EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2025
VERIFIED RATIONALE GRADED A+
Withdrawal from nicotine causes cravings, restlessness and hyperirritability, headache (B), insomnia,
depression, decreased blood pressure, and increased appetite. Nicotine is a highly addictive substance
that precipitates an intense withdrawal syndrome, not (A). Nicotine causes vasoconstriction which
increases peripheral resistance and blood pressure (C), but withdrawal is likely to relax peripheral blood
vessels and reduce blood pressure. Many individuals experience an increased appetite, not (D).
Which statement by the community health nurse is most helpful to an adult who is in a crisis situation? -
ansYou seem to be more tense these days. Would you like to talk about the problem and how you are
dealing with it?
which nursing intervention is an example of a competent preformance criterion for an occupational and
environmental health nurse? - ansImplements health programs for construction workers
Which nurse follows a client from admission through discharge or resolution of illness and coordinates
the client's care between healthcare providers? - ansCase manager.
Which intervention should the nurse include in the plan of care for a female client with severe
postpartum depression who is admitted to the inpatient psychiatric unit? - ansSupervised and guided
visits with infant
Which instruction should the nurse include in the discharge teaching for a client who is taking an
antipsycotioc medication? - ansIncrease daily intake of raw fruits and veggies
Which information should the nurse give a client with chronic kidney disease (CKD)? - ansAvoid salt
substitutes
Which info should the nurse provide a client who has undergone cryrosyrgery for stage 1A cerviacl
cancer? - ansUse a sanitary napkin instead of a tampon.
Which finding should the nurse idnetify as an early clinical manifestation of neonatal encephalopathy
related to hyperbilirubinemia? - ansLethargy or irritability
Which documentation indicates that the nurse correctly evaluated a pain medication's effectiveness
after administration? The client - ansreports decrease in pain
Which assessment finding should make the nurse suspect that a 21 year old male client is taking anabolic
steroids - ansDescribes working hard to develop muscles
Which approach should the nurse use when preparing a toddler for a procedure? - ansDemonstrate the
procedure using a doll.
Which action should the nurse implement when administering a prescription drug that should be given
on an empty stomach? - ansGive one hour before or two hours after a meal
When the infant suckles at the breast, oxytocin is released by the posterior pituitary to stimulates the
"letdown" reflex, which causes the release of colostrum, and contracts the uterus (C) to prevent uterine
,EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2025
VERIFIED RATIONALE GRADED A+
hemorrhage. (A and B) do not support the client's need in the immediate period after the emergency
delivery. Although maternal-newborn bonding (D) is facilitated by early breastfeeding, the priority is
uterine contraction stimulation.
When meeting with the client and the family, which nursing intervention demonstrates the nurses role
as collaborator of care? - ansCoordinating and educating about multidisciplinary services
When engaging in planned change on the unit, what should the nurse-manager establish first? - ansStaff
members are aware of the need for change
When documenting assessment data, which statement should the nurse record in the narrative nursing
notes? - ansS1 Murmur auscultated in supine position.
When administering a drug on an empty stomach, the drug should be given either one hour before a
meal or two hours after a meal (B), which is the average transit time from the stomach to the duodenum
after eating. An eight-hour fast is more time than is needed for the stomach to empty (C) and is not
necessary. The last time any food or drink has been ingested is a better indicator of an empty stomach,
rather than after the client has missed a meal (C). Some liquids, such as grapefruit juice, can alter the
drug's dilution and absorption (D).
What nursing delivery of care provides the nurse to plan and direct care of a group of clients over a 24-
hour period? - ansPrimary nursing.
What information best supports the nurse's explanation for promoting the use of alternative or
complementary therapies? - ansRecognizes the value of a client's input into their own health care.
Verapamil slows sinoatrial (SA) nodal automaticity, delays atrioventricular (AV) nodal conduction, which
slows the ventricular rate, and is used to treat atrial flutter, so (A) should be implemented, based on the
client's heart rate and blood pressure. (B and C) are not indicated. (D) delays the administration of the
scheduled dose.
