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EVOLVE Elsevier HESI Fundamentals Exam Study
Guide 2025 | HESI Nursing Fundamentals Practice
Questions, Answers & NCLEX Review
Ace the HESI Fundamentals Exam with this complete Elsevier-based review for 2025.
Includes detailed nursing fundamentals questions, critical thinking strategies, rationales, and
NCLEX-style practice focused on safety, patient care, and clinical reasoning.
• HESI Fundamentals Exam 2025
• Elsevier HESI Fundamentals study guide
• HESI Fundamentals practice questions
• HESI Fundamentals test answers
•
A patient is receiving an IV push medication. If the drug infiltrates into the outer tissues, the nurse: [31]
1. Continues to let the IV run
2. Applies a warm compress to the infiltrated site
3. Stops the administration of the medicine and follows agency policy
4. Should not worry about this because vesicant filtration is not a problem - ANSWER-3
If a patient who is receiving IV fluids develops tenderness, warmth, erythema, and pain at the site, the
nurse suspects: [31]
1. Sepsis
2. Phlebitis
3. Infiltration
,2|Page
4. Fluid overload - ANSWER-2
After seeing a patient, the physician gives a nursing student a verbal order for a new medication. The
nursing student first needs to: [31]
1. Follow ISMP guidelines for safe medication abbreviations
2. Explain to the physician that the order needs to be given to a registered nurse
3. Write the order on the patient's order sheet and read it back to the physician
4. Ensure that the six rights of medication administration are followed when giving the medication -
ANSWER-2
A nurse accidentally gives a patient a medication at the wrong time. The nurse's first priority is to: [31]
1. Complete an occurence report
2. Notify the healthcare provider
3. Inform the charge nurse of the error
4. Assess the patient for adverse effects - ANSWER-4
A patient is taking albuterol through a pressurized metered-dose inhaler that contains a total of 200
puffs. The patient takes 2 puffs every 4 hours. How many days will the inhaler last? [31]
_______ days. - ANSWER-16
The nurse's first action after discovering an electrical fire in a patient's room is to: [27]
1. Activate the fire alarm
2. Confine the fire by closing all doors and windows
3. Remove all patients in immediate danger
4. Extinguish the fire by using the nearest fire extinguisher - ANSWER-3
A parent calls the pediatrician's office frantic about the bottle of cleaner that her 2-year-old son drank.
Which of the following is the most important instruction the nurse gives to this parent? [27]
1. Give the child milk
2. Give the child syrup of ipecac
,3|Page
3. Call the poison control center
4. Take the child to the emergency department - ANSWER-3
43.The nurse is digitally removing a fecal impaction for a client. The nurse should stop the procedure
and take corrective action if which client reaction is noted?
A. Temperature increases from 98.8° to 99.0° F.
B. Pulse rate decreases from 78 to 52 beats/min.
C. Respiratory rate increases from 16 to 24 breaths/min.
D. Blood pressure increases from 110/84 to 118/88 mm/Hg. - ANSWER-Parasympathetic reaction can
occur as a result of digital stimulation of the anal sphincter, which should be stopped if the client
experiences a vagal response, such as bradycardia (B). (A, C, and D) do not warrant stopping the
procedure.
Correct Answer: B
44.A client is admitted with a stage four pressure ulcer that has a black, hardened surface and a light-
pink wound bed with a malodorous green drainage. Which dressing is best for the nurse to use first?
A. Hydrogel.
B. Exudate absorber.
C. Wet to moist dressing.
D. Transparent adhesive film. - ANSWER-To provide moisture and loosen the necrotic tissue, the eschar
should be covered first with wet to moist dressings (C), which are discontinued and then a hydrogel
alginate can be placed in the prepared wound bed to prevent further damage of granulating any
surrounding tissue. Although a hydrogel (A) liquefies necrotic tissue of slough and rehydrates the wound
bed, it does not address wicking the purulent drainage from the wound. Exudate absorbers (B) provide a
moist wound surface, absorb exudate, and support debridement, but do not prepare the wound bed for
proper healing. Transparent dressings (D) are used to protect against contamination and friction while
maintaining a clean moist surface.
