Page 1 of 99
HESI LPN-ADN ENTRANCE EXAM 2026 QUESTIONS LATEST
VERSION QUESTIONS AND ANSWERS
HESI LPN-ADN ENTRANCE EXAM: 250 PRACTICE QUESTIONS WITH RA
SECTION 1: FUNDAMENTALS OF NURSING (Questions 1-30)
1. The nurse is preparing to insert an indwelling urinary catheter for a female patient.
Which action is most critical to prevent the introduction of microorganisms into the
urinary tract during this sterile procedure?
A) Wearing sterile gloves during the entire insertion procedure
B) Maintaining the sterile field and using sterile technique throughout
C) Cleansing the perineal area thoroughly with antiseptic solution
D) Using sterile lubricant on the catheter tip before insertion
Rationale: Maintaining the sterile field and using sterile technique throughout the procedure
is the most critical action to prevent infection. While wearing sterile gloves (A) and cleansing
the perineal area (C) are important components of sterile technique, maintaining the entire
sterile field protects the catheter from any contamination during the entire procedure. Using
sterile lubricant (D) is necessary but does not ensure overall sterility.
2. An elderly patient who is immobile and bedridden has developed a reddened area
over their sacrum that does not blanch when pressure is applied. The nurse should
initially implement which intervention to prevent further skin breakdown?
A) Massage the reddened area vigorously to promote circulation
B) Reposition the patient at least every two hours to relieve pressure
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C) Apply a heating pad to the area to increase blood flow
D) Place the patient in a supine position to reduce pressure on the area
Rationale: Repositioning the patient every two hours is the primary intervention to relieve
pressure and prevent further tissue damage. Massaging a reddened area (A) can actually
damage capillaries and worsen tissue injury, especially if breakdown has already begun.
Applying heat (C) could increase metabolic demand and tissue damage. A supine position
(D) increases pressure on the sacrum, which is the opposite of what is needed.
3. A patient is scheduled for a surgical procedure and has signed the informed consent
form. While reviewing the form, the nurse notices that the patient appears confused
about the risks of the procedure. What is the nurse's most appropriate action regarding
the informed consent process?
A) Have the patient sign the consent form again to ensure they agree
B) Call the physician to clarify the risks with the patient before the procedure
C) Proceed with the surgery since the consent form has already been signed
D) Notify the nursing supervisor that the patient is confused about the risks
Rationale: The nurse should contact the physician to clarify the risks with the patient. The
physician is ultimately responsible for obtaining informed consent and ensuring the patient
understands the risks, benefits, and alternatives. Having the patient sign again (A) does not
address their confusion. Proceeding without further clarification (C) violates the patient's
right to informed decision-making. Notifying the supervisor (D) is not the most direct action
when the physician can clarify the information.
4. The nurse is caring for a patient who has been placed in wrist restraints due to
confusion and pulling at their intravenous line. Which action demonstrates that the
nurse is implementing safe and appropriate care for this patient who is in restraints?
A) Tightening the restraints securely so the patient cannot move their wrists
B) Removing the restraints every four hours to assess skin integrity
C) Checking the patient's circulation and skin condition every two hours
D) Documenting that the patient is in restraints but not mentioning the reason
, Page 3 of 99
Rationale: The nurse must check the patient's circulation, skin condition, and neurovascular
status every two hours when restraints are applied. Tightening restraints (A) is unsafe and can
compromise circulation. Restraints should be removed every two hours (not four) for skin
assessment and range-of-motion exercises. Documentation must include the reason for
restraints (D), the type used, and frequent assessments.
5. A patient who is postoperative day one following abdominal surgery has not had a
bowel movement yet. The patient asks the nurse for a laxative because they are feeling
uncomfortable. What should the nurse do first before administering any medication for
this patient's constipation concern?
A) Administer a stool softener as the patient requested for their comfort
B) Instruct the patient to drink prune juice to stimulate bowel movement
C) Assess the patient's abdomen for bowel sounds and distention
D) Encourage the patient to ambulate to promote intestinal motility
Rationale: The nurse should first assess the patient's abdomen for bowel sounds, distention,
and any signs of obstruction before administering any laxative or stool softener.
Administering a laxative (A) without assessment is unsafe, especially if there is an ileus or
obstruction. While prune juice (B) and ambulation (D) can help promote bowel motility, they
should not be the first action before a thorough assessment.
6. The nurse is providing care to a patient who is on fall precautions. Which
intervention is most effective in preventing falls for this patient who is at high risk for
injury?
