NACE Foundations of Nursing Exam | 2026/2027
NACE FOUNDATIONS OF NURSING EXAM
2026/2027 Edition
75 Questions with Correct Answers and Rationales
Domain Questions Points
Basic Nursing Skills & Patient Care 1-8
Infection Control & Safety Protocols 9-16
Medication Administration & Rights 17-24
Vital Signs & Physical Assessment Fundamentals 25-32
Nursing Process & Clinical Judgment 33-40
Communication & Therapeutic Relationships 41-48
Legal/Ethical Principles in Nursing 49-56
Documentation Standards 57-64
Cultural Competence & Patient Advocacy 65-72
NCLEX-RN Readiness Strategies 68-75
TOTAL 1-75 75
Instructions
• This examination consists of 75 multiple-choice questions covering 10 foundational nursing domains.
• Select the single best answer for each question. Each correct answer is worth 1 point (Total: 75 points).
• Correct answers are displayed in bold cyan with a detailed clinical rationale following each question.
• All questions are aligned with NACE/ATI foundational test plans and NCSBN competency standards.
• Focus on the key words in each question stem and prioritize using ABCs and Maslow's hierarchy when
applicable.
Name: Date: ________________________ Score: _______ / 75
________________________
Domain 1: Basic Nursing Skills & Patient Care
1
, NACE Foundations of Nursing Exam | 2026/2027
1. A nurse is assisting a patient with a bed bath. Which action demonstrates proper technique?
A. Starting at the feet and working upward
B. Washing from the cleanest area to the dirtiest
C. Using a single washcloth for the entire bath
D. Applying lotion before the skin is completely dry
Correct Answer: B. Washing from the cleanest area to the dirtiest
Rationale: Washing from the cleanest to the dirtiest area (typically from distal to proximal on each extremity) prevents
cross-contamination. This approach aligns with standard infection control principles and NCSBN guidelines for patient
hygiene.
2. When repositioning an immobile patient in bed, which action is most important to prevent injury to both the
patient and the nurse?
A. Performing the move as quickly as possible
B. Using proper body mechanics by keeping the load close to the body
C. Asking the patient to help by pulling on the side rails
D. Raising the head of the bed to a 90-degree angle first
Correct Answer: B. Using proper body mechanics by keeping the load close to the body
Rationale: Keeping the load close to the center of gravity and using the legs rather than the back are foundational body
mechanics principles. This reduces the risk of musculoskeletal injury to the nurse and prevents shearing forces on the
patient's skin.
3. A nurse is caring for a postoperative patient who has not voided for 8 hours. What is the most appropriate initial
nursing intervention?
A. Insert a straight catheter immediately
B. Assess for bladder distension and palpate the suprapubic area
C. Administer IV fluids rapidly
D. Document the finding and reassess in 4 hours
Correct Answer: B. Assess for bladder distension and palpate the suprapubic area
Rationale: The nursing process begins with assessment. Bladder distension should be evaluated before proceeding to
invasive measures such as catheterization. Interventions should follow the principle of least invasiveness.
4. Which of the following is the correct way to apply anti-embolism stockings (TED hose) to a patient?
A. Pull them up as high as possible without measuring the leg
B. Ensure the heel is correctly positioned in the heel pocket before pulling upward
C. Apply them only during the daytime and remove at night
D. Choose a size based on the patient's shoe size
Correct Answer: B. Ensure the heel is correctly positioned in the heel pocket before pulling upward
Rationale: Proper positioning of the heel in the designated heel pocket prevents the stocking from causing pressure
injuries and ensures uniform compression. Sizing should be based on leg measurements, not shoe size.
5. A patient is on bed rest with a physician's order for progressive mobility. Which sequence best represents the
appropriate progression of activity?
A. Ambulation, standing at bedside, sitting on edge of bed, dangling legs
2
, NACE Foundations of Nursing Exam | 2026/2027
B. Dangling legs, sitting on edge of bed, standing at bedside, ambulation
C. Passive ROM exercises, active ROM exercises, ambulation, dangling legs
D. Standing at bedside, dangling legs, passive ROM exercises, ambulation
Correct Answer: B. Dangling legs, sitting on edge of bed, standing at bedside, ambulation
Rationale: Progressive mobility follows a stepwise increase in activity tolerance. Dangling legs first allows the patient
to adjust to orthostatic changes before progressing to sitting, standing, and eventually ambulating.
