HESI RN FUNDAMENTALS NGN EXAM PREP
2026 SUCCESS QUESTIONS & RATIONALE
BUNDLE
This premium study guide delivers high-yield, Next-
Generation NCLEX (NGN) style multiple-choice questions
meticulously tailored for the 2026 HESI RN Fundamentals
Exam. Each question features an immediate correct answer
breakdown coupled with highly detailed, bold-italicized
logical rationales to rapidly sharpen your clinical judgment
and prioritization skills. It serves as an essential, high-
density resource engineered to maximize test scores, ensure
an effortless pass, and secure top-tier rankings on digital
study marketplaces.
Question 1
A nurse is caring for a client who is 2 days postoperative following
abdominal surgery. The client states, "I feel like something just
popped in my incision." Upon assessment, the nurse notes
evisceration of the wound. Which of the following actions should
the nurse take first?
A. Cover the protruding organs with a sterile dressing moistened
with warm sterile normal saline.
B. Place the client in a low-Fowler's position with knees bent.
C. Notify the surgeon immediately.
D. Obtain a set of vital signs.
,Answer: A
Rationale: Wound evisceration is a medical emergency. The
immediate priority action is to protect the protruding organs
from drying out and becoming infected by covering them
with a sterile dressing moistened with sterile normal saline.
Placing the client in low-Fowler's position with knees bent
reduces abdominal tension and should be done quickly, but
protecting the exposed bowel is the paramount safety action.
Notifying the surgeon and taking vital signs are necessary
steps that should occur immediately after protecting the
wound.
Question 2
A nurse is preparing to administer an intramuscular (IM) injection
to an adult client who has a body mass index (BMI) of 22. Which
of the following needles should the nurse select for a
ventrogluteal injection?
A. 25-gauge, 5/8-inch needle
B. 22-gauge, 1.5-inch needle
C. 18-gauge, 1-inch needle
D. 27-gauge, 0.5-inch needle
Answer: B
Rationale: For an adult client with a normal BMI (18.5–24.9), a
ventrogluteal IM injection requires a 1.5-inch needle to
ensure the medication penetrates the deep muscle tissue
past the subcutaneous layer. A 22-gauge needle is
appropriate for standard viscous medications. A 5/8-inch
needle is too short for a ventrogluteal injection in an adult
and is typically used for subcutaneous or deltoid injections
,in thin patients. An 18-gauge needle is too large and causes
unnecessary trauma, while a 27-gauge, 0.5-inch needle is
used for intradermal injections.
Question 3
A nurse is reviewing the laboratory results of a client who is
receiving intravenous heparin for a deep vein thrombosis. Which
of the following laboratory values indicates that the therapy is
effective?
A. Prothrombin time (PT) of 22 seconds
B. International Normalized Ratio (INR) of 3.0
C. Activated partial thromboplastin time (aPTT) of 65 seconds
D. Platelet count of 95,000/mm³
Answer: C
Rationale: Heparin efficacy is monitored using the activated
partial thromboplastin time (aPTT). A therapeutic range is
typically 1.5 to 2.5 times the normal control value (normal
control is roughly 30 to 40 seconds), making 65 seconds an
expected therapeutic finding. PT and INR are used to monitor
warfarin therapy, not heparin. A platelet count of 95,000/mm³
indicates thrombocytopenia, which is an adverse effect
(Heparin-Induced Thrombocytopenia) rather than a
therapeutic sign.
Question 4
A nurse is performing a physical assessment on a client and
notes bilateral +3 pitting edema in the lower extremities. Which of
, the following fluid volume imbalances does this finding suggest?
A. Extracellular fluid volume deficit
B. Hypokalemia
C. Extracellular fluid volume excess
D. Hypernatremia
Answer: C
Rationale: Pitting edema is a classic manifestation of fluid
volume excess (hypervolemia) due to fluid overloading the
interstitial spaces. Fluid volume deficit would manifest as
poor skin turgor, dry mucous membranes, and weight loss.
While electrolyte imbalances like hypokalemia or
hypernatremia can coexist with fluid shifts, pitting edema is
directly caused by a hydrostatic pressure shift associated
with fluid volume excess.
Question 5
A nurse is caring for an older adult client who is at risk for skin
breakdown. Which of the following interventions should the nurse
include in the plan of care?
A. Massage bony prominences daily.
B. Keep the head of the bed elevated at 45 degrees at all times.
C. Apply a moisture barrier ointment to skin exposed to
incontinence.
