HESI FundamEntalS Exam mEd Surg
[2026/2027] updatEd VErSIon |
VErIFIEd QuEStIonS & dEtaIlEd
ratIonalES alrEadY gradEd a+
The HESI Fundamentals exam is a proctored specialty test taken during your Fundamentals of
Nursing course. It evaluates your understanding of foundational nursing concepts including the
nursing process, patient safety, infection control, medication administration, vital signs, basic
care, and therapeutic communication .
Below is a comprehensive 100-question practice test with detailed rationales for every answer.
Use these to build your clinical judgment and prepare for success.
Section 1: The Nursing Process & Clinical Judgment (Questions 1-10)
1. A nurse is caring for a client who reports severe pain. After assessing the client, the nurse
determines the pain is related to the surgical incision. Which phase of the nursing process is
the nurse demonstrating?
A) Assessment
B) Diagnosis
C) Planning
D) Implementation
Answer: B
Rationale: The nursing diagnosis phase involves analyzing assessment data to identify a client's
health problems. The nurse has assessed pain and is now identifying it as related to the surgical
incision—this is the diagnostic phase. Assessment (A) is data collection; Planning (C) involves
setting goals; Implementation (D) involves carrying out interventions .
2. A nurse is developing a plan of care for a client with impaired mobility. Which statement is
an appropriate client-centered goal?
1
, A) "The client will be turned every 2 hours."
B) "The client will ambulate to the bathroom without assistance."
C) "The nurse will assist the client with range-of-motion exercises."
D) "The client will be encouraged to perform ADLs."
Answer: B
Rationale: Client-centered goals should be specific, measurable, and achievable. "The client will
ambulate to the bathroom without assistance" is a client-centered outcome. Options A and C
focus on nursing actions, not client outcomes .
3. A nurse is caring for a client with a new colostomy. Which action reflects the
implementation phase of the nursing process?
A) Measuring the stoma and applying a new pouch
B) Identifying that the client is at risk for skin breakdown
C) Teaching the client how to care for the colostomy after discharge
D) Evaluating the client's ability to perform colostomy care independently
Answer: A
Rationale: Implementation involves performing nursing interventions. Measuring the stoma and
applying a new pouch is an intervention. Teaching is also implementation, but applying the
pouch is a direct nursing action. Evaluation is (D), diagnosis is (B), and planning is setting goals .
4. A nurse is caring for a client who is confused and attempting to pull out their IV line. Using
Maslow's hierarchy of needs, which intervention should the nurse prioritize?
A) Assign a staff member to sit with the client to ensure safety
B) Provide the client with a calm, quiet environment
C) Assess the client's pain level
D) Educate the family about the client's confusion
Answer: A
Rationale: Maslow's hierarchy prioritizes physiological needs first, followed by safety. The
client's behavior poses a safety risk, which is the priority before addressing comfort (C),
environment (B), or education (D). Safety is the second level of Maslow's hierarchy .
5. A nurse is evaluating a client's response to pain medication. Which finding indicates the
intervention was effective?
2
, A) The client states, "My pain is a 3 out of 10."
B) The client's vital signs are within normal limits.
C) The client reports feeling tired.
D) The client asks for more pain medication.
Answer: A
Rationale: Evaluation involves determining whether the interventions achieved the desired
outcomes. The client's self-report of pain is the most reliable indicator of pain relief. Vital signs
(B) may improve but are not the primary pain indicator .
6. A nurse is using the SBAR communication tool during a handoff. Which of the following is
the correct order of SBAR?
A) Situation, Background, Assessment, Recommendation
B) Background, Situation, Assessment, Recommendation
C) Assessment, Background, Situation, Recommendation
D) Situation, Assessment, Background, Recommendation
Answer: A
Rationale: SBAR stands for Situation (what is happening now), Background (relevant
history), Assessment (what you think is happening), and Recommendation (what you think
should be done) .
7. A nurse is preparing a client for discharge. Which action demonstrates the evaluation phase
of the nursing process?