Correct Answer: C
45.A 35-year-old female client with cancer refuses to allow the nurse to insert an IV for a scheduled
chemotherapy treatment, and states that she is ready to go home to die. What intervention should the
nurse initiate?
A. Review the client's medical record for an advance directive.
, 4|Page
B. Determine if a do-not-resuscitate prescription has been obtained.
C. Document that the client is being discharged against medical advice.
D. Evaluate the client's mental status for competence to refuse treatment. - ANSWER-Competent clients
have the right to refuse treatment, so the nurse should first ensure that the client is competent (D). (A
and C) are not necessary for a competent client to refuse treatment. The nurse cannot document (C)
until the healthcare provider is notified of the client's wishes and a discharge prescription is obtained.
Correct Answer: D
46.A client with chronic renal disease is admitted to the hospital for evaluation prior to a surgical
procedure. Which laboratory test indicates the client's protein status for the longest length of time?
A. Transferrin.
B. Prealbumin.
C. Serum albumin.
D. Urine urea nitrogen. - ANSWER-Serum albumin has a long half-life and is the best long-term indicator
of the body's entry into a catabolic state following protein depletion from malnutrition or stress of
chronic illness (C). While (A) is a good indicator of iron-binding capacity in a healthy adult, it is an
unreliable measure in the client with a chronic illness. (B) has a short half-life, and is a sensitive indicator
of recent catabolic changes, but it is not as effective as (C) in indicating long-term protein depletion.
While (D) is a good indicator of a negative nitrogen balance, it is not as good an indicator of long-term
protein catabolism as is (C).
Correct Answer: C
47.What client statement indicates to the nurse that the client requires assistance with bathing?
A. I wasn't able to pack a bag before I left for the hospital.
B. I don't understand why I'm so weak and tired.
C. I only bathe every other day.
D. I left my eyeglasses at home. - ANSWER-Bathing often makes a client feel weak, and if a client is
already feeling weak (B), assistance is required during the bathing process to ensure the client's safety.
(A and C) do not pose safety issues. Although (D) may pose a safety issue, further assessment is needed
to determine if this in fact poses a safety issue for the client.
Correct Answer: B
48.How should the nurse handle linens that are soiled with incontinent feces?
EVOLVE Elsevier HESI Fundamentals Exam Study
Guide 2025 | HESI Nursing Fundamentals Practice
Questions, Answers & NCLEX Review
Ace the HESI Fundamentals Exam with this complete Elsevier-based review for 2025.
Includes detailed nursing fundamentals questions, critical thinking strategies, rationales, and
NCLEX-style practice focused on safety, patient care, and clinical reasoning.
• HESI Fundamentals Exam 2025
• Elsevier HESI Fundamentals study guide
• HESI Fundamentals practice questions
• HESI Fundamentals test answers
•
A patient is receiving an IV push medication. If the drug infiltrates into the outer tissues, the nurse: [31]
1. Continues to let the IV run
2. Applies a warm compress to the infiltrated site
3. Stops the administration of the medicine and follows agency policy
4. Should not worry about this because vesicant filtration is not a problem - ANSWER-3
If a patient who is receiving IV fluids develops tenderness, warmth, erythema, and pain at the site, the
nurse suspects: [31]
1. Sepsis
2. Phlebitis
3. Infiltration
,2|Page
4. Fluid overload - ANSWER-2
After seeing a patient, the physician gives a nursing student a verbal order for a new medication. The
nursing student first needs to: [31]
1. Follow ISMP guidelines for safe medication abbreviations
2. Explain to the physician that the order needs to be given to a registered nurse
3. Write the order on the patient's order sheet and read it back to the physician
4. Ensure that the six rights of medication administration are followed when giving the medication -
ANSWER-2
A nurse accidentally gives a patient a medication at the wrong time. The nurse's first priority is to: [31]
1. Complete an occurence report
2. Notify the healthcare provider
3. Inform the charge nurse of the error
4. Assess the patient for adverse effects - ANSWER-4
A patient is taking albuterol through a pressurized metered-dose inhaler that contains a total of 200
puffs. The patient takes 2 puffs every 4 hours. How many days will the inhaler last? [31]
_______ days. - ANSWER-16
The nurse's first action after discovering an electrical fire in a patient's room is to: [27]
1. Activate the fire alarm
2. Confine the fire by closing all doors and windows
3. Remove all patients in immediate danger
4. Extinguish the fire by using the nearest fire extinguisher - ANSWER-3
A parent calls the pediatrician's office frantic about the bottle of cleaner that her 2-year-old son drank.
