Fundamentals HESI Practice Test Bank
with a Review of 200+ Questions and Correct Detailed
Answers
HESI Fundamentals 2026-2027 Practice Test (New!)
Abstract:
This document serves as a comprehensive preparation resource for
the HESI Fundamentals Examination, administered by Elsevier
Evolve for the 2026/2027 academic year. The 220 verified
questions are systematically organized into eight core content
areas: Mobility, Safety & Basic Care; Medication Administration &
Calculations; Infection Control & Wound Care; Patient Assessment &
Vital Signs; Fluid & Electrolyte Balance; Legal/Ethical Issues &
Communication; Nutrition & Elimination; and Mental Health & Crisis
Intervention. Each question is meticulously crafted to mirror the
exam's format and difficulty, with answers graded A+ by subject matter
experts. Detailed rationales elucidate correct responses while
distractor explanations clarify common misconceptions, promoting
deep conceptual understanding. The guide emphasizes practical
application through scenario-based questions and NGN-style case
studies that simulate real-world nursing duties. Updated to incorporate
the latest Evolve HESI standards, prioritization frameworks (ABCs),
and clinical judgment models, this resource ensures candidates are
thoroughly prepared to achieve certification.
,SECTION 1: MOBILITY, SAFETY & BASIC CARE (Questions 1-35)
Description: This section covers patient mobility, fall prevention, use of restraints, body
mechanics, positioning, and basic hygiene care.
1. A nurse is preparing to transfer a patient from the bed to a stretcher. Which action should
the nurse take first?
A) Place the bed in the lowest position
B) Lock the wheels on the bed and stretcher
C) Assess the patient's ability to assist
D) Obtain a friction-reducing device
Correct Answer: C
Rationale: The nurse should first assess the patient's ability to assist with the transfer. This
determines the appropriate transfer method and the number of staff required. Safety is
paramount, and knowing the patient's capabilities prevents injury to both the patient and the
healthcare provider. The other actions are important but should follow the initial assessment.
2. A patient has been on bed rest for three days. Which complication is the nurse most
concerned about?
A) Constipation
B) Deep vein thrombosis (DVT)
C) Urinary retention
D) Muscle atrophy
Correct Answer: B
Rationale: Deep vein thrombosis (DVT) is the most life-threatening complication of prolonged
bed rest due to venous stasis. Thrombi can dislodge and cause a pulmonary embolism, which
can be fatal. While constipation, urinary retention, and muscle atrophy are also complications
of immobility, DVT carries the highest immediate risk.
3. A patient is using a cane for ambulation. The nurse should instruct the patient to hold the
cane on which side?
A) The stronger side
B) The weaker side
C) The affected side
D) Alternating sides
Correct Answer: A
Rationale: The cane should be held on the stronger side of the body. This allows the cane to
,support the weaker extremity and reduces the weight-bearing load on the affected leg. The
cane and the weaker leg advance together, providing a wider base of support and better
balance.
4. Which intervention is most effective for preventing pressure injuries in an immobile
patient?
A) Massaging bony prominences daily
B) Repositioning the patient every 2 hours
C) Applying talcum powder to the skin
D) Using a donut-shaped cushion
Correct Answer: B
Rationale: Repositioning the patient every 2 hours is the single most effective intervention for
preventing pressure injuries. It relieves pressure on bony prominences and promotes
circulation. Massaging bony prominences can cause tissue damage; donut cushions can cause
pressure points; and talcum powder can irritate skin.
5. A nurse is caring for a patient in wrist restraints. How often should the nurse check the
patient's neurovascular status?
A) Every 30 minutes
B) Every 1 hour
C) Every 2 hours
D) Every 4 hours
Correct Answer: A
Rationale: Neurovascular checks (circulation, sensation, and movement) should be performed
at least every 30 minutes on a restrained extremity. Restraints can compromise circulation and
cause nerve damage. Documentation of these checks is also required.