Using Nägele's rule to calculate EDB, subtract 3 months and add 7 days to the first day of the last normal
menstrual period. The client's LMP is February 14, so less 3 months + 7 days is November 21 (B) of the
next year. (A, C, and D) are inaccurate.
Two unlicensed assistive personnel (UAP) are arguing on the unit about who deserves to take a break
first. What is the most important basic guideline that the nurse should follow in resolving the conflict? -
ansDeal with issues and not personalities.
Two hours after vaginal devilry of a 7-pound 3 ounces infant, a clients fundus is 3 cm above the
umbilicus, boggy, and located to the right of midline. Which action should the nurse take first? -
ansPalpate above the symphysis for the bladder.
Two hours after giving birth, the uterus should be firm, in the midline, and below the umbilicus. If the
fundus is high, dextroverted and boggy, urinary retention is likely distending the bladder, so palpating for
,EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2025
VERIFIED RATIONALE GRADED A+
a full bladder above the symphysis (B) should be implemented first. (A, C, and D) are implemented after
the client voids or the bladder is emptied by catheterization.
To ease the client's discomfort, a water soluble lubricant to the lips and nares assists to keep the mucous
membranes moist (D). (A) is a petroleum-based product and should not be used because it is flammable.
(B and C) should not be given to the client with a nasogastric tube to suction because it can cause further
distension and interfere with fluid and electrolyte balance.
To correctly solve this problem, use the formula: Desired/On Hand, or the algebraic formula: 75: x = 50 :
1. 50x = 75. x = 75/50 or reduced to 1.5 mL (C).
To check the accommodation response, the client should gaze and fixate on an object 2 to 3 feet away,
then bring the object closer until the client is fixated on the object at 6 to 8 inches (10 cm) and identify
pupillary constriction as the client focuses on the near object (D). (A and B) evaluate pupillary reactivity
to light (PERL). (C) evaluates pupil and blink reflexes (Cranial Nerve III).
To assess a client's pupillary response to accommodation, a nurse should perform which activity? -
ansAsk the client to look at a distant object and then at an object held 10 cm from the nose.
This is a legal document that allows individuals to identify someone to make decisions for health care,
identifies how aggressive treatment should be if the client should ever be in a coma or persistent
vegetative state, and lists any medical treatments they would never want performed (B). (A) is the
definition of the "Living Will"; some states and Canada do not consider Living Wills legal documents. A
durable power of attorney is a legal document (C), and it is not a hospital form (D).
This client is exhibiting symptoms associated with hyperthyroidism or Grave's disease (A), which is an
autoimmune condition affecting the thyroid. (B, C, and D) are not associated with these symptoms.
The triple marker screen measures maternal serum levels for alpha-fetoprotein (AFP), human chorionic
gonadotropin (HCG), and estriol, which screens for indications of possible fetal defects. An elevated
result may be a false indicator, so other tests are indicated (B). (A) is not necessary or helpful. Elevated
results warrant further testing with ultrasound or amniocentesis before initiating (C or D).
The supine position with the foot of the bed elevated (D) (Trendelenburg) is one position used to
alleviate gravitational pressure by the fetus on the prolapsed umbilical cord, (A, B, and C) do not alleviate
pressure on the umbilical cord.
The state's Board of Nursing (A) is authorized to promulgate rules and regulations that carry the weight
of law. The State Legislature delegates its law-making authority to this administrative law body. (B and C)
are influential in defining and describing nursing standards of care, but neither have the authority to
pass laws that legally define the professional scope of nursing practice. Although (D) may rule on issues
important to nursing practice, the scope of professional nursing practice is determined by the laws, rules,
and regulations promulgated by state Boards of Nursing.
, EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2025
VERIFIED RATIONALE GRADED A+
The sequential steps in problem-solving are to first identify the problem (B), then consider alternatives
(C), consider outcomes of the alternatives (D), predict the likelihood of the outcomes occurring, and
choose the alternative with the best chance of success (A).
the scope of professional nursing practice is determined by rules promulgated by which organization.? -
ansState's board of nursing
The school nurse is reviewing health risks associated with extracurricular activities of grade-school
children. Regular participation in which activity places the child at highest risk for developing external
otitis? - ansSwimming lessons in an indoor pool.
