HESI Nursing EXAM 2026-2027 LATEST UPDATED
VERSION QUESTIONS AND ANSWERS
When conducting diet teaching for a client who was diagnosed with nutritional anemia in pregnancy,
which foods should the nurse encourage the client to eat? (Select all that apply)
a. Seeds, spices, lettuce
b. Consomme, celery, carrot
c. Oranges, orange juice, bananas
d. Fortified whole wheat cereals, whole-grain pasta, brown rice
e. Spinach, kale, dried raisins and apricots
DE
Rationale: Nutritional anemia in pregnancy should be supplemented with additional iron in the diet.
Foods that are high in iron content are often protein based, whole grains (D), green leafy vegetables
and dried fruits (E). (A, B, and C) are not iron rich sources
A client with type 2 diabetes mellitus is admitted for antibiotic treatment for a leg ulcer. To monitor the
client for the onset of hyperosmolar hyperglycemic nonketotic syndrome (HHNS), what actions should
the nurse take? (Select all that apply)
a. Check urine for ketones
b. Measure blood glucose
c. Monitor vital signs
d. Assessed level of consciousness
,e. Obtain culture of wound
BCD
Rationale: Blood glucose greater than 600 mg/dl (33.3 mmol/L SI), vital sign changes in mental
awareness are indicators of possible HHNS. Urine ketones are monitored in diabetic ketoacidosis.
Wound culture is performed prior to treating the wound infection but is not useful in monitoring for
HHNS.
An infant is receiving penicillin G procaine 220,000 units IM. The drug is supplied as 600,000 units/ml.
How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to
the nearest tenth)
0.4
Rationale: Calsulate using the formula, desired dose (220,000 units) over dose on hand (600,000 units) x
the volume of the available dose (1 ml). 220,,000 x 1 ml = 0.36 = 0.4 ml
After receiving report, the nurse can most safely plan to assess which client last? The client with...
a. A rectal tube draining clear, pale red liquid drainage
b. A distended abdomen and no drainage from the nasogastric tube
c. No postoperative drainage in the Jackson-Pratt drain with the bulb compressed
d. Dark red drainage on a postoperative dressing, but no drainage in the Hemovac®.
C
Rationale: The most stable client is the one with a functioning drainage device and no drainage. This
client can most safely be assessing last. Other clients are either actively bleeding, have an obstruction in
the nasogastric tube which may result in vomiting, or may be bleeding and / or may have a malfunction
in the Hemovac® drain.
A client who is admitted to the intensive care unit with syndrome of inappropriate antidiuretic hormone
(SIADH) has developed osmotic demyelination. Which intervention should the nurse implement first?
a. Patch one eye.
,b. Reorient often.
c. Range of motion.
d. Evaluate swallow
Evaluate swallow
Rational: Osmotic demyelination, also known as central pontine myelinolysis, is nerve damage caused
by the destruction of the myelin sheath covering nerve cells in the brainstem. The most common cause
is a rapid, drastic change in sodium levels when a client is being treated for hyponatremia, a common
occurrence in SIADH. Difficulty swallowing due to brainstem nerve damage should be care but
determining the client's risk for aspiration is most important.
The nurse is preparing a client who had a below-the-knee (BKA) amputation for discharge to home.
Which recommendations should the nurse provide this client? (Select all that apply)
a. Inspect skin for redness
b. Use a residual limb shrinker
c. Apply alcohol to the stump after bathing
d. Wash the stump with soap and water
e. Avoid range of motion exercises
ABD
Rationale: Several actions are recommended for home care following an amputation. The skin should be
inspected regularly for abnormalities such as redness, blistering, or abrasions. A residual limb shrinker
should be applied over the stump to protect it and reduce edema. The stump should be washed daily
with a mild soap and carefully rinse and dried. The client should avoid cleansing with alcohol because it
can dry and crack the skin. Range of motion should be done daily.
When assessing the surgical dressing of a client who had abdominal surgery the previous day, the nurse
observes that a small amount of drainage is present on the dressing and the wound's Hemovac suction
device is empty with the plug open. How should the nurse respond?
a. Replace the dressing and remove the drainage device
b. Reposition the drainage device and keep the plug open
, c. Notify the healthcare provider that the drain is not working
d. Recompress the wound suction device and secure to plug
Recompress the wound suction device and secure to plug
Rationale: The plug of a wound suction device, such as a Hemovac, should be closed after compressing
the device to apply gentle suction in a closed surgical wound to facilitate the evacuation of
subcutaneous fluids into the device. Compressing the device and securing the plug should restore
function of the closed wound device. A small amount of drainage should be marked on the dressing, but
replacing the dressing is not necessary and the nurse should not remove the device. Other options are
not indicated.
A mother brings her 4-month-old son to the clinic with a quarter taped over his umbilicus, and tells the
nurse the quarter is supposed to fix her child's hernia. Which explanations should the nurse provide?
a. This hernia is a normal variation that resolves without treatment.
b. Restrictive clothing will be adequate to help the hernia go away.
c. An abdominal binder can be worn daily to reduce the protrusion.
d. The quarter should be secured with an elastic bandage wrap.
This hernia is a normal variation that resolves without treatment.
Rational: an umbilical hernia is a normal variation in infants that occurs due to an incomplete fusion of
the abdominal musculature through the umbilical ring that usually resolves spontaneously as the child
learns to walk. Other choices are ineffective and unnecessary.
