This comprehensive HESI practice exam for BSN 225 (Week 3) consists of 400 multiple-choice
questions designed to simulate the EAQ (Evolve Adaptive Quizzing) assessment. It covers
fundamental nursing concepts including safety, mobility, asepsis, oxygenation,
fluid/electrolytes, pain management, elimination, nutrition, medication administration,
perioperative care, and gerontology. Each question includes a correct answer and a detailed,
medium-length rationale to reinforce critical thinking and clinical reasoning. This test bank
serves as a rigorous self-assessment tool to prepare students for the HESI exit exam and
clinical practice.
TABLE OF CONTENTS
SECTION 1: SAFETY, MOBILITY, AND IMMOBILITY ........................ QUESTIONS 1-15
SECTION 2: ACTIVITY AND EXERCISE .................................... QUESTIONS 16-30
SECTION 3: ASEPSIS AND INFECTION CONTROL ............................ QUESTIONS 31-50
SECTION 4: OXYGENATION AND RESPIRATORY FUNCTION ...................... QUESTIONS 51-65
SECTION 5: FLUID, ELECTROLYTE, AND ACID-BASE BALANCE ................ QUESTIONS 66-90
SECTION 6: PAIN MANAGEMENT .......................................... QUESTIONS 91-120
SECTION 7: ELIMINATION AND BOWEL/URINARY HEALTH ..................... QUESTIONS 121-150
SECTION 8: NUTRITION AND METABOLISM ................................. QUESTIONS 151-180
SECTION 9: HYGIENE AND SKIN INTEGRITY ............................... QUESTIONS 181-205
SECTION 10: MEDICATION ADMINISTRATION ................................ QUESTIONS 206-240
SECTION 11: PERIOPERATIVE CARE ....................................... QUESTIONS 241-265
SECTION 12: THERMOREGULATION AND HYGIENE ............................. QUESTIONS 266-275
SECTION 13: PSYCHOSOCIAL AND SPIRITUAL CARE .......................... QUESTIONS 276-297
SECTION 14: LEGAL AND ETHICAL ISSUES ................................. QUESTIONS 298-307
SECTION 15: GERONTOLOGICAL CONSIDERATIONS ............................ QUESTIONS 308-325
SECTION 16: CRITICAL THINKING AND PRIORITIZATION ..................... QUESTIONS 326-350
SECTION 17: ASSESSMENT AND DIAGNOSTIC TESTS .......................... QUESTIONS 351-370
SECTION 18: INTEGUMENTARY AND SENSORY SYSTEMS ........................ QUESTIONS 371-380
SECTION 19: MUSCULOSKELETAL AND NEUROLOGICAL CONDITIONS .............. QUESTIONS 381-400
[1]
,SECTION 1: SAFETY, MOBILITY, AND IMMOBILITY
1. An older client with a fractured left hip is on strict bedrest. Which nursing measure is
essential to the client's nursing care?
A. Massage any reddened areas for at least five minutes.
B. Encourage active range of motion exercises on all extremities.
C. Position the client laterally, prone, and dorsally in sequence.
D. Gently lift the client when moving into a desired position.
Correct Answer: D
Rationale: To avoid shearing forces when repositioning, the client should be lifted gently across
a surface. Reddened areas should not be massaged since this may increase the damage to
already traumatized skin. To control pain and muscle spasms, active range of motion may be
limited on the affected leg. A systematic turning schedule is important, but lifting the client to
prevent friction and shearing is the priority when moving them.
2. The nurse is caring for a client on prolonged bed rest. Which intervention is most effective
for preventing the formation of deep vein thrombosis (DVT)?
A. Encouraging active range of motion exercises of the lower extremities.
B. Massaging the client's calves twice daily.
C. Applying sequential compression devices (SCDs) as prescribed.
D. Placing a pillow under the client's knees.
Correct Answer: C
Rationale: SCDs are the most effective mechanical prophylaxis for DVT because they promote
venous return and prevent venous stasis. Active ROM is beneficial but may not be sufficient for
all clients. Massaging the calves is contraindicated because it could dislodge a thrombus.
Placing a pillow under the knees can impede venous return and increase the risk of DVT.
[2]
,3. A client is at risk for developing pressure ulcers. Which nursing intervention is most
appropriate for reducing pressure?
A. Reposition the client every four hours.
B. Use a donut-shaped cushion for the client to sit on.
C. Maintain the head of the bed at 45 degrees.
D. Reposition the client at least every two hours.
Correct Answer: D
Rationale: Repositioning at least every two hours is the standard of care to relieve pressure on
bony prominences. Repositioning every four hours is too infrequent. Donut-shaped cushions
can create a ring of pressure, impairing blood flow, and are not recommended. Elevating the
head of the bed to 45 degrees increases shearing forces, which can cause tissue damage.
