EVOLVE HESI FUNDAMENTALS ACTUAL EXAM
EXPERT VERIFIED WITH DETAILED ANSWERS AND
RATIONALES|100% CORRECT |GUARANTEED
PASS | LATEST 2025/2026
An elderly client with a fractured left hip is on strict bedrest. Which
nursing measure is essential to the client's nursing care?
A) Massage any reddened areas for at least five minutes.
B) Encourage active range of motion exercises on extremities.
C) Position the client laterally, prone, and dorsally in sequence.
D) Gently lift the client when moving into a desired position.
D) Gently lift the client when moving into a desired position.
Rationale: To avoid shearing forces when repositioning, the client should
be lifted gently across a surface (D). Reddened areas should NOT be
massaged (A) since this may increase the damage to already
traumatized skin. To control pain and muscle spasms, active range of
motion (B) may be limited on the affected leg. The position described in
(C) is contraindicated for a client with a fractured left hip.
The UAPs working on a chronic neuro unit ask the nurse to help them
determine the safest way to transfer an elderly client w/ left-sided
weakness from the bed to the chair. What method describes the correct
transfer procedure for this client?
A) Place the chair at a right angle to the bed on the client's left side
before moving.
B) Assist the client to a standing position, then place the right hand on
,the armrest.
C) Have the client place the left foot next to the chair and pivot to the left
before sitting.
D) Move the chair parallel to the right side of the bed, and stand the
client on the right foot.
- Correct Answer - D) Move the chair parallel to the right side of the bed,
and stand the client on the right foot.
The nurse is administering medications through a nasogastric tube
(NGT) which is connected to suction. After ensuring correct tube
placement, what action should the nurse take next?
A) Clamp the tube for 20 minutes.
B) Flush the tube with water.
C) Administer the medications as prescribed.
D) Crush the tablets and dissolve in sterile water.
- Correct Answer - B) Flush the tube with water.
The NGT should be flushed before, after, and in between each
medication administered (B). Once all medications are administered, the
NGT should be clamped for 20 minutes (A). (C and D) may be
implemented only after the tubing has been flushed.
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?
A) Contact the healthcare provider and complete a medication variance
form.
,B) Administer the Levaquin at 1300 and resume the 0900 schedule in
the morning.
C) Notify the charge nurse and complete an incident report to explain the
missed dose.
D) Give the missed dose at 1300 and change the schedule to administer
daily at 1300.
- Correct Answer - D) Give the missed dose at 1300 and change the
schedule to administer daily at 1300.
Rationale: To ensure that a therapeutic level of medication is
maintained, the nurse should administer dose as soon as possible, and
revise the administration schedule accordingly to prevent dangerously
increasing the level of medication in the bloodstream (D). The nurse
should document the reason for the late dose, but (A and C) are not
warranted. (B) could result in increased blood levels of the drug.
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?
A) Give an around-the-clock schedule for administration of analgesics.
B) Administer analgesic medication as needed when the pain is severe.
C) Provide medication to keep the client sedated and unaware of stimuli.
D) Offer a medication-free period so that the client can do daily activities.
- Correct Answer - A) Give an around-the-clock schedule for
administration of analgesics.
Rationale: The most effective management of pain is achieved using an
around-the-clock schedule that provides analgesic medications on a
, regular basis (A) and in a timely manner. Analgesics are less effective if
pain persists until it is severe, so an analgesic medication should be
administered before the client's pain peaks (B). Providing comfort is a
priority for the client who is dying, but sedation that impairs the client's
ability to interact and experience the time before life ends should be
minimized (C). Offering a medication-free period allows the serum drug
level to fall, which is not an effective method to manage chronic pain.
A client with pneumonia has a decrease in oxygen saturation from 94%
to 88% while ambulating. Based on these findings, which intervention
should the nurse implement first?
A) Assist the ambulating client back to the bed.
B) Encourage the client to ambulate to resolve pneumonia.
C) Obtain a prescription for portable oxygen while ambulating.
D) Move the oximetry probe from the finger to the earlobe.
- Correct Answer - A) Assist the ambulating client back to the bed.
Rationale: An oxygen saturation below 90% indicates inadequate
oxygen. First, the client should be assisted to return to bed (A) to
minimize oxygen demands. Ambulation increases aeration of the lungs
to prevent pooling of respiratory secretions, but the client's activity at this
time is depleting oxygen saturation of the blood, so (B) is
contraindicated. Increased activity increases respiratory effort, and
oxygen may be necessary to continue ambulation (C), but first the client
should return to the bed to rest. Oxygen saturation levels at different
sites should be evaluated AFTER the client returns to bed (D).
