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EVOLVE HESI COMPREHENSIVE EXIT ACTUAL
EXAM 2026/2027 ACADEMIC YEAR – COMPLETE
PRACTICE QUESTION BANK WITH 250+ VERIFIED
QUESTIONS & ANSWERS, DETAILED RATIONALES,
NGN-STYLE CLINICAL JUDGMENT CASES, AND
EXAM PREP GUIDE | LATEST UPDATED VERSION |
100% GRADED A+ | GUARANTEED PASS
# TABLE OF CONTENTS
| Section | Content Area | Question Numbers | Weight |
|---------|--------------|------------------|--------|
| **I** | **Safe & Effective Care Environment** | | |
| | A. Management of Care | 1–50 | 17–23% |
| | B. Safety & Infection Control | 51–85 | 9–15% |
| **II** | **Health Promotion & Maintenance** | 86–115 | 6–12% |
| **III** | **Psychosocial Integrity** | 116–145 | 6–12% |
| **IV** | **Physiological Integrity** | | |
| | A. Basic Care & Comfort | 146–175 | 6–12% |
| | B. Pharmacological & Parenteral Therapies | 176–210 | 12–18% |
| | C. Reduction of Risk Potential | 211–240 | 9–15% |
| | D. Physiological Adaptation | 241–275 | 11–17% |
| **V** | **Next Generation NCLEX (NGN) Clinical Judgment** | 276–290 | Integrated |
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# SECTION I: SAFE & EFFECTIVE CARE ENVIRONMENT
## A. Management of Care (Questions 1–50)
**Question 1**
A nurse is preparing to delegate tasks to an unlicensed assistive personnel (UAP) on a medical-
surgical unit. Which task is appropriate for the nurse to delegate to the UAP?
A. Assessing a client's pain level using a 0–10 scale
B. Administering oral medications to a stable client
C. Ambulating a stable client who has been cleared for activity
D. Evaluating the effectiveness of a client's pain medication
**Correct Answer: C**
**Rationale:** Delegation follows the "Five Rights": right task, right circumstance, right person,
right direction/communication, and right supervision. UAPs can ambulate stable clients, assist
with activities of daily living, and obtain vital signs on stable clients. Assessment (A),
medication administration (B), and evaluation (D) require nursing judgment and cannot be
delegated to UAPs.
---
**Question 2**
A nurse receives a telephone order from a healthcare provider for a client's pain medication.
What is the nurse's priority action?
A. Implement the order immediately to prevent delay in pain relief
B. Write the order in the chart and sign it with "TO" (telephone order)
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C. Read the order back to the provider for verification
D. Ask another nurse to listen to the order as a witness
**Correct Answer: C**
**Rationale:** The "read back" process is a critical safety measure that ensures accurate
transmission of verbal and telephone orders. The nurse must read the order back to the provider
to verify accuracy before implementation. This prevents medication errors and is consistent with
The Joint Commission's National Patient Safety Goals. Implementing without verification (A),
writing without reading back (B), or having another nurse witness (D) does not ensure accuracy.
---
**Question 3**
A charge nurse is making patient assignments on a medical-surgical unit. Which client should be
assigned to the most experienced RN?
A. A 45-year-old client with diabetes mellitus requiring insulin administration
B. A 72-year-old client with pneumonia who is stable on room air
C. A 60-year-old client 1-day post-operative following a total hip replacement
D. A 55-year-old client with unstable angina on a continuous cardiac monitor
**Correct Answer: D**
**Rationale:** The client with unstable angina on continuous cardiac monitoring is the most
unstable and requires the highest level of nursing assessment and intervention. This client should
be assigned to the most experienced RN. The other clients are stable and can be assigned to less
experienced staff or LPNs under appropriate supervision. Prioritization is based on acuity and
stability.
, Page 4 of 184
**Question 4**
A client is being discharged with a new prescription for warfarin. Which statement by the client
indicates understanding of the medication teaching?
A. "I will eat more leafy green vegetables to help my blood clot better."
B. "I will get my INR checked regularly as scheduled."
C. "I can take ibuprofen if I have pain since it's over-the-counter."
D. "I will stop taking the medication if I notice any bruising."
**Correct Answer: B**
**Rationale:** Warfarin is an anticoagulant that requires regular monitoring of the International
Normalized Ratio (INR) to maintain therapeutic levels and prevent complications. Clients should
NOT increase leafy green vegetables (A) as they contain vitamin K which antagonizes warfarin.
Ibuprofen (C) increases bleeding risk and should be avoided. Stopping medication without
provider guidance (D) can lead to thrombotic events.
---
**Question 5**
A nurse is caring for a client who has a do-not-resuscitate (DNR) order. The client's family
member requests that the nurse perform CPR if the client's heart stops. What is the nurse's best
response?