D. Use a donut-shaped cushion when sitting in a chair.
Answer: C
Rationale: Protecting the skin from moisture caused by
incontinence prevents chemical irritation and maceration,
which accelerate skin breakdown. Massaging bony
2026 SUCCESS QUESTIONS & RATIONALE
BUNDLE
This premium study guide delivers high-yield, Next-
Generation NCLEX (NGN) style multiple-choice questions
meticulously tailored for the 2026 HESI RN Fundamentals
Exam. Each question features an immediate correct answer
breakdown coupled with highly detailed, bold-italicized
logical rationales to rapidly sharpen your clinical judgment
and prioritization skills. It serves as an essential, high-
density resource engineered to maximize test scores, ensure
an effortless pass, and secure top-tier rankings on digital
study marketplaces.
Question 1
A nurse is caring for a client who is 2 days postoperative following
abdominal surgery. The client states, "I feel like something just
popped in my incision." Upon assessment, the nurse notes
evisceration of the wound. Which of the following actions should
the nurse take first?
A. Cover the protruding organs with a sterile dressing moistened
with warm sterile normal saline.
B. Place the client in a low-Fowler's position with knees bent.
C. Notify the surgeon immediately.
D. Obtain a set of vital signs.
,Answer: A
Rationale: Wound evisceration is a medical emergency. The
immediate priority action is to protect the protruding organs
from drying out and becoming infected by covering them
with a sterile dressing moistened with sterile normal saline.
Placing the client in low-Fowler's position with knees bent
reduces abdominal tension and should be done quickly, but
protecting the exposed bowel is the paramount safety action.
Notifying the surgeon and taking vital signs are necessary
steps that should occur immediately after protecting the
wound.
Question 2
A nurse is preparing to administer an intramuscular (IM) injection
to an adult client who has a body mass index (BMI) of 22. Which
of the following needles should the nurse select for a
ventrogluteal injection?
A. 25-gauge, 5/8-inch needle
B. 22-gauge, 1.5-inch needle
C. 18-gauge, 1-inch needle
D. 27-gauge, 0.5-inch needle
Answer: B
Rationale: For an adult client with a normal BMI (18.5–24.9), a
ventrogluteal IM injection requires a 1.5-inch needle to
ensure the medication penetrates the deep muscle tissue
past the subcutaneous layer. A 22-gauge needle is
appropriate for standard viscous medications. A 5/8-inch
needle is too short for a ventrogluteal injection in an adult
and is typically used for subcutaneous or deltoid injections
,in thin patients. An 18-gauge needle is too large and causes
unnecessary trauma, while a 27-gauge, 0.5-inch needle is
used for intradermal injections.
Question 3
A nurse is reviewing the laboratory results of a client who is
receiving intravenous heparin for a deep vein thrombosis. Which
of the following laboratory values indicates that the therapy is
effective?
A. Prothrombin time (PT) of 22 seconds
B. International Normalized Ratio (INR) of 3.0
C. Activated partial thromboplastin time (aPTT) of 65 seconds
D. Platelet count of 95,000/mm³
Answer: C
Rationale: Heparin efficacy is monitored using the activated
partial thromboplastin time (aPTT). A therapeutic range is
typically 1.5 to 2.5 times the normal control value (normal
control is roughly 30 to 40 seconds), making 65 seconds an
expected therapeutic finding. PT and INR are used to monitor
warfarin therapy, not heparin. A platelet count of 95,000/mm³
indicates thrombocytopenia, which is an adverse effect
(Heparin-Induced Thrombocytopenia) rather than a
therapeutic sign.
Question 4
A nurse is performing a physical assessment on a client and
notes bilateral +3 pitting edema in the lower extremities. Which of
, the following fluid volume imbalances does this finding suggest?
A. Extracellular fluid volume deficit
B. Hypokalemia
C. Extracellular fluid volume excess
D. Hypernatremia
Answer: C
Rationale: Pitting edema is a classic manifestation of fluid
volume excess (hypervolemia) due to fluid overloading the
interstitial spaces. Fluid volume deficit would manifest as
poor skin turgor, dry mucous membranes, and weight loss.
While electrolyte imbalances like hypokalemia or
hypernatremia can coexist with fluid shifts, pitting edema is
directly caused by a hydrostatic pressure shift associated
with fluid volume excess.
Question 5
A nurse is caring for an older adult client who is at risk for skin
breakdown. Which of the following interventions should the nurse
include in the plan of care?
A. Massage bony prominences daily.
B. Keep the head of the bed elevated at 45 degrees at all times.
C. Apply a moisture barrier ointment to skin exposed to
incontinence.
D. Use a donut-shaped cushion when sitting in a chair.
Answer: C
Rationale: Protecting the skin from moisture caused by
incontinence prevents chemical irritation and maceration,
which accelerate skin breakdown. Massaging bony
