Evolve HESI Fundamentals Exam
Review 2025–2026 Complete Study
Guide, Practice Questions, Detailed
Rationales & Comprehensive Exam
Prep
An elderly client with a fractured left hip is on strict To avoid shearing forces when repositioning, the client should be lifted gently
bedrest. Which nursing measure is essential to the client's across a surface (D). Reddened areas should not be massaged (A) since this may
nursing care? 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
A. Massage any reddened areas for at least five minutes. position described in (C) is contraindicated for a client with a fractured left hip.
B. Encourage active range of motion exercises on
extremities. Correct Answer: D
C. Position the client laterally, prone, and dorsally in
sequence.
D. Gently lift the client when moving into a desired
position.
The nurse is administering medications through a The NGT should be flushed before, after and in between each medication
nasogastric tube (NGT) which is connected to suction. administered (B). Once all medications are administered, the NGT should be
After ensuring correct tube placement, what action clamped for 20 minutes (A). (C and D) may be implemented only after the tubing
should the nurse take next? has been flushed.
A. Clamp the tube for 20 minutes. Correct Answer: B
B. Flush the tube with water.
C. Administer the medications as prescribed.
D. Crush the tablets and dissolve in sterile water.
,A client who is in hospice care complains of increasing The most effective management of pain is achieved using an around-the-clock
amounts of pain. The healthcare provider prescribes an schedule that provides analgesic medications on a regular basis (A) and in a
analgesic every four hours as needed. Which action timely manner. Analgesics are less effective if pain persists until it is severe, so an
should the nurse implement? 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
A. Give an around-the-clock schedule for administration the client's ability to interact and experience the time before life ends should be
of analgesics. minimized (C). Offering a medication-free period allows the serum drug level to
B. Administer analgesic medication as needed when the fall, which is not an effective method to manage chronic pain (D).
pain is severe.
C. Provide medication to keep the client sedated and Correct Answer: A
unaware of stimuli.
D. Offer a medication-free period so that the client can
do daily activities.
When assessing a client with wrist restraints, the nurse The priority nursing action is to restore circulation by loosening the restraint (A),
observes that the fingers on the right hand are blue. What because blue fingers (cyanosis) indicates decreased circulation. (C and D) are also
action should the nurse implement first? important nursing interventions, but do not have the priority of (A). Pulse oximetry
(B) measures the saturation of hemoglobin with oxygen and is not indicated in
A. Loosen the right wrist restraint. situations where the cyanosis is related to mechanical compression (the restraints).
B. Apply a pulse oximeter to the right hand.
C. Compare hand color bilaterally. Correct Answer: A
D. Palpate the right radial pulse.
The nurse is assessing the nutritional status of several A lactating woman (B) has the greatest need for additional protein intake. (A, C,
clients. Which client has the greatest nutritional need for and D) are all conditions that require protein, but do not have the increased
additional intake of protein? metabolic protein demands of lactation.
A. A college-age track runner with a sprained ankle. Correct Answer: B
B. A lactating woman nursing her 3-day-old infant.
C. A school-aged child with Type 2 diabetes.
D. An elderly man being treated for a peptic ulcer.
,A client is in the radiology department at 0900 when the To ensure that a therapeutic level of medication is maintained, the nurse should
prescription levofloxacin (Levaquin) 500 mg IV q24h is administer the missed dose as soon as possible, and revise the administration
scheduled to be administered. The client returns to the schedule accordingly to prevent dangerously increasing the level of the
unit at 1300. What is the best intervention for the nurse to medication in the bloodstream (D). The nurse should document the reason for the
implement? late dose, but (A and C) are not warranted. (B) could result in increased blood
levels of the drug.
A. Contact the healthcare provider and complete a
medication variance form. Correct Answer: D
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.
