HESI Fundamentals Exit Exam Actual Exam 2026/2027 |
Versions 1, 2, and 3 | 225 Verified Questions
Elsevier HESI / Nursing Education Standards | Verified Q&A | Professional Nursing
Students
Introduction
Welcome to the comprehensive, original, and verified question bank for the HESI Fundamentals Exit
Exam Actual Exam 2026/2027. This preparatory document contains exactly 225 highly detailed
questions, representing three complete, distinct versions (Version 1, Version 2, and Version 3) of the
examination. Each version contains exactly 75 questions distributed across four primary nursing
domains: Basic Care and Comfort (19 questions), Safety and Infection Control (19 questions), Health
Promotion and Maintenance (19 questions), and Pharmacological and Parenteral Therapies (18
questions). This original content is designed to reinforce official Elsevier HESI objectives and clinical
nursing standards, providing University-Level and College-Level nursing students with the critical
decision-making, procedural safety, and pharmacology competencies required for actual exam readiness
and successful professional nursing licensing.
HESI Fundamentals Exit Exam - Version 1
Domain: Basic Care and Comfort
Question 1: [Pressure Injury Prevention]
A nurse is compiling a care plan for an immobile client. Which of the following
interventions should the nurse include to most effectively reduce the risk of skin
breakdown?
(A) Massaging reddened sacral and trochanteric areas once per shift
(B) Applying medicated talcum powder to all major bony landmarks
(C) Using a soft plastic donut-shaped cushion for chair sitting
(D) Implementing a turning and repositioning schedule at least every 2 hours
Correct Answer: D
Rationale: Frequent turning (at least every 2 hours) redistributes body pressure and restores localized
blood perfusion to the skin. Powder causes irritation; donut cushions concentrate pressure on
surrounding capillaries; and massaging reddened skin causes deep tissue tearing. This is a vital basic
care objective.
HESI Fundamentals Exit Exam Actual Exam 2026/2027
,Question 2: [Cane Ambulation Technique]
The nurse is instructing a client who has right-sided hemiplegia on how to use a single-
ended cane. Which of the following instructions is correct?
(A) Hold the cane in the left hand and advance the left leg first
(B) Hold the cane in the right hand and advance the cane with the left leg
(C) Hold the cane in the left hand and advance the cane with the right leg
(D) Hold the cane in the right hand and advance the right leg first
Correct Answer: C
Rationale: A cane must always be held on the unaffected, stronger side of the body (the left side) to
provide optimal balance. The cane is advanced simultaneously with the affected leg (the right leg) to
support the weight. This is standard mobility safety teaching.
Question 3: [Indwelling Catheter Care]
Which of the following techniques should the nurse implement when performing
indwelling urinary catheter care for a female client?
(A) Cleanse the catheter tube starting from 4 inches away and moving toward the meatus
(B) Cleanse the catheter tube starting at the urinary meatus and moving outward using mild soap and
water
(C) Place the catheter drainage bag on the client's bed adjacent to the thigh
(D) Apply an alcohol-based antiseptic gel to the urinary meatus daily
Correct Answer: B
Rationale: To prevent ascending infections, catheter care involves cleaning the catheter tube starting
at the meatus and moving downward (outward). The drainage bag must always be kept below the level
of the bladder to prevent urinary reflux, and harsh antiseptics are contraindicated due to mucosal
damage.
Question 4: [Dysphagia Feeding Safety]
A nurse is preparing to feed a client who has dysphagia following a stroke. Which of the
following actions should the nurse perform?
(A) Use a syringe to squirt liquids quickly into the back of the client's mouth
(B) Place the client in a semi-Fowler's position and provide thin, clear liquids to ease swallowing
(C) Encourage the client to talk while chewing to evaluate their cranial nerve function
(D) Elevate the head of the bed to 90 degrees and instruct the client to flex their neck slightly forward
Correct Answer: D
Rationale: Positioning a dysphagia client in high Fowler's (90 degrees) with the chin tucked forward
(chin-tuck) closes the airway and opens the esophagus, preventing aspiration. Thin liquids are difficult
to control; talking while chewing and squirting fluids increase choking risks.
