BSN 225 HESI RN Specialty
Fundamentals of Nursing Examination
Practice Questions with Comprehensive Rationales
Latest Update 2026/2027 | 50 Questions | 100% Verified Correct | Grade A
Nightingale College BSN Curriculum Aligned
Exam HESI RN Specialty Fundamentals
Course BSN 225
Questions 50 Multiple Choice
Alignment NCLEX-RN Test Plan, Nightingale College BSN
Year 2026/2027
Section 1: Safe, Effective Care Environment (Management of
Care, Safety & Infection Control)
Q1: A nurse is caring for a client who is scheduled for a colonoscopy. The client asks the
nurse to explain the procedure. Which response by the nurse is most appropriate?
A. The nurse provides a detailed explanation of the colonoscopy procedure, including
risks, benefits, and alternatives
B. The nurse tells the client that the provider will explain the procedure and
documents that the client has questions [CORRECT]
C. The nurse states that the procedure is routine and the client should not worry
about it
D. The nurse refers the client to the internet for information about colonoscopies
Correct Answer: B
Rationale: The nurse's role in informed consent is to witness the client's signature and confirm
understanding of what was explained by the provider. The provider has the responsibility to
explain the procedure, risks, benefits, and alternatives. If the client has unanswered questions,
the nurse should notify the provider before the client signs the consent form. Providing the
explanation directly (A) exceeds the nurse's scope for informed consent. Offering false
reassurance (C) is non-therapeutic, and referring to the internet (D) does not ensure accurate,
individualized information is provided.
,Q2: Which of the following actions by a nurse demonstrates compliance with the Patient
Self-Determination Act (PSDA)?
A. Documenting that the client was informed about their right to advance
directives upon admission [CORRECT]
B. Making decisions for a client who lacks decision-making capacity without
consulting family members
C. Encouraging a competent client to complete a living will only if diagnosed with a
terminal illness
D. Withholding information about advance directives because the client appears
healthy and young
Correct Answer: A
Rationale: The Patient Self-Determination Act requires healthcare facilities to inform all adult
clients of their right to make decisions about their medical care, including the right to accept or
refuse treatment and to formulate advance directives such as a living will or Durable Power of
Attorney for Health Care (DPOA-HC). Documenting that the client was informed upon admission
ensures compliance. Making decisions without consulting family (B), limiting advance directive
discussion to terminal diagnoses (C), and withholding information (D) all violate the PSDA and
client autonomy.
Q3: A nurse overhears two unlicensed assistive personnel (UAP) discussing a client's
diagnosis in the hospital elevator. Which action should the nurse take first?
A. Report the incident to the charge nurse and complete an incident report
B. Speak to the UAPs immediately and remind them about HIPAA
confidentiality protections [CORRECT]
C. Wait until the end of the shift to address the issue privately with the UAPs
D. Document the conversation in the client's medical record as a privacy breach
Correct Answer: B
Rationale: The first priority is to stop the ongoing HIPAA violation immediately by speaking to
the UAPs directly. The Health Insurance Portability and Accountability Act (HIPAA) protects
Protected Health Information (PHI) and permits disclosure only for Treatment, Payment, or
Healthcare Operations (TPO). Discussion in a public elevator is a clear breach. Reporting to the
charge nurse (A) is important but should follow after the immediate intervention. Waiting (C)
allows the breach to continue, and documenting in the client's chart (D) is inappropriate because
the medical record is for clinical care, not incident documentation.
Q4: A nurse on a medical-surgical unit receives a new admission. Which task can the
nurse delegate to the UAP?
A. Obtaining the client's admission vital signs [CORRECT]
B. Performing the initial nursing assessment
C. Assisting the client with ADLs such as bathing and toileting
D. Documenting the nursing care plan
Correct Answer: A
BSN 225 HESI Fundamentals Exam Prep | Page 2
, Rationale: The UAP scope of practice includes performing ADLs (bathing, feeding, toileting),
measuring vital signs, ambulation, positioning, and intake/output measurement. The nurse can
delegate obtaining admission vital signs (A) and assisting with ADLs (C). However, this question
requires identifying the single best answer demonstrating delegation. Assessment (B), nursing
care planning (D), client education, and nursing judgment tasks cannot be delegated because
they require RN-level critical thinking as defined by the Five Rights of Delegation: Right Task,
Right Circumstance, Right Person, Right Direction/Communication, and Right
Supervision/Evaluation.