While instructing a male client's wife in the performance The wife is performing the passive ROM correctly, therefore the nurse should
of passive range-of-motion exercises to his contracted acknowledge this fact (A). The joint that is being exercised should be uncovered
shoulder, the nurse observes that she is holding his arm (B) while the rest of the body should remain covered for warmth and privacy. (C
above and below the elbow. What nursing action should and D) do not provide adequate support to the joint while still allowing for joint
the nurse implement? movement.
A. Acknowledge that she is supporting the arm correctly. Correct Answer: A
B. Encourage her to keep the joint covered to maintain
warmth.
C. Reinforce the need to grip directly under the joint for
better support.
D. Instruct her to grip directly over the joint for better
motion.
What is the most important reason for starting Venous return is usually better in the upper extremities. Cannulation of the veins in
intravenous infusions in the upper extremities rather than the lower extremities increases the risk of thrombus formation (B) which, if
the lower extremities of adults? dislodged, could be life-threatening. Superficial veins are often very easy (A) to
find in the feet and legs. Handling a leg or foot with an IV (C) is probably not any
A. It is more difficult to find a superficial vein in the feet more difficult than handling an arm or hand. Even if the nurse did believe moving
and ankles. a cannulated leg was more difficult, this is not the most important reason for using
B. A decreased flow rate could result in the formation of a the upper extremities. Pain (D) is not a consideration.
thrombosis.
C. A cannulated extremity is more difficult to move when Correct Answer: B
the leg or foot is used.
D. Veins are located deep in the feet and ankles, resulting
in a more painful procedure.
, The nurse observes an unlicensed assistive personnel The most important action is to ensure that an accurate BP reading is obtained.
(UAP) taking a client's blood pressure with a cuff that is The nurse should reassess the BP with the correct size cuff (B). Reassessment
too small, but the blood pressure reading obtained is should not be postponed (A). Though (C and D) are likely indicated, these actions
within the client's usual range. What action is most do not have the priority of (B).
important for the nurse to implement?
Correct Answer: B
A. Tell the UAP to use a larger cuff at the next scheduled
assessment.
B. Reassess the client's blood pressure using a larger cuff.
C. Have the unit educator review this procedure with the
UAPs.
D. Teach the UAP the correct technique for assessing
blood pressure.
Twenty minutes after beginning a heat application, the (D) describes thermal adaptation, which occurs 20 to 30 minutes after heat
client states that the heating pad no longer feels warm application. (A and B) provide false information. (C) is not based on a knowledge
enough. What is the best response by the nurse? of physiology and is an unsafe action that may harm the client.
A. "That means you have derived the maximum benefit, Correct Answer: D
and the heat can be removed."
B. "Your blood vessels are becoming dilated and
removing the heat from the site."
C. "We will increase the temperature 5 degrees when the
pad no longer feels warm."
D. "The body's receptors adapt over time as they are
exposed to heat."
The nurse is instructing a client with high cholesterol Limiting saturated fat from animal food sources to no more than 4 ounces per
about diet and life style modification. What comment week (C) is an important diet modification for lowering cholesterol. To be
from the client indicates that the teaching has been effective in reducing cholesterol, the client should exercise 30 minutes per day, or
effective? at least 4 to 6 times per week (A). Red meat and all proteins do not need to be
eliminated (B) to lower cholesterol, but should be restricted to lean cuts of red
A. "If I exercise at least two times weekly for one hour, I meat and smaller portions (2-ounce servings). The low density lipoproteins (D)
will lower my cholesterol." need to decrease rather than increase.
B. "I need to avoid eating proteins, including red meat."
C. "I will limit my intake of beef to 4 ounces per week." Correct Answer: C
D. "My blood level of low density lipoproteins needs to
increase."
The UAPs working on a chronic neuro unit ask the nurse (D) uses the client's stronger side, the right side, for weight-bearing during the
to help them determine the safest way to transfer an transfer, and is the safest approach to take. (A, B, and C) are unsafe methods of
elderly client with left-sided weakness from the bed to transfer and include the use of poor body mechanics by the caregiver.
the chair. What method describes the correct transfer
procedure for this client? Correct Answer: D
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.
