NACE Foundations of Nursing Exam Review | 2026/2027
NACE Foundations of Nursing Exam Review
2026/2027 | 75 Questions and Correct Answers
Institutional Course Assessment | Introductory Clinical Competency & Professional Identity Formation
Instructions: This exam review contains 75 multiple-choice questions across five foundational nursing domains. Correct
answers are highlighted in bold blue. Each question includes a rationale grounded in evidence-based practice guidelines
(ANA, CDC, NCSBN, Joint Commission).
Self-Assessment Score Tracker
Domain Questions Score
I. Nursing Process, Professional Identity & Legal/Ethical Standards 1–20 /20
II. Communication, Cultural Humility & Therapeutic Relationships 21–32 /12
III. Safety, Infection Control & Vital Signs Assessment 33–50 /18
IV. Basic Care, Medication Principles & Documentation 51–65 /15
V. Health Promotion, Interprofessional Collaboration & Test Strategies 66–75 /10
Total 1–75 /75
Section I: Nursing Process, Professional Identity & Legal/Ethical Standards (Questions 1–20)
1. A nurse is caring for a patient admitted with dehydration. Which action by the nurse best demonstrates the
Assessment phase of the nursing process?
A) Administering IV fluids as prescribed B) Asking the patient about fluid intake over the
past 24 hours
C) Setting a goal for the patient to drink 2,000 mL D) Documenting that the patient received 500 mL of
daily IV fluid
Correct Answer: B) Asking the patient about fluid intake over the past 24 hours
Rationale: The Assessment phase involves collecting subjective and objective data to establish a patient database.
Asking about fluid intake directly gathers patient-reported data. Administering fluids is Implementation; setting goals
is Planning; and charting administered fluid is Evaluation/Documentation.
2. A patient states, "I feel like something terrible is going to happen." Which nursing diagnosis is most
appropriate?
A) Acute Pain B) Anxiety C) Risk for Falls D) Deficient Knowledge
Correct Answer: B) Anxiety
Rationale: The patient's expression of apprehension and dread aligns with the defining characteristics of Anxiety
(NANDA-I). Acute Pain requires reports of physical discomfort; Risk for Falls pertains to mobility/vulnerability
factors; Deficient Knowledge relates to a cognitive deficit, not an emotional one.
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, NACE Foundations of Nursing Exam Review | 2026/2027
3. Which statement reflects the Evaluation phase of the nursing process?
A) The patient will ambulate 50 feet by end of shift B) The nurse measures the patient's oxygen
saturation after repositioning
C) The nurse repositions the patient to improve D) The nurse identifies that the patient has impaired
oxygenation gas exchange
Correct Answer: B) The nurse measures the patient's oxygen saturation after repositioning
Rationale: Evaluation involves measuring patient outcomes against established goals and determining the
effectiveness of interventions. Measuring oxygen saturation after repositioning evaluates whether the intervention
achieved the desired outcome. Option A is Planning; C is Implementation; D is Diagnosis.
4. A nurse observes that a patient's wound dressing has serosanguineous drainage. In the NCSBN Clinical
Judgment Measurement Model (CJMM), which cognitive skill is the nurse demonstrating?
A) Generate Solutions B) Take Action C) Recognize Cues D) Evaluate Outcomes
Correct Answer: C) Recognize Cues
Rationale: Recognizing Cues involves identifying relevant clinical data from assessments. Noting the type and
presence of wound drainage is identifying a clinical cue. Generate Solutions and Take Action occur later; Evaluate
Outcomes follows intervention.
5. A registered nurse (RN) delegates vital sign measurement to an unlicensed assistive personnel (UAP). Which
of the Five Rights of Delegation is violated if the RN does not clearly explain the expected frequency?
A) Right Task B) Right Circumstance C) Right D) Right Supervision
Direction/Communication
Correct Answer: C) Right Direction/Communication
Rationale: Right Direction/Communication requires that the delegator provide clear, specific instructions about the
task, including what to do, how to do it, and what to report. Failing to specify frequency violates this right. Right Task
and Right Circumstance concern task selection and patient condition appropriateness; Right Supervision involves
ongoing monitoring.
6. A nursing student accesses a patient's electronic health record out of personal curiosity, not related to any
assigned care. Which legal principle has been violated?
A) Informed Consent B) Mandatory Reporting C) HIPAA Privacy Rule D) Nurse Practice Act
scope violation
Correct Answer: C) HIPAA Privacy Rule
Rationale: The HIPAA Privacy Rule (1996) protects patients' protected health information (PHI) from unauthorized
access. Viewing records without a care-related need constitutes an unauthorized access and is a HIPAA violation.
Informed Consent relates to procedure authorization; Mandatory Reporting concerns suspected abuse; scope of
practice relates to performing tasks beyond licensure.
7. A patient is scheduled for an invasive cardiac procedure but cannot explain the purpose or risks. What is the
nurse's most appropriate action?
