Evolve HESI Fundamentals 2026/2027 | HESI RN Fundamentals Specialty
Exam Study Guide, HESI Fundamentals Exam Prep, Evolve HESI Nursing
Fundamentals Review, Nursing Process, Assessment, Safety, Infection
Control, Vital Signs, Medication Administration, Communication,
Documentation, Patient Care, Clinical Judgment, Practice Questions,
Answers & Rationales
Question 1: A nurse is preparing to administer a medication via the enteral
route. Which action should the nurse take first?
A. Verify the medication order against the medication administration record
B. Crush the medication and mix it with applesauce
C. Position the client in a supine position
D. Administer the medication with a full glass of water
CORRECT ANSWER: A. Verify the medication order against the medication
administration record
Rationale: The first step in safe medication administration is verifying the order
against the medication administration record to ensure the right medication,
dose, route, and time. Crushing medication, positioning, and administering water
are subsequent steps and depend on the specific medication and client condition.
Question 2: A nurse is assessing a client who has been receiving intravenous
fluids for 24 hours. Which finding indicates a potential complication?
A. Blood pressure of 118/76 mm Hg
B. Heart rate of 88 beats per minute
C. Crackles in the lung bases
D. Urine output of 50 mL/hr
CORRECT ANSWER: C. Crackles in the lung bases
Rationale: Crackles in the lung bases may indicate fluid overload or pulmonary
edema, a potential complication of IV fluid therapy. The other findings are within
normal limits and do not suggest a complication.
Question 3: A nurse is caring for a client who requires a sterile dressing change.
Which action demonstrates proper sterile technique?
A. Reaching over the sterile field to obtain supplies
B. Placing sterile items on the edge of the sterile field
,C. Holding sterile instruments above the waist
D. Using a contaminated glove to touch sterile items
CORRECT ANSWER: C. Holding sterile instruments above the waist
Rationale: Sterile instruments must be held above the waist because areas below
the waist are considered contaminated. Reaching over the field, placing items on
the edge, and using contaminated gloves all break sterile technique.
Question 4: A nurse is teaching a client about the purpose of a low-sodium diet.
Which statement by the client indicates understanding?
A. "I should avoid foods like canned soups and processed meats."
B. "I can use salt substitutes freely without checking with my doctor."
C. "I should increase my intake of pickled foods."
D. "I only need to avoid adding salt at the table."
CORRECT ANSWER: A. "I should avoid foods like canned soups and processed
meats."
Rationale: Canned soups and processed meats are high in sodium and should be
avoided on a low-sodium diet. Salt substitutes may contain potassium and require
provider approval. Pickled foods are high in sodium. Avoiding only table salt is
insufficient because most sodium comes from processed foods.
Question 5: A nurse is performing a focused respiratory assessment. Which
technique should the nurse use to assess for tactile fremitus?
A. Auscultating lung sounds with a stethoscope
B. Percussing the chest wall
C. Palpating the chest while the client speaks
D. Inspecting the chest for symmetrical expansion
CORRECT ANSWER: C. Palpating the chest while the client speaks
Rationale: Tactile fremitus is assessed by palpating the chest wall while the client
speaks and feeling for vibrations. Auscultation assesses breath sounds, percussion
assesses density, and inspection assesses visual symmetry.
Question 6: A nurse is preparing to insert a urinary catheter. Which action is
most important to prevent infection?
,A. Using clean gloves during insertion
B. Performing hand hygiene and using sterile technique
C. Lubricating the catheter with petroleum jelly
D. Reusing the catheter if insertion is unsuccessful
CORRECT ANSWER: B. Performing hand hygiene and using sterile technique
Rationale: Hand hygiene and sterile technique are essential to prevent catheter-
associated urinary tract infections. Clean gloves are not sufficient, petroleum jelly
is not appropriate lubricant, and catheters must never be reused.
Question 7: A nurse is caring for a client with a stage 2 pressure injury. Which
characteristic is expected?
