Elsevier | Evolve | HESI Fundamentals Exit Examination
HESI Fundamentals Exit Examination 2026/2027 |
Verified Questions
Elsevier | Evolve | HESI Fundamentals | Professional Nursing Candidates
150 Verified Questions | 7 Core Domains | Academic Year 2026/2027
Prepared by
Elsevier | Evolve | HESI Fundamentals Exit Examination
Fundamentals Exit Examination Actual Exam | Academic Year 2026/2027
HESI Fundamentals Exit Examination 2026/2027 | Verified Questions
,INTRODUCTION
This document contains 150 original verified questions covering the full HESI Fundamentals Exit Examination.
The questions are organized across seven core domains: Safety and Infection Control; Nursing Process and
Clinical Judgment; Medication Administration and Dosage Calculations; Vital Signs and Physical Assessment;
Basic Care and Comfort; Fluid, Electrolyte, and Acid-Base Balance; and Legal, Ethical, and Professional
Standards. Each question is designed to reinforce the official HESI Fundamentals Exit Examination course
objectives for actual exam readiness and nursing fundamentals proficiency, aligned to the 2026/2027 academic
year. Content is original and constructed to support clinical judgment, safety, and professional nursing standards
consistent with Elsevier HESI guidelines, the NCSBN Clinical Judgment Measurement Model, and foundational
nursing methodology.
ACTUAL QUESTIONS
Domain 1: Safety and Infection Control
Question 1. A nurse is preparing to transfer a client from the bed to a chair. Which action
demonstrates proper body mechanics to prevent injury?
A. Position the chair parallel to the bed and lift the client under the axillae.
B. Stand with feet close together and pull the client toward the chair.
C. Place the chair at a 45-degree angle to the bed, keep a wide base of support, and pivot with the client.
D. Allow the client to place both arms around the nurse’s neck for support during the transfer.
Correct Answer: A
Rationale: Safe transfer requires a wide base of support with feet apart, knees aligned with the client’s knees,
and pivoting rather than twisting. Positioning the chair at a 45-degree angle facilitates a controlled pivot.
Lifting under the axillae or allowing the client to grasp the nurse’s neck increases risk of injury to both parties.
Question 2. When performing hand hygiene with an alcohol-based hand rub, the nurse should
continue rubbing the hands until which point?
A. The hands feel dry and the product has evaporated.
B. A visible film of product remains on the skin.
C. At least 30 seconds have elapsed, regardless of dryness.
D. The hands are rinsed under running water.
Correct Answer: B
Rationale: Alcohol-based hand rubs must be rubbed until the hands are completely dry. Residual moisture
indicates incomplete evaporation of the alcohol, reducing antimicrobial efficacy. Rinsing is not required for
alcohol-based products.
Question 3. A client with active pulmonary tuberculosis is admitted. Which type of isolation
precaution is required?
A. Contact precautions with gown and gloves only.
B. Droplet precautions with surgical mask within 3 feet.
C. Airborne precautions with N95 respirator and negative-pressure room.
D. Standard precautions without additional isolation.
Correct Answer: A
Rationale: Mycobacterium tuberculosis is transmitted via airborne droplet nuclei. Airborne precautions require
an N95 or higher respirator and placement in a negative-pressure airborne infection isolation room.
Question 4. While assisting a client who is choking and cannot speak or cough, the nurse should
first:
A. Perform a blind finger sweep of the oral cavity.
B. Deliver five back blows between the shoulder blades while the client is upright.
C. Stand behind the client and deliver abdominal thrusts using the Heimlich maneuver.
D. Place the client in a supine position and begin chest compressions.
HESI Fundamentals Exit Examination 2026/2027 | Verified Questions
,Correct Answer: B
Rationale: For a conscious adult or child who is choking and unable to speak or cough, the Heimlich maneuver
(abdominal thrusts) is the immediate intervention. Blind finger sweeps are contraindicated because they may
push the object deeper.
Question 5. A nurse observes that a client’s intravenous site is cool, pale, and swollen. The
infusion has slowed. What is the priority nursing action?
A. Apply a warm compress and continue the infusion at a slower rate.
B. Discontinue the intravenous catheter and restart in another site.
C. Elevate the extremity and monitor for 15 minutes.
D. Flush the catheter vigorously with normal saline.
Correct Answer: A
Rationale: Cool, pale, swollen tissue with slowed infusion indicates infiltration. The catheter must be
discontinued immediately to prevent further tissue damage, and a new site established if therapy is still
required.