HESI Fundamentals Exit Exam Actual Exam 2026/2027
,Question 5: [Occupied Bedmaking Safety]
Regarding 'Occupied Bedmaking Safety' in clinical nursing, A client with an indwelling
urinary catheter is preparing to ambulate. Which of the following safety actions must the
nurse perform? (Clinical Parameter: Occupied Bedmaking Safety).
(A) Instruct the client to hold the drainage bag at chest level during walking
(B) Secure the drainage bag below the level of the bladder and ensure the tubing is free of kinks
(C) Empty the drainage bag only once every 48 hours to minimize contamination
(D) Clamp the catheter tubing tightly during ambulation to prevent leakage
Correct Answer: B
Rationale: This question evaluates Occupied Bedmaking Safety. Urinary drainage bags must always
remain below the level of the bladder (even during ambulation) to prevent gravity-fed reflux of stagnant
urine back into the bladder, which causes UTIs. Tubing must remain unkinked, and catheters must
never be clamped without specific orders.
Question 6: [Active Range-of-Motion]
Regarding 'Active Range-of-Motion' in clinical nursing, A nurse is bathing an elderly client
who has dry, fragile skin. Which of the following actions should the nurse take? (Clinical
Parameter: Active Range-of-Motion).
(A) Wash the skin with hot water and antibacterial soap daily
(B) Apply a moisturizing lotion to the skin immediately after patting it dry
(C) Rub the skin vigorously with a coarse towel to stimulate blood flow
(D) Avoid bathing the client more than once a month
Correct Answer: B
Rationale: This question evaluates Active Range-of-Motion. Elderly skin has decreased sebum
production and elasticity. The nurse should use warm (not hot) water, mild pH-balanced soaps, pat the
skin dry gently, and apply moisturizing emollients immediately to lock in moisture and prevent
cracking. Vigorous rubbing or hot water causes epidermal tearing and severe dryness.
Question 7: [Assessing Urinary Retention]
Regarding 'Assessing Urinary Retention' in clinical nursing, A client with an indwelling
urinary catheter is preparing to ambulate. Which of the following safety actions must the
nurse perform? (Clinical Parameter: Assessing Urinary Retention).
(A) Instruct the client to hold the drainage bag at chest level during walking
(B) Clamp the catheter tubing tightly during ambulation to prevent leakage
(C) Empty the drainage bag only once every 48 hours to minimize contamination
(D) Secure the drainage bag below the level of the bladder and ensure the tubing is free of kinks
Correct Answer: D
Rationale: This question evaluates Assessing Urinary Retention. Urinary drainage bags must always
remain below the level of the bladder (even during ambulation) to prevent gravity-fed reflux of stagnant
urine back into the bladder, which causes UTIs. Tubing must remain unkinked, and catheters must
never be clamped without specific orders.
HESI Fundamentals Exit Exam Actual Exam 2026/2027
, Question 8: [Orthopneic Positioning]
Regarding 'Orthopneic Positioning' in clinical nursing, A nurse is bathing an elderly client
who has dry, fragile skin. Which of the following actions should the nurse take? (Clinical
Parameter: Orthopneic Positioning).
(A) Apply a moisturizing lotion to the skin immediately after patting it dry
(B) Avoid bathing the client more than once a month
(C) Rub the skin vigorously with a coarse towel to stimulate blood flow
(D) Wash the skin with hot water and antibacterial soap daily
Correct Answer: A
Rationale: This question evaluates Orthopneic Positioning. Elderly skin has decreased sebum
production and elasticity. The nurse should use warm (not hot) water, mild pH-balanced soaps, pat the
skin dry gently, and apply moisturizing emollients immediately to lock in moisture and prevent
cracking. Vigorous rubbing or hot water causes epidermal tearing and severe dryness.
