Evolve Fundamentals HESI Exam: Complete
Review, Question Format, and Essential Study Tips
for Success
A Sub-Saharan African widowed immigrant woman lives with her deceased husband's
brother and his family, which includes the brother-in-law's children and the widow's adult
children. Each family member speaks fluent English. Surgery was recommended for the
client. What is the best plan to obtain consent for surgery for this client?
A. Obtain an interpreter to explain the procedure to the client.
B. Encourage the client to make her own decision regarding surgery.
C. Ask the family members to provide a clarification of the surgeon's explanation to the
client.
D. Tell the surgeon that the brother-in-law will decide after explanation of the proposed
surgery is provided to him and the widow. - - correct ans- -Customary law in some rural
sub-Saharan countries encompasses wife inheritance and polygamy; the widow becomes
the inherited wife of her husband's brother. In those rural areas women live in a patriarchal
family where decisions are made by men. Most likely, the brother-in-law will make the
decision for his inherited wife, so (D) provides the surgeon with culturally sensitive
information. (A) all family members speak fluent English therefore there is no need for
translation. It is culturally insensitive to encourage the woman to go against her wishes and
her cultural worldview, as in (B). Family members are more likely to misinterpret medical
information (C).
Correct Answer: D
Which response by a client with a nursing diagnosis of "Spiritual distress," indicates to the
nurse that a desired outcome measure has been met?
,A. Express concern about the meaning and importance of life.
B. Remains angry at God for the continuation of the illness.
C. Accepts that punishment from God is not related to illness.
D. Refuses to participate in religious rituals that have no meaning. - - correct ans- -
Acceptance that she is not being punished by God indicates a desired outcome (C) for
some degree of resolution of spiritual distress. (A, B, and D) do not support the concept of
grief, loss, and cultural/spiritual acceptance.
Correct Answer: C
During shift change report, the nurse receives report that a client has abnormal heart
sounds. Which placement of the stethoscope should the nurse use to hear the client's hear
sounds?
A. Place the stethoscope bell at random points on the posterior chest.
B. Use the stethoscope bell over the valvular areas of the anterior chest.
C. Move the diaphragm of the stethoscope over the left anterior chest,
D. Position the diaphragm of the stethoscope at Erb's point on the chest. - - correct ans- -
Abdominal heart sounds are best heard with the bell of the stethoscope, which picks up
lower-pitched sounds, that is placed at points on the anterior chest (B). (A, C, and D) do not
provide the best assessment of abdominal heart valve sounds.
Correct Answer: B
A nurse is preparing to give medications through a nasogastric feeding tube. Which nursing
action should prevent complications during administration?
A. Mix each medication individually.
,B. Use sterile gloves for the procedure.
C. Monitor vital signs before giving medications.
D. Mix all medications together to facilitate administration. - - correct ans- -Medications
should be mixed separately (A) to prevent clumping. (B, C, and D) are not indicated.
Correct Answer: A
During the admission interview, which technique is most efficient for the nurse to use when
obtaining information about signs and symptoms of a client's primary health problem?
A. Restatement of responses.
B. Open-ended questions.
C. Closed-ended questions.
D. Problem-seeking responses. - - correct ans- -Lay descriptions of health problems can be
vague and nonspecific. To efficiently obtain specific information, the nurse should use
closed-ended questions (C) that focus on common signs and symptoms about a client's
health problem. (A, B, and D) are used when therapeutically interacting and should be used
after specific information is obtained from the client.
Correct answer: C
An older client who is a resident in a long term care facility has been bedridden for a week.
Which finding should the nurse identify as a client risk factor for pressure ulcers?
A. Generalized dry skin.
B. Localized dry skin on lower extremities.
C. Red flush over entire skin surface.
, D. Rashes in the axillary, groin, and skin fold regions. - - correct ans- -Immobility, constant
with bed clothing, and excessive heat and moisture in areas where air flow is limited
contributes to bacterial and fungal growth, which increases the risk for rashes (D), skin
breakdown, and the development of pressure ulcers. (A, B, and C) do not address the
concepts of inflammation and tissue integrity.
Correct Answer: D
A client who has been NPO for 3 days is receiving an infusion of D5W 0.45 normal saline
(NS) with potassium chloride (KCl) 20 mEq at 83 mL/hour. The client's eight-hour urine
output is 400 mL blood urea nitrogen (BUN) is 15 mg/dL, lungs are clear bilaterally, serum
glucose is 120 mg/dL, and the serum potassium is 3.7 mEq/L. Which action is most
important for the nurse to implement?
A. Notify healthcare provider and request to change the IV infusion to hypertonic D 10W.
B. Decrease in the infusion rate of the current IV and report to the healthcare provider.
C. Document in the medical record that these normal findings are expected outcomes.
D. Obtain potassium chloride 20 mEq in anticipation of a prescription to add to present IV. -
- correct ans- -The results are all within normal range (C). No changes are needed (A, B, and
D).
Correct Answer: C
Secobarbital (Seconal) 150 mg is prescribed at bedtime for a male client who is scheduled
for surgery in the morning. The scored tablets are labeled 0.1 gram/tablet. How many
tablets should the nurse administer? (Enter numerical value only. If rounding is required,
round to the nearest tenth.) - - correct ans- -1,000 mg : 1 gram :: X mg : 0.1 gram
X = 100 mg D/H = 150/100 = 1.5 tablets
Review, Question Format, and Essential Study Tips
for Success
A Sub-Saharan African widowed immigrant woman lives with her deceased husband's
brother and his family, which includes the brother-in-law's children and the widow's adult
children. Each family member speaks fluent English. Surgery was recommended for the
client. What is the best plan to obtain consent for surgery for this client?
