266 HESI Practice Questions: (Latest 2026/2027 Update) NCLEX-RN
Review | Q&A | Grade A | 100% Correct (Verified Answers) – Nursing
Program
Subject: HESI Comprehensive Review / NCLEX-RN Preparation
Source: Medical-Surgical Nursing, Pharmacology, Emergency Care, and Pathophysiology
Format: Q&A Guide with Rationale | All Questions Exhausted
Total questions: 110+ (every question from raw data)
1: The nurse is evaluating a client's understanding about the DASH (Dietary Approaches to
Stop Hypertension) eating plan. Which behavior indicates that the client is adhering to the
eating plan?
Correct Answer: D. Enjoys fat-free yogurt as an occasional snack food.
1. DASH diet emphasizes low-fat dairy products, fruits, vegetables, and whole grains while limiting saturated fat,
cholesterol, and sodium.
2. Fat-free yogurt is an excellent low-fat dairy choice that supports blood pressure reduction.
3. Eliminating grains (option C) is incorrect; lactose-free dairy (option A) is not required; cleaning produce (option B) is
general food safety, not DASH-specific.
2: A client who has a history of hypothyroidism was initially admitted with lethargy and
confusion. Which additional finding warrants the most immediate action by the nurse?
[Hematocrit reference: Male 42%-52%]
Correct Answer: A. Further decline in level of consciousness.
1. Declining LOC in hypothyroidism may indicate myxedema coma, a life-threatening emergency requiring immediate
intervention.
2. Myxedema coma presents with hypothermia, bradycardia, hypotension, and progressive cognitive decline.
3. Hematocrit of 30% (anemia) and other symptoms require treatment but are not immediately life-threatening
compared to worsening LOC.
3: The nurse is caring for a client with a burn that is severely edematous with a wound bed
that is brown and yellow in appearance. The client expresses feeling no pain. Which
classification of burn depth should the nurse document?
Correct Answer: B. Full thickness (third-degree).
1. Full-thickness burns involve destruction of epidermis and dermis, including nerve endings → painless appearance.
2. Appearance: brown, charred, white, or yellow; leathery; edema present; no blanching.
3. Deep partial-thickness burns are painful; superficial partial-thickness involve blisters and pain.
4: An older client who is agitated, dyspneic, orthopneic, and using accessory muscles to
breathe is admitted. An hour after furosemide 60 mg IV, which assessments should the
nurse obtain to determine response to treatment? (Select all that apply.)
Correct Answer: A. Urinary output, B. Oxygen saturation, D. Lung sounds.
1. Furosemide is a loop diuretic used to reduce pulmonary edema in heart failure.
2. Urinary output confirms diuretic effectiveness; oxygen saturation and lung sounds (crackles) assess respiratory
improvement.
3. Pain scale (C) and skin elasticity (E) are not primary indicators of response to furosemide.
,5: A client is diagnosed with chronic kidney disease and needs to begin dialysis. Which
condition entered on the client's medical record should the nurse recognize as a
contraindication for peritoneal dialysis?
Correct Answer: B. Crohn's disease with colectomy.
1. Extensive abdominal surgery (colectomy) reduces peritoneal membrane surface area and causes adhesions, making
effective peritoneal dialysis impossible.
2. Peritoneal dialysis requires intact peritoneal membrane for waste exchange.
3. Other options are not absolute contraindications; hepatitis C may require precautions but does not preclude PD.
6: The nurse assesses a client with cirrhosis and finds 4+ pitting edema and massive
ascites. Which mechanism contributes to edema and ascites in cirrhosis?
Correct Answer: D. Hypoalbuminemia that results in a decreased colloidal oncotic pressure.
1. The liver produces albumin; cirrhosis impairs albumin synthesis, reducing plasma oncotic pressure.
2. Low oncotic pressure allows fluid to leak into interstitial spaces (edema) and peritoneal cavity (ascites).
3. Hyperaldosteronism (B) also contributes but is secondary; decreased oncotic pressure is primary mechanism.
7: While assessing a client with degenerative joint disease, the nurse observes Heberden's
nodes that are reddened and painful. Which action should the nurse take?
Correct Answer: B. Discuss approaches to chronic pain control with the client.
1. Heberden's nodes are a sign of osteoarthritis; pain management is the priority intervention.
2. Chronic pain control includes NSAIDs, acetaminophen, heat/cold therapy, and lifestyle modifications.
3. Reddened nodes are not an emergency; dietary intake (A) and pulses (D) are not directly relevant.
8: Which information should the nurse include in the teaching plan of a client diagnosed
with GERD?
