Evolve Comprehensive Exit Exam (HESI) 230+
Original Practice Questions and Correct Answers
with Rationales | Complete Nursing Resource
Q1Med-Su
A client with heart failure is prescribed furosemide (Lasix) 40 mg IV. Which assessment
finding requires the nurse to hold the medication and notify the provider?
A.Urine output of 200 mL in 4 hours
B.Serum potassium of 2.9 mEq/L
C.Blood pressure of 138/86 mmHg
D.Peripheral edema 2+
Q2PharmacologyHard
A client is receiving heparin infusion for DVT. The aPTT result is 120 seconds (therapeutic
range 60–100 seconds). Which action should the nurse take first?
A.Continue the infusion at the current rate
B.Stop the infusion and notify the provider
C.Administer protamine sulfate immediately
D.Recheck the aPTT in 30 minutes
Q3OB/MaternityMedium
A nurse is caring for a client at 38 weeks gestation who suddenly reports bright red,
painless vaginal bleeding. Which condition does the nurse suspect?
A.Abruptio placentae
B.Placenta previa
,C.Preterm labor
D.Uterine rupture
Q4PediatricsEasy
A 6-month-old infant is brought to the clinic. Which developmental milestone should the
nurse expect the infant to demonstrate?
A.Walking with support
B.Saying 2-word phrases
C.Sitting with support
D.Using a pincer grasp
Q5Psych/Mental HealthMedium
A client tells the nurse, 'I've given my dog away and said goodbye to all my friends.' The
nurse recognizes this behavior as:
A.Grief reaction
B.Saying goodbye behaviors (suicidal planning)
C.Antisocial personality traits
D.Adjustment disorder
Q6FundamentalsEasy
The nurse is preparing to administer a subcutaneous injection of insulin. At what angle
should the needle be inserted for a client with average body weight?
A.15 degrees
B.45 degrees
C.90 degrees
D.30 degrees
Q7Med-SurgHard
,A client post-coronary artery bypass graft (CABG) develops a urine output of 20 mL/hr for 2
consecutive hours. Which intervention is the priority?
A.Encourage oral fluid intake
B.Notify the provider immediately
C.Reposition the urinary catheter
D.Document and continue monitoring
Q8PharmacologyMedium
A client is prescribed metformin for type 2 diabetes and is scheduled for a CT scan with IV
contrast. The nurse should:
A.Administer metformin as scheduled
B.Hold metformin 24–48 hours before and after the procedure
C.Double the dose after the scan to compensate
D.Switch to insulin for one dose only
Q9OB/MaternityHard
A laboring client has epidural anesthesia and her blood pressure drops from 122/78 to
88/50 mmHg. What is the nurse's priority action?
A.Increase the epidural infusion rate
B.Place the client in left lateral position and increase IV fluid rate
C.Administer oxygen at 2 L/min via nasal cannula
D.Call for an emergency cesarean section
Q10PediatricsHard
A child with croup has a barking cough, stridor at rest, and marked sternal retractions.
Which intervention is the priority?
A.Administer nebulized racemic epinephrine as ordered
B.Position the child flat in bed
, C.Obtain a throat culture
D.Encourage oral fluids
Q11Psych/Mental HealthMedium
A client with schizophrenia states, 'The CIA has planted a microchip in my brain.' The
nurse's best response is:
A.'That sounds very frightening. Tell me more about how you are feeling.'
B.'That is not real. No one put a chip in your brain.'
C.'I believe you. Let's report it to hospital security.'
D.'Have you been taking your medications?'
Q12FundamentalsMedium
The nurse is preparing to give a medication through a nasogastric (NG) tube. Before
administering, the nurse should verify tube placement by:
A.Injecting 10 mL of air and auscultating
B.Aspirating gastric contents and checking pH
C.Asking the client to swallow water
D.Checking the last X-ray report from morning
Q13Med-SurgMedium
A client with chronic kidney disease (CKD) stage 4 has a potassium level of 6.2 mEq/L.
Which food should the nurse instruct the client to avoid?