6. Which statement indicates that a patient understands proper body mechanics for lifting a
heavy object?
A) "I should keep my back straight and lift with my legs."
B) "I should bend at the waist and use my back muscles."
C) "I should twist while lifting to get better leverage."
D) "I should lift the object quickly to avoid strain."
Correct Answer: A
Rationale: Proper body mechanics require keeping the back straight and using the strong
, muscles of the legs to lift. Bending at the waist, twisting, or lifting quickly increases the risk of
musculoskeletal injury, particularly to the lower back.
7. A patient with a hip fracture is being logrolled. Which action is essential during this
procedure?
A) The patient crosses their arms over their chest
B) The patient bends their knees
C) The patient assists by pushing with their heels
D) The patient's head is raised 30 degrees
Correct Answer: A
Rationale: During a logroll, the patient should keep their arms crossed over their chest to
prevent them from falling off the bed and to maintain spinal alignment. The patient's head,
shoulders, and hips must move as one unit (like a log) to prevent further injury.
8. The nurse is teaching a patient about fall prevention at home. Which statement indicates
the need for further teaching?
A) "I should remove throw rugs from my home."
B) "I should wear socks with nonskid soles."
C) "I should turn on a nightlight in the hallway."
D) "I should keep my pathways clear of clutter."
Correct Answer: B
Rationale: While nonskid soles are important, wearing socks alone can be slippery. The patient
should wear shoes with nonskid soles or use special non-slip socks for optimal safety. All other
options are appropriate fall prevention strategies.
9. What is the correct position for a patient experiencing orthostatic hypotension?
A) Supine with feet elevated
B) Sitting upright with legs dangling
C) Trendelenburg position
D) High Fowler's position
Correct Answer: C
Rationale: The Trendelenburg position (flat on the back with legs elevated higher than the
head) promotes venous return to the heart, improving blood pressure in a patient experiencing
orthostatic hypotension. This helps restore cerebral perfusion.
with a Review of 200+ Questions and Correct Detailed
Answers
HESI Fundamentals 2026-2027 Practice Test (New!)
Abstract:
This document serves as a comprehensive preparation resource for
the HESI Fundamentals Examination, administered by Elsevier
Evolve for the 2026/2027 academic year. The 220 verified
questions are systematically organized into eight core content
areas: Mobility, Safety & Basic Care; Medication Administration &
Calculations; Infection Control & Wound Care; Patient Assessment &
Vital Signs; Fluid & Electrolyte Balance; Legal/Ethical Issues &
Communication; Nutrition & Elimination; and Mental Health & Crisis
Intervention. Each question is meticulously crafted to mirror the
exam's format and difficulty, with answers graded A+ by subject matter
experts. Detailed rationales elucidate correct responses while
distractor explanations clarify common misconceptions, promoting
deep conceptual understanding. The guide emphasizes practical
application through scenario-based questions and NGN-style case
studies that simulate real-world nursing duties. Updated to incorporate
the latest Evolve HESI standards, prioritization frameworks (ABCs),
and clinical judgment models, this resource ensures candidates are
thoroughly prepared to achieve certification.
,SECTION 1: MOBILITY, SAFETY & BASIC CARE (Questions 1-35)
Description: This section covers patient mobility, fall prevention, use of restraints, body
mechanics, positioning, and basic hygiene care.
1. A nurse is preparing to transfer a patient from the bed to a stretcher. Which action should
the nurse take first?
A) Place the bed in the lowest position
B) Lock the wheels on the bed and stretcher
C) Assess the patient's ability to assist
D) Obtain a friction-reducing device
Correct Answer: C
Rationale: The nurse should first assess the patient's ability to assist with the transfer. This
determines the appropriate transfer method and the number of staff required. Safety is
paramount, and knowing the patient's capabilities prevents injury to both the patient and the
healthcare provider. The other actions are important but should follow the initial assessment.
