Page 1 of 232
HESI 345 COMPREHENSIVE EXAM BANK
2026-2027 | 300+ PRACTICE QUESTIONS
WITH RATIONALES & DISTRACTOR ANALYSIS
| ALREADY GRADED A+
itsjereguides
# SECTION I: FUNDAMENTALS OF NURSING & PATIENT SAFETY (25 Questions)
## Question 1
A nurse is preparing to perform a sterile dressing change for a client with a surgical wound.
Which action by the nurse indicates a breach in sterile technique?
A. Opening the sterile package away from the body
B. Holding sterile objects above waist level
C. Placing the sterile field within 1 inch of the edge of the table
D. Using sterile gloves to handle sterile items
**Correct Answer: C**
**Rationale:** Sterile technique requires that a sterile field be established with a 1-inch border
around the edges considered contaminated. Placing the sterile field within 1 inch of the edge
violates this principle because the edges are considered unsterile. Opening sterile packages away
from the body (A) is correct technique. Holding sterile objects above waist level (B) maintains
sterility. Using sterile gloves (D) is appropriate.
,Page 2 of 232
**Distractor Analysis:**
- **A:** Opening away from the body is correct sterile technique to prevent contamination.
- **B:** Keeping objects above waist level is correct as below waist is considered contaminated.
- **D:** Sterile gloves are required for sterile procedures—this is correct practice.
---
## Question 2
The nurse is caring for a client who is at risk for falls. Which intervention should the nurse
implement first?
A. Place the bed in the lowest position
B. Apply a fall risk wristband
C. Orient the client to the call light
D. Perform a comprehensive fall risk assessment
**Correct Answer: D**
**Rationale:** The nursing process dictates that assessment is always the first step. Before
implementing any fall prevention interventions, the nurse must first perform a comprehensive
fall risk assessment to identify specific risk factors and determine appropriate interventions.
While options A, B, and C are appropriate interventions, they should be implemented after a
thorough assessment.
**Distractor Analysis:**
- **A:** Bed in lowest position is an appropriate intervention but should follow assessment.
- **B:** Fall risk wristband alerts staff but is not the priority first action.
- **C:** Call light orientation is important but should follow assessment.
,Page 3 of 232
## Question 3
A client with a nasogastric (NG) tube attached to continuous suction complains of nausea and
abdominal distention. What is the nurse's priority action?
A. Irrigate the NG tube with normal saline
B. Check the patency of the NG tube
C. Increase the suction pressure
D. Administer an antiemetic medication
**Correct Answer: B**
**Rationale:** Nausea and abdominal distention in a client with an NG tube on suction suggest
tube obstruction or malfunction. The priority action is to assess tube patency. Irrigation may be
necessary after assessing patency, but checking patency comes first. Increasing suction pressure
(C) could cause mucosal damage. Administering an antiemetic (D) without addressing the
underlying cause is inappropriate.
**Distractor Analysis:**
- **A:** Irrigation may be needed but only after determining the tube is obstructed.
- **C:** Increasing suction without assessing can cause gastric mucosal injury.
- **D:** Treating symptoms without addressing the cause is inappropriate nursing practice.
---
## Question 4
The nurse is providing discharge teaching to a client who will be using a walker. Which
statement by the client indicates a need for further teaching?
A. "I will hold the walker on my weak side."
, Page 4 of 232
B. "I will advance the walker first, then my weak leg."
C. "I will keep my elbows slightly bent when using the walker."
D. "I will make sure the walker is at waist level."
**Correct Answer: D**
**Rationale:** A walker should be positioned at the level of the client's wrists when arms are
hanging down naturally, with elbows slightly bent at about 15-30 degrees when holding the
handgrips. A walker at waist level is too high and would compromise stability and safety. The
correct technique involves advancing the walker first, then the weak leg, followed by the strong
leg.
**Distractor Analysis:**
- **A:** The walker should be held with both hands; it is not held on one side.
- **B:** Advancing the walker first is correct gait pattern.
- **C:** Slight elbow bend (15-30°) is correct positioning.
---
## Question 5
A nurse is caring for a client who is 2 days postoperative and reports incisional pain rated 8 on a
scale of 0 to 10. Which action should the nurse take first?
