HESI Evolve Practice Exam with Rationales –
2025/2026 Updated Study Guide & Practice
Questions | 100% Pass Guarantee
an antacid (Maalox) is prescribed for a client with peptic ulcer disease. the nurse knows
that the purpose of this medicatio is:
A. decrease production of gastric secretions
B. produce an adherent barrier over the ulcer
C. maintain a gastric pH of 3.5 or higher
D. decrease gastric motor activity - correct answerC. maintain a gastric pH of 3.5 or
higher
rationale: objective of antacids is to neutralize gastric acids and keep a pH of 3.5 or
above, which is necessary for pepsinogen activity
In evaluation the effects of lactulose (Cephulac), which outcome would indicate that the
drug is performing as intended?
A. increase in urine output
B. 2 or 3 soft stools per day.
C. watery, diarrhea stools
D. increased serum bilirubin - correct answerB. 2 or 3 soft stools per day.
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with CHF.
which intervention should the nurse implement prior to administering Digoxin?
A. observe respiratory rate and depth
B. assess serum potassium level
C. obtain the client's BP
D. Monitor the serum glucose level - correct answerB. assess serum potassium level
Following the administration of sublingual nitroglycerin to a client experiencing an acute
anginal attack, which assessment finding indicates to the nurse that the desired effect
has been achieved?
A. client states chest pain is relieved
B. client's pulse decreases from 120 to 90
C. client's systolic BP decreases from 180 to 90.
D. clients Oxygen level increases form 92% to 96% - correct answerA. client states
chest pain is relieved
A client with CHF is being discharges with a new prescription for ACE inhibitor Captopril
(Capoten). The nurse's discharge instruction should include reporting which problem to
the health care provider?
A. weight loss
,B. Dizziness
C. Muscle cramps
D. Dry mucous membreanes - correct answerB. Dizziness
A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse
knows that the action of this drug is to:
A. decrease the amount of thyroid-stimulating hormone circulating in the blood.
B. increase the amount of thyroid-stimulating hormone circulating in the blood.
C. increase the amount of T4 and decrease the amount of T3 produced by the thyroid.
D. inhibit synthesis of T3 and T4 by the thyroid glanf - correct answerD. inhibits
synthesis of T3 and T4 by the thyroid gland.
A client with Parkinson's disease is taking carbidopa-levadopa (Sinemet). which
observation by the nurse would indicate that the desired outcome of the medication is
being achieved?
A. decreased BP
B. lessening of tremors
C. increased salivation
D. increased attention span - correct answerB. lessening of tremors
rationale: sinemet carbidopa increases the amount of levodopa to the CNS (dopamine
to the brain). increased amounts of dopamine improve the symptoms of Parkinsons,
such as involuntary movements, resting tremors, shuffling air, etc. dec drooling would
be a desired effect of levodopa/carbidopa
Following heparin treatment for a pulmonary embolism, a client is being discharged with
a prescription for warfarin (coumadin). In conducting discharge teaching, the nurse
advises the client to have which diagnostic test monitored regularly after discharge?
A. perfusion scan
B. Prothrombin Time (PT/INR)
C. activated partial thromboplastin (APPT)
D. serum coumadin level (SCL). - correct answerB. prothrombin time (PT/INR)
rationale: when used for a client with a pulmonary embolus, the theraputic goal for
warfarin therapy is 1-2x greater than the control, Orr an INR of 2-3
A postoperative client has been receiving a continuous IV infusion of meperidine
(demerol) 35mg/hr for four days. the client has a PRN prescription for Demerol 100 mg
PO q3h. The nurse notes that the client has become increasingly restless, irritable and
confused, stating that there are bugs all over the walls. what action should the nurse
take first?
A. administer a PRN dose of PO meperidine (Demerol).
B. administer naloxone (Narcan) IV per PRN protocol/
C. Decrease the IV infusion rate of the meperidine (Demerol) per protocol.
D. notify the healthcare provider of the client's confusion and hallucinations - correct
answerC. Decrease the IV infusion rate of the meperidine (Demerol) per protocol.
