HESI Fundamentals Exam Practice Test
Bank 2026/2027: 100 Questions with
Answers, Rationales, and Clinical Judgment
Review for Nursing Students
Description:
Ace the HESI Fundamentals exam with a 100-question practice test bank updated for
2026/2027. Every item includes a verified answer, a full rationale covering all four options,
and a cognitive-level tag for clinical judgment review. Topics span Safety and Infection
Control, Pharmacological Therapies, Basic Care and Comfort, Health Promotion,
Psychosocial Integrity, and Physiological Adaptation, aligned to the NCLEX-RN 2026 Test
Plan and the HESI blueprint. An instructor version is included for classroom use.
Download the complete HESI Fundamentals Test Bank 2026/2027 and walk into exam day fully
prepared.
, HESI Fundamentals Practice Test 2026/2027 — 100 Questions &
Answers
Section One: Foundations of Nursing Practice
1. A client with a history of hypertension informs the nurse that he plans to discontinue his
antihypertensive medications and rely solely on spiritual meditation to manage his blood
pressure. What is the nurse's most appropriate initial response?
A. "You should obtain your healthcare provider's permission before starting meditation."
B. "Spiritual meditation requires a daily commitment of at least 15 to 20 minutes."
C. "Complementary therapies can replace Western medicine when practiced consistently."
D. "It is important that you continue your medication while learning to meditate."
Answer: D
Explanation: The prolonged practice of meditation may eventually reduce the need for
antihypertensive medications; however, this physiologic response must be monitored over time.
The client must continue prescribed medications during this transition period to prevent
hypertensive crisis. Option A is incorrect because permission is not required to begin
meditation—notification is sufficient. Option B addresses logistics rather than client safety.
Option C is dangerously misleading; complementary therapies work alongside, not instead of,
prescribed treatment. This item evaluates the nurse's ability to prioritize client safety while
respecting complementary health practices under Management of Care.
2. The nurse is caring for a client receiving 24-hour total parenteral nutrition (TPN) via a
central line at 54 mL/hr. Upon assessment, the nurse notes the TPN solution has run out
and the next bag is unavailable. What immediate action should the nurse take?
A. Infuse 10% dextrose in water at 54 mL/hr.
B. Discontinue the IV and flush the port with heparin.
C. Infuse normal saline at a keep-vein-open rate.
D. Obtain a stat blood glucose level and notify the healthcare provider.
,Answer: A
Explanation: TPN must be discontinued gradually to prevent rebound hypoglycemia. Infusing
10% dextrose in water at the prescribed rate maintains the client's glucose level until the next
TPN solution is available. Option B would cause abrupt cessation and potential hypoglycemia.
Option C does not provide sufficient glucose to prevent hypoglycemia. Option D delays
intervention; the nurse must act immediately to maintain glycemic stability. This item assesses
parenteral nutrition management under Pharmacological and Parenteral Therapies.
3. A client with a suspected frontal lobe injury is being assessed for cognitive changes.
Which finding should the nurse prioritize as most consistent with frontal lobe dysfunction?
A. Difficulty identifying objects placed in the hand with eyes closed.
B. Impaired judgment, disinhibition, and personality changes.
C. Inability to localize sound to one side.
D. Loss of peripheral vision in both visual fields.
Answer: B
Explanation: The frontal lobe governs higher-order executive functions including judgment,
impulse control, personality, and social behavior. Impaired judgment, disinhibition, and
personality change are the classic hallmarks of frontal lobe dysfunction. Option A describes
astereognosis, associated with parietal lobe damage. Option C describes auditory localization
deficits, associated with temporal lobe involvement. Option D describes homonymous
hemianopsia, associated with occipital lobe or optic pathway damage. This item assesses
neurologic assessment at the Analysis level under Reduction of Risk Potential.
4. The nurse is evaluating a client's understanding of a low-sodium diet. Which meal
selection indicates effective teaching?
A. Ham sandwich, tomato soup, and salted crackers
B. Bacon, lettuce, and tomato sandwich with pickles
C. Skim milk, turkey salad, roll, and vanilla ice cream
D. Canned vegetable soup with salted crackers and cheese
, Answer: C
Explanation: This meal is lowest in sodium among the options. Fresh turkey, skim milk, and
vanilla ice cream have relatively low sodium content compared to processed meats such as ham
and bacon, canned soups, and pickled items. Option A contains ham and tomato soup, both high
in sodium. Option B includes bacon and pickles. Option D features canned soup and cheese. This
item evaluates the nurse's ability to assess client learning under Health Promotion and
Maintenance.
5. A client with high cholesterol is receiving dietary instruction. Which statement indicates
the teaching has been effective?
A. "I will exercise at least twice weekly for one hour to lower my cholesterol."
B. "I will limit my intake of beef to 4 ounces per week."
C. "I need to eliminate all proteins, including red meat, from my diet."
D. "My blood level of low-density lipoproteins needs to increase."
Answer: B
Explanation: Limiting saturated fat from animal sources to no more than 4 ounces per week is
an evidence-based dietary modification for lowering cholesterol. Option A is insufficient;
effective cholesterol reduction requires 30 minutes of exercise daily or at least 4 to 6 times
weekly. Option C is unnecessary and potentially harmful; lean proteins should be included in
moderation. Option D is incorrect because LDL levels should decrease, not increase. This item
assesses client education effectiveness under Health Promotion and Maintenance.
6. A client receiving hospice care reports increasing pain. The healthcare provider
prescribes an analgesic every four hours as needed. Which action should the nurse
implement?
