Spring Semester 2026 | HESI Fundamentals
Exam – Complete Nursing Foundations Review,
Patient Safety, Infection Control, Vital Signs,
Basic Skills, Communication, Legal & Ethical
Concepts, Clinical Judgment, NCLEX-Style
Practice Questions & High-Yield Exam
Preparation
Question 1:
What is the primary purpose of hand hygiene in a healthcare setting?
A) To prevent the spread of infections
B) To protect patient health and safety
C) To comply with hospital regulations
D) To remove visible dirt
Correct Option: B
Rationale: Hand hygiene is fundamental in healthcare as it significantly reduces the
transmission of pathogens, thereby protecting patient health and safety. It is a primary
defense against infections, particularly in environments where patients may have
compromised immune systems.
Question 2:
Which assessment finding is most concerning in a patient with a respiratory
illness?
A) Mild wheezing
B) Productive cough with yellow sputum
C) Oxygen saturation of 92%
D) Severe respiratory distress
Correct Option: D
Rationale: Severe respiratory distress indicates a potential life-threatening situation
and requires immediate intervention. While other findings may warrant attention, they
do not present as urgent a risk to the patient’s life as severe distress does.
Question 3:
A patient receiving anticoagulant therapy requires further teaching if they state:
A) “I should avoid sharp objects and use an electric razor.”
B) “I will follow up with my doctor for regular INR checks.”
,C) “I should report any unusual bruising or bleeding.”
D) “I can take any over-the-counter supplements without consulting my doctor.”
Correct Option: D
Rationale: Patients on anticoagulants must be cautious about any medications,
including over-the-counter supplements, that could increase bleeding risk. This
statement indicates a lack of understanding of the importance of medical consultation
regarding other medications and potential interactions.
Question 4:
Which of the following actions should a nurse take first when caring for a patient
with a suspected anaphylactic reaction?
A) Administer oxygen
B) Start an IV line
C) Administer epinephrine
D) Monitor vital signs
Correct Option: C
Rationale: In cases of anaphylaxis, the priority intervention is the immediate
administration of epinephrine, which counteracts the life-threatening effects of the
reaction. Oxygen supplementation and IV access are important but should follow the
administration of epinephrine.
Question 5:
A nurse is caring for a patient who is post-operative day 2. The patient reports pain
at the surgical site rated 8 out of 10. What is the nurse's best initial action?
A) Offer ice packs to the area
B) Assess the surgical site for signs of complications
C) Administer prescribed pain medication
D) Document the patient's report
Correct Option: B
Rationale: Before any interventions such as medication or comfort measures, it is
essential for the nurse to physically assess the surgical site for any signs of
complications like infection, hematoma, or excessive bleeding. This assessment guides
the appropriate response to the patient’s pain.
Question 6:
What is the most effective method to prevent the spread of healthcare-associated
infections in a hospital setting?
,A) Hand hygiene practices
B) Use of personal protective equipment (PPE)
C) Frequent environmental cleaning
D) Vaccination of staff
Correct Option: A
Rationale: Hand hygiene is the most effective method for preventing the spread of
infections in healthcare settings. Proper handwashing before and after patient contact
significantly reduces the transmission of pathogens.
Question 7:
In a patient with diabetes mellitus, which of the following symptoms would
indicate hyperglycemia?
A) Sweating and tremors
B) Increased thirst and frequent urination
C) Dizziness and confusion
D) Shakiness and irritability
Correct Option: B
Rationale: Hyperglycemia is characterized by symptoms such as increased thirst
(polydipsia) and frequent urination (polyuria). Understanding these symptoms helps in
better management of the condition.
Question 8:
Which action should the nurse take when a patient refuses medication?
A) Tell the patient they must take the medication
B) Assess the patient’s reasons for refusal
C) Document the refusal without further action
D) Offer the medication again later
Correct Option: B
Rationale: It is essential for the nurse to understand the patient’s reasons for refusing
medication. This assessment can reveal misconceptions, fears, or side effects that can
be addressed to encourage adherence.
Question 9:
What is the most important action for a nurse to take when preparing to administer
a blood transfusion?
, A) Verify the patient's identity and blood compatibility
B) Pre-medicate the patient with antihistamines
C) Ensure the patient has eaten
D) Take baseline vital signs only after starting the transfusion
Correct Option: A
Rationale: The most crucial action is to verify the patient’s identity and ensure blood
compatibility to prevent transfusion reactions. This safety measure is fundamental to
patient care during transfusions.
Question 10:
A nurse is preparing to teach a patient about the use of a metered-dose inhaler
(MDI). Which statement should the nurse include?
A) “Hold your breath for 5 seconds after inhalation.”
B) “Shake the inhaler before each use.”
C) “Use the inhaler only when you feel short of breath.”
D) “You can use the MDI during meals.”
Correct Option: B
Rationale: Shaking the inhaler before use is important to ensure proper mixing of
medication and propellant, which is essential for effective delivery to the lungs.
Question 11:
Which vital sign abnormality is most concerning for a patient with a history of
cardiovascular disease?
A) Respiratory rate of 20 breaths per minute
B) Blood pressure of 180/100 mmHg
C) Temperature of 100.4°F
D) Heart rate of 80 beats per minute
Correct Option: B
Rationale: A blood pressure reading of 180/100 mmHg is indicative of hypertension and
poses a significant risk for cardiovascular complications, necessitating prompt
assessment and intervention.
Question 12:
What is the primary purpose of the preoperative assessment?