, A client is being treated for osteoporosis with alendronate (fosamax), and the nurse has
completed discharge teaching regarding medication administration. Which morning
schedule would indicate to the nurse that the client teaching has been effective?
A. take medication, go for a 30 minute morning walk, then eat breakfast
B. take medication, rest in bed for 30 minutes , eat breakfast, go for morning walk
C. take medication with breakfast, then take a 30 minute morning walk.
D. go for a 30 minute morning walk, eat breakfast, then take medication - correct
answerA. take medication, go for a 30 minute morning walk, then eat breakfast
A client is receibing metoprolol (Lopressor). What assessment is most important for the
nurse to obtain?
A. temp.
B. lung sounds
C. BP
D. urinary output - correct answerC. BP
A client with a dysrhythmia is to receive procainamide (pronestyl) in divided 4 doses
over the next 24 hours. what dosing schedule is best for the nurse to implement?
A. q6h
B. QID
C. AC and bedtime
D. PC and bedtime - correct answerA. q6h
rationale: procainamide is a class 1A antidysrhythmic. it should be taken around the
clock, so that a stable blood level of the drug can be maintained, thereby decreasing the
possibility of hypotension (an adverse effect) occurring because too much of the drug
circulating systemically at any particular time of the day. pronestyl may be given with
food if GI distress is a problem
Which action is most important for the nurse to implement prior to the administration of
the antiarrhythmic drug adenosine (adenocard)?
A. assess pupillary response to light.
B. instruct the patient that facial flushing may occur
C. apply continuous cardiac monitoring
D. request that family members leave the room - correct answerC. apply continuous
cardiac monitoring
a client has continuous IV infusion of dopamine (intropin) and an IV of normal saline at
50 ml/hr. the nurse notes that the client;s urinary output has been 20 ml/hour for the last
2 hours. which intervention should the nurse initiate?
A. stop the infusion of dopamine
B. change the normal saline to keep open rate
C. replace the urinary catheter
D. notify the healthcare provider of the urinary output. - correct answerD. notify the
healthcare provider of the urinary output.
2025/2026 Updated Study Guide & Practice
Questions | 100% Pass Guarantee
an antacid (Maalox) is prescribed for a client with peptic ulcer disease. the nurse knows
that the purpose of this medicatio is:
A. decrease production of gastric secretions
B. produce an adherent barrier over the ulcer
C. maintain a gastric pH of 3.5 or higher
D. decrease gastric motor activity - correct answerC. maintain a gastric pH of 3.5 or
higher
rationale: objective of antacids is to neutralize gastric acids and keep a pH of 3.5 or
above, which is necessary for pepsinogen activity
In evaluation the effects of lactulose (Cephulac), which outcome would indicate that the
drug is performing as intended?
A. increase in urine output
B. 2 or 3 soft stools per day.
C. watery, diarrhea stools
D. increased serum bilirubin - correct answerB. 2 or 3 soft stools per day.
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with CHF.
which intervention should the nurse implement prior to administering Digoxin?
A. observe respiratory rate and depth
B. assess serum potassium level
C. obtain the client's BP
D. Monitor the serum glucose level - correct answerB. assess serum potassium level
Following the administration of sublingual nitroglycerin to a client experiencing an acute
anginal attack, which assessment finding indicates to the nurse that the desired effect
has been achieved?
A. client states chest pain is relieved
B. client's pulse decreases from 120 to 90
C. client's systolic BP decreases from 180 to 90.
D. clients Oxygen level increases form 92% to 96% - correct answerA. client states
chest pain is relieved
A client with CHF is being discharges with a new prescription for ACE inhibitor Captopril
(Capoten). The nurse's discharge instruction should include reporting which problem to
the health care provider?
A. weight loss
,B. Dizziness
C. Muscle cramps
D. Dry mucous membreanes - correct answerB. Dizziness
A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse
knows that the action of this drug is to:
A. decrease the amount of thyroid-stimulating hormone circulating in the blood.
B. increase the amount of thyroid-stimulating hormone circulating in the blood.
C. increase the amount of T4 and decrease the amount of T3 produced by the thyroid.
D. inhibit synthesis of T3 and T4 by the thyroid glanf - correct answerD. inhibits
synthesis of T3 and T4 by the thyroid gland.
