Fundamentals of Nursing Evolve HESI Real Exams Questions Bank Review Latest 2026/2027
OBJECTIVE ASSESSMENT - EXAM
Fundamentals of Nursing
Evolve HESI Real Exams
Questions Bank Review
Latest 2026/2027
Best Exam Prep Test Bank
A+ Verified | 2026/2027 Official Exam | Passing Score: 75%
COVER PAGE - 1
,SECTIONS COVERED
Section 1: Patient Safety and Quality Improvement
Section 2: Infection Control and Asepsis
Section 3: Basic Nursing Skills and Vital Signs
Section 4: Fluid, Electrolyte, and Acid-Base Balance
Section 5: Medication Administration and Pharmacology
Section 6: Patient Assessment and Health History
Section 7: Nursing Process and Critical Thinking
Section 8: Professional Standards and Legal/Ethical Considerations
Section 1: Patient Safety and Quality Improvement
Q1.
A 78-year-old patient is admitted to the medical-surgical unit after a fall at home. The nurse assesses the patient and notes a
history of osteoarthritis, recent cataract surgery, and a prescribed diuretic. The patient reports feeling dizzy when standing up
quickly. The nurse needs to implement fall prevention strategies for this patient. What is the most appropriate initial nursing
action?
A. Place the patient on a low bed with the call light within reach and side rails up according to facility policy
B. Request a physical therapy consult before the patient gets out of bed independently
C. Restrict the patient to bed rest until all medications have been reviewed by the provider
D. Apply bilateral soft wrist restraints to prevent the patient from attempting to stand unassisted
Correct Answer: C
The correct answer is option C. This choice best reflects the nursing intervention or principle that addresses the clinical situation
described. The distractors represent common misconceptions or partially correct but less optimal responses.
Q2.
A nurse is preparing to administer oral medications to a patient in room 412. The nurse enters the room, greets the patient by
name, and verifies the medication against the electronic medication administration record. However, the nurse does not ask
the patient to state their date of birth. The patient takes the medications without incident. Later that shift, the nurse realizes the
omission. What should the nurse do next?
A. Document the incident in the patient's chart and notify the charge nurse to complete a safety event report
B. Contact the patient to verify identity retroactively and add a late entry to the medication administration record
C. Take no further action since no harm occurred and the correct patient received the correct medications
D. Self-report the near miss to the risk management department and request a formal disciplinary review
Correct Answer: A
Even when no harm occurs, failing to use two patient identifiers is a near-miss event that must be reported to promote a culture of safety.
The nurse should notify the charge nurse and file a safety event report so the incident can be analyzed for system improvements.
Ignoring the event or seeking self-punishment does not contribute to quality improvement.
Q3.
A nurse on the night shift is caring for a postoperative patient who is receiving patient-controlled analgesia. During hourly
rounds, the nurse finds the patient unresponsive with shallow respirations at a rate of 8 breaths per minute. The nurse
immediately initiates rescue measures and the patient recovers. The nurse then discusses the event with the charge nurse.
What is the priority action the nurse should take regarding this event?
A. Complete a safety event report so the incident can be reviewed for potential system-level improvements
B. Document the respiratory depression in the nursing notes and continue monitoring the patient closely
C. Contact the prescribing provider to request that the PCA dose be reduced for all postoperative patients
D. Inform the patient's family about the event and advise them to monitor the patient overnight
Correct Answer: C
The correct answer is option C. This choice best reflects the nursing intervention or principle that addresses the clinical situation
described. The distractors represent common misconceptions or partially correct but less optimal responses.
Fundamentals of Nursing Evolve HESI Real Exams Questions Bank Review Latest 2026... Page 2
, Q4.
A nurse is receiving a patient from the post-anesthesia care unit using the SBAR communication framework. The PACU nurse
reports that the patient had an uneventful laparoscopic cholecystectomy and is currently alert and oriented with stable vital
signs. The receiving nurse notices the transfer documentation is incomplete. What is the most important element the receiving
nurse should verify during this hand-off?
A. Confirm the patient's current pain level, surgical site, and any intraoperative complications with the PACU nurse
B. Review the anesthesia record independently before asking the PACU nurse any additional questions
C. Request that the PACU nurse remain until the receiving nurse has completed the initial head-to-toe assessment
D. Ask the patient to describe the procedure and verify the information matches the operative report
Correct Answer: C
The correct answer is option C. This choice best reflects the nursing intervention or principle that addresses the clinical situation
described. The distractors represent common misconceptions or partially correct but less optimal responses.