4. When positioning a client with a new left hip replacement, the nurse must ensure that the
client's legs are:
A. Adducted and internally rotated.
B. Abducted and maintained in a neutral position.
C. Crossed at the ankles to provide stability.
D. Adducted and externally rotated.
Correct Answer: B
Rationale: After a hip replacement, the hip joint must be kept in an abducted position to
prevent dislocation of the prosthesis. A pillow is usually placed between the legs to maintain
this position. The client must avoid crossing the legs or adducting the legs, as this can force the
head of the femur out of the acetabulum.
5. A client is being turned in bed using a draw sheet. The nurse understands that this technique
is primarily used to:
A. Prevent shear and friction.
B. Strengthen the nurse's back.
C. Increase client comfort.
[3]
, D. Maintain client alignment.
Correct Answer: A
Rationale: Using a draw sheet to move a client reduces friction and shearing forces on the
client's skin, which are major contributors to skin breakdown. While it may help protect the
nurse's back, the primary purpose is patient safety. It is a specific intervention for a specific
problem, not just general comfort or alignment.
6. The nurse is applying a restraint to an agitated client. Which action indicates a need for
further education?
A. Securing the restraint to a moveable part of the bed frame.
B. Ensuring two fingers can be inserted between the restraint and the client's wrist.
C. Using a quick-release knot to secure the restraint.
D. Checking the restraint every 30 minutes to ensure it is secure.
Correct Answer: A
Rationale: Restraints should never be attached to a moveable part of the bed (e.g., side rails)
because this could increase the risk of injury if the bed is adjusted. The restraint must be tied to
a fixed part of the bed frame. A quick-release knot, checking for a two-finger space, and
frequent monitoring are all appropriate safety measures.
7. A client on bed rest has been incontinent of stool. What is the priority nursing action for the
client's perineal area?
A. Clean the area with hot water and antibacterial soap.
B. Apply a moisture barrier ointment.
C. Assess the skin for redness and breakdown.
D. Place an absorbent pad under the client.
Correct Answer: C
Rationale: The priority is to assess the skin's condition to determine the extent of any damage.
Cleaning with warm (not hot) water and mild soap, followed by applying a moisture barrier, are
important interventions, but they should be preceded by a thorough assessment. Placing a pad
is a preventive measure that does not address the current issue.
[4]
questions designed to simulate the EAQ (Evolve Adaptive Quizzing) assessment. It covers
fundamental nursing concepts including safety, mobility, asepsis, oxygenation,
fluid/electrolytes, pain management, elimination, nutrition, medication administration,
perioperative care, and gerontology. Each question includes a correct answer and a detailed,
medium-length rationale to reinforce critical thinking and clinical reasoning. This test bank
serves as a rigorous self-assessment tool to prepare students for the HESI exit exam and
clinical practice.
TABLE OF CONTENTS
SECTION 1: SAFETY, MOBILITY, AND IMMOBILITY ........................ QUESTIONS 1-15
SECTION 2: ACTIVITY AND EXERCISE .................................... QUESTIONS 16-30
SECTION 3: ASEPSIS AND INFECTION CONTROL ............................ QUESTIONS 31-50
SECTION 4: OXYGENATION AND RESPIRATORY FUNCTION ...................... QUESTIONS 51-65
SECTION 5: FLUID, ELECTROLYTE, AND ACID-BASE BALANCE ................ QUESTIONS 66-90
SECTION 6: PAIN MANAGEMENT .......................................... QUESTIONS 91-120
SECTION 7: ELIMINATION AND BOWEL/URINARY HEALTH ..................... QUESTIONS 121-150
SECTION 8: NUTRITION AND METABOLISM ................................. QUESTIONS 151-180
SECTION 9: HYGIENE AND SKIN INTEGRITY ............................... QUESTIONS 181-205
SECTION 10: MEDICATION ADMINISTRATION ................................ QUESTIONS 206-240
SECTION 11: PERIOPERATIVE CARE ....................................... QUESTIONS 241-265
SECTION 12: THERMOREGULATION AND HYGIENE ............................. QUESTIONS 266-275
SECTION 13: PSYCHOSOCIAL AND SPIRITUAL CARE .......................... QUESTIONS 276-297
SECTION 14: LEGAL AND ETHICAL ISSUES ................................. QUESTIONS 298-307
SECTION 15: GERONTOLOGICAL CONSIDERATIONS ............................ QUESTIONS 308-325
SECTION 16: CRITICAL THINKING AND PRIORITIZATION ..................... QUESTIONS 326-350
SECTION 17: ASSESSMENT AND DIAGNOSTIC TESTS .......................... QUESTIONS 351-370
SECTION 18: INTEGUMENTARY AND SENSORY SYSTEMS ........................ QUESTIONS 371-380
SECTION 19: MUSCULOSKELETAL AND NEUROLOGICAL CONDITIONS .............. QUESTIONS 381-400
[1]
,SECTION 1: SAFETY, MOBILITY, AND IMMOBILITY
1. An older client with a fractured left hip is on strict bedrest. Which nursing measure is
essential to the client's nursing care?