A. Give an around-the-clock schedule for analgesic administration.
B. Administer the analgesic only when the client reports severe pain.
C. Provide medication to keep the client sedated and unaware of stimuli.
D. Offer a medication-free period so the client can participate in daily activities.
Bank 2026/2027: 100 Questions with
Answers, Rationales, and Clinical Judgment
Review for Nursing Students
Description:
Ace the HESI Fundamentals exam with a 100-question practice test bank updated for
2026/2027. Every item includes a verified answer, a full rationale covering all four options,
and a cognitive-level tag for clinical judgment review. Topics span Safety and Infection
Control, Pharmacological Therapies, Basic Care and Comfort, Health Promotion,
Psychosocial Integrity, and Physiological Adaptation, aligned to the NCLEX-RN 2026 Test
Plan and the HESI blueprint. An instructor version is included for classroom use.
Download the complete HESI Fundamentals Test Bank 2026/2027 and walk into exam day fully
prepared.
, HESI Fundamentals Practice Test 2026/2027 — 100 Questions &
Answers
Section One: Foundations of Nursing Practice
1. A client with a history of hypertension informs the nurse that he plans to discontinue his
antihypertensive medications and rely solely on spiritual meditation to manage his blood
pressure. What is the nurse's most appropriate initial response?
A. "You should obtain your healthcare provider's permission before starting meditation."
B. "Spiritual meditation requires a daily commitment of at least 15 to 20 minutes."
C. "Complementary therapies can replace Western medicine when practiced consistently."
D. "It is important that you continue your medication while learning to meditate."
Answer: D
Explanation: The prolonged practice of meditation may eventually reduce the need for
antihypertensive medications; however, this physiologic response must be monitored over time.
The client must continue prescribed medications during this transition period to prevent
hypertensive crisis. Option A is incorrect because permission is not required to begin
meditation—notification is sufficient. Option B addresses logistics rather than client safety.
Option C is dangerously misleading; complementary therapies work alongside, not instead of,
prescribed treatment. This item evaluates the nurse's ability to prioritize client safety while
respecting complementary health practices under Management of Care.
2. The nurse is caring for a client receiving 24-hour total parenteral nutrition (TPN) via a
central line at 54 mL/hr. Upon assessment, the nurse notes the TPN solution has run out
and the next bag is unavailable. What immediate action should the nurse take?
A. Infuse 10% dextrose in water at 54 mL/hr.
B. Discontinue the IV and flush the port with heparin.
C. Infuse normal saline at a keep-vein-open rate.
D. Obtain a stat blood glucose level and notify the healthcare provider.
,Answer: A
Explanation: TPN must be discontinued gradually to prevent rebound hypoglycemia. Infusing
10% dextrose in water at the prescribed rate maintains the client's glucose level until the next
TPN solution is available. Option B would cause abrupt cessation and potential hypoglycemia.
Option C does not provide sufficient glucose to prevent hypoglycemia. Option D delays
intervention; the nurse must act immediately to maintain glycemic stability. This item assesses
parenteral nutrition management under Pharmacological and Parenteral Therapies.
3. A client with a suspected frontal lobe injury is being assessed for cognitive changes.
Which finding should the nurse prioritize as most consistent with frontal lobe dysfunction?
A. Difficulty identifying objects placed in the hand with eyes closed.
B. Impaired judgment, disinhibition, and personality changes.
C. Inability to localize sound to one side.
D. Loss of peripheral vision in both visual fields.
Answer: B
Explanation: The frontal lobe governs higher-order executive functions including judgment,
impulse control, personality, and social behavior. Impaired judgment, disinhibition, and
personality change are the classic hallmarks of frontal lobe dysfunction. Option A describes
astereognosis, associated with parietal lobe damage. Option C describes auditory localization
deficits, associated with temporal lobe involvement. Option D describes homonymous
hemianopsia, associated with occipital lobe or optic pathway damage. This item assesses
neurologic assessment at the Analysis level under Reduction of Risk Potential.
4. The nurse is evaluating a client's understanding of a low-sodium diet. Which meal
selection indicates effective teaching?
A. Ham sandwich, tomato soup, and salted crackers
B. Bacon, lettuce, and tomato sandwich with pickles
C. Skim milk, turkey salad, roll, and vanilla ice cream
D. Canned vegetable soup with salted crackers and cheese
, Answer: C
Explanation: This meal is lowest in sodium among the options. Fresh turkey, skim milk, and
vanilla ice cream have relatively low sodium content compared to processed meats such as ham
and bacon, canned soups, and pickled items. Option A contains ham and tomato soup, both high
in sodium. Option B includes bacon and pickles. Option D features canned soup and cheese. This
item evaluates the nurse's ability to assess client learning under Health Promotion and
Maintenance.
5. A client with high cholesterol is receiving dietary instruction. Which statement indicates
the teaching has been effective?
A. "I will exercise at least twice weekly for one hour to lower my cholesterol."
B. "I will limit my intake of beef to 4 ounces per week."
C. "I need to eliminate all proteins, including red meat, from my diet."
D. "My blood level of low-density lipoproteins needs to increase."
Answer: B
Explanation: Limiting saturated fat from animal sources to no more than 4 ounces per week is
an evidence-based dietary modification for lowering cholesterol. Option A is insufficient;
effective cholesterol reduction requires 30 minutes of exercise daily or at least 4 to 6 times
weekly. Option C is unnecessary and potentially harmful; lean proteins should be included in
moderation. Option D is incorrect because LDL levels should decrease, not increase. This item
assesses client education effectiveness under Health Promotion and Maintenance.
6. A client receiving hospice care reports increasing pain. The healthcare provider
prescribes an analgesic every four hours as needed. Which action should the nurse
implement?
A. Give an around-the-clock schedule for analgesic administration.
B. Administer the analgesic only when the client reports severe pain.
C. Provide medication to keep the client sedated and unaware of stimuli.
D. Offer a medication-free period so the client can participate in daily activities.
