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HESI FUNDAMENTALS EXIT EXAM QUESTIONS
LATEST VERSION QUESTIONS AND ANSWERS
2026 EDITION
HESI Fundamentals Exit Exam: Questions with Rationales
EXAM COVERAGE SUMMARY (10 Key Points)
1. Safety & Emergency Procedures – Fall prevention (low bed position, locked
wheels, non-skid footwear, call light within reach), seizure precautions, fire
evacuation (ambulatory clients walk down stairs, elevators NOT used, fire doors kept
CLOSED), infant choking (5 backslaps, 5 chest thrusts, NO blind finger sweep),
restraints alternatives
2. Infection Control & Standard Precautions – Hand hygiene (single most effective
infection prevention measure), transmission-based precautions (contact, droplet,
airborne), C. difficile precautions (handwashing with soap and water, NOT alcohol-
based hand sanitizer), influenza (droplet precautions), tuberculosis (airborne
precautions, N95 respirator, negative pressure room)
3. Medication Administration & Dosage Calculations – Six Rights (Right Patient,
Drug, Dose, Route, Time, Documentation), patient identification using two identifiers
(name, DOB, medical record number), blood administration (normal saline ONLY
compatible IV solution), insulin administration, IV infusion calculations, MDI with
spacer technique
4. Nutrition & Fluid/Electrolyte Balance – Low-sodium diet teaching, fluid
intake/output calculation, blood transfusion compatibility (normal saline only), NG
tube feeding (HOB ≥30 degrees, formula at room temperature), hyperkalemia
management, protein status indicators (albumin = long-term, prealbumin = short-
term)
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5. Perioperative & Postoperative Care – Surgical site infection prevention (clippers
preferred over razors), SCDs for DVT prevention, PACU assessment, pain
management, respiratory complications prevention, medication reconciliation (pre-op
meds must be renewed post-op)
6. Patient Mobility & Body Mechanics – Transfer from bed to chair (feet spread apart,
knees aligned, pivot, wide base of support, DO NOT lift under axillae), proper body
mechanics, fall prevention strategies, turning/repositioning techniques
7. Oxygen Therapy & Respiratory Care – Incentive spirometry position (Semi-
Fowler's or High Semi-Fowler's), non-rebreather mask troubleshooting (reservoir bag
must remain partially inflated), partial rebreather mask (if bag collapses completely,
increase flow rate), oxygen safety (upright/secure, cotton fabrics only, no
wool/synthetics)
8. Catheter & Tube Management – Indwelling urinary catheter (check for
kinks/tubing obstruction first), NG tube placement verification (aspirate gastric
contents before irrigation), PICC line assessment (redness/tenderness =
infection/phlebitis), chest tube drainage (continuous bubbling = air leak requiring
immediate assessment)
9. Psychosocial & Therapeutic Communication – Active listening (sit facing client,
open posture, eye contact), validation therapy for dementia patients, non-
pharmacologic interventions (safe, well-lit environment, NOT restraints/sedatives for
wandering), patient refusal of treatment (assess first, encourage, document)
10. Documentation & Legal/Ethical Issues – Incident reporting, informed consent
(mentally competent individual, further assess if confusion), medication
documentation, intake/output records, client rights (Patient's Bill of Rights),
professional scope of practice, delegation principles
SECTION ONE: SAFETY & EMERGENCY PROCEDURES (Questions 1-30)
1. A nurse is caring for an older adult client who is at risk for falls. Which nursing
action is most effective in preventing falls?
A. Keeping the bed in the lowest position with the wheels locked
B. Encouraging the client to wear non-skid socks or footwear
C. Placing the call light within the client's reach
D. All of the above
Correct Answer: D
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Rationale: Comprehensive fall prevention includes multiple interventions: low bed position
with locked wheels reduces fall distance and prevents bed movement; non-skid footwear
prevents slipping; and a reachable call light allows the client to summon assistance.
Implementing all these measures is the most effective approach .
2. A client with dementia wanders at night. What is the best nursing intervention?
A. Use restraints
B. Provide a safe, well-lit environment
C. Lock the client in the room
D. Administer sedatives
Correct Answer: B
Rationale: For a client with dementia who wanders, the safest and most appropriate
intervention is to provide a safe, well-lit environment. Restraints, locking the client in the
room, and sedatives are restrictive and should be avoided as they can increase anxiety,
agitation, and fall risk .
3. The nurse observes that a male client has removed the covering from an ice pack
applied to his knee. What action should the nurse take first?
A. Observe the appearance of the skin under the ice pack
B. Instruct the client regarding the need for the covering
C. Reapply the covering after filling with fresh ice
D. Ask the client how long the ice was applied to the skin
Correct Answer: A
Rationale: The first action should be to assess the skin for any possible thermal injury. If no
injury has occurred, the nurse can take the other actions. Assessment always precedes
intervention .
4. A client who is weak from a recent stroke is attempting to get out of bed unassisted.
The nurse is helping the client back to bed when the client starts to fall. What is the
priority nursing action?
