Evolve HESI Fundamentals Exam 2026
Evolve HESI Fundamentals Exam 2026
Edition 100 Advanced Questions with
Answers and Detailed Rationales
This 100-question Original Evolve HESI Fundamentals–Style Practice Exam (2026
Edition), covers:
✅ Nursing Process (ADPIE)
✅ Client Safety & Quality Improvement
✅ Infection Prevention & Control
✅ Medication Administration
✅ Oxygenation & Airway Management
✅ Fluid & Electrolyte Balance
✅ Mobility & Positioning
✅ Nutrition & Elimination
✅ Delegation & Supervision
✅ Documentation & Legal/Ethical Practice
✅ NGN-style Priority, SATA, Matrix, Bow-Tie, and Case-Based Questions
Question 1
A nurse is admitting a client with heart failure. Which action should the nurse perform first?
A. Obtain the client's dietary history.
B. Assess the client's airway and breathing.
C. Explain hospital policies.
D. Ask about the client's support system.
✅ Correct Answer: B. Assess the client's airway and breathing.
Rationale
Airway, Breathing, and Circulation (ABC) always take priority during the initial assessment.
Clients with heart failure are at risk for pulmonary edema and impaired oxygenation.
, Evolve HESI Fundamentals Exam 2026
A: Important but not first.
C: Admission teaching occurs after stabilization.
D: Psychosocial assessment is appropriate later.
Question 2
The nurse observes a nursing assistant transferring a client without locking the wheelchair
brakes. What is the nurse's best action?
A. Ignore the incident.
B. Report the nursing assistant immediately.
C. Stop the transfer and instruct the assistant to lock the brakes.
D. Complete the transfer for the assistant.
✅ Correct Answer: C. Stop the transfer and instruct the assistant to lock the brakes.
Rationale
Immediate correction prevents injury and provides real-time education.
A: Unsafe.
B: Coaching should occur first unless there is repeated negligence.
D: Does not teach safe practice.
Question 3
Which client should the nurse assess first?
A. A postoperative client reporting pain rated 7/10
B. A diabetic client with a blood glucose of 210 mg/dL
C. A client receiving a blood transfusion who reports chills
D. A client requesting assistance to the bathroom
✅ Correct Answer: C. A client receiving a blood transfusion who reports chills.
, Evolve HESI Fundamentals Exam 2026
Rationale
Chills during a blood transfusion may indicate an acute transfusion reaction requiring immediate
intervention.
Pain is important but not immediately life-threatening.
Mild hyperglycemia is less urgent.
Bathroom assistance can be delegated.
Question 4
Which statement demonstrates effective therapeutic communication?
A. "Everything will be fine."
B. "Tell me more about how you're feeling."
C. "You shouldn't worry."
D. "At least the surgery is over."
✅ Correct Answer: B. "Tell me more about how you're feeling."
Rationale
Open-ended questions encourage expression and assessment.
The other responses minimize the client's feelings or provide false reassurance.
Question 5
A client suddenly becomes short of breath after surgery. Which nursing action has the highest
priority?
A. Notify the provider.
B. Raise the head of the bed.
C. Obtain vital signs.
D. Document findings.
, Evolve HESI Fundamentals Exam 2026
✅ Correct Answer: B. Raise the head of the bed.
Rationale
Positioning improves ventilation immediately. After ensuring airway and breathing, the nurse
can obtain vital signs and notify the provider.
Question 6
Which intervention best prevents healthcare-associated infections?
A. Wearing gloves for every procedure
B. Hand hygiene before and after client contact
C. Cleaning equipment once daily
D. Wearing a surgical mask during assessments
✅ Correct Answer: B. Hand hygiene before and after client contact.
Rationale
Hand hygiene remains the single most effective method to reduce transmission of
microorganisms.
Question 7
The nurse prepares to administer insulin. Which action is most important?
A. Verify the client's diet order.
B. Check the client's current blood glucose.
C. Assess bowel sounds.
D. Encourage fluid intake.
✅ Correct Answer: B. Check the client's current blood glucose.
