechanical removal. N95 is for airborne precautions. Negative
pressure is for airborne (TB, measles).
2. A nurse is preparing to insert a urinary catheter. Which technique maintains
sterile field?
A) Open the sterile kit and place the sterile drape on the bedside table
B) Don sterile gloves before opening the inner sterile wrapper
C) Pour sterile solution with the bottle cap facing downward
D) Use non-sterile gloves for the entire procedure
Rationale: Sterile gloves must be donned after opening the outer wrapper but
before handling the inner sterile wrapper. Pour solution with cap facing upward
(not downward). Non-sterile gloves are not acceptable for catheter insertion.
3. A client with tuberculosis is placed on airborne precautions. Which personal
protective equipment (PPE) is required when entering the room?
A) Surgical mask
B) N95 respirator
C) Gown and gloves only
D) Face shield
,Rationale: Airborne precautions require an N95 respirator (or PAPR). Surgical
masks are for droplet precautions. Gown/gloves are for contact precautions.
4. A nurse is disposing of a used needle. Which action prevents a needlestick
injury?
A) Recap the needle before disposal
B) Activate the safety device and discard into sharps container
C) Break the needle off before discarding
D) Place the uncapped needle into a red biohazard bag
Rationale: Safety devices must be activated immediately after use, and the entire
needle/syringe goes into a sharps container. Never recap, break, or overfill.
5. A client has a methicillin-resistant Staphylococcus aureus (MRSA) wound
infection. Which PPE is required?
A) N95 respirator and gown
B) Gown and gloves
C) Surgical mask and goggles
D) Face shield only
Rationale: MRSA requires contact precautions: gown and gloves for any room
entry. Mask is not needed unless risk of splash.
6. A nurse is performing hand hygiene before caring for a neutropenic client. How
long should the nurse rub hands with alcohol-based hand rub?
A) 5 seconds
B) 15–20 seconds
C) 1 minute
D) Until hands feel dry (usually 15–20 seconds)
Rationale: Alcohol-based hand rub should be applied to dry hands and rubbed
until dry, approximately 15–20 seconds. The total time is until dry, but the
question asks duration of rubbing.
,7. A nurse is placing a client on transmission-based precautions. Which infection
requires airborne precautions?
A) Influenza
B) Measles (rubeola)
C) Group A streptococcus
D) Respiratory syncytial virus (RSV)
Rationale: Measles, varicella (chickenpox), disseminated zoster, and TB require
airborne precautions. Influenza and strep are droplet; RSV is contact/droplet.
8. A nurse is caring for a client with an indwelling urinary catheter. Which action
best prevents catheter-associated urinary tract infection (CAUTI)?
A) Empty the drainage bag daily
B) Keep the drainage bag below the level of the bladder
C) Irrigate the catheter with sterile saline every shift
D) Change the catheter every 48 hours
Rationale: Keeping the bag below bladder level prevents backflow of urine.
Empty the bag when full (not just daily). Routine irrigation and scheduled changes
increase infection risk.
9. A nurse is preparing a sterile field for a dressing change. The nurse accidentally
touches the outer edge of the sterile drape. What should the nurse do?
A) Continue because the outer 1 inch is not sterile
B) Discard the drape and begin again with a new sterile field
C) Use sterile gloves to move the drape
D) Cover the contaminated area with sterile gauze
Rationale: The outer 1 inch of a sterile field is considered contaminated. However,
if the nurse's hand touched that edge, the field is broken. Discard and start over.
10. A client with hepatitis A is admitted. Which type of precautions should the
nurse initiate?
A) Airborne precautions
B) Droplet precautions
, C) Contact precautions
D) Standard precautions only
Rationale: Hepatitis A is transmitted via the fecal-oral route. Contact precautions
(gown, gloves) are used for diapered or incontinent clients. Standard precautions
alone are insufficient if the client is incontinent.
11. A nurse is removing personal protective equipment (PPE) after leaving a
client's room. Which item should be removed first?
A) Mask
B) Gloves
C) Gown
D) Eye protection
Rationale: Gloves are most contaminated and should be removed first, then
goggles/face shield, then gown, then mask (after leaving the room).
12. A client is on droplet precautions for bacterial meningitis. The nurse should
ensure that visitors:
A) Wear an N95 respirator
B) Stay at least 3 feet from the client
C) Wear a gown and gloves only
D) Avoid entering the room
Rationale: Droplet precautions require a surgical mask within 3 feet of the client.
Visitors should maintain 3 feet distance and wear a mask.
13. A nurse is caring for a client with a surgical wound infection. Which
observation indicates the wound is infected?
A) Serous drainage
B) Purulent drainage with foul odor
C) Well-approximated wound edges
D) Pink granulation tissue
QUESTIONS (SPRING 2023–2026
UPDATED)
1. A nurse is caring for a client on contact precautions for Clostridioides difficile.
Which action is essential when providing care?
