EVOLVE HESI FUNDAMENTALS EXAM 300 ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH RATIONALE
ALREADY GRADED A+ NEW!!!!!!!!!!!!!!!!!!!!!!!!
This comprehensive resource contains 300 unique, non-repetitive multiple-
choice questions meticulously designed to mirror the content and difficulty of
the Evolve HESI Fundamentals Exam. Each question is presented with a clear
stem, four distinct answer options, the correct answer, and a detailed,
evidence-based rationale that explains the underlying nursing principle. The
bank comprehensively covers all core content areas, including safe and
effective care environment, health promotion, psychosocial integrity, and
physiological integrity. Topics range from medication administration, wound
care, and nutrition to legal ethics, patient safety, and complex disease
management. This collection serves as an intensive review tool to strengthen
clinical judgment and prepare nursing students for success on their
standardized fundamentals examination.
1. A client with a nasogastric tube attached to low intermittent suction complains
of nausea. What is the priority nursing action?
A) Increase the suction level
B) Irrigate the tube with sterile water
C) Check for tube placement and patency
D) Administer an antiemetic as prescribed
Answer: C
Rationale: Nausea in a client with an NG tube often indicates tube displacement or
obstruction. The nurse must first verify placement and patency to ensure proper
functioning. Increasing suction could cause mucosal damage, irrigation without
checking placement risks aspiration, and an antiemetic does not address the
underlying mechanical issue.
2. A nurse is preparing to insert an indwelling urinary catheter. Which technique
should the nurse use to maintain sterility?
A) Clean gloves and sterile drapes
B) Sterile gloves and sterile drapes
C) Clean gloves and clean drapes
,D) Sterile gloves and clean drapes
Answer: B
Rationale: Indwelling catheter insertion requires sterile technique throughout.
Sterile gloves and sterile drapes maintain the sterile field and reduce the risk of
introducing pathogens into the urinary tract. Clean gloves or drapes violate sterility
and increase infection risk.
3. Which laboratory value indicates adequate protein intake over the past several
weeks?
A) Serum albumin
B) Prealbumin
C) Blood urea nitrogen (BUN)
D) Total lymphocyte count
Answer: A
Rationale: Serum albumin has a half-life of approximately 20 days, making it a
good indicator of protein status over weeks. Prealbumin reflects more acute
changes (2-3 days). BUN is affected by hydration and renal function, and
lymphocyte count reflects immune status rather than protein intake specifically.
4. A nurse notes that a client’s wound drainage is thick, yellow, and foul-smelling.
How should this finding be documented?
A) Serosanguineous drainage
B) Serous drainage
C) Purulent drainage
D) Sanguineous drainage
Answer: C
Rationale: Purulent drainage is thick, yellow, green, or brown and often has a foul
odor, indicating infection. Serous is clear and watery, sanguineous is bloody, and
serosanguineous is pink-tinged. Accurate documentation guides further treatment
such as wound cultures.
5. A postoperative client reports pain of 8 on a 0-10 scale. The nurse administers
morphine 2 mg IV. Thirty minutes later, the client reports pain of 6. What is the
nurse’s best action?
A) Administer another dose of morphine as prescribed
B) Document the pain reassessment and continue monitoring
C) Notify the healthcare provider immediately
D) Offer nonpharmacological comfort measures
Answer: B
,Rationale: A reduction from 8 to 6 indicates some analgesic effect. Documentation
is essential, and ongoing monitoring is appropriate. Another dose should only be
given when the prescribed interval allows. Nonpharmacologic measures can be
added but are not the priority action. Notification is not urgent since the pain is
improving.
6. A client with heart failure is prescribed a 2-gram sodium diet. Which food
selection indicates the client understands the teaching?
A) Grilled chicken breast with steamed vegetables
B) Canned tomato soup with crackers
C) Ham sandwich with pickles
D) Salted pretzels and cheese dip
Answer: A
Rationale: Fresh grilled chicken and steamed vegetables are naturally low in
sodium. Canned soups, ham, pickles, salted pretzels, and cheese dip are all high in
sodium and should be avoided on a restricted diet.
7. A nurse is caring for a client who is NPO and has a continuous IV infusion of
dextrose 5% in water. Which assessment finding indicates a complication of this
therapy?
A) Blood pressure 110/70 mmHg
B) Crackles auscultated in lung bases
C) Urine output 50 mL/hour
D) Skin turgor is normal
Answer: B
Rationale: Crackles in the lung bases suggest fluid volume overload, a
complication of IV therapy. Normal blood pressure, adequate urine output, and
normal skin turgor are expected findings. The nurse should reduce the infusion rate
and notify the provider.