Which of the following is the most important instruction the nurse gives to this parent? [27]
1. Give the child milk
2. Give the child syrup of ipecac
,3|Page
3. Call the poison control center
4. Take the child to the emergency department - ANSWER-3
43.The nurse is digitally removing a fecal impaction for a client. The nurse should stop the procedure
and take corrective action if which client reaction is noted?
A. Temperature increases from 98.8° to 99.0° F.
B. Pulse rate decreases from 78 to 52 beats/min.
C. Respiratory rate increases from 16 to 24 breaths/min.
D. Blood pressure increases from 110/84 to 118/88 mm/Hg. - ANSWER-Parasympathetic reaction can
occur as a result of digital stimulation of the anal sphincter, which should be stopped if the client
experiences a vagal response, such as bradycardia (B). (A, C, and D) do not warrant stopping the
procedure.
Correct Answer: B
44.A client is admitted with a stage four pressure ulcer that has a black, hardened surface and a light-
pink wound bed with a malodorous green drainage. Which dressing is best for the nurse to use first?
A. Hydrogel.
B. Exudate absorber.
C. Wet to moist dressing.
D. Transparent adhesive film. - ANSWER-To provide moisture and loosen the necrotic tissue, the eschar
should be covered first with wet to moist dressings (C), which are discontinued and then a hydrogel
alginate can be placed in the prepared wound bed to prevent further damage of granulating any
surrounding tissue. Although a hydrogel (A) liquefies necrotic tissue of slough and rehydrates the wound
bed, it does not address wicking the purulent drainage from the wound. Exudate absorbers (B) provide a
moist wound surface, absorb exudate, and support debridement, but do not prepare the wound bed for
proper healing. Transparent dressings (D) are used to protect against contamination and friction while
maintaining a clean moist surface.
Correct Answer: C
45.A 35-year-old female client with cancer refuses to allow the nurse to insert an IV for a scheduled
chemotherapy treatment, and states that she is ready to go home to die. What intervention should the
nurse initiate?
A. Review the client's medical record for an advance directive.
, 4|Page
B. Determine if a do-not-resuscitate prescription has been obtained.
C. Document that the client is being discharged against medical advice.
D. Evaluate the client's mental status for competence to refuse treatment. - ANSWER-Competent clients
have the right to refuse treatment, so the nurse should first ensure that the client is competent (D). (A
and C) are not necessary for a competent client to refuse treatment. The nurse cannot document (C)
until the healthcare provider is notified of the client's wishes and a discharge prescription is obtained.
Correct Answer: D
46.A client with chronic renal disease is admitted to the hospital for evaluation prior to a surgical
procedure. Which laboratory test indicates the client's protein status for the longest length of time?
A. Transferrin.
B. Prealbumin.
C. Serum albumin.
D. Urine urea nitrogen. - ANSWER-Serum albumin has a long half-life and is the best long-term indicator
of the body's entry into a catabolic state following protein depletion from malnutrition or stress of
chronic illness (C). While (A) is a good indicator of iron-binding capacity in a healthy adult, it is an
unreliable measure in the client with a chronic illness. (B) has a short half-life, and is a sensitive indicator
of recent catabolic changes, but it is not as effective as (C) in indicating long-term protein depletion.
While (D) is a good indicator of a negative nitrogen balance, it is not as good an indicator of long-term
protein catabolism as is (C).
Correct Answer: C
47.What client statement indicates to the nurse that the client requires assistance with bathing?
A. I wasn't able to pack a bag before I left for the hospital.
B. I don't understand why I'm so weak and tired.
C. I only bathe every other day.
D. I left my eyeglasses at home. - ANSWER-Bathing often makes a client feel weak, and if a client is
already feeling weak (B), assistance is required during the bathing process to ensure the client's safety.
(A and C) do not pose safety issues. Although (D) may pose a safety issue, further assessment is needed
to determine if this in fact poses a safety issue for the client.
Correct Answer: B
48.How should the nurse handle linens that are soiled with incontinent feces?
