,HESI FUNDAMENTALS EXAM TEST BANK 2026-2027
Complete Test Bank with 2000+ Questions, Detailed Rationales & Verified Answers
EXAM VERSION 1: SAFETY & INFECTION CONTROL
Questions 1-160
1. The home health nurse visits an elderly female client who had a brain attack three months ago and is
now able to ambulate with the assistance of a quad cane. Which assessment finding has the greatest
implications for this client's care?
A. The client's pulse rate is 10 beats higher than it was at the last visit
B. The client tells the nurse that she does not have much of an appetite today
C. The husband, who is the caregiver, begins to weep when asked how he is doing
D. The nurse notes that there are numerous scatter rugs throughout the house
Answer: D
Rationale: Scatter rugs pose a significant safety hazard because the client can trip on them when
ambulating with the quad cane. This finding has the greatest implications for planning this client's care
and preventing falls. An elevated pulse rate, decreased appetite, and caregiver distress are all important
findings but do not present the immediate safety risk that scatter rugs do.
Incorrect Options:
A: A slight elevation in pulse rate requires monitoring but does not pose an immediate safety risk.
B: Decreased appetite should be assessed but is not an immediate safety concern.
C: Caregiver distress is important to address but does not create an immediate physical safety hazard.
2. The nurse is digitally removing a fecal impaction for a client. The nurse should stop the procedure and
take corrective action if which client reaction is noted?
A. Pulse rate increases from 78 to 96 beats/min
B. Pulse rate decreases from 78 to 52 beats/min
C. Blood pressure increases from 110/70 to 130/80 mmHg
D. Respiratory rate increases from 16 to 20 breaths/min
Answer: B
Rationale: Parasympathetic reactions can occur as a result of digital stimulation of the anal sphincter.
The nurse should stop the procedure if the client experiences a vagal response, such as bradycardia
(pulse rate decreasing to 52 beats/min). This vagal stimulation can lead to syncope or cardiac
complications.
,Incorrect Options:
A: An increased pulse rate is not a vagal response and does not require stopping the procedure.
C: A mild blood pressure increase is not a reason to stop the procedure.
D: A slight respiratory rate increase is not a reason to stop the procedure.
3. The nurse is providing passive range of motion exercises to the hip and knee for a client who is
unconscious. After supporting the client's knee with one hand, what action should the nurse take next?
A. Raise the bed to a comfortable working level
B. Cradle the client's heel
C. Bend the knee and move it toward the chest
D. Support the client's ankle
Answer: B
Rationale: When providing passive ROM exercise for the hip and knee, the nurse should support the
joints of the knee and ankle and gently move the limb in a slow, smooth, firm but gentle manner. After
supporting the knee with one hand, the nurse should cradle the client's heel to support the ankle joint.
The bed should be raised to a comfortable working level first.
Incorrect Options:
A: Raising the bed should be done before beginning the ROM exercise.
C: Bending the knee and moving it toward the chest comes after proper hand placement.
D: Supporting the ankle is part of cradling the heel.
4. A client who has moderate, persistent, chronic neuropathic pain due to diabetic neuropathy takes
gabapentin and ibuprofen daily. If step 2 of the WHO pain relief ladder is prescribed, which drug
protocol should be implemented?
A. Discontinue gabapentin and start a nonopioid analgesic
B. Continue gabapentin and add a weak opioid
C. Discontinue both gabapentin and ibuprofen and start a strong opioid
D. Continue gabapentin and add a strong opioid
Answer: B
Rationale: According to the WHO analgesic ladder, step 1 drugs are nonopioid analgesics (e.g.,
ibuprofen). Step 2 involves adding a weak opioid (e.g., codeine, tramadol) to the nonopioid regimen.
Step 3 involves switching to a strong opioid (e.g., morphine). The client should continue gabapentin
(adjuvant for neuropathic pain) and add a weak opioid. Pain medications should be given around the
clock rather than PRN to maintain therapeutic levels.
, Incorrect Options:
A: Step 2 adds a weak opioid to the existing nonopioid regimen.
C: Step 3 involves strong opioids, not step 2.
D: Step 2 uses weak opioids, not strong opioids.
5. The nurse is preparing to irrigate a client's indwelling urinary catheter using an open technique. What
action should the nurse take after applying gloves?
A. Pour the irrigating solution into the sterile container
B. Draw up the irrigating solution into the syringe
C. Place the sterile drape under the catheter
D. Clean the catheter hub with antiseptic swab
Answer: B
Rationale: When using an open technique for catheter irrigation, the nurse should draw up the irrigating
solution into the syringe after applying gloves. This ensures the solution is ready for use while
maintaining sterility. The other steps are part of the procedure but occur after preparing the solution.
Incorrect Options:
A: Pouring solution should be done before applying sterile gloves.
C: Placing the sterile drape is part of setting up the sterile field.
D: Cleaning the catheter hub is done before attaching the syringe.
6. The charge nurse observes that a demographic screen has been left open on a hallway computer
while the UAP is involved in a personal phone call. Which action should the charge nurse take first?
A. Ask the UAP to end the phone call
B. Close the demographic screen on the computer
C. Report the UAP to the nurse manager
D. Educate the UAP about HIPAA violations
Answer: B
Rationale: Health information stored in computerized systems is considered protected health
information (PHI) under HIPAA. The first action is to close the demographic screen to protect client
confidentiality. Education and follow-up should occur after securing the information.
Incorrect Options:
A: Security is the priority over addressing the phone call.
