2026 Evolve HESI Fundamentals Exam (Versions 1-3) |
Complete Questions and Answers with Rationales
Version 1
1. Which action is most important when a nurse enters a
client's room?
A. Review the care plan
B. Identify the client
C. Assess pain
D. Obtain vital signs
Answer: B. Two identifiers help prevent identification errors.
2. Which finding requires immediate intervention?
A. Pulse 82/min
B. BP 118/72 mmHg
C. Respirations 8/min
D. Temperature 37°C
Answer: C. Bradypnea can compromise ventilation and requires
prompt assessment.
3. Which position best promotes lung expansion?
A. Supine
B. Prone
C. High-Fowler's
D. Trendelenburg
Answer: C. Upright positioning improves diaphragmatic
expansion.
,4. Which assessment is subjective?
A. Temperature 38°C
B. Oxygen saturation 94%
C. "My pain is 7/10"
D. Respiratory rate 24/min
Answer: C. Subjective data are reported by the client.
5. What is the first step of the nursing process?
A. Planning
B. Assessment
C. Implementation
D. Evaluation
Answer: B. Assessment provides the data needed for
subsequent nursing decisions.
6. Which intervention is appropriate for fall prevention?
A. Keep the bed elevated
B. Keep the call light within reach
C. Restrict fluids
D. Leave the room dark
Answer: B. Easy access to assistance reduces unsafe attempts
to ambulate.
7. Which method is most effective for preventing healthcare-
associated infection?
A. Wearing a mask routinely
B. Hand hygiene
C. Using sterile gloves for all care
D. Limiting visitors
,Answer: B. Hand hygiene is the primary method of reducing
transmission.
8. When removing contaminated gloves, the nurse should first:
A. Touch the outside of both gloves
B. Grasp the contaminated glove externally
C. Avoid touching the contaminated outer surface
D. Wash the gloves
Answer: C. Gloves should be removed without contaminating
the hands.
9. Which item requires sterile technique?
A. Taking oral temperature
B. Emptying a bedpan
C. Inserting an indwelling urinary catheter
D. Measuring weight
Answer: C. Catheter insertion requires sterile technique to
prevent infection.
10. Which client should the nurse assess first?
A. Client requesting pain medication
B. Client with new confusion and oxygen saturation of 86%
C. Client awaiting discharge
D. Client needing assistance with bathing
Answer: B. Hypoxemia and acute mental-status change indicate
an immediate threat.
11. A normal adult resting respiratory rate is approximately:
A. 4–8/min
B. 12–20/min
, C. 24–32/min
D. 35–40/min
Answer: B. Normal adult respirations are generally 12–20/min.
12. Which pulse is commonly assessed during CPR?
A. Radial
B. Pedal
C. Carotid
D. Temporal
Answer: C. The carotid pulse is a central pulse and is readily
assessed during emergencies.
13. Which finding is most concerning after opioid
administration?
A. Pain 3/10
B. Respiratory rate 7/min
C. Mild nausea
D. Drowsiness
Answer: B. Severe respiratory depression is a potentially life-
threatening opioid effect.
14. Before administering medication, the nurse should verify
the:
A. Client's room number only
B. Medication label against the prescription
C. Visitor's identity
D. Meal schedule
Answer: B. Medication verification reduces administration
errors.
Complete Questions and Answers with Rationales
Version 1
1. Which action is most important when a nurse enters a
client's room?
A. Review the care plan
B. Identify the client
C. Assess pain
D. Obtain vital signs
Answer: B. Two identifiers help prevent identification errors.
2. Which finding requires immediate intervention?
A. Pulse 82/min
B. BP 118/72 mmHg
C. Respirations 8/min
D. Temperature 37°C
Answer: C. Bradypnea can compromise ventilation and requires
prompt assessment.
3. Which position best promotes lung expansion?
A. Supine
B. Prone
C. High-Fowler's
D. Trendelenburg
Answer: C. Upright positioning improves diaphragmatic
expansion.
,4. Which assessment is subjective?
A. Temperature 38°C
B. Oxygen saturation 94%
C. "My pain is 7/10"
D. Respiratory rate 24/min
Answer: C. Subjective data are reported by the client.
5. What is the first step of the nursing process?
A. Planning
B. Assessment
C. Implementation
D. Evaluation
Answer: B. Assessment provides the data needed for
subsequent nursing decisions.
6. Which intervention is appropriate for fall prevention?
A. Keep the bed elevated
B. Keep the call light within reach
C. Restrict fluids
D. Leave the room dark
Answer: B. Easy access to assistance reduces unsafe attempts
to ambulate.
7. Which method is most effective for preventing healthcare-
associated infection?
A. Wearing a mask routinely
B. Hand hygiene
C. Using sterile gloves for all care
D. Limiting visitors
,Answer: B. Hand hygiene is the primary method of reducing
transmission.
8. When removing contaminated gloves, the nurse should first:
A. Touch the outside of both gloves
B. Grasp the contaminated glove externally
C. Avoid touching the contaminated outer surface
D. Wash the gloves
Answer: C. Gloves should be removed without contaminating
the hands.
9. Which item requires sterile technique?
A. Taking oral temperature
B. Emptying a bedpan
C. Inserting an indwelling urinary catheter
D. Measuring weight
Answer: C. Catheter insertion requires sterile technique to
prevent infection.
10. Which client should the nurse assess first?
A. Client requesting pain medication
B. Client with new confusion and oxygen saturation of 86%
C. Client awaiting discharge
D. Client needing assistance with bathing
Answer: B. Hypoxemia and acute mental-status change indicate
an immediate threat.
11. A normal adult resting respiratory rate is approximately:
A. 4–8/min
B. 12–20/min
, C. 24–32/min
D. 35–40/min
Answer: B. Normal adult respirations are generally 12–20/min.
12. Which pulse is commonly assessed during CPR?
A. Radial
B. Pedal
C. Carotid
D. Temporal
Answer: C. The carotid pulse is a central pulse and is readily
assessed during emergencies.
13. Which finding is most concerning after opioid
administration?
A. Pain 3/10
B. Respiratory rate 7/min
C. Mild nausea
D. Drowsiness
Answer: B. Severe respiratory depression is a potentially life-
threatening opioid effect.
14. Before administering medication, the nurse should verify
the:
A. Client's room number only
B. Medication label against the prescription
C. Visitor's identity
D. Meal schedule
Answer: B. Medication verification reduces administration
errors.