Exam – Complete Nursing Foundations Review,
Patient Safety, Infection Control, Vital Signs,
Basic Skills, Communication, Legal & Ethical
Concepts, Clinical Judgment, NCLEX-Style
Practice Questions & High-Yield Exam
Preparation
Question 1:
What is the primary purpose of hand hygiene in a healthcare setting?
A) To prevent the spread of infections
B) To protect patient health and safety
C) To comply with hospital regulations
D) To remove visible dirt
Correct Option: B
Rationale: Hand hygiene is fundamental in healthcare as it significantly reduces the
transmission of pathogens, thereby protecting patient health and safety. It is a primary
defense against infections, particularly in environments where patients may have
compromised immune systems.
Question 2:
Which assessment finding is most concerning in a patient with a respiratory
illness?
A) Mild wheezing
B) Productive cough with yellow sputum
C) Oxygen saturation of 92%
D) Severe respiratory distress
Correct Option: D
Rationale: Severe respiratory distress indicates a potential life-threatening situation
and requires immediate intervention. While other findings may warrant attention, they
do not present as urgent a risk to the patient’s life as severe distress does.
Question 3:
A patient receiving anticoagulant therapy requires further teaching if they state:
A) “I should avoid sharp objects and use an electric razor.”
B) “I will follow up with my doctor for regular INR checks.”
,C) “I should report any unusual bruising or bleeding.”
D) “I can take any over-the-counter supplements without consulting my doctor.”
Correct Option: D
Rationale: Patients on anticoagulants must be cautious about any medications,
including over-the-counter supplements, that could increase bleeding risk. This
statement indicates a lack of understanding of the importance of medical consultation
regarding other medications and potential interactions.
Question 4:
Which of the following actions should a nurse take first when caring for a patient
with a suspected anaphylactic reaction?
A) Administer oxygen
B) Start an IV line
C) Administer epinephrine
D) Monitor vital signs
Correct Option: C
Rationale: In cases of anaphylaxis, the priority intervention is the immediate
administration of epinephrine, which counteracts the life-threatening effects of the
reaction. Oxygen supplementation and IV access are important but should follow the
administration of epinephrine.
Question 5:
A nurse is caring for a patient who is post-operative day 2. The patient reports pain
at the surgical site rated 8 out of 10. What is the nurse's best initial action?
A) Offer ice packs to the area
B) Assess the surgical site for signs of complications
C) Administer prescribed pain medication
D) Document the patient's report
Correct Option: B
Rationale: Before any interventions such as medication or comfort measures, it is
essential for the nurse to physically assess the surgical site for any signs of
complications like infection, hematoma, or excessive bleeding. This assessment guides
the appropriate response to the patient’s pain.
Question 6:
What is the most effective method to prevent the spread of healthcare-associated
infections in a hospital setting?
,A) Hand hygiene practices
B) Use of personal protective equipment (PPE)
C) Frequent environmental cleaning
D) Vaccination of staff
Correct Option: A
Rationale: Hand hygiene is the most effective method for preventing the spread of
infections in healthcare settings. Proper handwashing before and after patient contact
significantly reduces the transmission of pathogens.
Question 7:
In a patient with diabetes mellitus, which of the following symptoms would
indicate hyperglycemia?
A) Sweating and tremors
B) Increased thirst and frequent urination
C) Dizziness and confusion
D) Shakiness and irritability
Correct Option: B
Rationale: Hyperglycemia is characterized by symptoms such as increased thirst
(polydipsia) and frequent urination (polyuria). Understanding these symptoms helps in
better management of the condition.
Question 8:
Which action should the nurse take when a patient refuses medication?
A) Tell the patient they must take the medication
B) Assess the patient’s reasons for refusal
C) Document the refusal without further action
D) Offer the medication again later
Correct Option: B
Rationale: It is essential for the nurse to understand the patient’s reasons for refusing
medication. This assessment can reveal misconceptions, fears, or side effects that can
be addressed to encourage adherence.
Question 9:
What is the most important action for a nurse to take when preparing to administer
a blood transfusion?
, A) Verify the patient's identity and blood compatibility
B) Pre-medicate the patient with antihistamines
C) Ensure the patient has eaten
D) Take baseline vital signs only after starting the transfusion
Correct Option: A
Rationale: The most crucial action is to verify the patient’s identity and ensure blood
compatibility to prevent transfusion reactions. This safety measure is fundamental to
patient care during transfusions.
Question 10:
A nurse is preparing to teach a patient about the use of a metered-dose inhaler
(MDI). Which statement should the nurse include?
A) “Hold your breath for 5 seconds after inhalation.”
B) “Shake the inhaler before each use.”
C) “Use the inhaler only when you feel short of breath.”
D) “You can use the MDI during meals.”
Correct Option: B
Rationale: Shaking the inhaler before use is important to ensure proper mixing of
medication and propellant, which is essential for effective delivery to the lungs.
Question 11:
Which vital sign abnormality is most concerning for a patient with a history of
cardiovascular disease?
A) Respiratory rate of 20 breaths per minute
B) Blood pressure of 180/100 mmHg
C) Temperature of 100.4°F
D) Heart rate of 80 beats per minute
Correct Option: B
Rationale: A blood pressure reading of 180/100 mmHg is indicative of hypertension and
poses a significant risk for cardiovascular complications, necessitating prompt
assessment and intervention.
Question 12:
What is the primary purpose of the preoperative assessment?