The role of the case manager (A) is to assist the continuum of care for the client, and coordinate the plan
of care, evaluate client needs, and collaborate with the interdisciplinary healthcare team to ensure that
goals are met, quality is maintained, and progress toward discharge is made. (B) focuses on staffing and
assigning work on client units. (C) reviews research and assesses opportunities for process improvement,
implement changes, measure outcomes, and start the improvement process. (D) is responsible for all of
the discharge needs of clients at the time of discharge but would not be involved with client admission
activities.
The risk of aspiration while under general anesthesia is increased when the stomach is not empty prior
to a surgical procedure, so the client's intake of juice (B) after midnight should be reported the
healthcare provider. Preoperative fear and anxiety (A) are common and should be further explored by
the nurse. (C) should be communicated using allergy identification tags on the client's records and
bracelets on the client's wrist. (D) is a common and expected side effect of perioperative medications.
The plan of care should include goals that are specific for chronic and acute illnesses. Adult-onset
diabetes is a life-long chronic disease, whereas influenza is an acute illness with a short term duration
(C). (A, B, and D) do not include the correct duration categories for this situation.
The parents of a 14-year-old boy express concern about their son's behavior, which ranges from clean-
cut and personable to "grungy" and sullen. They have tried talking with him and disciplining him, but he
continues to demonstrate confusing behaviors. Which information is best for the nurse to provide? -
ansAsk the spouse to step out for a few minutes
the nursie is caring for a client who is unable to void. The plan of care establishes an objective for the
client to ingest at least 1000 mL of fluid between 7:00 am and 3:30pm. Which client response should the
nurse document that indicates a successful outcome? - ansDrinks 240 mL of fluid five times during the
shift.
The nurse should provide a reality check by helping the client realize that there are consequences to his
behavior (D). (A and B) do not help the client realize that his behavior is manipulative and harmful to
himself as well as others. This behavior needs to be documented, but (C) does not need to be
implemented.
QUESTIONS AND ANSWERS LATEST VERSION 2025
VERIFIED RATIONALE GRADED A+
Withdrawal from nicotine causes cravings, restlessness and hyperirritability, headache (B), insomnia,
depression, decreased blood pressure, and increased appetite. Nicotine is a highly addictive substance
that precipitates an intense withdrawal syndrome, not (A). Nicotine causes vasoconstriction which
increases peripheral resistance and blood pressure (C), but withdrawal is likely to relax peripheral blood
vessels and reduce blood pressure. Many individuals experience an increased appetite, not (D).
Which statement by the community health nurse is most helpful to an adult who is in a crisis situation? -
ansYou seem to be more tense these days. Would you like to talk about the problem and how you are
dealing with it?
which nursing intervention is an example of a competent preformance criterion for an occupational and
environmental health nurse? - ansImplements health programs for construction workers
Which nurse follows a client from admission through discharge or resolution of illness and coordinates
the client's care between healthcare providers? - ansCase manager.
Which intervention should the nurse include in the plan of care for a female client with severe
postpartum depression who is admitted to the inpatient psychiatric unit? - ansSupervised and guided
visits with infant
Which instruction should the nurse include in the discharge teaching for a client who is taking an
antipsycotioc medication? - ansIncrease daily intake of raw fruits and veggies
Which information should the nurse give a client with chronic kidney disease (CKD)? - ansAvoid salt
substitutes
Which info should the nurse provide a client who has undergone cryrosyrgery for stage 1A cerviacl
cancer? - ansUse a sanitary napkin instead of a tampon.
Which finding should the nurse idnetify as an early clinical manifestation of neonatal encephalopathy
related to hyperbilirubinemia? - ansLethargy or irritability
Which documentation indicates that the nurse correctly evaluated a pain medication's effectiveness
after administration? The client - ansreports decrease in pain
Which assessment finding should make the nurse suspect that a 21 year old male client is taking anabolic
steroids - ansDescribes working hard to develop muscles
Which approach should the nurse use when preparing a toddler for a procedure? - ansDemonstrate the
procedure using a doll.
