HESI FUNDAMENTALS PRACTICE EXAM 2026/2027 | 100%
Correct Answers with Complete Solutions | Updated Edition |
NCLEX-RN Aligned | Pass Guaranteed - A+ Graded
Section 1: Safe and Effective Care Environment (25 Questions)
Q1: The nurse is caring for four clients on a medical-surgical unit. Which client requires
the nurse's immediate attention?
A. A client 2 hours post-op appendectomy with a respiratory rate of 18/min and pain
rated 3/10
B. A client with pneumonia whose oxygen saturation dropped from 94% to 88% on room
air [CORRECT]
C. A client with heart failure requesting assistance to ambulate to the bathroom
D. A client with diabetes mellitus complaining of thirst and requesting water
Correct Answer: B
Rationale: Apply the ABCs (Airway, Breathing, Circulation) priority framework. An oxygen
saturation of 88% indicates significant hypoxemia requiring immediate intervention to
prevent respiratory failure. This represents a threat to the patient's physiological
,stability. Why A is incorrect: Post-op pain of 3/10 and normal respiratory rate are
expected findings, not emergent. Why C is incorrect: Ambulation assistance, while
important for preventing complications, does not represent an immediate physiological
threat. Why D is incorrect: Thirst in diabetes is expected with hyperglycemia; while
glucose should be checked, this is not immediately life-threatening compared to
hypoxemia.
Q2: The charge nurse is delegating tasks to the nursing team. Which task is most
appropriate to delegate to an unlicensed assistive personnel (UAP)?
A. Administering oral medications to a stable client
B. Assessing a post-operative client's surgical incision
C. Assisting a client with a standard bed bath [CORRECT]
D. Teaching a newly diagnosed diabetic client about insulin administration
Correct Answer: C
Rationale: The Five Rights of Delegation (right task, right circumstance, right person,
right direction/communication, right supervision) guide appropriate delegation. Basic
hygiene tasks like bed baths are within the UAP's scope of practice, do not require
clinical judgment, and pose minimal risk. Why A is incorrect: Medication administration
requires nursing licensure and clinical judgment; it cannot be delegated to UAPs. Why B
is incorrect: Assessment requires nursing knowledge and clinical decision-making; it is
,a registered nurse responsibility. Why D is incorrect: Client education requires nursing
expertise and evaluation of learning; it cannot be delegated to UAPs.
Q3: A client is prescribed contact isolation for methicillin-resistant Staphylococcus
aureus (MRSA) wound infection. Which action by the nurse demonstrates correct
infection control practice?
A. Removing the isolation gown in the client's room before exiting
B. Performing hand hygiene after removing gloves and gown outside the room
C. Donning gloves and gown upon entering the room and performing hand hygiene after
removing both [CORRECT]
D. Wearing the same isolation gown between different clients in isolation
Correct Answer: C
Rationale: Contact isolation requires donning gloves and gown before entering the room
to prevent transmission. Hand hygiene must occur after removing gloves and gown
because gloves may have microscopic tears and hands may become contaminated
during removal. This follows CDC transmission-based precautions. Why A is incorrect:
Gowns should be removed inside the room to prevent environmental contamination;
however, hand hygiene timing is critical. Why B is incorrect: Hand hygiene must occur
after glove and gown removal but can occur inside or just outside the room; the
sequence of removal is more important than location. Why D is incorrect: Isolation
, gowns are single-use and must be changed between clients to prevent
cross-contamination.
Q4: The nurse identifies that a client is at risk for falls. Which intervention is the priority
for ensuring client safety?
A. Placing the call light within the client's reach
B. Keeping the bed in the lowest position with wheels locked [CORRECT]
C. Administering prescribed sedative medications as ordered
D. Restricting all client mobility to bed rest
Correct Answer: B
Rationale: The priority intervention follows the principle of least restrictive, most
effective fall prevention. Keeping the bed low with wheels locked addresses
environmental hazards (height and bed movement) that directly contribute to falls. This
is a fundamental safety intervention that protects all clients regardless of other factors.
Why A is incorrect: While important for communication, this does not directly prevent
falls if the client attempts to get up unassisted. Why C is incorrect: Sedatives increase
fall risk; they are not a fall prevention strategy and require careful evaluation of
necessity. Why D is incorrect: Unnecessary immobility causes complications (DVT,
deconditioning, pressure injuries); it is not a first-line fall prevention strategy.
