HESI RN FUNDAMENTALS PRACTICE EXAMINATION
– STUDY GUIDE | LATEST UPDATE 2026/2027 | ACTUAL
EXAM | PRACTICE QUESTIONS AND ANSWERS |
EXAM REVIEW | 100% CORRECT ANSWERS |
VERIFIED SOLUTIONS
This comprehensive practice examination is designed for nursing students
preparing for the HESI RN Fundamentals assessment, integrating Next Generation
NCLEX (NGN) clinical judgment measurement tools. It rigorously covers essential
nursing concepts: safety and infection control, mobility and immobility, hygiene,
nutrition, fluid and electrolyte balance, elimination, oxygenation, perioperative
care, wound management, and professional ethics. The 100 advanced-level
multiple-choice questions challenge your ability to apply foundational knowledge
to clinical scenarios, prioritize care, and make sound clinical decisions. Each item
reflects the level of the HESI exit exam and the NCLEX-RN, with a strong emphasis
on the nursing process, evidence-based practice, and patient-centered care.
Detailed rationales accompany every answer, explaining why the correct choice is
optimal and why alternatives fall short. Use this study guide to assess your
mastery of fundamental nursing principles, identify knowledge gaps, and build the
confidence and clinical reasoning skills essential for success on the HESI
Fundamentals examination and for safe, effective entry-level nursing practice.
Table of Contents
1. Safety and Infection Control
2. Mobility and Immobility
3. Vital Signs and Health Assessment
4. Hygiene and Personal Care
5. Nutrition and Fluid Balance
6. Elimination and Bowel/Bladder Management
7. Oxygenation and Respiratory Care
8. Wound Care and Skin Integrity
9. Perioperative Nursing
10. Professionalism, Ethics, and Legal Issues
, 1. The nurse is preparing to transfer a client from the bed to a wheelchair.
Which action by the nurse ensures safe body mechanics?
A) Twisting at the waist while pivoting the client.
B) Keeping the feet close together during the transfer.
C) Bending at the waist to lift the client.
D) Flexing the knees and keeping the back straight.
Correct Answer: D
Flexing the knees and keeping the back straight allows the nurse to use the large
leg muscles and protects the back from injury. Twisting at the waist (A) can cause
spinal injury. Keeping the feet close together (B) reduces stability. Bending at the
waist (C) strains the lower back and is improper body mechanics.
2. The nurse is caring for a client who has Clostridioides difficile (C. diff)
infection. Which type of precautions should the nurse implement?
A) Airborne precautions
B) Droplet precautions
C) Contact precautions
D) Standard precautions only
Correct Answer: C
C. diff is transmitted by direct contact with spores that can survive on surfaces.
Contact precautions, including gown and gloves, and hand hygiene with soap and
water (not alcohol-based sanitizer) are required. Airborne (A) and droplet (B) are
not indicated. Standard precautions alone (D) are insufficient for C. diff.
3. A client is admitted with pneumonia and has an oxygen saturation of 88%
on room air. The health care provider orders oxygen at 2 L/min via nasal
cannula. Which action should the nurse take first?
A) Apply the nasal cannula and start the oxygen.
B) Assess the client's respiratory rate and lung sounds.
C) Check the client's medical record for any previous oxygen orders.
D) Notify the respiratory therapist to set up the oxygen.
,Correct Answer: B
Before applying oxygen, the nurse should perform a focused respiratory
assessment to establish a baseline and identify any immediate concerns. After
assessment, oxygen can be applied (A). Checking records (C) and calling
respiratory therapy (D) are not the first actions.
4. The nurse is caring for an older adult client with dysphagia following a
stroke. Which intervention should the nurse implement to prevent
aspiration?
A) Encourage the client to drink thin liquids quickly.
B) Position the client upright at a 90-degree angle during meals.
C) Place food on the weak side of the mouth.
D) Have the client tilt the head backward when swallowing.
Correct Answer: B
Upright positioning facilitates swallowing and reduces the risk of aspiration. Thin
liquids (A) increase aspiration risk; thickened liquids are often recommended. Food
should be placed on the strong side of the mouth (C). The chin should be tilted
downward (chin tuck) to close the airway, not backward (D).
5. The nurse is performing hand hygiene. Which action demonstrates correct
technique?