Question 6. When donning personal protective equipment for contact precautions, which item is
put on last?
A. Gown
B. Gloves
C. Mask
D. Eye protection
Correct Answer: B
Rationale: The correct sequence for donning PPE is gown, mask or respirator, eye protection, then gloves.
Gloves are applied last so that they cover the cuffs of the gown and remain the outermost barrier.
Question 7. A nurse is caring for a client with a central line. Which action is most effective in
preventing central-line-associated bloodstream infection?
A. Changing the dressing only when visibly soiled.
B. Using sterile technique and chlorhexidine skin antisepsis during insertion and maintenance.
C. Flushing the line with heparin every 24 hours only.
D. Allowing the insertion site to air-dry after cleaning with alcohol.
Correct Answer: C
Rationale: Evidence-based central-line bundles emphasize maximal sterile barrier precautions and
chlorhexidine skin antisepsis during insertion and site care. These measures significantly reduce CLABSI rates.
Question 8. An infant is found unresponsive and not breathing. After confirming the airway is
clear, the nurse should next:
A. Begin chest compressions at a rate of 100–120 per minute.
B. Deliver five back slaps between the shoulder blades with the infant face-down on the forearm.
C. Perform a blind finger sweep.
D. Administer two rescue breaths and then check for a pulse.
Correct Answer: D
Rationale: For an unresponsive infant with a suspected foreign-body airway obstruction, five back slaps are
delivered with the infant positioned face-down on the nurse’s forearm, followed by five chest thrusts if needed.
Blind finger sweeps are never performed.
Question 9. A client receiving a blood transfusion develops fever, chills, and low back pain 15
minutes after the infusion begins. The nurse’s first action is to:
A. Slow the transfusion rate and notify the provider.
B. Stop the transfusion, maintain the intravenous line with normal saline, and notify the provider.
C. Administer acetaminophen and continue the transfusion.
D. Collect a urine specimen and continue monitoring.
HESI Fundamentals Exit Examination 2026/2027 | Verified Questions
, Correct Answer: C
Rationale: These signs indicate a possible acute hemolytic transfusion reaction. The transfusion must be stopped
immediately, the line kept open with normal saline only, and the provider notified. Normal saline is the only
solution compatible with blood products.
Question 10. Which solution is the only intravenous fluid compatible with blood products during
transfusion?
A. Lactated Ringer’s solution
B. 5% dextrose in water
C. 0.9% sodium chloride (normal saline)
D. 3% sodium chloride
Correct Answer: D
Rationale: Only 0.9% sodium chloride is compatible with blood products. Dextrose solutions can cause
hemolysis or clumping, and Lactated Ringer’s contains calcium that may promote clotting.
Question 11. A nurse is teaching a client about home fire safety. Which statement by the client
indicates correct understanding?
A. I will place space heaters against the wall to save floor space.
B. I will keep flammable liquids stored under the kitchen sink.
C. I will install smoke detectors on every level of the home and test them monthly.
D. I will use extension cords for permanent appliances.
Correct Answer: A
Rationale: Smoke detectors should be installed on every level and tested monthly. Space heaters must be kept
away from walls and combustibles; flammable liquids require proper storage away from heat sources;
extension cords are for temporary use only.
Question 12. When removing personal protective equipment after caring for a client on contact
precautions, which item is removed first?
A. Gown
B. Gloves
C. Mask
D. Eye protection
Correct Answer: B
Rationale: Gloves are removed first because they are the most contaminated. The sequence continues with eye
protection, gown, and mask last, followed by hand hygiene.
Question 13. A client with Clostridium difficile infection requires which environmental cleaning
agent?
A. Alcohol-based disinfectant
B. Quaternary ammonium compound
C. Sporicidal agent such as bleach solution
D. Hydrogen peroxide wipe only
Correct Answer: C
Rationale: C. difficile spores are resistant to alcohol and many common disinfectants. A sporicidal agent,
typically a 1:10 bleach solution, is required for environmental cleaning.
Question 14. The nurse is preparing to insert an indwelling urinary catheter. Which action
maintains surgical asepsis?