Review 2025–2026 Complete Study
Guide, Practice Questions, Detailed
Rationales & Comprehensive Exam
Prep
An elderly client with a fractured left hip is on strict To avoid shearing forces when repositioning, the client should be lifted gently
bedrest. Which nursing measure is essential to the client's across a surface (D). Reddened areas should not be massaged (A) since this may
nursing care? 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
A. Massage any reddened areas for at least five minutes. position described in (C) is contraindicated for a client with a fractured left hip.
B. Encourage active range of motion exercises on
extremities. Correct Answer: D
C. Position the client laterally, prone, and dorsally in
sequence.
D. Gently lift the client when moving into a desired
position.
The nurse is administering medications through a The NGT should be flushed before, after and in between each medication
nasogastric tube (NGT) which is connected to suction. administered (B). Once all medications are administered, the NGT should be
After ensuring correct tube placement, what action clamped for 20 minutes (A). (C and D) may be implemented only after the tubing
should the nurse take next? has been flushed.
A. Clamp the tube for 20 minutes. Correct Answer: B
B. Flush the tube with water.
C. Administer the medications as prescribed.
D. Crush the tablets and dissolve in sterile water.
,A client who is in hospice care complains of increasing The most effective management of pain is achieved using an around-the-clock
amounts of pain. The healthcare provider prescribes an schedule that provides analgesic medications on a regular basis (A) and in a
analgesic every four hours as needed. Which action timely manner. Analgesics are less effective if pain persists until it is severe, so an
should the nurse implement? 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
A. Give an around-the-clock schedule for administration the client's ability to interact and experience the time before life ends should be
of analgesics. minimized (C). Offering a medication-free period allows the serum drug level to
B. Administer analgesic medication as needed when the fall, which is not an effective method to manage chronic pain (D).
pain is severe.
C. Provide medication to keep the client sedated and Correct Answer: A
unaware of stimuli.
D. Offer a medication-free period so that the client can
do daily activities.
When assessing a client with wrist restraints, the nurse The priority nursing action is to restore circulation by loosening the restraint (A),
observes that the fingers on the right hand are blue. What because blue fingers (cyanosis) indicates decreased circulation. (C and D) are also
action should the nurse implement first? important nursing interventions, but do not have the priority of (A). Pulse oximetry
(B) measures the saturation of hemoglobin with oxygen and is not indicated in
A. Loosen the right wrist restraint. situations where the cyanosis is related to mechanical compression (the restraints).
B. Apply a pulse oximeter to the right hand.
C. Compare hand color bilaterally. Correct Answer: A
D. Palpate the right radial pulse.
The nurse is assessing the nutritional status of several A lactating woman (B) has the greatest need for additional protein intake. (A, C,
clients. Which client has the greatest nutritional need for and D) are all conditions that require protein, but do not have the increased
additional intake of protein? metabolic protein demands of lactation.
A. A college-age track runner with a sprained ankle. Correct Answer: B
B. A lactating woman nursing her 3-day-old infant.
C. A school-aged child with Type 2 diabetes.
D. An elderly man being treated for a peptic ulcer.
,A client is in the radiology department at 0900 when the To ensure that a therapeutic level of medication is maintained, the nurse should
prescription levofloxacin (Levaquin) 500 mg IV q24h is administer the missed dose as soon as possible, and revise the administration
scheduled to be administered. The client returns to the schedule accordingly to prevent dangerously increasing the level of the
unit at 1300. What is the best intervention for the nurse to medication in the bloodstream (D). The nurse should document the reason for the
implement? late dose, but (A and C) are not warranted. (B) could result in increased blood
levels of the drug.
A. Contact the healthcare provider and complete a
medication variance form. Correct Answer: D
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.
