HESI FUNDAMENTALS PRACTICE EXAM 2026–2027
Comprehensive Study Guide • 250 Original Practice
Questions • 15 NGN-Style Case Studies • Detailed Rationales
Prepared by: Expert Nursing Educators
For: Nursing Students Preparing for HESI-Style Fundamentals Examinations
Edition: 2026–2027
This study guide contains original HESI-style practice questions and is designed to
supplement your nursing education. It is not affiliated with, endorsed by, or approved by
Elsevier, HESI, NCSBN, ATI, Pearson, or any nursing school. These questions are practice
materials only and do not guarantee success on any official examination.
DISCLAIMER
IMPORTANT NOTICE TO STUDENTS
This study guide is an independent educational resource created by nursing educators
to assist students in preparing for HESI-style and NCLEX-style nursing examinations.
,This guide is NOT:
• A collection of actual, leaked, or recalled HESI examination questions
• Affiliated with, endorsed by, or approved by Elsevier, HESI, NCSBN, ATI, Pearson,
or any nursing school
• A guarantee of passing any official nursing examination
• This guide IS:
• Original practice questions written by experienced nursing educators
• Designed to strengthen nursing fundamentals, clinical reasoning, and test-taking
skills
• Based on publicly available nursing education standards and competency
frameworks
• Intended as a supplementary study tool to be used alongside your nursing
textbooks, course materials, and clinical experiences
Nursing Practice Acknowledgment:
All clinical scenarios, assessment findings, vital signs, laboratory values, medication
dosages, and nursing interventions presented in this guide are for educational practice
purposes only. They do not constitute medical advice, clinical guidelines, or protocols
for actual patient care. Always follow your institution's policies, procedures, and
protocols for clinical practice.
Exam Performance Disclaimer:
Success on any nursing examination depends on multiple factors, including but not
limited to: comprehensive content knowledge, clinical judgment skills, test-taking
strategies, time management, and individual preparation. This guide is designed to
support your preparation but does not guarantee any specific examination outcome.
Educational Use Only:
This material is intended for individual study use by nursing students. Reproduction,
distribution, or commercial use of this content without explicit permission is prohibited.
,By using this study guide, you acknowledge that you have read and understand
this disclaimer.
TABLE OF CONTENTS
COVER PAGE ............................................................................................................. 1
DISCLAIMER ............................................................................................................. 2
TABLE OF CONTENTS .............................................................................................. 3
HOW TO USE THIS GUIDE ....................................................................................... 6
PART 1 — FUNDAMENTALS REVIEW
1. Nursing Process ................................................................................................... 8
• ADPIE Framework
• Critical Thinking and Clinical Judgment
• Prioritization Principles
2. Health Assessment ............................................................................................ 12
• General Survey and Vital Signs
• Head-to-Toe Assessment
• System-Specific Assessment
• Abnormal Findings
3. Infection Prevention and Control ........................................................................ 17
• Standard and Transmission-Based Precautions
• PPE and Hand Hygiene
, • Aseptic Technique
4. Patient Safety .................................................................................................... 21
• Fall Prevention
• Seizure and Aspiration Precautions
• Restraints and Safety Equipment
• Medication Safety
5. Medication Administration ................................................................................. 25
• Medication Rights
• Routes of Administration
• Medication Errors and High-Alert Medications
6. Dosage Calculations .......................................................................................... 30
• Basic Calculations and Dimensional Analysis
• IV Flow Rates and Weight-Based Calculations
• Pediatric Calculations and Safe Dose Ranges
7. Therapeutic Communication .............................................................................. 34
• Therapeutic Techniques
• Nontherapeutic Communication
• Cultural Considerations
8. Documentation and Reporting ............................................................................ 38
• Charting Standards
• SBAR Communication
• Incident Reports
9. Patient Education .............................................................................................. 41
• Teaching Principles
• Teach-Back Method
• Barriers to Learning
10. Nutrition and Hydration .................................................................................... 44
• Therapeutic Diets
• Enteral and Parenteral Nutrition
Comprehensive Study Guide • 250 Original Practice
Questions • 15 NGN-Style Case Studies • Detailed Rationales
Prepared by: Expert Nursing Educators
For: Nursing Students Preparing for HESI-Style Fundamentals Examinations
Edition: 2026–2027
This study guide contains original HESI-style practice questions and is designed to
supplement your nursing education. It is not affiliated with, endorsed by, or approved by
Elsevier, HESI, NCSBN, ATI, Pearson, or any nursing school. These questions are practice
materials only and do not guarantee success on any official examination.