A. Support the client's weight while pressing the call light
B. Gently lower the client to the floor
C. Call for help from other staff members
D. Position the client on the bedpan
HESI FUNDAMENTALS EXIT EXAM QUESTIONS
LATEST VERSION QUESTIONS AND ANSWERS
2026 EDITION
HESI Fundamentals Exit Exam: Questions with Rationales
EXAM COVERAGE SUMMARY (10 Key Points)
1. Safety & Emergency Procedures – Fall prevention (low bed position, locked
wheels, non-skid footwear, call light within reach), seizure precautions, fire
evacuation (ambulatory clients walk down stairs, elevators NOT used, fire doors kept
CLOSED), infant choking (5 backslaps, 5 chest thrusts, NO blind finger sweep),
restraints alternatives
2. Infection Control & Standard Precautions – Hand hygiene (single most effective
infection prevention measure), transmission-based precautions (contact, droplet,
airborne), C. difficile precautions (handwashing with soap and water, NOT alcohol-
based hand sanitizer), influenza (droplet precautions), tuberculosis (airborne
precautions, N95 respirator, negative pressure room)
3. Medication Administration & Dosage Calculations – Six Rights (Right Patient,
Drug, Dose, Route, Time, Documentation), patient identification using two identifiers
(name, DOB, medical record number), blood administration (normal saline ONLY
compatible IV solution), insulin administration, IV infusion calculations, MDI with
spacer technique
4. Nutrition & Fluid/Electrolyte Balance – Low-sodium diet teaching, fluid
intake/output calculation, blood transfusion compatibility (normal saline only), NG
tube feeding (HOB ≥30 degrees, formula at room temperature), hyperkalemia
management, protein status indicators (albumin = long-term, prealbumin = short-
term)
, Page 2 of 20
5. Perioperative & Postoperative Care – Surgical site infection prevention (clippers
preferred over razors), SCDs for DVT prevention, PACU assessment, pain
management, respiratory complications prevention, medication reconciliation (pre-op
meds must be renewed post-op)
6. Patient Mobility & Body Mechanics – Transfer from bed to chair (feet spread apart,
knees aligned, pivot, wide base of support, DO NOT lift under axillae), proper body
mechanics, fall prevention strategies, turning/repositioning techniques
7. Oxygen Therapy & Respiratory Care – Incentive spirometry position (Semi-
Fowler's or High Semi-Fowler's), non-rebreather mask troubleshooting (reservoir bag
must remain partially inflated), partial rebreather mask (if bag collapses completely,
increase flow rate), oxygen safety (upright/secure, cotton fabrics only, no
wool/synthetics)
8. Catheter & Tube Management – Indwelling urinary catheter (check for
kinks/tubing obstruction first), NG tube placement verification (aspirate gastric
contents before irrigation), PICC line assessment (redness/tenderness =
infection/phlebitis), chest tube drainage (continuous bubbling = air leak requiring
immediate assessment)
9. Psychosocial & Therapeutic Communication – Active listening (sit facing client,
open posture, eye contact), validation therapy for dementia patients, non-
pharmacologic interventions (safe, well-lit environment, NOT restraints/sedatives for
wandering), patient refusal of treatment (assess first, encourage, document)
10. Documentation & Legal/Ethical Issues – Incident reporting, informed consent
(mentally competent individual, further assess if confusion), medication
documentation, intake/output records, client rights (Patient's Bill of Rights),
professional scope of practice, delegation principles
SECTION ONE: SAFETY & EMERGENCY PROCEDURES (Questions 1-30)
1. A nurse is caring for an older adult client who is at risk for falls. Which nursing
action is most effective in preventing falls?
A. Keeping the bed in the lowest position with the wheels locked
B. Encouraging the client to wear non-skid socks or footwear
C. Placing the call light within the client's reach
D. All of the above
Correct Answer: D
, Page 3 of 20
Rationale: Comprehensive fall prevention includes multiple interventions: low bed position
with locked wheels reduces fall distance and prevents bed movement; non-skid footwear
prevents slipping; and a reachable call light allows the client to summon assistance.
Implementing all these measures is the most effective approach .
2. A client with dementia wanders at night. What is the best nursing intervention?
A. Use restraints
B. Provide a safe, well-lit environment
C. Lock the client in the room
D. Administer sedatives
Correct Answer: B
Rationale: For a client with dementia who wanders, the safest and most appropriate
intervention is to provide a safe, well-lit environment. Restraints, locking the client in the
room, and sedatives are restrictive and should be avoided as they can increase anxiety,
agitation, and fall risk .
3. The nurse observes that a male client has removed the covering from an ice pack
applied to his knee. What action should the nurse take first?
A. Observe the appearance of the skin under the ice pack
B. Instruct the client regarding the need for the covering
C. Reapply the covering after filling with fresh ice
D. Ask the client how long the ice was applied to the skin
Correct Answer: A
Rationale: The first action should be to assess the skin for any possible thermal injury. If no
injury has occurred, the nurse can take the other actions. Assessment always precedes
intervention .
4. A client who is weak from a recent stroke is attempting to get out of bed unassisted.
The nurse is helping the client back to bed when the client starts to fall. What is the
priority nursing action?
A. Support the client's weight while pressing the call light
B. Gently lower the client to the floor
C. Call for help from other staff members
D. Position the client on the bedpan
