**HESI Fundamentals Exam 2025/2026: The
Ultimate Study Guide with Practice Questions and
Verified Answers for First-Attempt Success – 100
Questions with Detailed Rationales**
---
**1.** A nurse is preparing to insert an indwelling urinary catheter for a female client. Which action
demonstrates proper sterile technique?
A) Open the outer package and place it on the bedside table
B) Use sterile gloves to open the inner package and set up the sterile field
C) Clean the perineum with an antiseptic solution from the anal area toward the urethra
D) Inflate the balloon before inserting the catheter to ensure it is intact
🔍 **RATIONALE** 💡-- Sterile gloves are required to handle sterile supplies. The inner package should
be opened using sterile technique. Cleaning should be from the urethra outward (front to back). Balloon
is inflated after placement, not before.
ANSWER💫✔️-- **B) Use sterile gloves to open the inner package and set up the sterile field**
---
**2.** A client is on fall precautions. Which intervention should the nurse include in the plan of care?
A) Raise all four side rails when the client is in bed
B) Keep the call light within reach and the bed in the lowest position
C) Apply wrist restraints to prevent climbing over the side rails
D) Place the client in a room farthest from the nurses’ station
,🔍 **RATIONALE** 💡-- Keeping the call light within reach empowers the client to call for help. The bed
in the lowest position reduces injury risk from falling out of bed. Restraints are not used for fall
prevention alone; side rails should not all be raised (may be considered restraint).
ANSWER💫✔️-- **B) Keep the call light within reach and the bed in the lowest position**
---
**3.** A nurse is assessing a client’s pain using the PQRST mnemonic. What does the “P” stand for?
A) Provoking/Palliating factors
B) Pain level on a scale of 0‑10
C) Pattern of pain
D) Previous pain medication
🔍 **RATIONALE** 💡-- In the PQRST pain assessment, P = Provoking or Palliating factors (what makes
pain better or worse). Q = Quality, R = Region/Radiation, S = Severity (scale), T = Timing.
ANSWER💫✔️-- **A) Provoking/Palliating factors**
---
**4.** A client has an order for enoxaparin (Lovenox) 40 mg subcutaneously daily. Which technique
should the nurse use?
A) Inject into the deltoid muscle with a 1‑inch needle
B) Expel the air bubble from the prefilled syringe before injection
C) Administer into the abdomen, pinch the skin, and do not aspirate
D) Massage the site vigorously after injection to distribute the medication
🔍 **RATIONALE** 💡-- Enoxaparin is given subcutaneously into the abdomen. The air bubble should
not be expelled (prevents medication loss). Aspiration is not recommended; do not massage (risk of
hematoma).
,ANSWER💫✔️-- **C) Administer into the abdomen, pinch the skin, and do not aspirate**
---
**5.** A client with a new colostomy asks the nurse, “When should I change my pouch?” Which
response is correct?
A) “Change the pouch every day after a bowel movement.”
B) “Change the pouch every 3‑7 days or when it leaks.”
C) “Change the pouch every 2 weeks to prevent skin breakdown.”
D) “Change the pouch immediately after each meal.”
🔍 **RATIONALE** 💡-- Ostomy pouches are typically changed every 3‑7 days, depending on the
product and skin condition. Frequent changes irritate the skin; leaks require immediate change.
ANSWER💫✔️-- **B) “Change the pouch every 3‑7 days or when it leaks.”**
---
**6.** A nurse is performing a hand hygiene using alcohol‑based hand rub. Which action is correct?
A) Use alcohol rub when hands are visibly soiled
B) Apply alcohol rub to dry hands and rub until dry
C) Rinse hands with water after using alcohol rub
D) Use alcohol rub for Clostridioides difficile infection
🔍 **RATIONALE** 💡-- Alcohol‑based hand rub should be applied to dry hands and rubbed until dry (at
least 20 seconds). It is not effective against C. diff spores; soap and water are required. Visible soil
requires soap and water.
ANSWER💫✔️-- **B) Apply alcohol rub to dry hands and rub until dry**
, ---
**7.** A nurse is caring for a client who is postoperative day 1 after abdominal surgery. The client
reports not having a bowel movement for 2 days. Which action should the nurse take first?
A) Administer a suppository
B) Encourage ambulation and increase oral fluid intake
C) Notify the healthcare provider for a laxative order
D) Perform a digital rectal examination
🔍 **RATIONALE** 💡-- Postoperative ileus is common. Non‑pharmacologic measures (ambulation,
fluids, early feeding if allowed) should be attempted first before invasive interventions or medications.
ANSWER💫✔️-- **B) Encourage ambulation and increase oral fluid intake**
---
**8.** A client is receiving a blood transfusion. Fifteen minutes after the start, the client reports chills
and low back pain. What is the nurse’s priority action?
A) Slow the infusion rate
B) Stop the transfusion and infuse normal saline with new tubing
C) Administer acetaminophen as ordered
D) Notify the healthcare provider
🔍 **RATIONALE** 💡-- Chills and back pain suggest a hemolytic transfusion reaction. The priority is to
stop the transfusion immediately, keep the IV line open with normal saline using new tubing, and notify
the provider.
