EVOLVE FUNDAMENTALS HESI [2026] | UPDATED ACTUAL |
100% CORRECT ANSWERS | DETAILED SOLUTIONS |
• A client is in the radiology department at 0900 when the prescription
levofloxacin (Levaquin) 500 mg IV q24h is scheduled to be administered. The
client returns to the unit at 1300. What is the best intervention for the nurse to
implement? -✓✓ANSWER: Give the missed dose at 1300 and change the schedule
to administer daily at 1300.
• A client who is in hospice care complains of increasing amounts of pain. The
healthcare provider prescribes an analgesic every four hours as needed. Which
action should the nurse implement? -✓✓ANSWER: Give an around-the-clock
schedule for administration of analgesics.
• After completing an assessment and determining that a client has a problem,
which action should the nurse perform next? -✓✓ANSWER: determine the
etiology of the problem
• What is the most important reason for starting intravenous infusions in the
upper extremities rather than the lower extremities of adults? -✓✓ANSWER: A
decreased flow rate could result in the formation of a thrombosis.
• The nurse notices that the mother of a 9-year-old Vietnamese child always looks
at the floor when she talks to the nurse. What action should the nurse take? -
✓✓ANSWER: Continue asking the mother questions about the child.
• Which intervention is most important for the nurse to implement for a male
client who is experiencing urinary retention? -✓✓ANSWER: Assess for bladder
distention.
,• A client who is a Jehovah's Witness is admitted to the nursing unit. Which
concern should the nurse have for planning care in terms of the client's beliefs? -
✓✓ANSWER: Blood transfusions are forbidden.
• While instructing a male client's wife in the performance of passive range-of-
motion exercises to his contracted shoulder, the nurse observes that she is
holding his arm above and below the elbow. What nursing action should the
nurse implement? -✓✓ANSWER: Acknowledge that she is supporting the arm
correctly.
• An elderly male client who is unresponsive following a cerebral vascular
accident (CVA) is receiving bolus enteral feedings though a gastrostomy tube.
What is the best client position for administration of the bolus tube feedings? -
✓✓ANSWER: Fowler's.
• An adult male client with a history of hypertension tells the nurse that he is
tired of taking antihypertensive medications and is going to try spiritual
meditation instead. What should be the nurse's first response? -✓✓ANSWER: It is
important that you continue your medication while learning to meditate.
• A client is to receive cimetidine (Tagamet) 300 mg q6h IVPB. The preparation
arrives from the pharmacy diluted in 50 ml of 0.9% NaCl. The nurse plans to
administer the IVPB dose over 20 minutes. For how many ml/hr should the
infusion pump be set to deliver the secondary infusion? -✓✓ANSWER: 150
• The nurse is completing a mental assessment for a client who is demonstrating
slow thought processes, personality changes, and emotional lability. Which area
of the brain controls these neuro-cognitive functions? -✓✓ANSWER: Frontal lobe
, • A client is receiving a cephalosporin antibiotic IV and complains of pain and
irritation at the infusion site. The nurse observes erythema, swelling, and a red
streak along the vessel above the IV access site. Which action should the nurse
take at this time? -✓✓ANSWER: Initiate an alternate site for the IV infusion of the
medication.
• A female client asks the nurse to find someone who can translate into her native
language her concerns about a treatment. Which action should the nurse take? -
✓✓ANSWER: Request and document the name of the certified translator.
• A 73-year-old female client had a hemiarthroplasty of the left hip yesterday due
to a fracture resulting from a fall. In reviewing hip precautions with the client,
which instruction should the nurse include in this client's teaching plan? -
✓✓ANSWER: Place a pillow between your knees while lying in bed to prevent hip
dislocation.
• An elderly resident of a long-term care facility is no longer able to perform self-
care and is becoming progressively weaker. The resident previously requested
that no resuscitative efforts be performed, and the family requests hospice care.
What action should the nurse implement first? -✓✓ANSWER: Notify the
healthcare provider of the family's request.
• A young mother of three children complains of increased anxiety during her
annual physical exam. What information should the nurse obtain first? -
✓✓ANSWER: Nutritional history.