Which action should the nurse implement when administering a prescription drug that should be given
on an empty stomach? - ansGive one hour before or two hours after a meal
When the infant suckles at the breast, oxytocin is released by the posterior pituitary to stimulates the
"letdown" reflex, which causes the release of colostrum, and contracts the uterus (C) to prevent uterine
,EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2025
VERIFIED RATIONALE GRADED A+
hemorrhage. (A and B) do not support the client's need in the immediate period after the emergency
delivery. Although maternal-newborn bonding (D) is facilitated by early breastfeeding, the priority is
uterine contraction stimulation.
When meeting with the client and the family, which nursing intervention demonstrates the nurses role
as collaborator of care? - ansCoordinating and educating about multidisciplinary services
When engaging in planned change on the unit, what should the nurse-manager establish first? - ansStaff
members are aware of the need for change
When documenting assessment data, which statement should the nurse record in the narrative nursing
notes? - ansS1 Murmur auscultated in supine position.
When administering a drug on an empty stomach, the drug should be given either one hour before a
meal or two hours after a meal (B), which is the average transit time from the stomach to the duodenum
after eating. An eight-hour fast is more time than is needed for the stomach to empty (C) and is not
necessary. The last time any food or drink has been ingested is a better indicator of an empty stomach,
rather than after the client has missed a meal (C). Some liquids, such as grapefruit juice, can alter the
drug's dilution and absorption (D).
What nursing delivery of care provides the nurse to plan and direct care of a group of clients over a 24-
hour period? - ansPrimary nursing.
What information best supports the nurse's explanation for promoting the use of alternative or
complementary therapies? - ansRecognizes the value of a client's input into their own health care.
Verapamil slows sinoatrial (SA) nodal automaticity, delays atrioventricular (AV) nodal conduction, which
slows the ventricular rate, and is used to treat atrial flutter, so (A) should be implemented, based on the
client's heart rate and blood pressure. (B and C) are not indicated. (D) delays the administration of the
scheduled dose.
Using Nägele's rule to calculate EDB, subtract 3 months and add 7 days to the first day of the last normal
menstrual period. The client's LMP is February 14, so less 3 months + 7 days is November 21 (B) of the
next year. (A, C, and D) are inaccurate.
Two unlicensed assistive personnel (UAP) are arguing on the unit about who deserves to take a break
first. What is the most important basic guideline that the nurse should follow in resolving the conflict? -
ansDeal with issues and not personalities.
Two hours after vaginal devilry of a 7-pound 3 ounces infant, a clients fundus is 3 cm above the
umbilicus, boggy, and located to the right of midline. Which action should the nurse take first? -
ansPalpate above the symphysis for the bladder.
Two hours after giving birth, the uterus should be firm, in the midline, and below the umbilicus. If the
fundus is high, dextroverted and boggy, urinary retention is likely distending the bladder, so palpating for
,EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2025
VERIFIED RATIONALE GRADED A+
a full bladder above the symphysis (B) should be implemented first. (A, C, and D) are implemented after
the client voids or the bladder is emptied by catheterization.
To ease the client's discomfort, a water soluble lubricant to the lips and nares assists to keep the mucous
membranes moist (D). (A) is a petroleum-based product and should not be used because it is flammable.
(B and C) should not be given to the client with a nasogastric tube to suction because it can cause further
distension and interfere with fluid and electrolyte balance.
To correctly solve this problem, use the formula: Desired/On Hand, or the algebraic formula: 75: x = 50 :
1. 50x = 75. x = 75/50 or reduced to 1.5 mL (C).
To check the accommodation response, the client should gaze and fixate on an object 2 to 3 feet away,
then bring the object closer until the client is fixated on the object at 6 to 8 inches (10 cm) and identify
pupillary constriction as the client focuses on the near object (D). (A and B) evaluate pupillary reactivity
to light (PERL). (C) evaluates pupil and blink reflexes (Cranial Nerve III).
To assess a client's pupillary response to accommodation, a nurse should perform which activity? -
ansAsk the client to look at a distant object and then at an object held 10 cm from the nose.