DISCLAIMER
IMPORTANT NOTICE TO STUDENTS
This study guide is an independent educational resource created by nursing educators
to assist students in preparing for HESI-style and NCLEX-style nursing examinations.
,This guide is NOT:
• A collection of actual, leaked, or recalled HESI examination questions
• Affiliated with, endorsed by, or approved by Elsevier, HESI, NCSBN, ATI, Pearson,
or any nursing school
• A guarantee of passing any official nursing examination
• This guide IS:
• Original practice questions written by experienced nursing educators
• Designed to strengthen nursing fundamentals, clinical reasoning, and test-taking
skills
• Based on publicly available nursing education standards and competency
frameworks
• Intended as a supplementary study tool to be used alongside your nursing
textbooks, course materials, and clinical experiences
Nursing Practice Acknowledgment:
All clinical scenarios, assessment findings, vital signs, laboratory values, medication
dosages, and nursing interventions presented in this guide are for educational practice
purposes only. They do not constitute medical advice, clinical guidelines, or protocols
for actual patient care. Always follow your institution's policies, procedures, and
protocols for clinical practice.
Exam Performance Disclaimer:
Success on any nursing examination depends on multiple factors, including but not
limited to: comprehensive content knowledge, clinical judgment skills, test-taking
strategies, time management, and individual preparation. This guide is designed to
support your preparation but does not guarantee any specific examination outcome.
Educational Use Only:
This material is intended for individual study use by nursing students. Reproduction,
distribution, or commercial use of this content without explicit permission is prohibited.
,By using this study guide, you acknowledge that you have read and understand
this disclaimer.
TABLE OF CONTENTS
COVER PAGE ............................................................................................................. 1
DISCLAIMER ............................................................................................................. 2
TABLE OF CONTENTS .............................................................................................. 3
HOW TO USE THIS GUIDE ....................................................................................... 6
PART 1 — FUNDAMENTALS REVIEW
1. Nursing Process ................................................................................................... 8
• ADPIE Framework
• Critical Thinking and Clinical Judgment
• Prioritization Principles
2. Health Assessment ............................................................................................ 12
• General Survey and Vital Signs
• Head-to-Toe Assessment
• System-Specific Assessment
• Abnormal Findings
3. Infection Prevention and Control ........................................................................ 17
• Standard and Transmission-Based Precautions
• PPE and Hand Hygiene
, • Aseptic Technique
4. Patient Safety .................................................................................................... 21
• Fall Prevention
• Seizure and Aspiration Precautions
• Restraints and Safety Equipment
• Medication Safety
5. Medication Administration ................................................................................. 25
• Medication Rights
• Routes of Administration
• Medication Errors and High-Alert Medications
6. Dosage Calculations .......................................................................................... 30
• Basic Calculations and Dimensional Analysis
• IV Flow Rates and Weight-Based Calculations
• Pediatric Calculations and Safe Dose Ranges
7. Therapeutic Communication .............................................................................. 34
• Therapeutic Techniques
• Nontherapeutic Communication
• Cultural Considerations
8. Documentation and Reporting ............................................................................ 38
• Charting Standards
• SBAR Communication
• Incident Reports
9. Patient Education .............................................................................................. 41
• Teaching Principles
• Teach-Back Method
• Barriers to Learning
10. Nutrition and Hydration .................................................................................... 44
• Therapeutic Diets
• Enteral and Parenteral Nutrition
