Page | 1 M ! M!
2025 EVOLVE HESI FUNDAMENTALS VERSION 1, 2 &
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3| BRAND NEW ACTUAL EXAM WITH 100% VERIFIED Q
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UESTIONS AND CORRECT SOLUTIONS| GUARANTEED M! M! M! M! M!
VALUE PACK| ACE YOUR GRADES. M! M! M! M!
(WITH RATIONALES) M!
1. An elderly client with a fractured left hip is on strict bedrest. Whic
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h nursing measure is essential to the client's nursing care?
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A. Massage any reddened areas for at least five minutes. M! M! M! M! M! M! M! M!
B. Encourage active range of motion exercises on extremities. M! M! M! M! M! M! M!
C. Position the client laterally, prone, and dorsally in sequence.
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D. Gently lift the client when moving into a desired position. -
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correct answer -
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To avoid shearing forces when repositioning, the client should be lif
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ted gently across a surface (D). Reddened areas should not be mas
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saged (A) since this may increase the damage to already traumatize
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d skin. To control pain and muscle spasms, active range of motion (
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B) may be limited on the affected leg. The position described in (C) i
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s contraindicated for a client with a fractured left hip.
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Correct Answer: D M! M!
2. The nurse is administering medications through a nasogastric tube
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(NGT) which is connected to suction. After ensuring correct tube
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placement, what action should the nurse take next? M! M! M! M! M! M! M!
A. Clamp the tube for 20 minutes. M! M! M! M! M!
B. Flush the tube with water. M! M! M! M!
, Page | 2 M ! M!
C. Administer the medications as prescribed. M! M! M! M!
D. Crush the tablets and dissolve in sterile water. - correct answer -
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The NGT should be flushed before, after and in between each medi
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cation administered (B). Once all medications are administered, the
M! M! M! M! M! M! M! M! M!
NGT should be clamped for 20 minutes (A). (C and D) may be imple
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mented only after the tubing has been flushed.M! M! M! M! M! M! M!
Correct Answer: B M! M!
3. A client who is in hospice care complains of increasing amounts of pain
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. The healthcare provider prescribes an analgesic every four hours as
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needed. Which action should the nurse implement?
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A. Give an around-the-clock schedule for administration of analgesics.
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B. Administer analgesic medication as needed when the pain is severe.M! M! M! M! M! M! M! M! M!
C. Provide medication to keep the client sedated and unaware of stimuli.
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D. Offer a medication-free period so that the client can do daily activities.
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- correct answer -
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The most effective management of pain is achieved using an around
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-the-
clock schedule that provides analgesic medications on a regular basi
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s (A) and in a timely manner. Analgesics are less effective if pain per
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sists until it is severe, so an analgesic medication should be administ
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ered before the client's pain peaks (B). Providing comfort is a priority
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for the client who is dying, but sedation that impairs the client's ability
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to interact and experience the time before life ends should be minimi
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zed (C). Offering a medication-
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free period allows the serum drug level to fall, which is not an effectiv
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e method to manage chronic pain (D).
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Correct Answer: A M! M!
, Page | 3 M ! M!
4. When assessing a client with wrist restraints, the nurse observes tha
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t the fingers on the right hand are blue. What action should the nurs
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e implement first?
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A. Loosen the right wrist restraint. M! M! M! M!
B. Apply a pulse oximeter to the right hand.
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C. Compare hand color bilaterally. M! M! M!
D. Palpate the right radial pulse. - correct answer -
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The priority nursing action is to restore circulation by loosening the
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restraint (A), because blue fingers (cyanosis) indicates decreased cir
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culation. (C and D) are also important nursing interventions, but do
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not have the priority of
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(A). Pulse oximetry (B) measures the saturation of hemoglobin with o
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xygen and is not indicated in situations where the cyanosis is related
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to mechanical compression (the restraints).
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Correct Answer: A M! M!
5. The nurse is assessing the nutritional status of several clients. Whic
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h client has the greatest nutritional need for additional intake of protei
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n?
A. A college-age track runner with a sprained ankle.
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B. A lactating woman nursing her 3-day-old infant.
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C. A school-aged child with Type 2 diabetes.
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D. An elderly man being treated for a peptic ulcer. - correct answer -
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A lactating woman (B) has the greatest need for additional protein i
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ntake. (A, C, and D) are all conditions that require protein, but do not
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have the increased metabolic protein demands of lactation.
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Correct Answer: B M! M!
, Page | 4 M ! M!
6. A client is in the radiology department at 0900 when the prescriptio
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n levofloxacin (Levaquin) 500 mg IV q24h is scheduled to be admi
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nistered. The client returns to the unit at 1300. What is the best inte
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rvention for the nurse to implement?
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A. Contact the healthcare provider and complete a medication variance
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form.
M!
B. Administer the Levaquin at 1300 and resume the 0900 schedule in th
M! M! M! M! M! M! M! M! M! M! M!
e morning.M!
C. Notify the charge nurse and complete an incident report to explain th
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e missed dose.