A) Assessing the client's vital signs
B) Determining if the client can demonstrate self-injection of insulin
C) Creating a teaching plan for the client
D) Administering the client's medications
Answer: B
Rationale: Evaluation involves determining if client goals have been met. Assessing if the client
can demonstrate self-injection evaluates the effectiveness of teaching. Assessment (A) is the
first step; Planning (C) involves creating goals; Implementation (D) involves carrying out
interventions .
3
, 8. A nurse is admitting a client to a medical-surgical unit. Which action should the nurse
perform first?
A) Obtain the client's weight
B) Administer prescribed medications
C) Conduct a comprehensive nursing assessment
D) Review the client's advance directives
Answer: C
Rationale: The nursing process begins with assessment. The nurse should first conduct a
comprehensive assessment to gather baseline data before implementing other interventions
(medications) or reviewing advance directives. The assessment drives the plan of care .
9. A nurse is planning care for a client with a new diagnosis of diabetes. Which of the
following is a priority nursing diagnosis?
A) Risk for infection
B) Deficient knowledge related to new diagnosis
C) Imbalanced nutrition: more than body requirements
D) Risk for unstable blood glucose
Answer: B
Rationale: A client with a new diabetes diagnosis needs education about the disease, diet,
exercise, and medication. While all options are appropriate, addressing knowledge deficit first
empowers the client to manage the condition and prevent complications. Maslow's hierarchy:
education supports safety and self-care .
10. A nurse is caring for a client who is 2 days postoperative following a total hip arthroplasty.
The client reports pain rated 7/10. Which action should the nurse take first?
A) Administer the prescribed PRN analgesic
B) Assess the client's pain characteristics
C) Reposition the client to improve comfort
D) Notify the healthcare provider
Answer: B
Rationale: The nurse should first assess the client's pain characteristics (location, quality,
intensity, aggravating/relieving factors) to determine the cause and appropriate intervention.
Pain assessment is an essential part of the nursing process before implementing interventions .
4
[2026/2027] updatEd VErSIon |
VErIFIEd QuEStIonS & dEtaIlEd
ratIonalES alrEadY gradEd a+
The HESI Fundamentals exam is a proctored specialty test taken during your Fundamentals of
Nursing course. It evaluates your understanding of foundational nursing concepts including the
nursing process, patient safety, infection control, medication administration, vital signs, basic
care, and therapeutic communication .
Below is a comprehensive 100-question practice test with detailed rationales for every answer.
Use these to build your clinical judgment and prepare for success.
Section 1: The Nursing Process & Clinical Judgment (Questions 1-10)
1. A nurse is caring for a client who reports severe pain. After assessing the client, the nurse
determines the pain is related to the surgical incision. Which phase of the nursing process is
the nurse demonstrating?
A) Assessment
B) Diagnosis
C) Planning
D) Implementation
Answer: B
Rationale: The nursing diagnosis phase involves analyzing assessment data to identify a client's
health problems. The nurse has assessed pain and is now identifying it as related to the surgical
incision—this is the diagnostic phase. Assessment (A) is data collection; Planning (C) involves
setting goals; Implementation (D) involves carrying out interventions .
2. A nurse is developing a plan of care for a client with impaired mobility. Which statement is
an appropriate client-centered goal?
1
, A) "The client will be turned every 2 hours."
B) "The client will ambulate to the bathroom without assistance."
C) "The nurse will assist the client with range-of-motion exercises."
D) "The client will be encouraged to perform ADLs."
Answer: B
Rationale: Client-centered goals should be specific, measurable, and achievable. "The client will
ambulate to the bathroom without assistance" is a client-centered outcome. Options A and C
focus on nursing actions, not client outcomes .
3. A nurse is caring for a client with a new colostomy. Which action reflects the
implementation phase of the nursing process?
