HESI Foundations of Nursing Final Exam 2026

Question 2

HESI Foundations of Nursing Final Exam 2026. The healthcare provider prescribes a bolus of 0.9% sodium chloride at 20 mL/kg over one hour for a toddler with dehydration after several days of vomiting and diarrhea. The toddler weighs 44 pounds. The practical nurse should program the infusion pump to deliver how many mL/hour? (Enter the numerical value only.)

• 400

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Question 3

A client with a diagnosis of bipolar disorder is taking lithium and divalproex sodium. In assessing this client, which symptom should the practical nurse (PN) report to the healthcare provider (HCP) immediately?

• A Noticeable fine hand tremors.
• B Reports having blurred vision.
• C Describes having a dry mouth.
• D Recent significant hair loss.

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Question 4

After administering an analgesic, which response is the best indicator to the practical nurse (PN) that the medication was effective? HESI Foundations of Nursing Final Exam 2026

• A Change in systolic blood pressure reading from 120 to 114 mm Hg.
• B Client appears cheerful and talks easily with family members.
• C Spouse reports to nurse that client seems less restless.
• D Client reports change in pain intensity from 7 to 3 on a 0 to 10 scale.

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Question 5

A client with type 1 diabetes mellitus is receiving glargine insulin 10 units subcutaneous every morning upon arising and regular insulin 30 minutes before meals. When should the practical nurse (PN) recommend that the client perform self-monitoring of blood glucose (SMBG)?

• A Two hours postprandial.
• B Time of glargine peak action.
• C Before each meal.
• D Prior to bedtime.

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Question 6

The practical nurse (PN) prepares to administer morphine 10 mg IM to a postoperative client. Before administering morphine, the PN should recognize the necessity for monitoring which parameter(s)?

• A Nausea and vomiting.
• B Constipation and distention.
• C Palpitations, bradycardia, and edema.
• D Dyspnea, respiratory depth, and respiratory rate.

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Question 7

Review H and P, and nurses’ note. Which actions are appropriate for the practical nurse (PN) caring for this child? Select all that apply.

• A Have the child sign a treatment contract promising he will participate in therapy
• B Ask the mother to bring a familiar object from home
• C Develop a trusting relationship with the child
• D Notify the mother that social services will be notified if she does not visit regularly
• E Avoid mentioning anything about the mother to the child

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Question 8

The practical nurse (PN) is providing postoperative care for a client with peptic ulcer disease (PUD) who underwent gastric surgery. The client received a prescription for ondansetron 32 mg in 50 mL of 0.9% sodium chloride IV prior to anesthesia. The client now describes experiencing a headache, dry mouth, musculoskeletal pain, profuse sweating, and photophobia. The PN should recognize which symptom(s) may be attributed to the administration of ondansetron? Select all that apply.

• A Musculoskeletal pain.
• B Dry mouth.
• C Photophobia.
• D Profuse sweating.
• E Headache.

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Question 9

The practical nurse (PN) reviews a client’s medication history and learns that the client takes an anticoagulant and has recently started taking phenytoin. Which instruction should the PN provide when assigning the client’s morning care to an unlicensed assistive personnel (UAP)? HESI Foundations of Nursing Final Exam 2026

• A Elevate both feet on two pillows.
• B Protect skin from injury and bruising.
• C Initiate hourly turning schedule.
• D Measure temperature every 4 hours.

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Question 10

The practical nurse (PN) is participating in a health screening for hypertension at a local health fair. One of the community residents has a blood pressure reading of 138/80 mm Hg. Which interventions should the PN implement for this client? Select all that apply.

• A Assess client’s life style and other risk factors for hypertension.
• B Obtain another blood pressure to verify the first reading.
• C Ask the client about any current antihypertensive medications.
• D Encourage the client to, “Keep doing whatever you are doing.”
• E Recommend further evaluation for possible prehypertension.

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Question 11

The practical nurse (PN) is administering insulin to a client who was recently diagnosed with type 1 diabetes mellitus. In which order should the PN perform these tasks of administration? (Arrange from first action on top to last on the bottom.)

1. Select an injection site to allow client to observe.
2. Clean the injection site with alcohol prep pad.
3. Pinch the skin around the injection site.
4. Insert needle at 45 to 90 degree angle.
5. Release the skin and give the injection.

