HESI FUNDAMENTALS EXIT EXAM V1, V2 & V3 RN & PN FUNDAMENTALS T QUESTIONS AND ANSWERS
ALREADY GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+....
Core Domains:
- Foundations of Nursing Practice
- Health Assessment and Physical Examination
- Safety and Infection Control
- Basic Care and Comfort
- Pharmacological and Parenteral Therapies
- Reduction of Risk Potential
- Physiological Adaptation
- Psychosocial Integrity
- Professional Standards and Legal/Ethics
This comprehensive HESI Fundamentals Exit Exam assessment is designed to evaluate the essential knowledge and
clinical judgment required for safe and effective nursing practice at both the RN and PN levels. The exam
encompasses multiple-choice and scenario-based questions that reflect real-world clinical situations, testing your
ability to apply foundational theory, prioritize patient care, and make sound decisions under pressure. Questions
assess core nursing concepts, legal and ethical standards, and critical thinking skills necessary for entry-level
nursing competence. Successful completion demonstrates readiness for licensure and the delivery of high-quality,
patient-centered care.
SECTION ONE: QUESTIONS 1–100
,1. The nurse is preparing to administer a subcutaneous injection of enoxaparin. Which site is most appropriate?
A. Deltoid muscle
B. Vastus lateralis
🟢 C. Abdomen, at least 2 inches from the umbilicus
D. Dorsogluteal area
🔴 RATIONALE: Enoxaparin is a low-molecular-weight heparin given subcutaneously into the fatty tissue of
the abdomen, avoiding the 2-inch radius around the umbilicus. The deltoid and vastus lateralis are
intramuscular sites; the dorsogluteal area is avoided for subcutaneous injections due to risk of injury.
2. A client with a nasogastric tube to low intermittent suction reports nausea and abdominal distention. What
should the nurse do first?
A. Increase the suction pressure
🟢 B. Assess the tube for patency and placement
C. Administer an antiemetic as prescribed
D. Irrigate the tube with sterile water
🔴 RATIONALE: Nausea and distention may indicate the NG tube is not functioning properly. The nurse must
first assess patency and verify placement before any intervention. Increasing suction or irrigating without
assessment can cause harm.
3. Which action by the nurse best prevents the spread of Clostridioides difficile?
A. Wearing a surgical mask
🟢 B. Washing hands with soap and water
C. Using alcohol-based hand sanitizer
D. Applying sterile gloves for all care
🔴 RATIONALE: C. difficile spores are not killed by alcohol-based hand rubs; soap and water with friction
effectively remove spores. Mask is not required for contact precautions. Sterile gloves are not necessary;
standard contact precautions with clean gloves suffice.
,4. The nurse is auscultating a client’s lungs and hears high-pitched, musical sounds on expiration. How should
the nurse document this finding?
A. Crackles
B. Pleural friction rub
C. Rhonchi
🟢 D. Wheezes
🔴 RATIONALE: Wheezes are continuous, high-pitched, musical sounds usually heard on expiration due to
narrowed airways. Crackles are discontinuous, pleural friction rub is grating, and rhonchi are low-pitched,
coarse sounds that may clear with coughing.
5. A client is scheduled for a thoracentesis. Which position should the nurse assist the client into?
A. Prone with arms at sides
🟢 B. Sitting upright and leaning over the overbed table
C. Left lateral recumbent with right arm raised
D. Supine with head of bed elevated 30 degrees
🔴 RATIONALE: The upright, forward-leaning position maximizes separation of the ribs and allows access to
the pleural space. The other positions do not provide optimal exposure and may compromise the procedure.
6. Which finding requires immediate nursing intervention for a client receiving a blood transfusion?
A. Temperature 99.2°F (37.3°C)
B. Mild itching at the site
🟢 C. Urine output 15 mL/hour for 2 hours
D. Complaints of feeling cold
🔴 RATIONALE: Oliguria may indicate a hemolytic transfusion reaction or acute kidney injury, a life-
threatening complication. The other findings are common and less urgent; itching alone could be mild
allergic reaction but oliguria signals severe reaction.
, 7. The nurse is caring for a client with a new colostomy. Which stoma finding is expected within the first 24
hours postoperatively?
A. Dry, dark purple
🟢 B. Moist, red-pink
C. Dusky, bluish
D. Pale, retracted
🔴 RATIONALE: A healthy stoma should be moist and reddish-pink, indicating adequate blood supply. Dark
purple (dusky), bluish, or pale/retracted stomas suggest ischemia and are abnormal findings requiring
immediate notification.
8. What is the nurse’s priority action when discovering a small fire in a wastebasket in a client’s room?
A. Extinguish the fire with a blanket
B. Pull the nearest fire alarm
🟢 C. Remove the client from the room
D. Close all doors to contain smoke
🔴 RATIONALE: The RACE acronym (Rescue, Alarm, Contain, Extinguish) prioritizes client safety. First,
rescue/remove any clients in immediate danger. Then alarm, contain, and extinguish if safe.
9. A client with dysphagia is being fed. Which food consistency is safest?
A. Thin liquids
B. Chunky stew
🟢 C. Nectar-thickened liquids
D. Dry, crumbly solids
🔴 RATIONALE: Nectar-thickened liquids slow transit time, reducing risk of aspiration. Thin liquids increase
aspiration risk. Chunky and crumbly foods are difficult to control and may be aspirated. A dysphagia diet
often uses thickened liquids and pureed or soft foods.
