HESI Fundamentals Practice Exam
100 Questions with ANSWERs & Rationales
2026
Questions 1–100
Question 1
A nurse is preparing to administer an enteral feeding via a nasogastric (NG) tube. Which action should
the nurse take first?
A. Flush the tube with 30 mL of water
B. Verify tube placement by checking the pH of gastric aspirate
C. Elevate the head of the bed to 30–45 degrees
D. Auscultate for bowel sounds
ANSWER: B
Rationale: Before administering any enteral feeding, the nurse must first verify proper NG tube
placement to prevent aspiration pneumonia. Checking the pH of gastric aspirate (should be ≤ 4–5) is a
reliable method. Elevating the head of the bed is important but should occur after placement is
confirmed. Flushing the tube and auscultating bowel sounds are also important but not the first priority.
Question 2
A client is prescribed 500 mg of a medication orally. The available tablets are 250 mg each. How many
tablets should the nurse administer?
A. 1 tablet
B. 1.5 tablets
,C. 2 tablets
D. 2.5 tablets
ANSWER: C
Rationale: 500 mg ÷ 250 mg per tablet = 2 tablets. Basic dosage calculation requires dividing the desired
dose by the dose on hand.
Question 3
The nurse is caring for a client with a diagnosis of dehydration. Which laboratory value would the nurse
expect to be elevated?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
ANSWER: A
Rationale: In dehydration, there is a loss of water relative to solutes, leading to hypernatremia (elevated
serum sodium). Potassium, calcium, and magnesium levels are typically not elevated in simple
dehydration.
Question 4
A client reports pain rated as 8 on a 0–10 pain scale. The nurse administers morphine 4 mg IV push.
Thirty minutes later, the client rates pain as 3. Which action should the nurse take next?
A. Document the pain rating and continue monitoring
B. Administer an additional dose of morphine
C. Notify the healthcare provider
D. Assess for signs of respiratory depression
,ANSWER: A
Rationale: The pain has decreased from 8 to 3, indicating the intervention was effective. The nurse
should document the finding and continue to monitor. Additional doses, notifying the provider, or
focusing solely on respiratory depression are not indicated at this time.
Question 5
Which of the following clients is at the highest risk for falls?
A. A 45-year-old client with hypertension
B. A 72-year-old client taking antihypertensive medications
C. A 30-year-old client with a sprained ankle
D. A 60-year-old client with well-controlled diabetes
ANSWER: B
Rationale: Older adults (age >65) are at increased fall risk, and antihypertensive medications can cause
orthostatic hypotension, further increasing fall risk. The other clients have fewer risk factors.
Question 6
The nurse is teaching a client about a low-sodium diet. Which food selection by the client indicates
understanding?
A. Canned soup
B. Fresh grilled chicken
C. Pickles
D. Processed cheese
ANSWER: B
Rationale: Fresh grilled chicken is naturally low in sodium. Canned soup, pickles, and processed cheese
are all high in sodium.
, Question 7
A client with an indwelling urinary catheter has cloudy, foul-smelling urine. What is the nurse's priority
action?
A. Increase fluid intake
B. Obtain a urine specimen for culture and sensitivity
C. Irrigate the catheter
D. Change the catheter tubing
ANSWER: B
Rationale: Cloudy, foul-smelling urine in a client with an indwelling catheter suggests a urinary tract
infection. The priority is to obtain a urine specimen for culture and sensitivity to identify the organism
and guide antibiotic therapy.
Question 8
The nurse is preparing to insert a peripheral IV catheter. Which site should the nurse avoid?
A. Cephalic vein
B. Basilic vein
C. Vein in the client's dominant arm
D. Median cubital vein
ANSWER: C
Rationale: The nurse should avoid using the client's dominant arm for IV insertion whenever possible to
preserve the client's ability to perform activities of daily living. The cephalic, basilic, and median cubital
veins are all appropriate sites.
Question 9
A client is ordered to receive 1000 mL of normal saline over 8 hours. The drop factor is 15 gtt/mL. What
is the drip rate in gtt/min?
