EVOLVE HESI FUNDAMENTALS EXAM 300 ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH RATIONALE
LATEST 2026 ALREADY GRADED A+ ASSURED PASS
This comprehensive 300-question examination bank is specifically designed
for the EVOLVE HESI Fundamentals Exam, covering foundational nursing
concepts including patient care, safety, hygiene, mobility, nutrition,
medication administration, and basic nursing interventions. Each question
presents a unique clinical scenario involving vital signs, infection control,
wound care, elimination, fluid balance, and therapeutic communication.
Topics include sterile technique, medication routes, diet modifications,
pressure injury staging, catheterization, enema administration, and pain
assessment. No question is repeated, ensuring thorough preparation for this
standardized nursing fundamentals examination and clinical competency
assessment.
1. A nurse is preparing to administer a subcutaneous injection to a patient. Which
needle gauge and length are most appropriate for a subcutaneous injection in an
average-sized adult?
A) 18 gauge, 1.5 inch
B) 21 gauge, 1 inch
C) 25 gauge, 5/8 inch
D) 27 gauge, 1.5 inch
Answer: C
Rationale: Subcutaneous injections are administered into the fatty tissue layer just
below the skin. A 25-gauge needle with a length of 5/8 inch is appropriate for an
average-sized adult. Larger gauges and longer needles are used for intramuscular
injections.
2. A patient is on strict isolation precautions. Which personal protective equipment
should the nurse wear when entering the room?
A) Gloves only
B) Gloves and gown
C) Gloves, gown, and mask
D) Gloves, gown, mask, and eye protection
Answer: C
,Rationale: Strict isolation precautions require gloves, gown, and mask. Eye
protection may be needed if there is a risk of splashes, but it is not required for
standard strict isolation. The level of PPE depends on the specific type of isolation.
3. A nurse is assessing a patient's peripheral pulse. Which site is most commonly
used to assess the apical pulse?
A) Radial artery
B) Brachial artery
C) Carotid artery
D) Left fifth intercostal space at the midclavicular line
Answer: D
Rationale: The apical pulse is assessed at the left fifth intercostal space at the
midclavicular line. This is the point of maximal impulse (PMI) and is where the
heartbeat is most easily auscultated. The radial, brachial, and carotid sites are used
for peripheral pulses.
4. A patient has a prescription for an enema. Which position is most appropriate
for administering an enema?
A) Supine
B) Prone
C) Left lateral Sims position
D) Right lateral Sims position
Answer: C
Rationale: The left lateral Sims position (lying on the left side with the right knee
flexed) is the preferred position for enema administration because it follows the
natural curvature of the sigmoid colon and allows for easier flow of the enema
solution.
5. A nurse is calculating the intake and output for a patient. Which of the following
should be included in the intake calculation?
A) Ice chips and intravenous fluids
B) Only oral fluids
C) Only intravenous fluids
D) Only water
Answer: A
Rationale: Intake includes all fluids that enter the body, including oral fluids,
intravenous fluids, tube feedings, and ice chips (calculated as half the volume of
the ice chips). All sources of fluid intake must be documented.
,6. A patient with a nasogastric tube is receiving continuous tube feeding. The nurse
should place the patient in which position to prevent aspiration?
A) Supine
B) Prone
C) Semi-Fowler position
D) Trendelenburg position
Answer: C
Rationale: The semi-Fowler position (head of bed elevated 30 to 45 degrees) is
recommended for patients receiving tube feedings to prevent aspiration. This
position uses gravity to keep the feeding in the stomach and reduces the risk of
reflux.
7. A nurse is performing a sterile dressing change. Which action is correct when
opening a sterile package?
A) Open the package away from the body
B) Open the package toward the body
C) Open the package with the top flap away from the body
D) Open the package with the top flap toward the body
Answer: A
Rationale: When opening a sterile package, the top flap should be opened away
from the body to prevent contamination of the sterile field. The side flaps are then
opened to the sides, and the bottom flap is opened toward the body.
8. A patient is complaining of pain rated 8 on a scale of 0 to 10. The nurse
administers a prescribed analgesic. Which action is most important after
administration?
