NSG 122 HESI Exam: Nursing Fundamental Concepts | 2026/2027
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NSG 122 HESI EXAM
NURSING FUNDAMENTAL
CONCEPTS
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Comprehensive Clinical Competency Assessment
2026/2027 Academic Year
60 Questions with Correct Answers and Rationales
15 Clinical Domains | Evidence-Based Practice | NCSBN Aligned
Alignment References:
• NCSBN Clinical Judgment Measurement Model (CJMM)
• NANDA-I Nursing Diagnoses: Definitions & Classification (12th Edition)
• ANA Nursing: Scope and Standards of Practice (4th Edition)
• The Joint Commission National Patient Safety Goals (2026)
• CDC/WHO Infection Prevention Guidelines
• USPSTF Preventive Care Recommendations (Current)
• CMS Conditions of Participation for Hospitals (42 CFR Part 482)
Page 1 | Comprehensive Clinical Competency Assessment
, NSG 122 HESI Exam: Nursing Fundamental Concepts | 2026/2027
TABLE OF CONTENTS
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# Domain Questions
1 Nursing Process & Clinical Judgment (ADPIE, CJMM) Q1–Q5
2 Basic Care & Comfort (ADLs, Mobility, Hygiene, Nutrition, Elimination, Sleep) Q6–Q10
3 Infection Control & Standard/Transmission-Based Precautions Q11–Q15
4 Medication Administration Fundamentals Q16–Q19
5 Vital Signs Assessment & Interpretation Q20–Q23
6 Communication & Therapeutic Relationship Building Q24–Q27
7 Legal/Ethical Principles & Scope of Practice Q28–Q31
8 Documentation Standards & EHR Q32–Q34
9 Patient Safety Protocols Q35–Q39
10 Cultural Competence & Health Equity Q40–Q43
11 Health Promotion & Patient Education Q44–Q47
12 Prioritization & Delegation Frameworks Q48–Q51
13 Skin Integrity & Wound Care Q52–Q55
14 Interprofessional Collaboration & Team Communication Q56–Q57
15 NCLEX-RN Test-Taking Strategies for Fundamentals Q58–Q60
Page 2 | Comprehensive Clinical Competency Assessment
, NSG 122 HESI Exam: Nursing Fundamental Concepts | 2026/2027
Domain 1: Nursing Process & Clinical Judgment (ADPIE,
CJMM)
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Q1. A nurse is caring for a patient admitted with heart failure who reports increasing dyspnea and 2-
pillow orthopnea. The nurse reviews the medical record, notes the patient's weight has increased by 3 lb
in 2 days, and observes bilateral 2+ pitting edema. According to the NCSBN Clinical Judgment
Measurement Model (CJMM), which cognitive step is the nurse performing?
A) Recognize Cues ✓
B) Analyze Cues
C) Prioritize Hypotheses
D) Generate Solutions
Rationale: The nurse is identifying and clustering relevant clinical data (weight gain, dyspnea, orthopnea,
pitting edema) to recognize that a clinical problem exists. According to the NCSBN CJMM, 'Recognize Cues' is
the first step in which the nurse identifies relevant information and recognizes deviations from expected findings.
Analysis of cues (B) follows and involves comparing data to norms. Prioritizing hypotheses (C) and generating
solutions (D) are subsequent CJMM steps requiring deeper interpretation and intervention planning.
Q2. A nursing student writes the following diagnosis for a postoperative patient: 'Risk for Infection as
evidenced by surgical incision on the abdomen.' Which PES (Problem-Etiology-Signs/Symptoms) format
error should the instructor correct?
A) The problem statement is incorrectly worded
B) A risk diagnosis should not have 'evidenced by' defining characteristics ✓
C) The etiology is missing
D) NANDA-I terminology is not used
Rationale: Risk nursing diagnoses describe human responses to health conditions/life processes that may
develop in a vulnerable individual. Per NANDA-I guidelines, risk diagnoses use the format 'Risk for [Problem]
related to [Risk Factors]' and do NOT include 'as evidenced by' (signs/symptoms/defining characteristics)
because the condition has not yet occurred. The problem statement 'Risk for Infection' is correctly stated,
NANDA-I terminology is present, and the etiology is implied by the risk context—but the critical error is
including defining characteristics for a risk diagnosis.
Q3. A nurse on a medical-surgical unit evaluates the effectiveness of an intervention for a patient with the
nursing diagnosis of 'Impaired Skin Integrity related to immobility.' The original goal was: 'The patient
will maintain intact skin without redness or breakdown by discharge in 3 days.' On day 3, the nurse notes
a 2 cm × 2 cm stage 1 pressure injury on the sacrum. Which is the most appropriate next action in the
evaluation phase of the nursing process?
