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HESI Fundamentals Exam 2025: Everything
Nursing Students Need to Know to Succeed
Question 1: During the daily nursing assessment, a client begins to cry and states that the majority of family and friends have stopped calling and visiting. What action should the nurse take? a. Listen and show interest as the client expresses these feelings. b. Reinforce that this behavior means they were not true friends. c. Ask the healthcare provider for a psychiatric consult. d. Continue with the assessment and tell the client not to worry. Rationale: The correct answer is a. When a client expresses emotional distress, the nurse's initial response should be to provide therapeutic communication. Listening attentively and showing genuine interest allows the client to express their feelings, which can be cathartic and help build trust in the nurse-client relationship. Option b is judgmental and unhelpful. Option c might be considered later if the distress is severe or prolonged, but active listening should come first. Option d dismisses the client's feelings and hinders communication. Question 2: A client who is 5 foot 5 inches tall and weighs 200 pounds is scheduled for surgery the next day. Which question is most important for the nurse to include during the preoperative assessment? a. "What is your daily calorie consumption?" b. "What vitamin and mineral supplements do you take?" c. "Do you feel that you are overweight?" d. "Will a clear liquid diet be okay after surgery?" Rationale: The correct answer is b. A client with a body mass index (BMI) indicating obesity may be taking various vitamin and mineral supplements. It is crucial for the nurse to know about these preoperatively because some supplements can interact with anesthesia or surgical procedures (e.g., vitamin E can increase bleeding risk). Daily calorie consumption (a) is less directly relevant to immediate surgical risks. The client's perception of their weight (c) is subjective. A clear liquid diet postoperatively (d) is a standard question but less critical than
identifying potential interactions from supplements. Question 3: A male client with obesity discusses with the nurse his plans to begin a long-term weight loss regimen. In addition to dietary changes, he plans to begin an intensive aerobic exercise program 3 to 4 times a week and to take stress management classes. After praising the client for his decision, which instruction is most important for the nurse to provide? a. "Be sure to have a complete physical examination before beginning your planned exercise program." b. "Be careful that the exercise program doesn't simply add to your stress level, making you want to eat more." c. "Increased exercise helps to reduce stress, so you may not need to spend money on a stress management class." d. "Make sure to monitor your weight loss regularly to provide a sense of accomplishment and motivation." Rationale: The correct answer is a. Before starting an intensive exercise program, especially for an individual with obesity, a complete physical examination is essential to identify any underlying cardiovascular or musculoskeletal conditions that could be aggravated by exercise. While the other options offer valid points, ensuring the client's safety through medical clearance is the most important initial instruction. Question 4: The nurse is teaching a client with numerous allergies how to avoid allergens. Which instruction should be included in this teaching plan? A. Avoid any types of sprays, powders, and perfumes. B. Wearing a mask while cleaning will not help to avoid allergens. C. Purchase any type of clothing, but be sure it is washed before wearing it. D. Pollen count is related to hay fever, not to allergens. Rationale: The correct answer is A. Sprays, powders, and perfumes often contain volatile organic compounds and fragrances that can act as irritants or allergens, exacerbating allergic reactions in sensitive individuals. While masks can help with some airborne allergens (B is incorrect), washing new clothing (C) is good practice to remove potential irritants from manufacturing, and pollen is indeed a common allergen related to hay fever (D is incorrect), avoiding common chemical irritants like sprays, powders, and perfumes is a broad and important instruction for someone with numerous allergies.
