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HESI COMPREHENSIVE REVIEW FOR THE NCLEX-
RN EXAMINATION**200+ PRACTICE QUESTIONS
WITH VERIFIED ANSWERS & DETAILED
RATIONALES**SAFE & EFFECTIVE CARE
ENVIRONMENT • HEALTH PROMOTION •
PSYCHOSOCIAL INTEGRITY • PHYSIOLOGICAL
INTEGRITY**HIGH-YIELD CONTENT • FIRST-TIME
PASS**
TABLE OF CONTENTS
| Section | Topic | Questions |
| 1 | Safe & Effective Care Environment (Management of Care, Safety,
Infection Control) | 1–30 |
| 2 | Health Promotion & Maintenance | 31–55 |
| 3 | Psychosocial Integrity | 56–75 |
| 4 | Physiological Integrity – Basic Care & Comfort | 76–90 |
| 5 | Physiological Integrity – Pharmacological & Parenteral Therapies |
91–115 |
| 6 | Physiological Integrity – Reduction of Risk Potential | 116–140 |
| 7 | Physiological Integrity – Physiological Adaptation | 141–170 |
| 8 | Leadership & Delegation / Prioritization | 171–190 |
| 9 | Maternity & Newborn Nursing | 191–205 |
| 10 | Pediatric Nursing | 206–220 |
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# SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT
(Management of Care, Safety, Infection Control) – Questions 1–30
**1. A nurse is caring for a client with a new diagnosis of tuberculosis
(TB). Which type of isolation precaution should the nurse implement?**
A) Contact precautions
B) Droplet precautions
C) Airborne precautions (negative pressure room, N95 respirator)
D) Standard precautions only
**Answer: C**
*Rationale:* TB is transmitted via airborne droplet nuclei. Airborne
precautions require a negative-pressure isolation room and an N95
respirator (or higher) for health care workers. The client should wear a
surgical mask when outside the room.
**2. Which task can the nurse delegate to an unlicensed assistive
personnel (UAP)?**
A) Assessing a client's lung sounds
B) Teaching a client about insulin self-administration
C) Ambulating a client who has a fractured tibia with a walker
D) Administering a tube feeding via nasogastric tube
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**Answer: C**
*Rationale:* UAPs can perform ambulation tasks for stable clients with
musculoskeletal injuries. Assessment (A), teaching (B), and tube feeding
administration (D – in most states) require licensed nursing judgment.
**3. A nurse receives a telephone order from a health care provider for a
medication the nurse has never administered. What is the most
appropriate action?**
A) Administer the medication as ordered
B) Ask the provider to clarify the order verbally and repeat it back, then
write it down and have the provider sign within 24 hours
C) Refuse to take the order
D) Ask another nurse to take the order
**Answer: B**
*Rationale:* Telephone orders should be read back to the provider
("read back") to ensure accuracy. The order must be signed by the
provider within 24 hours per facility policy.
**4. A client is placed in wrist restraints after trying to pull out an IV
line. The nurse checks the restraints and finds them to be snug with good
capillary refill. How often must the nurse remove the restraints for range
of motion and skin assessment?**
A) Every 30 minutes
B) Every 1 hour
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C) Every 2 hours (or per facility policy, typically q2h for ROM and skin
check)
D) Every 4 hours
**Answer: C**
*Rationale:* Restraints require release every 2 hours (or more frequently
per policy) for range of motion, repositioning, toileting, and skin
assessment. Never leave restraints on for extended periods without
assessment.
**5. A nurse is preparing to administer a blood transfusion. Which IV
solution is compatible with packed red blood cells?**
A) 5% dextrose in water (D5W)
B) Lactated Ringer's (LR)
C) 0.9% normal saline (NS)
D) 0.45% normal saline (half NS)
**Answer: C**
*Rationale:* Only 0.9% normal saline (NS) should be used with PRBCs.
Dextrose solutions can cause hemolysis; Lactated Ringer's may cause
clotting or hemolysis.