8. A client is placed in restraints after other interventions failed to prevent harm.
How often must the nurse assess this client?
A) Every 30 minutes
B) Every 1 hour
C) Every 2 hours
D) Every 4 hours
Answer: C
Rationale: The standard requirement is that a restrained client must be assessed at
least every 2 hours for circulation, safety, comfort, and readiness for restraint
, removal. More frequent checks may be needed, but every 2 hours is the minimum
regulatory standard.
9. A nurse is teaching a client about fall prevention at home. Which statement
indicates the client needs further teaching?
A) I will use nightlights in the hallway
B) I will remove throw rugs from the floor
C) I will keep my walker close to my bed at night
D) I will wear socks without grips to be comfortable
Answer: D
Rationale: Wearing socks without grips increases fall risk due to slipping. The
client should wear nonskid footwear. Nightlights, removing throw rugs, and
keeping the walker close are all appropriate fall prevention strategies.
10. A client refuses to take a prescribed oral medication. What is the nurse’s initial
response?
A) Crush the medication and hide it in applesauce
B) Tell the client that the provider will be notified
C) Explore the client’s reasons for refusing
D) Document the refusal and leave the medication at the bedside
Answer: C
Rationale: The nurse must first explore the client’s reasons for refusal to address
concerns, misconceptions, or side effects. Coercion or deception is unethical.
Notification and documentation are necessary but follow the initial assessment.
11. A nurse is performing a sterile wound dressing change. Which action is a break
in sterile technique?
A) Opening the sterile kit away from the body
B) Touching the sterile field with sterile gloved hands only
C) Reaching over the sterile field to obtain a supply
D) Pouring sterile solution into a sterile basin
Answer: C
Rationale: Reaching over the sterile field contaminates it because nonsterile items
or clothing may shed particles. Opening the kit away from the body, touching only
with sterile gloves, and pouring solution correctly maintain sterility.
12. A client is 2 days postoperative and has not had a bowel movement. Which
intervention should the nurse implement first?
A) Administer a suppository
B) Offer prune juice
QUESTIONS AND CORRECT ANSWERS WITH RATIONALE
ALREADY GRADED A+ NEW!!!!!!!!!!!!!!!!!!!!!!!!
This comprehensive resource contains 300 unique, non-repetitive multiple-
choice questions meticulously designed to mirror the content and difficulty of
the Evolve HESI Fundamentals Exam. Each question is presented with a clear
stem, four distinct answer options, the correct answer, and a detailed,
evidence-based rationale that explains the underlying nursing principle. The
bank comprehensively covers all core content areas, including safe and
effective care environment, health promotion, psychosocial integrity, and
physiological integrity. Topics range from medication administration, wound
care, and nutrition to legal ethics, patient safety, and complex disease
management. This collection serves as an intensive review tool to strengthen
clinical judgment and prepare nursing students for success on their
standardized fundamentals examination.
1. A client with a nasogastric tube attached to low intermittent suction complains
of nausea. What is the priority nursing action?
A) Increase the suction level
B) Irrigate the tube with sterile water
C) Check for tube placement and patency
D) Administer an antiemetic as prescribed
Answer: C
Rationale: Nausea in a client with an NG tube often indicates tube displacement or
obstruction. The nurse must first verify placement and patency to ensure proper
functioning. Increasing suction could cause mucosal damage, irrigation without
checking placement risks aspiration, and an antiemetic does not address the
underlying mechanical issue.
2. A nurse is preparing to insert an indwelling urinary catheter. Which technique
should the nurse use to maintain sterility?
A) Clean gloves and sterile drapes
B) Sterile gloves and sterile drapes
C) Clean gloves and clean drapes
,D) Sterile gloves and clean drapes
Answer: B
Rationale: Indwelling catheter insertion requires sterile technique throughout.
Sterile gloves and sterile drapes maintain the sterile field and reduce the risk of
introducing pathogens into the urinary tract. Clean gloves or drapes violate sterility
and increase infection risk.
3. Which laboratory value indicates adequate protein intake over the past several
weeks?
A) Serum albumin
B) Prealbumin
C) Blood urea nitrogen (BUN)
D) Total lymphocyte count
Answer: A
Rationale: Serum albumin has a half-life of approximately 20 days, making it a
good indicator of protein status over weeks. Prealbumin reflects more acute
changes (2-3 days). BUN is affected by hydration and renal function, and
lymphocyte count reflects immune status rather than protein intake specifically.