Correct Answer: B. Minimize symptoms by wearing loose, comfortable clothing.
1. Tight clothing increases intra-abdominal pressure and worsens reflux.
2. Other GERD teaching: small frequent meals (not three full meals), elevate head of bed (not sleep without pillows),
avoid late-night eating.
3. Exercise is not contraindicated; avoid bending/jumping after meals.
9: The nurse assesses a client with petechiae and ecchymosis scattered across the arms and
legs. Which laboratory result should the nurse review?
Correct Answer: D. Platelet count.
1. Petechiae and ecchymosis indicate thrombocytopenia (low platelets).
2. Normal platelet count: 150,000-400,000/uL.
3. Low platelets impair clotting, leading to spontaneous bleeding into skin.
10: The nurse is providing teaching to a client with Type 2 diabetes mellitus and peripheral
neuropathy. Which information should the nurse provide?
Correct Answer: A. Family members can help with regular foot exams.
1. Peripheral neuropathy causes loss of sensation; clients cannot feel injuries. Family assistance ensures thorough foot
exams.
2. Heating pads are dangerous (unnoticed burns), barefoot walking is unsafe, and prolonged soaking macerates skin.
3. Daily foot inspection for cuts, blisters, redness, and swelling is essential.
, 11: The nurse is providing discharge teaching to an older adult client hospitalized for
treatment of venous leg ulcers. Which instruction(s) should the nurse include? (Select all
that apply.)
Correct Answer: A. Inspect ankles daily for areas of darkening skin; C. Keep legs elevated when sitting or lying down; E. Eat
a diet high in protein and vitamins A and C.
1. Elevation promotes venous return and reduces edema; protein and vitamins support wound healing.
2. Cold compresses (B) are not indicated; bed rest (D) is discouraged — ambulation improves circulation.
3. Compression therapy is the standard treatment for venous ulcers.
12: An adult client who had gastric bypass surgery 2 weeks ago is admitted with possible
anastomosis leakage. Which intervention is most important for the nurse to include?
Correct Answer: D. Strict intravenous (IV) fluid replacement.
1. Suspected anastomotic leak with fever, tachycardia, hypotension indicates possible sepsis → hypovolemic shock.
2. IV fluids restore circulating volume and maintain blood pressure while awaiting surgical intervention.
3. Turning (A) and wound assessment (B) are important but not priority over hemodynamic stabilization.
13: A client receives a prescription for 1 liter of 0.9% sodium chloride IV to be infused over
4 hours. The IV administration set delivers 10 gtt/mL. How many gtt/min should the nurse
regulate? (Round to nearest whole number.)
Correct Answer: 42 gtt/min
1. Formula: (Volume in mL × drop factor) ÷ time in minutes = gtt/min.
2. (1000 mL × 10 gtt/mL) ÷ (4 hours × 60 min) = 10,000 ÷ 240 = 41.66 ≈ 42 gtt/min.
3. Always double-check calculations before setting infusion rate.
14: A client arrives to the ED reporting intermittent fever, night sweats for 3 weeks, and
productive cough with small amounts of blood. Which intervention should the nurse
prioritize?
Correct Answer: D. Move into airborne isolation.
1. Symptoms suggest tuberculosis (TB), which requires airborne precautions (negative-pressure room, N95 mask).
2. Recall airborne isolation mnemonics: MTV (Measles, TB, Varicella).
3. Initiate isolation before collecting specimens to prevent transmission to other patients and staff.
15: A client presents to the ED reporting chest pain radiating to left arm, shortness of
breath, and diaphoresis. Which medication should the nurse anticipate being prescribed?
Correct Answer: C. Morphine.
1. Morphine is the analgesic of choice for acute myocardial infarction (MI) — reduces pain, preload, and myocardial
oxygen demand.
2. Fentanyl (A) is also used but morphine is more traditional for MI pain.
3. Oxycodone and hydromorphone are not first-line for acute chest pain in MI.
16: The nurse is preparing a client for surgery after a motor vehicle collision with open
femur fracture. The client receives heparin 5000 units subcutaneously daily. Which is the
priority nursing action?
Correct Answer: D. Notify the healthcare provider of the client's medication history.
