NR-224 – Fundamentals of Nursing Foundational
nursing course covering basic patient care principles,
safety practices, nursing processes, communication,
professionalism, and clinical skills.
1. A nurse is caring for a patient on contact precautions. Which action
demonstrates correct technique when removing PPE?
• A) Remove gloves first, then gown, then mask, then perform hand hygiene
• B) Remove gown first, then gloves, then mask, then perform hand hygiene
• C) Remove mask first, then gloves, then gown, then perform hand hygiene
• D) Remove gloves and gown together, then mask, then perform hand
hygiene
Answer: A
Rationale: The correct sequence is gloves first (most contaminated), then gown,
then mask. Hand hygiene must be performed after removing all PPE. Removing
gloves first prevents contamination of hands when removing other PPE.
2. A patient has been placed on airborne precautions. Which PPE is essential
when entering the room?
• A) Surgical mask and gloves
• B) N95 respirator mask, gloves, gown, and eye protection
• C) Gloves and gown only
• D) N95 respirator mask only
Answer: B
Rationale: Airborne precautions require an N95 respirator (or higher) because
pathogens like TB, measles, and varicella remain infectious in air for prolonged
periods. Full PPE includes gloves, gown, and eye protection if splash risk exists.
,3. A nurse is preparing to insert a urinary catheter. After opening the sterile
kit, the nurse drops the sterile drape on the floor. What is the appropriate
action?
• A) Pick up the drape and continue because it was not touching the patient
• B) Use the drape but fold the contaminated edge under
• C) Discard the entire kit and obtain a new one
• D) Continue using the kit but avoid using the drape
Answer: C
Rationale: Once sterility is compromised (drape touching the floor), the item
cannot be used. The entire kit must be discarded as contaminating one item in a
sterile field contaminates the entire field.
4. A nurse is performing hand hygiene. Which statement indicates correct
understanding of proper technique?
• A) "I can use alcohol-based hand rub if my hands are visibly soiled"
• B) "I should wash my hands for at least 15 seconds using soap and water"
• C) "Hand sanitizer is effective against C. diff spores"
• D) "Fingernails should be kept longer than 1/4 inch for better cleaning"
Answer: B
Rationale: CDC recommends washing with soap and water for at least 15-20
seconds. Alcohol-based hand rub is ineffective against C. diff and not for visibly
soiled hands. Nails should be kept short (less than 1/4 inch).
5. A patient on fall precautions needs to use the bathroom at night. What is
the nurse's priority action?
• A) Tell the patient to call for assistance and wait for staff
• B) Place the bedpan on the bedside table
• C) Leave the call light within reach and dim the lights
• D) Apply a restraint to prevent the patient from getting up
,Answer: A
Rationale: Patient safety is paramount. The patient should call for assistance to
prevent falls. Restraints require an order and are last resort. Bedpan may be offered
as alternative, but patient request indicates desire to ambulate to bathroom.
6. A fire occurs in a patient's room. What is the correct order of actions using
RACE?
• A) Extinguish, Alarm, Contain, Evacuate
• B) Rescue, Alarm, Contain, Extinguish
• C) Alarm, Rescue, Contain, Extinguish
• D) Rescue, Contain, Alarm, Extinguish
Answer: B
Rationale: RACE = Rescue anyone in immediate danger, Alarm (activate fire
alarm), Contain the fire (close doors/windows), Extinguish (use fire extinguisher)
or Evacuate.
7. A nurse is applying wrist restraints to a confused patient. Which action is
essential?
• A) Tie restraints to the side rail for easy access
• B) Apply restraints tightly to prevent slipping off
• C) Secure restraints to the bed frame with a quick-release knot
• D) Remove restraints every 4 hours for skin assessment
Answer: C
Rationale: Restraints must be secured to the bed frame (not side rails) using a
quick-release knot for emergency removal. Restraints should allow two fingers of
space and be removed every 2 hours for assessment and range of motion.
8. Which patient is at HIGHEST risk for a hospital-acquired infection?
• A) 25-year-old with a broken arm
, • B) 68-year-old with an indwelling urinary catheter and diabetes
• C) 40-year-old with hypertension
• D) 30-year-old post-appendectomy day 2
Answer: B
Rationale: Elderly, diabetic, and catheterized patients have multiple risk factors:
advanced age (immunosenescence), diabetes (impaired immunity), and indwelling
catheter (breach in natural defenses).
9. A nurse is educating about standard precautions. Which body fluid
requires these precautions regardless of visible blood?
• A) Tears
• B) Sweat
• C) Cerebrospinal fluid
• D) Saliva (non-bloody)
Answer: C
Rationale: Cerebrospinal fluid, amniotic fluid, semen, vaginal secretions, synovial
fluid, pleural fluid, and pericardial fluid require standard precautions. Tears, sweat,
and non-bloody saliva are exceptions unless visibly bloody.
10. A patient has a Clostridium difficile infection. Which hand hygiene
method is correct?
• A) Alcohol-based hand rub only
• B) Soap and water only
• C) Either alcohol rub or soap and water
• D) Chlorhexidine wipes
Answer: B
Rationale: Alcohol-based hand rub is ineffective against C. diff spores.
