HESI PN Fundamentals Exam Comprehensive Study Guide,
HESI Fundamentals Practice Questions & Rationales,
Practical Nursing Fundamentals Review Notes, HESI PN
Exam Prep Bundle for Nursing Students – Key Concepts,
Test Strategies & NCLEX-Style Questions
Question 1: A licensed practical nurse is preparing to administer oral medication to a client who
has difficulty swallowing. Which action should the nurse take first?
A. Crush the medication and mix it with applesauce
B. Assess the client's ability to follow instructions
C. Request a liquid formulation from the pharmacy
D. Position the client in high Fowler's position
CORRECT ANSWER: D. Position the client in high Fowler's position
Rationale: Safety is the priority. Positioning the client upright (high Fowler's) reduces aspiration
risk during oral intake. Assessment of swallowing ability and medication formulation are
important but occur after ensuring immediate physical safety. Crushing medications without
verification can alter drug efficacy or cause harm.
Question 2: Which finding should the licensed practical nurse report immediately to the
registered nurse for a client receiving intravenous potassium chloride?
A. Urine output of 40 mL/hr
B. Serum potassium level of 4.2 mEq/L
C. Burning sensation at the IV site
D. Heart rate of 88 beats per minute
CORRECT ANSWER: C. Burning sensation at the IV site
Rationale: Potassium chloride is vesicant and highly irritating to veins. A burning sensation at
the IV site may indicate infiltration or phlebitis, requiring immediate intervention to prevent
tissue necrosis. Urine output >30 mL/hr is adequate; serum potassium 4.2 mEq/L is within
normal limits; heart rate 88 bpm is unremarkable.
Question 3: When performing hand hygiene, the licensed practical nurse understands that
alcohol-based hand rub is contraindicated in which situation?
A. After removing gloves
B. Before administering medication
C. When hands are visibly soiled
,D. After touching the client's bed rail
CORRECT ANSWER: C. When hands are visibly soiled
Rationale: Alcohol-based hand rubs are ineffective when hands are visibly dirty or
contaminated with proteinaceous material. In such cases, soap and water must be used to
mechanically remove debris and pathogens. All other scenarios are appropriate indications for
alcohol-based hand rub per CDC guidelines.
Question 4: A client with a newly applied cast to the left leg reports increasing pain unrelieved
by prescribed analgesics. Which assessment finding requires immediate notification of the
registered nurse?
A. Capillary refill of 3 seconds in the left toes
B. Client reports numbness and tingling in the left foot
C. Slight swelling of the left ankle
D. Warmth of the skin distal to the cast
CORRECT ANSWER: B. Client reports numbness and tingling in the left foot
Rationale: Numbness and tingling suggest neurovascular compromise, possibly compartment
syndrome—a medical emergency. While delayed capillary refill, swelling, or warmth warrant
monitoring, paresthesia indicates nerve ischemia requiring urgent cast evaluation or bivalving.
Early intervention prevents permanent damage.
Question 5: The licensed practical nurse is teaching a client about proper use of a walker. Which
statement by the client indicates understanding?
A. "I will move the walker forward after I take a step."
B. "I will hold the walker with my elbows fully extended."
C. "I will step into the walker after moving it forward."
D. "I will push the walker with my chest for stability."
CORRECT ANSWER: C. "I will step into the walker after moving it forward."
Rationale: Correct walker technique: lift or roll walker forward 6-12 inches, then step into it
while maintaining two points of contact. Elbows should be slightly flexed (20-30 degrees), not
fully extended. Moving the walker after stepping risks loss of balance. Using the chest to push
compromises posture and safety.
Question 6: Which action by the licensed practical nurse demonstrates proper technique when
donning sterile gloves using the open-glove method?
, A. Touching the outside of the first glove with bare fingers
B. Sliding fingers of the gloved hand under the cuff of the second glove
C. Adjusting the fit of the first glove by pulling on the fingers
D. Allowing the gloved hands to drop below waist level
CORRECT ANSWER: B. Sliding fingers of the gloved hand under the cuff of the second glove
Rationale: In the open-glove method, after donning the first glove, the gloved fingers slide
under the folded cuff of the second glove (touching only the inside) to avoid contaminating the
sterile outer surface. Bare fingers must only touch the inside of the first glove's cuff. Adjusting
gloves by pulling fingers or dropping hands below waist compromises sterility.
Question 7: A client is prescribed 25 mg of hydrochlorothiazide orally daily. The pharmacy
supplies 50 mg tablets. How many tablets should the licensed practical nurse administer?
A. 0.25 tablet
B. 0.5 tablet
C. 1 tablet
D. 2 tablets
CORRECT ANSWER: B. 0.5 tablet
Rationale: Desired dose (25 mg) ÷ Available dose (50 mg) = 0.5 tablet. Accurate medication
calculation prevents under- or overdosing. Hydrochlorothiazide tablets are often scored to
allow safe splitting. The nurse must verify institutional policy regarding tablet splitting and use
appropriate equipment.
Question 8: Which finding is the earliest indicator of hypoxia in an adult client?
A. Cyanosis of the lips
B. Restlessness and agitation
C. Bradycardia
D. Decreased level of consciousness
CORRECT ANSWER: B. Restlessness and agitation
Rationale: Restlessness and agitation are early cerebral signs of hypoxia due to decreased
oxygen delivery to the brain. Cyanosis is a late sign requiring significant desaturation.
Bradycardia occurs late; tachycardia is an earlier cardiac response. Decreased LOC indicates
progressive hypoxia. Early recognition enables timely intervention.
