2026 Evolve HESI Fundamentals Exam –
Comprehensive Practice Questions with answers
Question 1
A nurse is preparing to administer medications to a client. Which of the following is the most
important action to prevent medication errors?
A) Checking the medication label three times
B) Verifying the client's identity using two identifiers
C) Administering medications within 30 minutes of the scheduled time
D) Documenting the medication immediately after administration
Answer: B
Rationale: Verifying the client's identity using two identifiers (e.g., name and date of birth) is
the most critical step to prevent medication errors and ensure the right medication is given to
the right client. While checking the label three times and timely documentation are important,
client identification is the priority to prevent harm.
Question 2
A nurse is caring for a client with a new colostomy. Which of the following statements by the
client indicates a need for further teaching?
A) "I should empty the pouch when it is one-third to one-half full."
B) "I can use a pouching system that fits snugly around the stoma."
,C) "I should avoid eating foods that cause gas and odor."
D) "I will change the pouching system every 7 to 10 days."
Answer: D
Rationale: The pouching system should be changed every 3 to 7 days, not 7 to 10 days. Waiting
too long increases the risk of leakage, skin breakdown, and infection. The other statements are
correct: emptying when one-third to one-half full prevents leakage, a snug fit protects the skin,
and avoiding gas-forming foods helps manage odor and output.
Question 3
A nurse is assessing a client who has been receiving IV fluids for 24 hours. Which of the
following findings indicates fluid overload?
A) Decreased blood pressure
B) Crackles in the lungs
C) Decreased urine output
D) Dry mucous membranes
Answer: B
Rationale: Crackles in the lungs are a classic sign of fluid overload (pulmonary edema) due to
excess fluid in the alveoli. Other signs include weight gain, edema, elevated blood pressure, and
jugular venous distention. Decreased urine output and dry mucous membranes indicate
dehydration, not fluid overload.
Question 4
, A nurse is teaching a client about proper hand hygiene. Which of the following statements by
the client indicates understanding?
A) "I should use alcohol-based hand rub when my hands are visibly soiled."
B) "I should rub my hands together until the alcohol evaporates completely."
C) "I should wash my hands for at least 5 seconds."
D) "I should keep my hands below my elbows while washing."
Answer: B
Rationale: Alcohol-based hand rub should be rubbed into the hands until completely dry
(evaporated), which takes about 15-30 seconds. Alcohol-based rubs are not effective when
hands are visibly soiled; soap and water must be used. Handwashing should last at least 20
seconds, and hands should be kept lower than the elbows to allow water to flow downward,
preventing contamination of the forearms.
Question 5
A nurse is preparing to insert an indwelling urinary catheter. Which of the following actions
should the nurse take first?
A) Perform hand hygiene
B) Open the catheterization kit
C) Position the client supine with legs apart
D) Cleanse the urinary meatus
Answer: A
Comprehensive Practice Questions with answers
Question 1
A nurse is preparing to administer medications to a client. Which of the following is the most
important action to prevent medication errors?
A) Checking the medication label three times
B) Verifying the client's identity using two identifiers
C) Administering medications within 30 minutes of the scheduled time
D) Documenting the medication immediately after administration
Answer: B
Rationale: Verifying the client's identity using two identifiers (e.g., name and date of birth) is
the most critical step to prevent medication errors and ensure the right medication is given to
the right client. While checking the label three times and timely documentation are important,
client identification is the priority to prevent harm.
Question 2
A nurse is caring for a client with a new colostomy. Which of the following statements by the
client indicates a need for further teaching?
A) "I should empty the pouch when it is one-third to one-half full."
B) "I can use a pouching system that fits snugly around the stoma."
,C) "I should avoid eating foods that cause gas and odor."
D) "I will change the pouching system every 7 to 10 days."
Answer: D
Rationale: The pouching system should be changed every 3 to 7 days, not 7 to 10 days. Waiting
too long increases the risk of leakage, skin breakdown, and infection. The other statements are
correct: emptying when one-third to one-half full prevents leakage, a snug fit protects the skin,
and avoiding gas-forming foods helps manage odor and output.
Question 3
A nurse is assessing a client who has been receiving IV fluids for 24 hours. Which of the
following findings indicates fluid overload?
A) Decreased blood pressure
B) Crackles in the lungs
C) Decreased urine output
D) Dry mucous membranes
Answer: B
Rationale: Crackles in the lungs are a classic sign of fluid overload (pulmonary edema) due to
excess fluid in the alveoli. Other signs include weight gain, edema, elevated blood pressure, and
jugular venous distention. Decreased urine output and dry mucous membranes indicate
dehydration, not fluid overload.
Question 4
, A nurse is teaching a client about proper hand hygiene. Which of the following statements by
the client indicates understanding?
A) "I should use alcohol-based hand rub when my hands are visibly soiled."
B) "I should rub my hands together until the alcohol evaporates completely."
C) "I should wash my hands for at least 5 seconds."
D) "I should keep my hands below my elbows while washing."
Answer: B
Rationale: Alcohol-based hand rub should be rubbed into the hands until completely dry
(evaporated), which takes about 15-30 seconds. Alcohol-based rubs are not effective when
hands are visibly soiled; soap and water must be used. Handwashing should last at least 20
seconds, and hands should be kept lower than the elbows to allow water to flow downward,
preventing contamination of the forearms.
Question 5
A nurse is preparing to insert an indwelling urinary catheter. Which of the following actions
should the nurse take first?
A) Perform hand hygiene
B) Open the catheterization kit
C) Position the client supine with legs apart
D) Cleanse the urinary meatus
Answer: A
