HESI RN FUNDAMENTALS EXIT EXAM LATEST 2025-
2026 ACTUAL EXAM 100 QUESTIONS AND CORRECT
ANSWERS WITH RATIOANLES (VERIFIED ANSWERS)
The nurse is called to the waiting room of a pediatric clinic. The
frantic mother states, "I think my 4-month-old baby is choking!" What
steps will the nurse take? (Select all that apply.)
Note any obstruction or absence of breathing.
Deliver five backslaps between the shoulder blades.
Place the infant over the nurse's arm.
Which fluid will the nurse select to administer with the prescribed
blood transfusion?
Normal saline
When assisting a client from the bed to a chair, which procedure is
best for the nurse to follow?
With the nurse's feet spread apart and knees aligned with the client's
knees, stand and pivot the client into the chair.
How many mL will the nurse document on the client's intake and
output record from the items listed? _____ mL
1200 mL water
4 ounce container of gelatin
8 ounces of orange juice
355 mL can of soda1 cup of soup
Answer: 2155
Rationale: 1200 + 240 (8 oz) + 240 (1 cup) + 120 (4 oz) + 355 = 2155
The nurse observes a UAP taking a client's blood pressure in the
lower extremity. Which observation of this procedure requires the
nurse to intervene with the UAP's approach?
The UAP auscultates the popliteal pulse with the cuff on the lower leg.
During a clinic visit, the mother of a 7-year-old reports to the nurse
that her child is often awake until midnight playing and is then very
,difficult to awaken in the morning for school. Which assessment data
should the nurse obtain in response to the mother's concern?
Description of the family's home environment
The nurse identifies a potential for infection in a client with partial-
thickness (second-degree) and full-thickness (third-degree) burns.
What action has the highest priority in decreasing the client's risk of
infection?
Use of careful handwashing technique
The nurse assesses a 2-year-old who is admitted for dehydration and
finds that the peripheral IV rate by gravity has slowed, even though
the venous access site is healthy. What should the nurse do next?
Check for kinks in the tubing and raise the IV pole.
The nurse manager of a skilled nursing (chronic care) unit is
instructing UAPs on ways to prevent complications of immobility.
Which action should be included in this instruction?
Perform range-of-motion exercises to prevent contractures.
The nurse administered 10 mg of diazepam to the preoperative client.
What steps will the nurse take next? (Select all that apply.)
Instruct the client not to get out of bed.
Place the call bell within the client's reach.
Place the side rails up, according to institutional policy.
A terminally ill client tells the nurse, "I am so tired and in so much
pain! Please help me to die." Which is the best response for the nurse
to provide?
Talk with the client about thoughts and feelings about death.
A nurse stops at a motor vehicle collision site to render aid until the
emergency personnel arrive and applies pressure to a groin wound
that is bleeding profusely. Later the client has to have the leg
amputated and sues the nurse for malpractice. Which statement
reflects the likely outcome for the nurse?
There will be no judgment against the nurse, whose actions are protected
under the Good Samaritan Act.
An older client who had abdominal surgery 3 days earlier was given a
barbiturate for sleep and is now requesting to go to the bathroom.
What is the priority nursing action for this client?
Assist the client to walk to the bathroom and do not leave the client alone.
The nurse is planning care for a client with an indwelling urinary
catheter. Which nursing action has the highest priority?
, Assist the client with daily cleansing
When bathing an uncircumcised boy older than 3 years, which action
should the nurse take?
Retract the foreskin gently to cleanse the penis.
A nurse is assigned to care for a close friend in the hospital setting.
Which action should the nurse take first when given the assignment?
Explain the relationship to the charge nurse and ask for reassignment.
The nurse selects the best site for insertion of an IV catheter in the
client's right arm. Which documentation should the nurse use to
identify placement of the IV access?
Right cephalic vein
The nurse transcribes the postoperative prescriptions for a client who
returns to the unit following surgery and notes that an
antihypertensive medication that was prescribed preoperatively is not
listed. Which action should the nurse take?
Contact the health care provider to renew the prescription for the
medication.
When emptying 350 mL of pale yellow urine from a client's urinal, the
nurse notes that this is the first time the client has voided in 4 hours.
Which action should the nurse take next?
Record the amount on the client's fluid output record.
The client states to the nurse, "This medication makes my mouth so
dry." What are the nurse's suggestions to quench the client's thirst?
(Select all that apply.)
Infuse your water with fresh citrus fruits to quench your thirst.
Freeze strawberries and water together in popsicle mold.
Keep a few pieces of hard candy with you to suck on.
The nurse notes in the client's plan of care altered sleep patterns
related to nocturia. Which nursing actions are important for the nurse
to provide? (Select all that apply.)
Decrease intake of fluids after the evening meal.
Assess the client's usual sleep pattern.
The nurse is counting a client's respiratory rate. During a 30-second
interval, the nurse counts six respirations and the client coughs three
times. In repeating the count for a second 30-second interval, the
nurse counts eight respirations. Which respiratory rate will the nurse
document?