A client with possible acute kidney injury (AKI) is admitted to the hospital and mannitol is prescribed as
a fluid challenge. Prior to carrying out this prescription, what intervention should the nurse implement?
a. Collect a clean catch urine specimen.
b. Instruct the client to empty the bladder.
c. Obtain vital signs and breath sounds.
d. No specific nursing action is required
VERSION QUESTIONS AND ANSWERS
When conducting diet teaching for a client who was diagnosed with nutritional anemia in pregnancy,
which foods should the nurse encourage the client to eat? (Select all that apply)
a. Seeds, spices, lettuce
b. Consomme, celery, carrot
c. Oranges, orange juice, bananas
d. Fortified whole wheat cereals, whole-grain pasta, brown rice
e. Spinach, kale, dried raisins and apricots
DE
Rationale: Nutritional anemia in pregnancy should be supplemented with additional iron in the diet.
Foods that are high in iron content are often protein based, whole grains (D), green leafy vegetables
and dried fruits (E). (A, B, and C) are not iron rich sources
A client with type 2 diabetes mellitus is admitted for antibiotic treatment for a leg ulcer. To monitor the
client for the onset of hyperosmolar hyperglycemic nonketotic syndrome (HHNS), what actions should
the nurse take? (Select all that apply)
a. Check urine for ketones
b. Measure blood glucose
c. Monitor vital signs
d. Assessed level of consciousness
,e. Obtain culture of wound
BCD
Rationale: Blood glucose greater than 600 mg/dl (33.3 mmol/L SI), vital sign changes in mental
awareness are indicators of possible HHNS. Urine ketones are monitored in diabetic ketoacidosis.
Wound culture is performed prior to treating the wound infection but is not useful in monitoring for
HHNS.
An infant is receiving penicillin G procaine 220,000 units IM. The drug is supplied as 600,000 units/ml.
How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to
the nearest tenth)
0.4
Rationale: Calsulate using the formula, desired dose (220,000 units) over dose on hand (600,000 units) x
the volume of the available dose (1 ml). 220,,000 x 1 ml = 0.36 = 0.4 ml
After receiving report, the nurse can most safely plan to assess which client last? The client with...
a. A rectal tube draining clear, pale red liquid drainage
b. A distended abdomen and no drainage from the nasogastric tube
c. No postoperative drainage in the Jackson-Pratt drain with the bulb compressed
d. Dark red drainage on a postoperative dressing, but no drainage in the Hemovac®.
C
Rationale: The most stable client is the one with a functioning drainage device and no drainage. This
client can most safely be assessing last. Other clients are either actively bleeding, have an obstruction in
the nasogastric tube which may result in vomiting, or may be bleeding and / or may have a malfunction
in the Hemovac® drain.
A client who is admitted to the intensive care unit with syndrome of inappropriate antidiuretic hormone
(SIADH) has developed osmotic demyelination. Which intervention should the nurse implement first?
a. Patch one eye.
,b. Reorient often.
c. Range of motion.
d. Evaluate swallow
Evaluate swallow
Rational: Osmotic demyelination, also known as central pontine myelinolysis, is nerve damage caused
by the destruction of the myelin sheath covering nerve cells in the brainstem. The most common cause
is a rapid, drastic change in sodium levels when a client is being treated for hyponatremia, a common
occurrence in SIADH. Difficulty swallowing due to brainstem nerve damage should be care but
determining the client's risk for aspiration is most important.
The nurse is preparing a client who had a below-the-knee (BKA) amputation for discharge to home.
Which recommendations should the nurse provide this client? (Select all that apply)
a. Inspect skin for redness
b. Use a residual limb shrinker
c. Apply alcohol to the stump after bathing
d. Wash the stump with soap and water
e. Avoid range of motion exercises
ABD
Rationale: Several actions are recommended for home care following an amputation. The skin should be
inspected regularly for abnormalities such as redness, blistering, or abrasions. A residual limb shrinker
should be applied over the stump to protect it and reduce edema. The stump should be washed daily
with a mild soap and carefully rinse and dried. The client should avoid cleansing with alcohol because it
can dry and crack the skin. Range of motion should be done daily.
When assessing the surgical dressing of a client who had abdominal surgery the previous day, the nurse
observes that a small amount of drainage is present on the dressing and the wound's Hemovac suction
device is empty with the plug open. How should the nurse respond?
a. Replace the dressing and remove the drainage device
b. Reposition the drainage device and keep the plug open
, c. Notify the healthcare provider that the drain is not working
d. Recompress the wound suction device and secure to plug
Recompress the wound suction device and secure to plug
Rationale: The plug of a wound suction device, such as a Hemovac, should be closed after compressing
the device to apply gentle suction in a closed surgical wound to facilitate the evacuation of
subcutaneous fluids into the device. Compressing the device and securing the plug should restore
function of the closed wound device. A small amount of drainage should be marked on the dressing, but
replacing the dressing is not necessary and the nurse should not remove the device. Other options are
not indicated.
A mother brings her 4-month-old son to the clinic with a quarter taped over his umbilicus, and tells the
nurse the quarter is supposed to fix her child's hernia. Which explanations should the nurse provide?
a. This hernia is a normal variation that resolves without treatment.
b. Restrictive clothing will be adequate to help the hernia go away.
c. An abdominal binder can be worn daily to reduce the protrusion.
d. The quarter should be secured with an elastic bandage wrap.
This hernia is a normal variation that resolves without treatment.
Rational: an umbilical hernia is a normal variation in infants that occurs due to an incomplete fusion of
the abdominal musculature through the umbilical ring that usually resolves spontaneously as the child
learns to walk. Other choices are ineffective and unnecessary.
A client with possible acute kidney injury (AKI) is admitted to the hospital and mannitol is prescribed as
a fluid challenge. Prior to carrying out this prescription, what intervention should the nurse implement?
a. Collect a clean catch urine specimen.
b. Instruct the client to empty the bladder.
c. Obtain vital signs and breath sounds.
d. No specific nursing action is required