C: Reporting should occur after the immediate safety issue is addressed.
Complete Test Bank with 2000+ Questions, Detailed Rationales & Verified Answers
EXAM VERSION 1: SAFETY & INFECTION CONTROL
Questions 1-160
1. The home health nurse visits an elderly female client who had a brain attack three months ago and is
now able to ambulate with the assistance of a quad cane. Which assessment finding has the greatest
implications for this client's care?
A. The client's pulse rate is 10 beats higher than it was at the last visit
B. The client tells the nurse that she does not have much of an appetite today
C. The husband, who is the caregiver, begins to weep when asked how he is doing
D. The nurse notes that there are numerous scatter rugs throughout the house
Answer: D
Rationale: Scatter rugs pose a significant safety hazard because the client can trip on them when
ambulating with the quad cane. This finding has the greatest implications for planning this client's care
and preventing falls. An elevated pulse rate, decreased appetite, and caregiver distress are all important
findings but do not present the immediate safety risk that scatter rugs do.
Incorrect Options:
A: A slight elevation in pulse rate requires monitoring but does not pose an immediate safety risk.
B: Decreased appetite should be assessed but is not an immediate safety concern.
C: Caregiver distress is important to address but does not create an immediate physical safety hazard.
2. The nurse is digitally removing a fecal impaction for a client. The nurse should stop the procedure and
take corrective action if which client reaction is noted?
A. Pulse rate increases from 78 to 96 beats/min
B. Pulse rate decreases from 78 to 52 beats/min
C. Blood pressure increases from 110/70 to 130/80 mmHg
D. Respiratory rate increases from 16 to 20 breaths/min
Answer: B
Rationale: Parasympathetic reactions can occur as a result of digital stimulation of the anal sphincter.
The nurse should stop the procedure if the client experiences a vagal response, such as bradycardia
(pulse rate decreasing to 52 beats/min). This vagal stimulation can lead to syncope or cardiac
complications.
,Incorrect Options:
A: An increased pulse rate is not a vagal response and does not require stopping the procedure.
C: A mild blood pressure increase is not a reason to stop the procedure.
D: A slight respiratory rate increase is not a reason to stop the procedure.
3. The nurse is providing passive range of motion exercises to the hip and knee for a client who is
unconscious. After supporting the client's knee with one hand, what action should the nurse take next?
A. Raise the bed to a comfortable working level
B. Cradle the client's heel
C. Bend the knee and move it toward the chest
D. Support the client's ankle
Answer: B
Rationale: When providing passive ROM exercise for the hip and knee, the nurse should support the
joints of the knee and ankle and gently move the limb in a slow, smooth, firm but gentle manner. After
supporting the knee with one hand, the nurse should cradle the client's heel to support the ankle joint.
The bed should be raised to a comfortable working level first.
Incorrect Options:
A: Raising the bed should be done before beginning the ROM exercise.
C: Bending the knee and moving it toward the chest comes after proper hand placement.
D: Supporting the ankle is part of cradling the heel.
4. A client who has moderate, persistent, chronic neuropathic pain due to diabetic neuropathy takes
gabapentin and ibuprofen daily. If step 2 of the WHO pain relief ladder is prescribed, which drug
protocol should be implemented?
A. Discontinue gabapentin and start a nonopioid analgesic
B. Continue gabapentin and add a weak opioid
C. Discontinue both gabapentin and ibuprofen and start a strong opioid
D. Continue gabapentin and add a strong opioid
Answer: B
Rationale: According to the WHO analgesic ladder, step 1 drugs are nonopioid analgesics (e.g.,
ibuprofen). Step 2 involves adding a weak opioid (e.g., codeine, tramadol) to the nonopioid regimen.
Step 3 involves switching to a strong opioid (e.g., morphine). The client should continue gabapentin
(adjuvant for neuropathic pain) and add a weak opioid. Pain medications should be given around the
clock rather than PRN to maintain therapeutic levels.
, Incorrect Options:
A: Step 2 adds a weak opioid to the existing nonopioid regimen.
C: Step 3 involves strong opioids, not step 2.
D: Step 2 uses weak opioids, not strong opioids.
5. The nurse is preparing to irrigate a client's indwelling urinary catheter using an open technique. What
action should the nurse take after applying gloves?
A. Pour the irrigating solution into the sterile container
B. Draw up the irrigating solution into the syringe
C. Place the sterile drape under the catheter
D. Clean the catheter hub with antiseptic swab
Answer: B
Rationale: When using an open technique for catheter irrigation, the nurse should draw up the irrigating
solution into the syringe after applying gloves. This ensures the solution is ready for use while
maintaining sterility. The other steps are part of the procedure but occur after preparing the solution.
Incorrect Options:
A: Pouring solution should be done before applying sterile gloves.
C: Placing the sterile drape is part of setting up the sterile field.
D: Cleaning the catheter hub is done before attaching the syringe.
6. The charge nurse observes that a demographic screen has been left open on a hallway computer
while the UAP is involved in a personal phone call. Which action should the charge nurse take first?
A. Ask the UAP to end the phone call
B. Close the demographic screen on the computer
C. Report the UAP to the nurse manager
D. Educate the UAP about HIPAA violations
Answer: B
Rationale: Health information stored in computerized systems is considered protected health
information (PHI) under HIPAA. The first action is to close the demographic screen to protect client
confidentiality. Education and follow-up should occur after securing the information.
Incorrect Options:
A: Security is the priority over addressing the phone call.
C: Reporting should occur after the immediate safety issue is addressed.