2026 ACTUAL EXAM 100 QUESTIONS AND CORRECT
ANSWERS WITH RATIOANLES (VERIFIED ANSWERS)
The nurse is called to the waiting room of a pediatric clinic. The
frantic mother states, "I think my 4-month-old baby is choking!" What
steps will the nurse take? (Select all that apply.)
Note any obstruction or absence of breathing.
Deliver five backslaps between the shoulder blades.
Place the infant over the nurse's arm.
Which fluid will the nurse select to administer with the prescribed
blood transfusion?
Normal saline
When assisting a client from the bed to a chair, which procedure is
best for the nurse to follow?
With the nurse's feet spread apart and knees aligned with the client's
knees, stand and pivot the client into the chair.
How many mL will the nurse document on the client's intake and
output record from the items listed? _____ mL
1200 mL water
4 ounce container of gelatin
8 ounces of orange juice
355 mL can of soda1 cup of soup
Answer: 2155
Rationale: 1200 + 240 (8 oz) + 240 (1 cup) + 120 (4 oz) + 355 = 2155
The nurse observes a UAP taking a client's blood pressure in the
lower extremity. Which observation of this procedure requires the
nurse to intervene with the UAP's approach?
The UAP auscultates the popliteal pulse with the cuff on the lower leg.
During a clinic visit, the mother of a 7-year-old reports to the nurse
that her child is often awake until midnight playing and is then very
,difficult to awaken in the morning for school. Which assessment data
should the nurse obtain in response to the mother's concern?
Description of the family's home environment
The nurse identifies a potential for infection in a client with partial-
thickness (second-degree) and full-thickness (third-degree) burns.
What action has the highest priority in decreasing the client's risk of
infection?
Use of careful handwashing technique
The nurse assesses a 2-year-old who is admitted for dehydration and
finds that the peripheral IV rate by gravity has slowed, even though
the venous access site is healthy. What should the nurse do next?
Check for kinks in the tubing and raise the IV pole.
The nurse manager of a skilled nursing (chronic care) unit is
instructing UAPs on ways to prevent complications of immobility.
Which action should be included in this instruction?
Perform range-of-motion exercises to prevent contractures.
The nurse administered 10 mg of diazepam to the preoperative client.
What steps will the nurse take next? (Select all that apply.)
Instruct the client not to get out of bed.
Place the call bell within the client's reach.
Place the side rails up, according to institutional policy.
A terminally ill client tells the nurse, "I am so tired and in so much
pain! Please help me to die." Which is the best response for the nurse
to provide?
Talk with the client about thoughts and feelings about death.
A nurse stops at a motor vehicle collision site to render aid until the
emergency personnel arrive and applies pressure to a groin wound
that is bleeding profusely. Later the client has to have the leg
amputated and sues the nurse for malpractice. Which statement
reflects the likely outcome for the nurse?
There will be no judgment against the nurse, whose actions are protected
under the Good Samaritan Act.
An older client who had abdominal surgery 3 days earlier was given a
barbiturate for sleep and is now requesting to go to the bathroom.
What is the priority nursing action for this client?
Assist the client to walk to the bathroom and do not leave the client alone.
The nurse is planning care for a client with an indwelling urinary
catheter. Which nursing action has the highest priority?
, Assist the client with daily cleansing
When bathing an uncircumcised boy older than 3 years, which action
should the nurse take?
Retract the foreskin gently to cleanse the penis.
A nurse is assigned to care for a close friend in the hospital setting.
Which action should the nurse take first when given the assignment?
Explain the relationship to the charge nurse and ask for reassignment.
The nurse selects the best site for insertion of an IV catheter in the
client's right arm. Which documentation should the nurse use to
identify placement of the IV access?
Right cephalic vein
The nurse transcribes the postoperative prescriptions for a client who
returns to the unit following surgery and notes that an
antihypertensive medication that was prescribed preoperatively is not
listed. Which action should the nurse take?
Contact the health care provider to renew the prescription for the
medication.
When emptying 350 mL of pale yellow urine from a client's urinal, the
nurse notes that this is the first time the client has voided in 4 hours.
Which action should the nurse take next?
Record the amount on the client's fluid output record.
The client states to the nurse, "This medication makes my mouth so
dry." What are the nurse's suggestions to quench the client's thirst?
(Select all that apply.)
Infuse your water with fresh citrus fruits to quench your thirst.
Freeze strawberries and water together in popsicle mold.
Keep a few pieces of hard candy with you to suck on.
The nurse notes in the client's plan of care altered sleep patterns
related to nocturia. Which nursing actions are important for the nurse
to provide? (Select all that apply.)
Decrease intake of fluids after the evening meal.
Assess the client's usual sleep pattern.
The nurse is counting a client's respiratory rate. During a 30-second
interval, the nurse counts six respirations and the client coughs three
times. In repeating the count for a second 30-second interval, the
nurse counts eight respirations. Which respiratory rate will the nurse
document?
