Fundamentals of Nursing Evolve HESI
Real Exams Questions Bank Review
Latest | Evolve Hesi Fundamentals Best
Exam Prep Test Bank- a Review of 340
Latest Correctly Answered Questions
with Rationale (new!)
Practice Questions
Question 1
When turning an immobile bedridden client without assistance, which action by the nurse best
ensures client safety?
A. Securely grasp the client's arm and leg
B. Put bed rails up on the side of bed opposite from the nurse
C. Correctly position and use a turn sheet
D. Lower the head of the client's bed slowly
Answer: B
Rationale: Because the nurse can only stand on one side of the bed, bed rails should be up on
the opposite side to ensure that the client does not fall out of bed. Grasping the client's arm
and leg can cause injury to the skin or joint. Turn sheets and lowering the bed are useful
techniques but have less priority for safety than bed rails .
,Question 2
The nurse identifies a potential for infection in a client with partial-thickness (second-degree)
and full-thickness (third-degree) burns. What intervention has the highest priority in decreasing
the client's risk of infection?
A. Administration of plasma expanders
B. Use of careful handwashing technique
C. Application of a topical antibacterial cream
D. Limiting visitors to the client with burns
Answer: B
Rationale: Careful handwashing technique is the single most effective intervention for the
prevention of contamination to all clients. Plasma expanders reverse hypovolemia but are not
related to decreasing the proliferation of infective organisms. Topical creams and limiting
visitors are recommended, but handwashing is the proven technique to prevent infection .
Question 3
The nurse is wearing personal protective equipment while caring for a patient. When exiting the
room, which PPE should be removed first?
A. Mask
B. Gown
C. Gloves
D. Eye protection
Answer: C
Rationale: Gloves are considered the most contaminated piece of PPE and should be removed
first to avoid contaminating other items or surfaces during doffing. The order of removal is
typically: gloves, eye protection, gown, mask .
Question 4
An elderly client with a fractured left hip is on strict bedrest. Which nursing measure is essential
to the client's care?
,A. Massage any reddened areas for at least five minutes
B. Encourage active range of motion exercises on extremities
C. Position the client laterally, prone, and dorsally in sequence
D. Gently lift the client when moving into a desired position
Answer: D
Rationale: To avoid shearing forces when repositioning, the client should be lifted gently across
a surface. Reddened areas should not be massaged as this may increase damage to already
traumatized skin. Active range of motion may be limited on the affected leg, and the positioning
described in C is contraindicated for a client with a fractured left hip .
Question 5
A client who is in hospice care complains of increasing amounts of pain. The healthcare provider
prescribes an analgesic every four hours as needed. Which action should the nurse implement?
A. Give an around-the-clock schedule for administration of analgesics
B. Administer analgesic medication as needed when the pain is severe
C. Provide medication to keep the client sedated and unaware of stimuli
D. Offer a medication-free period so that the client can do daily activities
Answer: A
Rationale: The most effective management of pain is achieved using an around-the-clock
schedule that provides analgesic medications on a regular basis and in a timely manner.
Analgesics are less effective if pain persists until it is severe. Providing comfort is a priority, but
sedation that impairs the client's ability to interact should be minimized .
Question 6
While assessing a client's right wrist, the nurse notes that the client's right hand is cool, with a
blue tint and capillary refill greater than 3 seconds. The right wrist restraint is in place. What
action should the nurse implement first?
A. Loosen the right wrist restraint
B. Apply a pulse oximeter to the right hand
C. Compare hand color bilaterally
D. Palpate the right radial pulse
Answer: A
, Rationale: The priority nursing action is to restore circulation by loosening the restraint,
because blue fingers (cyanosis) indicate decreased circulation. While comparing hand color and
palpating the pulse are also important interventions, they do not have the priority of loosening
the restraint .
Question 7
The nurse is administering medications through a nasogastric tube (NGT) which is connected to
suction. After ensuring correct tube placement, what action should the nurse take next?
A. Clamp the tube for 20 minutes
B. Flush the tube with water
C. Administer the medications as prescribed
D. Crush the tablets and dissolve in sterile water
Answer: B
Rationale: The NGT should be flushed before, after, and in between each medication
administered. Once all medications are administered, the NGT should be clamped for 20
minutes. Options C and D may be implemented only after the tubing has been flushed .
Question 8
A client is in the radiology department at 0900 when the prescription levofloxacin (Levaquin)
500 mg IV q24h is scheduled to be administered. The client returns to the unit at 1300. What is
the best intervention for the nurse to implement?
A. Contact the healthcare provider and complete a medication variance form
B. Administer the Levaquin at 1300 and resume the 0900 schedule in the morning
C. Notify the charge nurse and complete an incident report to explain the missed dose
D. Give the missed dose at 1300 and change the schedule to administer daily at 1300
Answer: D
Rationale: To ensure that a therapeutic level of medication is maintained, the nurse should
administer the missed dose as soon as possible and revise the administration schedule
accordingly to prevent dangerously increasing the level of the medication in the bloodstream.
The nurse should document the reason for the late dose, but contacting the provider and
completing an incident report are not warranted .
