This exam bank contains 300 multiple-choice questions with correct answers and detailed
rationales covering fundamental nursing concepts. Topics include medical-surgical nursing,
pharmacology, nutrition, wound care, medication administration, blood transfusions, tube feedings,
patient safety, and therapeutic communication. Designed for HESI exam preparation, this resource
reinforces critical thinking and clinical judgment skills essential for nursing students. Each rationale
provides in-depth explanations to enhance understanding and retention. Ideal for self-study,
group review, and exam readiness.
SECTION 1: QUESTIONS 1-50
1. A 26-year-old homosexual client is diagnosed with acquired immune deficiency syndrome
(AIDS). The primary nurse reports to the nursing team that the client cried when told of the
diagnosis. One of the nursing assistants responds, "I don't feel sorry for him. He made his bed,
and now he can lie in it." To best help the nursing assistant, the nurse manager must first identify
that this comment most likely is a result of the nursing assistant's:
a. Values and beliefs about sexual lifestyles.
b. Anger and mistrust of homosexual males in general.
c. Discomfort with men who are unable to control their emotions.
d. Hostility over having to care for someone with a sexually transmitted infection.
Correct Answer: a
Rationale: The nursing assistant's statement reflects personal values and beliefs that view
homosexuality negatively and imply that the client deserves punishment for his lifestyle choices.
This judgmental attitude stems from deeply held values rather than professional nursing judgment.
There is insufficient evidence to conclude that the assistant has anger toward all homosexual
males, discomfort with emotional men, or hostility about caring for someone with an STI. The nurse
,manager must first recognize this value-based bias to address it appropriately through education
and professional development.
2. A client is being prepared for surgery to have placement of a percutaneous endoscopic
gastrostomy (PEG) tube. The client asks why the PEG tube is preferred over the existing
nasogastric tube that is being used for feedings. The nurse explains that a PEG tube is preferred
for administering a tube feeding because:
a. There is less chance of aspiration.
b. This procedure does not require a pump.
c. Self-administration of the feeding is possible.
d. More tube feeding mixture can be given each time.
Correct Answer: a
Rationale: PEG tubes bypass the upper gastrointestinal tract, including the oropharynx,
esophagus, and cardiac sphincter, which significantly reduces the risk of tracheal aspiration
compared to nasogastric tubes. While PEG tubes may be used with or without pumps, pump use
depends on the prescribed feeding schedule rather than tube type. Both PEG and NG tubes can
be used for self-administration with proper teaching. The volume of feeding administered is
determined by the client's nutritional needs and tolerance, not the tube type. Therefore, the
primary advantage of a PEG tube is its lower aspiration risk.
3. A parent and 3-month-old infant are visiting the well-baby clinic for a routine examination.
What instruction should the nurse include in the accident-prevention teaching plan?
a. Remove small objects from the floor.
b. Cover electric outlets with safety plugs.
c. Remove toxic substances from accessible areas.
d. Test the temperature of water before bathing.
Correct Answer: d
Rationale: At 3 months of age, infants have delicate skin that is highly susceptible to burns from
excessively hot water. Testing bath water temperature is the most immediate safety concern for
this age group. While removing small objects, covering outlets, and removing toxic substances are
important safety measures, these are more appropriate for older infants and toddlers who are
mobile and exploring their environment. A 3-month-old infant is not yet crawling, placing objects
in their mouth intentionally, or able to reach outlets or toxic substances.
,4. During change of shift report the night nurse indicates that a client cannot tolerate the
prescribed intermittent tube feedings. The nurse receiving report should first:
a. Suggest that an antiemetic be prescribed.
b. Change the feeding schedule to omit nights.
c. Request that the type of solution be changed.
d. Gather more data from the night nurse about the technique used.
Correct Answer: d
Rationale: The receiving nurse must first collect comprehensive data about the feeding technique
used, including administration rate, client positioning, and solution temperature, as these are
common causes of intolerance. Rapid administration, incorrect positioning, and inappropriate
solution temperature frequently cause nausea, vomiting, and discomfort. While pharmacologic
interventions, schedule changes, or formula modifications may eventually be necessary, these
should only be considered after a thorough assessment of the current technique. The nursing
process requires assessment before implementation of any interventions.
