HESI Fundamentals Exit Exam 2026
(Versions 1, 2 & 3) – RN & PN Complete
Test Bank with 100% Verified Answers/
EACH VERSION WITH 160 Q&A
Complete HESI Fundamentals Exit Exam
Pack 2026/2027: Versions1,2&3–
Correct Solutions & DETAILED RATIONALES
Contents
VERSION 1 ------------------------------------------------------------------------------------------------------------- 1
VERSION 2------------------------------------------------------------------------------------------------------- 101
VERSION 3 --------------------------------------------------------------------------------------------------- 206
VERSION 1
QUESTION 1
An elderly client with a fractured left hip is on strict bedrest. Which
nursing measure is essential to the client's nursing care?(Select all that
apply.)
A. Massage any reddened areas for at least five minutes.
B. Encourage active range of motion exercises on extremities.
,C. Position the client laterally, prone, and dorsally in sequence.
D. Gently lift the client when moving into a desired position.
Correct Answer: D. Gently lift the client when moving into a desired
position.
Expert Rationale
To avoid shearing forces when repositioning, the client should be lifted
gently across a surface. Shearing forces occur when the skin remains
stationary against a surface while the underlying tissues and bones
move, causing tearing of small blood vessels and damage to the skin.
This is particularly dangerous for elderly clients who already have fragile
skin and are at high risk for pressure ulcer development. Reddened
areas should never be massaged because this can further traumatize
already damaged tissue and potentially worsen the injury. Active range
of motion exercises may be limited on the affected leg due to pain and
muscle spasms following the fracture, so they should not be
encouraged without specific provider orders. The position described in
option C (lateral, prone, and dorsal in sequence) is contraindicated for a
client with a fractured left hip, as this would cause significant pain and
potentially displace the fracture. Therefore, gently lifting the client
during repositioning is the essential nursing measure to prevent
shearing forces and maintain skin integrity.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process Step:
Implementation MSC: NCLEX: Physiological Integrity (Reduction of Risk
Potential / Skin Integrity / Fractured Hip)
QUESTION 2
,The nurse is administering medications through a nasogastric tube
(NGT) which is connected to suction. After ensuring correct tube
placement, what action should the nurse take next? (Select all that
apply.)
A. Clamp the tube for 20 minutes.
B. Flush the tube with water.
C. Administer the medications as prescribed.
D. Crush the tablets and dissolve in sterile water.
Correct Answer: B. Flush the tube with water.
Expert Rationale
The NGT should be flushed with water before, after, and in between
each medication administered to ensure that the tube remains patent
and that all medication is delivered completely to the stomach. Flushing
before medication administration clears the tube of any residual
contents from suctioning. Flushing between medications prevents drug
interactions within the tube. Flushing after medications ensures that
the full dose has been delivered and prevents clogging of the tube.
Once all medications are administered, the NGT should be clamped for
20 minutes to allow for absorption of the medications. Crushing the
tablets and dissolving them in sterile water is a step that must occur
before administration, not after ensuring tube placement. Therefore,
flushing the tube with water is the correct next action after verifying
tube placement.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process Step:
Implementation MSC: NCLEX: Physiological Integrity (Pharmacological
and Parenteral Therapies / Medication Administration / NGT)
, QUESTION 3
A client who is in hospice care complains of increasing amounts of pain.
The healthcare provider prescribes an analgesic every four hours as
needed. Which action should the nurse implement? (Select all that
apply.)
A. Give an around-the-clock schedule for administration of analgesics.
B. Administer analgesic medication as needed when the pain is severe.
C. Provide medication to keep the client sedated and unaware of
stimuli.
D. Offer a medication-free period so that the client can do daily
activities.
Correct Answer: A. Give an around-the-clock schedule for
administration of analgesics.
Expert Rationale
The most effective management of pain is achieved using an around-
the-clock schedule that provides analgesic medications on a regular
basis and in a timely manner. This approach maintains a therapeutic
blood level of the analgesic, preventing the pain from escalating and
providing consistent comfort. Analgesics are less effective if the client
waits until the pain becomes severe before requesting medication, as
higher doses are then required to achieve relief, and the client
experiences unnecessary suffering. Providing comfort is a priority for
the client who is dying, but sedation that impairs the client's ability to
interact and experience the time before life ends should be minimized,
as this does not promote quality of life. Offering a medication-free
period allows the serum drug level to fall, which is not an effective
method to manage chronic pain and can result in unnecessary suffering.