A. Administer the prescribed PRN analgesic
B. Assess the surgical incision for signs of infection
C. Reposition the client for comfort
D. Document the client's pain rating
**Correct Answer: B**
HESI 345 COMPREHENSIVE EXAM BANK
2026-2027 | 300+ PRACTICE QUESTIONS
WITH RATIONALES & DISTRACTOR ANALYSIS
| ALREADY GRADED A+
itsjereguides
# SECTION I: FUNDAMENTALS OF NURSING & PATIENT SAFETY (25 Questions)
## Question 1
A nurse is preparing to perform a sterile dressing change for a client with a surgical wound.
Which action by the nurse indicates a breach in sterile technique?
A. Opening the sterile package away from the body
B. Holding sterile objects above waist level
C. Placing the sterile field within 1 inch of the edge of the table
D. Using sterile gloves to handle sterile items
**Correct Answer: C**
**Rationale:** Sterile technique requires that a sterile field be established with a 1-inch border
around the edges considered contaminated. Placing the sterile field within 1 inch of the edge
violates this principle because the edges are considered unsterile. Opening sterile packages away
from the body (A) is correct technique. Holding sterile objects above waist level (B) maintains
sterility. Using sterile gloves (D) is appropriate.
,Page 2 of 232
**Distractor Analysis:**
- **A:** Opening away from the body is correct sterile technique to prevent contamination.
- **B:** Keeping objects above waist level is correct as below waist is considered contaminated.
- **D:** Sterile gloves are required for sterile procedures—this is correct practice.
---
## Question 2
The nurse is caring for a client who is at risk for falls. Which intervention should the nurse
implement first?
A. Place the bed in the lowest position
B. Apply a fall risk wristband
C. Orient the client to the call light
D. Perform a comprehensive fall risk assessment
**Correct Answer: D**
**Rationale:** The nursing process dictates that assessment is always the first step. Before
implementing any fall prevention interventions, the nurse must first perform a comprehensive
fall risk assessment to identify specific risk factors and determine appropriate interventions.
While options A, B, and C are appropriate interventions, they should be implemented after a
thorough assessment.
**Distractor Analysis:**
- **A:** Bed in lowest position is an appropriate intervention but should follow assessment.
- **B:** Fall risk wristband alerts staff but is not the priority first action.
- **C:** Call light orientation is important but should follow assessment.
,Page 3 of 232
## Question 3
A client with a nasogastric (NG) tube attached to continuous suction complains of nausea and
abdominal distention. What is the nurse's priority action?
A. Irrigate the NG tube with normal saline
B. Check the patency of the NG tube
C. Increase the suction pressure
D. Administer an antiemetic medication
**Correct Answer: B**
**Rationale:** Nausea and abdominal distention in a client with an NG tube on suction suggest
tube obstruction or malfunction. The priority action is to assess tube patency. Irrigation may be
necessary after assessing patency, but checking patency comes first. Increasing suction pressure
(C) could cause mucosal damage. Administering an antiemetic (D) without addressing the
underlying cause is inappropriate.
**Distractor Analysis:**
- **A:** Irrigation may be needed but only after determining the tube is obstructed.
- **C:** Increasing suction without assessing can cause gastric mucosal injury.
- **D:** Treating symptoms without addressing the cause is inappropriate nursing practice.
---
## Question 4
The nurse is providing discharge teaching to a client who will be using a walker. Which
statement by the client indicates a need for further teaching?
A. "I will hold the walker on my weak side."
, Page 4 of 232
B. "I will advance the walker first, then my weak leg."
C. "I will keep my elbows slightly bent when using the walker."
D. "I will make sure the walker is at waist level."
**Correct Answer: D**
**Rationale:** A walker should be positioned at the level of the client's wrists when arms are
hanging down naturally, with elbows slightly bent at about 15-30 degrees when holding the
handgrips. A walker at waist level is too high and would compromise stability and safety. The
correct technique involves advancing the walker first, then the weak leg, followed by the strong
leg.
**Distractor Analysis:**
- **A:** The walker should be held with both hands; it is not held on one side.
- **B:** Advancing the walker first is correct gait pattern.
- **C:** Slight elbow bend (15-30°) is correct positioning.
---
## Question 5
A nurse is caring for a client who is 2 days postoperative and reports incisional pain rated 8 on a
scale of 0 to 10. Which action should the nurse take first?
A. Administer the prescribed PRN analgesic
B. Assess the surgical incision for signs of infection
C. Reposition the client for comfort
D. Document the client's pain rating
**Correct Answer: B**