4. A nurse notes that a client’s wound drainage is thick, yellow, and foul-smelling.
How should this finding be documented?
A) Serosanguineous drainage
B) Serous drainage
C) Purulent drainage
D) Sanguineous drainage
Answer: C
Rationale: Purulent drainage is thick, yellow, green, or brown and often has a foul
odor, indicating infection. Serous is clear and watery, sanguineous is bloody, and
serosanguineous is pink-tinged. Accurate documentation guides further treatment
such as wound cultures.
5. A postoperative client reports pain of 8 on a 0-10 scale. The nurse administers
morphine 2 mg IV. Thirty minutes later, the client reports pain of 6. What is the
nurse’s best action?
A) Administer another dose of morphine as prescribed
B) Document the pain reassessment and continue monitoring
C) Notify the healthcare provider immediately
D) Offer nonpharmacological comfort measures
Answer: B
,Rationale: A reduction from 8 to 6 indicates some analgesic effect. Documentation
is essential, and ongoing monitoring is appropriate. Another dose should only be
given when the prescribed interval allows. Nonpharmacologic measures can be
added but are not the priority action. Notification is not urgent since the pain is
improving.
6. A client with heart failure is prescribed a 2-gram sodium diet. Which food
selection indicates the client understands the teaching?
A) Grilled chicken breast with steamed vegetables
B) Canned tomato soup with crackers
C) Ham sandwich with pickles
D) Salted pretzels and cheese dip
Answer: A
Rationale: Fresh grilled chicken and steamed vegetables are naturally low in
sodium. Canned soups, ham, pickles, salted pretzels, and cheese dip are all high in
sodium and should be avoided on a restricted diet.
7. A nurse is caring for a client who is NPO and has a continuous IV infusion of
dextrose 5% in water. Which assessment finding indicates a complication of this
therapy?
A) Blood pressure 110/70 mmHg
B) Crackles auscultated in lung bases
C) Urine output 50 mL/hour
D) Skin turgor is normal
Answer: B
Rationale: Crackles in the lung bases suggest fluid volume overload, a
complication of IV therapy. Normal blood pressure, adequate urine output, and
normal skin turgor are expected findings. The nurse should reduce the infusion rate
and notify the provider.
8. A client is placed in restraints after other interventions failed to prevent harm.
How often must the nurse assess this client?
A) Every 30 minutes
B) Every 1 hour
C) Every 2 hours
D) Every 4 hours
Answer: C
Rationale: The standard requirement is that a restrained client must be assessed at
least every 2 hours for circulation, safety, comfort, and readiness for restraint
, removal. More frequent checks may be needed, but every 2 hours is the minimum
regulatory standard.
9. A nurse is teaching a client about fall prevention at home. Which statement
indicates the client needs further teaching?
A) I will use nightlights in the hallway
B) I will remove throw rugs from the floor
C) I will keep my walker close to my bed at night
D) I will wear socks without grips to be comfortable
Answer: D
Rationale: Wearing socks without grips increases fall risk due to slipping. The
client should wear nonskid footwear. Nightlights, removing throw rugs, and
keeping the walker close are all appropriate fall prevention strategies.
10. A client refuses to take a prescribed oral medication. What is the nurse’s initial
response?
A) Crush the medication and hide it in applesauce
B) Tell the client that the provider will be notified
C) Explore the client’s reasons for refusing
D) Document the refusal and leave the medication at the bedside
Answer: C
Rationale: The nurse must first explore the client’s reasons for refusal to address
concerns, misconceptions, or side effects. Coercion or deception is unethical.
Notification and documentation are necessary but follow the initial assessment.
11. A nurse is performing a sterile wound dressing change. Which action is a break
in sterile technique?
A) Opening the sterile kit away from the body
B) Touching the sterile field with sterile gloved hands only
C) Reaching over the sterile field to obtain a supply
D) Pouring sterile solution into a sterile basin
Answer: C
Rationale: Reaching over the sterile field contaminates it because nonsterile items
or clothing may shed particles. Opening the kit away from the body, touching only
with sterile gloves, and pouring solution correctly maintain sterility.
12. A client is 2 days postoperative and has not had a bowel movement. Which
intervention should the nurse implement first?
A) Administer a suppository
B) Offer prune juice