A) Document the administration
B) Reassess the patient's pain level in 30 to 60 minutes
C) Offer the patient a warm compress
D) Turn off the lights
Answer: B
Rationale: After administering an analgesic, the nurse must reassess the patient's
pain level to evaluate the effectiveness of the medication. Documentation is
important, but reassessment is the priority to ensure the pain is adequately
managed.
9. A nurse is assessing a patient's skin and notes a stage 2 pressure injury. Which
finding is characteristic of a stage 2 pressure injury?
A) Full-thickness skin loss with visible bone
B) Partial-thickness skin loss with exposed dermis
, C) Non-blanchable erythema of intact skin
D) Full-thickness skin loss with undermining
Answer: B
Rationale: A stage 2 pressure injury is characterized by partial-thickness skin loss
with exposed dermis. The wound bed is pink or red and moist. Stage 1 is non-
blanchable erythema, stage 3 is full-thickness skin loss without bone exposure, and
stage 4 involves bone exposure.
10. A patient is on a clear liquid diet. Which of the following items is permitted on
this diet?
A) Milk
B) Orange juice with pulp
C) Chicken broth
D) Cream of wheat
Answer: C
Rationale: A clear liquid diet includes clear fluids that are easily digested and leave
little residue. Chicken broth, clear juices (without pulp), gelatin, and tea are
permitted. Milk, orange juice with pulp, and cream of wheat are not part of a clear
liquid diet.
11. A nurse is preparing to insert an indwelling urinary catheter. Which technique
should be used for this procedure?
A) Clean technique
B) Sterile technique
C) Aseptic technique
D) Surgical asepsis
Answer: D
Rationale: Urinary catheter insertion requires surgical asepsis (sterile technique) to
prevent introduction of microorganisms into the urinary tract. Clean technique is
not sufficient for this invasive procedure.
12. A patient is receiving oxygen via a nasal cannula at 2 liters per minute. Which
complication should the nurse monitor for?
A) Oxygen toxicity
B) Nasal dryness and irritation
C) Carbon dioxide retention
D) Pneumothorax
Answer: B
QUESTIONS AND CORRECT ANSWERS WITH RATIONALE
LATEST 2026 ALREADY GRADED A+ ASSURED PASS
This comprehensive 300-question examination bank is specifically designed
for the EVOLVE HESI Fundamentals Exam, covering foundational nursing
concepts including patient care, safety, hygiene, mobility, nutrition,
medication administration, and basic nursing interventions. Each question
presents a unique clinical scenario involving vital signs, infection control,
wound care, elimination, fluid balance, and therapeutic communication.
Topics include sterile technique, medication routes, diet modifications,
pressure injury staging, catheterization, enema administration, and pain
assessment. No question is repeated, ensuring thorough preparation for this
standardized nursing fundamentals examination and clinical competency
assessment.
1. A nurse is preparing to administer a subcutaneous injection to a patient. Which
needle gauge and length are most appropriate for a subcutaneous injection in an
average-sized adult?
A) 18 gauge, 1.5 inch
B) 21 gauge, 1 inch
C) 25 gauge, 5/8 inch
D) 27 gauge, 1.5 inch
Answer: C
Rationale: Subcutaneous injections are administered into the fatty tissue layer just
below the skin. A 25-gauge needle with a length of 5/8 inch is appropriate for an
average-sized adult. Larger gauges and longer needles are used for intramuscular
injections.
2. A patient is on strict isolation precautions. Which personal protective equipment
should the nurse wear when entering the room?
A) Gloves only
B) Gloves and gown
C) Gloves, gown, and mask
D) Gloves, gown, mask, and eye protection
Answer: C
,Rationale: Strict isolation precautions require gloves, gown, and mask. Eye
protection may be needed if there is a risk of splashes, but it is not required for
standard strict isolation. The level of PPE depends on the specific type of isolation.
3. A nurse is assessing a patient's peripheral pulse. Which site is most commonly
used to assess the apical pulse?
