1|Page
2026 Evolve HESI Fundamentals Exam (Versions 1, 2
& 3) | Complete Questions and Guide Answers, 100%
Verified Graded A+
1. A nurse is receiving a client from the emergency department who
reports sudden shortness of breath and chest pressure. The client's
respiratory rate is 30/min, oxygen saturation is 88% on room air, and the
client appears anxious and diaphoretic. Which action should the nurse
take first?
A. Obtain a complete health history.
B. Place the client in a high-Fowler's position and initiate oxygen
according to protocol.
C. Ask the client to rate the chest pressure from 0 to 10.
D. Document the findings before contacting the healthcare provider.
Answer: B
2. A nurse is caring for four clients. Which client should the nurse assess
first?
A. A client with chronic arthritis reporting pain of 6/10.
B. A postoperative client requesting assistance to the bathroom.
C. A client with pneumonia whose oxygen saturation has decreased from
95% to 86%.
D. A client awaiting discharge who has questions about prescribed
medications.
Answer: C
3. While preparing a sterile field for a urinary catheterization, the nurse
accidentally allows the sterile glove to touch the edge of the bedside
table. What is the nurse's best action?
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A. Continue because only the outside of the glove touched the table.
B. Clean the glove with antiseptic solution and continue.
C. Replace the contaminated glove before proceeding.
D. Ask the client whether contamination is acceptable.
Answer: C
4. A client receiving enteral nutrition through a nasogastric tube
suddenly begins coughing forcefully and develops difficulty breathing
during the feeding. Which action is the priority?
A. Increase the rate of the feeding to complete it quickly.
B. Stop the feeding and assess the client's respiratory status.
C. Flush the tube with 30 mL of water.
D. Place the client flat to facilitate tube drainage.
Answer: B
5. A nurse is preparing to administer an oral medication to an older adult
who has difficulty swallowing. Which intervention is most appropriate?
A. Crush every medication and mix it with food.
B. Ask the client to swallow the medication while lying flat.
C. Determine whether the medication can safely be crushed and
administer it using an appropriate swallowing technique.
D. Leave the medication at the bedside so the client can take it later.
Answer: C
6. A nurse enters a client's room and discovers the client lying on the
floor beside the bed. Which action should occur first?
A. Complete an incident report.
B. Move the client immediately back into bed.
C. Assess the client for injury and determine the level of responsiveness.
D. Notify the client's family.
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Answer: C
7. A confused client repeatedly attempts to get out of bed without
assistance. Which intervention should the nurse implement first?
A. Apply wrist restraints.
B. Place the client in a room far away from the nurses' station.
C. Identify and address the cause of the behavior while implementing
the least restrictive safety measures.
D. Administer a sedative without further assessment.
Answer: C
8. A client with orthostatic hypotension becomes dizzy when moving
from a lying position to standing. Which nursing intervention is most
appropriate?
A. Encourage the client to stand rapidly to improve circulation.
B. Assist the client to sit at the bedside before standing and monitor for
symptoms.
C. Restrict all oral fluids.
D. Keep the client on strict bed rest indefinitely.
Answer: B
9. A nurse is teaching a client how to use a cane after a lower-extremity
injury. Which instruction is correct?
A. Hold the cane on the injured side.
B. Move the strong leg first, followed by the cane.
C. Hold the cane on the stronger side of the body while advancing it
with the affected leg.
D. Place the cane approximately 2 feet in front of the body with every
step.
Answer: C
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10. A hospitalized client develops redness over the sacral area that does
not blanch when pressure is removed. Which intervention should the
nurse prioritize?
A. Massage the reddened area vigorously.
B. Apply a heating pad directly over the area.
C. Relieve pressure from the area and implement pressure-injury
prevention measures.
D. Keep the client in the same position to prevent friction.
Answer: C
11. A nurse is assessing a client's risk for pressure injury using the
Braden Scale. Which finding should increase the nurse's concern?
A. Independent ambulation
B. Frequent repositioning
C. Limited mobility combined with moisture exposure and inadequate
nutrition
D. Intact sensation and adequate dietary intake
Answer: C
12. A client has a prescription for an intramuscular medication. Which
site is generally preferred for many adult IM injections because of its
location away from major nerves and blood vessels?
A. Dorsogluteal
B. Ventrogluteal
C. Inner forearm
D. Abdomen
Answer: B
13. A nurse realizes that the wrong dose of medication was administered
to a client. The client currently has no symptoms. Which action is the
priority?