ALREADY GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+....
Core Domains:
- Foundations of Nursing Practice
- Health Assessment and Physical Examination
- Safety and Infection Control
- Basic Care and Comfort
- Pharmacological and Parenteral Therapies
- Reduction of Risk Potential
- Physiological Adaptation
- Psychosocial Integrity
- Professional Standards and Legal/Ethics
This comprehensive HESI Fundamentals Exit Exam assessment is designed to evaluate the essential knowledge and
clinical judgment required for safe and effective nursing practice at both the RN and PN levels. The exam
encompasses multiple-choice and scenario-based questions that reflect real-world clinical situations, testing your
ability to apply foundational theory, prioritize patient care, and make sound decisions under pressure. Questions
assess core nursing concepts, legal and ethical standards, and critical thinking skills necessary for entry-level
nursing competence. Successful completion demonstrates readiness for licensure and the delivery of high-quality,
patient-centered care.
SECTION ONE: QUESTIONS 1–100
,1. The nurse is preparing to administer a subcutaneous injection of enoxaparin. Which site is most appropriate?
A. Deltoid muscle
B. Vastus lateralis
🟢 C. Abdomen, at least 2 inches from the umbilicus
D. Dorsogluteal area
🔴 RATIONALE: Enoxaparin is a low-molecular-weight heparin given subcutaneously into the fatty tissue of
the abdomen, avoiding the 2-inch radius around the umbilicus. The deltoid and vastus lateralis are
intramuscular sites; the dorsogluteal area is avoided for subcutaneous injections due to risk of injury.
2. A client with a nasogastric tube to low intermittent suction reports nausea and abdominal distention. What
should the nurse do first?
A. Increase the suction pressure
🟢 B. Assess the tube for patency and placement
C. Administer an antiemetic as prescribed
D. Irrigate the tube with sterile water
🔴 RATIONALE: Nausea and distention may indicate the NG tube is not functioning properly. The nurse must
first assess patency and verify placement before any intervention. Increasing suction or irrigating without
assessment can cause harm.
3. Which action by the nurse best prevents the spread of Clostridioides difficile?
A. Wearing a surgical mask
🟢 B. Washing hands with soap and water
C. Using alcohol-based hand sanitizer
D. Applying sterile gloves for all care
🔴 RATIONALE: C. difficile spores are not killed by alcohol-based hand rubs; soap and water with friction
effectively remove spores. Mask is not required for contact precautions. Sterile gloves are not necessary;
standard contact precautions with clean gloves suffice.
,4. The nurse is auscultating a client’s lungs and hears high-pitched, musical sounds on expiration. How should
the nurse document this finding?
A. Crackles
B. Pleural friction rub
C. Rhonchi
🟢 D. Wheezes
🔴 RATIONALE: Wheezes are continuous, high-pitched, musical sounds usually heard on expiration due to
narrowed airways. Crackles are discontinuous, pleural friction rub is grating, and rhonchi are low-pitched,
coarse sounds that may clear with coughing.
5. A client is scheduled for a thoracentesis. Which position should the nurse assist the client into?
A. Prone with arms at sides
🟢 B. Sitting upright and leaning over the overbed table
C. Left lateral recumbent with right arm raised
D. Supine with head of bed elevated 30 degrees
🔴 RATIONALE: The upright, forward-leaning position maximizes separation of the ribs and allows access to
the pleural space. The other positions do not provide optimal exposure and may compromise the procedure.
6. Which finding requires immediate nursing intervention for a client receiving a blood transfusion?
A. Temperature 99.2°F (37.3°C)
B. Mild itching at the site
🟢 C. Urine output 15 mL/hour for 2 hours
D. Complaints of feeling cold
🔴 RATIONALE: Oliguria may indicate a hemolytic transfusion reaction or acute kidney injury, a life-
threatening complication. The other findings are common and less urgent; itching alone could be mild
allergic reaction but oliguria signals severe reaction.
, 7. The nurse is caring for a client with a new colostomy. Which stoma finding is expected within the first 24
hours postoperatively?
A. Dry, dark purple
🟢 B. Moist, red-pink
C. Dusky, bluish
D. Pale, retracted
🔴 RATIONALE: A healthy stoma should be moist and reddish-pink, indicating adequate blood supply. Dark
purple (dusky), bluish, or pale/retracted stomas suggest ischemia and are abnormal findings requiring
immediate notification.
8. What is the nurse’s priority action when discovering a small fire in a wastebasket in a client’s room?
A. Extinguish the fire with a blanket
B. Pull the nearest fire alarm
🟢 C. Remove the client from the room
D. Close all doors to contain smoke
🔴 RATIONALE: The RACE acronym (Rescue, Alarm, Contain, Extinguish) prioritizes client safety. First,
rescue/remove any clients in immediate danger. Then alarm, contain, and extinguish if safe.
9. A client with dysphagia is being fed. Which food consistency is safest?
A. Thin liquids
B. Chunky stew
🟢 C. Nectar-thickened liquids
D. Dry, crumbly solids
🔴 RATIONALE: Nectar-thickened liquids slow transit time, reducing risk of aspiration. Thin liquids increase
aspiration risk. Chunky and crumbly foods are difficult to control and may be aspirated. A dysphagia diet
often uses thickened liquids and pureed or soft foods.
