HESI Fundamentals V1 Exam Sets A-D
Official Foundational Nursing
Competency Assessment Actual Exam
2026/2027 with Detailed Rationales |
Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
══════════════════════════════════════
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 78-year-old patient with Alzheimer's disease is found on the floor beside his bed after
attempting to get up unassisted. He is alert, oriented to person, and denies hitting his head.
His vital signs are stable. What is the nurse's priority action?
A. Complete a full head-to-toe physical assessment
B. Perform a focused neurological assessment and palpate for occult injury ✓ CORRECT
C. Call the provider immediately for new orders
D. Document the incident and notify the family first
Correct Answer: B
Rationale: A focused neuro assessment and palpation for injury address the immediate
consequences of a fall in an older adult with dementia, who may not reliably report pain. A
full head-to-toe is thorough but delays identification of time-sensitive injuries such as
bleeding or fracture. Falls in this population require rapid assessment before notification or
documentation.
Question 2 of 50
A nurse enters the room of a postoperative patient to change a surgical dressing. The patient
is in a semi-private room, and the roommate has a productive cough. What action best
protects the surgical patient from infection?
A. Keep the privacy curtain drawn between the two beds
,B. Ask the roommate to turn toward the window during the dressing change
C. Wear clean gloves and a standard surgical mask
D. Close the door and perform hand hygiene before donning sterile gloves ✓ CORRECT
Correct Answer: D
Rationale: Closing the door limits airborne exposure and hand hygiene before sterile glove
application maintains aseptic technique during a sterile procedure. A curtain does not block
airborne particles, and clean gloves without sterile technique violate aseptic principles during
dressing changes.
Question 3 of 50
A nurse on a medical-surgical unit smells smoke coming from the utility room during a busy
afternoon shift. According to the RACE protocol, what is the nurse's first action?
A. Activate the nearest fire alarm and close doors to contain smoke and fire ✓ CORRECT
B. Call the hospital operator from the nurses' station to announce the code
C. Begin moving patients to another unit immediately
D. Locate the nearest fire extinguisher and attempt to extinguish the blaze
Correct Answer: A
Rationale: RACE prioritizes Rescue, Alarm, Contain, and Extinguish or Evacuate; activating the
alarm and containing the fire are the immediate priorities before attempting extinguishment
or evacuation. Calling the operator or moving patients first delays containment and allows
the fire to spread.
Question 4 of 50
A nurse receives report on four patients at the start of the shift. Which task is most
appropriate to delegate to an unlicensed assistive personnel?
A. Assess a postoperative patient's pain level after receiving analgesia
B. Evaluate the surgical incision for signs of dehiscence
C. Measure and record intake and output for a hemodynamically stable patient ✓ CORRECT
D. Teach a patient with a new colostomy how to empty the pouch
Correct Answer: C
Rationale: Measuring and recording intake and output is a routine, non-invasive task that
does not require nursing judgment and is appropriate for UAP delegation. Assessment,
evaluation, and patient teaching require the clinical knowledge and licensure of a registered
nurse.
Question 5 of 50
, An 82-year-old patient keeps pulling at his nasogastric tube despite repeated redirection. The
provider orders a wrist restraint. To maintain patient safety and rights, the nurse must:
A. Secure the restraint to the bed rail for quick release if needed
B. Check peripheral circulation every two hours and release the restraint per protocol ✓
CORRECT
C. Apply the restraint only during night shifts when observation is limited
D. Document that the family insisted on the restraint to protect the tube
Correct Answer: B
Rationale: Restraints require regular assessment of circulation and skin integrity with release
per protocol to prevent neurovascular compromise. Securing restraints to bed rails is unsafe,
and restraints must never be applied based on convenience or family request alone without
clinical indication and provider orders.
Question 6 of 50
A patient with a history of orthostatic hypotension is being transferred from bed to a chair
using a gait belt. As the patient stands, they report dizziness and begin leaning forward. What
is the nurse's safest response?
A. Tighten the gait belt and quickly complete the transfer to the chair
B. Call for another staff member to pull the patient upright by the arms
C. Guide the patient into the chair while holding the gait belt loosely
D. Widen your stance, bend your knees, and slowly lower the patient toward the bed or floor ✓
CORRECT
Correct Answer: D
Rationale: Lowering the patient in a controlled manner using proper body mechanics prevents
both patient and nurse injury during a near-fall. Tightening the belt or pulling the patient
upright increases the risk of losing balance and causing strain or fracture.
Question 7 of 50
A nurse is preparing to administer a unit of packed red blood cells. Two nurses are present at
the bedside for verification. What is the most critical step in this safety check?