A client with acute hemorrhagic anemia is to receive four units of packed RBCs (red blood cells) as rapidly as possible. Which intervention is most important for the nurse to implement? A. Obtain the pre-transfusion hemoglobin level. B. Prime the tubing and prepare a blood pump set-up. C. Monitor vital signs q15 minutes for the first hour. D. Ensure the accuracy of the blood type match. Rationale: The correct answer is d. Ensuring the accuracy of the blood type match (ABO and Rh compatibility) is the most critical intervention before initiating a blood transfusion to prevent a potentially fatal hemolytic transfusion reaction. Obtaining pre-transfusion hemoglobin (a) is important for assessing the need for blood but doesn't prevent immediate transfusion reactions. Priming the tubing and setting up the pump (b) prepares for administration but doesn't guarantee compatibility. Frequent vital sign monitoring (c) is essential during the transfusion to detect reactions, but preventing a mismatch is the priority. Question 8: A client who is a Jehovah's Witness is admitted to the nursing unit. Which concern should the nurse have for planning care in terms of the client's beliefs? A. Autopsy of the body is prohibited. B. Blood transfusions are forbidden. C. Alcohol use in any form is not allowed. D. A vegetarian diet must be followed. Rationale: The correct answer is b. A central tenet of the Jehovah's Witness faith is the refusal of blood transfusions, based on their interpretation of biblical scripture. This belief has significant implications for medical treatment planning, especially in situations involving potential blood loss. While some Jehovah's Witnesses may have personal views on autopsy, alcohol, or diet, the refusal of blood transfusions is the most universally recognized and critical concern for nurses planning their care. Question 9: On admission, a client presents a signed living will that includes a Do Not Resuscitate (DNR) prescription. When the client stops breathing, the nurse performs cardiopulmonary resuscitation (CPR) and successfully revives the client. What legal issues could be brought against the nurse? A) Assault.
B) Battery. C) Malpractice. D) False imprisonment. Rationale: The correct answer is b. Performing CPR on a client with a valid DNR order constitutes battery, which is intentional physical contact without the person's consent. The living will and DNR express the client's wish to refuse resuscitation. Assault is the threat of unwanted touching. Malpractice involves negligence by a professional. False imprisonment involves unlawfully restricting a person's freedom of movement. In this case, the physical act of CPR against the client's expressed wishes is battery. Question 10: A client with chronic kidney disease (CKD) selects a scrambled egg for his breakfast. Which action should the nurse take? a. Commend the client for selecting a high biologic value protein. b. Remind the client that protein in the diet should be avoided. c. Suggest that the client also select orange juice, to promote absorption. d. Encourage the client to attend classes on dietary management of CKD. Rationale: The correct answer is a. For clients with CKD, especially those not yet on dialysis, protein intake often needs to be restricted, but high biologic value proteins (complete proteins containing all essential amino acids) are generally preferred in smaller amounts when protein is allowed. Eggs are a source of high biologic value protein. Completely avoiding protein (b) is not always indicated, especially in early stages. Orange juice (c) is a source of potassium, which may be restricted in CKD. Encouraging dietary education (d) is a good long-term goal but doesn't address the immediate dietary choice. Therefore, acknowledging a good protein choice within the context of CKD dietary management is appropriate. A hospitalized male client is receiving nasogastric tube feedings via a small-bore tube and a continuous pump infusion. He reports that he had a bad bout of severe coughing a few minutes ago, but feels fine now. What action is best for the nurse to take? A. Record the coughing incident. No further action is required at this time. B. Stop the feeding, explain to the family why it is being stopped, and notify the healthcare provider. C. After clearing the tube with 30 ml of air, check the pH of fluid withdrawn from the tube.