EXPERT VERIFIED WITH DETAILED ANSWERS AND
RATIONALES|100% CORRECT |GUARANTEED
PASS | LATEST 2025/2026
An elderly client with a fractured left hip is on strict bedrest. Which
nursing measure is essential to the client's nursing care?
A) Massage any reddened areas for at least five minutes.
B) Encourage active range of motion exercises on extremities.
C) Position the client laterally, prone, and dorsally in sequence.
D) Gently lift the client when moving into a desired position.
D) Gently lift the client when moving into a desired position.
Rationale: To avoid shearing forces when repositioning, the client should
be lifted gently across a surface (D). Reddened areas should NOT be
massaged (A) since this may increase the damage to already
traumatized skin. To control pain and muscle spasms, active range of
motion (B) may be limited on the affected leg. The position described in
(C) is contraindicated for a client with a fractured left hip.
The UAPs working on a chronic neuro unit ask the nurse to help them
determine the safest way to transfer an elderly client w/ left-sided
weakness from the bed to the chair. What method describes the correct
transfer procedure for this client?
A) Place the chair at a right angle to the bed on the client's left side
before moving.
B) Assist the client to a standing position, then place the right hand on
,the armrest.
C) Have the client place the left foot next to the chair and pivot to the left
before sitting.
D) Move the chair parallel to the right side of the bed, and stand the
client on the right foot.
- Correct Answer - D) Move the chair parallel to the right side of the bed,
and stand the client on the right foot.
The nurse is administering medications through a nasogastric tube
(NGT) which is connected to suction. After ensuring correct tube
placement, what action should the nurse take next?
A) Clamp the tube for 20 minutes.
B) Flush the tube with water.
C) Administer the medications as prescribed.
D) Crush the tablets and dissolve in sterile water.
- Correct Answer - B) Flush the tube with water.
The NGT should be flushed before, after, and in between each
medication administered (B). Once all medications are administered, the
NGT should be clamped for 20 minutes (A). (C and D) may be
implemented only after the tubing has been flushed.
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?
A) Contact the healthcare provider and complete a medication variance
form.
,B) Administer the Levaquin at 1300 and resume the 0900 schedule in
the morning.
C) Notify the charge nurse and complete an incident report to explain the
missed dose.
D) Give the missed dose at 1300 and change the schedule to administer
daily at 1300.
- Correct Answer - D) Give the missed dose at 1300 and change the
schedule to administer daily at 1300.
Rationale: To ensure that a therapeutic level of medication is
maintained, the nurse should administer dose as soon as possible, and
revise the administration schedule accordingly to prevent dangerously
increasing the level of medication in the bloodstream (D). The nurse
should document the reason for the late dose, but (A and C) are not
warranted. (B) could result in increased blood levels of the drug.
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?
A) Give an around-the-clock schedule for administration of analgesics.
B) Administer analgesic medication as needed when the pain is severe.
C) Provide medication to keep the client sedated and unaware of stimuli.
D) Offer a medication-free period so that the client can do daily activities.
- Correct Answer - A) Give an around-the-clock schedule for
administration of analgesics.
Rationale: The most effective management of pain is achieved using an
around-the-clock schedule that provides analgesic medications on a
, regular basis (A) and in a timely manner. Analgesics are less effective if
pain persists until it is severe, so an analgesic medication should be
administered before the client's pain peaks (B). Providing comfort is a
priority for the client who is dying, but sedation that impairs the client's
ability to interact and experience the time before life ends should be
minimized (C). Offering a medication-free period allows the serum drug
level to fall, which is not an effective method to manage chronic pain.
A client with pneumonia has a decrease in oxygen saturation from 94%
to 88% while ambulating. Based on these findings, which intervention
should the nurse implement first?
A) Assist the ambulating client back to the bed.
B) Encourage the client to ambulate to resolve pneumonia.
C) Obtain a prescription for portable oxygen while ambulating.
D) Move the oximetry probe from the finger to the earlobe.
- Correct Answer - A) Assist the ambulating client back to the bed.
Rationale: An oxygen saturation below 90% indicates inadequate
oxygen. First, the client should be assisted to return to bed (A) to
minimize oxygen demands. Ambulation increases aeration of the lungs
to prevent pooling of respiratory secretions, but the client's activity at this
time is depleting oxygen saturation of the blood, so (B) is
contraindicated. Increased activity increases respiratory effort, and
oxygen may be necessary to continue ambulation (C), but first the client
should return to the bed to rest. Oxygen saturation levels at different
sites should be evaluated AFTER the client returns to bed (D).
