EVOLVE HESI FUNDAMENTALS EXAM
CURRENTLY TESTING EXAM 200
QUESTIONS WITH DETAILED VERIFIED
ANSWERS (100% CORRECT ANSWERS
/ALREADY GRADED A+
This comprehensive collection of 200 unique Evolve HESI Fundamentals exam questions
provides a rigorous review of essential nursing concepts. Each question presents a distinct
clinical scenario covering critical areas such as medication administration, dosage calculations,
wound care, fluid and electrolyte balance, infection control, patient safety, nutritional support,
oxygenation, perioperative care, and neurological assessments. Every question is formatted with
four answer choices (A, B, C, D) and includes a detailed rationale explaining the correct answer
while clarifying why the distractors are incorrect. This resource is designed to enhance clinical
judgment, reinforce evidence-based practice, and prepare nursing students for the high-stakes
fundamentals proctored examination without any repetition of content or scenarios.
1. A client with a diagnosis of deep vein thrombosis is receiving heparin therapy.
The nurse notes that the client's activated partial thromboplastin time (aPTT) is 98
seconds. The baseline aPTT is 30 seconds. Which action should the nurse take?
A. Administer the next scheduled dose of heparin as ordered.
B. Hold the next dose and notify the healthcare provider.
C. Increase the heparin infusion rate by 2 units/kg/hour.
D. Document the finding as the only action.
Answer: B
Rationale: The therapeutic range for aPTT on heparin is typically 1.5 to 2.5 times
the baseline value. In this case, 2.5 times 30 is 75 seconds. An aPTT of 98 seconds
is significantly above the therapeutic range and indicates a high risk of bleeding.
Therefore, the nurse should hold the next dose and notify the healthcare provider
1
,for further orders. Administering, increasing, or merely documenting without
intervention are all unsafe actions.
2. A nurse is preparing to insert a urinary catheter in a female client. After
positioning the client, cleaning the perineum, and opening the sterile kit, which
action is critical for preventing a urinary tract infection?
A. Inflate the balloon with 30 mL of sterile saline.
B. Use sterile technique throughout the entire procedure.
C. Advance the catheter 5 inches (12.5 cm) before inflating the balloon.
D. Tape the catheter securely to the client's inner thigh.
Answer: B
Rationale: Maintaining sterile technique is the most critical action to prevent
introducing bacteria into the bladder, which would cause a urinary tract infection.
Inflating the balloon with 30 mL is excessive for a standard Foley catheter (10 mL
is typical for adults) and could cause trauma. Advancing the catheter 5 inches is
appropriate for a female after urine flows, but it is not the primary preventive
measure for infection. Taping the catheter is important for stabilization and
preventing traction, not for infection prevention.
3. A client is receiving a blood transfusion of packed red blood cells. Fifteen
minutes after the infusion begins, the client reports chills and low back pain. What
is the nurse's priority action?
A. Slow the infusion rate and monitor the client.
B. Stop the transfusion and disconnect the tubing.
C. Stop the transfusion and keep the IV line open with normal saline.
D. Administer diphenhydramine as a prn order for allergic reaction.
Answer: C
Rationale: Chills and low back pain are classic signs of an acute hemolytic
transfusion reaction. The nurse must stop the transfusion immediately to prevent
further reaction, but must keep the IV line open with normal saline (using new
2
,tubing) to have venous access for emergency medications if needed. Slowing the
infusion would continue the reaction. Disconnecting the tubing entirely would lose
IV access. Administering diphenhydramine is not the priority; the priority is to stop
the causative agent and maintain access.
4. The nurse is caring for a client who is 2 days post-operative from an abdominal
surgery. The client has a nasogastric tube set to low intermittent suction. The
morning laboratory results show a serum sodium of 130 mEq/L and a serum
potassium of 3.0 mEq/L. Which finding does the nurse anticipate?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: B
Rationale: The client is losing gastric fluid, which is rich in hydrochloric acid,
through the nasogastric suction. This loss of acid leads to a relative increase in
bicarbonate, causing metabolic alkalosis. Electrolyte losses, particularly potassium
and sodium, are also seen with this condition. Metabolic acidosis would be
expected with diarrhea or renal failure. Respiratory imbalances are related to lung
function, not gastric suction.