A) Using alcohol-based hand sanitizer on hands that are visibly soiled.
B) Rubbing hands together for at least 5 seconds with soap and water.
C) Washing hands with soap and water for at least 20 seconds.
D) Drying hands with a reusable cloth towel.
Correct Answer: C
The CDC recommends washing with soap and water for at least 20 seconds.
Alcohol-based sanitizer is not effective on visibly soiled hands (A). Rubbing for only
5 seconds (B) is insufficient. Reusable cloth towels (D) can harbor bacteria;
disposable paper towels are preferred.
6. A client who is immobile is at risk for developing a pressure injury. The
nurse should institute which preventive measure?
, A) Massaging reddened areas of skin to increase circulation.
B) Repositioning the client at least every 2 hours.
C) Keeping the head of the bed elevated at 45 degrees at all times.
D) Applying moisture barriers to intact skin only after a pressure injury
develops.
Correct Answer: B
Frequent repositioning (every 1-2 hours) relieves pressure on bony prominences.
Reddened areas should not be massaged (A) because this can damage capillaries.
The head of bed should be elevated no more than 30 degrees to reduce shear (C).
Moisture barriers are applied to intact skin prophylactically (D).
7. The nurse is measuring a client’s blood pressure manually. Which action is
correct?
A) Deflating the cuff rapidly to prevent prolonged pressure on the arm.
B) Placing the stethoscope over the cuff so it stays in place.
C) Inflating the cuff 30 mm Hg above the point where the radial pulse
disappears.
D) Using a cuff with a bladder that covers 80% of the arm circumference.
Correct Answer: C
The cuff should be inflated until the pulse disappears, then inflated an additional
30 mm Hg to ensure accurate systolic reading. The cuff should be deflated slowly
(2-3 mm Hg per second), not rapidly (A). The stethoscope is placed over the
brachial artery, not under the cuff (B). The bladder width should be 40% of arm
circumference, length 80% (D is imprecise).
8. A client has a new prescription for a 2-gram sodium diet. Which food
selection by the client indicates a need for further teaching?
A) Fresh fruit salad
B) Baked chicken breast with herbs
C) Canned vegetable soup
D) Steamed brown rice
– STUDY GUIDE | LATEST UPDATE 2026/2027 | ACTUAL
EXAM | PRACTICE QUESTIONS AND ANSWERS |
EXAM REVIEW | 100% CORRECT ANSWERS |
VERIFIED SOLUTIONS
This comprehensive practice examination is designed for nursing students
preparing for the HESI RN Fundamentals assessment, integrating Next Generation
NCLEX (NGN) clinical judgment measurement tools. It rigorously covers essential
nursing concepts: safety and infection control, mobility and immobility, hygiene,
nutrition, fluid and electrolyte balance, elimination, oxygenation, perioperative
care, wound management, and professional ethics. The 100 advanced-level
multiple-choice questions challenge your ability to apply foundational knowledge
to clinical scenarios, prioritize care, and make sound clinical decisions. Each item
reflects the level of the HESI exit exam and the NCLEX-RN, with a strong emphasis
on the nursing process, evidence-based practice, and patient-centered care.
Detailed rationales accompany every answer, explaining why the correct choice is
optimal and why alternatives fall short. Use this study guide to assess your
mastery of fundamental nursing principles, identify knowledge gaps, and build the
confidence and clinical reasoning skills essential for success on the HESI
Fundamentals examination and for safe, effective entry-level nursing practice.
Table of Contents
1. Safety and Infection Control
2. Mobility and Immobility
3. Vital Signs and Health Assessment
4. Hygiene and Personal Care
5. Nutrition and Fluid Balance
6. Elimination and Bowel/Bladder Management
7. Oxygenation and Respiratory Care
8. Wound Care and Skin Integrity
9. Perioperative Nursing
10. Professionalism, Ethics, and Legal Issues
, 1. The nurse is preparing to transfer a client from the bed to a wheelchair.
Which action by the nurse ensures safe body mechanics?
A) Twisting at the waist while pivoting the client.
B) Keeping the feet close together during the transfer.
C) Bending at the waist to lift the client.
D) Flexing the knees and keeping the back straight.
