HESI Fundamentals Practice Exam 2026/2027
| Comprehensive Study Guide with Complete
Exam Questions, Verified Correct Answers
and Detailed Rationales | Latest Update!
Question 1
The nurse observes that a male client has removed the covering from an ice pack applied to
his knee. What action should the nurse take first?
A. Observe the appearance of the skin under the ice pack.
B. Instruct the client regarding the need for the covering.
C. Reapply the covering after filling with fresh ice.
D. Ask the client how long the ice was applied to the skin.
Answer: A
Rationale: The first action should be to assess the skin for any possible thermal injury. If
no injury has occurred, the nurse can then take other actions.
Question 2
The nurse mixes 50 mg of Nipride in 250 mL of D5W and plans to administer the solution
at a rate of 5 mcg/kg/min to a client weighing 182 lbs. Using a drip factor of 60 gtt/mL,
how many drops per minute should the client receive?
Answer: 124 gtt/min
Rationale: Weight in kg = 182 ÷ 2.2 = 82.7 kg. Dose = 5 mcg × 82.7 = 413.6 mcg/min =
0.4136 mg/min. Concentration = 50 mg/250 mL = 0.2 mg/mL. Rate = 0.4136 ÷ 0.2 = 2.068
mL/min. Drops = 2.068 × 60 = 124 gtt/min.
Question 3
The healthcare provider prescribes an IV infusion of 1000 mL of Ringer's Lactate with 30
units of Pitocin to run over 4 hours. The tubing has a 20 gtt/mL administration set. The
nurse should set the flow rate at how many gtt/min?
Answer: 83 gtt/min
Rationale: 1000 mL ÷ 4 hours = 250 mL/hr. 250 mL/hr × 20 gtt/mL = 5,000 gtt/hr. 5,000 ÷
60 min = 83.3 gtt/min.
1
,Question 4
Which assessment data provides the most accurate determination of proper placement of a
nasogastric tube?
Answer: pH testing of aspirated gastric contents
Rationale: pH testing of aspirated fluid (pH ≤ 5.5) is the most reliable indicator of NG tube
placement in the stomach.
Question 5
Three days following surgery, a male client observes his colostomy for the first time. He
becomes upset and tells the nurse that it is much bigger than he expected. What is the best
response by the nurse?
A. Reassure the client that he will become accustomed to the stoma appearance in time.
B. Instruct the client that the stoma will become much smaller when the initial swelling
diminishes.
C. Offer to contact a member of the local ostomy support group to help him with his
concerns.
D. Encourage the client to handle the stoma equipment to gain confidence with the
procedure.
Answer: B
Rationale: Postoperative swelling causes enlargement of the stoma. The nurse can teach
the client that the stoma will become smaller when swelling diminishes, which will reduce
anxiety and promote acceptance.
Question 6
A female client with a nasogastric tube attached to low suction states that she is nauseated.
The nurse assesses that there has been no drainage through the nasogastric tube in the last
two hours. What action should the nurse take first?
A. Irrigate the nasogastric tube with sterile normal saline.
B. Reposition the client on her side.
C. Advance the nasogastric tube an additional five centimeters.
D. Administer an intravenous antiemetic prescribed for PRN use.
Answer: B
Rationale: The immediate priority is to determine if the tube is functioning correctly. The
least invasive intervention—repositioning the client—should be attempted first.
Question 7
A hospitalized male client is receiving nasogastric tube feedings via a small-bore tube and a
continuous pump infusion. He reports that he had a bad bout of severe coughing a few
minutes ago but feels fine now. What action is best for the nurse to take?
2
, A. Record the coughing incident; no further action is required.
B. Stop the feeding, explain to the family why it is being stopped, and notify the HCP.
C. After clearing the tube with 30 mL of air, check the pH of fluid withdrawn from the tube.
D. Inject 30 mL of air into the tube while auscultating the epigastrium for gurgling.
Answer: C
Rationale: Severe coughing can displace the tube. Checking the pH of aspirated fluid
confirms gastric placement before continuing the feeding.
Question 8
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?
A. The client has a decreased level of consciousness.
B. The client is having difficulty expressing himself.
C. The client has a diminished attention span.
D. The client is disoriented to place and time.
Answer: D
Rationale: The client is exhibiting disorientation to place and time.
Question 9
A client with chronic kidney disease (CKD) selects a scrambled egg for his breakfast. What
action should the nurse take?
A. Commend the client for selecting a high biologic value protein.
B. Remind the client that protein in the diet should be avoided.
C. Suggest that the client also select orange juice, to promote absorption.
D. Encourage the client to attend classes on dietary management of CKD.
Answer: A
Rationale: Eggs are high biologic value proteins (complete proteins) that supply essential
amino acids. The client has made a good diet choice.
Question 10
When assisting an 82-year-old client to ambulate, it is important for the nurse to realize that
the center of gravity for an elderly person is the:
A. Lower torso
B. Upper torso
C. Hips
D. Knees
Answer: B
Rationale: The center of gravity for adults is the hips. However, with aging, stooped
3
| Comprehensive Study Guide with Complete
Exam Questions, Verified Correct Answers
and Detailed Rationales | Latest Update!