6. A nurse is providing oral care to an unconscious patient. Which intervention is essential for patient safety?
A. Positioning the patient supine with the head tilted back
B. Placing the patient in a lateral (side-lying) position
C. Using mouthwash instead of normal saline for rinsing
D. Inserting the toothbrush as far back as possible for thorough cleaning
Correct Answer: B. Placing the patient in a lateral (side-lying) position
Rationale: Placing the unconscious patient in a lateral position prevents aspiration of oral secretions and cleaning
solutions. The supine position with head tilted back increases aspiration risk significantly.
7. A patient has a stage II pressure injury on the sacrum. Which nursing intervention is most appropriate?
A. Applying a transparent film dressing and repositioning every 4 hours
B. Cleaning the wound with hydrogen peroxide and covering with a dry gauze
C. Applying a hydrocolloid dressing and repositioning the patient at least every 2 hours
D. Massaging the reddened area around the wound to promote circulation
Correct Answer: C. Applying a hydrocolloid dressing and repositioning the patient at least every 2 hours
Rationale: Hydrocolloid dressings maintain a moist wound healing environment appropriate for stage II pressure
injuries. Repositioning every 2 hours relieves pressure. Massaging reddened areas is contraindicated as it can damage
already compromised tissue.
8. Which nursing action is most effective in preventing patient falls in the hospital setting?
A. Keeping all four side rails raised at all times
B. Using a standardized fall risk assessment tool on admission and with each shift
C. Restraining the patient to the bed as a precaution
D. Encouraging family members to stay with the patient at all times
Correct Answer: B. Using a standardized fall risk assessment tool on admission and with each shift
Rationale: Standardized fall risk assessment tools (e.g., Morse Fall Scale) allow for early identification of at-risk
patients and implementation of targeted interventions. Routine restraint use is unethical and can increase agitation and
injury risk.
Domain 2: Infection Control & Safety Protocols
9. According to the CDC's Standard Precautions, when should a healthcare worker perform hand hygiene?
A. Only before and after direct contact with blood and body fluids
B. Before and after all patient contact, after contact with body fluids, and after removing gloves
C. Only when hands are visibly soiled
D. After caring for patients on contact precautions only
3
NACE FOUNDATIONS OF NURSING EXAM
2026/2027 Edition
75 Questions with Correct Answers and Rationales
Domain Questions Points
Basic Nursing Skills & Patient Care 1-8
Infection Control & Safety Protocols 9-16
Medication Administration & Rights 17-24
Vital Signs & Physical Assessment Fundamentals 25-32
Nursing Process & Clinical Judgment 33-40
Communication & Therapeutic Relationships 41-48
Legal/Ethical Principles in Nursing 49-56
Documentation Standards 57-64
Cultural Competence & Patient Advocacy 65-72
NCLEX-RN Readiness Strategies 68-75
TOTAL 1-75 75
Instructions
• This examination consists of 75 multiple-choice questions covering 10 foundational nursing domains.
• Select the single best answer for each question. Each correct answer is worth 1 point (Total: 75 points).
• Correct answers are displayed in bold cyan with a detailed clinical rationale following each question.
• All questions are aligned with NACE/ATI foundational test plans and NCSBN competency standards.
• Focus on the key words in each question stem and prioritize using ABCs and Maslow's hierarchy when
applicable.
Name: Date: ________________________ Score: _______ / 75
________________________
Domain 1: Basic Nursing Skills & Patient Care
1
, NACE Foundations of Nursing Exam | 2026/2027
1. A nurse is assisting a patient with a bed bath. Which action demonstrates proper technique?
A. Starting at the feet and working upward
B. Washing from the cleanest area to the dirtiest
C. Using a single washcloth for the entire bath
D. Applying lotion before the skin is completely dry
Correct Answer: B. Washing from the cleanest area to the dirtiest
Rationale: Washing from the cleanest to the dirtiest area (typically from distal to proximal on each extremity) prevents
cross-contamination. This approach aligns with standard infection control principles and NCSBN guidelines for patient
hygiene.
2. When repositioning an immobile patient in bed, which action is most important to prevent injury to both the
patient and the nurse?