Question 9: [Male Perineal Hygiene]
Regarding 'Male Perineal Hygiene' in clinical nursing, A client with an indwelling urinary
catheter is preparing to ambulate. Which of the following safety actions must the nurse
perform? (Clinical Parameter: Male Perineal Hygiene).
(A) Clamp the catheter tubing tightly during ambulation to prevent leakage
(B) Instruct the client to hold the drainage bag at chest level during walking
(C) Secure the drainage bag below the level of the bladder and ensure the tubing is free of kinks
(D) Empty the drainage bag only once every 48 hours to minimize contamination
Correct Answer: C
Rationale: This question evaluates Male Perineal Hygiene. Urinary drainage bags must always
remain below the level of the bladder (even during ambulation) to prevent gravity-fed reflux of stagnant
urine back into the bladder, which causes UTIs. Tubing must remain unkinked, and catheters must
never be clamped without specific orders.
Question 10: [Footdrop Prevention]
Regarding 'Footdrop Prevention' in clinical nursing, A nurse is bathing an elderly client
who has dry, fragile skin. Which of the following actions should the nurse take? (Clinical
Parameter: Footdrop Prevention).
(A) Avoid bathing the client more than once a month
(B) Apply a moisturizing lotion to the skin immediately after patting it dry
(C) Rub the skin vigorously with a coarse towel to stimulate blood flow
(D) Wash the skin with hot water and antibacterial soap daily
Correct Answer: B
Rationale: This question evaluates Footdrop Prevention. Elderly skin has decreased sebum production
and elasticity. The nurse should use warm (not hot) water, mild pH-balanced soaps, pat the skin dry
gently, and apply moisturizing emollients immediately to lock in moisture and prevent cracking.
Vigorous rubbing or hot water causes epidermal tearing and severe dryness.
HESI Fundamentals Exit Exam Actual Exam 2026/2027
Versions 1, 2, and 3 | 225 Verified Questions
Elsevier HESI / Nursing Education Standards | Verified Q&A | Professional Nursing
Students
Introduction
Welcome to the comprehensive, original, and verified question bank for the HESI Fundamentals Exit
Exam Actual Exam 2026/2027. This preparatory document contains exactly 225 highly detailed
questions, representing three complete, distinct versions (Version 1, Version 2, and Version 3) of the
examination. Each version contains exactly 75 questions distributed across four primary nursing
domains: Basic Care and Comfort (19 questions), Safety and Infection Control (19 questions), Health
Promotion and Maintenance (19 questions), and Pharmacological and Parenteral Therapies (18
questions). This original content is designed to reinforce official Elsevier HESI objectives and clinical
nursing standards, providing University-Level and College-Level nursing students with the critical
decision-making, procedural safety, and pharmacology competencies required for actual exam readiness
and successful professional nursing licensing.
HESI Fundamentals Exit Exam - Version 1
Domain: Basic Care and Comfort
Question 1: [Pressure Injury Prevention]
A nurse is compiling a care plan for an immobile client. Which of the following
interventions should the nurse include to most effectively reduce the risk of skin
breakdown?
(A) Massaging reddened sacral and trochanteric areas once per shift
(B) Applying medicated talcum powder to all major bony landmarks
(C) Using a soft plastic donut-shaped cushion for chair sitting
(D) Implementing a turning and repositioning schedule at least every 2 hours
Correct Answer: D
Rationale: Frequent turning (at least every 2 hours) redistributes body pressure and restores localized
blood perfusion to the skin. Powder causes irritation; donut cushions concentrate pressure on
surrounding capillaries; and massaging reddened skin causes deep tissue tearing. This is a vital basic
care objective.
HESI Fundamentals Exit Exam Actual Exam 2026/2027
,Question 2: [Cane Ambulation Technique]
The nurse is instructing a client who has right-sided hemiplegia on how to use a single-
ended cane. Which of the following instructions is correct?