Q5: A nurse is caring for four clients. Which client should the nurse assess first?
A. A client 2 days post-operative who has not had a bowel movement since surgery
B. A client with a fever of 38.9 degrees Celsius who reports chills and
appears flushed [CORRECT]
C. A client who is scheduled for discharge teaching later in the afternoon
D. A client requesting pain medication for chronic knee pain rated at 3 out of 10
Correct Answer: B
Rationale: Using the ABCs (Airway, Breathing, Circulation) priority-setting framework, the nurse
should first assess the client with a fever of 38.9 degrees Celsius who has chills and appears
flushed. A fever may indicate an infection or sepsis that could progress to hemodynamic
instability. The ABCs framework prioritizes physiological needs and identifies the client whose
condition is most acute. While all clients require nursing care, the febrile client has the greatest
risk for deterioration and requires immediate assessment, including vital signs, oxygen
saturation, and further evaluation for infection sources.
Q6: A fire is discovered in a trash can in the hallway of a medical-surgical unit. Using the
RACE protocol, what is the nurse's first action?
A. Pull the pin on the nearest fire extinguisher and aim at the base of the fire
B. Activate the fire alarm and call the switchboard to report the fire location
C. Rescue and evacuate all clients from immediate danger in the area
[CORRECT]
D. Confine the fire by closing all doors and windows in the immediate area
Correct Answer: C
Rationale: The RACE protocol for fire safety stands for Rescue, Alarm, Confine, and
Extinguish/Evacuate. The first priority is always to Rescue clients and individuals from immediate
danger. After ensuring client safety, the nurse should then Activate the alarm (B), Confine the fire
by closing doors and windows (D), and only then attempt to Extinguish using the PASS technique
(A: Pull, Aim, Squeeze, Sweep). This order follows Maslow's hierarchy by addressing physiological
safety first and is the universally accepted fire response protocol in healthcare settings.
Q7: A nurse is preparing to delegate medication administration to an LPN/LVN. Which
medication can the LPN/LVN safely administer?
A. Intravenous push morphine sulfate for acute pain management
BSN 225 HESI Fundamentals Exam Prep | Page 3
Fundamentals of Nursing Examination
Practice Questions with Comprehensive Rationales
Latest Update 2026/2027 | 50 Questions | 100% Verified Correct | Grade A
Nightingale College BSN Curriculum Aligned
Exam HESI RN Specialty Fundamentals
Course BSN 225
Questions 50 Multiple Choice
Alignment NCLEX-RN Test Plan, Nightingale College BSN
Year 2026/2027
Section 1: Safe, Effective Care Environment (Management of
Care, Safety & Infection Control)
Q1: A nurse is caring for a client who is scheduled for a colonoscopy. The client asks the
nurse to explain the procedure. Which response by the nurse is most appropriate?
A. The nurse provides a detailed explanation of the colonoscopy procedure, including
risks, benefits, and alternatives
B. The nurse tells the client that the provider will explain the procedure and
documents that the client has questions [CORRECT]
C. The nurse states that the procedure is routine and the client should not worry
about it
D. The nurse refers the client to the internet for information about colonoscopies
Correct Answer: B
Rationale: The nurse's role in informed consent is to witness the client's signature and confirm
understanding of what was explained by the provider. The provider has the responsibility to
explain the procedure, risks, benefits, and alternatives. If the client has unanswered questions,
the nurse should notify the provider before the client signs the consent form. Providing the
explanation directly (A) exceeds the nurse's scope for informed consent. Offering false
reassurance (C) is non-therapeutic, and referring to the internet (D) does not ensure accurate,
individualized information is provided.
,Q2: Which of the following actions by a nurse demonstrates compliance with the Patient
Self-Determination Act (PSDA)?
A. Documenting that the client was informed about their right to advance
directives upon admission [CORRECT]
B. Making decisions for a client who lacks decision-making capacity without
consulting family members
C. Encouraging a competent client to complete a living will only if diagnosed with a
terminal illness
D. Withholding information about advance directives because the client appears
healthy and young
Correct Answer: A
Rationale: The Patient Self-Determination Act requires healthcare facilities to inform all adult
clients of their right to make decisions about their medical care, including the right to accept or
refuse treatment and to formulate advance directives such as a living will or Durable Power of
Attorney for Health Care (DPOA-HC). Documenting that the client was informed upon admission
ensures compliance. Making decisions without consulting family (B), limiting advance directive
discussion to terminal diagnoses (C), and withholding information (D) all violate the PSDA and
client autonomy.
