HESI RN FUNDAMENTALS 2026 CORE MAIN EXAMS
QUESTIONS AND ANSWERS SURE A+
✔✔In developing a plan of care for a client with dementia, the nurse should remember
that confusion in the elderly
A. is to be expected, and progresses with age
B. often follows relocation to new surroundings
C. is a result of irreversible brain pathology
D. can be prevented with adequate sleep - ✔✔B. often follows relocation to new
surroundings (Relocation (B) often results in confusion among elderly clients-- moving is
stressful for anyone. (A) is stereotypical judgement. Stress in the elderly often manifests
itself as confusion, so (C) is wrong. Adequate sleep is not a prevention (D) for
confusion.)
✔✔A postoperative client will need to perform daily dressing changes after discharge.
Which outcome statement best demonstrates the client's readiness to manage his
wound care after discharge? The client
A. asks relevant questions regarding the dressing change
B. states he will be able to complete the wound care regimen
C. demonstrates the wound care procedure correctly
D. has all the necessary supplies for wound care - ✔✔C. demonstrates the wound care
procedure correctly
,(A return demonstration of a procedure (C) provides an objective assessment of the
client's ability to perform a task, while (A and B) are subjective measures. (D) is
important, but is less of a priority than the the nurse's assessment of the client's ability
to complete wound care.)
✔✔A client who is 5 '5" tall and weighs 200 pounds is scheduled for surgery the next
day. What question is most important for the nurse to include during the preoperative
assessment?
A. What is your daily calorie consumption?
B. What vitamin and mineral supplements do you take?"
C. "Do you feel that you are overweight?"
D. "Will a clear liquid diet be okay after surgery?" - ✔✔B. "What vitamin and mineral
supplements do you take?"
(Vitamin and mineral supplements (B) may impact medications used during the
operative period. (A and C) are appropriate questions for long-term dietary counseling.
The nature of the surgery and anesthesia will determine the need for a clear liquid diet
(D), rather than the client's preference.)
✔✔During the initial morning assessment, a male client denies dysuria but reports that
his urine appears dark amber. Which intervention should the nurse implement?
A. Provide additional coffee on the client's breakfast tray.
B. Exchange the client's grape juice for cranberry juice.
C. Bring the client additional fruit at mid-morning.
D. Encourage additional oral intake of juices and water. - ✔✔D. Encourage additional
oral intake of juices and water.
✔✔Which intervention is most important for the nurse to implement for a male client
who is experiencing urinary retention?
A. Apply a condom catheter
B. Apply a skin protectant
C. Encourage increased fluid intake
D. Assess for bladder distention - ✔✔D. Assess the bladder for distention (Urinary
retention is the inability to void all urine collected in the bladder, which leads to
uncomfortable bladder distention (D). (A and B) are useful actions to protect the skin of
a client with urinary incontinence. (C) may worsen the bladder distention.)
✔✔A client with acute hemorrhagic anemia is to receive four units of packed RBCs as
rapidly as possible. Which intervention is most important for the nurse to implement?
A. Obtain the pre-transfusion hemoglobin level.
B. Prime the tubing and prepare a blood pump set-up
C. Monitor vital signs q 15 min for the first hour.
D. Ensure the accuracy of the blood type match. - ✔✔D. Ensure the accuracy of the
blood type match.
, (ALL interventions should be implemented prior to administering blood, but (D) has the
highest priority. Any time blood is administered the nurse should ensure the accuracy of
the blood type match in order to prevent a possible hemolytic reaction.)
✔✔A male client being discharged with a prescription for the bronchodilator theophylline
tells the nurse that he understands he is to take three doses of the medication each
day. Since, at the time of discharge, time-released capsules are not available, which
dosing schedule should the nurse advise the client to follow? - ✔✔8 AM, 4 PM, and
midnight
(Theophylline should be administered on a regular around the clock schedule to provide
the best bronchodilating effect and reduce the potential for adverse effects.)
✔✔A client is to receive 10 mEq of KCl diluted in 250 mL of normal saline over 4 hours.
At what rate should the nurse set the client's intravenous infusion pump? - ✔✔63 mL/hr
✔✔When evaluating a client's plan of care, the nurse determines that a desire outcome
was not achieved. Which action should the nurse implement first?
A. Establish a new nursing diagnosis.
B. Note which actions were not implemented.
C. Add additional nursing orders to the plan.
D. Collaborate with the HCP to make changes. - ✔✔B. Note which actions were not
implemented.
(First, the nurse should review which actions in the original plan were not implemented
(B) in order to determine why the original plan did not produce the desired outcome.
Appropriate revisions can then be made, which may include revising the expected
outcome, or identifying a new nursing diagnosis (A). (C) may be needed if the nursing
actions were unsuccessful, or were unable to be implemented. (D) other members of
the healthcare team may be necessary to collaborate changes once the nurse
determines why the original plan did not produce the desired outcome.
✔✔Which snack food is best for the nurse to provide a client with myasthenia graves
who is at risk for altered nutritional status?
A. chocolate pudding
B. graham crackers
C. sugar free gelatin
D. apple slices - ✔✔A. chocolate pudding
(The client with myasthenia graves is at high risk for altered nutrition because of fatigue
and muscle weakness resulting in dysphagia. Snacks that are semisolid, such as
pudding (A) are easy to swallow and require minimal chewing effort, and provide
calories and protein. (C) does not provide any nutritional value. (B and D) require
energy to chew and are more difficult to swallow than pudding.)
✔✔The nurse is instructing a client with high cholesterol about diet and life style
modification. What comment from the client indicates that the teaching has been
effective?
