HESI PRACTICE EXAM 2026-2027 – VERIFIED
ANSWERS, UPDATED NURSING PREP
Comprehensive Practice Examination
Total Questions: 150
SECTION 1: FUNDAMENTALS OF NURSING (Questions 1-25)
1. A nurse is preparing to insert a nasogastric tube for a patient with bowel obstruction.
Which position should the nurse place the patient in to facilitate tube insertion?
A. Supine with head flat
B. Left lateral position
C. High Fowler's position with head tilted forward
D. Trendelenburg position
Answer: C. High Fowler's position with head tilted forward
Rationale: High Fowler's position with the head tilted forward allows for natural anatomical
alignment of the oropharynx and esophagus, facilitating easier passage of the NG tube. This
position reduces the risk of tracheal aspiration and makes the patient more comfortable during
the procedure. Supine positioning increases the risk of accidental tracheal intubation.
2. A nurse is caring for a patient with a new colostomy. Which observation would indicate
that the stoma is healthy and functioning properly?
A. Dusky purple color with minimal output
B. Bright red, moist appearance with moderate output
C. Pale, dry appearance with no output
D. Blackened tissue with foul odor
Answer: B. Bright red, moist appearance with moderate output
Rationale: A healthy stoma should appear bright red and moist, similar to the color of oral
mucosa, indicating adequate blood supply. Moderate output within the first 24-48 hours is
expected. Dusky purple, pale, dry, or blackened tissue indicates compromised circulation or
necrosis, which requires immediate intervention.
,3. A patient is prescribed 500 mg of a medication that is available as 250 mg per tablet. How
many tablets should the nurse administer?
A. 1 tablet
B. 2 tablets
C. 3 tablets
D. 4 tablets
Answer: B. 2 tablets
Rationale: Using dimensional analysis: 500 mg ÷ 250 mg/tablet = 2 tablets. Always verify
calculations independently and check for medication errors, including five rights of medication
administration.
4. A nurse is assessing a patient's vital signs. The patient's blood pressure is 148/92 mmHg.
Which category does this reading fall into according to the JNC 8 guidelines?
A. Normal
B. Elevated
C. Stage 1 Hypertension
D. Stage 2 Hypertension
Answer: C. Stage 1 Hypertension
Rationale: According to JNC 8 guidelines, Stage 1 Hypertension is defined as systolic BP of 140-
159 mmHg or diastolic BP of 90-99 mmHg. This patient's reading of 148/92 falls within Stage 1
Hypertension, warranting lifestyle modifications and possible pharmacologic intervention based
on overall cardiovascular risk assessment.
5. A nurse is providing discharge teaching to a patient with heart failure. Which of the
following statements by the patient indicates a need for further teaching?
A. "I will weigh myself every morning before breakfast"
B. "I should limit my fluid intake to 2 liters per day"
C. "I can stop taking my diuretic when I feel better"
D. "I need to monitor for swelling in my feet and ankles"
Answer: C. "I can stop taking my diuretic when I feel better"
Rationale: Patients with heart failure should NEVER stop taking diuretics without healthcare
provider guidance, even if symptoms improve. Stopping diuretics can lead to fluid overload,
worsening of heart failure symptoms, and potentially life-threatening complications. The other
statements demonstrate correct understanding of self-management strategies.
,6. Which of the following is the priority nursing action when a patient experiences a seizure?
A. Insert a bite block to prevent tongue injury
B. Restrain the patient to prevent injury
C. Turn the patient to the side and protect the airway
D. Administer IV diazepam immediately
Answer: C. Turn the patient to the side and protect the airway
Rationale: During a seizure, the priority is to protect the airway and prevent aspiration. Turning
the patient to the side allows secretions to drain and prevents obstruction. Inserting objects into
the mouth is contraindicated as it can cause injury or obstruct the airway. Restraint can cause
injury, and medications are not administered during active seizure activity unless ordered and
available.
7. A patient is receiving a blood transfusion. Fifteen minutes after initiation, the patient
develops chills, fever, and back pain. What should the nurse do first?
A. Decrease the infusion rate
B. Stop the transfusion immediately
C. Administer diphenhydramine as prescribed
D. Notify the healthcare provider
Answer: B. Stop the transfusion immediately
Rationale: The patient is showing signs of a possible transfusion reaction (chills, fever, back
pain). The immediate priority is to stop the transfusion to prevent further complications. After
stopping the transfusion, the nurse should maintain IV access with normal saline, assess the
patient, and then notify the healthcare provider and blood bank. Decreasing the rate would not
be appropriate for a suspected reaction.
8. A nurse is performing a sterile dressing change. Which of the following actions would break
sterile technique?