(A) Hold the cane in the left hand and advance the left leg first
(B) Hold the cane in the right hand and advance the cane with the left leg
(C) Hold the cane in the left hand and advance the cane with the right leg
(D) Hold the cane in the right hand and advance the right leg first
Correct Answer: C
Rationale: A cane must always be held on the unaffected, stronger side of the body (the left side) to
provide optimal balance. The cane is advanced simultaneously with the affected leg (the right leg) to
support the weight. This is standard mobility safety teaching.
Question 3: [Indwelling Catheter Care]
Which of the following techniques should the nurse implement when performing
indwelling urinary catheter care for a female client?
(A) Cleanse the catheter tube starting from 4 inches away and moving toward the meatus
(B) Cleanse the catheter tube starting at the urinary meatus and moving outward using mild soap and
water
(C) Place the catheter drainage bag on the client's bed adjacent to the thigh
(D) Apply an alcohol-based antiseptic gel to the urinary meatus daily
Correct Answer: B
Rationale: To prevent ascending infections, catheter care involves cleaning the catheter tube starting
at the meatus and moving downward (outward). The drainage bag must always be kept below the level
of the bladder to prevent urinary reflux, and harsh antiseptics are contraindicated due to mucosal
damage.
Question 4: [Dysphagia Feeding Safety]
A nurse is preparing to feed a client who has dysphagia following a stroke. Which of the
following actions should the nurse perform?
(A) Use a syringe to squirt liquids quickly into the back of the client's mouth
(B) Place the client in a semi-Fowler's position and provide thin, clear liquids to ease swallowing
(C) Encourage the client to talk while chewing to evaluate their cranial nerve function
(D) Elevate the head of the bed to 90 degrees and instruct the client to flex their neck slightly forward
Correct Answer: D
Rationale: Positioning a dysphagia client in high Fowler's (90 degrees) with the chin tucked forward
(chin-tuck) closes the airway and opens the esophagus, preventing aspiration. Thin liquids are difficult
to control; talking while chewing and squirting fluids increase choking risks.
HESI Fundamentals Exit Exam Actual Exam 2026/2027
,Question 5: [Occupied Bedmaking Safety]
Regarding 'Occupied Bedmaking Safety' in clinical nursing, A client with an indwelling
urinary catheter is preparing to ambulate. Which of the following safety actions must the
nurse perform? (Clinical Parameter: Occupied Bedmaking Safety).
(A) Instruct the client to hold the drainage bag at chest level during walking
(B) Secure the drainage bag below the level of the bladder and ensure the tubing is free of kinks
(C) Empty the drainage bag only once every 48 hours to minimize contamination
(D) Clamp the catheter tubing tightly during ambulation to prevent leakage
Correct Answer: B
Rationale: This question evaluates Occupied Bedmaking Safety. Urinary drainage bags must always
remain below the level of the bladder (even during ambulation) to prevent gravity-fed reflux of stagnant
urine back into the bladder, which causes UTIs. Tubing must remain unkinked, and catheters must
never be clamped without specific orders.
Question 6: [Active Range-of-Motion]
Regarding 'Active Range-of-Motion' in clinical nursing, A nurse is bathing an elderly client
who has dry, fragile skin. Which of the following actions should the nurse take? (Clinical
Parameter: Active Range-of-Motion).
(A) Wash the skin with hot water and antibacterial soap daily
(B) Apply a moisturizing lotion to the skin immediately after patting it dry
(C) Rub the skin vigorously with a coarse towel to stimulate blood flow
(D) Avoid bathing the client more than once a month
Correct Answer: B
Rationale: This question evaluates Active Range-of-Motion. Elderly skin has decreased sebum
production and elasticity. The nurse should use warm (not hot) water, mild pH-balanced soaps, pat the
skin dry gently, and apply moisturizing emollients immediately to lock in moisture and prevent
cracking. Vigorous rubbing or hot water causes epidermal tearing and severe dryness.