b. Blood specimens not collected because client no longer wants blood tests performed. c. Healthcare provider notified of client's refusal to have blood specimens collected for testing. d. Client irritable, uncooperative, and refuses to have blood collected. Healthcare provider notified. - - correct ans- - c The nurse plans to obtain health assessment information from a primary source. Which option is a primary source for the completion of the health assessment? a. client b. healthcare provider c. a family member d. previous medical records - - correct ans- - a During a visit to the outpatient clinic, the nurse assesses a client with severe osteoarthritis using a goniometer. Which finding should the nurse expect to measure? A. Adequate venous blood flow to the lower extremities. B. Estimated amount of body fat by an underarm skinfold. C. Degree of flexion and extension of the client's knee joint. D. Change in the circumference of the joint in centimeters. - - correct ans- - c A female client asks the nurse to find someone who can translate her treatment concerns into her native language. Which action should the nurse take? a. Explain that anyone who speaks her language can answer her questions. b. Provide a translator only in an emergency situation. c. Ask a family member or friend of the client to translate. d. Request and document the name of the certified translator. - - correct ans- - d
At the beginning of the shift, the nurse assesses a client who is admitted from the post-anesthesia care unit (PACU). When should the nurse document the client's findings? a. At the beginning, middle, and end of the shift. b. After client priorities are identified for the development of the nursing care plan. c. At the end of the shift so full attention can be given to the client's needs. d. Immediately after the assessments are completed - - correct ans- - d An older client who is unresponsive following a cerebral vascular accident (CVA) is receiving bolus enteral feedings through a gastrostomy tube (GT). What is the best position for the client for administration of the bolus tube feedings? a. prone b. fowler's c. sim's d. supine - - correct ans- - b Which assessment data provides the most accurate determination of proper placement of a nasogastric tube? a. aspirating gastric contents to assure a pH value of 4 or less. b. hearing air pass in the stomach after injecting air into the tubing c. examining a chest x-ray obtained after the tubing was inserted. d. checking the remaining length of tubing to ensure that the correct length was inserted. - - correct ans-
- c _______ A client with pericardial effusion has phrenic nerve compression resulting in recurrent hiccups. The healthcare provider prescribes metoclopramide (Reglan) liquid 10 mg PO q 6 hours. Reglan is available as 5 mg/ml. A measuring device marked in teaspoons is being used. How many teaspoons should the nurse administer? - - correct ans- - 2
The nurse notices that the Hispanic parents of a toddler who returns from surgery offer the child only the broth that comes on the clear liquid tray. Other liquids, including gelatin, popsicles, and juices, remain untouched. What explanation is most appropriate for this behavior? A. The belief is held that the "evil eye" enters the child if anything cold is ingested. B. After surgery the child probably has refused all foods except broth. C. Eating broth strengthens the child's innate energy called "chi." D. Hot remedies restore balance after surgery, which is considered a "cold" condition. - - correct ans- - d An older client had a hemiarthroplasty of the left hip yesterday due to a fracture resulting from a fall. In reviewing hip precautions with the client, which instruction should the nurse include in this client's teaching plan? a. in 8 weeks you will be able to bend at the waist to reach items on the floor b. place a pillow between your knees while lying in bed to prevent hip dislocation c. it is safe to use a walker to get out of bed, but you need assistance when walking d. take pain medication 30 minutes after your physical therapy sessions - - correct ans- - b An African-American grandmother tells the nurse that her 4-year-old grandson is suffering with "miseries." Based on this statement, which focused assessment should the nurse conduct? A. Inquire about the source and type of pain. B. Examine the nose for congestion and discharge. C. Take vital signs for temperature elevation. D. Explore the abdominal area for distension. - - correct ans- - a The nurse is administering medications through a nasogastric tube (NGT) which is connected to suction. After ensuring correct tube placement, which action should the nurse take next? a. clamp the tube for 20 minutes