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Question 12

The practical nurse (PN) is caring for a client receiving a prescription for paroxetine who suddenly exhibits restlessness, tachycardia, fever, and elevated blood pressure. Which action should the PN implement first?

• A Take the client to a quiet area and provide reassurance.
• B Obtain a cooling blanket from the hospital central supply department.
• C Administer a PRN prescription for benzodiazepine and acetaminophen.
• D Withhold the next dose and contact the health care provider.

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Question 13

Before the practical nurse (PN) administers a client’s morning dose of Humulin 70/30 insulin, which action is important for the PN to take?

• A Ensure that breakfast trays have been delivered to the unit.
• B Schedule a time for the client’s morning snack to be delivered.
• C Provide the client with a warm washcloth and oral care supplies.
• D Elevate the head of the bed and help the client to a position of comfort.

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Question 14

The practical nurse (PN) is changing the dressing for a client with a fresh ileostomy. Which intervention is most important for the PN to implement?

• A Ensure the stoma is moist and dark red.
• B Cleanse the stoma with a moisturizing soap.
• C Apply a barrier cream to the skin around the stoma.
• D Cut the wafer 1/4 inch larger than the stoma.
  

Question 14

The practical nurse (PN) has been regularly assigned the care of an older adult client who resides in a long term care facility. When the client is told that they have a terminal illness, which action is best for the PN to take?

• A Request the chaplain to talk with client.
• B Remain quietly in the client’s room for a while.
• C Quickly complete tasks and leave client’s room.
• D Ask the client if praying together would help.

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Question 15

The practical nurse (PN) is administering sulfamethoxazole-trimethoprim to a client with a urinary tract infection. Which action should the PN take to reduce risk that the medication will crystallize during excretion?

• A Monitor serum electrolyte values.
• B Provide high fiber snacks.
• C Limit intake of dairy products.
• D Encourage increased fluid intake.

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Question 16

A client with terminal cancer reports increasing pain that occurs 1 to 2 hours before the next scheduled dose of a prescribed opioid analgesic. Which action should the practical nurse (PN) implement?

• A Withhold further doses of the medication until the healthcare provider is notified.
• B Administer the medication when the report of pain exceeds 5 on a 0 to 10 scale.
• C Notify the healthcare provider that the medication dosage has been increased.
• D Consult with the charge nurse about the need to increase the medication dosage.

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Question 17

A client had a right total knee arthroplasty one day ago. The client is receiving oxycodone with ibuprofen 5 mg/400 mg tablets PO every 4 to 6 hours for pain greater than 3 on a 0 to 10 scale. The practical nurse (PN) recognizes which focused assessment finding requires immediate intervention?

• A Reports of a sharp throbbing right knee pain.
• B A 24 hour intake 1400 mL and urinary output of 400 mL.
• C Arousable with signs of drowsiness and euphoria.
• D No bowel movement for 24 hours.

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Question 18

The practical nurse (PN) is administering subcutaneous heparin into a client’s abdominal tissue. A primary concern for such administration is bleeding related to trauma of the injection site. Which action should the PN implement?

• A Aspirate for blood return.
• B Pull the skin surface taut.
• C Massage the site prior to needle insertion.
• D Pinch the fat tissue during insertion.

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Question 19

The practical nurse (PN) is providing care for a client who is receiving an aminoglycoside to treat a bacterial infection. To assess for signs of ototoxicity, which action should the PN take? HESI Foundations of Nursing Final Exam 2026

• A Monitor the client’s hearing.
• B Observe the skin for a rash.
• C Measure the urinary output.
• D Check for changes in vision.

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Question 20

The practical nurse (PN) monitors a client who received a dose of intravenous (IV) hydromorphone for severe pain thirty minutes ago. The client is sleeping and has a respiratory rate of 14 breaths per minute with an oxygen saturation of 97%. Which action should the PN take next?

• A Auscultate the client’s breath sounds.
• B Arouse the client to determine pain relief.
• C Determine if the client can be easily awakened by verbal stimulation.
• D Document the findings in the client’s electronic medical record (EMR).

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Question 21

The practical nurse (PN) cares for a client receiving vancomycin 500 mg IV. Fifteen minutes into the infusion, the client reports itching at the IV site and shortness of breath. Which action should the PN take first?