A. Performing the move as quickly as possible
B. Using proper body mechanics by keeping the load close to the body
C. Asking the patient to help by pulling on the side rails
D. Raising the head of the bed to a 90-degree angle first
Correct Answer: B. Using proper body mechanics by keeping the load close to the body
Rationale: Keeping the load close to the center of gravity and using the legs rather than the back are foundational body
mechanics principles. This reduces the risk of musculoskeletal injury to the nurse and prevents shearing forces on the
patient's skin.
3. A nurse is caring for a postoperative patient who has not voided for 8 hours. What is the most appropriate initial
nursing intervention?
A. Insert a straight catheter immediately
B. Assess for bladder distension and palpate the suprapubic area
C. Administer IV fluids rapidly
D. Document the finding and reassess in 4 hours
Correct Answer: B. Assess for bladder distension and palpate the suprapubic area
Rationale: The nursing process begins with assessment. Bladder distension should be evaluated before proceeding to
invasive measures such as catheterization. Interventions should follow the principle of least invasiveness.
4. Which of the following is the correct way to apply anti-embolism stockings (TED hose) to a patient?
A. Pull them up as high as possible without measuring the leg
B. Ensure the heel is correctly positioned in the heel pocket before pulling upward
C. Apply them only during the daytime and remove at night
D. Choose a size based on the patient's shoe size
Correct Answer: B. Ensure the heel is correctly positioned in the heel pocket before pulling upward
Rationale: Proper positioning of the heel in the designated heel pocket prevents the stocking from causing pressure
injuries and ensures uniform compression. Sizing should be based on leg measurements, not shoe size.
5. A patient is on bed rest with a physician's order for progressive mobility. Which sequence best represents the
appropriate progression of activity?
A. Ambulation, standing at bedside, sitting on edge of bed, dangling legs
2
, NACE Foundations of Nursing Exam | 2026/2027
B. Dangling legs, sitting on edge of bed, standing at bedside, ambulation
C. Passive ROM exercises, active ROM exercises, ambulation, dangling legs
D. Standing at bedside, dangling legs, passive ROM exercises, ambulation
Correct Answer: B. Dangling legs, sitting on edge of bed, standing at bedside, ambulation
Rationale: Progressive mobility follows a stepwise increase in activity tolerance. Dangling legs first allows the patient
to adjust to orthostatic changes before progressing to sitting, standing, and eventually ambulating.
6. A nurse is providing oral care to an unconscious patient. Which intervention is essential for patient safety?
A. Positioning the patient supine with the head tilted back
B. Placing the patient in a lateral (side-lying) position
C. Using mouthwash instead of normal saline for rinsing
D. Inserting the toothbrush as far back as possible for thorough cleaning
Correct Answer: B. Placing the patient in a lateral (side-lying) position
Rationale: Placing the unconscious patient in a lateral position prevents aspiration of oral secretions and cleaning
solutions. The supine position with head tilted back increases aspiration risk significantly.
7. A patient has a stage II pressure injury on the sacrum. Which nursing intervention is most appropriate?
A. Applying a transparent film dressing and repositioning every 4 hours
B. Cleaning the wound with hydrogen peroxide and covering with a dry gauze
C. Applying a hydrocolloid dressing and repositioning the patient at least every 2 hours
D. Massaging the reddened area around the wound to promote circulation
Correct Answer: C. Applying a hydrocolloid dressing and repositioning the patient at least every 2 hours
Rationale: Hydrocolloid dressings maintain a moist wound healing environment appropriate for stage II pressure
injuries. Repositioning every 2 hours relieves pressure. Massaging reddened areas is contraindicated as it can damage
already compromised tissue.
8. Which nursing action is most effective in preventing patient falls in the hospital setting?
A. Keeping all four side rails raised at all times
B. Using a standardized fall risk assessment tool on admission and with each shift
C. Restraining the patient to the bed as a precaution
D. Encouraging family members to stay with the patient at all times
Correct Answer: B. Using a standardized fall risk assessment tool on admission and with each shift
Rationale: Standardized fall risk assessment tools (e.g., Morse Fall Scale) allow for early identification of at-risk
patients and implementation of targeted interventions. Routine restraint use is unethical and can increase agitation and
injury risk.
Domain 2: Infection Control & Safety Protocols
9. According to the CDC's Standard Precautions, when should a healthcare worker perform hand hygiene?
A. Only before and after direct contact with blood and body fluids
B. Before and after all patient contact, after contact with body fluids, and after removing gloves
C. Only when hands are visibly soiled
D. After caring for patients on contact precautions only
3