QUESTIONS AND ANSWERS SURE A+
✔✔In developing a plan of care for a client with dementia, the nurse should remember
that confusion in the elderly
A. is to be expected, and progresses with age
B. often follows relocation to new surroundings
C. is a result of irreversible brain pathology
D. can be prevented with adequate sleep - ✔✔B. often follows relocation to new
surroundings (Relocation (B) often results in confusion among elderly clients-- moving is
stressful for anyone. (A) is stereotypical judgement. Stress in the elderly often manifests
itself as confusion, so (C) is wrong. Adequate sleep is not a prevention (D) for
confusion.)
✔✔A postoperative client will need to perform daily dressing changes after discharge.
Which outcome statement best demonstrates the client's readiness to manage his
wound care after discharge? The client
A. asks relevant questions regarding the dressing change
B. states he will be able to complete the wound care regimen
C. demonstrates the wound care procedure correctly
D. has all the necessary supplies for wound care - ✔✔C. demonstrates the wound care
procedure correctly
,(A return demonstration of a procedure (C) provides an objective assessment of the
client's ability to perform a task, while (A and B) are subjective measures. (D) is
important, but is less of a priority than the the nurse's assessment of the client's ability
to complete wound care.)
✔✔A client who is 5 '5" tall and weighs 200 pounds is scheduled for surgery the next
day. What question is most important for the nurse to include during the preoperative
assessment?
A. What is your daily calorie consumption?
B. What vitamin and mineral supplements do you take?"
C. "Do you feel that you are overweight?"
D. "Will a clear liquid diet be okay after surgery?" - ✔✔B. "What vitamin and mineral
supplements do you take?"
(Vitamin and mineral supplements (B) may impact medications used during the
operative period. (A and C) are appropriate questions for long-term dietary counseling.
The nature of the surgery and anesthesia will determine the need for a clear liquid diet
(D), rather than the client's preference.)
✔✔During the initial morning assessment, a male client denies dysuria but reports that
his urine appears dark amber. Which intervention should the nurse implement?
A. Provide additional coffee on the client's breakfast tray.
B. Exchange the client's grape juice for cranberry juice.
C. Bring the client additional fruit at mid-morning.
D. Encourage additional oral intake of juices and water. - ✔✔D. Encourage additional
oral intake of juices and water.
✔✔Which intervention is most important for the nurse to implement for a male client
who is experiencing urinary retention?
A. Apply a condom catheter
B. Apply a skin protectant
C. Encourage increased fluid intake
D. Assess for bladder distention - ✔✔D. Assess the bladder for distention (Urinary
retention is the inability to void all urine collected in the bladder, which leads to
uncomfortable bladder distention (D). (A and B) are useful actions to protect the skin of
a client with urinary incontinence. (C) may worsen the bladder distention.)
✔✔A client with acute hemorrhagic anemia is to receive four units of packed RBCs as
rapidly as possible. Which intervention is most important for the nurse to implement?
A. Obtain the pre-transfusion hemoglobin level.
B. Prime the tubing and prepare a blood pump set-up
C. Monitor vital signs q 15 min for the first hour.
D. Ensure the accuracy of the blood type match. - ✔✔D. Ensure the accuracy of the
blood type match.
, (ALL interventions should be implemented prior to administering blood, but (D) has the
highest priority. Any time blood is administered the nurse should ensure the accuracy of
the blood type match in order to prevent a possible hemolytic reaction.)
✔✔A male client being discharged with a prescription for the bronchodilator theophylline
tells the nurse that he understands he is to take three doses of the medication each
day. Since, at the time of discharge, time-released capsules are not available, which
dosing schedule should the nurse advise the client to follow? - ✔✔8 AM, 4 PM, and
midnight
(Theophylline should be administered on a regular around the clock schedule to provide
the best bronchodilating effect and reduce the potential for adverse effects.)
✔✔A client is to receive 10 mEq of KCl diluted in 250 mL of normal saline over 4 hours.
At what rate should the nurse set the client's intravenous infusion pump? - ✔✔63 mL/hr
✔✔When evaluating a client's plan of care, the nurse determines that a desire outcome
was not achieved. Which action should the nurse implement first?
A. Establish a new nursing diagnosis.
B. Note which actions were not implemented.
C. Add additional nursing orders to the plan.
D. Collaborate with the HCP to make changes. - ✔✔B. Note which actions were not
implemented.
(First, the nurse should review which actions in the original plan were not implemented
(B) in order to determine why the original plan did not produce the desired outcome.
Appropriate revisions can then be made, which may include revising the expected
outcome, or identifying a new nursing diagnosis (A). (C) may be needed if the nursing
actions were unsuccessful, or were unable to be implemented. (D) other members of
the healthcare team may be necessary to collaborate changes once the nurse
determines why the original plan did not produce the desired outcome.
✔✔Which snack food is best for the nurse to provide a client with myasthenia graves
who is at risk for altered nutritional status?
A. chocolate pudding
B. graham crackers
C. sugar free gelatin
D. apple slices - ✔✔A. chocolate pudding
(The client with myasthenia graves is at high risk for altered nutrition because of fatigue
and muscle weakness resulting in dysphagia. Snacks that are semisolid, such as
pudding (A) are easy to swallow and require minimal chewing effort, and provide
calories and protein. (C) does not provide any nutritional value. (B and D) require
energy to chew and are more difficult to swallow than pudding.)
✔✔The nurse is instructing a client with high cholesterol about diet and life style
modification. What comment from the client indicates that the teaching has been
effective?