A. Opening sterile packages away from the body
B. Reaching over the sterile field to obtain additional supplies
C. Keeping sterile field above waist level
D. Pouring sterile solutions into a sterile container
Answer: B. Reaching over the sterile field to obtain additional supplies
Rationale: Reaching over a sterile field compromises sterility as non-sterile arms or clothing may
contaminate the field. Proper sterile technique requires that all actions be performed without
passing over the sterile field. All other options represent correct sterile technique practices.
, 9. A patient with diabetes mellitus is experiencing hypoglycemia. Which of the following
findings would the nurse expect to observe?
A. Dry skin and tachycardia
B. Diaphoresis and tremors
C. Fruity breath odor and polyuria
D. Bradycardia and muscle weakness
Answer: B. Diaphoresis and tremors
Rationale: Hypoglycemia triggers the release of counterregulatory hormones (epinephrine,
glucagon, cortisol), causing autonomic nervous system symptoms including diaphoresis,
tremors, palpitations, and anxiety. Dry skin and fruity breath odor are associated with
hyperglycemia and diabetic ketoacidosis. Polyuria is associated with hyperglycemia.
10. A nurse is assessing a patient's pain level using the numeric rating scale. The patient rates
their pain as 8 out of 10. Which type of pain is this patient most likely experiencing?
A. Mild pain
B. Moderate pain
C. Severe pain
D. Neuropathic pain
Answer: C. Severe pain
Rationale: On a 0-10 numeric rating scale, pain scores of 7-10 indicate severe pain. Mild pain is
typically rated 1-3, moderate pain 4-6, and severe pain 7-10. Pain management should be
tailored to the pain intensity level, with severe pain requiring more aggressive intervention.
11. The nurse is caring for a patient with an indwelling urinary catheter. Which finding
indicates a possible catheter-associated urinary tract infection (CAUTI)?
A. Clear urine with specific gravity of 1.015
B. Foul-smelling, cloudy urine with fever
C. Scant urine output of 30 mL/hr
D. Urine pH of 6.0
Answer: B. Foul-smelling, cloudy urine with fever
Rationale: Signs of CAUTI include cloudy, foul-smelling urine, fever, suprapubic tenderness, and
general malaise. Clear urine with normal specific gravity and pH are not indicative of infection.
Scant output may indicate dehydration or obstruction but is not specific to CAUTI.
12. A patient is prescribed warfarin (Coumadin). Which laboratory value should the nurse
monitor to assess therapeutic effectiveness?
ANSWERS, UPDATED NURSING PREP
Comprehensive Practice Examination
Total Questions: 150
SECTION 1: FUNDAMENTALS OF NURSING (Questions 1-25)
1. A nurse is preparing to insert a nasogastric tube for a patient with bowel obstruction.
Which position should the nurse place the patient in to facilitate tube insertion?
A. Supine with head flat
B. Left lateral position
C. High Fowler's position with head tilted forward
D. Trendelenburg position
Answer: C. High Fowler's position with head tilted forward
Rationale: High Fowler's position with the head tilted forward allows for natural anatomical
alignment of the oropharynx and esophagus, facilitating easier passage of the NG tube. This
position reduces the risk of tracheal aspiration and makes the patient more comfortable during
the procedure. Supine positioning increases the risk of accidental tracheal intubation.
2. A nurse is caring for a patient with a new colostomy. Which observation would indicate
that the stoma is healthy and functioning properly?
A. Dusky purple color with minimal output
B. Bright red, moist appearance with moderate output
C. Pale, dry appearance with no output
D. Blackened tissue with foul odor
Answer: B. Bright red, moist appearance with moderate output
Rationale: A healthy stoma should appear bright red and moist, similar to the color of oral
mucosa, indicating adequate blood supply. Moderate output within the first 24-48 hours is
expected. Dusky purple, pale, dry, or blackened tissue indicates compromised circulation or
necrosis, which requires immediate intervention.
,3. A patient is prescribed 500 mg of a medication that is available as 250 mg per tablet. How
many tablets should the nurse administer?
A. 1 tablet
B. 2 tablets
C. 3 tablets
D. 4 tablets
Answer: B. 2 tablets
Rationale: Using dimensional analysis: 500 mg ÷ 250 mg/tablet = 2 tablets. Always verify
calculations independently and check for medication errors, including five rights of medication
administration.
4. A nurse is assessing a patient's vital signs. The patient's blood pressure is 148/92 mmHg.
Which category does this reading fall into according to the JNC 8 guidelines?
A. Normal
B. Elevated
C. Stage 1 Hypertension
D. Stage 2 Hypertension
Answer: C. Stage 1 Hypertension
Rationale: According to JNC 8 guidelines, Stage 1 Hypertension is defined as systolic BP of 140-
159 mmHg or diastolic BP of 90-99 mmHg. This patient's reading of 148/92 falls within Stage 1
Hypertension, warranting lifestyle modifications and possible pharmacologic intervention based
on overall cardiovascular risk assessment.