• A Administer epinephrine.
• B Stop the vancomycin infusion.
• C Call health care provider.
• D Auscultate bilateral lung sounds.

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Case Study: Sodium Bicarbonate

Determine if the following assessment findings are therapeutic, nontherapeutic, or unrelated to the administration of Sodium Bicarbonate.

Assessment Finding	Therapeutic	Nontherapeutic	Unrelated
Blood pressure 113/72	X
Capillary refill 2 seconds	X
400 mL urine output	X
Heart rate 77 beats/min	X
Bicarbonate 22 mEq/L	X

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Question 22

A client with an intestinal infection is receiving metronidazole. Which finding should the practical nurse (PN) identify as a therapeutic response to the medication?

• A Decrease in the frequency of loose stools.
• B Increased appetite.
• C Absence of nausea and vomiting.
• D Decrease in abdominal distention.

Question 23

A client with Paget’s disease receives a new prescription for alendronate. Which information should the practical nurse (PN) reinforce with the client?

• A Wear protective clothing when in direct sunlight.
• B Suck on hard candy to increase oral secretions.
• C Lay supine for 30 minutes after taking the medication.
• D Drink 8 ounces (240 mL) of mineral water with each dose.

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Question 24

A client with type 1 diabetes mellitus (DM) and neuropathy receives a prescription for gabapentin. The practical nurse (PN) should monitor the client for which effect of gabapentin?

• A Report of decreased burning and shooting pain in feet.
• B Changes from baseline liver function enzyme results.
• C Development of hearing loss and onset of tinnitus.
• D Improvement in memory, attention, and affect.

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Question 25

The practical nurse (PN) is administering the aminoglycoside amikacin IM to a client who is admitted with Pseudomonas pneumonia. Which parameters should the PN monitor to assess for nephrotoxicity? HESI Foundations of Nursing Final Exam 2026

• A Weight gain and anorexia.
• B Serum creatinine and blood urea nitrogen (BUN).
• C Orthostatic hypotension and fever.
• D Tinnitus and vertigo.

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Question 26

A client with eczema receives a prescription for betamethasone cream. Which client statement indicates to the practical nurse (PN) that reinforcement of teaching is needed?

• A Limit exposure to direct sunlight.
• B Apply the cream to the area for 2 weeks.
• C Use the cream only on intact skin.
• D Cover the site with an occlusive dressing.

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Question 27

The practical nurse (PN) is reviewing instructions for the use of pilocarpine eye drops with a client who has glaucoma. The client states, “I should use these drops to anesthetize my eye if I experience eye pain.” Which action should the PN implement?

• A Document the client’s statement about the action and use of the drops in the chart.
• B Reinstruct the client about the eye drop action of decreasing pressure in the eyes.
• C Explain to the client that the eye drops do provide pain relief, but do not anesthetize the eyes.
• D Assure the client that the drops are not often needed since eye pain in glaucoma is uncommon. HESI Foundations of Nursing Final Exam 2026

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Question 28

Which symptom, reported by a client, indicates that the practical nurse (PN) may need to withhold a scheduled dose of a thiazide diuretic?

• A Cough.
• B Swollen feet.
• C Dizziness.
• D Headache.

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Question 29

A client with generalized anxiety disorder (GAD) receives a new prescription for lorazepam. Which statement provided by the client requires reinforcement of instruction by the practical nurse (PN)?

• A Avoid alcohol and other sedatives while taking the medication.
• B Use relaxation techniques to reduce excessive anxiety.
• C Move slowly from a sitting position to a standing position.
• D Stop taking the medication if intended effect is not immediate.

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Question 30

The practical nurse (PN) is planning to administer 0900 medication to a client who is receiving treatment for an infection. The client reports feeling dizzy and weak. His vital signs are temperature 102° F (38.8° C), pulse 102 beats/minute, respirations 18 breaths/minute, and blood pressure 82/50 mm Hg. Which of the client’s scheduled medications should the PN withhold?

• A Antibiotic.
• B Anti-inflammatory.
• C Antihypertensive.
• D Antipyretic.

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Question 31

A 15-year-old with asthma is to begin long term therapy with both inhaled and oral corticosteroids. The registered nurse (RN) and practical nurse (PN) collaborate on the plan of care. Which nursing problem should receive the highest priority when setting goals and planning interventions?