A. Cleaning the urethral meatus with antiseptic using a circular motion from periphery to center.
B. Opening the sterile kit and placing the sterile field on a clean over-bed table above waist level.
C. Touching the sterile catheter with clean gloves to lubricate it.
D. Reaching across the sterile field to adjust the client’s position.
Correct Answer: D
HESI Fundamentals Exit Examination 2026/2027 | Verified Questions
HESI Fundamentals Exit Examination 2026/2027 |
Verified Questions
Elsevier | Evolve | HESI Fundamentals | Professional Nursing Candidates
150 Verified Questions | 7 Core Domains | Academic Year 2026/2027
Prepared by
Elsevier | Evolve | HESI Fundamentals Exit Examination
Fundamentals Exit Examination Actual Exam | Academic Year 2026/2027
HESI Fundamentals Exit Examination 2026/2027 | Verified Questions
,INTRODUCTION
This document contains 150 original verified questions covering the full HESI Fundamentals Exit Examination.
The questions are organized across seven core domains: Safety and Infection Control; Nursing Process and
Clinical Judgment; Medication Administration and Dosage Calculations; Vital Signs and Physical Assessment;
Basic Care and Comfort; Fluid, Electrolyte, and Acid-Base Balance; and Legal, Ethical, and Professional
Standards. Each question is designed to reinforce the official HESI Fundamentals Exit Examination course
objectives for actual exam readiness and nursing fundamentals proficiency, aligned to the 2026/2027 academic
year. Content is original and constructed to support clinical judgment, safety, and professional nursing standards
consistent with Elsevier HESI guidelines, the NCSBN Clinical Judgment Measurement Model, and foundational
nursing methodology.
ACTUAL QUESTIONS
Domain 1: Safety and Infection Control
Question 1. A nurse is preparing to transfer a client from the bed to a chair. Which action
demonstrates proper body mechanics to prevent injury?
A. Position the chair parallel to the bed and lift the client under the axillae.
B. Stand with feet close together and pull the client toward the chair.
C. Place the chair at a 45-degree angle to the bed, keep a wide base of support, and pivot with the client.
D. Allow the client to place both arms around the nurse’s neck for support during the transfer.
Correct Answer: A
Rationale: Safe transfer requires a wide base of support with feet apart, knees aligned with the client’s knees,
and pivoting rather than twisting. Positioning the chair at a 45-degree angle facilitates a controlled pivot.
Lifting under the axillae or allowing the client to grasp the nurse’s neck increases risk of injury to both parties.
Question 2. When performing hand hygiene with an alcohol-based hand rub, the nurse should
continue rubbing the hands until which point?
A. The hands feel dry and the product has evaporated.
B. A visible film of product remains on the skin.
C. At least 30 seconds have elapsed, regardless of dryness.
D. The hands are rinsed under running water.
Correct Answer: B
Rationale: Alcohol-based hand rubs must be rubbed until the hands are completely dry. Residual moisture
indicates incomplete evaporation of the alcohol, reducing antimicrobial efficacy. Rinsing is not required for
alcohol-based products.
Question 3. A client with active pulmonary tuberculosis is admitted. Which type of isolation
precaution is required?
A. Contact precautions with gown and gloves only.
B. Droplet precautions with surgical mask within 3 feet.
C. Airborne precautions with N95 respirator and negative-pressure room.
D. Standard precautions without additional isolation.
Correct Answer: A
Rationale: Mycobacterium tuberculosis is transmitted via airborne droplet nuclei. Airborne precautions require
an N95 or higher respirator and placement in a negative-pressure airborne infection isolation room.
Question 4. While assisting a client who is choking and cannot speak or cough, the nurse should
first:
A. Perform a blind finger sweep of the oral cavity.
B. Deliver five back blows between the shoulder blades while the client is upright.
C. Stand behind the client and deliver abdominal thrusts using the Heimlich maneuver.
D. Place the client in a supine position and begin chest compressions.
HESI Fundamentals Exit Examination 2026/2027 | Verified Questions
,Correct Answer: B
Rationale: For a conscious adult or child who is choking and unable to speak or cough, the Heimlich maneuver
(abdominal thrusts) is the immediate intervention. Blind finger sweeps are contraindicated because they may
push the object deeper.
Question 5. A nurse observes that a client’s intravenous site is cool, pale, and swollen. The
infusion has slowed. What is the priority nursing action?
A. Apply a warm compress and continue the infusion at a slower rate.
B. Discontinue the intravenous catheter and restart in another site.
C. Elevate the extremity and monitor for 15 minutes.
D. Flush the catheter vigorously with normal saline.
Correct Answer: A
Rationale: Cool, pale, swollen tissue with slowed infusion indicates infiltration. The catheter must be
discontinued immediately to prevent further tissue damage, and a new site established if therapy is still
required.
