HESI FUNDAMENTALS PRACTICE EXAM 2026–2027
250 Additional Original Practice Questions • 15 New NGN-Style
Case Studies • Comprehensive Rationales
Prepared by: Expert Nursing Educators
For: Nursing Students Preparing for HESI-Style Fundamentals Examinations
Edition: 2026–2027 — Second Edition
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
• A substitute for formal nursing education, clinical experience, or comprehensive
exam preparation
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
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.
Exam Performance Disclaimer:
Success on any nursing examination depends on multiple factors. This guide 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 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
PART 1 — FUNDAMENTALS REVIEW (SECOND EDITION)
1. Nursing Process Review ...................................................................................... 6
2. Health Assessment Review ................................................................................ 8
3. Infection Prevention Review ............................................................................... 10
4. Safety and Emergency Preparedness ................................................................ 12
5. Medication Administration Review ..................................................................... 14
6. Calculation Review ............................................................................................ 16
7. Communication and Documentation .................................................................. 18
8. Patient Education and Health Promotion ........................................................... 20
9. Nutrition, Fluids, and Elimination ....................................................................... 22
10. Mobility, Skin, and Wound Care ....................................................................... 24
11. Oxygenation and Pain Management ................................................................ 26
12. Ethics, Law, and End-of-Life Care .................................................................... 28
13. Delegation and Scope of Practice .................................................................... 30
, PART 2 — 250 ADDITIONAL PRACTICE QUESTIONS
Section 1: Nursing Process (Questions 1–15) .......................................................... 32
Section 2: Health Assessment (Questions 16–35) ................................................... 35
Section 3: Infection Prevention (Questions 36–55) ................................................. 39
Section 4: Patient Safety (Questions 56–75) ........................................................... 43
Section 5: Medication Administration (Questions 76–95) ....................................... 47
Section 6: Dosage Calculations (Questions 96–110) ............................................... 51
Section 7: Therapeutic Communication (Questions 111–125) ................................ 54
Section 8: Documentation (Questions 126–140) ..................................................... 57
Section 9: Patient Education (Questions 141–155) ................................................. 60
Section 10: Nutrition and Hydration (Questions 156–170) ...................................... 63
Section 11: Mobility and Immobility (Questions 171–185) ...................................... 66
Section 12: Skin and Wound Care (Questions 186–200) ........................................ 69
Section 13: Elimination (Questions 201–215) ......................................................... 72
Section 14: Oxygenation (Questions 216–230) ....................................................... 75
Section 15: Pain Management (Questions 231–245) .............................................. 78
Section 16: Sleep and Rest (Questions 246–250) ................................................... 81
PART 3 — 15 NEW NGN-STYLE CASE STUDIES
Case Study 1: Acute Kidney Injury and Fluid Management .................................... 83
Case Study 2: Postoperative Pain Management ..................................................... 87
Case Study 3: Medication Error Prevention ............................................................ 91
Case Study 4: Diabetic Ketoacidosis ...................................................................... 95
Case Study 5: Falls and Injury Prevention .............................................................. 99
Case Study 6: Respiratory Failure ......................................................................... 103
Case Study 7: Surgical Site Infection ..................................................................... 107
Case Study 8: Electrolyte Imbalance ..................................................................... 111
Case Study 9: End-of-Life Decision Making ........................................................... 115
Case Study 10: Delegation and Teamwork ............................................................ 119
Case Study 11: Cardiac Event Recognition ........................................................... 123
Case Study 12: Wound Dehiscence ...................................................................... 127
Case Study 13: Nutritional Support ....................................................................... 131
Case Study 14: Cultural Competence ................................................................... 135
Case Study 15: Complex Multisystem Patient ........................................................ 139
250 Additional Original Practice Questions • 15 New NGN-Style
Case Studies • Comprehensive Rationales
Prepared by: Expert Nursing Educators
For: Nursing Students Preparing for HESI-Style Fundamentals Examinations
Edition: 2026–2027 — Second Edition
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
• A substitute for formal nursing education, clinical experience, or comprehensive
exam preparation
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
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.
Exam Performance Disclaimer:
Success on any nursing examination depends on multiple factors. This guide 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 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
PART 1 — FUNDAMENTALS REVIEW (SECOND EDITION)
1. Nursing Process Review ...................................................................................... 6
2. Health Assessment Review ................................................................................ 8
3. Infection Prevention Review ............................................................................... 10
4. Safety and Emergency Preparedness ................................................................ 12
5. Medication Administration Review ..................................................................... 14
6. Calculation Review ............................................................................................ 16
7. Communication and Documentation .................................................................. 18
8. Patient Education and Health Promotion ........................................................... 20
9. Nutrition, Fluids, and Elimination ....................................................................... 22
10. Mobility, Skin, and Wound Care ....................................................................... 24
11. Oxygenation and Pain Management ................................................................ 26
12. Ethics, Law, and End-of-Life Care .................................................................... 28
13. Delegation and Scope of Practice .................................................................... 30
, PART 2 — 250 ADDITIONAL PRACTICE QUESTIONS
Section 1: Nursing Process (Questions 1–15) .......................................................... 32
Section 2: Health Assessment (Questions 16–35) ................................................... 35
Section 3: Infection Prevention (Questions 36–55) ................................................. 39
Section 4: Patient Safety (Questions 56–75) ........................................................... 43
Section 5: Medication Administration (Questions 76–95) ....................................... 47
Section 6: Dosage Calculations (Questions 96–110) ............................................... 51
Section 7: Therapeutic Communication (Questions 111–125) ................................ 54
Section 8: Documentation (Questions 126–140) ..................................................... 57
Section 9: Patient Education (Questions 141–155) ................................................. 60
Section 10: Nutrition and Hydration (Questions 156–170) ...................................... 63
Section 11: Mobility and Immobility (Questions 171–185) ...................................... 66
Section 12: Skin and Wound Care (Questions 186–200) ........................................ 69
Section 13: Elimination (Questions 201–215) ......................................................... 72
Section 14: Oxygenation (Questions 216–230) ....................................................... 75
Section 15: Pain Management (Questions 231–245) .............................................. 78
Section 16: Sleep and Rest (Questions 246–250) ................................................... 81
PART 3 — 15 NEW NGN-STYLE CASE STUDIES
Case Study 1: Acute Kidney Injury and Fluid Management .................................... 83
Case Study 2: Postoperative Pain Management ..................................................... 87
Case Study 3: Medication Error Prevention ............................................................ 91
Case Study 4: Diabetic Ketoacidosis ...................................................................... 95
Case Study 5: Falls and Injury Prevention .............................................................. 99
Case Study 6: Respiratory Failure ......................................................................... 103
Case Study 7: Surgical Site Infection ..................................................................... 107
Case Study 8: Electrolyte Imbalance ..................................................................... 111
Case Study 9: End-of-Life Decision Making ........................................................... 115
Case Study 10: Delegation and Teamwork ............................................................ 119
Case Study 11: Cardiac Event Recognition ........................................................... 123
Case Study 12: Wound Dehiscence ...................................................................... 127
Case Study 13: Nutritional Support ....................................................................... 131
Case Study 14: Cultural Competence ................................................................... 135
Case Study 15: Complex Multisystem Patient ........................................................ 139
