Nightingale College PN 106 HESI Fundamentals Exam (pdf)
| 2026/2027 | HESI Q&A | Nursing
INTRODUCTION
This study package is specifically engineered to align with the rigorous
HESI Fundamentals specialty exam, giving you a distinct competitive edge
for the 2026/2027 academic cycles. Featuring meticulously curated
multiple-choice questions, this guide systematically covers crucial
nursing concepts—including safe medication administration, advanced
infection control protocols, acute wound care, and fluid balance dynamics.
By delivering the verified updated answer in bold italic alongside a
complete clinical explanation in bold italic for every single question, this
tool eliminates guesswork, accelerates your content mastery, and
provides the exact blueprint needed to surpass the mandatory benchmark
score on your very first attempt.
Question 1
A nurse is preparing to administer an intramuscular injection to an adult
client. Which of the following actions should the nurse plan to take?
A) Choose a 22-gauge, 1/2-inch needle for a dorsogluteal injection
B) Use the Z-track technique to prevent medication leakage into
subcutaneous tissue
,C) Aspirate for 15 seconds before injecting the medication
D) Insert the needle at a 45-degree angle to the skin surface
Answer: B) Use the Z-track technique to prevent medication leakage
into subcutaneous tissue
Explanation: The Z-track method is recommended for all
intramuscular injections in adults to seal the medication within the
muscle tissue and prevent tracking back into sensitive
subcutaneous layers. Needles for adult IM injections are typically 1
to 1.5 inches long, inserted at a 90-degree angle, and routine
aspiration is no longer universally recommended unless specified
for specific medications.
Question 2
A client who is 2 days postoperative following abdominal surgery reports
sudden pain and a "popping" sensation in the incision line while coughing.
The nurse notes immediate evisceration. Which action should the nurse
take first?
A) Carefully pack the wound with dry, sterile gauze dressings
B) Cover the protruding organs with sterile towels moistened with warm
sterile normal saline
C) Position the client supine with their hips and knees fully extended
D) Notify the surgical team immediately before assessing vital signs
Answer: B) Cover the protruding organs with sterile towels
moistened with warm sterile normal saline
,Explanation: Evisceration is a medical emergency. The priority
action is to protect the exposed organs from drying out and
becoming infected by covering them with sterile dressings
moistened with sterile normal saline. The client should be placed in a
low-Fowler's position with knees slightly bent to reduce abdominal
tension. Notification happens immediately after securing the wound
environment.
Question 3
An assistive personnel (AP) reports to the nurse that a client’s
respiratory rate is 26 breaths per minute. Which of the following actions
should the nurse take first?
A) Reassess the client’s respiratory pattern and rate directly
B) Direct the AP to obtain a pulse oximetry reading
C) Document the respiratory rate in the electronic health record
D) Administer supplemental oxygen at 2 L/min via nasal cannula
Answer: A) Reassess the client’s respiratory pattern and rate
directly
Explanation: When an abnormal vital sign is reported by assistive
personnel, the nurse’s first action must be to personally assess the
client to verify the finding, evaluate clinical status, and determine
appropriate nursing interventions before acting or documenting.
, Question 4
A nurse is reviewing blood gas results for a client with severe, prolonged
vomiting. The values are: pH 7.49, PaCO2 44 mmHg, HCO3 31 mEq/L. How
should the nurse interpret these findings?
A) Respiratory Acidosis
B) Metabolic Acidosis
C) Respiratory Alkalosis
D) Metabolic Alkalosis
Answer: D) Metabolic Alkalosis
Explanation: A pH above 7.45 indicates alkalosis. The bicarbonate
(HCO3) is elevated above the normal range (22-26 mEq/L), while
the PaCO2 is within normal limits (35-45 mmHg). Loss of gastric
acids through severe vomiting results in metabolic alkalosis.
Question 5
A nurse is caring for an older adult client who is at risk for pressure
injury development. Which of the following interventions should be
included in the care plan?
