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Examiner/Administrator: Elsevier HESI Exams
CANDIDATE EXAMINATION BOOKLET
Candidate Name: ________________________________________
Candidate ID Number: ___________________________________
Date of Examination: ___________________________________
Testing Center / Location: ______________________________
Program / Institution: __________________________________
Instructor / Proctor: ___________________________________
Time Allocation: 2 Hours 30 Minutes
Approximate Total Questions: 75 Multiple-Choice Questions
Permitted Materials: Basic Calculator (if approved), Photo ID
CANDIDATE INSTRUCTIONS
This assessment is designed to evaluate the candidate’s foundational nursing
knowledge and clinical judgment in preparation for safe entry-level nursing
practice. The examination reflects the style and rigor commonly associated
with standardized nursing school exit and progression testing. Candidates will
be expected to demonstrate competency in nursing fundamentals, patient
safety, infection control, communication, documentation, ethical practice,
mobility, hygiene, medication principles, and clinical reasoning. Questions
are intentionally scenario-based and require application of nursing concepts
rather than memorization alone. Read each question carefully and select the
single best answer based on current evidence-based nursing practice.
Candidates are required to complete all questions within the allotted testing
period. Carefully review each scenario before selecting an answer. Some
, items contain priority-based decision making requiring identification of the
safest or most appropriate nursing intervention. No negative marking is
applied for incorrect responses. Ensure all answers are recorded clearly.
Candidates should manage time effectively, spending approximately two
minutes per question. This examination simulation is independently created
for educational and preparation purposes and does not reproduce or disclose
any proprietary examination material.
CORE COMPETENCY DOMAINS
• Infection Prevention and Standard Precautions
• Basic Nursing Care and Comfort
• Safety and Risk Reduction
• Vital Signs and Health Assessment
• Communication and Documentation
• Ethical and Legal Nursing Practice
• Mobility and Positioning
• Nutrition and Hydration
• Medication Administration Principles
• Elimination and Hygiene
• Delegation and Prioritization
• Clinical Judgment and Patient Education
Q1. A nurse is caring for an older adult admitted with dehydration and
confusion. The client repeatedly attempts to climb out of bed without assistance
despite fall precautions. Which nursing intervention is the most appropriate
initial action?
A. Apply bilateral wrist restraints immediately
B. Request a prescription for a sedative medication
C. Place the client in a room near the nurses’ station
D. Insert a Foley catheter to reduce ambulation
Correct Answer: C. Place the client in a room near the nurses’ station
,Explanation: Placing the client near the nurses’ station promotes frequent
observation and is the least restrictive intervention that enhances safety.
Restraints and sedatives should only be used after less restrictive measures fail
because they increase injury risk, delirium, and immobility. Foley catheter
insertion increases infection risk and is not an appropriate fall-prevention
strategy. The nurse should always implement the least restrictive safety
intervention first.
Q2. A nurse is preparing to administer oral medications to a client who reports
difficulty swallowing tablets. Which action by the nurse is best?
A. Crush all medications and mix them with applesauce
B. Consult the pharmacist regarding crushable medications
C. Administer medications with less water
D. Substitute medications without consulting the provider
Correct Answer: B. Consult the pharmacist regarding crushable
medications
Explanation: Some medications, including enteric-coated and extended-
release tablets, must never be crushed because doing so alters absorption and
may cause toxicity. Consulting the pharmacist ensures medication safety and
therapeutic effectiveness. Crushing all medications is unsafe. Giving less water
increases aspiration risk. Medication substitution requires authorization from
the provider.
, Q3. A postoperative client reports pain rated 8/10 one hour after receiving
prescribed analgesics. Which nursing action is most appropriate?
A. Tell the client the medication needs more time to work
B. Reassess the client in two hours
C. Perform a comprehensive pain reassessment
D. Inform the client that severe pain is expected after surgery
Correct Answer: C. Perform a comprehensive pain reassessment
Explanation: Persistent severe pain requires reassessment of location,
characteristics, effectiveness of previous interventions, and possible
complications. Pain management begins with assessment before additional
interventions. Delaying reassessment may worsen suffering or miss
complications. Dismissing pain as expected is nontherapeutic and
inappropriate.
Q4. A nurse enters a client’s room and discovers the client lying on the floor
beside the bed. Which action should the nurse perform first?
A. Assist the client back into bed immediately
B. Assess the client for injuries and level of consciousness
C. Notify the healthcare provider
D. Complete an incident report
Correct Answer: B. Assess the client for injuries and level of
consciousness