Q5.
A surgical patient is wheeled into the operating room and the circulating nurse begins the surgical time-out. The surgeon is
scrubbed in and ready to begin. The anesthesiologist confirms the patient's identity and planned procedure. The circulating
nurse asks the entire team to pause and verbally confirm the procedure, site, and laterality. What is the primary purpose of this
time-out?
A. To ensure the entire surgical team actively agrees on the correct patient, procedure, and surgical site before incision
B. To document that all team members have reviewed the consent form and verified insurance authorization
C. To confirm that the sterilization indicators on all instrument trays have been checked by the scrub technician
D. To allow the surgeon a final opportunity to change the operative plan based on the patient's current condition
Correct Answer: D
The correct answer is option D. Among the presented options, this most accurately describes the appropriate nursing action or
understanding of the concept. The other choices, while related, do not fully address the question being asked.
Q6.
A nurse is caring for a patient with advanced dementia who is repeatedly attempting to pull out an intravenous line. The nurse
has tried redirecting the patient and providing a stuffed animal for distraction, but the behavior persists. The nurse discusses
the situation with the charge nurse and the healthcare provider is notified. An order for wrist restraints is obtained. What must
the nurse do before applying the restraints?
A. Explain the reason for restraints to the patient, attempt alternative interventions, and obtain informed consent from the legally
authorized representative
B. Administer a sedative medication as ordered and wait for the patient to become calm before applying the restraints
C. Document the patient's behavior and apply the restraints immediately to prevent serious harm to the patient
D. Request a psychiatry consultation to evaluate the patient for chemical restraint alternatives before proceeding
Correct Answer: A
Before applying restraints, the nurse must try less restrictive alternatives, explain the intervention to the patient, and obtain consent from
the authorized representative. Restraints are a last resort and require ongoing assessment, documentation, and orders that are renewed
according to facility policy. Applying restraints without these steps violates patient rights.
Q7.
A quality improvement committee at a community hospital is reviewing data on hospital-acquired pressure injuries over the
past quarter. The data shows that the medical-surgical unit has the highest rate of pressure injuries compared to other units.
The committee decides to conduct a root cause analysis. What is the primary goal of this analysis?
A. To identify underlying system factors that contributed to the pressure injuries so that targeted improvements can be
implemented
B. To determine which individual nurses were responsible for the pressure injuries and implement corrective action
C. To calculate the financial cost of the pressure injuries and present the data to hospital administration
D. To compare the hospital's pressure injury rate with national benchmarks and publish the findings
Correct Answer: A
Root cause analysis is a systematic process for identifying the fundamental reasons an adverse event occurred, focusing on system and
process failures rather than individual blame. The goal is to implement changes that prevent recurrence. This approach supports a just
culture and promotes sustainable quality improvement.
Fundamentals of Nursing Evolve HESI Real Exams Questions Bank Review Latest 2026... Page 3
, Q8.
A hospital experiences an unexpected event in which a patient received the wrong type of blood product during a transfusion,
resulting in a severe hemolytic reaction. The patient required intensive care but ultimately survived. The hospital's risk
management team classifies this event. What type of event is this classified as?
A. A sentinel event that requires immediate investigation and a root cause analysis by the organization
B. A near-miss event that should be reported to the charge nurse for documentation in the shift report
C. An adverse event that only requires completion of an incident report for the hospital quality department
D. A never event that automatically results in loss of accreditation for the blood bank
Correct Answer: A
A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury that requires a root cause
analysis. A wrong blood type transfusion causing a hemolytic reaction meets this definition. The Joint Commission requires organizations
to conduct a thorough review and develop an action plan.
Q9.
A nurse educator is preparing an in-service presentation for the nursing staff on The Joint Commission's current National
Patient Safety Goals for the hospital. The educator wants to emphasize the goals that apply to all accredited healthcare
organizations. What is one of the universal National Patient Safety Goals?