5. An infant is receiving intermittent nasogastric tube feedings. In what position should the nurse
place the infant?
a. Prone
b. Semi-Fowler
c. Left side-lying
d. Supine with the head turned
Correct Answer: b
Rationale: The semi-Fowler position (elevated head) is the safest position for tube feeding
administration because gravity helps keep the feeding within the stomach, minimizing the risk of
aspiration. The prone position increases the risk of gastric reflux and aspiration due to pressure
on the abdomen. Left side-lying also promotes gastric reflux and aspiration. Supine with the head
turned provides no protection against reflux and aspiration, as stomach contents can easily flow
back into the esophagus and pharynx.
6. A nurse is teaching a class to parents about keeping medications and household cleaning
supplies out of the reach of toddlers. The nurse explains that this is necessary because toddlers:
a. Have increased appetites.
b. Are developing a sense of taste.
, c. Have a high level of oral activity.
d. Are rebelling against parental authority.
Correct Answer: c
Rationale: Toddlers explore their environment primarily through oral activity, putting objects
into their mouths to learn about texture, taste, and shape. This normal developmental behavior
places them at high risk for accidental poisoning. Appetite typically decreases during the toddler
years, a phenomenon called physiologic anorexia. The sense of taste is fully developed at birth.
Toddlers assert independence but are not yet capable of the rebellion against authority that is
characteristic of adolescents.
7. A client with a new colostomy asks the nurse, "Will I ever be able to control my bowel
movements again?" What is the nurse's best response?
a. "No, you will never have control."
b. "You can learn to irrigate the colostomy."
c. "Most people learn to control bowel movements."
d. "Why are you concerned about controlling bowel movements?"
Correct Answer: b
Rationale: Colostomy irrigation is a method that allows some clients to regulate their bowel
movements and achieve predictability, though it does not restore normal sphincter control. Telling
the client "never" is incorrect and discouraging. Saying "most people learn to control" is inaccurate
because a colostomy bypasses the sphincter muscle, making true control impossible. Asking "why"
is dismissive and blocks therapeutic communication. The nurse should provide accurate information
about available options.
8. The nurse is caring for a client with a nasogastric tube attached to continuous suction. Which
assessment finding indicates that the tube is functioning properly?
a. The client complains of nausea.
b. The drainage appears bloody.
c. The drainage is green and yellow.
d. The tube is taped securely to the nose.
Correct Answer: c
Rationale: Green and yellow drainage indicates gastric contents, confirming the tube is
properly positioned in the stomach. Nausea may indicate the tube is not functioning correctly or
rationales covering fundamental nursing concepts. Topics include medical-surgical nursing,
pharmacology, nutrition, wound care, medication administration, blood transfusions, tube feedings,
patient safety, and therapeutic communication. Designed for HESI exam preparation, this resource
reinforces critical thinking and clinical judgment skills essential for nursing students. Each rationale
provides in-depth explanations to enhance understanding and retention. Ideal for self-study,
group review, and exam readiness.
SECTION 1: QUESTIONS 1-50
1. A 26-year-old homosexual client is diagnosed with acquired immune deficiency syndrome
(AIDS). The primary nurse reports to the nursing team that the client cried when told of the
diagnosis. One of the nursing assistants responds, "I don't feel sorry for him. He made his bed,
and now he can lie in it." To best help the nursing assistant, the nurse manager must first identify
that this comment most likely is a result of the nursing assistant's:
a. Values and beliefs about sexual lifestyles.
b. Anger and mistrust of homosexual males in general.
c. Discomfort with men who are unable to control their emotions.
d. Hostility over having to care for someone with a sexually transmitted infection.
Correct Answer: a
Rationale: The nursing assistant's statement reflects personal values and beliefs that view
homosexuality negatively and imply that the client deserves punishment for his lifestyle choices.
This judgmental attitude stems from deeply held values rather than professional nursing judgment.
There is insufficient evidence to conclude that the assistant has anger toward all homosexual
males, discomfort with emotional men, or hostility about caring for someone with an STI. The nurse
,manager must first recognize this value-based bias to address it appropriately through education
and professional development.
2. A client is being prepared for surgery to have placement of a percutaneous endoscopic
gastrostomy (PEG) tube. The client asks why the PEG tube is preferred over the existing
nasogastric tube that is being used for feedings. The nurse explains that a PEG tube is preferred
for administering a tube feeding because:
a. There is less chance of aspiration.
b. This procedure does not require a pump.
c. Self-administration of the feeding is possible.
d. More tube feeding mixture can be given each time.