A. Compare the patient identification band with the blood product tag and crossmatch
compatibility ✓ CORRECT
B. Verify the blood type documented in the electronic health record
C. Ask the patient to verbally confirm their blood type
D. Check the expiration date and temperature of the blood bag
Correct Answer: A
Official Foundational Nursing
Competency Assessment Actual Exam
2026/2027 with Detailed Rationales |
Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
══════════════════════════════════════
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 78-year-old patient with Alzheimer's disease is found on the floor beside his bed after
attempting to get up unassisted. He is alert, oriented to person, and denies hitting his head.
His vital signs are stable. What is the nurse's priority action?
A. Complete a full head-to-toe physical assessment
B. Perform a focused neurological assessment and palpate for occult injury ✓ CORRECT
C. Call the provider immediately for new orders
D. Document the incident and notify the family first
Correct Answer: B
Rationale: A focused neuro assessment and palpation for injury address the immediate
consequences of a fall in an older adult with dementia, who may not reliably report pain. A
full head-to-toe is thorough but delays identification of time-sensitive injuries such as
bleeding or fracture. Falls in this population require rapid assessment before notification or
documentation.
Question 2 of 50
A nurse enters the room of a postoperative patient to change a surgical dressing. The patient
is in a semi-private room, and the roommate has a productive cough. What action best
protects the surgical patient from infection?
A. Keep the privacy curtain drawn between the two beds
,B. Ask the roommate to turn toward the window during the dressing change
C. Wear clean gloves and a standard surgical mask
D. Close the door and perform hand hygiene before donning sterile gloves ✓ CORRECT
Correct Answer: D
Rationale: Closing the door limits airborne exposure and hand hygiene before sterile glove
application maintains aseptic technique during a sterile procedure. A curtain does not block
airborne particles, and clean gloves without sterile technique violate aseptic principles during
dressing changes.
Question 3 of 50
A nurse on a medical-surgical unit smells smoke coming from the utility room during a busy
afternoon shift. According to the RACE protocol, what is the nurse's first action?
A. Activate the nearest fire alarm and close doors to contain smoke and fire ✓ CORRECT
B. Call the hospital operator from the nurses' station to announce the code
C. Begin moving patients to another unit immediately
D. Locate the nearest fire extinguisher and attempt to extinguish the blaze
Correct Answer: A
Rationale: RACE prioritizes Rescue, Alarm, Contain, and Extinguish or Evacuate; activating the
alarm and containing the fire are the immediate priorities before attempting extinguishment
or evacuation. Calling the operator or moving patients first delays containment and allows
the fire to spread.
Question 4 of 50
A nurse receives report on four patients at the start of the shift. Which task is most
appropriate to delegate to an unlicensed assistive personnel?
A. Assess a postoperative patient's pain level after receiving analgesia
B. Evaluate the surgical incision for signs of dehiscence
C. Measure and record intake and output for a hemodynamically stable patient ✓ CORRECT
D. Teach a patient with a new colostomy how to empty the pouch
Correct Answer: C
Rationale: Measuring and recording intake and output is a routine, non-invasive task that
does not require nursing judgment and is appropriate for UAP delegation. Assessment,
evaluation, and patient teaching require the clinical knowledge and licensure of a registered
nurse.
Question 5 of 50
, An 82-year-old patient keeps pulling at his nasogastric tube despite repeated redirection. The
provider orders a wrist restraint. To maintain patient safety and rights, the nurse must:
A. Secure the restraint to the bed rail for quick release if needed
B. Check peripheral circulation every two hours and release the restraint per protocol ✓
CORRECT
C. Apply the restraint only during night shifts when observation is limited
D. Document that the family insisted on the restraint to protect the tube
Correct Answer: B
Rationale: Restraints require regular assessment of circulation and skin integrity with release
per protocol to prevent neurovascular compromise. Securing restraints to bed rails is unsafe,
and restraints must never be applied based on convenience or family request alone without
clinical indication and provider orders.
Question 6 of 50
A patient with a history of orthostatic hypotension is being transferred from bed to a chair
using a gait belt. As the patient stands, they report dizziness and begin leaning forward. What
is the nurse's safest response?
A. Tighten the gait belt and quickly complete the transfer to the chair
B. Call for another staff member to pull the patient upright by the arms
C. Guide the patient into the chair while holding the gait belt loosely
D. Widen your stance, bend your knees, and slowly lower the patient toward the bed or floor ✓
CORRECT
Correct Answer: D
Rationale: Lowering the patient in a controlled manner using proper body mechanics prevents
both patient and nurse injury during a near-fall. Tightening the belt or pulling the patient
upright increases the risk of losing balance and causing strain or fracture.
Question 7 of 50
A nurse is preparing to administer a unit of packed red blood cells. Two nurses are present at
the bedside for verification. What is the most critical step in this safety check?
A. Compare the patient identification band with the blood product tag and crossmatch
compatibility ✓ CORRECT
B. Verify the blood type documented in the electronic health record
C. Ask the patient to verbally confirm their blood type
D. Check the expiration date and temperature of the blood bag
Correct Answer: A