b. flush the tube with water c. administer the medications as prescribed d. crush the tablets and dissolve in sterile water - - correct ans- - b Which nutritional assessment data should the nurse collect to best reflect total muscle mass in an adolescent? a. height in inches or centimeters b. weight in kilograms or pounds c. triceps skin fold thickness d. upper arm circumference - - correct ans- - d Three days following surgery, a male client observes his colostomy for the first time. He becomes quite upset and tells the nurse that it is much bigger than he expected. What is the best response by the nurse? A. Reassure the client that he will become accustomed to the stoma appearance in time. B. Instruct the client that the stoma will become smaller when the initial swelling diminishes. C. Offer to contact a member of the local ostomy support group to help him with his concerns. D. Encourage the client to handle the stoma equipment to gain confidence with the procedure. - correct ans- - b When evaluating a client's plan of care, the nurse determines that a desired outcome was not achieved. Which action will the nurse implement first? A. Establish a new nursing diagnosis. B. Note which actions were not implemented. C. Add additional nursing orders to the plan. D. Collaborate with the healthcare provider to make changes. - - correct ans- - b
c. reposition in a Sims' position with the client's weight on the anterior ilium d. raise the side rails on both sides of the bed and elevate the bed to waist level - - correct ans- - c _____ A client with type 2 diabetes is receiving metformin (Glucophage) 1 gram PO twice daily. The medication is available in 500 mg tablets. How many tablets should the nurse administer? - - correct ans-
- 2 The nurse assigns an unlicensed assistive personnel (UAP) to obtain vital signs from a very anxious client. What instruction should the nurse give the UAP? a. remain calm with the client and record abnormal results in the chart b. notify the medication nurse immediately if the pulse or blood pressure is low c. report the results of the vital signs to the nurse d. reassure the client that the vital signs are normal - - correct ans- - c _____ A client's daily PO prescription for aripiprazole (Abilify is increased from 15 mg to 30 mg. The medication is available in 15 mg tablets, and the client already received one tablet today. How many additional tablets should the nurse administer so the client receives the total newly prescribed dose for the day? - - correct ans- - 1 Secobarbital (Seconal) 150 mg is prescribed at bedtime for a male client who is scheduled for surgery in the morning. The scored tablets are labeled 0.1 gram/tablet. How many tablets should the nurse administer? - - correct ans- - 1. A young mother of three children complains of increased anxiety during her annual physical exam. What information should the nurse obtain first? a. sexual activity patterns b. nutritional history c. leisure activities
d. financial stressors - - correct ans- - b The nurse is teaching a client proper use of an inhaler. When should the client administer the inhalerdelivered medication to demonstrate correct use of the inhaler? a. immediately after exhalation b. during the inhalation c. at the end of three inhalations d. immediately after inhalation - - correct ans- - b The unlicensed assistive personnel (UAP) working on a chronic neuro unit asks the nurse to help determine the safest way to transfer an older client with left-sided weakness from the bed to the chair. Which method describes the correct transfer procedure for this client? a. place the chair at a right angle to the bed on the client's left side before moving b. assist the client to a standing position, then place the right hand on the armrest c. have the client place the left foot next to the chair and pivot to the left before sitting d. move the chair parallel to the right side of the bed, and stand the client on the right foot - - correct ans- - d Docusate sodium (Colace) 0.3 grams is prescribed for a client who has frequent constipation. Each capsule contains 100 mg. How many capsules should the nurse administer? - - correct ans- - 3 During the initial morning assessment, a male client denies dysuria but reports that his urine appears dark amber. Which intervention should the nurse implement? a. provide additional coffee on the client's breakfast tray b. exchange the client's grape juice for cranberry juice c. bring the client additional fruit at mid-morning d. encourage additional oral intake of juices and water - - correct ans- - d
c. reinforce the need to grip directly under the joint for better support d. instruct the spouse to grip directly over the joint for better motion - - correct ans- - a The nurse is using a venogram while conducting a client's health assessment and past medical history. What information should the venogram provide? a. inherited familial health disorders b. chronic health problems c. reason for seeking health care d. undetected disorders - - correct ans- - a The nurse is assessing the nutritional status of several clients. Which client has the greatest nutritional need for additional intake of protein? A. A college-age track runner with a sprained ankle. B. A lactating woman nursing her 3-day-old infant. C. A school-aged child with Type 2 diabetes. D. An elderly man being treated for a peptic ulcer. - - correct ans- - b A client with multiple sclerosis is prescribed Dantrolene (Dantrium) 0.1 grams PO bid for spasticity. Dantrolene is available in 100 mg capsules. How many capsules should the nurse administer? - - correct ans- - 1 The nurse is assisting an 82-year-old client to ambulate. Which is the center of gravity for an elderly person? a. arms b. upper torso c. head d. feet - - correct ans- - b