A.Rice
B.Apples
C.Bananas
D.Pasta
Q14PharmacologyHard
Original Practice Questions and Correct Answers
with Rationales | Complete Nursing Resource
Q1Med-Su
A client with heart failure is prescribed furosemide (Lasix) 40 mg IV. Which assessment
finding requires the nurse to hold the medication and notify the provider?
A.Urine output of 200 mL in 4 hours
B.Serum potassium of 2.9 mEq/L
C.Blood pressure of 138/86 mmHg
D.Peripheral edema 2+
Q2PharmacologyHard
A client is receiving heparin infusion for DVT. The aPTT result is 120 seconds (therapeutic
range 60–100 seconds). Which action should the nurse take first?
A.Continue the infusion at the current rate
B.Stop the infusion and notify the provider
C.Administer protamine sulfate immediately
D.Recheck the aPTT in 30 minutes
Q3OB/MaternityMedium
A nurse is caring for a client at 38 weeks gestation who suddenly reports bright red,
painless vaginal bleeding. Which condition does the nurse suspect?
A.Abruptio placentae
B.Placenta previa
,C.Preterm labor
D.Uterine rupture
Q4PediatricsEasy
A 6-month-old infant is brought to the clinic. Which developmental milestone should the
nurse expect the infant to demonstrate?
A.Walking with support
B.Saying 2-word phrases
C.Sitting with support
D.Using a pincer grasp
Q5Psych/Mental HealthMedium
A client tells the nurse, 'I've given my dog away and said goodbye to all my friends.' The
nurse recognizes this behavior as:
A.Grief reaction
B.Saying goodbye behaviors (suicidal planning)
C.Antisocial personality traits
D.Adjustment disorder
Q6FundamentalsEasy
The nurse is preparing to administer a subcutaneous injection of insulin. At what angle
should the needle be inserted for a client with average body weight?
A.15 degrees
B.45 degrees
C.90 degrees
D.30 degrees
Q7Med-SurgHard
,A client post-coronary artery bypass graft (CABG) develops a urine output of 20 mL/hr for 2
consecutive hours. Which intervention is the priority?
A.Encourage oral fluid intake
B.Notify the provider immediately
C.Reposition the urinary catheter
D.Document and continue monitoring
Q8PharmacologyMedium
A client is prescribed metformin for type 2 diabetes and is scheduled for a CT scan with IV
contrast. The nurse should:
A.Administer metformin as scheduled
B.Hold metformin 24–48 hours before and after the procedure
C.Double the dose after the scan to compensate
D.Switch to insulin for one dose only
Q9OB/MaternityHard
A laboring client has epidural anesthesia and her blood pressure drops from 122/78 to
88/50 mmHg. What is the nurse's priority action?
A.Increase the epidural infusion rate
B.Place the client in left lateral position and increase IV fluid rate
C.Administer oxygen at 2 L/min via nasal cannula
D.Call for an emergency cesarean section
Q10PediatricsHard
A child with croup has a barking cough, stridor at rest, and marked sternal retractions.
Which intervention is the priority?
A.Administer nebulized racemic epinephrine as ordered
B.Position the child flat in bed
, C.Obtain a throat culture
D.Encourage oral fluids
Q11Psych/Mental HealthMedium
A client with schizophrenia states, 'The CIA has planted a microchip in my brain.' The
nurse's best response is:
A.'That sounds very frightening. Tell me more about how you are feeling.'
B.'That is not real. No one put a chip in your brain.'
C.'I believe you. Let's report it to hospital security.'
D.'Have you been taking your medications?'
Q12FundamentalsMedium
The nurse is preparing to give a medication through a nasogastric (NG) tube. Before
administering, the nurse should verify tube placement by:
A.Injecting 10 mL of air and auscultating
B.Aspirating gastric contents and checking pH
C.Asking the client to swallow water
D.Checking the last X-ray report from morning
Q13Med-SurgMedium
A client with chronic kidney disease (CKD) stage 4 has a potassium level of 6.2 mEq/L.
Which food should the nurse instruct the client to avoid?
A.Rice
B.Apples
C.Bananas
D.Pasta
Q14PharmacologyHard
