BSN 225 HESI RN Specialty Fundamentals of Nursing (2026/2027)
Nightingale College · 100 Verified Questions · 8 NCLEX Categories
BSN 225 — HESI RN Specialty Fundamentals of Nursing
Exam Study Guide (Latest Update 2026/2027) · 100% Correct · Grade A · Nightingale College
Nightingale College BSN Program · NCLEX-RN Test Plan · 8 Client-Need Categories · 100 Questions · 30% Recall · 50% Application ·
20% Analysis
Instructions: This study guide contains 100 verified multiple-choice questions distributed across the eight NCLEX
client-need categories aligned with the HESI RN Specialty Fundamentals examination blueprint. Each question has exactly one
correct answer (marked [CORRECT]) accompanied by a comprehensive nursing rationale citing priority-setting frameworks
(ABC, Maslow, nursing process, Five Rights of Delegation), evidence-based practice, patient-safety principles, and
Nightingale College BSN 225 curriculum standards. High-yield topics covered: informed consent and patient rights, HIPAA,
advance directives, delegation (RN vs. LPN vs. UAP), infection control (contact, droplet, airborne precautions), vital signs, lab
values, ABG interpretation, medication administration, IV therapy, fluid/electrolyte imbalances, pressure injury staging,
therapeutic communication, and end-of-life care.
Section 1: Safe, Effective Care Environment (Management of Care, Safety &
Infection Control) (Q1–Q30)
Q1. A postoperative patient is scheduled for a cholecystectomy. The surgeon has explained the procedure,
risks, and alternatives, and the patient signs the consent form. What is the nurse's primary role in the
informed consent process?
A. Explain the surgical procedure in detail to ensure patient understanding.
B. Witness the patient's signature and verify the patient's understanding and that consent is given
voluntarily. [CORRECT]
C. Ensure the patient's family agrees with the surgical decision before proceeding.
D. Cancel the consent if the patient has additional questions about anesthesia.
Correct Answer: B — Witness the patient's signature and verify the patient's understanding and
that consent is given voluntarily.
Rationale: The nurse's role in informed consent is to witness the signature, confirm the patient understands the procedure, and
verify consent is voluntary. The provider (surgeon) is responsible for explaining the procedure, risks, benefits, and alternatives (A
is the provider's role). Family agreement is not required for competent adults (C), and if the patient has additional questions, the
nurse should notify the provider rather than cancel the consent (D).
Nightingale College BSN 225 — HESI RN Specialty FundamentalsPage
Study1 Guide 2026/2027 Edition · Grade A
,BSN 225 HESI RN Specialty Fundamentals of Nursing (2026/2027)
Nightingale College · 100 Verified Questions · 8 NCLEX Categories
Q2. A patient is scheduled for a cardiac catheterization. The physician explains the procedure and leaves
the room. The patient then asks the nurse, "What are the major risks of this procedure?" The nurse's best
response is to:
A. Provide a detailed list of complications including bleeding, infection, and contrast reaction.
B. Answer only general questions and defer specific risk questions to the physician at a later time.
C. Notify the physician that the patient has questions about risks and needs further explanation
before consent is valid. [CORRECT]
D. Document that the patient refused the procedure due to unanswered questions.
Correct Answer: C — Notify the physician that the patient has questions about risks and needs
further explanation before consent is valid.
Rationale: The provider is responsible for explaining procedure risks, benefits, and alternatives. If the patient has unanswered
questions about risks, the nurse must notify the provider to return and answer them before consent is considered valid. The nurse
should not provide detailed risk explanations (A) as this is the provider's responsibility. Deferring to the physician without
notification (B) leaves the patient's question unanswered. Documenting refusal (D) is inappropriate; the patient is asking for
information, not refusing.
Q3. Which situation requires the nurse to delay obtaining informed consent and notify the healthcare
provider?
A. The patient asks the nurse to explain the procedure one more time after signing.
B. The patient received a preoperative sedative 30 minutes ago and is drowsy. [CORRECT]
C. The patient's family member expresses concern about the surgery.
D. The patient signed the consent form 24 hours ago.
Correct Answer: B — The patient received a preoperative sedative 30 minutes ago and is drowsy.
Rationale: A patient who has received a sedative or opioid analgesic cannot give valid informed consent because they are not
mentally competent at that time. The nurse must wait until the medication wears off or notify the provider to re-consent the
patient. Patients asking for re-explanation (A) should have the provider return to clarify. Family concerns (C) do not invalidate
the patient's consent. A 24-hour-old signed consent (D) remains valid.