This is a legal document that allows individuals to identify someone to make decisions for health care,
identifies how aggressive treatment should be if the client should ever be in a coma or persistent
vegetative state, and lists any medical treatments they would never want performed (B). (A) is the
definition of the "Living Will"; some states and Canada do not consider Living Wills legal documents. A
durable power of attorney is a legal document (C), and it is not a hospital form (D).
This client is exhibiting symptoms associated with hyperthyroidism or Grave's disease (A), which is an
autoimmune condition affecting the thyroid. (B, C, and D) are not associated with these symptoms.
The triple marker screen measures maternal serum levels for alpha-fetoprotein (AFP), human chorionic
gonadotropin (HCG), and estriol, which screens for indications of possible fetal defects. An elevated
result may be a false indicator, so other tests are indicated (B). (A) is not necessary or helpful. Elevated
results warrant further testing with ultrasound or amniocentesis before initiating (C or D).
The supine position with the foot of the bed elevated (D) (Trendelenburg) is one position used to
alleviate gravitational pressure by the fetus on the prolapsed umbilical cord, (A, B, and C) do not alleviate
pressure on the umbilical cord.
The state's Board of Nursing (A) is authorized to promulgate rules and regulations that carry the weight
of law. The State Legislature delegates its law-making authority to this administrative law body. (B and C)
are influential in defining and describing nursing standards of care, but neither have the authority to
pass laws that legally define the professional scope of nursing practice. Although (D) may rule on issues
important to nursing practice, the scope of professional nursing practice is determined by the laws, rules,
and regulations promulgated by state Boards of Nursing.
, EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2025
VERIFIED RATIONALE GRADED A+
The sequential steps in problem-solving are to first identify the problem (B), then consider alternatives
(C), consider outcomes of the alternatives (D), predict the likelihood of the outcomes occurring, and
choose the alternative with the best chance of success (A).
the scope of professional nursing practice is determined by rules promulgated by which organization.? -
ansState's board of nursing
The school nurse is reviewing health risks associated with extracurricular activities of grade-school
children. Regular participation in which activity places the child at highest risk for developing external
otitis? - ansSwimming lessons in an indoor pool.
The role of the case manager (A) is to assist the continuum of care for the client, and coordinate the plan
of care, evaluate client needs, and collaborate with the interdisciplinary healthcare team to ensure that
goals are met, quality is maintained, and progress toward discharge is made. (B) focuses on staffing and
assigning work on client units. (C) reviews research and assesses opportunities for process improvement,
implement changes, measure outcomes, and start the improvement process. (D) is responsible for all of
the discharge needs of clients at the time of discharge but would not be involved with client admission
activities.
The risk of aspiration while under general anesthesia is increased when the stomach is not empty prior
to a surgical procedure, so the client's intake of juice (B) after midnight should be reported the
healthcare provider. Preoperative fear and anxiety (A) are common and should be further explored by
the nurse. (C) should be communicated using allergy identification tags on the client's records and
bracelets on the client's wrist. (D) is a common and expected side effect of perioperative medications.
The plan of care should include goals that are specific for chronic and acute illnesses. Adult-onset
diabetes is a life-long chronic disease, whereas influenza is an acute illness with a short term duration
(C). (A, B, and D) do not include the correct duration categories for this situation.
The parents of a 14-year-old boy express concern about their son's behavior, which ranges from clean-
cut and personable to "grungy" and sullen. They have tried talking with him and disciplining him, but he
continues to demonstrate confusing behaviors. Which information is best for the nurse to provide? -
ansAsk the spouse to step out for a few minutes
the nursie is caring for a client who is unable to void. The plan of care establishes an objective for the
client to ingest at least 1000 mL of fluid between 7:00 am and 3:30pm. Which client response should the
nurse document that indicates a successful outcome? - ansDrinks 240 mL of fluid five times during the
shift.
The nurse should provide a reality check by helping the client realize that there are consequences to his
behavior (D). (A and B) do not help the client realize that his behavior is manipulative and harmful to
himself as well as others. This behavior needs to be documented, but (C) does not need to be
implemented.