5. A client has an order for a 24-hour urine collection to begin at 0800. The client
voids at 0730 and discards this specimen. At 0900, the client voids again, and the
nurse adds this to the collection container. Which action, if any, is correct?
A. The nurse started the collection correctly.
B. The nurse should have started the collection at 0730.
C. The collection should have begun at 0600 to account for the 24-hour period.
D. The collection should be restarted because the first void was not discarded.
Answer: A
3
, Rationale: A 24-hour urine collection begins after the client empties their bladder
completely, and that first void is discarded. The collection then includes all urine
voided over the next 24 hours. The discard time (0730) marks the official start
time. The next void at 0900 is correctly added. Starting at 0730 would be incorrect
because that discarded specimen should not be included. The collection does not
have to start at a specific hour like 0600; it starts when the client voids and
discards.
6. A nurse is assessing a client's wound and notes a moderate amount of
sanguineous drainage on the dressing. The nurse correctly describes this drainage
as which color?
A. Clear and amber
B. Thick and yellow
C. Thin and watery red
D. Thick and green
Answer: C
Rationale: Sanguineous drainage is bright red, thin, and watery, indicating fresh
bleeding. Clear and amber is serous drainage. Thick and yellow is purulent
drainage, indicating infection. Thick and green also indicates purulent drainage,
often associated with a specific type of infection.
7. The nurse is teaching a client with type 2 diabetes about foot care. Which
statement indicates that the client needs further teaching?
A. "I will check the inside of my shoes every time before I put them on."
B. "I can use a heating pad on my feet if they feel cold."
C. "I will wash my feet daily with warm water and mild soap."
D. "I will dry between my toes carefully after washing."
Answer: B
Rationale: Clients with diabetes have peripheral neuropathy and impaired
circulation, making them susceptible to burns. Using a heating pad is
4
CURRENTLY TESTING EXAM 200
QUESTIONS WITH DETAILED VERIFIED
ANSWERS (100% CORRECT ANSWERS
/ALREADY GRADED A+
This comprehensive collection of 200 unique Evolve HESI Fundamentals exam questions
provides a rigorous review of essential nursing concepts. Each question presents a distinct
clinical scenario covering critical areas such as medication administration, dosage calculations,
wound care, fluid and electrolyte balance, infection control, patient safety, nutritional support,
oxygenation, perioperative care, and neurological assessments. Every question is formatted with
four answer choices (A, B, C, D) and includes a detailed rationale explaining the correct answer
while clarifying why the distractors are incorrect. This resource is designed to enhance clinical
judgment, reinforce evidence-based practice, and prepare nursing students for the high-stakes
fundamentals proctored examination without any repetition of content or scenarios.
1. A client with a diagnosis of deep vein thrombosis is receiving heparin therapy.
The nurse notes that the client's activated partial thromboplastin time (aPTT) is 98
seconds. The baseline aPTT is 30 seconds. Which action should the nurse take?
A. Administer the next scheduled dose of heparin as ordered.
B. Hold the next dose and notify the healthcare provider.
C. Increase the heparin infusion rate by 2 units/kg/hour.
D. Document the finding as the only action.
Answer: B
Rationale: The therapeutic range for aPTT on heparin is typically 1.5 to 2.5 times
the baseline value. In this case, 2.5 times 30 is 75 seconds. An aPTT of 98 seconds
is significantly above the therapeutic range and indicates a high risk of bleeding.
Therefore, the nurse should hold the next dose and notify the healthcare provider
1
,for further orders. Administering, increasing, or merely documenting without
intervention are all unsafe actions.
2. A nurse is preparing to insert a urinary catheter in a female client. After
positioning the client, cleaning the perineum, and opening the sterile kit, which
action is critical for preventing a urinary tract infection?
