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HESI Fundamentals 300 Practice
Questions & Answers 2026 – Evolve
HESI Exam Prep with Rationales –
Nursing Fundamentals, Pharmacology,
Med-Surg, & Critical Thinking Q&A
Ace your HESI Fundamentals exam with this
300 Q&A practice set! Each question is
presented clearly with answers in italic bold
and detailed rationales in italic to help you
understand the "why" behind every answer.
Covers key HESI topics: Safety & Infection
Control, Medication Administration & Dosage
Calculations, Nursing Process (ADPIE), Basic
Care & Comfort, Fluid & Electrolytes,
Pharmacology, and Wound Care. Built to mirror
the Evolve HESI platform, this resource
develops critical thinking, clinical judgment,
and test-taking confidence. Perfect for nursing
students at Chamberlain, GCU, Herzing, and
more. Instant download – start practicing now
and pass on your first try!
,2|Page
Question 1:
A client who is 2 days post-operative following an abdominal hysterectomy reports
feeling "gassy" and has not had a bowel movement since before surgery. The nurse
auscultates the abdomen and hears high-pitched, hyperactive bowel sounds in all
four quadrants. Which action should the nurse take first?
A. Administer a prescribed bisacodyl suppository
B. Encourage the client to ambulate in the hallway
C. Offer a warm glass of prune juice
D. Insert a rectal tube to relieve flatus
Answer: B. Encourage the client to ambulate in the hallway
Rationale: Early ambulation is the least invasive and most effective initial intervention
to stimulate peristalsis and promote passage of flatus after abdominal surgery.
Hyperactive bowel sounds indicate that bowel function is returning, so mechanical or
chemical stimulation (suppository, prune juice) is not yet indicated as the first step. A
rectal tube is invasive and carries risks of mucosal trauma; it should be reserved for
persistent, severe gas pain after conservative measures have failed. Ambulation uses
gravity and gentle abdominal muscle movement to help propel gas and stool through
the intestines, making it the priority nursing action.
Question 2:
A nurse is preparing to insert an indwelling urinary catheter in a female client. After
positioning the client, opening the sterile kit, and donning sterile gloves, which step
should the nurse perform next?
A. Lubricate the catheter tip
B. Clean the meatus with antiseptic solution using a circular motion from the outside
in
C. Separate the labia with the nondominant hand and maintain this position
D. Test the balloon by inflating it with sterile saline
Answer: D. Test the balloon by inflating it with sterile saline
Rationale: Before insertion, the nurse must test the balloon to ensure it inflates properly
and is not defective. This is done after donning sterile gloves and before lubricating the
catheter or cleaning the meatus. Cleaning the meatus is performed using a downward
stroke from the inside out (not outside in). Separating the labia is done with the
nondominant hand, but this occurs after testing the balloon and after cleaning, just
,3|Page
prior to insertion. Testing the balloon first prevents having to restart the entire
procedure if the balloon is faulty.
Question 3:
A client with heart failure is prescribed furosemide 40 mg IV push. Which laboratory
value should the nurse monitor most closely before administering this medication?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Answer: B. Serum potassium
Rationale: Furosemide is a loop diuretic that causes significant potassium loss in the
urine, leading to hypokalemia. Hypokalemia increases the risk of cardiac arrhythmias,
especially in clients with heart failure who may also be taking digoxin. While sodium,
calcium, and magnesium can also be affected, potassium is the most critical value to
monitor prior to administration due to its direct impact on cardiac function and the
high risk of depletion.
Question 4:
A nurse is caring for a client on fall precautions. Which intervention is most
appropriate to include in the client's plan of care?
A. Keep the bed in the lowest position with the side rails fully raised
B. Place the call light within reach and encourage use before getting up
C. Apply wrist restraints at night to prevent wandering
D. Keep the room completely dark to promote sleep
Answer: B. Place the call light within reach and encourage use before getting up
Rationale: Keeping the call light within reach empowers the client to ask for assistance,
which is a safe and least-restrictive intervention. Side rails should not be fully raised as
a restraint unless ordered; they can increase injury risk if a client climbs over them.