A. Full-thickness skin loss with visible subcutaneous fat
B. Partial-thickness skin loss with exposed dermis
C. Intact skin with nonblanchable redness
D. Full-thickness tissue loss with exposed bone
CORRECT ANSWER: B. Partial-thickness skin loss with exposed dermis
Rationale: A stage 2 pressure injury involves partial-thickness skin loss with
exposed dermis. Stage 1 is intact skin with nonblanchable redness, stage 3 is full-
thickness loss with visible fat, and stage 4 involves exposed bone, tendon, or
muscle.
Question 8: A nurse is calculating intake and output. The client drank 8 oz of
coffee, 4 oz of juice, and 12 oz of water. What is the total intake in milliliters?
A. 480 mL
B. 600 mL
C. 720 mL
D. 840 mL
CORRECT ANSWER: C. 720 mL
Rationale: 8 oz + 4 oz + 12 oz = 24 oz. Since 1 oz = 30 mL, 24 × 30 = 720 mL.
Question 9: A nurse is preparing to administer oxygen to a client with COPD.
Which delivery device provides the most precise oxygen concentration?
, A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Nonrebreather mask
CORRECT ANSWER: C. Venturi mask
Rationale: The Venturi mask delivers the most precise oxygen concentration
because it uses a specific air-to-oxygen ratio. Nasal cannula, simple face mask,
and nonrebreather mask provide less precise concentrations.
Question 10: A nurse is assessing a client for signs of dehydration. Which finding
is most consistent with dehydration?
A. Bounding pulse
B. Moist mucous membranes
C. Poor skin turgor
D. Increased urine output
CORRECT ANSWER: C. Poor skin turgor
Rationale: Poor skin turgor is a classic sign of dehydration. Bounding pulse, moist
mucous membranes, and increased urine output are not consistent with
dehydration.
Question 11: A nurse is preparing to administer a subcutaneous injection. Which
site is most appropriate?
A. Deltoid muscle
B. Vastus lateralis
C. Abdomen
D. Dorsogluteal
CORRECT ANSWER: C. Abdomen
Rationale: The abdomen is a preferred site for subcutaneous injections because of
its consistent absorption. Deltoid, vastus lateralis, and dorsogluteal are
intramuscular sites.
Question 12: A nurse is caring for a client on fall precautions. Which
intervention is most effective in preventing falls?
Exam Study Guide, HESI Fundamentals Exam Prep, Evolve HESI Nursing
Fundamentals Review, Nursing Process, Assessment, Safety, Infection
Control, Vital Signs, Medication Administration, Communication,
Documentation, Patient Care, Clinical Judgment, Practice Questions,
Answers & Rationales
Question 1: A nurse is preparing to administer a medication via the enteral
route. Which action should the nurse take first?
A. Verify the medication order against the medication administration record
B. Crush the medication and mix it with applesauce
C. Position the client in a supine position
D. Administer the medication with a full glass of water
CORRECT ANSWER: A. Verify the medication order against the medication
administration record
Rationale: The first step in safe medication administration is verifying the order
against the medication administration record to ensure the right medication,
dose, route, and time. Crushing medication, positioning, and administering water
are subsequent steps and depend on the specific medication and client condition.
Question 2: A nurse is assessing a client who has been receiving intravenous
fluids for 24 hours. Which finding indicates a potential complication?
A. Blood pressure of 118/76 mm Hg
B. Heart rate of 88 beats per minute
C. Crackles in the lung bases
D. Urine output of 50 mL/hr
CORRECT ANSWER: C. Crackles in the lung bases
Rationale: Crackles in the lung bases may indicate fluid overload or pulmonary
edema, a potential complication of IV fluid therapy. The other findings are within
normal limits and do not suggest a complication.
Question 3: A nurse is caring for a client who requires a sterile dressing change.
Which action demonstrates proper sterile technique?
A. Reaching over the sterile field to obtain supplies
B. Placing sterile items on the edge of the sterile field
,C. Holding sterile instruments above the waist
D. Using a contaminated glove to touch sterile items
CORRECT ANSWER: C. Holding sterile instruments above the waist
Rationale: Sterile instruments must be held above the waist because areas below
the waist are considered contaminated. Reaching over the field, placing items on
the edge, and using contaminated gloves all break sterile technique.
Question 4: A nurse is teaching a client about the purpose of a low-sodium diet.