Question 7: [Assessing Urinary Retention]
Regarding 'Assessing Urinary Retention' in clinical nursing, A client with an indwelling
urinary catheter is preparing to ambulate. Which of the following safety actions must the
nurse perform? (Clinical Parameter: Assessing Urinary Retention).
(A) Instruct the client to hold the drainage bag at chest level during walking
(B) Clamp the catheter tubing tightly during ambulation to prevent leakage
(C) Empty the drainage bag only once every 48 hours to minimize contamination
(D) Secure the drainage bag below the level of the bladder and ensure the tubing is free of kinks
Correct Answer: D
Rationale: This question evaluates Assessing Urinary Retention. Urinary drainage bags must always
remain below the level of the bladder (even during ambulation) to prevent gravity-fed reflux of stagnant
urine back into the bladder, which causes UTIs. Tubing must remain unkinked, and catheters must
never be clamped without specific orders.
HESI Fundamentals Exit Exam Actual Exam 2026/2027
, Question 8: [Orthopneic Positioning]
Regarding 'Orthopneic Positioning' in clinical nursing, A nurse is bathing an elderly client
who has dry, fragile skin. Which of the following actions should the nurse take? (Clinical
Parameter: Orthopneic Positioning).
(A) Apply a moisturizing lotion to the skin immediately after patting it dry
(B) Avoid bathing the client more than once a month
(C) Rub the skin vigorously with a coarse towel to stimulate blood flow
(D) Wash the skin with hot water and antibacterial soap daily
Correct Answer: A
Rationale: This question evaluates Orthopneic Positioning. Elderly skin has decreased sebum
production and elasticity. The nurse should use warm (not hot) water, mild pH-balanced soaps, pat the
skin dry gently, and apply moisturizing emollients immediately to lock in moisture and prevent
cracking. Vigorous rubbing or hot water causes epidermal tearing and severe dryness.
Question 9: [Male Perineal Hygiene]
Regarding 'Male Perineal Hygiene' in clinical nursing, A client with an indwelling urinary
catheter is preparing to ambulate. Which of the following safety actions must the nurse
perform? (Clinical Parameter: Male Perineal Hygiene).
(A) Clamp the catheter tubing tightly during ambulation to prevent leakage
(B) Instruct the client to hold the drainage bag at chest level during walking
(C) Secure the drainage bag below the level of the bladder and ensure the tubing is free of kinks
(D) Empty the drainage bag only once every 48 hours to minimize contamination
Correct Answer: C
Rationale: This question evaluates Male Perineal Hygiene. Urinary drainage bags must always
remain below the level of the bladder (even during ambulation) to prevent gravity-fed reflux of stagnant
urine back into the bladder, which causes UTIs. Tubing must remain unkinked, and catheters must
never be clamped without specific orders.
Question 10: [Footdrop Prevention]
Regarding 'Footdrop Prevention' in clinical nursing, A nurse is bathing an elderly client
who has dry, fragile skin. Which of the following actions should the nurse take? (Clinical
Parameter: Footdrop Prevention).
(A) Avoid bathing the client more than once a month
(B) Apply a moisturizing lotion to the skin immediately after patting it dry
(C) Rub the skin vigorously with a coarse towel to stimulate blood flow
(D) Wash the skin with hot water and antibacterial soap daily
Correct Answer: B
Rationale: This question evaluates Footdrop Prevention. Elderly skin has decreased sebum production
and elasticity. The nurse should use warm (not hot) water, mild pH-balanced soaps, pat the skin dry
gently, and apply moisturizing emollients immediately to lock in moisture and prevent cracking.
Vigorous rubbing or hot water causes epidermal tearing and severe dryness.
HESI Fundamentals Exit Exam Actual Exam 2026/2027