• A Altered family processes related to exacerbations of asthma.
• B Altered nutrition: more than body requirements related to steroid use.
• C Body image disturbance (acne) related to steroid use.
• D Risk for infection related to immunosuppression secondary to steroid use.

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Question 32

The practical nurse (PN) should reinforce which instruction to a client who has been prescribed sublingual nitroglycerin for anginal pain?

• A The medication can be chewed, crushed or swallowed as a whole tablet.
• B Take one tablet every 15 minutes for 3 doses for pain relief.
• C Place the tablet under the tongue when pain begins.
• D If the tablet stings mouth when used, discontinue medication.

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Question 33

The practical nurse (PN) is caring for a hospice client who requests a priest for the “Last Rites.” Which should be the next response by the PN?

• A Suggest that the hospital chaplain is available.
• B Explore the client’s thoughts about dying.
• C Offer to contact the priest for the client.
• D Propose to notify the family of the request.

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Question 34

The practical nurse (PN), in collaboration with the nurse, identifies “Deficient Knowledge: related to self-administration of insulin” as a priority nursing problem for a client with diabetes mellitus (DM). Which learning outcome is correctly stated and can be included in the client’s plan of care?

• A Client knows the equipment needed for insulin injection.
• B Client explains steps to obtain and measure blood glucose specimen.
• C Client correctly draws up prescribed dose of medication.
• D Client understands importance of expelling air bubbles from syringe.

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Question 35

The practical nurse (PN) is preparing to administer a client’s prescribed 0900 dose of one tablet of bisacodyl when the client reports that he has recently expelled three large, semi-formed bowel movements. Which action should the PN take?

• A Consult with the charge nurse about the need to increase the client’s prescribed dose of bisacodyl.
• B Advise the client that the prescribed bisacodyl will help prevent any further episodes of diarrhea.
• C Administer the bisacodyl as prescribed and document the number of bowel movements.
• D Withhold the scheduled dose of bisacodyl until the healthcare provider is notified of the diarrhea. HESI Foundations of Nursing Final Exam 2026

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Question 36

The practical nurse (PN) is administering cyclobenzaprine to a client who had a lumbar laminectomy. The PN should evaluate for which therapeutic responses first?

• A Drowsiness and potential for abuse.
• B Enhanced posture while ambulating.
• C Distal movement and sensation of both lower legs.
• D Reduced muscular back spasms and surgical pain.

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Question 37

A client is admitted for a brain biopsy and is receiving phenytoin 100 mg IV three times a day. Which safety measure is most important for the practical nurse (PN) to implement?

• A Ensure that the suction equipment is at the bedside.
• B Keep the room lights dimmed during the day.
• C Apply soft limb restraints to all four extremities.
• D Monitor the client for signs of gingival hyperplasia.

Question 37

Based on the provided laboratory results and clinical findings, categorize each as Therapeutic, Non-therapeutic, or Unrelated:

• Normal sinus rhythm: Therapeutic / Unrelated
• Potassium 3.1 mEq/L (3.1 mmol/L): Non-therapeutic
• Blood pressure 122/85 mm Hg: Therapeutic
• International normalized ratio (INR) 2.2: Therapeutic
• 600 mL of urine output: Therapeutic
• Clear breath sounds: Therapeutic

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Question 38

The practical nurse (PN) administers a dose of filgrastim SUBQ to a client with neutropenia. Several hours later, the PN notes that the client is experiencing bone pain. Which action should the PN implement?

• A Report the pain to the healthcare provider immediately.
• B Prepare a variance report about this adverse event.
• C Administer a PRN dose of analgesic.
• D Plan to give the next dose of medication more slowly.

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Question 39

A client with osteoarthritis receives a prescription for diclofenac sodium. Which finding should the practical nurse (PN) document as an indication of the medication’s effectiveness? HESI Foundations of Nursing Final Exam 2026

• A Increased drowsiness.
• B Unassisted ambulation.
• C Temperature 98.6° F (37° C).
• D Improved joint mobility.

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Question 40

A client undergoing chemotherapy is traveling across the country with a caregiver to another healthcare agency for treatment and receives a prescription for promethazine 25 mg per rectum every 4 hours as needed for nausea. Which information should the practical nurse (PN) reinforce with the client and caregiver? Select all that apply.