A) Wear an N95 respirator
B) Use alcohol-based hand rub after glove removal
C) Perform hand hygiene with soap and water after glove removal
D) Place the client in a negative-pressure room
Rationale: C. diff spores are not killed by alcohol-based hand rub; soap and water
must be used for mechanical removal. N95 is for airborne precautions. Negative
pressure is for airborne (TB, measles).
2. A nurse is preparing to insert a urinary catheter. Which technique maintains
sterile field?
A) Open the sterile kit and place the sterile drape on the bedside table
B) Don sterile gloves before opening the inner sterile wrapper
C) Pour sterile solution with the bottle cap facing downward
D) Use non-sterile gloves for the entire procedure
Rationale: Sterile gloves must be donned after opening the outer wrapper but
before handling the inner sterile wrapper. Pour solution with cap facing upward
(not downward). Non-sterile gloves are not acceptable for catheter insertion.
3. A client with tuberculosis is placed on airborne precautions. Which personal
protective equipment (PPE) is required when entering the room?
A) Surgical mask
B) N95 respirator
C) Gown and gloves only
D) Face shield
,Rationale: Airborne precautions require an N95 respirator (or PAPR). Surgical
masks are for droplet precautions. Gown/gloves are for contact precautions.
4. A nurse is disposing of a used needle. Which action prevents a needlestick
injury?
A) Recap the needle before disposal
B) Activate the safety device and discard into sharps container
C) Break the needle off before discarding
D) Place the uncapped needle into a red biohazard bag
Rationale: Safety devices must be activated immediately after use, and the entire
needle/syringe goes into a sharps container. Never recap, break, or overfill.
5. A client has a methicillin-resistant Staphylococcus aureus (MRSA) wound
infection. Which PPE is required?
A) N95 respirator and gown
B) Gown and gloves
C) Surgical mask and goggles
D) Face shield only
Rationale: MRSA requires contact precautions: gown and gloves for any room
entry. Mask is not needed unless risk of splash.
6. A nurse is performing hand hygiene before caring for a neutropenic client. How
long should the nurse rub hands with alcohol-based hand rub?
A) 5 seconds
B) 15–20 seconds
C) 1 minute
D) Until hands feel dry (usually 15–20 seconds)
Rationale: Alcohol-based hand rub should be applied to dry hands and rubbed
until dry, approximately 15–20 seconds. The total time is until dry, but the
question asks duration of rubbing.
,7. A nurse is placing a client on transmission-based precautions. Which infection
requires airborne precautions?
A) Influenza
B) Measles (rubeola)
C) Group A streptococcus
D) Respiratory syncytial virus (RSV)
Rationale: Measles, varicella (chickenpox), disseminated zoster, and TB require
airborne precautions. Influenza and strep are droplet; RSV is contact/droplet.
8. A nurse is caring for a client with an indwelling urinary catheter. Which action
best prevents catheter-associated urinary tract infection (CAUTI)?
A) Empty the drainage bag daily
B) Keep the drainage bag below the level of the bladder
C) Irrigate the catheter with sterile saline every shift
D) Change the catheter every 48 hours
Rationale: Keeping the bag below bladder level prevents backflow of urine.
Empty the bag when full (not just daily). Routine irrigation and scheduled changes
increase infection risk.
9. A nurse is preparing a sterile field for a dressing change. The nurse accidentally
touches the outer edge of the sterile drape. What should the nurse do?
A) Continue because the outer 1 inch is not sterile
B) Discard the drape and begin again with a new sterile field
C) Use sterile gloves to move the drape
D) Cover the contaminated area with sterile gauze
Rationale: The outer 1 inch of a sterile field is considered contaminated. However,
if the nurse's hand touched that edge, the field is broken. Discard and start over.
10. A client with hepatitis A is admitted. Which type of precautions should the
nurse initiate?
A) Airborne precautions
B) Droplet precautions
, C) Contact precautions
D) Standard precautions only
Rationale: Hepatitis A is transmitted via the fecal-oral route. Contact precautions
(gown, gloves) are used for diapered or incontinent clients. Standard precautions
alone are insufficient if the client is incontinent.
11. A nurse is removing personal protective equipment (PPE) after leaving a
client's room. Which item should be removed first?
A) Mask
B) Gloves
C) Gown
D) Eye protection
Rationale: Gloves are most contaminated and should be removed first, then
goggles/face shield, then gown, then mask (after leaving the room).
12. A client is on droplet precautions for bacterial meningitis. The nurse should
ensure that visitors:
A) Wear an N95 respirator
B) Stay at least 3 feet from the client
C) Wear a gown and gloves only
D) Avoid entering the room
Rationale: Droplet precautions require a surgical mask within 3 feet of the client.
Visitors should maintain 3 feet distance and wear a mask.
13. A nurse is caring for a client with a surgical wound infection. Which
observation indicates the wound is infected?
A) Serous drainage
B) Purulent drainage with foul odor
C) Well-approximated wound edges
D) Pink granulation tissue