Wrist restraints require a physician order and are used only as a last resort. A nightlight
should be provided; complete darkness increases fall risk by reducing visibility.
, 4|Page
Question 5:
A nurse is assessing a client's surgical wound 24 hours post-operation. The wound
edges are approximated, there is slight redness, and a small amount of
serosanguineous drainage is noted. Which action should the nurse take?
A. Notify the healthcare provider immediately
B. Culture the drainage for infection
C. Document the findings as normal healing
D. Apply a wet-to-dry dressing to promote debridement
Answer: C. Document the findings as normal healing
Rationale: Approximated wound edges, mild redness, and serosanguineous drainage
(pink-tinged) are expected findings in the first 24–48 hours of healing. This indicates
normal inflammatory response and capillary oozing. There is no sign of infection
(purulent drainage, foul odor, severe redness, or fever), so notifying the provider or
culturing is unnecessary. Wet-to-dry dressings are used for debridement of necrotic
tissue, which is not present here.
Question 6:
A client is receiving a continuous enteral tube feeding at 80 mL/hr. The nurse checks
the gastric residual volume (GRV) and finds 250 mL. Which action should the nurse
take?
A. Discard the residual and continue the feeding at the same rate
B. Hold the feeding and notify the healthcare provider
C. Reinstill the residual and continue the feeding
D. Decrease the rate to 40 mL/hr and recheck in 4 hours
Answer: C. Reinstill the residual and continue the feeding
Rationale: Current guidelines recommend reinstilling gastric residual volumes (up to
500 mL in most institutions) to prevent electrolyte losses and maintain gastric acidity. A
GRV of 250 mL is generally within acceptable limits and does not require holding the
feeding or notifying the provider. Discarding residual is no longer standard practice
unless specifically ordered. Decreasing the rate without an order is outside the nurse's
scope.
HESI Fundamentals 300 Practice
Questions & Answers 2026 – Evolve
HESI Exam Prep with Rationales –
Nursing Fundamentals, Pharmacology,
Med-Surg, & Critical Thinking Q&A
Ace your HESI Fundamentals exam with this
300 Q&A practice set! Each question is
presented clearly with answers in italic bold
and detailed rationales in italic to help you
understand the "why" behind every answer.
Covers key HESI topics: Safety & Infection
Control, Medication Administration & Dosage
Calculations, Nursing Process (ADPIE), Basic
Care & Comfort, Fluid & Electrolytes,
Pharmacology, and Wound Care. Built to mirror
the Evolve HESI platform, this resource
develops critical thinking, clinical judgment,
and test-taking confidence. Perfect for nursing
students at Chamberlain, GCU, Herzing, and
more. Instant download – start practicing now
and pass on your first try!
,2|Page
Question 1:
A client who is 2 days post-operative following an abdominal hysterectomy reports
feeling "gassy" and has not had a bowel movement since before surgery. The nurse
auscultates the abdomen and hears high-pitched, hyperactive bowel sounds in all
four quadrants. Which action should the nurse take first?
A. Administer a prescribed bisacodyl suppository
B. Encourage the client to ambulate in the hallway
C. Offer a warm glass of prune juice
D. Insert a rectal tube to relieve flatus
Answer: B. Encourage the client to ambulate in the hallway
Rationale: Early ambulation is the least invasive and most effective initial intervention
to stimulate peristalsis and promote passage of flatus after abdominal surgery.
Hyperactive bowel sounds indicate that bowel function is returning, so mechanical or
chemical stimulation (suppository, prune juice) is not yet indicated as the first step. A
rectal tube is invasive and carries risks of mucosal trauma; it should be reserved for
persistent, severe gas pain after conservative measures have failed. Ambulation uses
gravity and gentle abdominal muscle movement to help propel gas and stool through
the intestines, making it the priority nursing action.