Q4. A patient tells the nurse, "If I can't speak for myself, I want my daughter to make all healthcare
decisions for me." Which document should the nurse recommend the patient complete?
A. Living will
B. Durable Power of Attorney for Health Care (DPOA-HC) [CORRECT]
C. Do Not Resuscitate (DNR) order
D. Informed consent form for hospitalization
Correct Answer: B — Durable Power of Attorney for Health Care (DPOA-HC)
Rationale: The Durable Power of Attorney for Health Care (DPOA-HC) designates a surrogate decision-maker if the patient
becomes incapacitated. A living will (A) specifies treatment preferences but does not designate a proxy. A DNR order (C) is a
physician order specific to resuscitation, not surrogate decision-making. Informed consent (D) is for a specific procedure, not
advance care planning.
Nightingale College BSN 225 — HESI RN Specialty FundamentalsPage
Study2 Guide 2026/2027 Edition · Grade A
,BSN 225 HESI RN Specialty Fundamentals of Nursing (2026/2027)
Nightingale College · 100 Verified Questions · 8 NCLEX Categories
Q5. The Patient Self-Determination Act (PSDA) requires healthcare facilities that receive Medicare or
Medicaid funding to:
A. Provide free advance directive forms to all patients on admission.
B. Inform patients of their rights to make decisions about their care, including the right to execute
advance directives. [CORRECT]
C. Require all patients to complete a living will before discharge.
D. Honor a patient's DNR order only if it is notarized by an attorney.
Correct Answer: B — Inform patients of their rights to make decisions about their care, including
the right to execute advance directives.
Rationale: The PSDA requires facilities receiving Medicare/Medicaid funding to inform patients of their rights to make
healthcare decisions, including the right to accept or refuse treatment and the right to execute advance directives. Facilities are not
required to provide free forms (A), nor can they mandate completion of a living will (C). DNR orders do not require notarization
(D); they require a physician order.
Q6. A nursing student posts on social media about a "really interesting patient with a rare disease"
without naming the patient. Which statement best describes this action?
A. Acceptable because the patient's name was not mentioned.
B. A HIPAA violation because protected health information (PHI) can identify a patient even
without a name. [CORRECT]
C. Acceptable if the post is deleted within 24 hours of publishing.
D. A violation only if the patient's family sees the post and reports it.
Correct Answer: B — A HIPAA violation because protected health information (PHI) can identify a
patient even without a name.
Rationale: PHI includes any information that could identify a patient, including rare diagnoses combined with location, dates, or
other contextual details. HIPAA violations occur regardless of whether a name is used. Deleting the post (C) does not undo the
violation, and the violation occurs at the time of posting, not when viewed (D). Posting about patients on social media is a clear
HIPAA breach.
Q7. Under HIPAA, which of the following disclosures of protected health information (PHI) is permitted
without specific patient authorization?
A. Sharing patient information with a pharmaceutical company for marketing purposes.
B. Discussing patient care with the physical therapist involved in the patient's treatment.
[CORRECT]
C. Posting patient photos on a personal nursing blog to educate the public.
D. Sharing the patient's diagnosis with the patient's employer without the patient's permission.
Correct Answer: B — Discussing patient care with the physical therapist involved in the patient's
treatment.
Rationale: HIPAA permits disclosure of PHI for Treatment, Payment, and Healthcare Operations (TPO) without specific patient
authorization. Discussing care with the physical therapist is a treatment disclosure. Marketing to pharmaceutical companies (A),
posting on personal blogs (C), and sharing with employers (D) all require explicit patient authorization.
Nightingale College BSN 225 — HESI RN Specialty FundamentalsPage
Study3 Guide 2026/2027 Edition · Grade A
, BSN 225 HESI RN Specialty Fundamentals of Nursing (2026/2027)
Nightingale College · 100 Verified Questions · 8 NCLEX Categories
Q8. A visitor at the nurses' station asks the nurse for an update on a patient's condition. The patient has
not given permission to share information with this visitor. The nurse's best response is:
A. "The patient is stable and recovering well, so don't worry."
B. "I cannot share patient information without the patient's permission; please ask the patient
directly when you visit." [CORRECT]
C. "You'll need to ask the patient directly when you visit later today, but they're doing okay."
D. "I'll need to check with the charge nurse before I can give you any information."
Correct Answer: B — "I cannot share patient information without the patient's permission; please
ask the patient directly when you visit."