A. Massage any reddened areas for at least five minutes.
B. Encourage active range of motion exercises on all extremities.
C. Position the client laterally, prone, and dorsally in sequence.
D. Gently lift the client when moving into a desired position.
Correct Answer: D
Rationale: To avoid shearing forces when repositioning, the client should be lifted gently across
a surface. Reddened areas should not be massaged since this may increase the damage to
already traumatized skin. To control pain and muscle spasms, active range of motion may be
limited on the affected leg. A systematic turning schedule is important, but lifting the client to
prevent friction and shearing is the priority when moving them.
2. The nurse is caring for a client on prolonged bed rest. Which intervention is most effective
for preventing the formation of deep vein thrombosis (DVT)?
A. Encouraging active range of motion exercises of the lower extremities.
B. Massaging the client's calves twice daily.
C. Applying sequential compression devices (SCDs) as prescribed.
D. Placing a pillow under the client's knees.
Correct Answer: C
Rationale: SCDs are the most effective mechanical prophylaxis for DVT because they promote
venous return and prevent venous stasis. Active ROM is beneficial but may not be sufficient for
all clients. Massaging the calves is contraindicated because it could dislodge a thrombus.
Placing a pillow under the knees can impede venous return and increase the risk of DVT.
[2]
,3. A client is at risk for developing pressure ulcers. Which nursing intervention is most
appropriate for reducing pressure?
A. Reposition the client every four hours.
B. Use a donut-shaped cushion for the client to sit on.
C. Maintain the head of the bed at 45 degrees.
D. Reposition the client at least every two hours.
Correct Answer: D
Rationale: Repositioning at least every two hours is the standard of care to relieve pressure on
bony prominences. Repositioning every four hours is too infrequent. Donut-shaped cushions
can create a ring of pressure, impairing blood flow, and are not recommended. Elevating the
head of the bed to 45 degrees increases shearing forces, which can cause tissue damage.
4. When positioning a client with a new left hip replacement, the nurse must ensure that the
client's legs are:
A. Adducted and internally rotated.
B. Abducted and maintained in a neutral position.
C. Crossed at the ankles to provide stability.
D. Adducted and externally rotated.
Correct Answer: B
Rationale: After a hip replacement, the hip joint must be kept in an abducted position to
prevent dislocation of the prosthesis. A pillow is usually placed between the legs to maintain
this position. The client must avoid crossing the legs or adducting the legs, as this can force the
head of the femur out of the acetabulum.
5. A client is being turned in bed using a draw sheet. The nurse understands that this technique
is primarily used to:
A. Prevent shear and friction.
B. Strengthen the nurse's back.
C. Increase client comfort.
[3]
, D. Maintain client alignment.
Correct Answer: A
Rationale: Using a draw sheet to move a client reduces friction and shearing forces on the
client's skin, which are major contributors to skin breakdown. While it may help protect the
nurse's back, the primary purpose is patient safety. It is a specific intervention for a specific
problem, not just general comfort or alignment.
6. The nurse is applying a restraint to an agitated client. Which action indicates a need for
further education?
A. Securing the restraint to a moveable part of the bed frame.
B. Ensuring two fingers can be inserted between the restraint and the client's wrist.
C. Using a quick-release knot to secure the restraint.
D. Checking the restraint every 30 minutes to ensure it is secure.
Correct Answer: A
Rationale: Restraints should never be attached to a moveable part of the bed (e.g., side rails)
because this could increase the risk of injury if the bed is adjusted. The restraint must be tied to
a fixed part of the bed frame. A quick-release knot, checking for a two-finger space, and
frequent monitoring are all appropriate safety measures.
7. A client on bed rest has been incontinent of stool. What is the priority nursing action for the
client's perineal area?
A. Clean the area with hot water and antibacterial soap.
B. Apply a moisture barrier ointment.
C. Assess the skin for redness and breakdown.
D. Place an absorbent pad under the client.
Correct Answer: C
Rationale: The priority is to assess the skin's condition to determine the extent of any damage.
Cleaning with warm (not hot) water and mild soap, followed by applying a moisture barrier, are
important interventions, but they should be preceded by a thorough assessment. Placing a pad
is a preventive measure that does not address the current issue.
[4]