The nurse is developing a plan of care for a client with dementia. Which feature of confusion in the elderly is accurate? a. bewilderment is to be expected, and progresses with age b. disorientation often follows relocation to new surroundings c. uncertainty is a result of irreversible brain pathology d. being perplexed can be prevented with adequate sleep - - correct ans- - b After completing an assessment and determining that a client has a problem, which action should the nurse perform next? a. determine the etiology of the problem b. prioritize nursing care interventions c. plan appropriate interventions d. collaborate with the client to set goals - - correct ans- - a Which snack food is best for the nurse to provide a client with myasthenia gravis who is at risk for altered nutritional status? a. chocolate pudding b. graham crackers c. sugar free gelatin d. apple slices - - correct ans- - a The nurse is instruction a client with high cholesterol about diet and lifestyle modification. What comment from the client indicates that the teaching has been effective? a. "If I exercise at least two times weekly for one hours, I will lower my cholesterol." b. "I need to avoid eating proteins, including red meat." c. "I will limit my intake of beef to 4 ounces per week."
The nurse is completing a mental assessment for a client who is demonstrating slow thought processes, personality changes, and emotional lability. Which area of the brain controls these neuro-cognitive functions? a. thalamus b. hypothalamus c. frontal lobe d. parietal lobe - - correct ans- - c An older client who is resident in a long term care facility has been bedridden for a week. Which finding should the nurse identify as a client risk factor for pressure ulcers? a. generalized dry skin b. localized dry skin on lower extremities c. red flush over entire skin surface d. rashes in the axillary, groin, and skin fold regions - - correct ans- - d During shift change report, the nurse receives report that a client has abnormal heart sounds. Which placement of the stethoscope should the nurse use to hear the client's heart sounds? a. place the stethoscope bell at random points on the posterior chest b. use the stethoscope bell over the valvular areas of the anterior chest c. move the diaphragm of the stethoscope over the left anterior chest d. position the diaphragm of the stethoscope at Erb's point on the chest - - correct ans- - b The nurse is performing nasotracheal suctioning. After suctioning the client's trachea for fifteen seconds, large amounts of thick yellow secretions return. What action should the nurse implement next? A. Encourage the client to cough to help loosen secretions. B. Advise the client to increase the intake of oral fluids. C. Rotate the suction catheter to obtain any remaining secretions.
D. Re-oxygenate the client before attempting to suction again. - - correct ans- - d Twenty minutes after beginning a heat application, the client states that the heating pad no longer feels warm enough. What is the best response by the nurse? a. "That means you have derived the maximum benefit, and the heat can be removed." b. "Your blood vessels are becoming dilated and removing the heat from the site." c. "We will increase the temperature 5 degrees when the pad no longer feels warm." d. "The body's receptors adapt over time as they are exposed to heat." - - correct ans- - d The nurse notices that the mother of a 9-year-old Vietnamese child always looks at the floor when she talks to the nurse. What action should the nurse take? a. talk directly to the child instead of the mother b. continue asking the mother questions about the child c. ask another nurse to interview the mother now d. tell the mother politely to look at you when answering - - correct ans- - b An older client who requires frequent monitoring fell and fractured a hip. Which nurse is at greatest risk for a malpractice judgment? a. the nurse who worked the 7 to 3 shift at the hospital and wrote poor nursing notes b. the nurse assigned to care for the client who was at lunch at the time of the fall c. the nurse who transferred the client to the chair when the fall occurred d. the charge nurse who completed rounds 30 minutes before the fall occurred - - correct ans- - c A client is receiving alprazolam (Xanax) 0.75 mg PO bid for anxiety. Alprazolam is available in 0.5 mg scored tablets. How many tablets should the nurse administer? - - correct ans- - 1.