ANSWER💫✔️-- **B) Stop the transfusion and infuse normal saline with new tubing**
Ultimate Study Guide with Practice Questions and
Verified Answers for First-Attempt Success – 100
Questions with Detailed Rationales**
---
**1.** A nurse is preparing to insert an indwelling urinary catheter for a female client. Which action
demonstrates proper sterile technique?
A) Open the outer package and place it on the bedside table
B) Use sterile gloves to open the inner package and set up the sterile field
C) Clean the perineum with an antiseptic solution from the anal area toward the urethra
D) Inflate the balloon before inserting the catheter to ensure it is intact
🔍 **RATIONALE** 💡-- Sterile gloves are required to handle sterile supplies. The inner package should
be opened using sterile technique. Cleaning should be from the urethra outward (front to back). Balloon
is inflated after placement, not before.
ANSWER💫✔️-- **B) Use sterile gloves to open the inner package and set up the sterile field**
---
**2.** A client is on fall precautions. Which intervention should the nurse include in the plan of care?
A) Raise all four side rails when the client is in bed
B) Keep the call light within reach and the bed in the lowest position
C) Apply wrist restraints to prevent climbing over the side rails
D) Place the client in a room farthest from the nurses’ station
,🔍 **RATIONALE** 💡-- Keeping the call light within reach empowers the client to call for help. The bed
in the lowest position reduces injury risk from falling out of bed. Restraints are not used for fall
prevention alone; side rails should not all be raised (may be considered restraint).
ANSWER💫✔️-- **B) Keep the call light within reach and the bed in the lowest position**
---
**3.** A nurse is assessing a client’s pain using the PQRST mnemonic. What does the “P” stand for?
A) Provoking/Palliating factors
B) Pain level on a scale of 0‑10
C) Pattern of pain
D) Previous pain medication
🔍 **RATIONALE** 💡-- In the PQRST pain assessment, P = Provoking or Palliating factors (what makes
pain better or worse). Q = Quality, R = Region/Radiation, S = Severity (scale), T = Timing.
ANSWER💫✔️-- **A) Provoking/Palliating factors**
---
**4.** A client has an order for enoxaparin (Lovenox) 40 mg subcutaneously daily. Which technique
should the nurse use?
A) Inject into the deltoid muscle with a 1‑inch needle
B) Expel the air bubble from the prefilled syringe before injection
C) Administer into the abdomen, pinch the skin, and do not aspirate
D) Massage the site vigorously after injection to distribute the medication
🔍 **RATIONALE** 💡-- Enoxaparin is given subcutaneously into the abdomen. The air bubble should
not be expelled (prevents medication loss). Aspiration is not recommended; do not massage (risk of
hematoma).
,ANSWER💫✔️-- **C) Administer into the abdomen, pinch the skin, and do not aspirate**
---
**5.** A client with a new colostomy asks the nurse, “When should I change my pouch?” Which
response is correct?
A) “Change the pouch every day after a bowel movement.”
B) “Change the pouch every 3‑7 days or when it leaks.”
C) “Change the pouch every 2 weeks to prevent skin breakdown.”
D) “Change the pouch immediately after each meal.”
🔍 **RATIONALE** 💡-- Ostomy pouches are typically changed every 3‑7 days, depending on the
product and skin condition. Frequent changes irritate the skin; leaks require immediate change.
ANSWER💫✔️-- **B) “Change the pouch every 3‑7 days or when it leaks.”**
---
**6.** A nurse is performing a hand hygiene using alcohol‑based hand rub. Which action is correct?
A) Use alcohol rub when hands are visibly soiled
B) Apply alcohol rub to dry hands and rub until dry
C) Rinse hands with water after using alcohol rub
D) Use alcohol rub for Clostridioides difficile infection
🔍 **RATIONALE** 💡-- Alcohol‑based hand rub should be applied to dry hands and rubbed until dry (at
least 20 seconds). It is not effective against C. diff spores; soap and water are required. Visible soil
requires soap and water.
ANSWER💫✔️-- **B) Apply alcohol rub to dry hands and rub until dry**
, ---
**7.** A nurse is caring for a client who is postoperative day 1 after abdominal surgery. The client
reports not having a bowel movement for 2 days. Which action should the nurse take first?
A) Administer a suppository
B) Encourage ambulation and increase oral fluid intake
C) Notify the healthcare provider for a laxative order
D) Perform a digital rectal examination
🔍 **RATIONALE** 💡-- Postoperative ileus is common. Non‑pharmacologic measures (ambulation,
fluids, early feeding if allowed) should be attempted first before invasive interventions or medications.
ANSWER💫✔️-- **B) Encourage ambulation and increase oral fluid intake**
---
**8.** A client is receiving a blood transfusion. Fifteen minutes after the start, the client reports chills
and low back pain. What is the nurse’s priority action?
A) Slow the infusion rate
B) Stop the transfusion and infuse normal saline with new tubing
C) Administer acetaminophen as ordered
D) Notify the healthcare provider
🔍 **RATIONALE** 💡-- Chills and back pain suggest a hemolytic transfusion reaction. The priority is to
stop the transfusion immediately, keep the IV line open with normal saline using new tubing, and notify
the provider.
ANSWER💫✔️-- **B) Stop the transfusion and infuse normal saline with new tubing**