A) Measuring the stoma and applying a new pouch
B) Identifying that the client is at risk for skin breakdown
C) Teaching the client how to care for the colostomy after discharge
D) Evaluating the client's ability to perform colostomy care independently
Answer: A
Rationale: Implementation involves performing nursing interventions. Measuring the stoma and
applying a new pouch is an intervention. Teaching is also implementation, but applying the
pouch is a direct nursing action. Evaluation is (D), diagnosis is (B), and planning is setting goals .
4. A nurse is caring for a client who is confused and attempting to pull out their IV line. Using
Maslow's hierarchy of needs, which intervention should the nurse prioritize?
A) Assign a staff member to sit with the client to ensure safety
B) Provide the client with a calm, quiet environment
C) Assess the client's pain level
D) Educate the family about the client's confusion
Answer: A
Rationale: Maslow's hierarchy prioritizes physiological needs first, followed by safety. The
client's behavior poses a safety risk, which is the priority before addressing comfort (C),
environment (B), or education (D). Safety is the second level of Maslow's hierarchy .
5. A nurse is evaluating a client's response to pain medication. Which finding indicates the
intervention was effective?
2
, A) The client states, "My pain is a 3 out of 10."
B) The client's vital signs are within normal limits.
C) The client reports feeling tired.
D) The client asks for more pain medication.
Answer: A
Rationale: Evaluation involves determining whether the interventions achieved the desired
outcomes. The client's self-report of pain is the most reliable indicator of pain relief. Vital signs
(B) may improve but are not the primary pain indicator .
6. A nurse is using the SBAR communication tool during a handoff. Which of the following is
the correct order of SBAR?
A) Situation, Background, Assessment, Recommendation
B) Background, Situation, Assessment, Recommendation
C) Assessment, Background, Situation, Recommendation
D) Situation, Assessment, Background, Recommendation
Answer: A
Rationale: SBAR stands for Situation (what is happening now), Background (relevant
history), Assessment (what you think is happening), and Recommendation (what you think
should be done) .
7. A nurse is preparing a client for discharge. Which action demonstrates the evaluation phase
of the nursing process?
A) Assessing the client's vital signs
B) Determining if the client can demonstrate self-injection of insulin
C) Creating a teaching plan for the client
D) Administering the client's medications
Answer: B
Rationale: Evaluation involves determining if client goals have been met. Assessing if the client
can demonstrate self-injection evaluates the effectiveness of teaching. Assessment (A) is the
first step; Planning (C) involves creating goals; Implementation (D) involves carrying out
interventions .
3
, 8. A nurse is admitting a client to a medical-surgical unit. Which action should the nurse
perform first?
A) Obtain the client's weight
B) Administer prescribed medications
C) Conduct a comprehensive nursing assessment
D) Review the client's advance directives
Answer: C
Rationale: The nursing process begins with assessment. The nurse should first conduct a
comprehensive assessment to gather baseline data before implementing other interventions
(medications) or reviewing advance directives. The assessment drives the plan of care .
9. A nurse is planning care for a client with a new diagnosis of diabetes. Which of the
following is a priority nursing diagnosis?
A) Risk for infection
B) Deficient knowledge related to new diagnosis
C) Imbalanced nutrition: more than body requirements
D) Risk for unstable blood glucose
Answer: B
Rationale: A client with a new diabetes diagnosis needs education about the disease, diet,
exercise, and medication. While all options are appropriate, addressing knowledge deficit first
empowers the client to manage the condition and prevent complications. Maslow's hierarchy:
education supports safety and self-care .
10. A nurse is caring for a client who is 2 days postoperative following a total hip arthroplasty.
The client reports pain rated 7/10. Which action should the nurse take first?
A) Administer the prescribed PRN analgesic
B) Assess the client's pain characteristics
C) Reposition the client to improve comfort
D) Notify the healthcare provider
Answer: B
Rationale: The nurse should first assess the client's pain characteristics (location, quality,
intensity, aggravating/relieving factors) to determine the cause and appropriate intervention.
Pain assessment is an essential part of the nursing process before implementing interventions .
4