Correct Answer: a
Rationale: PEG tubes bypass the upper gastrointestinal tract, including the oropharynx,
esophagus, and cardiac sphincter, which significantly reduces the risk of tracheal aspiration
compared to nasogastric tubes. While PEG tubes may be used with or without pumps, pump use
depends on the prescribed feeding schedule rather than tube type. Both PEG and NG tubes can
be used for self-administration with proper teaching. The volume of feeding administered is
determined by the client's nutritional needs and tolerance, not the tube type. Therefore, the
primary advantage of a PEG tube is its lower aspiration risk.
3. A parent and 3-month-old infant are visiting the well-baby clinic for a routine examination.
What instruction should the nurse include in the accident-prevention teaching plan?
a. Remove small objects from the floor.
b. Cover electric outlets with safety plugs.
c. Remove toxic substances from accessible areas.
d. Test the temperature of water before bathing.
Correct Answer: d
Rationale: At 3 months of age, infants have delicate skin that is highly susceptible to burns from
excessively hot water. Testing bath water temperature is the most immediate safety concern for
this age group. While removing small objects, covering outlets, and removing toxic substances are
important safety measures, these are more appropriate for older infants and toddlers who are
mobile and exploring their environment. A 3-month-old infant is not yet crawling, placing objects
in their mouth intentionally, or able to reach outlets or toxic substances.
,4. During change of shift report the night nurse indicates that a client cannot tolerate the
prescribed intermittent tube feedings. The nurse receiving report should first:
a. Suggest that an antiemetic be prescribed.
b. Change the feeding schedule to omit nights.
c. Request that the type of solution be changed.
d. Gather more data from the night nurse about the technique used.
Correct Answer: d
Rationale: The receiving nurse must first collect comprehensive data about the feeding technique
used, including administration rate, client positioning, and solution temperature, as these are
common causes of intolerance. Rapid administration, incorrect positioning, and inappropriate
solution temperature frequently cause nausea, vomiting, and discomfort. While pharmacologic
interventions, schedule changes, or formula modifications may eventually be necessary, these
should only be considered after a thorough assessment of the current technique. The nursing
process requires assessment before implementation of any interventions.
5. An infant is receiving intermittent nasogastric tube feedings. In what position should the nurse
place the infant?
a. Prone
b. Semi-Fowler
c. Left side-lying
d. Supine with the head turned
Correct Answer: b
Rationale: The semi-Fowler position (elevated head) is the safest position for tube feeding
administration because gravity helps keep the feeding within the stomach, minimizing the risk of
aspiration. The prone position increases the risk of gastric reflux and aspiration due to pressure
on the abdomen. Left side-lying also promotes gastric reflux and aspiration. Supine with the head
turned provides no protection against reflux and aspiration, as stomach contents can easily flow
back into the esophagus and pharynx.
6. A nurse is teaching a class to parents about keeping medications and household cleaning
supplies out of the reach of toddlers. The nurse explains that this is necessary because toddlers:
a. Have increased appetites.
b. Are developing a sense of taste.
, c. Have a high level of oral activity.
d. Are rebelling against parental authority.
Correct Answer: c
Rationale: Toddlers explore their environment primarily through oral activity, putting objects
into their mouths to learn about texture, taste, and shape. This normal developmental behavior
places them at high risk for accidental poisoning. Appetite typically decreases during the toddler
years, a phenomenon called physiologic anorexia. The sense of taste is fully developed at birth.
Toddlers assert independence but are not yet capable of the rebellion against authority that is
characteristic of adolescents.
7. A client with a new colostomy asks the nurse, "Will I ever be able to control my bowel
movements again?" What is the nurse's best response?
a. "No, you will never have control."
b. "You can learn to irrigate the colostomy."
c. "Most people learn to control bowel movements."
d. "Why are you concerned about controlling bowel movements?"
Correct Answer: b
Rationale: Colostomy irrigation is a method that allows some clients to regulate their bowel
movements and achieve predictability, though it does not restore normal sphincter control. Telling
the client "never" is incorrect and discouraging. Saying "most people learn to control" is inaccurate
because a colostomy bypasses the sphincter muscle, making true control impossible. Asking "why"
is dismissive and blocks therapeutic communication. The nurse should provide accurate information
about available options.
8. The nurse is caring for a client with a nasogastric tube attached to continuous suction. Which
assessment finding indicates that the tube is functioning properly?
a. The client complains of nausea.
b. The drainage appears bloody.
c. The drainage is green and yellow.
d. The tube is taped securely to the nose.
Correct Answer: c
Rationale: Green and yellow drainage indicates gastric contents, confirming the tube is
properly positioned in the stomach. Nausea may indicate the tube is not functioning correctly or
