HESI Fundamentals Exam 1 (Fall
2026)
100 Comprehensive NCLEX-Style Practice Questions & Rationales
MASLOW'S HIERARCHY OF NEEDS (PRIORITIZATION)
1. A nurse is caring for a client who is confused and repeatedly
attempts to pull out their IV line. After all other alternatives have
failed, the provider orders restraints. Which action is the priority
for the nurse?
A. Tie the restraints to the side rails of the bed.
B. Ensure two fingers can fit under the restraint.
C. Remove the restraints every 4 hours for range of motion.
D. Check the restraint order every 48 hours.
Correct Answer: B
Rationale: Safety first: To prevent neurovascular injury, the nurse must ensure
the restraint is not too tight (two-finger rule). Restraints are tied to the bed
frame (not rails), removed every 2 hours, and orders must usually be renewed
every 24 hours.
HESI Fundamentals - Page 1
,THERAPEUTIC COMMUNICATION
2. The nurse is preparing to enter the room of a client with a wound
infected with Methicillin-resistant Staphylococcus aureus (MRSA).
Which personal protective equipment (PPE) should the nurse don?
A. Gown and gloves
B. Mask and eye protection
C. N95 respirator
D. Gloves only
Correct Answer: A
Rationale: MRSA requires Contact Precautions. The nurse must wear a gown
and gloves to prevent transmission through direct or indirect contact.
BASIC PHYSICAL CARE (MOBILITY, HYGIENE)
3. A client on bed rest for three days is attempting to get out of bed
for the first time. Which action should the nurse take first?
A. Assist the client to a standing position immediately.
B. Dangle the client's legs over the side of the bed.
C. Check the client's blood pressure while lying flat.
D. Use a mechanical lift to move the client.
Correct Answer: B
Rationale: To prevent orthostatic hypotension and falls, the nurse should allow
the client to 'dangle' at the bedside to allow blood pressure to stabilize before
standing.
HESI Fundamentals - Page 2
,THE NURSING PROCESS (ASSESSMENT-FIRST)
4. Which task is most appropriate for the nurse to delegate to an
Unlicensed Assistive Personnel (UAP)?
A. Evaluating a client's response to pain medication.
B. Feeding a client with a high risk for aspiration.
C. Recording the output from a urinary catheter bag.
D. Assessing the skin integrity of a bedridden client.
Correct Answer: C
Rationale: UAPs can perform routine tasks with predictable outcomes, such as
measuring intake and output (I&O). Evaluation, feeding high-risk clients, and
assessment require the judgment of a licensed nurse.
LEGAL & ETHICAL (HIPAA, INFORMED CONSENT)
5. A client tells the nurse, 'I am so worried about my surgery
tomorrow.' Which response by the nurse is therapeutic?
A. 'Don't worry, you have a great surgeon.'
B. 'Why do you feel worried?'
C. 'It sounds like you are feeling anxious about your procedure.'
D. 'I was nervous before my surgery too, and I was fine.'
Correct Answer: C
Rationale: Paraphrasing or reflecting feelings is therapeutic. Option A is false
reassurance; Option B asks 'Why' (non-therapeutic/defensive); Option D focuses
on the nurse rather than the client.
HESI Fundamentals - Page 3
, VITAL SIGNS & BASIC LAB VALUES
6. HESI Question 6: A client with a new diagnosis is expressing
concern regarding Vital Signs & Basic Lab Values. Which nursing
action is the priority?
A. Document the client's concerns
B. Assess the client's current level of understanding
C. Provide a detailed educational pamphlet
D. Administer a sedative as ordered
Correct Answer: B
Rationale: According to the nursing process, Assessment is the first step. You
must determine what the client knows before you can implement a plan or
provide education.
MEDICATION ADMINISTRATION SAFETY
7. HESI Question 7: A client with a new diagnosis is expressing
concern regarding Medication Administration Safety. Which
nursing action is the priority?
A. Document the client's concerns
B. Assess the client's current level of understanding
C. Provide a detailed educational pamphlet
D. Administer a sedative as ordered
Correct Answer: B
Rationale: According to the nursing process, Assessment is the first step. You
must determine what the client knows before you can implement a plan or
provide education.
