EVOLVE HESI PHARM PRACTICE TEST 2026
QUESTIONS WITH ANSWERS FULL SOLUTION
PREPARATION FILE
▶ Understanding classifications of pain helps nurses develop a plan of care. A 62-year-
old male has fallen while trimming tree branches sustaining tissue injury. He describes
his condition as an aching, throbbing back. This is characteristic of:
A) mixed pain syndrome.
B) chronic pain.
C) neuropathic pain.
D) nociceptive pain. Answer: D
Nociceptive pain refers to the normal functioning of physiological systems that leads to
the perception of noxious stimuli (tissue injury) as being painful. Patients describe this
type of pain as aching, cramping, or throbbing. Neuropathic pain is pathologic and
results from abnormal processing of sensory input by the nervous system as a result of
damage to the brain, spinal cord, or peripheral nerves. Patients describe this type of
pain as burning, sharp, and shooting. Chronic pain is constant and unrelenting such as
pain associated with cancer. Mixed pain syndrome is not easily recognized, is unique
with multiple underlying and poorly understood mechanisms like fibromyalgia and low
back pain.
▶ The new nurse is caring for a client with a high temperature. Which action should the
nurse perform FIRST?
A) Obtaining a fan from central supply for the client's room
B) Monitoring the client's temperature more often than ordered
C) Sponging the client while monitoring for shivering
D) Apply cool packs to the client's axillae and groin Answer: D
The use of fans is discouraged to promote cooling in a febrile client because the fan can
disperse pathogens. The other actions are appropriate.
▶ A patient has been newly diagnosed with hypertension. The nurse assesses the need
to develop a collaborative plan of care that includes a goal of adhering to the prescribed
regimen. When the nurse is planning teaching for the patient, which is the most
important initial learning goal?
A) The patient will demonstrate coping skills needed to manage hypertension.
B) The patient will verbalize the side effects of treatment.
C) The patient will select the type of learning materials they prefer.
,D) The patient will verbalize an understanding of the importance of following the
regimen. Answer: C
Adults learn best when given information they can understand that is tailored to their
learning styles and needs. Verbalizing an understanding is important; however, the
nurse will first need to teach the patient.
▶ When reviewing the purposes of a family assessment, the nurse educator would
identify a need for further teaching if the student responded that family assessment is
used to gain an understanding of the family.
A) development.
B) function.
C) structure.
D) political views. Answer: D
An understanding of the political views of family members is not a primary purpose of a
family assessment. A family assessment provides the nurse with information and an
understanding of family dynamics. This is important to nurses for the provision of quality
health care. A family assessment provides an understanding of family development,
function, and structure.
▶ The client was given 15 mg of morphine IM for postsurgical pain. When the nurse
checks the client for pain relief 1 hour later, the client is sleeping and has a respiratory
rate of 10 breaths/min. What is the nurse's first action?
A) Administering oxygen by nasal cannula
B) Documenting the findings and continuing to monitor
C) Arousing the client by calling his or her name
D) Administering naloxone (Narcan) IV push Answer: C
Many clients experience some degree of respiratory depression with opioid analgesics.
If the client can be aroused with minimally intrusive techniques and the rate of
respiration is increased spontaneously, no further intervention is required.
▶ The physician orders Lanoxin(digoxin)0.375 mg po every day. On hand you have
0.25mg/5 mL. How many mL would you give your patient?
A) 8 mL
B) 7.5 mL
C) 7 mL
D) 5.5 mL Answer: B
▶ The nurse is admitting an older adult with decompensated congestive heart failure.
The nursing assessment reveals adventitious lung sounds, dyspnea, and orthopnea.
The nurse should question which doctor's order?
,A) KCl 20 mEq PO two times per day
B) Intravenous (IV) 500 mL of 0.9% NaCl at 125 mL/hr
C) Oxygen via face mask at 8 L/min
D) Furosemide (Lasix) 20 mg PO now Answer: B
A patient with decompensated heart failure has extracellular fluid volume (ECV) excess.
The IV of 0.9% NaCl is normal saline, which should be questioned because it would
expand ECV and place an additional load on the failing heart. Diuretics such as
furosemide are appropriate to decrease the ECV during heart failure. Increasing the
potassium intake with KCl is appropriate, because furosemide increases potassium
excretion. Oxygen administration is appropriate in this situation of near pulmonary
edema from ECV excess.