1. Heparin increases bleeding risk; the surgeon must be aware before operative intervention.
2. The provider may order coagulation studies or temporarily hold heparin.
3. Consent (C) can be obtained after the provider is aware of bleeding risk.
Review | Q&A | Grade A | 100% Correct (Verified Answers) – Nursing
Program
Subject: HESI Comprehensive Review / NCLEX-RN Preparation
Source: Medical-Surgical Nursing, Pharmacology, Emergency Care, and Pathophysiology
Format: Q&A Guide with Rationale | All Questions Exhausted
Total questions: 110+ (every question from raw data)
1: The nurse is evaluating a client's understanding about the DASH (Dietary Approaches to
Stop Hypertension) eating plan. Which behavior indicates that the client is adhering to the
eating plan?
Correct Answer: D. Enjoys fat-free yogurt as an occasional snack food.
1. DASH diet emphasizes low-fat dairy products, fruits, vegetables, and whole grains while limiting saturated fat,
cholesterol, and sodium.
2. Fat-free yogurt is an excellent low-fat dairy choice that supports blood pressure reduction.
3. Eliminating grains (option C) is incorrect; lactose-free dairy (option A) is not required; cleaning produce (option B) is
general food safety, not DASH-specific.
2: A client who has a history of hypothyroidism was initially admitted with lethargy and
confusion. Which additional finding warrants the most immediate action by the nurse?
[Hematocrit reference: Male 42%-52%]
Correct Answer: A. Further decline in level of consciousness.
1. Declining LOC in hypothyroidism may indicate myxedema coma, a life-threatening emergency requiring immediate
intervention.
2. Myxedema coma presents with hypothermia, bradycardia, hypotension, and progressive cognitive decline.
3. Hematocrit of 30% (anemia) and other symptoms require treatment but are not immediately life-threatening
compared to worsening LOC.
3: The nurse is caring for a client with a burn that is severely edematous with a wound bed
that is brown and yellow in appearance. The client expresses feeling no pain. Which
classification of burn depth should the nurse document?
Correct Answer: B. Full thickness (third-degree).
1. Full-thickness burns involve destruction of epidermis and dermis, including nerve endings → painless appearance.
2. Appearance: brown, charred, white, or yellow; leathery; edema present; no blanching.
3. Deep partial-thickness burns are painful; superficial partial-thickness involve blisters and pain.
4: An older client who is agitated, dyspneic, orthopneic, and using accessory muscles to
breathe is admitted. An hour after furosemide 60 mg IV, which assessments should the
nurse obtain to determine response to treatment? (Select all that apply.)
Correct Answer: A. Urinary output, B. Oxygen saturation, D. Lung sounds.
1. Furosemide is a loop diuretic used to reduce pulmonary edema in heart failure.
2. Urinary output confirms diuretic effectiveness; oxygen saturation and lung sounds (crackles) assess respiratory
improvement.
3. Pain scale (C) and skin elasticity (E) are not primary indicators of response to furosemide.
,5: A client is diagnosed with chronic kidney disease and needs to begin dialysis. Which
condition entered on the client's medical record should the nurse recognize as a
contraindication for peritoneal dialysis?
Correct Answer: B. Crohn's disease with colectomy.
1. Extensive abdominal surgery (colectomy) reduces peritoneal membrane surface area and causes adhesions, making
effective peritoneal dialysis impossible.
2. Peritoneal dialysis requires intact peritoneal membrane for waste exchange.
3. Other options are not absolute contraindications; hepatitis C may require precautions but does not preclude PD.
6: The nurse assesses a client with cirrhosis and finds 4+ pitting edema and massive
ascites. Which mechanism contributes to edema and ascites in cirrhosis?
Correct Answer: D. Hypoalbuminemia that results in a decreased colloidal oncotic pressure.
1. The liver produces albumin; cirrhosis impairs albumin synthesis, reducing plasma oncotic pressure.
2. Low oncotic pressure allows fluid to leak into interstitial spaces (edema) and peritoneal cavity (ascites).
3. Hyperaldosteronism (B) also contributes but is secondary; decreased oncotic pressure is primary mechanism.
7: While assessing a client with degenerative joint disease, the nurse observes Heberden's
nodes that are reddened and painful. Which action should the nurse take?
Correct Answer: B. Discuss approaches to chronic pain control with the client.
1. Heberden's nodes are a sign of osteoarthritis; pain management is the priority intervention.
2. Chronic pain control includes NSAIDs, acetaminophen, heat/cold therapy, and lifestyle modifications.
3. Reddened nodes are not an emergency; dietary intake (A) and pulses (D) are not directly relevant.
8: Which information should the nurse include in the teaching plan of a client diagnosed
with GERD?