HESI Fundamentals - Page 4
2026)
100 Comprehensive NCLEX-Style Practice Questions & Rationales
MASLOW'S HIERARCHY OF NEEDS (PRIORITIZATION)
1. A nurse is caring for a client who is confused and repeatedly
attempts to pull out their IV line. After all other alternatives have
failed, the provider orders restraints. Which action is the priority
for the nurse?
A. Tie the restraints to the side rails of the bed.
B. Ensure two fingers can fit under the restraint.
C. Remove the restraints every 4 hours for range of motion.
D. Check the restraint order every 48 hours.
Correct Answer: B
Rationale: Safety first: To prevent neurovascular injury, the nurse must ensure
the restraint is not too tight (two-finger rule). Restraints are tied to the bed
frame (not rails), removed every 2 hours, and orders must usually be renewed
every 24 hours.
HESI Fundamentals - Page 1
,THERAPEUTIC COMMUNICATION
2. The nurse is preparing to enter the room of a client with a wound
infected with Methicillin-resistant Staphylococcus aureus (MRSA).
Which personal protective equipment (PPE) should the nurse don?
A. Gown and gloves
B. Mask and eye protection
C. N95 respirator
D. Gloves only
Correct Answer: A
Rationale: MRSA requires Contact Precautions. The nurse must wear a gown
and gloves to prevent transmission through direct or indirect contact.
BASIC PHYSICAL CARE (MOBILITY, HYGIENE)
3. A client on bed rest for three days is attempting to get out of bed
for the first time. Which action should the nurse take first?
A. Assist the client to a standing position immediately.
B. Dangle the client's legs over the side of the bed.
C. Check the client's blood pressure while lying flat.
D. Use a mechanical lift to move the client.
Correct Answer: B
Rationale: To prevent orthostatic hypotension and falls, the nurse should allow
the client to 'dangle' at the bedside to allow blood pressure to stabilize before
standing.
HESI Fundamentals - Page 2
,THE NURSING PROCESS (ASSESSMENT-FIRST)
4. Which task is most appropriate for the nurse to delegate to an
Unlicensed Assistive Personnel (UAP)?
A. Evaluating a client's response to pain medication.
B. Feeding a client with a high risk for aspiration.
C. Recording the output from a urinary catheter bag.
D. Assessing the skin integrity of a bedridden client.
Correct Answer: C
Rationale: UAPs can perform routine tasks with predictable outcomes, such as
measuring intake and output (I&O). Evaluation, feeding high-risk clients, and
assessment require the judgment of a licensed nurse.
LEGAL & ETHICAL (HIPAA, INFORMED CONSENT)
5. A client tells the nurse, 'I am so worried about my surgery
tomorrow.' Which response by the nurse is therapeutic?
A. 'Don't worry, you have a great surgeon.'
B. 'Why do you feel worried?'
C. 'It sounds like you are feeling anxious about your procedure.'
D. 'I was nervous before my surgery too, and I was fine.'
Correct Answer: C
Rationale: Paraphrasing or reflecting feelings is therapeutic. Option A is false
reassurance; Option B asks 'Why' (non-therapeutic/defensive); Option D focuses
on the nurse rather than the client.
HESI Fundamentals - Page 3
, VITAL SIGNS & BASIC LAB VALUES
6. HESI Question 6: A client with a new diagnosis is expressing
concern regarding Vital Signs & Basic Lab Values. Which nursing
action is the priority?
A. Document the client's concerns
B. Assess the client's current level of understanding
C. Provide a detailed educational pamphlet
D. Administer a sedative as ordered
Correct Answer: B
Rationale: According to the nursing process, Assessment is the first step. You
must determine what the client knows before you can implement a plan or
provide education.
MEDICATION ADMINISTRATION SAFETY
7. HESI Question 7: A client with a new diagnosis is expressing
concern regarding Medication Administration Safety. Which
nursing action is the priority?
A. Document the client's concerns
B. Assess the client's current level of understanding
C. Provide a detailed educational pamphlet
D. Administer a sedative as ordered
Correct Answer: B
Rationale: According to the nursing process, Assessment is the first step. You
must determine what the client knows before you can implement a plan or
provide education.
HESI Fundamentals - Page 4