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D. Give the missed dose at 1300 and change the schedule to administe
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r daily at 1300. - correct answer -
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To ensure that a therapeutic level of medication is maintained, the
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nurse should administer the missed dose as soon as possible, and r
M! M! M! M! M! M! M! M! M! M! M!
evise the administration schedule accordingly to prevent dangerousl
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y increasing the level of the medication in the bloodstream (D). The
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nurse should document the reason for the late dose, but (A and C)
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are not warranted. (B) could result in increased blood levels of the d
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rug.
Correct Answer: D M! M!
7. While instructing a male client's wife in the performance of passive ra
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nge-of-
motion exercises to his contracted shoulder, the nurse observes that
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she is holding his arm above and below the elbow. What nursing actio
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n should the nurse implement?
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A. Acknowledge that she is supporting the arm correctly. M! M! M! M! M! M! M!
B. Encourage her to keep the joint covered to maintain warmth. M! M! M! M! M! M! M! M! M!
C. Reinforce the need to grip directly under the joint for better support.
M! M! M! M! M! M! M! M! M! M! M!
2025 EVOLVE HESI FUNDAMENTALS VERSION 1, 2 &
M! M! M! M! M! M! M!
3| BRAND NEW ACTUAL EXAM WITH 100% VERIFIED Q
M! M! M! M! M! M! M! M!
UESTIONS AND CORRECT SOLUTIONS| GUARANTEED M! M! M! M! M!
VALUE PACK| ACE YOUR GRADES. M! M! M! M!
(WITH RATIONALES) M!
1. An elderly client with a fractured left hip is on strict bedrest. Whic
M! M! M! M! M! M! M! M! M! M! M! M!
h nursing measure is essential to the client's nursing care?
M! M! M! M! M! M! M! M! M!
A. Massage any reddened areas for at least five minutes. M! M! M! M! M! M! M! M!
B. Encourage active range of motion exercises on extremities. M! M! M! M! M! M! M!
C. Position the client laterally, prone, and dorsally in sequence.
M! M! M! M! M! M! M! M!
D. Gently lift the client when moving into a desired position. -
M! M! M! M! M! M! M! M! M! M!
correct answer -
M! M! M!
To avoid shearing forces when repositioning, the client should be lif
M! M! M! M! M! M! M! M! M! M! M!
ted gently across a surface (D). Reddened areas should not be mas
M! M! M! M! M! M! M! M! M! M! M!
saged (A) since this may increase the damage to already traumatize
M! M! M! M! M! M! M! M! M! M!
d skin. To control pain and muscle spasms, active range of motion (
M! M! M! M! M! M! M! M! M! M! M! M!
B) may be limited on the affected leg. The position described in (C) i
M! M! M! M! M! M! M! M! M! M! M! M! M!
s contraindicated for a client with a fractured left hip.
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Correct Answer: D M! M!
2. The nurse is administering medications through a nasogastric tube
M! M! M! M! M! M! M! M!
(NGT) which is connected to suction. After ensuring correct tube
M! M! M! M! M! M! M! M! M! M! M!
placement, what action should the nurse take next? M! M! M! M! M! M! M!
A. Clamp the tube for 20 minutes. M! M! M! M! M!
B. Flush the tube with water. M! M! M! M!
, Page | 2 M ! M!
C. Administer the medications as prescribed. M! M! M! M!
D. Crush the tablets and dissolve in sterile water. - correct answer -
M! M! M! M! M! M! M! M! M! M! M!
The NGT should be flushed before, after and in between each medi
M! M! M! M! M! M! M! M! M! M! M! M!
cation administered (B). Once all medications are administered, the
M! M! M! M! M! M! M! M! M!
NGT should be clamped for 20 minutes (A). (C and D) may be imple
M! M! M! M! M! M! M! M! M! M! M! M! M!
mented only after the tubing has been flushed.M! M! M! M! M! M! M!
Correct Answer: B M! M!
3. A client who is in hospice care complains of increasing amounts of pain
M! M! M! M! M! M! M! M! M! M! M! M!
. The healthcare provider prescribes an analgesic every four hours as
M! M! M! M! M! M! M! M! M! M! M!
needed. Which action should the nurse implement?
M! M! M! M! M! M!
A. Give an around-the-clock schedule for administration of analgesics.
M! M! M! M! M! M! M!
B. Administer analgesic medication as needed when the pain is severe.M! M! M! M! M! M! M! M! M!
C. Provide medication to keep the client sedated and unaware of stimuli.
M! M! M! M! M! M! M! M! M! M!
D. Offer a medication-free period so that the client can do daily activities.
M! M! M! M! M! M! M! M! M! M! M!
- correct answer -
M! M! M!
The most effective management of pain is achieved using an around
M! M! M! M! M! M! M! M! M! M! M!