A client with Parkinson's disease is taking carbidopa-levadopa (Sinemet). which
observation by the nurse would indicate that the desired outcome of the medication is
being achieved?
A. decreased BP
B. lessening of tremors
C. increased salivation
D. increased attention span - correct answerB. lessening of tremors
rationale: sinemet carbidopa increases the amount of levodopa to the CNS (dopamine
to the brain). increased amounts of dopamine improve the symptoms of Parkinsons,
such as involuntary movements, resting tremors, shuffling air, etc. dec drooling would
be a desired effect of levodopa/carbidopa
Following heparin treatment for a pulmonary embolism, a client is being discharged with
a prescription for warfarin (coumadin). In conducting discharge teaching, the nurse
advises the client to have which diagnostic test monitored regularly after discharge?
A. perfusion scan
B. Prothrombin Time (PT/INR)
C. activated partial thromboplastin (APPT)
D. serum coumadin level (SCL). - correct answerB. prothrombin time (PT/INR)
rationale: when used for a client with a pulmonary embolus, the theraputic goal for
warfarin therapy is 1-2x greater than the control, Orr an INR of 2-3
A postoperative client has been receiving a continuous IV infusion of meperidine
(demerol) 35mg/hr for four days. the client has a PRN prescription for Demerol 100 mg
PO q3h. The nurse notes that the client has become increasingly restless, irritable and
confused, stating that there are bugs all over the walls. what action should the nurse
take first?
A. administer a PRN dose of PO meperidine (Demerol).
B. administer naloxone (Narcan) IV per PRN protocol/
C. Decrease the IV infusion rate of the meperidine (Demerol) per protocol.
D. notify the healthcare provider of the client's confusion and hallucinations - correct
answerC. Decrease the IV infusion rate of the meperidine (Demerol) per protocol.
, A client is being treated for osteoporosis with alendronate (fosamax), and the nurse has
completed discharge teaching regarding medication administration. Which morning
schedule would indicate to the nurse that the client teaching has been effective?
A. take medication, go for a 30 minute morning walk, then eat breakfast
B. take medication, rest in bed for 30 minutes , eat breakfast, go for morning walk
C. take medication with breakfast, then take a 30 minute morning walk.
D. go for a 30 minute morning walk, eat breakfast, then take medication - correct
answerA. take medication, go for a 30 minute morning walk, then eat breakfast
A client is receibing metoprolol (Lopressor). What assessment is most important for the
nurse to obtain?
A. temp.
B. lung sounds
C. BP
D. urinary output - correct answerC. BP
A client with a dysrhythmia is to receive procainamide (pronestyl) in divided 4 doses
over the next 24 hours. what dosing schedule is best for the nurse to implement?
A. q6h
B. QID
C. AC and bedtime
D. PC and bedtime - correct answerA. q6h
rationale: procainamide is a class 1A antidysrhythmic. it should be taken around the
clock, so that a stable blood level of the drug can be maintained, thereby decreasing the
possibility of hypotension (an adverse effect) occurring because too much of the drug
circulating systemically at any particular time of the day. pronestyl may be given with
food if GI distress is a problem
Which action is most important for the nurse to implement prior to the administration of
the antiarrhythmic drug adenosine (adenocard)?
A. assess pupillary response to light.
B. instruct the patient that facial flushing may occur
C. apply continuous cardiac monitoring
D. request that family members leave the room - correct answerC. apply continuous
cardiac monitoring
a client has continuous IV infusion of dopamine (intropin) and an IV of normal saline at
50 ml/hr. the nurse notes that the client;s urinary output has been 20 ml/hour for the last
2 hours. which intervention should the nurse initiate?
A. stop the infusion of dopamine
B. change the normal saline to keep open rate
C. replace the urinary catheter
D. notify the healthcare provider of the urinary output. - correct answerD. notify the
healthcare provider of the urinary output.
