HESI Nursing Fundamentals Exam (Verified
Questions & Answers)A+ Grade 2026/2027 |
Complete Fundamentals Study Guide
Terms in this set (91)
The nurse removes the dressing on Answer: C
a client's heel that is covering a Rationale
pressure sore one-inch in diameter Serous drainage is clear watery plasma, so (C)
and finds that there is straw- provides accurate documentation based on the
colored drainage seeping from the information provided. Information to stage this
wound. What description of this pressure score (A) is not provided, and sero-
finding should the nurse include in sanguineous drainage is pale and watery with a
the client's record? combination of plasma and red cells, and may be
blood-streaked. Exudate (B) is fluid such as pus
A) Stage 1 pressure sore draining and serum. Purulent drainage (D) is thick, yellow,
sero-sanguineous drainage. green, or brown indicating the presence of dead
B) Pressure sore at bony or living organisms and white blood cells.
prominence with exudate noted.
C) One-inch pressure sore draining
serous fluid.
D) Pressure sore on heel with a
small amount of purulent drainage.
,As the nurse prepares the Answer: C
equipment to be used to start an IV Rationale
on a 4-year-old boy in the A 4-year-old typically has a vivid imagination and
treatment room, he cries lacks concrete thinking abilities. The mother's
continuously. What intervention assistance (C) can provide a stabilizing presence
should the nurse implement? to help soothe the preschooler, who may
perceive the invasive procedure as mutilating. To
A) Take the child back to his room. preserve the child's sense of security associated
B) Recruit others to restrain the with the hospital room, it is best to perform
child. difficult or painful procedures in another area (A).
C) Ask the mother to be present to (B) may be necessary to prevent injury if the child
soothe the child. is unable to cooperate with the mother's coaxing.
D) Show the child how to (D) is best done before going to the treatment
manipulate the equipment. room when the child feels less threatened.
On the third postoperative day Answer: B
following thoracic surgery, a client Rationale
reports feeling constipated. Which Prune juice is a natural laxative that stimulates
intervention should the nurse peristalsis, and warming the prune juice (B)
implement to promote bowel facilitates peristalsis. (A) is also helpful in
elimination? promoting peristalsis but is less likely to relieve
the client's constipation. (C) reduces discomfort
A) Remind the client to turn every during ambulation, but will not help relieve the
two hours while lying in bed. client's constipation. Defecation is not painful
B) Provide warm prune juice before following most surgeries, and many analgesics
the client goes to bed at night. used postoperatively cause constipation, so (D) is
C) Teach the client to splint the contraindicated.
incision while walking to the
bathroom.
D) Administer an analgesic before
the client attempts to defecate.
,To obtain the most complete Answer: D
assessment data for a client with Rationale
chronic pain, which information A client with chronic pain is more likely to have
should the nurse obtain? adapted physiologically to vital sign changes,
localization or intensity, so pain assessment
A) Can you describe where your should focus on any interference with daily
pain is the most severe? activities (D), such as sleep, relationships with
B) What is your pain intensity on a others, physical activity, and emotional well-
scale of 1 to 10? being. Exacerbation of acute symptoms, such as
C) Is your pain best described as pain distribution, patterns, intensity, and
aching, throbbing, or sharp? descriptors elicit specific assessment findings,
D) Which activities during a routine whereas (A, B, and C) are limiting, closed-end
day are impacted by your pain? questions, and can be answered with a yes, no, or
a number.
A low-sodium, low-protein diet is Answers: A, C
prescribed for a 45-year-old client Rationale
with renal insufficiency and Potato chips (A) are high in sodium. Tuna (B) is
hypertension, who gained 3 pounds high in protein. Bacon (C) and crackers (E) are
in the last month. The nurse high in sodium. Only (D) is a meal that is in
determines that the client has been compliance with a low sodium, low protein diet.
noncompliant with the diet, based
on which report from the 24-hour
dietary recall? (Select all that
apply.)
A) Snack of potato chips, and diet
soda.
B) Lunch of tuna fish sandwich,
carrot sticks, fresh fruit, and coffee.
C) Breakfast of eggs, bacon, toast,
and coffee.
D) Dinner of vegetable lasagna,
tossed salad, sherbet, and iced tea.
E) Bedtime snack of crackers and
milk.
, A client provides the nurse with Answer: D
information about the reason for Rationale
seeking care. The nurse realizes that Direct questions should be used after the client's
some information about past opening narrative to fill in any details that have
hospitalizations is missing. How been left out or during the review of systems to
should the nurse obtain this elicit specific facts about past health problems.
information?
A) Solicit information on
hospitalization from the insurance
company.
B) Look up previous medical
records from archived hospital
documents.
C) Ask the client to discuss previous
hospitalizations in the last 5 years.
D) Elicit specific facts about past
hospitalizations with direct
questions.
An older female client with Answer: D
rheumatoid arthritis is complaining Rationale
of severe joint pain that is caused The nurse should first provide an immediate
by the weight of the linen on her comfort measure to address the client's
legs. What action should the nurse complaint about the linens and drape the linens
implement first? over the footboard of the bed (D) instead of
tucking them under the mattress, which can add
A) Apply flannel pajamas to provide pressure perceived by the client as the source of
warmth. her pain. (A, B, and C) may be components of the
B) Administer a PRN dose of client's plan of care, but the nurse should first
ibuprofen. address the client's complaint.
C) Perform range of motion
exercises in a warm tub.