Evolve HESI Fundamentals Exam 2026
Edition 100 Advanced Questions with
Answers and Detailed Rationales
This 100-question Original Evolve HESI Fundamentals–Style Practice Exam (2026
Edition), covers:
✅ Nursing Process (ADPIE)
✅ Client Safety & Quality Improvement
✅ Infection Prevention & Control
✅ Medication Administration
✅ Oxygenation & Airway Management
✅ Fluid & Electrolyte Balance
✅ Mobility & Positioning
✅ Nutrition & Elimination
✅ Delegation & Supervision
✅ Documentation & Legal/Ethical Practice
✅ NGN-style Priority, SATA, Matrix, Bow-Tie, and Case-Based Questions
Question 1
A nurse is admitting a client with heart failure. Which action should the nurse perform first?
A. Obtain the client's dietary history.
B. Assess the client's airway and breathing.
C. Explain hospital policies.
D. Ask about the client's support system.
✅ Correct Answer: B. Assess the client's airway and breathing.
Rationale
Airway, Breathing, and Circulation (ABC) always take priority during the initial assessment.
Clients with heart failure are at risk for pulmonary edema and impaired oxygenation.
, Evolve HESI Fundamentals Exam 2026
A: Important but not first.
C: Admission teaching occurs after stabilization.
D: Psychosocial assessment is appropriate later.
Question 2
The nurse observes a nursing assistant transferring a client without locking the wheelchair
brakes. What is the nurse's best action?
A. Ignore the incident.
B. Report the nursing assistant immediately.
C. Stop the transfer and instruct the assistant to lock the brakes.
D. Complete the transfer for the assistant.
✅ Correct Answer: C. Stop the transfer and instruct the assistant to lock the brakes.
Rationale
Immediate correction prevents injury and provides real-time education.
A: Unsafe.
B: Coaching should occur first unless there is repeated negligence.
D: Does not teach safe practice.
Question 3
Which client should the nurse assess first?
A. A postoperative client reporting pain rated 7/10
B. A diabetic client with a blood glucose of 210 mg/dL
C. A client receiving a blood transfusion who reports chills
D. A client requesting assistance to the bathroom
✅ Correct Answer: C. A client receiving a blood transfusion who reports chills.
, Evolve HESI Fundamentals Exam 2026
Rationale
Chills during a blood transfusion may indicate an acute transfusion reaction requiring immediate
intervention.
Pain is important but not immediately life-threatening.
Mild hyperglycemia is less urgent.
Bathroom assistance can be delegated.
Question 4
Which statement demonstrates effective therapeutic communication?
A. "Everything will be fine."
B. "Tell me more about how you're feeling."
C. "You shouldn't worry."
D. "At least the surgery is over."
✅ Correct Answer: B. "Tell me more about how you're feeling."
Rationale
Open-ended questions encourage expression and assessment.
The other responses minimize the client's feelings or provide false reassurance.
Question 5
A client suddenly becomes short of breath after surgery. Which nursing action has the highest
priority?
A. Notify the provider.
B. Raise the head of the bed.
C. Obtain vital signs.
D. Document findings.
, Evolve HESI Fundamentals Exam 2026
✅ Correct Answer: B. Raise the head of the bed.
Rationale
Positioning improves ventilation immediately. After ensuring airway and breathing, the nurse
can obtain vital signs and notify the provider.
Question 6
Which intervention best prevents healthcare-associated infections?
A. Wearing gloves for every procedure
B. Hand hygiene before and after client contact
C. Cleaning equipment once daily
D. Wearing a surgical mask during assessments
✅ Correct Answer: B. Hand hygiene before and after client contact.
Rationale
Hand hygiene remains the single most effective method to reduce transmission of
microorganisms.
Question 7
The nurse prepares to administer insulin. Which action is most important?
A. Verify the client's diet order.
B. Check the client's current blood glucose.
C. Assess bowel sounds.
D. Encourage fluid intake.
✅ Correct Answer: B. Check the client's current blood glucose.