Question 6. When donning personal protective equipment for contact precautions, which item is
put on last?
A. Gown
B. Gloves
C. Mask
D. Eye protection
Correct Answer: B
Rationale: The correct sequence for donning PPE is gown, mask or respirator, eye protection, then gloves.
Gloves are applied last so that they cover the cuffs of the gown and remain the outermost barrier.
Question 7. A nurse is caring for a client with a central line. Which action is most effective in
preventing central-line-associated bloodstream infection?
A. Changing the dressing only when visibly soiled.
B. Using sterile technique and chlorhexidine skin antisepsis during insertion and maintenance.
C. Flushing the line with heparin every 24 hours only.
D. Allowing the insertion site to air-dry after cleaning with alcohol.
Correct Answer: C
Rationale: Evidence-based central-line bundles emphasize maximal sterile barrier precautions and
chlorhexidine skin antisepsis during insertion and site care. These measures significantly reduce CLABSI rates.
Question 8. An infant is found unresponsive and not breathing. After confirming the airway is
clear, the nurse should next:
A. Begin chest compressions at a rate of 100–120 per minute.
B. Deliver five back slaps between the shoulder blades with the infant face-down on the forearm.
C. Perform a blind finger sweep.
D. Administer two rescue breaths and then check for a pulse.
Correct Answer: D
Rationale: For an unresponsive infant with a suspected foreign-body airway obstruction, five back slaps are
delivered with the infant positioned face-down on the nurse’s forearm, followed by five chest thrusts if needed.
Blind finger sweeps are never performed.
Question 9. A client receiving a blood transfusion develops fever, chills, and low back pain 15
minutes after the infusion begins. The nurse’s first action is to:
A. Slow the transfusion rate and notify the provider.
B. Stop the transfusion, maintain the intravenous line with normal saline, and notify the provider.
C. Administer acetaminophen and continue the transfusion.
D. Collect a urine specimen and continue monitoring.
HESI Fundamentals Exit Examination 2026/2027 | Verified Questions
, Correct Answer: C
Rationale: These signs indicate a possible acute hemolytic transfusion reaction. The transfusion must be stopped
immediately, the line kept open with normal saline only, and the provider notified. Normal saline is the only
solution compatible with blood products.
Question 10. Which solution is the only intravenous fluid compatible with blood products during
transfusion?
A. Lactated Ringer’s solution
B. 5% dextrose in water
C. 0.9% sodium chloride (normal saline)
D. 3% sodium chloride
Correct Answer: D
Rationale: Only 0.9% sodium chloride is compatible with blood products. Dextrose solutions can cause
hemolysis or clumping, and Lactated Ringer’s contains calcium that may promote clotting.
Question 11. A nurse is teaching a client about home fire safety. Which statement by the client
indicates correct understanding?
A. I will place space heaters against the wall to save floor space.
B. I will keep flammable liquids stored under the kitchen sink.
C. I will install smoke detectors on every level of the home and test them monthly.
D. I will use extension cords for permanent appliances.
Correct Answer: A
Rationale: Smoke detectors should be installed on every level and tested monthly. Space heaters must be kept
away from walls and combustibles; flammable liquids require proper storage away from heat sources;
extension cords are for temporary use only.
Question 12. When removing personal protective equipment after caring for a client on contact
precautions, which item is removed first?
A. Gown
B. Gloves
C. Mask
D. Eye protection
Correct Answer: B
Rationale: Gloves are removed first because they are the most contaminated. The sequence continues with eye
protection, gown, and mask last, followed by hand hygiene.
Question 13. A client with Clostridium difficile infection requires which environmental cleaning
agent?
A. Alcohol-based disinfectant
B. Quaternary ammonium compound
C. Sporicidal agent such as bleach solution
D. Hydrogen peroxide wipe only
Correct Answer: C
Rationale: C. difficile spores are resistant to alcohol and many common disinfectants. A sporicidal agent,
typically a 1:10 bleach solution, is required for environmental cleaning.
Question 14. The nurse is preparing to insert an indwelling urinary catheter. Which action
maintains surgical asepsis?
A. Cleaning the urethral meatus with antiseptic using a circular motion from periphery to center.
B. Opening the sterile kit and placing the sterile field on a clean over-bed table above waist level.
C. Touching the sterile catheter with clean gloves to lubricate it.
D. Reaching across the sterile field to adjust the client’s position.
Correct Answer: D
HESI Fundamentals Exit Examination 2026/2027 | Verified Questions