A) Massage reddened bony prominences daily to stimulate blood flow
B) Shift the client's weight in bed every 4 hours
C) Keep the head of the bed elevated at 45 degrees or higher continuously
D) Use a lift sheet to move and reposition the client in bed
Answer: D) Use a lift sheet to move and reposition the client in bed
Explanation: Utilizing a friction-reducing device or lift sheet
| 2026/2027 | HESI Q&A | Nursing
INTRODUCTION
This study package is specifically engineered to align with the rigorous
HESI Fundamentals specialty exam, giving you a distinct competitive edge
for the 2026/2027 academic cycles. Featuring meticulously curated
multiple-choice questions, this guide systematically covers crucial
nursing concepts—including safe medication administration, advanced
infection control protocols, acute wound care, and fluid balance dynamics.
By delivering the verified updated answer in bold italic alongside a
complete clinical explanation in bold italic for every single question, this
tool eliminates guesswork, accelerates your content mastery, and
provides the exact blueprint needed to surpass the mandatory benchmark
score on your very first attempt.
Question 1
A nurse is preparing to administer an intramuscular injection to an adult
client. Which of the following actions should the nurse plan to take?
A) Choose a 22-gauge, 1/2-inch needle for a dorsogluteal injection
B) Use the Z-track technique to prevent medication leakage into
subcutaneous tissue
,C) Aspirate for 15 seconds before injecting the medication
D) Insert the needle at a 45-degree angle to the skin surface
Answer: B) Use the Z-track technique to prevent medication leakage
into subcutaneous tissue
Explanation: The Z-track method is recommended for all
intramuscular injections in adults to seal the medication within the
muscle tissue and prevent tracking back into sensitive
subcutaneous layers. Needles for adult IM injections are typically 1
to 1.5 inches long, inserted at a 90-degree angle, and routine
aspiration is no longer universally recommended unless specified
for specific medications.
Question 2
A client who is 2 days postoperative following abdominal surgery reports
sudden pain and a "popping" sensation in the incision line while coughing.
The nurse notes immediate evisceration. Which action should the nurse
take first?
A) Carefully pack the wound with dry, sterile gauze dressings
B) Cover the protruding organs with sterile towels moistened with warm
sterile normal saline
C) Position the client supine with their hips and knees fully extended
D) Notify the surgical team immediately before assessing vital signs
Answer: B) Cover the protruding organs with sterile towels
moistened with warm sterile normal saline
,Explanation: Evisceration is a medical emergency. The priority
action is to protect the exposed organs from drying out and
becoming infected by covering them with sterile dressings
moistened with sterile normal saline. The client should be placed in a
low-Fowler's position with knees slightly bent to reduce abdominal
tension. Notification happens immediately after securing the wound
environment.
Question 3
An assistive personnel (AP) reports to the nurse that a client’s
respiratory rate is 26 breaths per minute. Which of the following actions
should the nurse take first?
A) Reassess the client’s respiratory pattern and rate directly
B) Direct the AP to obtain a pulse oximetry reading
C) Document the respiratory rate in the electronic health record
D) Administer supplemental oxygen at 2 L/min via nasal cannula
Answer: A) Reassess the client’s respiratory pattern and rate
directly
Explanation: When an abnormal vital sign is reported by assistive
personnel, the nurse’s first action must be to personally assess the
client to verify the finding, evaluate clinical status, and determine
appropriate nursing interventions before acting or documenting.
, Question 4
A nurse is reviewing blood gas results for a client with severe, prolonged
vomiting. The values are: pH 7.49, PaCO2 44 mmHg, HCO3 31 mEq/L. How
should the nurse interpret these findings?
A) Respiratory Acidosis
B) Metabolic Acidosis
C) Respiratory Alkalosis
D) Metabolic Alkalosis
Answer: D) Metabolic Alkalosis
Explanation: A pH above 7.45 indicates alkalosis. The bicarbonate
(HCO3) is elevated above the normal range (22-26 mEq/L), while
the PaCO2 is within normal limits (35-45 mmHg). Loss of gastric
acids through severe vomiting results in metabolic alkalosis.
Question 5
A nurse is caring for an older adult client who is at risk for pressure
injury development. Which of the following interventions should be
included in the care plan?
A) Massage reddened bony prominences daily to stimulate blood flow
B) Shift the client's weight in bed every 4 hours
C) Keep the head of the bed elevated at 45 degrees or higher continuously
D) Use a lift sheet to move and reposition the client in bed
Answer: D) Use a lift sheet to move and reposition the client in bed
Explanation: Utilizing a friction-reducing device or lift sheet