Which statement by the client indicates understanding?
A. "I should avoid foods like canned soups and processed meats."
B. "I can use salt substitutes freely without checking with my doctor."
C. "I should increase my intake of pickled foods."
D. "I only need to avoid adding salt at the table."
CORRECT ANSWER: A. "I should avoid foods like canned soups and processed
meats."
Rationale: Canned soups and processed meats are high in sodium and should be
avoided on a low-sodium diet. Salt substitutes may contain potassium and require
provider approval. Pickled foods are high in sodium. Avoiding only table salt is
insufficient because most sodium comes from processed foods.
Question 5: A nurse is performing a focused respiratory assessment. Which
technique should the nurse use to assess for tactile fremitus?
A. Auscultating lung sounds with a stethoscope
B. Percussing the chest wall
C. Palpating the chest while the client speaks
D. Inspecting the chest for symmetrical expansion
CORRECT ANSWER: C. Palpating the chest while the client speaks
Rationale: Tactile fremitus is assessed by palpating the chest wall while the client
speaks and feeling for vibrations. Auscultation assesses breath sounds, percussion
assesses density, and inspection assesses visual symmetry.
Question 6: A nurse is preparing to insert a urinary catheter. Which action is
most important to prevent infection?
,A. Using clean gloves during insertion
B. Performing hand hygiene and using sterile technique
C. Lubricating the catheter with petroleum jelly
D. Reusing the catheter if insertion is unsuccessful
CORRECT ANSWER: B. Performing hand hygiene and using sterile technique
Rationale: Hand hygiene and sterile technique are essential to prevent catheter-
associated urinary tract infections. Clean gloves are not sufficient, petroleum jelly
is not appropriate lubricant, and catheters must never be reused.
Question 7: A nurse is caring for a client with a stage 2 pressure injury. Which
characteristic is expected?
A. Full-thickness skin loss with visible subcutaneous fat
B. Partial-thickness skin loss with exposed dermis
C. Intact skin with nonblanchable redness
D. Full-thickness tissue loss with exposed bone
CORRECT ANSWER: B. Partial-thickness skin loss with exposed dermis
Rationale: A stage 2 pressure injury involves partial-thickness skin loss with
exposed dermis. Stage 1 is intact skin with nonblanchable redness, stage 3 is full-
thickness loss with visible fat, and stage 4 involves exposed bone, tendon, or
muscle.
Question 8: A nurse is calculating intake and output. The client drank 8 oz of
coffee, 4 oz of juice, and 12 oz of water. What is the total intake in milliliters?
A. 480 mL
B. 600 mL
C. 720 mL
D. 840 mL
CORRECT ANSWER: C. 720 mL
Rationale: 8 oz + 4 oz + 12 oz = 24 oz. Since 1 oz = 30 mL, 24 × 30 = 720 mL.
Question 9: A nurse is preparing to administer oxygen to a client with COPD.
Which delivery device provides the most precise oxygen concentration?
, A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Nonrebreather mask
CORRECT ANSWER: C. Venturi mask
Rationale: The Venturi mask delivers the most precise oxygen concentration
because it uses a specific air-to-oxygen ratio. Nasal cannula, simple face mask,
and nonrebreather mask provide less precise concentrations.
Question 10: A nurse is assessing a client for signs of dehydration. Which finding
is most consistent with dehydration?
A. Bounding pulse
B. Moist mucous membranes
C. Poor skin turgor
D. Increased urine output
CORRECT ANSWER: C. Poor skin turgor
Rationale: Poor skin turgor is a classic sign of dehydration. Bounding pulse, moist
mucous membranes, and increased urine output are not consistent with
dehydration.
Question 11: A nurse is preparing to administer a subcutaneous injection. Which
site is most appropriate?
A. Deltoid muscle
B. Vastus lateralis
C. Abdomen
D. Dorsogluteal
CORRECT ANSWER: C. Abdomen
Rationale: The abdomen is a preferred site for subcutaneous injections because of
its consistent absorption. Deltoid, vastus lateralis, and dorsogluteal are
intramuscular sites.
Question 12: A nurse is caring for a client on fall precautions. Which
intervention is most effective in preventing falls?
