HESI RN FUNDAMENTALS UPDATED EXAMS PAPER
2026 QUESTIONS AND ANSWERS SURE A+
✔✔The healthcare provider prescribes the diuretic metolazone (Zaroxolyn) 7.5 mg PO.
Zaroxolyn is available in 5 mg tablets. How much should the nurse plan to administer?
A) ½ tablet.
B) 1 tablet.
C) 1½ tablets.
D) 2 tablets. - ✔✔C) 1½ tablets
✔✔An elderly male client who suffered a cerebral vascular accident is receiving tube
feedings via a gastrostomy tube. The nurse knows that the best position for this client
during administration of the feedings is
A) prone.
B) Fowler's.
C) Sims'.
D) supine - ✔✔B) Fowler's
The client should be positioned in a semi-sitting (Fowler's) (B) position during feeding to
decrease the occurrence of aspiration. A gastrostomy tube, known as a PEG tube, due
to placement by a percutaneous endoscopic gastrostomy procedure, is inserted directly
,into the stomach through an incision in the abdomen for long-term administration of
nutrition and hydration in the debilitated client. In (A and/or C), the client is placed on
the abdomen, an unsafe position for feeding. Placing the client in (D) increases the risk
of aspiration
✔✔A resident in a skilled nursing facility for short-term rehabilitation after a hip
replacement tells the nurse, "I don't want any more blood taken for those useless tests."
Which narrative documentation should the nurse enter in the client's medical record?
A) Healthcare provider notified of failure to collect specimens for prescribed blood
studies.
B) Blood specimens not collected because client no longer wants blood tests
performed.
C) Healthcare provider notified of client's refusal to have blood specimens collected for
testing.
D) Client irritable, uncooperative, and refuses to have blood collected. Healthcare
provider notified - ✔✔C) Healthcare provider notified of client's refusal to have blood
specimens collected for testing
When a client refuses a treatment, the exact words of the client regarding the client's
refusal of care should be documented in a narrative format (C). (A, B, and D) do not
address the concepts of informatics and legal issues
✔✔While instructing a male client's wife in the performance of passive range-of-motion
exercises to his contracted shoulder, the nurse observes that she is holding his arm
above and below the elbow. What nursing action should the nurse implement?
A) Acknowledge that she is supporting the arm correctly.
B) Encourage her to keep the joint covered to maintain warmth.
C) Reinforce the need to grip directly under the joint for better support.
D) Instruct her to grip directly over the joint for better motion. - ✔✔A) Acknowledge that
she is supporting the arm correctly
The wife is performing the passive ROM correctly, therefore the nurse should
acknowledge this fact (A). The joint that is being exercised should be uncovered (B)
while the rest of the body should remain covered for warmth and privacy. (C and D) do
not provide adequate support to the joint while still allowing for joint movement
✔✔A young mother of three children complains of increased anxiety during her annual
physical exam. What information should the nurse obtain first?
A) Sexual activity patterns.
B) Nutritional history.
C) Leisure activities.
D) Financial stressors - ✔✔B) Nutritional history
,Caffeine, sugars, and alcohol can lead to increased levels of anxiety, so a nutritional
history (C) should be obtained first so that health teaching can be initiated if indicated.
(A and C) can be used for stress management. Though (D) can be a source of anxiety,
a nutritional history should be obtained first
✔✔The nurse is caring for a client who is receiving 24-hour total parenteral nutrition
(TPN) via a central line at 54 ml/hr. When initially assessing the client, the nurse notes
that the TPN solution has run out and the next TPN solution is not available. What
immediate action should the nurse take?
A) Infuse normal saline at a keep vein open rate.
B) Discontinue the IV and flush the port with heparin.
C) Infuse 10 percent dextrose and water at 54 ml/hr
D) Obtain a stat blood glucose level and notify the healthcare provider. - ✔✔C) Infuse
10 percent dextrose and water at 54 ml/hr
TPN is discontinued gradually to allow the client to adjust to decreased levels of
glucose. Administering 10% dextrose in water at the prescribed rate (C) will keep the
client from experiencing hypoglycemia until the next TPN solution is available. The
client could experience a hypoglycemic reaction if the current level of glucose (A) is not
maintained or if the TPN is discontinued abruptly (B). There is no reason to obtain a stat
blood glucose level (D) and the healthcare provider cannot do anything about this
situation
✔✔A client is receiving a cephalosporin antibiotic IV and complains of pain and irritation
at the infusion site. The nurse observes erythema, swelling, and a red streak along the
vessel above the IV access site. Which action should the nurse take at this time?
A) Administer the medication more rapidly using the same IV site.
B) Initiate an alternate site for the IV infusion of the medication.
C) Notify the healthcare provider before administering the next dose.