Correct Answer: B. Minimize symptoms by wearing loose, comfortable clothing.
1. Tight clothing increases intra-abdominal pressure and worsens reflux.
2. Other GERD teaching: small frequent meals (not three full meals), elevate head of bed (not sleep without pillows),
avoid late-night eating.
3. Exercise is not contraindicated; avoid bending/jumping after meals.
9: The nurse assesses a client with petechiae and ecchymosis scattered across the arms and
legs. Which laboratory result should the nurse review?
Correct Answer: D. Platelet count.
1. Petechiae and ecchymosis indicate thrombocytopenia (low platelets).
2. Normal platelet count: 150,000-400,000/uL.
3. Low platelets impair clotting, leading to spontaneous bleeding into skin.
10: The nurse is providing teaching to a client with Type 2 diabetes mellitus and peripheral
neuropathy. Which information should the nurse provide?
Correct Answer: A. Family members can help with regular foot exams.
1. Peripheral neuropathy causes loss of sensation; clients cannot feel injuries. Family assistance ensures thorough foot
exams.
2. Heating pads are dangerous (unnoticed burns), barefoot walking is unsafe, and prolonged soaking macerates skin.
3. Daily foot inspection for cuts, blisters, redness, and swelling is essential.
, 11: The nurse is providing discharge teaching to an older adult client hospitalized for
treatment of venous leg ulcers. Which instruction(s) should the nurse include? (Select all
that apply.)
Correct Answer: A. Inspect ankles daily for areas of darkening skin; C. Keep legs elevated when sitting or lying down; E. Eat
a diet high in protein and vitamins A and C.
1. Elevation promotes venous return and reduces edema; protein and vitamins support wound healing.
2. Cold compresses (B) are not indicated; bed rest (D) is discouraged — ambulation improves circulation.
3. Compression therapy is the standard treatment for venous ulcers.
12: An adult client who had gastric bypass surgery 2 weeks ago is admitted with possible
anastomosis leakage. Which intervention is most important for the nurse to include?
Correct Answer: D. Strict intravenous (IV) fluid replacement.
1. Suspected anastomotic leak with fever, tachycardia, hypotension indicates possible sepsis → hypovolemic shock.
2. IV fluids restore circulating volume and maintain blood pressure while awaiting surgical intervention.
3. Turning (A) and wound assessment (B) are important but not priority over hemodynamic stabilization.
13: A client receives a prescription for 1 liter of 0.9% sodium chloride IV to be infused over
4 hours. The IV administration set delivers 10 gtt/mL. How many gtt/min should the nurse
regulate? (Round to nearest whole number.)
Correct Answer: 42 gtt/min
1. Formula: (Volume in mL × drop factor) ÷ time in minutes = gtt/min.
2. (1000 mL × 10 gtt/mL) ÷ (4 hours × 60 min) = 10,000 ÷ 240 = 41.66 ≈ 42 gtt/min.
3. Always double-check calculations before setting infusion rate.
14: A client arrives to the ED reporting intermittent fever, night sweats for 3 weeks, and
productive cough with small amounts of blood. Which intervention should the nurse
prioritize?
Correct Answer: D. Move into airborne isolation.
1. Symptoms suggest tuberculosis (TB), which requires airborne precautions (negative-pressure room, N95 mask).
2. Recall airborne isolation mnemonics: MTV (Measles, TB, Varicella).
3. Initiate isolation before collecting specimens to prevent transmission to other patients and staff.
15: A client presents to the ED reporting chest pain radiating to left arm, shortness of
breath, and diaphoresis. Which medication should the nurse anticipate being prescribed?
Correct Answer: C. Morphine.
1. Morphine is the analgesic of choice for acute myocardial infarction (MI) — reduces pain, preload, and myocardial
oxygen demand.
2. Fentanyl (A) is also used but morphine is more traditional for MI pain.
3. Oxycodone and hydromorphone are not first-line for acute chest pain in MI.
16: The nurse is preparing a client for surgery after a motor vehicle collision with open
femur fracture. The client receives heparin 5000 units subcutaneously daily. Which is the
priority nursing action?
Correct Answer: D. Notify the healthcare provider of the client's medication history.
1. Heparin increases bleeding risk; the surgeon must be aware before operative intervention.
2. The provider may order coagulation studies or temporarily hold heparin.
3. Consent (C) can be obtained after the provider is aware of bleeding risk.
