Updated Evolve Fundamentals HESI EXAM
LATEST 2025 ACTUAL EXAM QUESTIONS
AND CORRECT ANSWERS WITH
RATIONALES GRADED A
A resident in a skilled nursing facility for short-term rehabilitation after a hip replacement tells the
nurse, "I don't want any more blood taken for those useless tests." Which narrative documentation
should the nurse enter in the client's medical record?
A. Healthcare provider notified of failure to collect specimens for prescribed blood studies.
B. Blood specimens not collected because client no longer wants blood tests performed.
C. Healthcare provider notified of client's refusal to have blood specimens collected for testing.
D. Client irritable, uncooperative, and refuses to have blood collected. Healthcare provider notified.
When a client refuses a treatment, the exact words of the client regarding the client's refusal of care
should be documented in a narrative format (C). (A, B, and D) do not address the concepts of informatics
and legal issues.
Correct Answer: C
At the beginning of the shift, the nurse assesses a client who is admitted from the post-anesthesia care
unit (PACU). When should the nurse document the client's findings?
A. A the beginning, middle, and end of the shift.
B. After client priorities are identified for the development of the nursing care plan.
C. At the end of the shift so full attention can be given to the client's needs.
D. Immediately after the assessments are completed.
,Documentation should occur immediately after any component of the nursing process, so assessments
should be entered in the client's medical record as readily as findings are obtained (D). (A, B, and C) do
not address the concepts of legal recommendations for information management and informatics.
Correct Answer: D
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.
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.
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.
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.
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.
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.
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
LATEST 2025 ACTUAL EXAM QUESTIONS
AND CORRECT ANSWERS WITH
RATIONALES GRADED A
A resident in a skilled nursing facility for short-term rehabilitation after a hip replacement tells the
nurse, "I don't want any more blood taken for those useless tests." Which narrative documentation
should the nurse enter in the client's medical record?
A. Healthcare provider notified of failure to collect specimens for prescribed blood studies.
B. Blood specimens not collected because client no longer wants blood tests performed.
C. Healthcare provider notified of client's refusal to have blood specimens collected for testing.
D. Client irritable, uncooperative, and refuses to have blood collected. Healthcare provider notified.
When a client refuses a treatment, the exact words of the client regarding the client's refusal of care
should be documented in a narrative format (C). (A, B, and D) do not address the concepts of informatics
and legal issues.
Correct Answer: C
At the beginning of the shift, the nurse assesses a client who is admitted from the post-anesthesia care
unit (PACU). When should the nurse document the client's findings?
A. A the beginning, middle, and end of the shift.
B. After client priorities are identified for the development of the nursing care plan.
C. At the end of the shift so full attention can be given to the client's needs.
D. Immediately after the assessments are completed.
,Documentation should occur immediately after any component of the nursing process, so assessments
should be entered in the client's medical record as readily as findings are obtained (D). (A, B, and C) do
not address the concepts of legal recommendations for information management and informatics.
Correct Answer: D
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.
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.
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.
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.
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.
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.
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