Question 2:
A nurse is preparing to insert an indwelling urinary catheter in a female client. After
positioning the client, opening the sterile kit, and donning sterile gloves, which step
should the nurse perform next?
A. Lubricate the catheter tip
B. Clean the meatus with antiseptic solution using a circular motion from the outside
in
C. Separate the labia with the nondominant hand and maintain this position
D. Test the balloon by inflating it with sterile saline
Answer: D. Test the balloon by inflating it with sterile saline
Rationale: Before insertion, the nurse must test the balloon to ensure it inflates properly
and is not defective. This is done after donning sterile gloves and before lubricating the
catheter or cleaning the meatus. Cleaning the meatus is performed using a downward
stroke from the inside out (not outside in). Separating the labia is done with the
nondominant hand, but this occurs after testing the balloon and after cleaning, just
,3|Page
prior to insertion. Testing the balloon first prevents having to restart the entire
procedure if the balloon is faulty.
Question 3:
A client with heart failure is prescribed furosemide 40 mg IV push. Which laboratory
value should the nurse monitor most closely before administering this medication?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Answer: B. Serum potassium
Rationale: Furosemide is a loop diuretic that causes significant potassium loss in the
urine, leading to hypokalemia. Hypokalemia increases the risk of cardiac arrhythmias,
especially in clients with heart failure who may also be taking digoxin. While sodium,
calcium, and magnesium can also be affected, potassium is the most critical value to
monitor prior to administration due to its direct impact on cardiac function and the
high risk of depletion.
Question 4:
A nurse is caring for a client on fall precautions. Which intervention is most
appropriate to include in the client's plan of care?
A. Keep the bed in the lowest position with the side rails fully raised
B. Place the call light within reach and encourage use before getting up
C. Apply wrist restraints at night to prevent wandering
D. Keep the room completely dark to promote sleep
Answer: B. Place the call light within reach and encourage use before getting up
Rationale: Keeping the call light within reach empowers the client to ask for assistance,
which is a safe and least-restrictive intervention. Side rails should not be fully raised as
a restraint unless ordered; they can increase injury risk if a client climbs over them.
Wrist restraints require a physician order and are used only as a last resort. A nightlight
should be provided; complete darkness increases fall risk by reducing visibility.
, 4|Page
Question 5:
A nurse is assessing a client's surgical wound 24 hours post-operation. The wound
edges are approximated, there is slight redness, and a small amount of
serosanguineous drainage is noted. Which action should the nurse take?
A. Notify the healthcare provider immediately
B. Culture the drainage for infection
C. Document the findings as normal healing
D. Apply a wet-to-dry dressing to promote debridement
Answer: C. Document the findings as normal healing
Rationale: Approximated wound edges, mild redness, and serosanguineous drainage
(pink-tinged) are expected findings in the first 24–48 hours of healing. This indicates
normal inflammatory response and capillary oozing. There is no sign of infection
(purulent drainage, foul odor, severe redness, or fever), so notifying the provider or
culturing is unnecessary. Wet-to-dry dressings are used for debridement of necrotic
tissue, which is not present here.
Question 6:
A client is receiving a continuous enteral tube feeding at 80 mL/hr. The nurse checks
the gastric residual volume (GRV) and finds 250 mL. Which action should the nurse
take?
A. Discard the residual and continue the feeding at the same rate
B. Hold the feeding and notify the healthcare provider
C. Reinstill the residual and continue the feeding
D. Decrease the rate to 40 mL/hr and recheck in 4 hours
Answer: C. Reinstill the residual and continue the feeding
Rationale: Current guidelines recommend reinstilling gastric residual volumes (up to
500 mL in most institutions) to prevent electrolyte losses and maintain gastric acidity. A
GRV of 250 mL is generally within acceptable limits and does not require holding the
feeding or notifying the provider. Discarding residual is no longer standard practice
unless specifically ordered. Decreasing the rate without an order is outside the nurse's
scope.