Rationale: HIPAA requires patient permission before sharing PHI with visitors. The nurse should politely decline and direct the
visitor to the patient. Sharing even general information such as 'stable' (A) or 'okay' (C) without permission violates HIPAA.
Deflecting to the charge nurse (D) delays the appropriate response and does not address the privacy requirement.
Q9. A competent adult patient with end-stage renal disease refuses to undergo hemodialysis, stating, "I'm
tired of fighting this disease." Which action by the nurse is most appropriate?
A. Document the refusal, notify the provider, and continue to provide supportive care. [CORRECT]
B. Convince the patient to accept dialysis by explaining the fatal consequences of refusal.
C. Notify the ethics committee to override the patient's decision.
D. Administer dialysis anyway because it is life-saving treatment.
Correct Answer: A — Document the refusal, notify the provider, and continue to provide supportive
care.
Rationale: Competent adults have the right to refuse treatment, even life-saving measures, under the ethical principle of
autonomy. The nurse must document the refusal, notify the provider, and continue providing supportive care. Coercing the patient
(B), involving ethics to override (C), or forcing treatment (D) all violate patient autonomy and constitute battery.
Q10. When delegating patient care tasks to unlicensed assistive personnel (UAP), which framework
should the RN use to ensure safe delegation?
A. Five Rights of Medication Administration
B. Five Rights of Delegation: Right Task, Right Circumstance, Right Person, Right
Direction/Communication, Right Supervision/Evaluation [CORRECT]
C. ABCs of prioritization (Airway, Breathing, Circulation)
D. Nursing Process (ADPIE)
Correct Answer: B — Five Rights of Delegation: Right Task, Right Circumstance, Right Person,
Right Direction/Communication, Right Supervision/Evaluation
Rationale: The Five Rights of Delegation (ANAs/NCSBNs framework) provide the structure for safe delegation: Right Task,
Right Circumstance, Right Person, Right Direction/Communication, and Right Supervision/Evaluation. The Five Rights of
Medication Administration (A) apply to medication giving. ABCs (C) and the Nursing Process (D) are clinical reasoning
frameworks, not delegation frameworks.
Nightingale College BSN 225 — HESI RN Specialty FundamentalsPage
Study4 Guide 2026/2027 Edition · Grade A
Nightingale College · 100 Verified Questions · 8 NCLEX Categories
BSN 225 — HESI RN Specialty Fundamentals of Nursing
Exam Study Guide (Latest Update 2026/2027) · 100% Correct · Grade A · Nightingale College
Nightingale College BSN Program · NCLEX-RN Test Plan · 8 Client-Need Categories · 100 Questions · 30% Recall · 50% Application ·
20% Analysis
Instructions: This study guide contains 100 verified multiple-choice questions distributed across the eight NCLEX
client-need categories aligned with the HESI RN Specialty Fundamentals examination blueprint. Each question has exactly one
correct answer (marked [CORRECT]) accompanied by a comprehensive nursing rationale citing priority-setting frameworks
(ABC, Maslow, nursing process, Five Rights of Delegation), evidence-based practice, patient-safety principles, and
Nightingale College BSN 225 curriculum standards. High-yield topics covered: informed consent and patient rights, HIPAA,
advance directives, delegation (RN vs. LPN vs. UAP), infection control (contact, droplet, airborne precautions), vital signs, lab
values, ABG interpretation, medication administration, IV therapy, fluid/electrolyte imbalances, pressure injury staging,
therapeutic communication, and end-of-life care.
Section 1: Safe, Effective Care Environment (Management of Care, Safety &
Infection Control) (Q1–Q30)
Q1. A postoperative patient is scheduled for a cholecystectomy. The surgeon has explained the procedure,
risks, and alternatives, and the patient signs the consent form. What is the nurse's primary role in the
informed consent process?
A. Explain the surgical procedure in detail to ensure patient understanding.
B. Witness the patient's signature and verify the patient's understanding and that consent is given
voluntarily. [CORRECT]
C. Ensure the patient's family agrees with the surgical decision before proceeding.
D. Cancel the consent if the patient has additional questions about anesthesia.
Correct Answer: B — Witness the patient's signature and verify the patient's understanding and
that consent is given voluntarily.
Rationale: The nurse's role in informed consent is to witness the signature, confirm the patient understands the procedure, and
verify consent is voluntary. The provider (surgeon) is responsible for explaining the procedure, risks, benefits, and alternatives (A
is the provider's role). Family agreement is not required for competent adults (C), and if the patient has additional questions, the
nurse should notify the provider rather than cancel the consent (D).