A) Document the findings and continue the current plan of care
B) Revise the nursing diagnosis, goals, and interventions based on the new data ✓
C) Notify the physician immediately and request a wound care consult
D) Discontinue the turning schedule since it was ineffective
Page 3 | Comprehensive Clinical Competency Assessment
───────────────────────────────────────────────────────
─────
NSG 122 HESI EXAM
NURSING FUNDAMENTAL
CONCEPTS
───────────────────────────────────────────────────────
─────
Comprehensive Clinical Competency Assessment
2026/2027 Academic Year
60 Questions with Correct Answers and Rationales
15 Clinical Domains | Evidence-Based Practice | NCSBN Aligned
Alignment References:
• NCSBN Clinical Judgment Measurement Model (CJMM)
• NANDA-I Nursing Diagnoses: Definitions & Classification (12th Edition)
• ANA Nursing: Scope and Standards of Practice (4th Edition)
• The Joint Commission National Patient Safety Goals (2026)
• CDC/WHO Infection Prevention Guidelines
• USPSTF Preventive Care Recommendations (Current)
• CMS Conditions of Participation for Hospitals (42 CFR Part 482)
Page 1 | Comprehensive Clinical Competency Assessment
, NSG 122 HESI Exam: Nursing Fundamental Concepts | 2026/2027
TABLE OF CONTENTS
──────────────────────────────────────────────────────────────────
─────────
# Domain Questions
1 Nursing Process & Clinical Judgment (ADPIE, CJMM) Q1–Q5
2 Basic Care & Comfort (ADLs, Mobility, Hygiene, Nutrition, Elimination, Sleep) Q6–Q10
3 Infection Control & Standard/Transmission-Based Precautions Q11–Q15
4 Medication Administration Fundamentals Q16–Q19
5 Vital Signs Assessment & Interpretation Q20–Q23
6 Communication & Therapeutic Relationship Building Q24–Q27
7 Legal/Ethical Principles & Scope of Practice Q28–Q31
8 Documentation Standards & EHR Q32–Q34
9 Patient Safety Protocols Q35–Q39
10 Cultural Competence & Health Equity Q40–Q43
11 Health Promotion & Patient Education Q44–Q47
12 Prioritization & Delegation Frameworks Q48–Q51
13 Skin Integrity & Wound Care Q52–Q55
14 Interprofessional Collaboration & Team Communication Q56–Q57
15 NCLEX-RN Test-Taking Strategies for Fundamentals Q58–Q60
Page 2 | Comprehensive Clinical Competency Assessment
, NSG 122 HESI Exam: Nursing Fundamental Concepts | 2026/2027
Domain 1: Nursing Process & Clinical Judgment (ADPIE,
CJMM)
────────────────────────────────────────────────────────────────────────────────
Q1. A nurse is caring for a patient admitted with heart failure who reports increasing dyspnea and 2-
pillow orthopnea. The nurse reviews the medical record, notes the patient's weight has increased by 3 lb
in 2 days, and observes bilateral 2+ pitting edema. According to the NCSBN Clinical Judgment
Measurement Model (CJMM), which cognitive step is the nurse performing?
A) Recognize Cues ✓
B) Analyze Cues
C) Prioritize Hypotheses
D) Generate Solutions
Rationale: The nurse is identifying and clustering relevant clinical data (weight gain, dyspnea, orthopnea,
pitting edema) to recognize that a clinical problem exists. According to the NCSBN CJMM, 'Recognize Cues' is
the first step in which the nurse identifies relevant information and recognizes deviations from expected findings.
Analysis of cues (B) follows and involves comparing data to norms. Prioritizing hypotheses (C) and generating
solutions (D) are subsequent CJMM steps requiring deeper interpretation and intervention planning.
Q2. A nursing student writes the following diagnosis for a postoperative patient: 'Risk for Infection as
evidenced by surgical incision on the abdomen.' Which PES (Problem-Etiology-Signs/Symptoms) format
error should the instructor correct?
A) The problem statement is incorrectly worded
B) A risk diagnosis should not have 'evidenced by' defining characteristics ✓
C) The etiology is missing
D) NANDA-I terminology is not used
Rationale: Risk nursing diagnoses describe human responses to health conditions/life processes that may
develop in a vulnerable individual. Per NANDA-I guidelines, risk diagnoses use the format 'Risk for [Problem]
related to [Risk Factors]' and do NOT include 'as evidenced by' (signs/symptoms/defining characteristics)
because the condition has not yet occurred. The problem statement 'Risk for Infection' is correctly stated,
NANDA-I terminology is present, and the etiology is implied by the risk context—but the critical error is
including defining characteristics for a risk diagnosis.
Q3. A nurse on a medical-surgical unit evaluates the effectiveness of an intervention for a patient with the
nursing diagnosis of 'Impaired Skin Integrity related to immobility.' The original goal was: 'The patient
will maintain intact skin without redness or breakdown by discharge in 3 days.' On day 3, the nurse notes
a 2 cm × 2 cm stage 1 pressure injury on the sacrum. Which is the most appropriate next action in the
evaluation phase of the nursing process?
A) Document the findings and continue the current plan of care
B) Revise the nursing diagnosis, goals, and interventions based on the new data ✓
C) Notify the physician immediately and request a wound care consult
D) Discontinue the turning schedule since it was ineffective
Page 3 | Comprehensive Clinical Competency Assessment