▶ The priority nursing intervention for a patient suspected to be hypothermic would be
to:
A) hydrate with intravenous (IV) fluids.
B) remove wet clothes.
C) assess vital signs.
D) provide a warm blanket. Answer: B
The first thing to do with a patient suspected to be hypothermic is to remove wet
clothes, because heat loss is five times greater when clothing is wet. Assessing vital
signs is important, but the wet clothes should be removed first. Hydration is very
important with hyperthermia and the associated danger of dehydration, but there is not
a similar risk with hypothermia. A warm blanket over wet clothes would not be an
effective warming strategy.
▶ The nurse admitting a patient to the emergency department on a very hot summer
day would suspect hyperthermia when the patient demonstrates:
A) slow capillary refill.
B) red, sweaty skin.
C) low pulse rate.
D) decreased respirations. Answer: B
With hyperthermia, vasodilatation occurs causing the skin to appear flushed and warm
or hot to touch. There is an increased respiration rate with hyperthermia. The heart rate
increases with hyperthermia. With hypothermia there is slow capillary refill.
▶ Why does the nurse always ask the client his or her pain level after taking routine
vital signs?
A) To follow McCaffery's guidelines on pain management
B) To ensure that pain assessment occurs on a regular basis
, C) To determine the need for more frequent vital sign measurement
D) To determine whether pain is influencing blood pressure and heart rate Answer: B
Making pain the fifth vital sign allows more frequent and accurate assessment, which
can contribute to better pain management.
▶ The nurse observes skin tenting on the back of the older adult client's hand. Which
action by the nurse is most appropriate?
A) Examine dependent body areas.
B) Notify the physician.
C) Document the finding and continue to monitor.
D) Assess turgor on the client's forehead. Answer: D
Skin turgor cannot be accurately assessed on an older adult client's hands because of
age-related loss of tissue elasticity in this area. Areas that more accurately show skin
turgor status on an older client include the skin of the forehead, chest, and abdomen.
These should also be assessed, rather than merely examining dependent body areas.
Further assessment is needed rather than only documenting, monitoring, and notifying
the physician.
▶ The nurse is assessing a client who has undergone a transurethral resection of the
prostate (TURP). Which assessment finding requires immediate action by the nurse?
A) Having the urge to void continuously while the catheter is inserted
B) Passing small blood clots after catheter removal
C) Having bright red drainage with multiple blood clots
D) Experiencing urinary frequency after catheter removal Answer: C
A client who undergoes a TURP is at risk for bleeding during the first 24 hours after
surgery. Passage of small blood clots and tissue debris, urinary frequency and leakage,
and the urge to void continuously while the client still has the catheter inserted are all
considered to be expected complications of the procedure. They will resolve as the
client continues to recover and the catheter is removed. However, the presence of
bright red blood with clots indicates arterial bleeding and should be reported to the
provider.
▶ Which finding puts a client at greatest risk for wound infection?
A) Presence of a deep wound
B) Coexisting medical conditions
C) Immune compromised status
D) Severely reddened skin Answer: C
QUESTIONS WITH ANSWERS FULL SOLUTION
PREPARATION FILE
▶ Understanding classifications of pain helps nurses develop a plan of care. A 62-year-
old male has fallen while trimming tree branches sustaining tissue injury. He describes
his condition as an aching, throbbing back. This is characteristic of:
A) mixed pain syndrome.
B) chronic pain.
C) neuropathic pain.
D) nociceptive pain. Answer: D
Nociceptive pain refers to the normal functioning of physiological systems that leads to
the perception of noxious stimuli (tissue injury) as being painful. Patients describe this
type of pain as aching, cramping, or throbbing. Neuropathic pain is pathologic and
results from abnormal processing of sensory input by the nervous system as a result of
damage to the brain, spinal cord, or peripheral nerves. Patients describe this type of
pain as burning, sharp, and shooting. Chronic pain is constant and unrelenting such as
pain associated with cancer. Mixed pain syndrome is not easily recognized, is unique
with multiple underlying and poorly understood mechanisms like fibromyalgia and low
back pain.
▶ The new nurse is caring for a client with a high temperature. Which action should the
nurse perform FIRST?
A) Obtaining a fan from central supply for the client's room
B) Monitoring the client's temperature more often than ordered
C) Sponging the client while monitoring for shivering
D) Apply cool packs to the client's axillae and groin Answer: D
The use of fans is discouraged to promote cooling in a febrile client because the fan can
disperse pathogens. The other actions are appropriate.