Mechanical friction and rinsing with soap and water are required to physically
remove spores.
nursing course covering basic patient care principles,
safety practices, nursing processes, communication,
professionalism, and clinical skills.
1. A nurse is caring for a patient on contact precautions. Which action
demonstrates correct technique when removing PPE?
• A) Remove gloves first, then gown, then mask, then perform hand hygiene
• B) Remove gown first, then gloves, then mask, then perform hand hygiene
• C) Remove mask first, then gloves, then gown, then perform hand hygiene
• D) Remove gloves and gown together, then mask, then perform hand
hygiene
Answer: A
Rationale: The correct sequence is gloves first (most contaminated), then gown,
then mask. Hand hygiene must be performed after removing all PPE. Removing
gloves first prevents contamination of hands when removing other PPE.
2. A patient has been placed on airborne precautions. Which PPE is essential
when entering the room?
• A) Surgical mask and gloves
• B) N95 respirator mask, gloves, gown, and eye protection
• C) Gloves and gown only
• D) N95 respirator mask only
Answer: B
Rationale: Airborne precautions require an N95 respirator (or higher) because
pathogens like TB, measles, and varicella remain infectious in air for prolonged
periods. Full PPE includes gloves, gown, and eye protection if splash risk exists.
,3. A nurse is preparing to insert a urinary catheter. After opening the sterile
kit, the nurse drops the sterile drape on the floor. What is the appropriate
action?
• A) Pick up the drape and continue because it was not touching the patient
• B) Use the drape but fold the contaminated edge under
• C) Discard the entire kit and obtain a new one
• D) Continue using the kit but avoid using the drape
Answer: C
Rationale: Once sterility is compromised (drape touching the floor), the item
cannot be used. The entire kit must be discarded as contaminating one item in a
sterile field contaminates the entire field.
4. A nurse is performing hand hygiene. Which statement indicates correct
understanding of proper technique?
• A) "I can use alcohol-based hand rub if my hands are visibly soiled"
• B) "I should wash my hands for at least 15 seconds using soap and water"
• C) "Hand sanitizer is effective against C. diff spores"
• D) "Fingernails should be kept longer than 1/4 inch for better cleaning"
Answer: B
Rationale: CDC recommends washing with soap and water for at least 15-20
seconds. Alcohol-based hand rub is ineffective against C. diff and not for visibly
soiled hands. Nails should be kept short (less than 1/4 inch).
5. A patient on fall precautions needs to use the bathroom at night. What is
the nurse's priority action?
• A) Tell the patient to call for assistance and wait for staff
• B) Place the bedpan on the bedside table
• C) Leave the call light within reach and dim the lights
• D) Apply a restraint to prevent the patient from getting up
,Answer: A
Rationale: Patient safety is paramount. The patient should call for assistance to
prevent falls. Restraints require an order and are last resort. Bedpan may be offered
as alternative, but patient request indicates desire to ambulate to bathroom.
6. A fire occurs in a patient's room. What is the correct order of actions using
RACE?
• A) Extinguish, Alarm, Contain, Evacuate
• B) Rescue, Alarm, Contain, Extinguish
• C) Alarm, Rescue, Contain, Extinguish
• D) Rescue, Contain, Alarm, Extinguish
Answer: B
Rationale: RACE = Rescue anyone in immediate danger, Alarm (activate fire
alarm), Contain the fire (close doors/windows), Extinguish (use fire extinguisher)
or Evacuate.
7. A nurse is applying wrist restraints to a confused patient. Which action is
essential?
• A) Tie restraints to the side rail for easy access
• B) Apply restraints tightly to prevent slipping off
• C) Secure restraints to the bed frame with a quick-release knot
• D) Remove restraints every 4 hours for skin assessment
Answer: C
Rationale: Restraints must be secured to the bed frame (not side rails) using a
quick-release knot for emergency removal. Restraints should allow two fingers of
space and be removed every 2 hours for assessment and range of motion.
8. Which patient is at HIGHEST risk for a hospital-acquired infection?
• A) 25-year-old with a broken arm
, • B) 68-year-old with an indwelling urinary catheter and diabetes
• C) 40-year-old with hypertension
• D) 30-year-old post-appendectomy day 2
Answer: B
Rationale: Elderly, diabetic, and catheterized patients have multiple risk factors:
advanced age (immunosenescence), diabetes (impaired immunity), and indwelling
catheter (breach in natural defenses).
9. A nurse is educating about standard precautions. Which body fluid
requires these precautions regardless of visible blood?
• A) Tears
• B) Sweat
• C) Cerebrospinal fluid
• D) Saliva (non-bloody)
Answer: C
Rationale: Cerebrospinal fluid, amniotic fluid, semen, vaginal secretions, synovial
fluid, pleural fluid, and pericardial fluid require standard precautions. Tears, sweat,
and non-bloody saliva are exceptions unless visibly bloody.
10. A patient has a Clostridium difficile infection. Which hand hygiene
method is correct?
• A) Alcohol-based hand rub only
• B) Soap and water only
• C) Either alcohol rub or soap and water
• D) Chlorhexidine wipes
Answer: B
Rationale: Alcohol-based hand rub is ineffective against C. diff spores.
Mechanical friction and rinsing with soap and water are required to physically
remove spores.