Real Exams Questions Bank Review
Latest | Evolve Hesi Fundamentals Best
Exam Prep Test Bank- a Review of 340
Latest Correctly Answered Questions
with Rationale (new!)
Practice Questions
Question 1
When turning an immobile bedridden client without assistance, which action by the nurse best
ensures client safety?
A. Securely grasp the client's arm and leg
B. Put bed rails up on the side of bed opposite from the nurse
C. Correctly position and use a turn sheet
D. Lower the head of the client's bed slowly
Answer: B
Rationale: Because the nurse can only stand on one side of the bed, bed rails should be up on
the opposite side to ensure that the client does not fall out of bed. Grasping the client's arm
and leg can cause injury to the skin or joint. Turn sheets and lowering the bed are useful
techniques but have less priority for safety than bed rails .
,Question 2
The nurse identifies a potential for infection in a client with partial-thickness (second-degree)
and full-thickness (third-degree) burns. What intervention has the highest priority in decreasing
the client's risk of infection?
A. Administration of plasma expanders
B. Use of careful handwashing technique
C. Application of a topical antibacterial cream
D. Limiting visitors to the client with burns
Answer: B
Rationale: Careful handwashing technique is the single most effective intervention for the
prevention of contamination to all clients. Plasma expanders reverse hypovolemia but are not
related to decreasing the proliferation of infective organisms. Topical creams and limiting
visitors are recommended, but handwashing is the proven technique to prevent infection .
Question 3
The nurse is wearing personal protective equipment while caring for a patient. When exiting the
room, which PPE should be removed first?
A. Mask
B. Gown
C. Gloves
D. Eye protection
Answer: C
Rationale: Gloves are considered the most contaminated piece of PPE and should be removed
first to avoid contaminating other items or surfaces during doffing. The order of removal is
typically: gloves, eye protection, gown, mask .
Question 4
An elderly client with a fractured left hip is on strict bedrest. Which nursing measure is essential
to the client's care?
,A. Massage any reddened areas for at least five minutes
B. Encourage active range of motion exercises on extremities
C. Position the client laterally, prone, and dorsally in sequence
D. Gently lift the client when moving into a desired position
Answer: D
Rationale: To avoid shearing forces when repositioning, the client should be lifted gently across
a surface. Reddened areas should not be massaged as this may increase damage to already
traumatized skin. Active range of motion may be limited on the affected leg, and the positioning
described in C is contraindicated for a client with a fractured left hip .
Question 5
A client who is in hospice care complains of increasing amounts of pain. The healthcare provider
prescribes an analgesic every four hours as needed. Which action should the nurse implement?
A. Give an around-the-clock schedule for administration of analgesics
B. Administer analgesic medication as needed when the pain is severe
C. Provide medication to keep the client sedated and unaware of stimuli
D. Offer a medication-free period so that the client can do daily activities
Answer: A
Rationale: The most effective management of pain is achieved using an around-the-clock
schedule that provides analgesic medications on a regular basis and in a timely manner.
Analgesics are less effective if pain persists until it is severe. Providing comfort is a priority, but
sedation that impairs the client's ability to interact should be minimized .
Question 6
While assessing a client's right wrist, the nurse notes that the client's right hand is cool, with a
blue tint and capillary refill greater than 3 seconds. The right wrist restraint is in place. What
action should the nurse implement first?
A. Loosen the right wrist restraint
B. Apply a pulse oximeter to the right hand
C. Compare hand color bilaterally
D. Palpate the right radial pulse
Answer: A
, Rationale: The priority nursing action is to restore circulation by loosening the restraint,
because blue fingers (cyanosis) indicate decreased circulation. While comparing hand color and
palpating the pulse are also important interventions, they do not have the priority of loosening
the restraint .
Question 7
The nurse is administering medications through a nasogastric tube (NGT) which is connected to
suction. After ensuring correct tube placement, what action should the nurse take next?
A. Clamp the tube for 20 minutes
B. Flush the tube with water
C. Administer the medications as prescribed
D. Crush the tablets and dissolve in sterile water
Answer: B
Rationale: The NGT should be flushed before, after, and in between each medication
administered. Once all medications are administered, the NGT should be clamped for 20
minutes. Options C and D may be implemented only after the tubing has been flushed .
Question 8
A client is in the radiology department at 0900 when the prescription levofloxacin (Levaquin)
500 mg IV q24h is scheduled to be administered. The client returns to the unit at 1300. What is
the best intervention for the nurse to implement?
A. Contact the healthcare provider and complete a medication variance form
B. Administer the Levaquin at 1300 and resume the 0900 schedule in the morning
C. Notify the charge nurse and complete an incident report to explain the missed dose
D. Give the missed dose at 1300 and change the schedule to administer daily at 1300
Answer: D
Rationale: To ensure that a therapeutic level of medication is maintained, the nurse should
administer the missed dose as soon as possible and revise the administration schedule
accordingly to prevent dangerously increasing the level of the medication in the bloodstream.
The nurse should document the reason for the late dose, but contacting the provider and
completing an incident report are not warranted .
