Evolve HESI Fundamentals Exam 2026/2027 –
Latest 200 Q&A with Detailed Italicized Rationales
| Elsevier Evolve RN & PN Practice Test
SECTION 1: Patient Safety & Basic Care (Questions 1–25)
1. When turning an immobile bedridden client without assistance, which action by the
nurse best ensures client safety?
A) Securely grasp the client's arm and leg.
B) Put bed rails up on the side of bed opposite from the nurse.
C) Correctly position and use a turn sheet.
D) Lower the head of the client's bed slowly.
Answer: B
Rationale: Because the nurse can only stand on one side of the bed, bed rails should be up
on the opposite side to ensure that the client does not fall out of bed. Option A can cause
client injury to the skin or joint. Options C and D are useful techniques while turning a client
but have less priority in terms of safety than use of the bed rails.
2. When assisting a client from the bed to a chair, which procedure is best for the
nurse to follow?
A) Place the chair parallel to the bed, with its back toward the head of the bed and assist the
client in moving to the chair.
,B) With the nurse's feet spread apart and knees aligned with the client's knees, stand and
pivot the client into the chair.
C) Assist the client to a standing position by gently lifting upward, underneath the axillae.
D) Stand beside the client, place the client's arms around the nurse's neck, and gently move
the client to the chair.
Answer: B
Rationale: Option B describes the correct positioning of the nurse and affords the nurse a
wide base of support while stabilizing the client's knees when assisting to a standing
position. The chair should be placed at a 45-degree angle to the bed, with the back of the
chair toward the head of the bed. Clients should never be lifted under the axillae; this could
damage nerves and strain the nurse's back. The client should be instructed to use the arms
of the chair and should never place his or her arms around the nurse's neck; this places
undue stress on the nurse's neck and back and increases the risk for a fall.
3. A 20-year-old female client with a noticeable body odor has refused to shower for
the last 3 days. She states, "I have been told that it is harmful to bathe during my
period." Which action should the nurse take first?
A) Insist that the client bathe.
B) Explain that bathing is safe during menstruation.
C) Respect the client's cultural beliefs and provide privacy.
D) Notify the healthcare provider.
Answer: B
Rationale: The nurse should first provide education about the safety of bathing during
menstruation, as the client's belief is based on misinformation. Respecting cultural beliefs is
important, but providing accurate health information takes priority. Insisting or notifying the
provider is not the first action.
,4. A client on fall precautions is attempting to get out of bed without assistance. What
is the nurse's priority action?
A) Apply a bed alarm.
B) Assist the client back to bed and assess for injury.
C) Document the incident.
D) Notify the healthcare provider.
Answer: B
Rationale: The priority is immediate safety. The nurse should assist the client back to bed
and assess for any injury before implementing further interventions such as a bed alarm or
documentation.
5. Which action is most effective for preventing transmission of infection?
A) Wearing gloves at all times.
B) Hand hygiene.
C) Wearing a mask.
D) Isolating all clients.
Answer: B
Rationale: Hand hygiene is the single most effective intervention for preventing the spread
of infection. Gloves, masks, and isolation are important but hand hygiene remains the
cornerstone of infection control.
6. A nurse is preparing to insert a urinary catheter. Which type of precautions
requires sterile technique?
A) Standard precautions
B) Contact precautions
C) Droplet precautions
D) Airborne precautions
, Answer: A
Rationale: Inserting a urinary catheter requires sterile technique because it involves entering
a sterile body cavity (the bladder). Standard precautions include the use of sterile technique
for invasive procedures.
7. A client with tuberculosis (TB) is admitted to the unit. Which precautions should
the nurse implement?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions only
Answer: C
Rationale: TB requires airborne precautions (negative pressure room, N95 respirator)
because it is transmitted via airborne droplet nuclei.
8. The nurse is caring for a client with a suspected urinary tract infection. Which
action is most important to prevent infection?
A) Emptying the drainage bag using sterile technique.
B) Disconnecting the catheter frequently.
C) Using alcohol swabs only.
D) Changing tubing every hour.
Answer: A
Rationale: Drains should be emptied using sterile technique to prevent infection. Maintaining
a closed drainage system and avoiding unnecessary disconnection are also important.