D) Give the client a PRN dose of aspirin while the medication infuses - ✔✔B) Initiate an
alternate site for the IV infusion of the medication
A cephalosporin antibiotic that is administered IV may cause vessel irritation. Rotating
the infusion site minimizes the risk of thrombophlebitis, so an alternate infusion site
should be initiated (B) before administering the next dose. Rapid administration (A) of
intravenous cephalosporins can potentiate vessel irritation and increase the risk of
thrombophlebitis. (C) is not necessary to initiate an alternative IV site. Although aspirin
has antiinflammatory actions, (D) is not indicated
✔✔The nurse is using a genogram while conducting a client's health assessment and
past medical history. What information should the genogram provide?
A) Genetic and familial health disorders.
B) Chronic health problems.
, C) Reason for seeking health care.
D) Undetected disorders. - ✔✔A) Genetic and familial health disorders
A genogram that is used during the health assessment process identifies genetic and
familial health disorders (A). It may not identify the client's chronic health problems (B),
so it is not a reason to seek health care (C). A genogram is not a diagnostic tool to
detect disorders (D), such as those based on pathological findings or DNA.
✔✔Heparin 20,000 units in 500 ml D5W at 50 ml/hour has been infusing for 5½ hours.
How much heparin has the client received?
A) 11,000 units.
B) 13,000 units.
C) 15,000 units.
D) 17,000 units - ✔✔A) 11,000 units
✔✔A male client tells the nurse that he does not know where he is or what year it is.
What data should the nurse document that is most accurate?
A) demonstrates loss of remote memory.
B) exhibits expressive dysphasia.
C) has a diminished attention span.
D) is disoriented to place and time. - ✔✔D) is disoriented to place and time
The client is exhibiting disorientation (D). (A) refers to memory of the distant past. The
client is able to express himself without difficulty (B), and does not demonstrate a
diminished attention span (C).
✔✔An obese male client discusses with the nurse his plans to begin a long-term weight
loss regimen. In addition to dietary changes, he plans to begin an intensive aerobic
exercise program 3 to 4 times a week and to take stress management classes. After
praising the client for his decision, which instruction is most important for the nurse to
provide?
A) Be sure to have a complete physical examination before beginning your planned
exercise program.
B) Be careful that the exercise program doesn't simply add to your stress level, making
you want to eat more.
C) Increased exercise helps to reduce stress, so you may not need to spend money on
a stress management class.
D) Make sure to monitor your weight loss regularly to provide a sense of
accomplishment and motivation. - ✔✔A) Be sure to have a complete physical
examination before beginning your planned exercise program
2026 QUESTIONS AND ANSWERS SURE A+
✔✔The healthcare provider prescribes the diuretic metolazone (Zaroxolyn) 7.5 mg PO.
Zaroxolyn is available in 5 mg tablets. How much should the nurse plan to administer?
A) ½ tablet.
B) 1 tablet.
C) 1½ tablets.
D) 2 tablets. - ✔✔C) 1½ tablets
✔✔An elderly male client who suffered a cerebral vascular accident is receiving tube
feedings via a gastrostomy tube. The nurse knows that the best position for this client
during administration of the feedings is
A) prone.
B) Fowler's.
C) Sims'.
D) supine - ✔✔B) Fowler's
The client should be positioned in a semi-sitting (Fowler's) (B) position during feeding to
decrease the occurrence of aspiration. A gastrostomy tube, known as a PEG tube, due
to placement by a percutaneous endoscopic gastrostomy procedure, is inserted directly
,into the stomach through an incision in the abdomen for long-term administration of
nutrition and hydration in the debilitated client. In (A and/or C), the client is placed on
the abdomen, an unsafe position for feeding. Placing the client in (D) increases the risk
of aspiration
✔✔A resident in a skilled nursing facility for short-term rehabilitation after a hip
replacement tells the nurse, "I don't want any more blood taken for those useless tests."
Which narrative documentation should the nurse enter in the client's medical record?
A) Healthcare provider notified of failure to collect specimens for prescribed blood
studies.
B) Blood specimens not collected because client no longer wants blood tests
performed.
C) Healthcare provider notified of client's refusal to have blood specimens collected for
testing.
D) Client irritable, uncooperative, and refuses to have blood collected. Healthcare
provider notified - ✔✔C) Healthcare provider notified of client's refusal to have blood
specimens collected for testing
When a client refuses a treatment, the exact words of the client regarding the client's
refusal of care should be documented in a narrative format (C). (A, B, and D) do not
address the concepts of informatics and legal issues
✔✔While instructing a male client's wife in the performance of passive range-of-motion
exercises to his contracted shoulder, the nurse observes that she is holding his arm
above and below the elbow. What nursing action should the nurse implement?
A) Acknowledge that she is supporting the arm correctly.
B) Encourage her to keep the joint covered to maintain warmth.
C) Reinforce the need to grip directly under the joint for better support.