100 Questions with ANSWERs & Rationales
2026
Questions 1–100
Question 1
A nurse is preparing to administer an enteral feeding via a nasogastric (NG) tube. Which action should
the nurse take first?
A. Flush the tube with 30 mL of water
B. Verify tube placement by checking the pH of gastric aspirate
C. Elevate the head of the bed to 30–45 degrees
D. Auscultate for bowel sounds
ANSWER: B
Rationale: Before administering any enteral feeding, the nurse must first verify proper NG tube
placement to prevent aspiration pneumonia. Checking the pH of gastric aspirate (should be ≤ 4–5) is a
reliable method. Elevating the head of the bed is important but should occur after placement is
confirmed. Flushing the tube and auscultating bowel sounds are also important but not the first priority.
Question 2
A client is prescribed 500 mg of a medication orally. The available tablets are 250 mg each. How many
tablets should the nurse administer?
A. 1 tablet
B. 1.5 tablets
,C. 2 tablets
D. 2.5 tablets
ANSWER: C
Rationale: 500 mg ÷ 250 mg per tablet = 2 tablets. Basic dosage calculation requires dividing the desired
dose by the dose on hand.
Question 3
The nurse is caring for a client with a diagnosis of dehydration. Which laboratory value would the nurse
expect to be elevated?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
ANSWER: A
Rationale: In dehydration, there is a loss of water relative to solutes, leading to hypernatremia (elevated
serum sodium). Potassium, calcium, and magnesium levels are typically not elevated in simple
dehydration.
Question 4
A client reports pain rated as 8 on a 0–10 pain scale. The nurse administers morphine 4 mg IV push.
Thirty minutes later, the client rates pain as 3. Which action should the nurse take next?
A. Document the pain rating and continue monitoring
B. Administer an additional dose of morphine
C. Notify the healthcare provider
D. Assess for signs of respiratory depression
,ANSWER: A
Rationale: The pain has decreased from 8 to 3, indicating the intervention was effective. The nurse
should document the finding and continue to monitor. Additional doses, notifying the provider, or
focusing solely on respiratory depression are not indicated at this time.
Question 5
Which of the following clients is at the highest risk for falls?
A. A 45-year-old client with hypertension
B. A 72-year-old client taking antihypertensive medications
C. A 30-year-old client with a sprained ankle
D. A 60-year-old client with well-controlled diabetes
ANSWER: B
Rationale: Older adults (age >65) are at increased fall risk, and antihypertensive medications can cause
orthostatic hypotension, further increasing fall risk. The other clients have fewer risk factors.
Question 6
The nurse is teaching a client about a low-sodium diet. Which food selection by the client indicates
understanding?
A. Canned soup
B. Fresh grilled chicken
C. Pickles
D. Processed cheese
ANSWER: B
Rationale: Fresh grilled chicken is naturally low in sodium. Canned soup, pickles, and processed cheese
are all high in sodium.
, Question 7
A client with an indwelling urinary catheter has cloudy, foul-smelling urine. What is the nurse's priority
action?
A. Increase fluid intake
B. Obtain a urine specimen for culture and sensitivity
C. Irrigate the catheter
D. Change the catheter tubing
ANSWER: B
Rationale: Cloudy, foul-smelling urine in a client with an indwelling catheter suggests a urinary tract
infection. The priority is to obtain a urine specimen for culture and sensitivity to identify the organism
and guide antibiotic therapy.
Question 8
The nurse is preparing to insert a peripheral IV catheter. Which site should the nurse avoid?
A. Cephalic vein
B. Basilic vein
C. Vein in the client's dominant arm
D. Median cubital vein
ANSWER: C
Rationale: The nurse should avoid using the client's dominant arm for IV insertion whenever possible to
preserve the client's ability to perform activities of daily living. The cephalic, basilic, and median cubital
veins are all appropriate sites.
Question 9
A client is ordered to receive 1000 mL of normal saline over 8 hours. The drop factor is 15 gtt/mL. What
is the drip rate in gtt/min?