• A Take 30 minutes to an hour before travel.
• B Expose the skin to sun to prevent jaundice.
• C Do not drive or operate machinery when taking.
• D Increase fluids to avoid becoming overheated.
• E Use hard candy or chew gum for a dry mouth.

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Question 41

An older adult ambulatory client is given a new prescription for alprazolam for anxiety. Which instruction is most important for the practical nurse (PN) to provide to this client’s family? HESI Foundations of Nursing Final Exam 2026

• A “Notify the nurse of any change in the client’s sleep pattern.”
• B “Initially take only half the prescribed dose to prevent over sedation.”
• C “Alprazolam should be stopped by gradually decreasing the dose.”
• D “Call the clinic if the client is unable to ambulate or becomes confused.”

Question 42

After a successful cardioversion, a male client with a new onset of atrial fibrillation receives a prescription for an anticoagulant. Which instruction should the practical nurse (PN) reinforce with the client?

• A Use electric razor when shaving.
• B If a dose is missed, double the next dose.
• C Eat green leafy vegetables high in vitamin K.
• D Take the medication before meals.

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Question 43

A client taking temazepam tells the practical nurse (PN) of plans to quit taking the medication because the client feels too “hungover” the next day. Which action should the PN implement?

• A Instruct the client that it is important to reduce the dose of the medication gradually.
• B Advise the client to stop taking the medication immediately, if so desired.
• C Discuss with the client to ask for a stimulant to relieve the hungover feeling.
• D Encourage the client to obtain a prescription for a benzodiazepine antagonist.

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Question 44

A client receives a prescription for heparin 7,500 units SUBQ every 12 hours. The medication is available in “Heparin 5,000 units/mL vial.” How many mL should the practical nurse (PN) administer? (Enter numerical value only. If round is required, round to the nearest tenth.)

• 1.5

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Question 45

The practical nurse (PN) is administering warfarin to a client who is diagnosed with endocarditis. Which serum laboratory value should be assessed by the PN prior to administering the next dose?

• A Activated Partial thromboplastin time (aPTT).
• B Platelet count.
• C International Normalized Ratio (INR).
• D Partial Thromboplastin time (PTT).

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Question 46

A client with chronic constipation is to begin receiving lactulose 45 mL PO daily. How many tablespoons should the practical nurse (PN) administer with each dose? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

• 3

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Question 47

The practical nurse (PN) is preparing the morning dose of insulin NPH for a client with type 1 diabetes mellitus. The client’s fingerstick glucose level is 50 mg/dL (2.8 mmol/L). Which action should the PN implement? Reference Range: Fasting Blood Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)]

• A Give orange juice with the insulin.
• B Reassess the glucose level in 30 minutes. HESI Foundations of Nursing Final Exam 2026
• C Withhold the dose of insulin NPH.
• D Give regular insulin per sliding scale.

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Question 48

A client with muscle spasticity receives a prescription for baclofen. Which information provided by the client requires additional reinforcement of instruction by the nurse?

• A Discontinue when spasms cease.
• B Take medication with meals.
• C Avoid the ingestion of alcohol.
• D Use a stool softener as needed.

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Question 49

The practical nurse (PN) is discussing precautions for prednisone with a client who recently had a renal transplant. Which instruction should the PN emphasize to the client taking prednisone?

• A Take with food or milk.
• B Discontinue if weight gain occurs.
• C Consume low potassium foods.
• D Avoid acetaminophen products.

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Question 50

Which statement by a middle aged client with advanced lung cancer best indicates a level of acceptance of the prognosis?

• A “I believe that this disease occurs mostly in women who have smoked.”
• B “I think I’ve had this disease for a long time, but the doctor did not find it.”
• C “I’ve found that support from my family and my faith are a comfort to me.”
• D “I don’t have any use for those who say this disease is going to triumph.”

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Question 51

A client with unstable angina pectoris receives a prescription for nitroglycerin 0.4 mg sublingual PRN chest pain every 5 minutes times 3. The prescription directions include leaving the medication at the bedside for self administration. Which assessment finding should the practical nurse (PN) obtain first?

• A Level of orientation and compliance.
• B Hourly urinary output and daily weight.
• C Number of tablets taken in past 24 hours.
• D Heart rate and blood pressure.