Nightingale College BSN 225 — HESI RN Specialty FundamentalsPage
Study1 Guide 2026/2027 Edition · Grade A
,BSN 225 HESI RN Specialty Fundamentals of Nursing (2026/2027)
Nightingale College · 100 Verified Questions · 8 NCLEX Categories
Q2. A patient is scheduled for a cardiac catheterization. The physician explains the procedure and leaves
the room. The patient then asks the nurse, "What are the major risks of this procedure?" The nurse's best
response is to:
A. Provide a detailed list of complications including bleeding, infection, and contrast reaction.
B. Answer only general questions and defer specific risk questions to the physician at a later time.
C. Notify the physician that the patient has questions about risks and needs further explanation
before consent is valid. [CORRECT]
D. Document that the patient refused the procedure due to unanswered questions.
Correct Answer: C — Notify the physician that the patient has questions about risks and needs
further explanation before consent is valid.
Rationale: The provider is responsible for explaining procedure risks, benefits, and alternatives. If the patient has unanswered
questions about risks, the nurse must notify the provider to return and answer them before consent is considered valid. The nurse
should not provide detailed risk explanations (A) as this is the provider's responsibility. Deferring to the physician without
notification (B) leaves the patient's question unanswered. Documenting refusal (D) is inappropriate; the patient is asking for
information, not refusing.
Q3. Which situation requires the nurse to delay obtaining informed consent and notify the healthcare
provider?
A. The patient asks the nurse to explain the procedure one more time after signing.
B. The patient received a preoperative sedative 30 minutes ago and is drowsy. [CORRECT]
C. The patient's family member expresses concern about the surgery.
D. The patient signed the consent form 24 hours ago.
Correct Answer: B — The patient received a preoperative sedative 30 minutes ago and is drowsy.
Rationale: A patient who has received a sedative or opioid analgesic cannot give valid informed consent because they are not
mentally competent at that time. The nurse must wait until the medication wears off or notify the provider to re-consent the
patient. Patients asking for re-explanation (A) should have the provider return to clarify. Family concerns (C) do not invalidate
the patient's consent. A 24-hour-old signed consent (D) remains valid.
Q4. A patient tells the nurse, "If I can't speak for myself, I want my daughter to make all healthcare
decisions for me." Which document should the nurse recommend the patient complete?
A. Living will
B. Durable Power of Attorney for Health Care (DPOA-HC) [CORRECT]
C. Do Not Resuscitate (DNR) order
D. Informed consent form for hospitalization
Correct Answer: B — Durable Power of Attorney for Health Care (DPOA-HC)
Rationale: The Durable Power of Attorney for Health Care (DPOA-HC) designates a surrogate decision-maker if the patient
becomes incapacitated. A living will (A) specifies treatment preferences but does not designate a proxy. A DNR order (C) is a
physician order specific to resuscitation, not surrogate decision-making. Informed consent (D) is for a specific procedure, not
advance care planning.
Nightingale College BSN 225 — HESI RN Specialty FundamentalsPage
Study2 Guide 2026/2027 Edition · Grade A
,BSN 225 HESI RN Specialty Fundamentals of Nursing (2026/2027)
Nightingale College · 100 Verified Questions · 8 NCLEX Categories
Q5. The Patient Self-Determination Act (PSDA) requires healthcare facilities that receive Medicare or
Medicaid funding to:
A. Provide free advance directive forms to all patients on admission.
B. Inform patients of their rights to make decisions about their care, including the right to execute
advance directives. [CORRECT]
C. Require all patients to complete a living will before discharge.
D. Honor a patient's DNR order only if it is notarized by an attorney.
Correct Answer: B — Inform patients of their rights to make decisions about their care, including
the right to execute advance directives.
Rationale: The PSDA requires facilities receiving Medicare/Medicaid funding to inform patients of their rights to make
healthcare decisions, including the right to accept or refuse treatment and the right to execute advance directives. Facilities are not
required to provide free forms (A), nor can they mandate completion of a living will (C). DNR orders do not require notarization
(D); they require a physician order.
Q6. A nursing student posts on social media about a "really interesting patient with a rare disease"
without naming the patient. Which statement best describes this action?