2. A patient has been on bed rest for three days. Which complication is the nurse most
concerned about?
A) Constipation
B) Deep vein thrombosis (DVT)
C) Urinary retention
D) Muscle atrophy
Correct Answer: B
Rationale: Deep vein thrombosis (DVT) is the most life-threatening complication of prolonged
bed rest due to venous stasis. Thrombi can dislodge and cause a pulmonary embolism, which
can be fatal. While constipation, urinary retention, and muscle atrophy are also complications
of immobility, DVT carries the highest immediate risk.
3. A patient is using a cane for ambulation. The nurse should instruct the patient to hold the
cane on which side?
A) The stronger side
B) The weaker side
C) The affected side
D) Alternating sides
Correct Answer: A
Rationale: The cane should be held on the stronger side of the body. This allows the cane to
,support the weaker extremity and reduces the weight-bearing load on the affected leg. The
cane and the weaker leg advance together, providing a wider base of support and better
balance.
4. Which intervention is most effective for preventing pressure injuries in an immobile
patient?
A) Massaging bony prominences daily
B) Repositioning the patient every 2 hours
C) Applying talcum powder to the skin
D) Using a donut-shaped cushion
Correct Answer: B
Rationale: Repositioning the patient every 2 hours is the single most effective intervention for
preventing pressure injuries. It relieves pressure on bony prominences and promotes
circulation. Massaging bony prominences can cause tissue damage; donut cushions can cause
pressure points; and talcum powder can irritate skin.
5. A nurse is caring for a patient in wrist restraints. How often should the nurse check the
patient's neurovascular status?
A) Every 30 minutes
B) Every 1 hour
C) Every 2 hours
D) Every 4 hours
Correct Answer: A
Rationale: Neurovascular checks (circulation, sensation, and movement) should be performed
at least every 30 minutes on a restrained extremity. Restraints can compromise circulation and
cause nerve damage. Documentation of these checks is also required.
6. Which statement indicates that a patient understands proper body mechanics for lifting a
heavy object?
A) "I should keep my back straight and lift with my legs."
B) "I should bend at the waist and use my back muscles."
C) "I should twist while lifting to get better leverage."
D) "I should lift the object quickly to avoid strain."
Correct Answer: A
Rationale: Proper body mechanics require keeping the back straight and using the strong
, muscles of the legs to lift. Bending at the waist, twisting, or lifting quickly increases the risk of
musculoskeletal injury, particularly to the lower back.
7. A patient with a hip fracture is being logrolled. Which action is essential during this
procedure?
A) The patient crosses their arms over their chest
B) The patient bends their knees
C) The patient assists by pushing with their heels
D) The patient's head is raised 30 degrees
Correct Answer: A
Rationale: During a logroll, the patient should keep their arms crossed over their chest to
prevent them from falling off the bed and to maintain spinal alignment. The patient's head,
shoulders, and hips must move as one unit (like a log) to prevent further injury.
8. The nurse is teaching a patient about fall prevention at home. Which statement indicates
the need for further teaching?
A) "I should remove throw rugs from my home."
B) "I should wear socks with nonskid soles."
C) "I should turn on a nightlight in the hallway."
D) "I should keep my pathways clear of clutter."
Correct Answer: B
Rationale: While nonskid soles are important, wearing socks alone can be slippery. The patient
should wear shoes with nonskid soles or use special non-slip socks for optimal safety. All other
options are appropriate fall prevention strategies.
9. What is the correct position for a patient experiencing orthostatic hypotension?
A) Supine with feet elevated
B) Sitting upright with legs dangling
C) Trendelenburg position
D) High Fowler's position
Correct Answer: C
Rationale: The Trendelenburg position (flat on the back with legs elevated higher than the
head) promotes venous return to the heart, improving blood pressure in a patient experiencing
orthostatic hypotension. This helps restore cerebral perfusion.
