2026
HESI RN Fundamentals Exit Exam 2026
Complete Study Guide: Core Nursing
Concepts, Clinical Judgment, and Safety
Principles
In planning care for a 6 month-old infant, what must the nurse provide to assist in the
development of trust?
A) Food
B) Warmth
C) Security
D) Comfort
Rationale: According to Erikson’s stages of psychosocial development, infants develop trust
when their needs are met consistently and they feel safe and secure. Food and warmth contribute
to comfort but do not fully address the concept of trust. Comfort alone does not ensure consistent
caregiving.
A nurse has just received a medication order which is not legible. Which statement best reflects
assertive communication?
A) "I cannot give this medication as it is written. I have no idea of what you mean."
B) "Would you please clarify what you have written so I am sure I am reading it
correctly?"
C) "I am having difficulty reading your handwriting. It would save me time if you would be
more careful."
D) "Please print in the future so I do not have to spend extra time attempting to read your
writing."
Rationale: Assertive communication is respectful, clear, and focused on patient safety. Option B
requests clarification without blame. The other responses are aggressive or passive-aggressive
and do not promote collaboration.
What is the most important consideration when teaching parents how to reduce risks in the
home?
,2026
A) Age and knowledge level of the parents
B) Proximity to emergency services
C) Number of children in the home
D) Age of children in the home
Rationale: Safety risks vary significantly depending on a child’s developmental stage. Teaching
must be tailored to the child’s age to effectively prevent injury. Other factors are less critical to
risk prevention.
A 35 year-old client with sickle cell crisis is talking on the telephone but stops as the nurse enters
the room to request something for pain. The nurse should
A) Administer a placebo
B) Encourage increased fluid intake
C) Administer the prescribed analgesia
D) Recommend relaxation exercises for pain control
Rationale: Pain during sickle cell crisis is severe and requires prompt analgesic intervention.
Talking on the phone does not indicate absence of pain. Fluids and relaxation may help but are
not substitutes for prescribed pain medication.
While caring for a toddler with croup, which initial sign of croup requires the nurse's immediate
attention?
A) Respiratory rate of 42
B) Lethargy for the past hour
C) Apical pulse of 54
D) Coughing up copious secretions
Rationale: An elevated respiratory rate indicates respiratory distress and requires immediate
assessment. Lethargy may occur later, and copious secretions are not typical of croup. A low
apical pulse is uncommon and not the primary concern.
A client is admitted with low T3 and T4 levels and an elevated TSH level. On initial assessment,
the nurse would anticipate which finding?
A) Lethargy
B) Heat intolerance
C) Diarrhea
D) Skin eruptions
,2026
Rationale: These findings are consistent with hypothyroidism. Lethargy is a classic symptom.
Heat intolerance and diarrhea are associated with hyperthyroidism. Skin eruptions are not
typical.
The emergency room nurse admits a child who experienced a seizure at school. The father states
this is the first occurrence and denies family history. What is the best nurse response?
A) "Do not worry. Epilepsy can be treated with medications."
B) "The seizure may or may not mean your child has epilepsy."
C) "Since this was the first convulsion, it may not happen again."
D) "Long term treatment will prevent future seizures."
Rationale: This response provides accurate information without making assumptions or false
reassurance. A single seizure does not confirm epilepsy. Other responses are premature or
misleading.
Alcohol and drug abuse impairs judgment and increases risk-taking behavior. What nursing
diagnosis best applies?
A) Risk for injury
B) Risk for knowledge deficit
C) Altered thought process
D) Disturbance in self-esteem
Rationale: Impaired judgment and risk-taking behaviors directly increase the likelihood of injury.
The other diagnoses do not best capture the primary safety concern.
Which finding would the nurse most closely associate with anemia in a 10 month-old infant?
A) Hemoglobin level of 12 g/dL
B) Pale mucosa of the eyelids and lips
C) Hypoactivity
D) Heart rate between 140 and 160
Rationale: Pallor is a classic sign of anemia. A hemoglobin of 12 g/dL is normal. Hypoactivity is
nonspecific, and a heart rate of 140–160 is within normal limits for infants.
, 2026
The nurse is caring for a client in hypertensive crisis. Which assessment is the priority in the first
hour?
A) Heart rate
B) Pedal pulses
C) Lung sounds
D) Pupil responses
Rationale: Hypertensive crisis can cause acute neurologic changes. Assessing pupil response
helps identify early signs of cerebral damage. Other assessments are important but secondary.
Which terminal cancer client is least appropriate for patient-controlled analgesia (PCA)?
A) A young adult with Down syndrome
B) A teenager who reads at a 4th grade level
C) An elderly client with arthritic nodules
D) A preschooler with intermittent alertness
Rationale: PCA requires consistent alertness and understanding. A preschooler with fluctuating
consciousness cannot safely manage PCA. The other clients may use PCA with proper
instruction.
The nurse is about to assess a 6 month-old with nonorganic failure-to-thrive. The nurse would
expect the infant to be
A) Irritable and colicky with no attempts to pull to stand
B) Alert, laughing, and playing with a rattle
C) Dusky skin with poor turgor
D) Pale, thin extremities and uninterested in surroundings
Rationale: NOFTT is associated with poor growth, lack of stimulation, and delayed
development. The other options reflect normal or unrelated findings.
As the nurse speaks with teens, which chemotherapy side effect would they be most interested
in?