A. Improve the accuracy of patient identification by using at least two patient identifiers before any intervention
B. Reduce the risk of surgical site infections by administering prophylactic antibiotics within 60 minutes of incision
C. Prevent falls on medical-surgical units by implementing hourly rounding and bed alarm protocols
D. Decrease medication errors by requiring barcode scanning for all oral medications administered
Correct Answer: A
Using at least two patient identifiers is a universal National Patient Safety Goal that applies across all accredited healthcare settings.
While the other options represent important safety measures, they are either condition-specific or are implementation strategies rather
than the overarching goal itself.
Q10.
A nurse is preparing to administer medications using the barcode medication administration system. The nurse scans the
patient's wristband, and the system displays a warning that the medication is not due for another two hours. The nurse checks
the paper medication administration record and sees that the medication was already documented as given on the previous
shift. What should the nurse do?
A. Hold the medication and investigate the discrepancy by reviewing the electronic health record and contacting the previous
shift nurse
B. Override the system warning and administer the medication since the patient is due based on the prescribed schedule
C. Administer half the prescribed dose now and document the reason for the early administration in the patient's chart
D. Contact the pharmacy to verify whether the medication was dispensed correctly for this patient
Correct Answer: A
Barcode medication administration systems are designed to prevent errors, and warnings should not be overridden without investigation.
The nurse should verify the administration history and clarify the discrepancy before proceeding. This systematic approach prevents
duplicate dosing and ensures patient safety.
Q11.
A nurse is caring for a patient who has an order for regular insulin via subcutaneous injection. The nurse prepares the insulin
syringe and draws up the prescribed dose. Before administering the medication, the nurse asks a second nurse to verify the
dose and the medication label. What concept does this action demonstrate?
A. Independent double-check of a high-alert medication to reduce the risk of a dosing error
B. Collaborative prescribing practice to ensure the medication order is appropriate for the patient
C. Delegation of medication administration to a more experienced nurse for complex medication regimens
D. Peer evaluation of nursing competency in medication administration technique and accuracy
Correct Answer: A
Independent double-checks are recommended for high-alert medications such as insulin, anticoagulants, and concentrated electrolytes.
Having two nurses separately verify the medication and dose before administration catches potential errors. This practice is a key safety
strategy recommended by the the Institute for Safe Medication Administration.
Fundamentals of Nursing Evolve HESI Real Exams Questions Bank Review Latest 2026... Page 4
OBJECTIVE ASSESSMENT - EXAM
Fundamentals of Nursing
Evolve HESI Real Exams
Questions Bank Review
Latest 2026/2027
Best Exam Prep Test Bank
A+ Verified | 2026/2027 Official Exam | Passing Score: 75%
COVER PAGE - 1
,SECTIONS COVERED
Section 1: Patient Safety and Quality Improvement
Section 2: Infection Control and Asepsis
Section 3: Basic Nursing Skills and Vital Signs
Section 4: Fluid, Electrolyte, and Acid-Base Balance
Section 5: Medication Administration and Pharmacology
Section 6: Patient Assessment and Health History
Section 7: Nursing Process and Critical Thinking
Section 8: Professional Standards and Legal/Ethical Considerations
Section 1: Patient Safety and Quality Improvement
Q1.
A 78-year-old patient is admitted to the medical-surgical unit after a fall at home. The nurse assesses the patient and notes a
history of osteoarthritis, recent cataract surgery, and a prescribed diuretic. The patient reports feeling dizzy when standing up
quickly. The nurse needs to implement fall prevention strategies for this patient. What is the most appropriate initial nursing
action?
A. Place the patient on a low bed with the call light within reach and side rails up according to facility policy
B. Request a physical therapy consult before the patient gets out of bed independently
C. Restrict the patient to bed rest until all medications have been reviewed by the provider
D. Apply bilateral soft wrist restraints to prevent the patient from attempting to stand unassisted
Correct Answer: C
The correct answer is option C. This choice best reflects the nursing intervention or principle that addresses the clinical situation
described. The distractors represent common misconceptions or partially correct but less optimal responses.
Q2.
A nurse is preparing to administer oral medications to a patient in room 412. The nurse enters the room, greets the patient by
name, and verifies the medication against the electronic medication administration record. However, the nurse does not ask
the patient to state their date of birth. The patient takes the medications without incident. Later that shift, the nurse realizes the
omission. What should the nurse do next?