2026 Evolve HESI Fundamentals Exam (Versions 1, 2
& 3) | Complete Questions and Guide Answers, 100%
Verified Graded A+
1. A nurse is receiving a client from the emergency department who
reports sudden shortness of breath and chest pressure. The client's
respiratory rate is 30/min, oxygen saturation is 88% on room air, and the
client appears anxious and diaphoretic. Which action should the nurse
take first?
A. Obtain a complete health history.
B. Place the client in a high-Fowler's position and initiate oxygen
according to protocol.
C. Ask the client to rate the chest pressure from 0 to 10.
D. Document the findings before contacting the healthcare provider.
Answer: B
2. A nurse is caring for four clients. Which client should the nurse assess
first?
A. A client with chronic arthritis reporting pain of 6/10.
B. A postoperative client requesting assistance to the bathroom.
C. A client with pneumonia whose oxygen saturation has decreased from
95% to 86%.
D. A client awaiting discharge who has questions about prescribed
medications.
Answer: C
3. While preparing a sterile field for a urinary catheterization, the nurse
accidentally allows the sterile glove to touch the edge of the bedside
table. What is the nurse's best action?
,2|Page
A. Continue because only the outside of the glove touched the table.
B. Clean the glove with antiseptic solution and continue.
C. Replace the contaminated glove before proceeding.
D. Ask the client whether contamination is acceptable.
Answer: C
4. A client receiving enteral nutrition through a nasogastric tube
suddenly begins coughing forcefully and develops difficulty breathing
during the feeding. Which action is the priority?
A. Increase the rate of the feeding to complete it quickly.
B. Stop the feeding and assess the client's respiratory status.
C. Flush the tube with 30 mL of water.
D. Place the client flat to facilitate tube drainage.
Answer: B
5. A nurse is preparing to administer an oral medication to an older adult
who has difficulty swallowing. Which intervention is most appropriate?
A. Crush every medication and mix it with food.
B. Ask the client to swallow the medication while lying flat.
C. Determine whether the medication can safely be crushed and
administer it using an appropriate swallowing technique.
D. Leave the medication at the bedside so the client can take it later.
Answer: C
6. A nurse enters a client's room and discovers the client lying on the
floor beside the bed. Which action should occur first?
A. Complete an incident report.
B. Move the client immediately back into bed.
C. Assess the client for injury and determine the level of responsiveness.
D. Notify the client's family.
,3|Page
Answer: C
7. A confused client repeatedly attempts to get out of bed without
assistance. Which intervention should the nurse implement first?
A. Apply wrist restraints.
B. Place the client in a room far away from the nurses' station.
C. Identify and address the cause of the behavior while implementing
the least restrictive safety measures.
D. Administer a sedative without further assessment.
Answer: C
8. A client with orthostatic hypotension becomes dizzy when moving
from a lying position to standing. Which nursing intervention is most
appropriate?
A. Encourage the client to stand rapidly to improve circulation.
B. Assist the client to sit at the bedside before standing and monitor for
symptoms.
C. Restrict all oral fluids.
D. Keep the client on strict bed rest indefinitely.
Answer: B
9. A nurse is teaching a client how to use a cane after a lower-extremity
injury. Which instruction is correct?
A. Hold the cane on the injured side.
B. Move the strong leg first, followed by the cane.
C. Hold the cane on the stronger side of the body while advancing it
with the affected leg.
D. Place the cane approximately 2 feet in front of the body with every
step.
Answer: C
, 4|Page
10. A hospitalized client develops redness over the sacral area that does
not blanch when pressure is removed. Which intervention should the
nurse prioritize?
A. Massage the reddened area vigorously.
B. Apply a heating pad directly over the area.
C. Relieve pressure from the area and implement pressure-injury
prevention measures.
D. Keep the client in the same position to prevent friction.
Answer: C
11. A nurse is assessing a client's risk for pressure injury using the
Braden Scale. Which finding should increase the nurse's concern?
A. Independent ambulation
B. Frequent repositioning
C. Limited mobility combined with moisture exposure and inadequate
nutrition
D. Intact sensation and adequate dietary intake
Answer: C
12. A client has a prescription for an intramuscular medication. Which
site is generally preferred for many adult IM injections because of its
location away from major nerves and blood vessels?
A. Dorsogluteal
B. Ventrogluteal
C. Inner forearm
D. Abdomen
Answer: B
13. A nurse realizes that the wrong dose of medication was administered
to a client. The client currently has no symptoms. Which action is the
priority?