A) Keeping the bed in the lowest position with all four side rails up
B) Placing the call light within the patient's reach and encouraging its use
C) Checking on the patient every four hours during the night shift
D) Restraining the patient to prevent them from getting out of bed
Rationale: Placing the call light within the patient's reach and encouraging its use helps
prevent falls by ensuring the patient can call for assistance before getting up. Keeping all four
side rails up (A) is considered a restraint in many facilities and can increase fall risk if the
patient tries to climb over them. Checking every four hours (C) is insufficient for a high-risk
patient. Restraining the patient (D) is not appropriate for fall prevention and carries risks.
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7. A patient is receiving a continuous tube feeding through a nasogastric tube. What is
the most important intervention the nurse should implement to reduce the risk of
aspiration in this patient who is receiving enteral nutrition?
A) Elevate the head of the bed to at least 30 degrees during the feeding
B) Flush the tube with 30 mL of water before and after each feeding
C) Check the residual volume every four hours to monitor gastric emptying
D) Verify tube placement by auscultating for air over the stomach
Rationale: Elevating the head of the bed to at least 30 degrees (preferably 45 degrees) during
continuous tube feedings reduces the risk of aspiration by preventing gastric contents from
flowing back into the esophagus and pharynx. Flushing the tube (B) is important for patency
but does not prevent aspiration. Checking residuals (C) is important but does not directly
prevent aspiration as effectively as positioning. Auscultation (D) is not the most reliable
method for verifying tube placement.
8. The nurse is performing wound care on a pressure injury that has yellow, stringy
tissue in the wound bed. The nurse should identify this tissue as which type and take
what appropriate action?
A) Granulation tissue; protect it with a moist dressing
B) Eschar; remove it through mechanical debridement
C) Slough; cleanse the wound and consider debridement
D) Epithelial tissue; cover it with a transparent dressing
Rationale: Slough is yellow, stringy, or fibrinous tissue that covers the wound bed and must
be removed for wound healing to occur. The nurse should cleanse the wound and consider
debridement. Granulation tissue (A) is red and beefy. Eschar (B) is black, brown, or necrotic
tissue that is firmly adherent. Epithelial tissue (D) is pink and shiny, indicating new skin
growth.
9. A patient has received a pain medication order for "Morphine sulfate 2-4 mg IV push
every 2-3 hours PRN for severe pain." The nurse must verify the order with the
physician before administration because it is missing which essential component for safe
medication administration?
HESI LPN-ADN ENTRANCE EXAM 2026 QUESTIONS LATEST
VERSION QUESTIONS AND ANSWERS
HESI LPN-ADN ENTRANCE EXAM: 250 PRACTICE QUESTIONS WITH RA
SECTION 1: FUNDAMENTALS OF NURSING (Questions 1-30)
1. The nurse is preparing to insert an indwelling urinary catheter for a female patient.
Which action is most critical to prevent the introduction of microorganisms into the
urinary tract during this sterile procedure?
A) Wearing sterile gloves during the entire insertion procedure
B) Maintaining the sterile field and using sterile technique throughout
C) Cleansing the perineal area thoroughly with antiseptic solution
D) Using sterile lubricant on the catheter tip before insertion
Rationale: Maintaining the sterile field and using sterile technique throughout the procedure
is the most critical action to prevent infection. While wearing sterile gloves (A) and cleansing
the perineal area (C) are important components of sterile technique, maintaining the entire
sterile field protects the catheter from any contamination during the entire procedure. Using
sterile lubricant (D) is necessary but does not ensure overall sterility.
2. An elderly patient who is immobile and bedridden has developed a reddened area
over their sacrum that does not blanch when pressure is applied. The nurse should
initially implement which intervention to prevent further skin breakdown?
A) Massage the reddened area vigorously to promote circulation
B) Reposition the patient at least every two hours to relieve pressure
, Page 2 of 99
C) Apply a heating pad to the area to increase blood flow
D) Place the patient in a supine position to reduce pressure on the area
Rationale: Repositioning the patient every two hours is the primary intervention to relieve
pressure and prevent further tissue damage. Massaging a reddened area (A) can actually
damage capillaries and worsen tissue injury, especially if breakdown has already begun.
Applying heat (C) could increase metabolic demand and tissue damage. A supine position
(D) increases pressure on the sacrum, which is the opposite of what is needed.
3. A patient is scheduled for a surgical procedure and has signed the informed consent
form. While reviewing the form, the nurse notices that the patient appears confused
about the risks of the procedure. What is the nurse's most appropriate action regarding
the informed consent process?