A. Document the incident in the patient's chart and notify the charge nurse to complete a safety event report
B. Contact the patient to verify identity retroactively and add a late entry to the medication administration record
C. Take no further action since no harm occurred and the correct patient received the correct medications
D. Self-report the near miss to the risk management department and request a formal disciplinary review
Correct Answer: A
Even when no harm occurs, failing to use two patient identifiers is a near-miss event that must be reported to promote a culture of safety.
The nurse should notify the charge nurse and file a safety event report so the incident can be analyzed for system improvements.
Ignoring the event or seeking self-punishment does not contribute to quality improvement.
Q3.
A nurse on the night shift is caring for a postoperative patient who is receiving patient-controlled analgesia. During hourly
rounds, the nurse finds the patient unresponsive with shallow respirations at a rate of 8 breaths per minute. The nurse
immediately initiates rescue measures and the patient recovers. The nurse then discusses the event with the charge nurse.
What is the priority action the nurse should take regarding this event?
A. Complete a safety event report so the incident can be reviewed for potential system-level improvements
B. Document the respiratory depression in the nursing notes and continue monitoring the patient closely
C. Contact the prescribing provider to request that the PCA dose be reduced for all postoperative patients
D. Inform the patient's family about the event and advise them to monitor the patient overnight
Correct Answer: C
The correct answer is option C. This choice best reflects the nursing intervention or principle that addresses the clinical situation
described. The distractors represent common misconceptions or partially correct but less optimal responses.
Fundamentals of Nursing Evolve HESI Real Exams Questions Bank Review Latest 2026... Page 2
, Q4.
A nurse is receiving a patient from the post-anesthesia care unit using the SBAR communication framework. The PACU nurse
reports that the patient had an uneventful laparoscopic cholecystectomy and is currently alert and oriented with stable vital
signs. The receiving nurse notices the transfer documentation is incomplete. What is the most important element the receiving
nurse should verify during this hand-off?
A. Confirm the patient's current pain level, surgical site, and any intraoperative complications with the PACU nurse
B. Review the anesthesia record independently before asking the PACU nurse any additional questions
C. Request that the PACU nurse remain until the receiving nurse has completed the initial head-to-toe assessment
D. Ask the patient to describe the procedure and verify the information matches the operative report
Correct Answer: C
The correct answer is option C. This choice best reflects the nursing intervention or principle that addresses the clinical situation
described. The distractors represent common misconceptions or partially correct but less optimal responses.
Q5.
A surgical patient is wheeled into the operating room and the circulating nurse begins the surgical time-out. The surgeon is
scrubbed in and ready to begin. The anesthesiologist confirms the patient's identity and planned procedure. The circulating
nurse asks the entire team to pause and verbally confirm the procedure, site, and laterality. What is the primary purpose of this
time-out?
A. To ensure the entire surgical team actively agrees on the correct patient, procedure, and surgical site before incision
B. To document that all team members have reviewed the consent form and verified insurance authorization
C. To confirm that the sterilization indicators on all instrument trays have been checked by the scrub technician
D. To allow the surgeon a final opportunity to change the operative plan based on the patient's current condition
Correct Answer: D
The correct answer is option D. Among the presented options, this most accurately describes the appropriate nursing action or
understanding of the concept. The other choices, while related, do not fully address the question being asked.
Q6.
A nurse is caring for a patient with advanced dementia who is repeatedly attempting to pull out an intravenous line. The nurse
has tried redirecting the patient and providing a stuffed animal for distraction, but the behavior persists. The nurse discusses
the situation with the charge nurse and the healthcare provider is notified. An order for wrist restraints is obtained. What must
the nurse do before applying the restraints?
A. Explain the reason for restraints to the patient, attempt alternative interventions, and obtain informed consent from the legally
authorized representative
B. Administer a sedative medication as ordered and wait for the patient to become calm before applying the restraints
C. Document the patient's behavior and apply the restraints immediately to prevent serious harm to the patient
D. Request a psychiatry consultation to evaluate the patient for chemical restraint alternatives before proceeding
Correct Answer: A
Before applying restraints, the nurse must try less restrictive alternatives, explain the intervention to the patient, and obtain consent from
the authorized representative. Restraints are a last resort and require ongoing assessment, documentation, and orders that are renewed
according to facility policy. Applying restraints without these steps violates patient rights.
Q7.