Question 1
The nurse observes that a male client has removed the covering from an ice pack applied to
his knee. What action should the nurse take first?
A. Observe the appearance of the skin under the ice pack.
B. Instruct the client regarding the need for the covering.
C. Reapply the covering after filling with fresh ice.
D. Ask the client how long the ice was applied to the skin.
Answer: A
Rationale: The first action should be to assess the skin for any possible thermal injury. If
no injury has occurred, the nurse can then take other actions.
Question 2
The nurse mixes 50 mg of Nipride in 250 mL of D5W and plans to administer the solution
at a rate of 5 mcg/kg/min to a client weighing 182 lbs. Using a drip factor of 60 gtt/mL,
how many drops per minute should the client receive?
Answer: 124 gtt/min
Rationale: Weight in kg = 182 ÷ 2.2 = 82.7 kg. Dose = 5 mcg × 82.7 = 413.6 mcg/min =
0.4136 mg/min. Concentration = 50 mg/250 mL = 0.2 mg/mL. Rate = 0.4136 ÷ 0.2 = 2.068
mL/min. Drops = 2.068 × 60 = 124 gtt/min.
Question 3
The healthcare provider prescribes an IV infusion of 1000 mL of Ringer's Lactate with 30
units of Pitocin to run over 4 hours. The tubing has a 20 gtt/mL administration set. The
nurse should set the flow rate at how many gtt/min?
Answer: 83 gtt/min
Rationale: 1000 mL ÷ 4 hours = 250 mL/hr. 250 mL/hr × 20 gtt/mL = 5,000 gtt/hr. 5,000 ÷
60 min = 83.3 gtt/min.
1
,Question 4
Which assessment data provides the most accurate determination of proper placement of a
nasogastric tube?
Answer: pH testing of aspirated gastric contents
Rationale: pH testing of aspirated fluid (pH ≤ 5.5) is the most reliable indicator of NG tube
placement in the stomach.
Question 5
Three days following surgery, a male client observes his colostomy for the first time. He
becomes upset and tells the nurse that it is much bigger than he expected. What is the best
response by the nurse?
A. Reassure the client that he will become accustomed to the stoma appearance in time.
B. Instruct the client that the stoma will become much smaller when the initial swelling
diminishes.
C. Offer to contact a member of the local ostomy support group to help him with his
concerns.
D. Encourage the client to handle the stoma equipment to gain confidence with the
procedure.
Answer: B
Rationale: Postoperative swelling causes enlargement of the stoma. The nurse can teach
the client that the stoma will become smaller when swelling diminishes, which will reduce
anxiety and promote acceptance.
Question 6
A female client with a nasogastric tube attached to low suction states that she is nauseated.
The nurse assesses that there has been no drainage through the nasogastric tube in the last
two hours. What action should the nurse take first?
A. Irrigate the nasogastric tube with sterile normal saline.
B. Reposition the client on her side.
C. Advance the nasogastric tube an additional five centimeters.
D. Administer an intravenous antiemetic prescribed for PRN use.
Answer: B
Rationale: The immediate priority is to determine if the tube is functioning correctly. The
least invasive intervention—repositioning the client—should be attempted first.
Question 7
A hospitalized male client is receiving nasogastric tube feedings via a small-bore tube and a
continuous pump infusion. He reports that he had a bad bout of severe coughing a few
minutes ago but feels fine now. What action is best for the nurse to take?
2
, A. Record the coughing incident; no further action is required.
B. Stop the feeding, explain to the family why it is being stopped, and notify the HCP.
C. After clearing the tube with 30 mL of air, check the pH of fluid withdrawn from the tube.
D. Inject 30 mL of air into the tube while auscultating the epigastrium for gurgling.
Answer: C
Rationale: Severe coughing can displace the tube. Checking the pH of aspirated fluid
confirms gastric placement before continuing the feeding.
Question 8
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?
A. The client has a decreased level of consciousness.
B. The client is having difficulty expressing himself.
C. The client has a diminished attention span.
D. The client is disoriented to place and time.
Answer: D
Rationale: The client is exhibiting disorientation to place and time.
Question 9
A client with chronic kidney disease (CKD) selects a scrambled egg for his breakfast. What
action should the nurse take?
A. Commend the client for selecting a high biologic value protein.
B. Remind the client that protein in the diet should be avoided.
C. Suggest that the client also select orange juice, to promote absorption.
D. Encourage the client to attend classes on dietary management of CKD.
Answer: A
Rationale: Eggs are high biologic value proteins (complete proteins) that supply essential
amino acids. The client has made a good diet choice.
Question 10
When assisting an 82-year-old client to ambulate, it is important for the nurse to realize that
the center of gravity for an elderly person is the:
A. Lower torso
B. Upper torso
C. Hips
D. Knees
Answer: B
Rationale: The center of gravity for adults is the hips. However, with aging, stooped
3
