2026
HESI Fundamentals 2026 Test Bank
Review with Rationales for Nursing
Success
When turning an immobile bedridden client without assistance, which action by the nurse best
ensures client safety?
A. Securely grasp the client's arm and leg.
B. Put bed rails up on the side of bed opposite from the nurse.
C. Correctly position and use a turn sheet.
D. Lower the head of the client's bed slowly.
Rationale
Raising the bed rails on the opposite side prevents the client from rolling or falling out of bed
while the nurse works from one side (B). Grasping limbs (A) can injure joints or skin. Using a
turn sheet (C) and lowering the head of the bed (D) are helpful techniques but do not provide the
same level of fall protection.
The nurse identifies a potential for infection in a client with partial- and full-thickness burns.
What intervention has the highest priority to decrease infection risk?
A. Administration of plasma expanders
B. Use of careful handwashing technique
C. Application of a topical antibacterial cream
D. Limiting visitors
Rationale
Hand hygiene is the most effective method for preventing infection transmission (B). Plasma
expanders (A) address fluid loss, not infection. Topical antimicrobials (C) and limiting visitors
(D) may help but are secondary to proper handwashing.
A community health nurse is assessing clients experiencing homelessness. Which laboratory
value is the most reliable indicator of chronic protein malnutrition?
A. Low serum albumin level
B. Low serum transferrin level
C. High hemoglobin level
D. High cholesterol level
,2026
Rationale
Albumin reflects long-term protein status due to its long half-life (A). Transferrin (B) reflects
short-term changes. Hemoglobin (C) and cholesterol (D) are not specific indicators of protein
malnutrition.
During a preoperative checklist, the nurse finds that the operative permit is unsigned and the
client has questions. What should the nurse do next?
A. Witness the client’s signature
B. Answer the client’s questions
C. Inform the surgeon that the permit is unsigned and the client has questions
D. Reassure the client the surgeon will explain later
Rationale
Obtaining informed consent is the surgeon’s responsibility (C). The nurse should not witness a
signature (A) or answer surgical questions (B) before the provider explains the procedure.
Delaying explanation (D) is inappropriate.
Which factor in a client’s history poses the greatest risk for surgical complications?
A. Long-term use of oral contraceptives
B. Use of anticoagulants for the past year
C. Recent antibiotic therapy
D. PRN laxative use
Rationale
Anticoagulants significantly increase bleeding risk during surgery (B). Oral contraceptives (A)
are more related to postoperative clot risk. Antibiotics (C) and laxatives (D) pose less immediate
surgical risk.
When assisting a client from bed to chair, which technique is safest?
A. Place the chair parallel to the bed
B. Spread feet apart, align knees, and pivot the client
C. Lift the client under the axillae
D. Allow the client to place arms around the nurse’s neck
Rationale
A wide base of support and knee stabilization protects both client and nurse (B). Lifting under
the arms (C) and allowing the client to hold the nurse’s neck (D) risk injury. Chair placement in
(A) is incorrect.
,2026
Which steps should the nurse take when administering ear drops to an adult? (Select all that
apply.)
A. Place the client in a side-lying position.
B. Pull the auricle upward and outward.
C. Hold the dropper 6 cm above the canal.
D. Place a cotton ball deep into the canal.
E. Pull the auricle down and back.
Rationale
Adults require the auricle to be pulled upward and outward, and side-lying positioning aids
medication retention (A, B). The dropper should be closer than 6 cm (C). Cotton should be
placed loosely in the outer ear (D). Pulling down and back (E) is for young children.
Which instruction ensures optimal use of a metered-dose inhaler?
A. Inhale fully, then compress the inhaler
B. Compress the inhaler while slowly inhaling through the mouth
C. Compress while inhaling rapidly through the nose
D. Exhale after compressing, then inhale
Rationale
Coordinating slow inhalation with inhaler activation delivers medication deep into the lungs (B).
The other methods reduce medication effectiveness.
A client refuses to bathe during menstruation, stating it is harmful. What should the nurse do
first?