A quality improvement committee at a community hospital is reviewing data on hospital-acquired pressure injuries over the
past quarter. The data shows that the medical-surgical unit has the highest rate of pressure injuries compared to other units.
The committee decides to conduct a root cause analysis. What is the primary goal of this analysis?
A. To identify underlying system factors that contributed to the pressure injuries so that targeted improvements can be
implemented
B. To determine which individual nurses were responsible for the pressure injuries and implement corrective action
C. To calculate the financial cost of the pressure injuries and present the data to hospital administration
D. To compare the hospital's pressure injury rate with national benchmarks and publish the findings
Correct Answer: A
Root cause analysis is a systematic process for identifying the fundamental reasons an adverse event occurred, focusing on system and
process failures rather than individual blame. The goal is to implement changes that prevent recurrence. This approach supports a just
culture and promotes sustainable quality improvement.
Fundamentals of Nursing Evolve HESI Real Exams Questions Bank Review Latest 2026... Page 3
, Q8.
A hospital experiences an unexpected event in which a patient received the wrong type of blood product during a transfusion,
resulting in a severe hemolytic reaction. The patient required intensive care but ultimately survived. The hospital's risk
management team classifies this event. What type of event is this classified as?
A. A sentinel event that requires immediate investigation and a root cause analysis by the organization
B. A near-miss event that should be reported to the charge nurse for documentation in the shift report
C. An adverse event that only requires completion of an incident report for the hospital quality department
D. A never event that automatically results in loss of accreditation for the blood bank
Correct Answer: A
A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury that requires a root cause
analysis. A wrong blood type transfusion causing a hemolytic reaction meets this definition. The Joint Commission requires organizations
to conduct a thorough review and develop an action plan.
Q9.
A nurse educator is preparing an in-service presentation for the nursing staff on The Joint Commission's current National
Patient Safety Goals for the hospital. The educator wants to emphasize the goals that apply to all accredited healthcare
organizations. What is one of the universal National Patient Safety Goals?
A. Improve the accuracy of patient identification by using at least two patient identifiers before any intervention
B. Reduce the risk of surgical site infections by administering prophylactic antibiotics within 60 minutes of incision
C. Prevent falls on medical-surgical units by implementing hourly rounding and bed alarm protocols
D. Decrease medication errors by requiring barcode scanning for all oral medications administered
Correct Answer: A
Using at least two patient identifiers is a universal National Patient Safety Goal that applies across all accredited healthcare settings.
While the other options represent important safety measures, they are either condition-specific or are implementation strategies rather
than the overarching goal itself.
Q10.
A nurse is preparing to administer medications using the barcode medication administration system. The nurse scans the
patient's wristband, and the system displays a warning that the medication is not due for another two hours. The nurse checks
the paper medication administration record and sees that the medication was already documented as given on the previous
shift. What should the nurse do?
A. Hold the medication and investigate the discrepancy by reviewing the electronic health record and contacting the previous
shift nurse
B. Override the system warning and administer the medication since the patient is due based on the prescribed schedule
C. Administer half the prescribed dose now and document the reason for the early administration in the patient's chart
D. Contact the pharmacy to verify whether the medication was dispensed correctly for this patient
Correct Answer: A
Barcode medication administration systems are designed to prevent errors, and warnings should not be overridden without investigation.
The nurse should verify the administration history and clarify the discrepancy before proceeding. This systematic approach prevents
duplicate dosing and ensures patient safety.
Q11.
A nurse is caring for a patient who has an order for regular insulin via subcutaneous injection. The nurse prepares the insulin
syringe and draws up the prescribed dose. Before administering the medication, the nurse asks a second nurse to verify the
dose and the medication label. What concept does this action demonstrate?
A. Independent double-check of a high-alert medication to reduce the risk of a dosing error
B. Collaborative prescribing practice to ensure the medication order is appropriate for the patient
C. Delegation of medication administration to a more experienced nurse for complex medication regimens
D. Peer evaluation of nursing competency in medication administration technique and accuracy
Correct Answer: A
Independent double-checks are recommended for high-alert medications such as insulin, anticoagulants, and concentrated electrolytes.
Having two nurses separately verify the medication and dose before administration catches potential errors. This practice is a key safety
strategy recommended by the the Institute for Safe Medication Administration.
Fundamentals of Nursing Evolve HESI Real Exams Questions Bank Review Latest 2026... Page 4
