RN HESI FUNDAMENTALS EXIT EXAM
STUDY GUIDE 2026/2027 QUESTIONS
AND ANSWERS
1. A nurse is caring for a client who is reporting severe chest pain. Which action should the
nurse take first based on the nursing process?
A. Administer prescribed analgesic medication.
B. Notify the provider of the client’s condition.
C. Document the client’s report in the medical record.
D. Perform a focused respiratory and cardiac assessment.
Answer: D
Conceptual Explanation: Assessment is the first step of the nursing process. The nurse
must collect data before planning or implementing interventions.
2. A nurse discovers a fire in a client’s trash can. Which of the following actions should the
nurse perform first?
A. Activate the fire alarm system.
B. Move the client to a safe location.
C. Extinguish the flames using a fire extinguisher.
,D. Contain the fire by closing the room door.
Answer: B
Conceptual Explanation: According to the RACE acronym (Rescue, Alarm, Contain,
Extinguish), the priority is to rescue/move the client to safety.
3. A client has a pressure injury that involves full-thickness skin loss with visible subcutaneous
fat, but no bone or muscle is exposed. The nurse should stage this as:
A. Stage II
B. Stage IV
C. Stage III
D. Unstageable
Answer: C
Conceptual Explanation: Stage III pressure injuries involve full-thickness skin loss with
visible adipose tissue (fat), but no exposure of fascia, muscle, or bone.
4. Which of the following laboratory values indicates a client is at risk for poor wound
healing?
A. Serum Albumin 2.8 g/dL
B. Hemoglobin 14 g/dL
C. WBC count 8,000/mm3
D. Creatinine 0.9 mg/dL
, Answer: A
Conceptual Explanation: A serum albumin level below 3.5 g/dL indicates malnutrition,
which significantly impairs wound healing.
5. A nurse is preparing to administer an IM injection to an obese client. Which angle should
the nurse use?
A. 90 degrees
B. 45 degrees
C. 15 degrees
D. 30 degrees
Answer: A
Conceptual Explanation: Intramuscular (IM) injections are administered at a 90-degree
angle to ensure the medication reaches the muscle tissue.
6. When performing tracheostomy care, which action by the nurse is essential to maintain
safety?
A. Ensure a spare tracheostomy tube of the same size is at the bedside.
B. Apply suction for 30 seconds at a time.
C. Clean the inner cannula with tap water.
D. Cut a 4x4 gauze pad to fit around the tube.
Answer: A
STUDY GUIDE 2026/2027 QUESTIONS
AND ANSWERS
1. A nurse is caring for a client who is reporting severe chest pain. Which action should the
nurse take first based on the nursing process?
A. Administer prescribed analgesic medication.
B. Notify the provider of the client’s condition.
C. Document the client’s report in the medical record.
D. Perform a focused respiratory and cardiac assessment.
Answer: D
Conceptual Explanation: Assessment is the first step of the nursing process. The nurse
must collect data before planning or implementing interventions.
2. A nurse discovers a fire in a client’s trash can. Which of the following actions should the
nurse perform first?
A. Activate the fire alarm system.
B. Move the client to a safe location.
C. Extinguish the flames using a fire extinguisher.
,D. Contain the fire by closing the room door.
Answer: B
Conceptual Explanation: According to the RACE acronym (Rescue, Alarm, Contain,
Extinguish), the priority is to rescue/move the client to safety.
3. A client has a pressure injury that involves full-thickness skin loss with visible subcutaneous
fat, but no bone or muscle is exposed. The nurse should stage this as:
A. Stage II
B. Stage IV
C. Stage III
D. Unstageable
Answer: C
Conceptual Explanation: Stage III pressure injuries involve full-thickness skin loss with
visible adipose tissue (fat), but no exposure of fascia, muscle, or bone.
4. Which of the following laboratory values indicates a client is at risk for poor wound
healing?
A. Serum Albumin 2.8 g/dL
B. Hemoglobin 14 g/dL
C. WBC count 8,000/mm3
D. Creatinine 0.9 mg/dL
, Answer: A
Conceptual Explanation: A serum albumin level below 3.5 g/dL indicates malnutrition,
which significantly impairs wound healing.
5. A nurse is preparing to administer an IM injection to an obese client. Which angle should
the nurse use?
A. 90 degrees
B. 45 degrees
C. 15 degrees
D. 30 degrees
Answer: A
Conceptual Explanation: Intramuscular (IM) injections are administered at a 90-degree
angle to ensure the medication reaches the muscle tissue.
6. When performing tracheostomy care, which action by the nurse is essential to maintain
safety?
A. Ensure a spare tracheostomy tube of the same size is at the bedside.
B. Apply suction for 30 seconds at a time.
C. Clean the inner cannula with tap water.
D. Cut a 4x4 gauze pad to fit around the tube.
Answer: A