A) Radial artery
B) Brachial artery
C) Carotid artery
D) Left fifth intercostal space at the midclavicular line
Answer: D
Rationale: The apical pulse is assessed at the left fifth intercostal space at the
midclavicular line. This is the point of maximal impulse (PMI) and is where the
heartbeat is most easily auscultated. The radial, brachial, and carotid sites are used
for peripheral pulses.
4. A patient has a prescription for an enema. Which position is most appropriate
for administering an enema?
A) Supine
B) Prone
C) Left lateral Sims position
D) Right lateral Sims position
Answer: C
Rationale: The left lateral Sims position (lying on the left side with the right knee
flexed) is the preferred position for enema administration because it follows the
natural curvature of the sigmoid colon and allows for easier flow of the enema
solution.
5. A nurse is calculating the intake and output for a patient. Which of the following
should be included in the intake calculation?
A) Ice chips and intravenous fluids
B) Only oral fluids
C) Only intravenous fluids
D) Only water
Answer: A
Rationale: Intake includes all fluids that enter the body, including oral fluids,
intravenous fluids, tube feedings, and ice chips (calculated as half the volume of
the ice chips). All sources of fluid intake must be documented.
,6. A patient with a nasogastric tube is receiving continuous tube feeding. The nurse
should place the patient in which position to prevent aspiration?
A) Supine
B) Prone
C) Semi-Fowler position
D) Trendelenburg position
Answer: C
Rationale: The semi-Fowler position (head of bed elevated 30 to 45 degrees) is
recommended for patients receiving tube feedings to prevent aspiration. This
position uses gravity to keep the feeding in the stomach and reduces the risk of
reflux.
7. A nurse is performing a sterile dressing change. Which action is correct when
opening a sterile package?
A) Open the package away from the body
B) Open the package toward the body
C) Open the package with the top flap away from the body
D) Open the package with the top flap toward the body
Answer: A
Rationale: When opening a sterile package, the top flap should be opened away
from the body to prevent contamination of the sterile field. The side flaps are then
opened to the sides, and the bottom flap is opened toward the body.
8. A patient is complaining of pain rated 8 on a scale of 0 to 10. The nurse
administers a prescribed analgesic. Which action is most important after
administration?
A) Document the administration
B) Reassess the patient's pain level in 30 to 60 minutes
C) Offer the patient a warm compress
D) Turn off the lights
Answer: B
Rationale: After administering an analgesic, the nurse must reassess the patient's
pain level to evaluate the effectiveness of the medication. Documentation is
important, but reassessment is the priority to ensure the pain is adequately
managed.
9. A nurse is assessing a patient's skin and notes a stage 2 pressure injury. Which
finding is characteristic of a stage 2 pressure injury?
A) Full-thickness skin loss with visible bone
B) Partial-thickness skin loss with exposed dermis
, C) Non-blanchable erythema of intact skin
D) Full-thickness skin loss with undermining
Answer: B
Rationale: A stage 2 pressure injury is characterized by partial-thickness skin loss
with exposed dermis. The wound bed is pink or red and moist. Stage 1 is non-
blanchable erythema, stage 3 is full-thickness skin loss without bone exposure, and
stage 4 involves bone exposure.
10. A patient is on a clear liquid diet. Which of the following items is permitted on
this diet?
A) Milk
B) Orange juice with pulp
C) Chicken broth
D) Cream of wheat
Answer: C
Rationale: A clear liquid diet includes clear fluids that are easily digested and leave
little residue. Chicken broth, clear juices (without pulp), gelatin, and tea are
permitted. Milk, orange juice with pulp, and cream of wheat are not part of a clear
liquid diet.
11. A nurse is preparing to insert an indwelling urinary catheter. Which technique
should be used for this procedure?
A) Clean technique
B) Sterile technique
C) Aseptic technique
D) Surgical asepsis
Answer: D
Rationale: Urinary catheter insertion requires surgical asepsis (sterile technique) to
prevent introduction of microorganisms into the urinary tract. Clean technique is
not sufficient for this invasive procedure.
12. A patient is receiving oxygen via a nasal cannula at 2 liters per minute. Which
complication should the nurse monitor for?
A) Oxygen toxicity
B) Nasal dryness and irritation
C) Carbon dioxide retention
D) Pneumothorax
Answer: B