9. Which patient is at highest risk for falls?
A) Young adult
Latest 200 Q&A with Detailed Italicized Rationales
| Elsevier Evolve RN & PN Practice Test
SECTION 1: Patient Safety & Basic Care (Questions 1–25)
1. When turning an immobile bedridden client without assistance, which action by the
nurse best ensures client safety?
A) Securely grasp the client's arm and leg.
B) Put bed rails up on the side of bed opposite from the nurse.
C) Correctly position and use a turn sheet.
D) Lower the head of the client's bed slowly.
Answer: B
Rationale: Because the nurse can only stand on one side of the bed, bed rails should be up
on the opposite side to ensure that the client does not fall out of bed. Option A can cause
client injury to the skin or joint. Options C and D are useful techniques while turning a client
but have less priority in terms of safety than use of the bed rails.
2. When assisting a client from the bed to a chair, which procedure is best for the
nurse to follow?
A) Place the chair parallel to the bed, with its back toward the head of the bed and assist the
client in moving to the chair.
,B) With the nurse's feet spread apart and knees aligned with the client's knees, stand and
pivot the client into the chair.
C) Assist the client to a standing position by gently lifting upward, underneath the axillae.
D) Stand beside the client, place the client's arms around the nurse's neck, and gently move
the client to the chair.
Answer: B
Rationale: Option B describes the correct positioning of the nurse and affords the nurse a
wide base of support while stabilizing the client's knees when assisting to a standing
position. The chair should be placed at a 45-degree angle to the bed, with the back of the
chair toward the head of the bed. Clients should never be lifted under the axillae; this could
damage nerves and strain the nurse's back. The client should be instructed to use the arms
of the chair and should never place his or her arms around the nurse's neck; this places
undue stress on the nurse's neck and back and increases the risk for a fall.
3. A 20-year-old female client with a noticeable body odor has refused to shower for
the last 3 days. She states, "I have been told that it is harmful to bathe during my
period." Which action should the nurse take first?
A) Insist that the client bathe.
B) Explain that bathing is safe during menstruation.
C) Respect the client's cultural beliefs and provide privacy.
D) Notify the healthcare provider.
Answer: B
Rationale: The nurse should first provide education about the safety of bathing during
menstruation, as the client's belief is based on misinformation. Respecting cultural beliefs is
important, but providing accurate health information takes priority. Insisting or notifying the
provider is not the first action.
,4. A client on fall precautions is attempting to get out of bed without assistance. What
is the nurse's priority action?
A) Apply a bed alarm.
B) Assist the client back to bed and assess for injury.
C) Document the incident.
D) Notify the healthcare provider.
Answer: B
Rationale: The priority is immediate safety. The nurse should assist the client back to bed
and assess for any injury before implementing further interventions such as a bed alarm or
documentation.
5. Which action is most effective for preventing transmission of infection?
A) Wearing gloves at all times.
B) Hand hygiene.
C) Wearing a mask.
D) Isolating all clients.
Answer: B
Rationale: Hand hygiene is the single most effective intervention for preventing the spread
of infection. Gloves, masks, and isolation are important but hand hygiene remains the
cornerstone of infection control.
6. A nurse is preparing to insert a urinary catheter. Which type of precautions
requires sterile technique?
A) Standard precautions
B) Contact precautions
C) Droplet precautions
D) Airborne precautions
, Answer: A
Rationale: Inserting a urinary catheter requires sterile technique because it involves entering
a sterile body cavity (the bladder). Standard precautions include the use of sterile technique
for invasive procedures.
7. A client with tuberculosis (TB) is admitted to the unit. Which precautions should
the nurse implement?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions only
Answer: C
Rationale: TB requires airborne precautions (negative pressure room, N95 respirator)
because it is transmitted via airborne droplet nuclei.
8. The nurse is caring for a client with a suspected urinary tract infection. Which
action is most important to prevent infection?
A) Emptying the drainage bag using sterile technique.
B) Disconnecting the catheter frequently.
C) Using alcohol swabs only.
D) Changing tubing every hour.
Answer: A
Rationale: Drains should be emptied using sterile technique to prevent infection. Maintaining
a closed drainage system and avoiding unnecessary disconnection are also important.
9. Which patient is at highest risk for falls?
A) Young adult