D) Drape the sheets over the
footboard of the bed.
Questions & Answers)A+ Grade 2026/2027 |
Complete Fundamentals Study Guide
Terms in this set (91)
The nurse removes the dressing on Answer: C
a client's heel that is covering a Rationale
pressure sore one-inch in diameter Serous drainage is clear watery plasma, so (C)
and finds that there is straw- provides accurate documentation based on the
colored drainage seeping from the information provided. Information to stage this
wound. What description of this pressure score (A) is not provided, and sero-
finding should the nurse include in sanguineous drainage is pale and watery with a
the client's record? combination of plasma and red cells, and may be
blood-streaked. Exudate (B) is fluid such as pus
A) Stage 1 pressure sore draining and serum. Purulent drainage (D) is thick, yellow,
sero-sanguineous drainage. green, or brown indicating the presence of dead
B) Pressure sore at bony or living organisms and white blood cells.
prominence with exudate noted.
C) One-inch pressure sore draining
serous fluid.
D) Pressure sore on heel with a
small amount of purulent drainage.
,As the nurse prepares the Answer: C
equipment to be used to start an IV Rationale
on a 4-year-old boy in the A 4-year-old typically has a vivid imagination and
treatment room, he cries lacks concrete thinking abilities. The mother's
continuously. What intervention assistance (C) can provide a stabilizing presence
should the nurse implement? to help soothe the preschooler, who may
perceive the invasive procedure as mutilating. To
A) Take the child back to his room. preserve the child's sense of security associated
B) Recruit others to restrain the with the hospital room, it is best to perform
child. difficult or painful procedures in another area (A).
C) Ask the mother to be present to (B) may be necessary to prevent injury if the child
soothe the child. is unable to cooperate with the mother's coaxing.
D) Show the child how to (D) is best done before going to the treatment
manipulate the equipment. room when the child feels less threatened.
On the third postoperative day Answer: B
following thoracic surgery, a client Rationale
reports feeling constipated. Which Prune juice is a natural laxative that stimulates
intervention should the nurse peristalsis, and warming the prune juice (B)
implement to promote bowel facilitates peristalsis. (A) is also helpful in
elimination? promoting peristalsis but is less likely to relieve
the client's constipation. (C) reduces discomfort
A) Remind the client to turn every during ambulation, but will not help relieve the
two hours while lying in bed. client's constipation. Defecation is not painful
B) Provide warm prune juice before following most surgeries, and many analgesics
the client goes to bed at night. used postoperatively cause constipation, so (D) is
C) Teach the client to splint the contraindicated.
incision while walking to the
bathroom.
D) Administer an analgesic before
the client attempts to defecate.
,To obtain the most complete Answer: D
assessment data for a client with Rationale
chronic pain, which information A client with chronic pain is more likely to have
should the nurse obtain? adapted physiologically to vital sign changes,
localization or intensity, so pain assessment
A) Can you describe where your should focus on any interference with daily
pain is the most severe? activities (D), such as sleep, relationships with
B) What is your pain intensity on a others, physical activity, and emotional well-
scale of 1 to 10? being. Exacerbation of acute symptoms, such as
C) Is your pain best described as pain distribution, patterns, intensity, and
aching, throbbing, or sharp? descriptors elicit specific assessment findings,
D) Which activities during a routine whereas (A, B, and C) are limiting, closed-end
day are impacted by your pain? questions, and can be answered with a yes, no, or
a number.
A low-sodium, low-protein diet is Answers: A, C
prescribed for a 45-year-old client Rationale
with renal insufficiency and Potato chips (A) are high in sodium. Tuna (B) is
hypertension, who gained 3 pounds high in protein. Bacon (C) and crackers (E) are
in the last month. The nurse high in sodium. Only (D) is a meal that is in
determines that the client has been compliance with a low sodium, low protein diet.
noncompliant with the diet, based
on which report from the 24-hour
dietary recall? (Select all that
apply.)
A) Snack of potato chips, and diet
soda.
B) Lunch of tuna fish sandwich,
carrot sticks, fresh fruit, and coffee.
C) Breakfast of eggs, bacon, toast,
and coffee.
D) Dinner of vegetable lasagna,
tossed salad, sherbet, and iced tea.
E) Bedtime snack of crackers and
milk.
, A client provides the nurse with Answer: D
information about the reason for Rationale
seeking care. The nurse realizes that Direct questions should be used after the client's
some information about past opening narrative to fill in any details that have
hospitalizations is missing. How been left out or during the review of systems to
should the nurse obtain this elicit specific facts about past health problems.
information?
A) Solicit information on
hospitalization from the insurance
company.
B) Look up previous medical
records from archived hospital
documents.
C) Ask the client to discuss previous
hospitalizations in the last 5 years.
D) Elicit specific facts about past
hospitalizations with direct
questions.
An older female client with Answer: D
rheumatoid arthritis is complaining Rationale
of severe joint pain that is caused The nurse should first provide an immediate
by the weight of the linen on her comfort measure to address the client's
legs. What action should the nurse complaint about the linens and drape the linens
implement first? over the footboard of the bed (D) instead of
tucking them under the mattress, which can add
A) Apply flannel pajamas to provide pressure perceived by the client as the source of
warmth. her pain. (A, B, and C) may be components of the
B) Administer a PRN dose of client's plan of care, but the nurse should first
ibuprofen. address the client's complaint.
C) Perform range of motion
exercises in a warm tub.
D) Drape the sheets over the
footboard of the bed.