HESI Fundamentals Practice Questions & Rationales,
Practical Nursing Fundamentals Review Notes, HESI PN
Exam Prep Bundle for Nursing Students – Key Concepts,
Test Strategies & NCLEX-Style Questions
Question 1: A licensed practical nurse is preparing to administer oral medication to a client who
has difficulty swallowing. Which action should the nurse take first?
A. Crush the medication and mix it with applesauce
B. Assess the client's ability to follow instructions
C. Request a liquid formulation from the pharmacy
D. Position the client in high Fowler's position
CORRECT ANSWER: D. Position the client in high Fowler's position
Rationale: Safety is the priority. Positioning the client upright (high Fowler's) reduces aspiration
risk during oral intake. Assessment of swallowing ability and medication formulation are
important but occur after ensuring immediate physical safety. Crushing medications without
verification can alter drug efficacy or cause harm.
Question 2: Which finding should the licensed practical nurse report immediately to the
registered nurse for a client receiving intravenous potassium chloride?
A. Urine output of 40 mL/hr
B. Serum potassium level of 4.2 mEq/L
C. Burning sensation at the IV site
D. Heart rate of 88 beats per minute
CORRECT ANSWER: C. Burning sensation at the IV site
Rationale: Potassium chloride is vesicant and highly irritating to veins. A burning sensation at
the IV site may indicate infiltration or phlebitis, requiring immediate intervention to prevent
tissue necrosis. Urine output >30 mL/hr is adequate; serum potassium 4.2 mEq/L is within
normal limits; heart rate 88 bpm is unremarkable.
Question 3: When performing hand hygiene, the licensed practical nurse understands that
alcohol-based hand rub is contraindicated in which situation?
A. After removing gloves
B. Before administering medication
C. When hands are visibly soiled
,D. After touching the client's bed rail
CORRECT ANSWER: C. When hands are visibly soiled
Rationale: Alcohol-based hand rubs are ineffective when hands are visibly dirty or
contaminated with proteinaceous material. In such cases, soap and water must be used to
mechanically remove debris and pathogens. All other scenarios are appropriate indications for
alcohol-based hand rub per CDC guidelines.
Question 4: A client with a newly applied cast to the left leg reports increasing pain unrelieved
by prescribed analgesics. Which assessment finding requires immediate notification of the
registered nurse?
A. Capillary refill of 3 seconds in the left toes
B. Client reports numbness and tingling in the left foot
C. Slight swelling of the left ankle
D. Warmth of the skin distal to the cast
CORRECT ANSWER: B. Client reports numbness and tingling in the left foot
Rationale: Numbness and tingling suggest neurovascular compromise, possibly compartment
syndrome—a medical emergency. While delayed capillary refill, swelling, or warmth warrant
monitoring, paresthesia indicates nerve ischemia requiring urgent cast evaluation or bivalving.
Early intervention prevents permanent damage.
Question 5: The licensed practical nurse is teaching a client about proper use of a walker. Which
statement by the client indicates understanding?
A. "I will move the walker forward after I take a step."
B. "I will hold the walker with my elbows fully extended."
C. "I will step into the walker after moving it forward."
D. "I will push the walker with my chest for stability."
CORRECT ANSWER: C. "I will step into the walker after moving it forward."
Rationale: Correct walker technique: lift or roll walker forward 6-12 inches, then step into it
while maintaining two points of contact. Elbows should be slightly flexed (20-30 degrees), not
fully extended. Moving the walker after stepping risks loss of balance. Using the chest to push
compromises posture and safety.
Question 6: Which action by the licensed practical nurse demonstrates proper technique when
donning sterile gloves using the open-glove method?
, A. Touching the outside of the first glove with bare fingers
B. Sliding fingers of the gloved hand under the cuff of the second glove
C. Adjusting the fit of the first glove by pulling on the fingers
D. Allowing the gloved hands to drop below waist level
CORRECT ANSWER: B. Sliding fingers of the gloved hand under the cuff of the second glove
Rationale: In the open-glove method, after donning the first glove, the gloved fingers slide
under the folded cuff of the second glove (touching only the inside) to avoid contaminating the
sterile outer surface. Bare fingers must only touch the inside of the first glove's cuff. Adjusting
gloves by pulling fingers or dropping hands below waist compromises sterility.
Question 7: A client is prescribed 25 mg of hydrochlorothiazide orally daily. The pharmacy
supplies 50 mg tablets. How many tablets should the licensed practical nurse administer?
A. 0.25 tablet
B. 0.5 tablet
C. 1 tablet
D. 2 tablets
CORRECT ANSWER: B. 0.5 tablet
Rationale: Desired dose (25 mg) ÷ Available dose (50 mg) = 0.5 tablet. Accurate medication
calculation prevents under- or overdosing. Hydrochlorothiazide tablets are often scored to
allow safe splitting. The nurse must verify institutional policy regarding tablet splitting and use
appropriate equipment.
Question 8: Which finding is the earliest indicator of hypoxia in an adult client?
A. Cyanosis of the lips
B. Restlessness and agitation
C. Bradycardia
D. Decreased level of consciousness
CORRECT ANSWER: B. Restlessness and agitation
Rationale: Restlessness and agitation are early cerebral signs of hypoxia due to decreased
oxygen delivery to the brain. Cyanosis is a late sign requiring significant desaturation.
Bradycardia occurs late; tachycardia is an earlier cardiac response. Decreased LOC indicates
progressive hypoxia. Early recognition enables timely intervention.