Correct Answer: D
Flexing the knees and keeping the back straight allows the nurse to use the large
leg muscles and protects the back from injury. Twisting at the waist (A) can cause
spinal injury. Keeping the feet close together (B) reduces stability. Bending at the
waist (C) strains the lower back and is improper body mechanics.
2. The nurse is caring for a client who has Clostridioides difficile (C. diff)
infection. Which type of precautions should the nurse implement?
A) Airborne precautions
B) Droplet precautions
C) Contact precautions
D) Standard precautions only
Correct Answer: C
C. diff is transmitted by direct contact with spores that can survive on surfaces.
Contact precautions, including gown and gloves, and hand hygiene with soap and
water (not alcohol-based sanitizer) are required. Airborne (A) and droplet (B) are
not indicated. Standard precautions alone (D) are insufficient for C. diff.
3. A client is admitted with pneumonia and has an oxygen saturation of 88%
on room air. The health care provider orders oxygen at 2 L/min via nasal
cannula. Which action should the nurse take first?
A) Apply the nasal cannula and start the oxygen.
B) Assess the client's respiratory rate and lung sounds.
C) Check the client's medical record for any previous oxygen orders.
D) Notify the respiratory therapist to set up the oxygen.
,Correct Answer: B
Before applying oxygen, the nurse should perform a focused respiratory
assessment to establish a baseline and identify any immediate concerns. After
assessment, oxygen can be applied (A). Checking records (C) and calling
respiratory therapy (D) are not the first actions.
4. The nurse is caring for an older adult client with dysphagia following a
stroke. Which intervention should the nurse implement to prevent
aspiration?
A) Encourage the client to drink thin liquids quickly.
B) Position the client upright at a 90-degree angle during meals.
C) Place food on the weak side of the mouth.
D) Have the client tilt the head backward when swallowing.
Correct Answer: B
Upright positioning facilitates swallowing and reduces the risk of aspiration. Thin
liquids (A) increase aspiration risk; thickened liquids are often recommended. Food
should be placed on the strong side of the mouth (C). The chin should be tilted
downward (chin tuck) to close the airway, not backward (D).
5. The nurse is performing hand hygiene. Which action demonstrates correct
technique?
A) Using alcohol-based hand sanitizer on hands that are visibly soiled.
B) Rubbing hands together for at least 5 seconds with soap and water.
C) Washing hands with soap and water for at least 20 seconds.
D) Drying hands with a reusable cloth towel.
Correct Answer: C
The CDC recommends washing with soap and water for at least 20 seconds.
Alcohol-based sanitizer is not effective on visibly soiled hands (A). Rubbing for only
5 seconds (B) is insufficient. Reusable cloth towels (D) can harbor bacteria;
disposable paper towels are preferred.
6. A client who is immobile is at risk for developing a pressure injury. The
nurse should institute which preventive measure?
, A) Massaging reddened areas of skin to increase circulation.
B) Repositioning the client at least every 2 hours.
C) Keeping the head of the bed elevated at 45 degrees at all times.
D) Applying moisture barriers to intact skin only after a pressure injury
develops.
Correct Answer: B
Frequent repositioning (every 1-2 hours) relieves pressure on bony prominences.
Reddened areas should not be massaged (A) because this can damage capillaries.
The head of bed should be elevated no more than 30 degrees to reduce shear (C).
Moisture barriers are applied to intact skin prophylactically (D).
7. The nurse is measuring a client’s blood pressure manually. Which action is
correct?
A) Deflating the cuff rapidly to prevent prolonged pressure on the arm.
B) Placing the stethoscope over the cuff so it stays in place.
C) Inflating the cuff 30 mm Hg above the point where the radial pulse
disappears.
D) Using a cuff with a bladder that covers 80% of the arm circumference.
Correct Answer: C
The cuff should be inflated until the pulse disappears, then inflated an additional
30 mm Hg to ensure accurate systolic reading. The cuff should be deflated slowly
(2-3 mm Hg per second), not rapidly (A). The stethoscope is placed over the
brachial artery, not under the cuff (B). The bladder width should be 40% of arm
circumference, length 80% (D is imprecise).
8. A client has a new prescription for a 2-gram sodium diet. Which food
selection by the client indicates a need for further teaching?
A) Fresh fruit salad
B) Baked chicken breast with herbs
C) Canned vegetable soup
D) Steamed brown rice