A. Obtain an interpreter to explain the procedure to the client.
B. Encourage the client to make her own decision regarding surgery.
C. Ask the family members to provide a clarification of the surgeon's explanation to the
client.
D. Tell the surgeon that the brother-in-law will decide after explanation of the proposed
surgery is provided to him and the widow. - - correct ans- -Customary law in some rural
sub-Saharan countries encompasses wife inheritance and polygamy; the widow becomes
the inherited wife of her husband's brother. In those rural areas women live in a patriarchal
family where decisions are made by men. Most likely, the brother-in-law will make the
decision for his inherited wife, so (D) provides the surgeon with culturally sensitive
information. (A) all family members speak fluent English therefore there is no need for
translation. It is culturally insensitive to encourage the woman to go against her wishes and
her cultural worldview, as in (B). Family members are more likely to misinterpret medical
information (C).
Correct Answer: D
Which response by a client with a nursing diagnosis of "Spiritual distress," indicates to the
nurse that a desired outcome measure has been met?
,A. Express concern about the meaning and importance of life.
B. Remains angry at God for the continuation of the illness.
C. Accepts that punishment from God is not related to illness.
D. Refuses to participate in religious rituals that have no meaning. - - correct ans- -
Acceptance that she is not being punished by God indicates a desired outcome (C) for
some degree of resolution of spiritual distress. (A, B, and D) do not support the concept of
grief, loss, and cultural/spiritual acceptance.
Correct Answer: C
During shift change report, the nurse receives report that a client has abnormal heart
sounds. Which placement of the stethoscope should the nurse use to hear the client's hear
sounds?
A. Place the stethoscope bell at random points on the posterior chest.
B. Use the stethoscope bell over the valvular areas of the anterior chest.
C. Move the diaphragm of the stethoscope over the left anterior chest,
D. Position the diaphragm of the stethoscope at Erb's point on the chest. - - correct ans- -
Abdominal heart sounds are best heard with the bell of the stethoscope, which picks up
lower-pitched sounds, that is placed at points on the anterior chest (B). (A, C, and D) do not
provide the best assessment of abdominal heart valve sounds.
Correct Answer: B
A nurse is preparing to give medications through a nasogastric feeding tube. Which nursing
action should prevent complications during administration?
A. Mix each medication individually.
,B. Use sterile gloves for the procedure.
C. Monitor vital signs before giving medications.
D. Mix all medications together to facilitate administration. - - correct ans- -Medications
should be mixed separately (A) to prevent clumping. (B, C, and D) are not indicated.
Correct Answer: A
During the admission interview, which technique is most efficient for the nurse to use when
obtaining information about signs and symptoms of a client's primary health problem?
A. Restatement of responses.
B. Open-ended questions.
C. Closed-ended questions.
D. Problem-seeking responses. - - correct ans- -Lay descriptions of health problems can be
vague and nonspecific. To efficiently obtain specific information, the nurse should use
closed-ended questions (C) that focus on common signs and symptoms about a client's
health problem. (A, B, and D) are used when therapeutically interacting and should be used
after specific information is obtained from the client.
Correct answer: C
An older client who is a resident in a long term care facility has been bedridden for a week.
Which finding should the nurse identify as a client risk factor for pressure ulcers?
A. Generalized dry skin.
B. Localized dry skin on lower extremities.
C. Red flush over entire skin surface.
, D. Rashes in the axillary, groin, and skin fold regions. - - correct ans- -Immobility, constant
with bed clothing, and excessive heat and moisture in areas where air flow is limited
contributes to bacterial and fungal growth, which increases the risk for rashes (D), skin
breakdown, and the development of pressure ulcers. (A, B, and C) do not address the
concepts of inflammation and tissue integrity.
Correct Answer: D
A client who has been NPO for 3 days is receiving an infusion of D5W 0.45 normal saline
(NS) with potassium chloride (KCl) 20 mEq at 83 mL/hour. The client's eight-hour urine
output is 400 mL blood urea nitrogen (BUN) is 15 mg/dL, lungs are clear bilaterally, serum
glucose is 120 mg/dL, and the serum potassium is 3.7 mEq/L. Which action is most
important for the nurse to implement?
A. Notify healthcare provider and request to change the IV infusion to hypertonic D 10W.
B. Decrease in the infusion rate of the current IV and report to the healthcare provider.
C. Document in the medical record that these normal findings are expected outcomes.
D. Obtain potassium chloride 20 mEq in anticipation of a prescription to add to present IV. -
- correct ans- -The results are all within normal range (C). No changes are needed (A, B, and
D).
Correct Answer: C
Secobarbital (Seconal) 150 mg is prescribed at bedtime for a male client who is scheduled
for surgery in the morning. The scored tablets are labeled 0.1 gram/tablet. How many
tablets should the nurse administer? (Enter numerical value only. If rounding is required,
round to the nearest tenth.) - - correct ans- -1,000 mg : 1 gram :: X mg : 0.1 gram
X = 100 mg D/H = 150/100 = 1.5 tablets