A. Document the refusal
B. Offer a bed bath
C. Provide educational brochures
D. Teach the importance of hygiene during menstruation
Rationale
Client teaching that respects beliefs while promoting health is the priority (D). Documentation
(A) and alternatives (B) may follow teaching. Written materials (C) reinforce but do not replace
discussion.
A 72-year-old client notes decreased sexual drive as a medication side effect. What is the nurse’s
best response?
A. “How will this affect your present sexual activity?”
B. “How active is your sex life?”
, 2026
C. “How has aging changed your sex life?”
D. “Tell me about your sexual needs as an older adult.”
Rationale
This open-ended, relevant question addresses the client’s concern directly (A). The other options
are less focused or may feel intrusive.
Using the Glasgow Coma Scale, a comatose client withdraws from pain. What should the nurse
do next?
A. Document the response to painful stimulus
B. Assess response to verbal stimuli
C. Initiate seizure precautions
D. Report decorticate posturing
Rationale
Purposeful withdrawal should be documented (A). Verbal response is assessed before pain, not
after (B). There is no seizure indication (C), and decorticate posturing (D) is nonpurposeful.
The nurse must administer diazepam 4 mg IV. The vial concentration is 5 mg/mL. How many
milliliters should be given?
A. 0.2 mL
B. 0.8 mL
C. 1.25 mL
D. 2.0 mL
Rationale
4 mg ÷ 5 mg/mL = 0.8 mL (B). The other options are incorrect calculations.
Which actions are appropriate when inserting a nasogastric tube in an alert client? (Select all that
apply.)
A. Place the client in high Fowler position.
D. Instruct the client to swallow after the tube passes the pharynx.
B. Place the client in left side-lying position
C. Measure the tube from nose to umbilicus
E. Extend the neck backward throughout insertion
Rationale
High Fowler positioning and swallowing aid tube passage (A, D). Side-lying (B) is for
unconscious clients. Proper measurement is nose–ear–xiphoid, not umbilicus (C). Neck flexion,
not extension, is needed after passing the pharynx (E).
HESI Fundamentals 2026 Test Bank
Review with Rationales for Nursing
Success
When turning an immobile bedridden client without assistance, which action by the nurse best
ensures client safety?
A. Securely grasp the client's arm and leg.
B. Put bed rails up on the side of bed opposite from the nurse.
C. Correctly position and use a turn sheet.
D. Lower the head of the client's bed slowly.
Rationale
Raising the bed rails on the opposite side prevents the client from rolling or falling out of bed
while the nurse works from one side (B). Grasping limbs (A) can injure joints or skin. Using a
turn sheet (C) and lowering the head of the bed (D) are helpful techniques but do not provide the
same level of fall protection.
The nurse identifies a potential for infection in a client with partial- and full-thickness burns.
What intervention has the highest priority to decrease infection risk?
A. Administration of plasma expanders
B. Use of careful handwashing technique
C. Application of a topical antibacterial cream
D. Limiting visitors
Rationale
Hand hygiene is the most effective method for preventing infection transmission (B). Plasma
expanders (A) address fluid loss, not infection. Topical antimicrobials (C) and limiting visitors
(D) may help but are secondary to proper handwashing.
A community health nurse is assessing clients experiencing homelessness. Which laboratory
value is the most reliable indicator of chronic protein malnutrition?
A. Low serum albumin level
B. Low serum transferrin level
C. High hemoglobin level
D. High cholesterol level
,2026
Rationale
Albumin reflects long-term protein status due to its long half-life (A). Transferrin (B) reflects
short-term changes. Hemoglobin (C) and cholesterol (D) are not specific indicators of protein
malnutrition.
During a preoperative checklist, the nurse finds that the operative permit is unsigned and the
client has questions. What should the nurse do next?
A. Witness the client’s signature
B. Answer the client’s questions
C. Inform the surgeon that the permit is unsigned and the client has questions
D. Reassure the client the surgeon will explain later
Rationale
Obtaining informed consent is the surgeon’s responsibility (C). The nurse should not witness a
signature (A) or answer surgical questions (B) before the provider explains the procedure.