While instructing a male client's wife in the performance The wife is performing the passive ROM correctly, therefore the nurse should
of passive range-of-motion exercises to his contracted acknowledge this fact (A). The joint that is being exercised should be uncovered
shoulder, the nurse observes that she is holding his arm (B) while the rest of the body should remain covered for warmth and privacy. (C
above and below the elbow. What nursing action should and D) do not provide adequate support to the joint while still allowing for joint
the nurse implement? movement.
A. Acknowledge that she is supporting the arm correctly. Correct Answer: A
B. Encourage her to keep the joint covered to maintain
warmth.
C. Reinforce the need to grip directly under the joint for
better support.
D. Instruct her to grip directly over the joint for better
motion.
What is the most important reason for starting Venous return is usually better in the upper extremities. Cannulation of the veins in
intravenous infusions in the upper extremities rather than the lower extremities increases the risk of thrombus formation (B) which, if
the lower extremities of adults? dislodged, could be life-threatening. Superficial veins are often very easy (A) to
find in the feet and legs. Handling a leg or foot with an IV (C) is probably not any
A. It is more difficult to find a superficial vein in the feet more difficult than handling an arm or hand. Even if the nurse did believe moving
and ankles. a cannulated leg was more difficult, this is not the most important reason for using
B. A decreased flow rate could result in the formation of a the upper extremities. Pain (D) is not a consideration.
thrombosis.
C. A cannulated extremity is more difficult to move when Correct Answer: B
the leg or foot is used.
D. Veins are located deep in the feet and ankles, resulting
in a more painful procedure.
, The nurse observes an unlicensed assistive personnel The most important action is to ensure that an accurate BP reading is obtained.
(UAP) taking a client's blood pressure with a cuff that is The nurse should reassess the BP with the correct size cuff (B). Reassessment
too small, but the blood pressure reading obtained is should not be postponed (A). Though (C and D) are likely indicated, these actions
within the client's usual range. What action is most do not have the priority of (B).
important for the nurse to implement?
Correct Answer: B
A. Tell the UAP to use a larger cuff at the next scheduled
assessment.
B. Reassess the client's blood pressure using a larger cuff.
C. Have the unit educator review this procedure with the
UAPs.
D. Teach the UAP the correct technique for assessing
blood pressure.
Twenty minutes after beginning a heat application, the (D) describes thermal adaptation, which occurs 20 to 30 minutes after heat
client states that the heating pad no longer feels warm application. (A and B) provide false information. (C) is not based on a knowledge
enough. What is the best response by the nurse? of physiology and is an unsafe action that may harm the client.
A. "That means you have derived the maximum benefit, Correct Answer: D
and the heat can be removed."
B. "Your blood vessels are becoming dilated and
removing the heat from the site."
C. "We will increase the temperature 5 degrees when the
pad no longer feels warm."
D. "The body's receptors adapt over time as they are
exposed to heat."
The nurse is instructing a client with high cholesterol Limiting saturated fat from animal food sources to no more than 4 ounces per
about diet and life style modification. What comment week (C) is an important diet modification for lowering cholesterol. To be
from the client indicates that the teaching has been effective in reducing cholesterol, the client should exercise 30 minutes per day, or
effective? at least 4 to 6 times per week (A). Red meat and all proteins do not need to be
eliminated (B) to lower cholesterol, but should be restricted to lean cuts of red
A. "If I exercise at least two times weekly for one hour, I meat and smaller portions (2-ounce servings). The low density lipoproteins (D)
will lower my cholesterol." need to decrease rather than increase.
B. "I need to avoid eating proteins, including red meat."
C. "I will limit my intake of beef to 4 ounces per week." Correct Answer: C
D. "My blood level of low density lipoproteins needs to
increase."
The UAPs working on a chronic neuro unit ask the nurse (D) uses the client's stronger side, the right side, for weight-bearing during the
to help them determine the safest way to transfer an transfer, and is the safest approach to take. (A, B, and C) are unsafe methods of
elderly client with left-sided weakness from the bed to transfer and include the use of poor body mechanics by the caregiver.
the chair. What method describes the correct transfer
procedure for this client? Correct Answer: D
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.