Q3: A nurse overhears two unlicensed assistive personnel (UAP) discussing a client's
diagnosis in the hospital elevator. Which action should the nurse take first?
A. Report the incident to the charge nurse and complete an incident report
B. Speak to the UAPs immediately and remind them about HIPAA
confidentiality protections [CORRECT]
C. Wait until the end of the shift to address the issue privately with the UAPs
D. Document the conversation in the client's medical record as a privacy breach
Correct Answer: B
Rationale: The first priority is to stop the ongoing HIPAA violation immediately by speaking to
the UAPs directly. The Health Insurance Portability and Accountability Act (HIPAA) protects
Protected Health Information (PHI) and permits disclosure only for Treatment, Payment, or
Healthcare Operations (TPO). Discussion in a public elevator is a clear breach. Reporting to the
charge nurse (A) is important but should follow after the immediate intervention. Waiting (C)
allows the breach to continue, and documenting in the client's chart (D) is inappropriate because
the medical record is for clinical care, not incident documentation.
Q4: A nurse on a medical-surgical unit receives a new admission. Which task can the
nurse delegate to the UAP?
A. Obtaining the client's admission vital signs [CORRECT]
B. Performing the initial nursing assessment
C. Assisting the client with ADLs such as bathing and toileting
D. Documenting the nursing care plan
Correct Answer: A
BSN 225 HESI Fundamentals Exam Prep | Page 2
, Rationale: The UAP scope of practice includes performing ADLs (bathing, feeding, toileting),
measuring vital signs, ambulation, positioning, and intake/output measurement. The nurse can
delegate obtaining admission vital signs (A) and assisting with ADLs (C). However, this question
requires identifying the single best answer demonstrating delegation. Assessment (B), nursing
care planning (D), client education, and nursing judgment tasks cannot be delegated because
they require RN-level critical thinking as defined by the Five Rights of Delegation: Right Task,
Right Circumstance, Right Person, Right Direction/Communication, and Right
Supervision/Evaluation.
Q5: A nurse is caring for four clients. Which client should the nurse assess first?
A. A client 2 days post-operative who has not had a bowel movement since surgery
B. A client with a fever of 38.9 degrees Celsius who reports chills and
appears flushed [CORRECT]
C. A client who is scheduled for discharge teaching later in the afternoon
D. A client requesting pain medication for chronic knee pain rated at 3 out of 10
Correct Answer: B
Rationale: Using the ABCs (Airway, Breathing, Circulation) priority-setting framework, the nurse
should first assess the client with a fever of 38.9 degrees Celsius who has chills and appears
flushed. A fever may indicate an infection or sepsis that could progress to hemodynamic
instability. The ABCs framework prioritizes physiological needs and identifies the client whose
condition is most acute. While all clients require nursing care, the febrile client has the greatest
risk for deterioration and requires immediate assessment, including vital signs, oxygen
saturation, and further evaluation for infection sources.
Q6: A fire is discovered in a trash can in the hallway of a medical-surgical unit. Using the
RACE protocol, what is the nurse's first action?
A. Pull the pin on the nearest fire extinguisher and aim at the base of the fire
B. Activate the fire alarm and call the switchboard to report the fire location
C. Rescue and evacuate all clients from immediate danger in the area
[CORRECT]
D. Confine the fire by closing all doors and windows in the immediate area
Correct Answer: C
Rationale: The RACE protocol for fire safety stands for Rescue, Alarm, Confine, and
Extinguish/Evacuate. The first priority is always to Rescue clients and individuals from immediate
danger. After ensuring client safety, the nurse should then Activate the alarm (B), Confine the fire
by closing doors and windows (D), and only then attempt to Extinguish using the PASS technique
(A: Pull, Aim, Squeeze, Sweep). This order follows Maslow's hierarchy by addressing physiological
safety first and is the universally accepted fire response protocol in healthcare settings.
Q7: A nurse is preparing to delegate medication administration to an LPN/LVN. Which
medication can the LPN/LVN safely administer?
A. Intravenous push morphine sulfate for acute pain management
BSN 225 HESI Fundamentals Exam Prep | Page 3