Delaying explanation (D) is inappropriate.
Which factor in a client’s history poses the greatest risk for surgical complications?
A. Long-term use of oral contraceptives
B. Use of anticoagulants for the past year
C. Recent antibiotic therapy
D. PRN laxative use
Rationale
Anticoagulants significantly increase bleeding risk during surgery (B). Oral contraceptives (A)
are more related to postoperative clot risk. Antibiotics (C) and laxatives (D) pose less immediate
surgical risk.
When assisting a client from bed to chair, which technique is safest?
A. Place the chair parallel to the bed
B. Spread feet apart, align knees, and pivot the client
C. Lift the client under the axillae
D. Allow the client to place arms around the nurse’s neck
Rationale
A wide base of support and knee stabilization protects both client and nurse (B). Lifting under
the arms (C) and allowing the client to hold the nurse’s neck (D) risk injury. Chair placement in
(A) is incorrect.
,2026
Which steps should the nurse take when administering ear drops to an adult? (Select all that
apply.)
A. Place the client in a side-lying position.
B. Pull the auricle upward and outward.
C. Hold the dropper 6 cm above the canal.
D. Place a cotton ball deep into the canal.
E. Pull the auricle down and back.
Rationale
Adults require the auricle to be pulled upward and outward, and side-lying positioning aids
medication retention (A, B). The dropper should be closer than 6 cm (C). Cotton should be
placed loosely in the outer ear (D). Pulling down and back (E) is for young children.
Which instruction ensures optimal use of a metered-dose inhaler?
A. Inhale fully, then compress the inhaler
B. Compress the inhaler while slowly inhaling through the mouth
C. Compress while inhaling rapidly through the nose
D. Exhale after compressing, then inhale
Rationale
Coordinating slow inhalation with inhaler activation delivers medication deep into the lungs (B).
The other methods reduce medication effectiveness.
A client refuses to bathe during menstruation, stating it is harmful. What should the nurse do
first?
A. Document the refusal
B. Offer a bed bath
C. Provide educational brochures
D. Teach the importance of hygiene during menstruation
Rationale
Client teaching that respects beliefs while promoting health is the priority (D). Documentation
(A) and alternatives (B) may follow teaching. Written materials (C) reinforce but do not replace
discussion.
A 72-year-old client notes decreased sexual drive as a medication side effect. What is the nurse’s
best response?
A. “How will this affect your present sexual activity?”
B. “How active is your sex life?”
, 2026
C. “How has aging changed your sex life?”
D. “Tell me about your sexual needs as an older adult.”
Rationale
This open-ended, relevant question addresses the client’s concern directly (A). The other options
are less focused or may feel intrusive.
Using the Glasgow Coma Scale, a comatose client withdraws from pain. What should the nurse
do next?
A. Document the response to painful stimulus
B. Assess response to verbal stimuli
C. Initiate seizure precautions
D. Report decorticate posturing
Rationale
Purposeful withdrawal should be documented (A). Verbal response is assessed before pain, not
after (B). There is no seizure indication (C), and decorticate posturing (D) is nonpurposeful.
The nurse must administer diazepam 4 mg IV. The vial concentration is 5 mg/mL. How many
milliliters should be given?
A. 0.2 mL
B. 0.8 mL
C. 1.25 mL
D. 2.0 mL
Rationale
4 mg ÷ 5 mg/mL = 0.8 mL (B). The other options are incorrect calculations.
Which actions are appropriate when inserting a nasogastric tube in an alert client? (Select all that
apply.)
A. Place the client in high Fowler position.
D. Instruct the client to swallow after the tube passes the pharynx.
B. Place the client in left side-lying position
C. Measure the tube from nose to umbilicus
E. Extend the neck backward throughout insertion
Rationale
High Fowler positioning and swallowing aid tube passage (A, D). Side-lying (B) is for
unconscious clients. Proper measurement is nose–ear–xiphoid, not umbilicus (C). Neck flexion,
not extension, is needed after passing the pharynx (E).