D) Instruct her to grip directly over the joint for better motion. - ✔✔A) Acknowledge that
she is supporting the arm correctly
The wife is performing the passive ROM correctly, therefore the nurse should
acknowledge this fact (A). The joint that is being exercised should be uncovered (B)
while the rest of the body should remain covered for warmth and privacy. (C and D) do
not provide adequate support to the joint while still allowing for joint movement
✔✔A young mother of three children complains of increased anxiety during her annual
physical exam. What information should the nurse obtain first?
A) Sexual activity patterns.
B) Nutritional history.
C) Leisure activities.
D) Financial stressors - ✔✔B) Nutritional history
,Caffeine, sugars, and alcohol can lead to increased levels of anxiety, so a nutritional
history (C) should be obtained first so that health teaching can be initiated if indicated.
(A and C) can be used for stress management. Though (D) can be a source of anxiety,
a nutritional history should be obtained first
✔✔The nurse is caring for a client who is receiving 24-hour total parenteral nutrition
(TPN) via a central line at 54 ml/hr. When initially assessing the client, the nurse notes
that the TPN solution has run out and the next TPN solution is not available. What
immediate action should the nurse take?
A) Infuse normal saline at a keep vein open rate.
B) Discontinue the IV and flush the port with heparin.
C) Infuse 10 percent dextrose and water at 54 ml/hr
D) Obtain a stat blood glucose level and notify the healthcare provider. - ✔✔C) Infuse
10 percent dextrose and water at 54 ml/hr
TPN is discontinued gradually to allow the client to adjust to decreased levels of
glucose. Administering 10% dextrose in water at the prescribed rate (C) will keep the
client from experiencing hypoglycemia until the next TPN solution is available. The
client could experience a hypoglycemic reaction if the current level of glucose (A) is not
maintained or if the TPN is discontinued abruptly (B). There is no reason to obtain a stat
blood glucose level (D) and the healthcare provider cannot do anything about this
situation
✔✔A client is receiving a cephalosporin antibiotic IV and complains of pain and irritation
at the infusion site. The nurse observes erythema, swelling, and a red streak along the
vessel above the IV access site. Which action should the nurse take at this time?
A) Administer the medication more rapidly using the same IV site.
B) Initiate an alternate site for the IV infusion of the medication.
C) Notify the healthcare provider before administering the next dose.
D) Give the client a PRN dose of aspirin while the medication infuses - ✔✔B) Initiate an
alternate site for the IV infusion of the medication
A cephalosporin antibiotic that is administered IV may cause vessel irritation. Rotating
the infusion site minimizes the risk of thrombophlebitis, so an alternate infusion site
should be initiated (B) before administering the next dose. Rapid administration (A) of
intravenous cephalosporins can potentiate vessel irritation and increase the risk of
thrombophlebitis. (C) is not necessary to initiate an alternative IV site. Although aspirin
has antiinflammatory actions, (D) is not indicated
✔✔The nurse is using a genogram while conducting a client's health assessment and
past medical history. What information should the genogram provide?
A) Genetic and familial health disorders.
B) Chronic health problems.
, C) Reason for seeking health care.
D) Undetected disorders. - ✔✔A) Genetic and familial health disorders
A genogram that is used during the health assessment process identifies genetic and
familial health disorders (A). It may not identify the client's chronic health problems (B),
so it is not a reason to seek health care (C). A genogram is not a diagnostic tool to
detect disorders (D), such as those based on pathological findings or DNA.
✔✔Heparin 20,000 units in 500 ml D5W at 50 ml/hour has been infusing for 5½ hours.
How much heparin has the client received?
A) 11,000 units.
B) 13,000 units.
C) 15,000 units.
D) 17,000 units - ✔✔A) 11,000 units
✔✔A male client tells the nurse that he does not know where he is or what year it is.
What data should the nurse document that is most accurate?
A) demonstrates loss of remote memory.
B) exhibits expressive dysphasia.
C) has a diminished attention span.
D) is disoriented to place and time. - ✔✔D) is disoriented to place and time
The client is exhibiting disorientation (D). (A) refers to memory of the distant past. The
client is able to express himself without difficulty (B), and does not demonstrate a
diminished attention span (C).
✔✔An obese male client discusses with the nurse his plans to begin a long-term weight
loss regimen. In addition to dietary changes, he plans to begin an intensive aerobic
exercise program 3 to 4 times a week and to take stress management classes. After
praising the client for his decision, which instruction is most important for the nurse to
provide?
A) Be sure to have a complete physical examination before beginning your planned
exercise program.
B) Be careful that the exercise program doesn't simply add to your stress level, making
you want to eat more.
C) Increased exercise helps to reduce stress, so you may not need to spend money on
a stress management class.
D) Make sure to monitor your weight loss regularly to provide a sense of
accomplishment and motivation. - ✔✔A) Be sure to have a complete physical
examination before beginning your planned exercise program