A) Proceed with the procedure as scheduled B) Document that the patient lacks understanding
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, NACE Foundations of Nursing Exam Review | 2026/2027
C) Notify the healthcare provider before the D) Have the patient sign the consent form anyway
procedure
Correct Answer: C) Notify the healthcare provider before the procedure
Rationale: Informed consent requires that the patient understands the purpose, risks, benefits, and alternatives. If the
patient cannot demonstrate understanding, the nurse must notify the provider (who obtained consent) before
proceeding. Proceeding without valid consent is unethical and legally risky.
8. A nurse suspects that an elderly patient is being neglected by a family caregiver. Which action is required by
mandatory reporting laws?
A) Confront the family caregiver directly B) Document observations and report to the
appropriate agency
C) Wait for the patient to confirm the abuse before D) Discuss concerns with the patient's primary care
reporting provider only
Correct Answer: B) Document observations and report to the appropriate agency
Rationale: Mandatory reporting laws require nurses to report suspected abuse, neglect, or exploitation of vulnerable
populations to the designated agency (e.g., Adult Protective Services). The nurse does not need proof or patient
confirmation; reasonable suspicion is sufficient. Confrontation may endanger the patient.
9. Which provision of the ANA Code of Ethics most directly supports a nurse's obligation to maintain patient
confidentiality?
A) Provision 1: Respect for human dignity B) Provision 3: Protection of patient rights
C) Provision 5: Professional competence D) Provision 7: Advancing the profession
Correct Answer: B) Provision 3: Protection of patient rights
Rationale: ANA Code of Ethics Provision 3 specifically addresses the nurse's duty to protect patient rights, including
privacy and confidentiality. Provision 1 addresses dignity broadly; Provision 5 concerns competence; Provision 7
focuses on professional advancement through research and scholarship.
10. A nurse is assigned to care for five patients on a medical-surgical unit. One patient requires a blood
transfusion. Which task may the nurse delegate to the UAP?
A) Monitoring the blood transfusion for adverse B) Performing the initial pre-transfusion assessment
reactions
C) Obtaining the patient's vital signs 15 minutes D) Verifying the blood type and crossmatch
after transfusion starts
Correct Answer: C) Obtaining the patient's vital signs 15 minutes after transfusion starts
Rationale: UAPs may measure and report vital signs, including during a blood transfusion, as this falls within routine
measurement tasks with appropriate direction. However, the RN must assess the patient, monitor for reactions
(clinical judgment), and verify blood products. The UAP collects the data; the RN interprets it.
11. A nurse is prioritizing hypotheses using the CJMM framework. Which patient finding would be classified as
the most urgent cue?
A) A patient reports mild fatigue after ambulation B) A patient has a new-onset temperature of 38.9°C
(102°F)
3
NACE Foundations of Nursing Exam Review
2026/2027 | 75 Questions and Correct Answers
Institutional Course Assessment | Introductory Clinical Competency & Professional Identity Formation
Instructions: This exam review contains 75 multiple-choice questions across five foundational nursing domains. Correct
answers are highlighted in bold blue. Each question includes a rationale grounded in evidence-based practice guidelines
(ANA, CDC, NCSBN, Joint Commission).
Self-Assessment Score Tracker
Domain Questions Score
I. Nursing Process, Professional Identity & Legal/Ethical Standards 1–20 /20
II. Communication, Cultural Humility & Therapeutic Relationships 21–32 /12
III. Safety, Infection Control & Vital Signs Assessment 33–50 /18
IV. Basic Care, Medication Principles & Documentation 51–65 /15
V. Health Promotion, Interprofessional Collaboration & Test Strategies 66–75 /10
Total 1–75 /75
Section I: Nursing Process, Professional Identity & Legal/Ethical Standards (Questions 1–20)
1. A nurse is caring for a patient admitted with dehydration. Which action by the nurse best demonstrates the
Assessment phase of the nursing process?
A) Administering IV fluids as prescribed B) Asking the patient about fluid intake over the
past 24 hours
C) Setting a goal for the patient to drink 2,000 mL D) Documenting that the patient received 500 mL of
daily IV fluid
Correct Answer: B) Asking the patient about fluid intake over the past 24 hours
Rationale: The Assessment phase involves collecting subjective and objective data to establish a patient database.
Asking about fluid intake directly gathers patient-reported data. Administering fluids is Implementation; setting goals
is Planning; and charting administered fluid is Evaluation/Documentation.
2. A patient states, "I feel like something terrible is going to happen." Which nursing diagnosis is most
appropriate?
A) Acute Pain B) Anxiety C) Risk for Falls D) Deficient Knowledge
Correct Answer: B) Anxiety
Rationale: The patient's expression of apprehension and dread aligns with the defining characteristics of Anxiety
(NANDA-I). Acute Pain requires reports of physical discomfort; Risk for Falls pertains to mobility/vulnerability
factors; Deficient Knowledge relates to a cognitive deficit, not an emotional one.