Correct Answers with Complete Solutions | Updated Edition |
NCLEX-RN Aligned | Pass Guaranteed - A+ Graded
Section 1: Safe and Effective Care Environment (25 Questions)
Q1: The nurse is caring for four clients on a medical-surgical unit. Which client requires
the nurse's immediate attention?
A. A client 2 hours post-op appendectomy with a respiratory rate of 18/min and pain
rated 3/10
B. A client with pneumonia whose oxygen saturation dropped from 94% to 88% on room
air [CORRECT]
C. A client with heart failure requesting assistance to ambulate to the bathroom
D. A client with diabetes mellitus complaining of thirst and requesting water
Correct Answer: B
Rationale: Apply the ABCs (Airway, Breathing, Circulation) priority framework. An oxygen
saturation of 88% indicates significant hypoxemia requiring immediate intervention to
prevent respiratory failure. This represents a threat to the patient's physiological
,stability. Why A is incorrect: Post-op pain of 3/10 and normal respiratory rate are
expected findings, not emergent. Why C is incorrect: Ambulation assistance, while
important for preventing complications, does not represent an immediate physiological
threat. Why D is incorrect: Thirst in diabetes is expected with hyperglycemia; while
glucose should be checked, this is not immediately life-threatening compared to
hypoxemia.
Q2: The charge nurse is delegating tasks to the nursing team. Which task is most
appropriate to delegate to an unlicensed assistive personnel (UAP)?
A. Administering oral medications to a stable client
B. Assessing a post-operative client's surgical incision
C. Assisting a client with a standard bed bath [CORRECT]
D. Teaching a newly diagnosed diabetic client about insulin administration
Correct Answer: C
Rationale: The Five Rights of Delegation (right task, right circumstance, right person,
right direction/communication, right supervision) guide appropriate delegation. Basic
hygiene tasks like bed baths are within the UAP's scope of practice, do not require
clinical judgment, and pose minimal risk. Why A is incorrect: Medication administration
requires nursing licensure and clinical judgment; it cannot be delegated to UAPs. Why B
is incorrect: Assessment requires nursing knowledge and clinical decision-making; it is
,a registered nurse responsibility. Why D is incorrect: Client education requires nursing
expertise and evaluation of learning; it cannot be delegated to UAPs.
Q3: A client is prescribed contact isolation for methicillin-resistant Staphylococcus
aureus (MRSA) wound infection. Which action by the nurse demonstrates correct
infection control practice?
A. Removing the isolation gown in the client's room before exiting
B. Performing hand hygiene after removing gloves and gown outside the room
C. Donning gloves and gown upon entering the room and performing hand hygiene after
removing both [CORRECT]
D. Wearing the same isolation gown between different clients in isolation
Correct Answer: C
Rationale: Contact isolation requires donning gloves and gown before entering the room
to prevent transmission. Hand hygiene must occur after removing gloves and gown
because gloves may have microscopic tears and hands may become contaminated
during removal. This follows CDC transmission-based precautions. Why A is incorrect:
Gowns should be removed inside the room to prevent environmental contamination;
however, hand hygiene timing is critical. Why B is incorrect: Hand hygiene must occur
after glove and gown removal but can occur inside or just outside the room; the
sequence of removal is more important than location. Why D is incorrect: Isolation
, gowns are single-use and must be changed between clients to prevent
cross-contamination.
Q4: The nurse identifies that a client is at risk for falls. Which intervention is the priority
for ensuring client safety?
A. Placing the call light within the client's reach
B. Keeping the bed in the lowest position with wheels locked [CORRECT]
C. Administering prescribed sedative medications as ordered
D. Restricting all client mobility to bed rest
Correct Answer: B
Rationale: The priority intervention follows the principle of least restrictive, most
effective fall prevention. Keeping the bed low with wheels locked addresses
environmental hazards (height and bed movement) that directly contribute to falls. This
is a fundamental safety intervention that protects all clients regardless of other factors.
Why A is incorrect: While important for communication, this does not directly prevent
falls if the client attempts to get up unassisted. Why C is incorrect: Sedatives increase
fall risk; they are not a fall prevention strategy and require careful evaluation of
necessity. Why D is incorrect: Unnecessary immobility causes complications (DVT,
deconditioning, pressure injuries); it is not a first-line fall prevention strategy.