-the-
clock schedule that provides analgesic medications on a regular basi
M! M! M! M! M! M! M! M! M!
s (A) and in a timely manner. Analgesics are less effective if pain per
M! M! M! M! M! M! M! M! M! M! M! M! M!
sists until it is severe, so an analgesic medication should be administ
M! M! M! M! M! M! M! M! M! M! M!
ered before the client's pain peaks (B). Providing comfort is a priority
M! M! M! M! M! M! M! M! M! M! M! M!
for the client who is dying, but sedation that impairs the client's ability
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to interact and experience the time before life ends should be minimi
M! M! M! M! M! M! M! M! M! M! M! M!
zed (C). Offering a medication-
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free period allows the serum drug level to fall, which is not an effectiv
M! M! M! M! M! M! M! M! M! M! M! M! M!
e method to manage chronic pain (D).
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Correct Answer: A M! M!
, Page | 3 M ! M!
4. When assessing a client with wrist restraints, the nurse observes tha
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t the fingers on the right hand are blue. What action should the nurs
M! M! M! M! M! M! M! M! M! M! M! M! M!
e implement first?
M! M!
A. Loosen the right wrist restraint. M! M! M! M!
B. Apply a pulse oximeter to the right hand.
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C. Compare hand color bilaterally. M! M! M!
D. Palpate the right radial pulse. - correct answer -
M! M! M! M! M! M! M! M!
The priority nursing action is to restore circulation by loosening the
M! M! M! M! M! M! M! M! M! M! M! M!
restraint (A), because blue fingers (cyanosis) indicates decreased cir
M! M! M! M! M! M! M! M!
culation. (C and D) are also important nursing interventions, but do
M! M! M! M! M! M! M! M! M! M! M!
not have the priority of
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(A). Pulse oximetry (B) measures the saturation of hemoglobin with o
M! M! M! M! M! M! M! M! M!
xygen and is not indicated in situations where the cyanosis is related
M! M! M! M! M! M! M! M! M! M! M! M!
to mechanical compression (the restraints).
M! M! M! M!
Correct Answer: A M! M!
5. The nurse is assessing the nutritional status of several clients. Whic
M! M! M! M! M! M! M! M! M! M!
h client has the greatest nutritional need for additional intake of protei
M! M! M! M! M! M! M! M! M! M! M!
n?
A. A college-age track runner with a sprained ankle.
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B. A lactating woman nursing her 3-day-old infant.
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C. A school-aged child with Type 2 diabetes.
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D. An elderly man being treated for a peptic ulcer. - correct answer -
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A lactating woman (B) has the greatest need for additional protein i
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ntake. (A, C, and D) are all conditions that require protein, but do not
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have the increased metabolic protein demands of lactation.
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Correct Answer: B M! M!
, Page | 4 M ! M!
6. A client is in the radiology department at 0900 when the prescriptio
M! M! M! M! M! M! M! M! M! M! M!
n levofloxacin (Levaquin) 500 mg IV q24h is scheduled to be admi
M! M! M! M! M! M! M! M! M! M! M!
nistered. The client returns to the unit at 1300. What is the best inte
M! M! M! M! M! M! M! M! M! M! M! M! M!
rvention for the nurse to implement?
M! M! M! M! M!
A. Contact the healthcare provider and complete a medication variance
M! M! M! M! M! M! M! M!
form.
M!
B. Administer the Levaquin at 1300 and resume the 0900 schedule in th
M! M! M! M! M! M! M! M! M! M! M!
e morning.M!
C. Notify the charge nurse and complete an incident report to explain th
M! M! M! M! M! M! M! M! M! M! M!
e missed dose.
M! M!
D. Give the missed dose at 1300 and change the schedule to administe
M! M! M! M! M! M! M! M! M! M! M!
r daily at 1300. - correct answer -
M! M! M! M! M! M! M!
To ensure that a therapeutic level of medication is maintained, the
M! M! M! M! M! M! M! M! M! M! M! M!
nurse should administer the missed dose as soon as possible, and r
M! M! M! M! M! M! M! M! M! M! M!
evise the administration schedule accordingly to prevent dangerousl
M! M! M! M! M! M! M!
y increasing the level of the medication in the bloodstream (D). The
M! M! M! M! M! M! M! M! M! M! M! M!
nurse should document the reason for the late dose, but (A and C)
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are not warranted. (B) could result in increased blood levels of the d
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rug.
Correct Answer: D M! M!
7. While instructing a male client's wife in the performance of passive ra
M! M! M! M! M! M! M! M! M! M! M!
nge-of-
motion exercises to his contracted shoulder, the nurse observes that
M! M! M! M! M! M! M! M! M! M!
she is holding his arm above and below the elbow. What nursing actio
M! M! M! M! M! M! M! M! M! M! M! M!
n should the nurse implement?
M! M! M! M!
A. Acknowledge that she is supporting the arm correctly. M! M! M! M! M! M! M!
B. Encourage her to keep the joint covered to maintain warmth. M! M! M! M! M! M! M! M! M!
C. Reinforce the need to grip directly under the joint for better support.
M! M! M! M! M! M! M! M! M! M! M!