A. Inflate the balloon with 30 mL of sterile saline.
B. Use sterile technique throughout the entire procedure.
C. Advance the catheter 5 inches (12.5 cm) before inflating the balloon.
D. Tape the catheter securely to the client's inner thigh.
Answer: B
Rationale: Maintaining sterile technique is the most critical action to prevent
introducing bacteria into the bladder, which would cause a urinary tract infection.
Inflating the balloon with 30 mL is excessive for a standard Foley catheter (10 mL
is typical for adults) and could cause trauma. Advancing the catheter 5 inches is
appropriate for a female after urine flows, but it is not the primary preventive
measure for infection. Taping the catheter is important for stabilization and
preventing traction, not for infection prevention.
3. A client is receiving a blood transfusion of packed red blood cells. Fifteen
minutes after the infusion begins, the client reports chills and low back pain. What
is the nurse's priority action?
A. Slow the infusion rate and monitor the client.
B. Stop the transfusion and disconnect the tubing.
C. Stop the transfusion and keep the IV line open with normal saline.
D. Administer diphenhydramine as a prn order for allergic reaction.
Answer: C
Rationale: Chills and low back pain are classic signs of an acute hemolytic
transfusion reaction. The nurse must stop the transfusion immediately to prevent
further reaction, but must keep the IV line open with normal saline (using new
2
,tubing) to have venous access for emergency medications if needed. Slowing the
infusion would continue the reaction. Disconnecting the tubing entirely would lose
IV access. Administering diphenhydramine is not the priority; the priority is to stop
the causative agent and maintain access.
4. The nurse is caring for a client who is 2 days post-operative from an abdominal
surgery. The client has a nasogastric tube set to low intermittent suction. The
morning laboratory results show a serum sodium of 130 mEq/L and a serum
potassium of 3.0 mEq/L. Which finding does the nurse anticipate?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: B
Rationale: The client is losing gastric fluid, which is rich in hydrochloric acid,
through the nasogastric suction. This loss of acid leads to a relative increase in
bicarbonate, causing metabolic alkalosis. Electrolyte losses, particularly potassium
and sodium, are also seen with this condition. Metabolic acidosis would be
expected with diarrhea or renal failure. Respiratory imbalances are related to lung
function, not gastric suction.
5. A client has an order for a 24-hour urine collection to begin at 0800. The client
voids at 0730 and discards this specimen. At 0900, the client voids again, and the
nurse adds this to the collection container. Which action, if any, is correct?
A. The nurse started the collection correctly.
B. The nurse should have started the collection at 0730.
C. The collection should have begun at 0600 to account for the 24-hour period.
D. The collection should be restarted because the first void was not discarded.
Answer: A
3
, Rationale: A 24-hour urine collection begins after the client empties their bladder
completely, and that first void is discarded. The collection then includes all urine
voided over the next 24 hours. The discard time (0730) marks the official start
time. The next void at 0900 is correctly added. Starting at 0730 would be incorrect
because that discarded specimen should not be included. The collection does not
have to start at a specific hour like 0600; it starts when the client voids and
discards.
6. A nurse is assessing a client's wound and notes a moderate amount of
sanguineous drainage on the dressing. The nurse correctly describes this drainage
as which color?
A. Clear and amber
B. Thick and yellow
C. Thin and watery red
D. Thick and green
Answer: C
Rationale: Sanguineous drainage is bright red, thin, and watery, indicating fresh
bleeding. Clear and amber is serous drainage. Thick and yellow is purulent
drainage, indicating infection. Thick and green also indicates purulent drainage,
often associated with a specific type of infection.
7. The nurse is teaching a client with type 2 diabetes about foot care. Which
statement indicates that the client needs further teaching?
A. "I will check the inside of my shoes every time before I put them on."
B. "I can use a heating pad on my feet if they feel cold."
C. "I will wash my feet daily with warm water and mild soap."
D. "I will dry between my toes carefully after washing."
Answer: B
Rationale: Clients with diabetes have peripheral neuropathy and impaired
circulation, making them susceptible to burns. Using a heating pad is
4