(Versions 1, 2 & 3) – RN & PN Complete
Test Bank with 100% Verified Answers/
EACH VERSION WITH 160 Q&A
Complete HESI Fundamentals Exit Exam
Pack 2026/2027: Versions1,2&3–
Correct Solutions & DETAILED RATIONALES
Contents
VERSION 1 ------------------------------------------------------------------------------------------------------------- 1
VERSION 2------------------------------------------------------------------------------------------------------- 101
VERSION 3 --------------------------------------------------------------------------------------------------- 206
VERSION 1
QUESTION 1
An elderly client with a fractured left hip is on strict bedrest. Which
nursing measure is essential to the client's nursing care?(Select all that
apply.)
A. Massage any reddened areas for at least five minutes.
B. Encourage active range of motion exercises on extremities.
,C. Position the client laterally, prone, and dorsally in sequence.
D. Gently lift the client when moving into a desired position.
Correct Answer: D. Gently lift the client when moving into a desired
position.
Expert Rationale
To avoid shearing forces when repositioning, the client should be lifted
gently across a surface. Shearing forces occur when the skin remains
stationary against a surface while the underlying tissues and bones
move, causing tearing of small blood vessels and damage to the skin.
This is particularly dangerous for elderly clients who already have fragile
skin and are at high risk for pressure ulcer development. Reddened
areas should never be massaged because this can further traumatize
already damaged tissue and potentially worsen the injury. Active range
of motion exercises may be limited on the affected leg due to pain and
muscle spasms following the fracture, so they should not be
encouraged without specific provider orders. The position described in
option C (lateral, prone, and dorsal in sequence) is contraindicated for a
client with a fractured left hip, as this would cause significant pain and
potentially displace the fracture. Therefore, gently lifting the client
during repositioning is the essential nursing measure to prevent
shearing forces and maintain skin integrity.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process Step:
Implementation MSC: NCLEX: Physiological Integrity (Reduction of Risk
Potential / Skin Integrity / Fractured Hip)
QUESTION 2
,The nurse is administering medications through a nasogastric tube
(NGT) which is connected to suction. After ensuring correct tube
placement, what action should the nurse take next? (Select all that
apply.)
A. Clamp the tube for 20 minutes.
B. Flush the tube with water.
C. Administer the medications as prescribed.
D. Crush the tablets and dissolve in sterile water.
Correct Answer: B. Flush the tube with water.
Expert Rationale
The NGT should be flushed with water before, after, and in between
each medication administered to ensure that the tube remains patent
and that all medication is delivered completely to the stomach. Flushing
before medication administration clears the tube of any residual
contents from suctioning. Flushing between medications prevents drug
interactions within the tube. Flushing after medications ensures that
the full dose has been delivered and prevents clogging of the tube.
Once all medications are administered, the NGT should be clamped for
20 minutes to allow for absorption of the medications. Crushing the
tablets and dissolving them in sterile water is a step that must occur
before administration, not after ensuring tube placement. Therefore,
flushing the tube with water is the correct next action after verifying
tube placement.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process Step:
Implementation MSC: NCLEX: Physiological Integrity (Pharmacological
and Parenteral Therapies / Medication Administration / NGT)
, QUESTION 3
A client who is in hospice care complains of increasing amounts of pain.
The healthcare provider prescribes an analgesic every four hours as
needed. Which action should the nurse implement? (Select all that
apply.)
A. Give an around-the-clock schedule for administration of analgesics.
B. Administer analgesic medication as needed when the pain is severe.
C. Provide medication to keep the client sedated and unaware of
stimuli.
D. Offer a medication-free period so that the client can do daily
activities.
Correct Answer: A. Give an around-the-clock schedule for
administration of analgesics.
Expert Rationale
The most effective management of pain is achieved using an around-
the-clock schedule that provides analgesic medications on a regular
basis and in a timely manner. This approach maintains a therapeutic
blood level of the analgesic, preventing the pain from escalating and
providing consistent comfort. Analgesics are less effective if the client
waits until the pain becomes severe before requesting medication, as
higher doses are then required to achieve relief, and the client
experiences unnecessary suffering. Providing comfort is a priority for
the client who is dying, but sedation that impairs the client's ability to
interact and experience the time before life ends should be minimized,
as this does not promote quality of life. Offering a medication-free
period allows the serum drug level to fall, which is not an effective
method to manage chronic pain and can result in unnecessary suffering.