A) Mouth sores
B) Fatigue
C) Diarrhea
D) Hair loss
HESI RN Fundamentals Exit Exam 2026
Complete Study Guide: Core Nursing
Concepts, Clinical Judgment, and Safety
Principles
In planning care for a 6 month-old infant, what must the nurse provide to assist in the
development of trust?
A) Food
B) Warmth
C) Security
D) Comfort
Rationale: According to Erikson’s stages of psychosocial development, infants develop trust
when their needs are met consistently and they feel safe and secure. Food and warmth contribute
to comfort but do not fully address the concept of trust. Comfort alone does not ensure consistent
caregiving.
A nurse has just received a medication order which is not legible. Which statement best reflects
assertive communication?
A) "I cannot give this medication as it is written. I have no idea of what you mean."
B) "Would you please clarify what you have written so I am sure I am reading it
correctly?"
C) "I am having difficulty reading your handwriting. It would save me time if you would be
more careful."
D) "Please print in the future so I do not have to spend extra time attempting to read your
writing."
Rationale: Assertive communication is respectful, clear, and focused on patient safety. Option B
requests clarification without blame. The other responses are aggressive or passive-aggressive
and do not promote collaboration.
What is the most important consideration when teaching parents how to reduce risks in the
home?
,2026
A) Age and knowledge level of the parents
B) Proximity to emergency services
C) Number of children in the home
D) Age of children in the home
Rationale: Safety risks vary significantly depending on a child’s developmental stage. Teaching
must be tailored to the child’s age to effectively prevent injury. Other factors are less critical to
risk prevention.
A 35 year-old client with sickle cell crisis is talking on the telephone but stops as the nurse enters
the room to request something for pain. The nurse should
A) Administer a placebo
B) Encourage increased fluid intake
C) Administer the prescribed analgesia
D) Recommend relaxation exercises for pain control
Rationale: Pain during sickle cell crisis is severe and requires prompt analgesic intervention.
Talking on the phone does not indicate absence of pain. Fluids and relaxation may help but are
not substitutes for prescribed pain medication.
While caring for a toddler with croup, which initial sign of croup requires the nurse's immediate
attention?
A) Respiratory rate of 42
B) Lethargy for the past hour
C) Apical pulse of 54
D) Coughing up copious secretions
Rationale: An elevated respiratory rate indicates respiratory distress and requires immediate
assessment. Lethargy may occur later, and copious secretions are not typical of croup. A low
apical pulse is uncommon and not the primary concern.
A client is admitted with low T3 and T4 levels and an elevated TSH level. On initial assessment,
the nurse would anticipate which finding?
A) Lethargy
B) Heat intolerance
C) Diarrhea
D) Skin eruptions
,2026
Rationale: These findings are consistent with hypothyroidism. Lethargy is a classic symptom.
Heat intolerance and diarrhea are associated with hyperthyroidism. Skin eruptions are not
typical.
The emergency room nurse admits a child who experienced a seizure at school. The father states
this is the first occurrence and denies family history. What is the best nurse response?
A) "Do not worry. Epilepsy can be treated with medications."
B) "The seizure may or may not mean your child has epilepsy."
C) "Since this was the first convulsion, it may not happen again."
D) "Long term treatment will prevent future seizures."
Rationale: This response provides accurate information without making assumptions or false
reassurance. A single seizure does not confirm epilepsy. Other responses are premature or
misleading.
Alcohol and drug abuse impairs judgment and increases risk-taking behavior. What nursing
diagnosis best applies?
A) Risk for injury
B) Risk for knowledge deficit
C) Altered thought process
D) Disturbance in self-esteem
Rationale: Impaired judgment and risk-taking behaviors directly increase the likelihood of injury.
The other diagnoses do not best capture the primary safety concern.
Which finding would the nurse most closely associate with anemia in a 10 month-old infant?
A) Hemoglobin level of 12 g/dL
B) Pale mucosa of the eyelids and lips
C) Hypoactivity
D) Heart rate between 140 and 160
Rationale: Pallor is a classic sign of anemia. A hemoglobin of 12 g/dL is normal. Hypoactivity is
nonspecific, and a heart rate of 140–160 is within normal limits for infants.
, 2026
The nurse is caring for a client in hypertensive crisis. Which assessment is the priority in the first
hour?
A) Heart rate
B) Pedal pulses
C) Lung sounds
D) Pupil responses
Rationale: Hypertensive crisis can cause acute neurologic changes. Assessing pupil response
helps identify early signs of cerebral damage. Other assessments are important but secondary.
Which terminal cancer client is least appropriate for patient-controlled analgesia (PCA)?
A) A young adult with Down syndrome
B) A teenager who reads at a 4th grade level
C) An elderly client with arthritic nodules
D) A preschooler with intermittent alertness
Rationale: PCA requires consistent alertness and understanding. A preschooler with fluctuating
consciousness cannot safely manage PCA. The other clients may use PCA with proper
instruction.
The nurse is about to assess a 6 month-old with nonorganic failure-to-thrive. The nurse would
expect the infant to be
A) Irritable and colicky with no attempts to pull to stand
B) Alert, laughing, and playing with a rattle
C) Dusky skin with poor turgor
D) Pale, thin extremities and uninterested in surroundings
Rationale: NOFTT is associated with poor growth, lack of stimulation, and delayed
development. The other options reflect normal or unrelated findings.
As the nurse speaks with teens, which chemotherapy side effect would they be most interested
in?
A) Mouth sores
B) Fatigue
C) Diarrhea
D) Hair loss