• The nurse prepares a 1,000 ml IV of 5% dextrose and water to be infused over 8
hours. The infusion set delivers 10 drops per milliliter. The nurse should regulate
the IV to administer approximately how many drops per minute? -✓✓ANSWER:
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100% CORRECT ANSWERS | DETAILED SOLUTIONS |
• A client is in the radiology department at 0900 when the prescription
levofloxacin (Levaquin) 500 mg IV q24h is scheduled to be administered. The
client returns to the unit at 1300. What is the best intervention for the nurse to
implement? -✓✓ANSWER: Give the missed dose at 1300 and change the schedule
to administer daily at 1300.
• A client who is in hospice care complains of increasing amounts of pain. The
healthcare provider prescribes an analgesic every four hours as needed. Which
action should the nurse implement? -✓✓ANSWER: Give an around-the-clock
schedule for administration of analgesics.
• After completing an assessment and determining that a client has a problem,
which action should the nurse perform next? -✓✓ANSWER: determine the
etiology of the problem
• What is the most important reason for starting intravenous infusions in the
upper extremities rather than the lower extremities of adults? -✓✓ANSWER: A
decreased flow rate could result in the formation of a thrombosis.
• The nurse notices that the mother of a 9-year-old Vietnamese child always looks
at the floor when she talks to the nurse. What action should the nurse take? -
✓✓ANSWER: Continue asking the mother questions about the child.
• Which intervention is most important for the nurse to implement for a male
client who is experiencing urinary retention? -✓✓ANSWER: Assess for bladder
distention.
,• A client who is a Jehovah's Witness is admitted to the nursing unit. Which
concern should the nurse have for planning care in terms of the client's beliefs? -
✓✓ANSWER: Blood transfusions are forbidden.
• While instructing a male client's wife in the performance of passive range-of-
motion exercises to his contracted shoulder, the nurse observes that she is
holding his arm above and below the elbow. What nursing action should the
nurse implement? -✓✓ANSWER: Acknowledge that she is supporting the arm
correctly.
• An elderly male client who is unresponsive following a cerebral vascular
accident (CVA) is receiving bolus enteral feedings though a gastrostomy tube.
What is the best client position for administration of the bolus tube feedings? -
✓✓ANSWER: Fowler's.
• An adult male client with a history of hypertension tells the nurse that he is
tired of taking antihypertensive medications and is going to try spiritual
meditation instead. What should be the nurse's first response? -✓✓ANSWER: It is
important that you continue your medication while learning to meditate.
• A client is to receive cimetidine (Tagamet) 300 mg q6h IVPB. The preparation
arrives from the pharmacy diluted in 50 ml of 0.9% NaCl. The nurse plans to
administer the IVPB dose over 20 minutes. For how many ml/hr should the
infusion pump be set to deliver the secondary infusion? -✓✓ANSWER: 150
• The nurse is completing a mental assessment for a client who is demonstrating
slow thought processes, personality changes, and emotional lability. Which area
of the brain controls these neuro-cognitive functions? -✓✓ANSWER: Frontal lobe
, • A client is receiving a cephalosporin antibiotic IV and complains of pain and
irritation at the infusion site. The nurse observes erythema, swelling, and a red
streak along the vessel above the IV access site. Which action should the nurse
take at this time? -✓✓ANSWER: Initiate an alternate site for the IV infusion of the
medication.
• A female client asks the nurse to find someone who can translate into her native
language her concerns about a treatment. Which action should the nurse take? -
✓✓ANSWER: Request and document the name of the certified translator.
• A 73-year-old female client had a hemiarthroplasty of the left hip yesterday due
to a fracture resulting from a fall. In reviewing hip precautions with the client,
which instruction should the nurse include in this client's teaching plan? -
✓✓ANSWER: Place a pillow between your knees while lying in bed to prevent hip
dislocation.
• An elderly resident of a long-term care facility is no longer able to perform self-
care and is becoming progressively weaker. The resident previously requested
that no resuscitative efforts be performed, and the family requests hospice care.
What action should the nurse implement first? -✓✓ANSWER: Notify the
healthcare provider of the family's request.
• A young mother of three children complains of increased anxiety during her
annual physical exam. What information should the nurse obtain first? -
✓✓ANSWER: Nutritional history.
• The nurse prepares a 1,000 ml IV of 5% dextrose and water to be infused over 8
hours. The infusion set delivers 10 drops per milliliter. The nurse should regulate
the IV to administer approximately how many drops per minute? -✓✓ANSWER:
21