1
, NACE Foundations of Nursing Exam Review | 2026/2027
3. Which statement reflects the Evaluation phase of the nursing process?
A) The patient will ambulate 50 feet by end of shift B) The nurse measures the patient's oxygen
saturation after repositioning
C) The nurse repositions the patient to improve D) The nurse identifies that the patient has impaired
oxygenation gas exchange
Correct Answer: B) The nurse measures the patient's oxygen saturation after repositioning
Rationale: Evaluation involves measuring patient outcomes against established goals and determining the
effectiveness of interventions. Measuring oxygen saturation after repositioning evaluates whether the intervention
achieved the desired outcome. Option A is Planning; C is Implementation; D is Diagnosis.
4. A nurse observes that a patient's wound dressing has serosanguineous drainage. In the NCSBN Clinical
Judgment Measurement Model (CJMM), which cognitive skill is the nurse demonstrating?
A) Generate Solutions B) Take Action C) Recognize Cues D) Evaluate Outcomes
Correct Answer: C) Recognize Cues
Rationale: Recognizing Cues involves identifying relevant clinical data from assessments. Noting the type and
presence of wound drainage is identifying a clinical cue. Generate Solutions and Take Action occur later; Evaluate
Outcomes follows intervention.
5. A registered nurse (RN) delegates vital sign measurement to an unlicensed assistive personnel (UAP). Which
of the Five Rights of Delegation is violated if the RN does not clearly explain the expected frequency?
A) Right Task B) Right Circumstance C) Right D) Right Supervision
Direction/Communication
Correct Answer: C) Right Direction/Communication
Rationale: Right Direction/Communication requires that the delegator provide clear, specific instructions about the
task, including what to do, how to do it, and what to report. Failing to specify frequency violates this right. Right Task
and Right Circumstance concern task selection and patient condition appropriateness; Right Supervision involves
ongoing monitoring.
6. A nursing student accesses a patient's electronic health record out of personal curiosity, not related to any
assigned care. Which legal principle has been violated?
A) Informed Consent B) Mandatory Reporting C) HIPAA Privacy Rule D) Nurse Practice Act
scope violation
Correct Answer: C) HIPAA Privacy Rule
Rationale: The HIPAA Privacy Rule (1996) protects patients' protected health information (PHI) from unauthorized
access. Viewing records without a care-related need constitutes an unauthorized access and is a HIPAA violation.
Informed Consent relates to procedure authorization; Mandatory Reporting concerns suspected abuse; scope of
practice relates to performing tasks beyond licensure.
7. A patient is scheduled for an invasive cardiac procedure but cannot explain the purpose or risks. What is the
nurse's most appropriate action?
A) Proceed with the procedure as scheduled B) Document that the patient lacks understanding
2
, NACE Foundations of Nursing Exam Review | 2026/2027
C) Notify the healthcare provider before the D) Have the patient sign the consent form anyway
procedure
Correct Answer: C) Notify the healthcare provider before the procedure
Rationale: Informed consent requires that the patient understands the purpose, risks, benefits, and alternatives. If the
patient cannot demonstrate understanding, the nurse must notify the provider (who obtained consent) before
proceeding. Proceeding without valid consent is unethical and legally risky.
8. A nurse suspects that an elderly patient is being neglected by a family caregiver. Which action is required by
mandatory reporting laws?
A) Confront the family caregiver directly B) Document observations and report to the
appropriate agency
C) Wait for the patient to confirm the abuse before D) Discuss concerns with the patient's primary care
reporting provider only
Correct Answer: B) Document observations and report to the appropriate agency
Rationale: Mandatory reporting laws require nurses to report suspected abuse, neglect, or exploitation of vulnerable
populations to the designated agency (e.g., Adult Protective Services). The nurse does not need proof or patient
confirmation; reasonable suspicion is sufficient. Confrontation may endanger the patient.
9. Which provision of the ANA Code of Ethics most directly supports a nurse's obligation to maintain patient
confidentiality?
A) Provision 1: Respect for human dignity B) Provision 3: Protection of patient rights
C) Provision 5: Professional competence D) Provision 7: Advancing the profession
Correct Answer: B) Provision 3: Protection of patient rights
Rationale: ANA Code of Ethics Provision 3 specifically addresses the nurse's duty to protect patient rights, including
privacy and confidentiality. Provision 1 addresses dignity broadly; Provision 5 concerns competence; Provision 7
focuses on professional advancement through research and scholarship.
10. A nurse is assigned to care for five patients on a medical-surgical unit. One patient requires a blood
transfusion. Which task may the nurse delegate to the UAP?
A) Monitoring the blood transfusion for adverse B) Performing the initial pre-transfusion assessment
reactions
C) Obtaining the patient's vital signs 15 minutes D) Verifying the blood type and crossmatch
after transfusion starts
Correct Answer: C) Obtaining the patient's vital signs 15 minutes after transfusion starts
Rationale: UAPs may measure and report vital signs, including during a blood transfusion, as this falls within routine
measurement tasks with appropriate direction. However, the RN must assess the patient, monitor for reactions
(clinical judgment), and verify blood products. The UAP collects the data; the RN interprets it.
11. A nurse is prioritizing hypotheses using the CJMM framework. Which patient finding would be classified as
the most urgent cue?
A) A patient reports mild fatigue after ambulation B) A patient has a new-onset temperature of 38.9°C
(102°F)
3