A. Acceptable because the patient's name was not mentioned.
B. A HIPAA violation because protected health information (PHI) can identify a patient even
without a name. [CORRECT]
C. Acceptable if the post is deleted within 24 hours of publishing.
D. A violation only if the patient's family sees the post and reports it.
Correct Answer: B — A HIPAA violation because protected health information (PHI) can identify a
patient even without a name.
Rationale: PHI includes any information that could identify a patient, including rare diagnoses combined with location, dates, or
other contextual details. HIPAA violations occur regardless of whether a name is used. Deleting the post (C) does not undo the
violation, and the violation occurs at the time of posting, not when viewed (D). Posting about patients on social media is a clear
HIPAA breach.
Q7. Under HIPAA, which of the following disclosures of protected health information (PHI) is permitted
without specific patient authorization?
A. Sharing patient information with a pharmaceutical company for marketing purposes.
B. Discussing patient care with the physical therapist involved in the patient's treatment.
[CORRECT]
C. Posting patient photos on a personal nursing blog to educate the public.
D. Sharing the patient's diagnosis with the patient's employer without the patient's permission.
Correct Answer: B — Discussing patient care with the physical therapist involved in the patient's
treatment.
Rationale: HIPAA permits disclosure of PHI for Treatment, Payment, and Healthcare Operations (TPO) without specific patient
authorization. Discussing care with the physical therapist is a treatment disclosure. Marketing to pharmaceutical companies (A),
posting on personal blogs (C), and sharing with employers (D) all require explicit patient authorization.
Nightingale College BSN 225 — HESI RN Specialty FundamentalsPage
Study3 Guide 2026/2027 Edition · Grade A
, BSN 225 HESI RN Specialty Fundamentals of Nursing (2026/2027)
Nightingale College · 100 Verified Questions · 8 NCLEX Categories
Q8. A visitor at the nurses' station asks the nurse for an update on a patient's condition. The patient has
not given permission to share information with this visitor. The nurse's best response is:
A. "The patient is stable and recovering well, so don't worry."
B. "I cannot share patient information without the patient's permission; please ask the patient
directly when you visit." [CORRECT]
C. "You'll need to ask the patient directly when you visit later today, but they're doing okay."
D. "I'll need to check with the charge nurse before I can give you any information."
Correct Answer: B — "I cannot share patient information without the patient's permission; please
ask the patient directly when you visit."
Rationale: HIPAA requires patient permission before sharing PHI with visitors. The nurse should politely decline and direct the
visitor to the patient. Sharing even general information such as 'stable' (A) or 'okay' (C) without permission violates HIPAA.
Deflecting to the charge nurse (D) delays the appropriate response and does not address the privacy requirement.
Q9. A competent adult patient with end-stage renal disease refuses to undergo hemodialysis, stating, "I'm
tired of fighting this disease." Which action by the nurse is most appropriate?
A. Document the refusal, notify the provider, and continue to provide supportive care. [CORRECT]
B. Convince the patient to accept dialysis by explaining the fatal consequences of refusal.
C. Notify the ethics committee to override the patient's decision.
D. Administer dialysis anyway because it is life-saving treatment.
Correct Answer: A — Document the refusal, notify the provider, and continue to provide supportive
care.
Rationale: Competent adults have the right to refuse treatment, even life-saving measures, under the ethical principle of
autonomy. The nurse must document the refusal, notify the provider, and continue providing supportive care. Coercing the patient
(B), involving ethics to override (C), or forcing treatment (D) all violate patient autonomy and constitute battery.
Q10. When delegating patient care tasks to unlicensed assistive personnel (UAP), which framework
should the RN use to ensure safe delegation?
A. Five Rights of Medication Administration
B. Five Rights of Delegation: Right Task, Right Circumstance, Right Person, Right
Direction/Communication, Right Supervision/Evaluation [CORRECT]
C. ABCs of prioritization (Airway, Breathing, Circulation)
D. Nursing Process (ADPIE)
Correct Answer: B — Five Rights of Delegation: Right Task, Right Circumstance, Right Person,
Right Direction/Communication, Right Supervision/Evaluation
Rationale: The Five Rights of Delegation (ANAs/NCSBNs framework) provide the structure for safe delegation: Right Task,
Right Circumstance, Right Person, Right Direction/Communication, and Right Supervision/Evaluation. The Five Rights of
Medication Administration (A) apply to medication giving. ABCs (C) and the Nursing Process (D) are clinical reasoning
frameworks, not delegation frameworks.
Nightingale College BSN 225 — HESI RN Specialty FundamentalsPage
Study4 Guide 2026/2027 Edition · Grade A