A) Have the patient sign the consent form again to ensure they agree
B) Call the physician to clarify the risks with the patient before the procedure
C) Proceed with the surgery since the consent form has already been signed
D) Notify the nursing supervisor that the patient is confused about the risks
Rationale: The nurse should contact the physician to clarify the risks with the patient. The
physician is ultimately responsible for obtaining informed consent and ensuring the patient
understands the risks, benefits, and alternatives. Having the patient sign again (A) does not
address their confusion. Proceeding without further clarification (C) violates the patient's
right to informed decision-making. Notifying the supervisor (D) is not the most direct action
when the physician can clarify the information.
4. The nurse is caring for a patient who has been placed in wrist restraints due to
confusion and pulling at their intravenous line. Which action demonstrates that the
nurse is implementing safe and appropriate care for this patient who is in restraints?
A) Tightening the restraints securely so the patient cannot move their wrists
B) Removing the restraints every four hours to assess skin integrity
C) Checking the patient's circulation and skin condition every two hours
D) Documenting that the patient is in restraints but not mentioning the reason
, Page 3 of 99
Rationale: The nurse must check the patient's circulation, skin condition, and neurovascular
status every two hours when restraints are applied. Tightening restraints (A) is unsafe and can
compromise circulation. Restraints should be removed every two hours (not four) for skin
assessment and range-of-motion exercises. Documentation must include the reason for
restraints (D), the type used, and frequent assessments.
5. A patient who is postoperative day one following abdominal surgery has not had a
bowel movement yet. The patient asks the nurse for a laxative because they are feeling
uncomfortable. What should the nurse do first before administering any medication for
this patient's constipation concern?
A) Administer a stool softener as the patient requested for their comfort
B) Instruct the patient to drink prune juice to stimulate bowel movement
C) Assess the patient's abdomen for bowel sounds and distention
D) Encourage the patient to ambulate to promote intestinal motility
Rationale: The nurse should first assess the patient's abdomen for bowel sounds, distention,
and any signs of obstruction before administering any laxative or stool softener.
Administering a laxative (A) without assessment is unsafe, especially if there is an ileus or
obstruction. While prune juice (B) and ambulation (D) can help promote bowel motility, they
should not be the first action before a thorough assessment.
6. The nurse is providing care to a patient who is on fall precautions. Which
intervention is most effective in preventing falls for this patient who is at high risk for
injury?
A) Keeping the bed in the lowest position with all four side rails up
B) Placing the call light within the patient's reach and encouraging its use
C) Checking on the patient every four hours during the night shift
D) Restraining the patient to prevent them from getting out of bed
Rationale: Placing the call light within the patient's reach and encouraging its use helps
prevent falls by ensuring the patient can call for assistance before getting up. Keeping all four
side rails up (A) is considered a restraint in many facilities and can increase fall risk if the
patient tries to climb over them. Checking every four hours (C) is insufficient for a high-risk
patient. Restraining the patient (D) is not appropriate for fall prevention and carries risks.
, Page 4 of 99
7. A patient is receiving a continuous tube feeding through a nasogastric tube. What is
the most important intervention the nurse should implement to reduce the risk of
aspiration in this patient who is receiving enteral nutrition?
A) Elevate the head of the bed to at least 30 degrees during the feeding
B) Flush the tube with 30 mL of water before and after each feeding
C) Check the residual volume every four hours to monitor gastric emptying
D) Verify tube placement by auscultating for air over the stomach
Rationale: Elevating the head of the bed to at least 30 degrees (preferably 45 degrees) during
continuous tube feedings reduces the risk of aspiration by preventing gastric contents from
flowing back into the esophagus and pharynx. Flushing the tube (B) is important for patency
but does not prevent aspiration. Checking residuals (C) is important but does not directly
prevent aspiration as effectively as positioning. Auscultation (D) is not the most reliable
method for verifying tube placement.
8. The nurse is performing wound care on a pressure injury that has yellow, stringy
tissue in the wound bed. The nurse should identify this tissue as which type and take
what appropriate action?
A) Granulation tissue; protect it with a moist dressing
B) Eschar; remove it through mechanical debridement
C) Slough; cleanse the wound and consider debridement
D) Epithelial tissue; cover it with a transparent dressing
Rationale: Slough is yellow, stringy, or fibrinous tissue that covers the wound bed and must
be removed for wound healing to occur. The nurse should cleanse the wound and consider
debridement. Granulation tissue (A) is red and beefy. Eschar (B) is black, brown, or necrotic
tissue that is firmly adherent. Epithelial tissue (D) is pink and shiny, indicating new skin
growth.
9. A patient has received a pain medication order for "Morphine sulfate 2-4 mg IV push
every 2-3 hours PRN for severe pain." The nurse must verify the order with the
physician before administration because it is missing which essential component for safe
medication administration?