**6. Which client should the nurse assess first?**
HESI COMPREHENSIVE REVIEW FOR THE NCLEX-
RN EXAMINATION**200+ PRACTICE QUESTIONS
WITH VERIFIED ANSWERS & DETAILED
RATIONALES**SAFE & EFFECTIVE CARE
ENVIRONMENT • HEALTH PROMOTION •
PSYCHOSOCIAL INTEGRITY • PHYSIOLOGICAL
INTEGRITY**HIGH-YIELD CONTENT • FIRST-TIME
PASS**
TABLE OF CONTENTS
| Section | Topic | Questions |
| 1 | Safe & Effective Care Environment (Management of Care, Safety,
Infection Control) | 1–30 |
| 2 | Health Promotion & Maintenance | 31–55 |
| 3 | Psychosocial Integrity | 56–75 |
| 4 | Physiological Integrity – Basic Care & Comfort | 76–90 |
| 5 | Physiological Integrity – Pharmacological & Parenteral Therapies |
91–115 |
| 6 | Physiological Integrity – Reduction of Risk Potential | 116–140 |
| 7 | Physiological Integrity – Physiological Adaptation | 141–170 |
| 8 | Leadership & Delegation / Prioritization | 171–190 |
| 9 | Maternity & Newborn Nursing | 191–205 |
| 10 | Pediatric Nursing | 206–220 |
,2|Page
# SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT
(Management of Care, Safety, Infection Control) – Questions 1–30
**1. A nurse is caring for a client with a new diagnosis of tuberculosis
(TB). Which type of isolation precaution should the nurse implement?**
A) Contact precautions
B) Droplet precautions
C) Airborne precautions (negative pressure room, N95 respirator)
D) Standard precautions only
**Answer: C**
*Rationale:* TB is transmitted via airborne droplet nuclei. Airborne
precautions require a negative-pressure isolation room and an N95
respirator (or higher) for health care workers. The client should wear a
surgical mask when outside the room.
**2. Which task can the nurse delegate to an unlicensed assistive
personnel (UAP)?**
A) Assessing a client's lung sounds
B) Teaching a client about insulin self-administration
C) Ambulating a client who has a fractured tibia with a walker
D) Administering a tube feeding via nasogastric tube
,3|Page
**Answer: C**
*Rationale:* UAPs can perform ambulation tasks for stable clients with
musculoskeletal injuries. Assessment (A), teaching (B), and tube feeding
administration (D – in most states) require licensed nursing judgment.
**3. A nurse receives a telephone order from a health care provider for a
medication the nurse has never administered. What is the most
appropriate action?**
A) Administer the medication as ordered
B) Ask the provider to clarify the order verbally and repeat it back, then
write it down and have the provider sign within 24 hours
C) Refuse to take the order
D) Ask another nurse to take the order
**Answer: B**
*Rationale:* Telephone orders should be read back to the provider
("read back") to ensure accuracy. The order must be signed by the
provider within 24 hours per facility policy.
**4. A client is placed in wrist restraints after trying to pull out an IV
line. The nurse checks the restraints and finds them to be snug with good
capillary refill. How often must the nurse remove the restraints for range
of motion and skin assessment?**
A) Every 30 minutes
B) Every 1 hour
, 4|Page
C) Every 2 hours (or per facility policy, typically q2h for ROM and skin
check)
D) Every 4 hours
**Answer: C**
*Rationale:* Restraints require release every 2 hours (or more frequently
per policy) for range of motion, repositioning, toileting, and skin
assessment. Never leave restraints on for extended periods without
assessment.
**5. A nurse is preparing to administer a blood transfusion. Which IV
solution is compatible with packed red blood cells?**
A) 5% dextrose in water (D5W)
B) Lactated Ringer's (LR)
C) 0.9% normal saline (NS)
D) 0.45% normal saline (half NS)
**Answer: C**
*Rationale:* Only 0.9% normal saline (NS) should be used with PRBCs.
Dextrose solutions can cause hemolysis; Lactated Ringer's may cause
clotting or hemolysis.
**6. Which client should the nurse assess first?**