5. A nurse is providing discharge teaching to a patient with heart failure. Which of the
following statements by the patient indicates a need for further teaching?
A. "I will weigh myself every morning before breakfast"
B. "I should limit my fluid intake to 2 liters per day"
C. "I can stop taking my diuretic when I feel better"
D. "I need to monitor for swelling in my feet and ankles"
Answer: C. "I can stop taking my diuretic when I feel better"
Rationale: Patients with heart failure should NEVER stop taking diuretics without healthcare
provider guidance, even if symptoms improve. Stopping diuretics can lead to fluid overload,
worsening of heart failure symptoms, and potentially life-threatening complications. The other
statements demonstrate correct understanding of self-management strategies.
,6. Which of the following is the priority nursing action when a patient experiences a seizure?
A. Insert a bite block to prevent tongue injury
B. Restrain the patient to prevent injury
C. Turn the patient to the side and protect the airway
D. Administer IV diazepam immediately
Answer: C. Turn the patient to the side and protect the airway
Rationale: During a seizure, the priority is to protect the airway and prevent aspiration. Turning
the patient to the side allows secretions to drain and prevents obstruction. Inserting objects into
the mouth is contraindicated as it can cause injury or obstruct the airway. Restraint can cause
injury, and medications are not administered during active seizure activity unless ordered and
available.
7. A patient is receiving a blood transfusion. Fifteen minutes after initiation, the patient
develops chills, fever, and back pain. What should the nurse do first?
A. Decrease the infusion rate
B. Stop the transfusion immediately
C. Administer diphenhydramine as prescribed
D. Notify the healthcare provider
Answer: B. Stop the transfusion immediately
Rationale: The patient is showing signs of a possible transfusion reaction (chills, fever, back
pain). The immediate priority is to stop the transfusion to prevent further complications. After
stopping the transfusion, the nurse should maintain IV access with normal saline, assess the
patient, and then notify the healthcare provider and blood bank. Decreasing the rate would not
be appropriate for a suspected reaction.
8. A nurse is performing a sterile dressing change. Which of the following actions would break
sterile technique?
A. Opening sterile packages away from the body
B. Reaching over the sterile field to obtain additional supplies
C. Keeping sterile field above waist level
D. Pouring sterile solutions into a sterile container
Answer: B. Reaching over the sterile field to obtain additional supplies
Rationale: Reaching over a sterile field compromises sterility as non-sterile arms or clothing may
contaminate the field. Proper sterile technique requires that all actions be performed without
passing over the sterile field. All other options represent correct sterile technique practices.
, 9. A patient with diabetes mellitus is experiencing hypoglycemia. Which of the following
findings would the nurse expect to observe?
A. Dry skin and tachycardia
B. Diaphoresis and tremors
C. Fruity breath odor and polyuria
D. Bradycardia and muscle weakness
Answer: B. Diaphoresis and tremors
Rationale: Hypoglycemia triggers the release of counterregulatory hormones (epinephrine,
glucagon, cortisol), causing autonomic nervous system symptoms including diaphoresis,
tremors, palpitations, and anxiety. Dry skin and fruity breath odor are associated with
hyperglycemia and diabetic ketoacidosis. Polyuria is associated with hyperglycemia.
10. A nurse is assessing a patient's pain level using the numeric rating scale. The patient rates
their pain as 8 out of 10. Which type of pain is this patient most likely experiencing?
A. Mild pain
B. Moderate pain
C. Severe pain
D. Neuropathic pain
Answer: C. Severe pain
Rationale: On a 0-10 numeric rating scale, pain scores of 7-10 indicate severe pain. Mild pain is
typically rated 1-3, moderate pain 4-6, and severe pain 7-10. Pain management should be
tailored to the pain intensity level, with severe pain requiring more aggressive intervention.
11. The nurse is caring for a patient with an indwelling urinary catheter. Which finding
indicates a possible catheter-associated urinary tract infection (CAUTI)?
A. Clear urine with specific gravity of 1.015
B. Foul-smelling, cloudy urine with fever
C. Scant urine output of 30 mL/hr
D. Urine pH of 6.0
Answer: B. Foul-smelling, cloudy urine with fever
Rationale: Signs of CAUTI include cloudy, foul-smelling urine, fever, suprapubic tenderness, and
general malaise. Clear urine with normal specific gravity and pH are not indicative of infection.
Scant output may indicate dehydration or obstruction but is not specific to CAUTI.
12. A patient is prescribed warfarin (Coumadin). Which laboratory value should the nurse
monitor to assess therapeutic effectiveness?