A. "I will perform CPR if the family requests it."
B. "The DNR order is a legal document that must be followed."
C. "I will call the healthcare provider to change the order."
D. "I will perform CPR and then notify the provider afterward."
EVOLVE HESI COMPREHENSIVE EXIT ACTUAL
EXAM 2026/2027 ACADEMIC YEAR – COMPLETE
PRACTICE QUESTION BANK WITH 250+ VERIFIED
QUESTIONS & ANSWERS, DETAILED RATIONALES,
NGN-STYLE CLINICAL JUDGMENT CASES, AND
EXAM PREP GUIDE | LATEST UPDATED VERSION |
100% GRADED A+ | GUARANTEED PASS
# TABLE OF CONTENTS
| Section | Content Area | Question Numbers | Weight |
|---------|--------------|------------------|--------|
| **I** | **Safe & Effective Care Environment** | | |
| | A. Management of Care | 1–50 | 17–23% |
| | B. Safety & Infection Control | 51–85 | 9–15% |
| **II** | **Health Promotion & Maintenance** | 86–115 | 6–12% |
| **III** | **Psychosocial Integrity** | 116–145 | 6–12% |
| **IV** | **Physiological Integrity** | | |
| | A. Basic Care & Comfort | 146–175 | 6–12% |
| | B. Pharmacological & Parenteral Therapies | 176–210 | 12–18% |
| | C. Reduction of Risk Potential | 211–240 | 9–15% |
| | D. Physiological Adaptation | 241–275 | 11–17% |
| **V** | **Next Generation NCLEX (NGN) Clinical Judgment** | 276–290 | Integrated |
,Page 2 of 184
# SECTION I: SAFE & EFFECTIVE CARE ENVIRONMENT
## A. Management of Care (Questions 1–50)
**Question 1**
A nurse is preparing to delegate tasks to an unlicensed assistive personnel (UAP) on a medical-
surgical unit. Which task is appropriate for the nurse to delegate to the UAP?
A. Assessing a client's pain level using a 0–10 scale
B. Administering oral medications to a stable client
C. Ambulating a stable client who has been cleared for activity
D. Evaluating the effectiveness of a client's pain medication
**Correct Answer: C**
**Rationale:** Delegation follows the "Five Rights": right task, right circumstance, right person,
right direction/communication, and right supervision. UAPs can ambulate stable clients, assist
with activities of daily living, and obtain vital signs on stable clients. Assessment (A),
medication administration (B), and evaluation (D) require nursing judgment and cannot be
delegated to UAPs.
---
**Question 2**
A nurse receives a telephone order from a healthcare provider for a client's pain medication.
What is the nurse's priority action?
A. Implement the order immediately to prevent delay in pain relief
B. Write the order in the chart and sign it with "TO" (telephone order)
,Page 3 of 184
C. Read the order back to the provider for verification
D. Ask another nurse to listen to the order as a witness
**Correct Answer: C**
**Rationale:** The "read back" process is a critical safety measure that ensures accurate
transmission of verbal and telephone orders. The nurse must read the order back to the provider
to verify accuracy before implementation. This prevents medication errors and is consistent with
The Joint Commission's National Patient Safety Goals. Implementing without verification (A),
writing without reading back (B), or having another nurse witness (D) does not ensure accuracy.
---
**Question 3**
A charge nurse is making patient assignments on a medical-surgical unit. Which client should be
assigned to the most experienced RN?
A. A 45-year-old client with diabetes mellitus requiring insulin administration
B. A 72-year-old client with pneumonia who is stable on room air
C. A 60-year-old client 1-day post-operative following a total hip replacement
D. A 55-year-old client with unstable angina on a continuous cardiac monitor
**Correct Answer: D**
**Rationale:** The client with unstable angina on continuous cardiac monitoring is the most
unstable and requires the highest level of nursing assessment and intervention. This client should
be assigned to the most experienced RN. The other clients are stable and can be assigned to less
experienced staff or LPNs under appropriate supervision. Prioritization is based on acuity and
stability.
, Page 4 of 184
**Question 4**
A client is being discharged with a new prescription for warfarin. Which statement by the client
indicates understanding of the medication teaching?
A. "I will eat more leafy green vegetables to help my blood clot better."
B. "I will get my INR checked regularly as scheduled."
C. "I can take ibuprofen if I have pain since it's over-the-counter."
D. "I will stop taking the medication if I notice any bruising."
**Correct Answer: B**
**Rationale:** Warfarin is an anticoagulant that requires regular monitoring of the International
Normalized Ratio (INR) to maintain therapeutic levels and prevent complications. Clients should
NOT increase leafy green vegetables (A) as they contain vitamin K which antagonizes warfarin.
Ibuprofen (C) increases bleeding risk and should be avoided. Stopping medication without
provider guidance (D) can lead to thrombotic events.
---
**Question 5**
A nurse is caring for a client who has a do-not-resuscitate (DNR) order. The client's family
member requests that the nurse perform CPR if the client's heart stops. What is the nurse's best
response?
A. "I will perform CPR if the family requests it."
B. "The DNR order is a legal document that must be followed."
C. "I will call the healthcare provider to change the order."
D. "I will perform CPR and then notify the provider afterward."