▶ A patient has been newly diagnosed with hypertension. The nurse assesses the need
to develop a collaborative plan of care that includes a goal of adhering to the prescribed
regimen. When the nurse is planning teaching for the patient, which is the most
important initial learning goal?
A) The patient will demonstrate coping skills needed to manage hypertension.
B) The patient will verbalize the side effects of treatment.
C) The patient will select the type of learning materials they prefer.
,D) The patient will verbalize an understanding of the importance of following the
regimen. Answer: C
Adults learn best when given information they can understand that is tailored to their
learning styles and needs. Verbalizing an understanding is important; however, the
nurse will first need to teach the patient.
▶ When reviewing the purposes of a family assessment, the nurse educator would
identify a need for further teaching if the student responded that family assessment is
used to gain an understanding of the family.
A) development.
B) function.
C) structure.
D) political views. Answer: D
An understanding of the political views of family members is not a primary purpose of a
family assessment. A family assessment provides the nurse with information and an
understanding of family dynamics. This is important to nurses for the provision of quality
health care. A family assessment provides an understanding of family development,
function, and structure.
▶ The client was given 15 mg of morphine IM for postsurgical pain. When the nurse
checks the client for pain relief 1 hour later, the client is sleeping and has a respiratory
rate of 10 breaths/min. What is the nurse's first action?
A) Administering oxygen by nasal cannula
B) Documenting the findings and continuing to monitor
C) Arousing the client by calling his or her name
D) Administering naloxone (Narcan) IV push Answer: C
Many clients experience some degree of respiratory depression with opioid analgesics.
If the client can be aroused with minimally intrusive techniques and the rate of
respiration is increased spontaneously, no further intervention is required.
▶ The physician orders Lanoxin(digoxin)0.375 mg po every day. On hand you have
0.25mg/5 mL. How many mL would you give your patient?
A) 8 mL
B) 7.5 mL
C) 7 mL
D) 5.5 mL Answer: B
▶ The nurse is admitting an older adult with decompensated congestive heart failure.
The nursing assessment reveals adventitious lung sounds, dyspnea, and orthopnea.
The nurse should question which doctor's order?
,A) KCl 20 mEq PO two times per day
B) Intravenous (IV) 500 mL of 0.9% NaCl at 125 mL/hr
C) Oxygen via face mask at 8 L/min
D) Furosemide (Lasix) 20 mg PO now Answer: B
A patient with decompensated heart failure has extracellular fluid volume (ECV) excess.
The IV of 0.9% NaCl is normal saline, which should be questioned because it would
expand ECV and place an additional load on the failing heart. Diuretics such as
furosemide are appropriate to decrease the ECV during heart failure. Increasing the
potassium intake with KCl is appropriate, because furosemide increases potassium
excretion. Oxygen administration is appropriate in this situation of near pulmonary
edema from ECV excess.
▶ The priority nursing intervention for a patient suspected to be hypothermic would be
to:
A) hydrate with intravenous (IV) fluids.
B) remove wet clothes.
C) assess vital signs.
D) provide a warm blanket. Answer: B
The first thing to do with a patient suspected to be hypothermic is to remove wet
clothes, because heat loss is five times greater when clothing is wet. Assessing vital
signs is important, but the wet clothes should be removed first. Hydration is very
important with hyperthermia and the associated danger of dehydration, but there is not
a similar risk with hypothermia. A warm blanket over wet clothes would not be an
effective warming strategy.
▶ The nurse admitting a patient to the emergency department on a very hot summer
day would suspect hyperthermia when the patient demonstrates:
A) slow capillary refill.
B) red, sweaty skin.
C) low pulse rate.
D) decreased respirations. Answer: B
With hyperthermia, vasodilatation occurs causing the skin to appear flushed and warm
or hot to touch. There is an increased respiration rate with hyperthermia. The heart rate
increases with hyperthermia. With hypothermia there is slow capillary refill.
▶ Why does the nurse always ask the client his or her pain level after taking routine
vital signs?
A) To follow McCaffery's guidelines on pain management
B) To ensure that pain assessment occurs on a regular basis
, C) To determine the need for more frequent vital sign measurement
D) To determine whether pain is influencing blood pressure and heart rate Answer: B
Making pain the fifth vital sign allows more frequent and accurate assessment, which
can contribute to better pain management.
▶ The nurse observes skin tenting on the back of the older adult client's hand. Which
action by the nurse is most appropriate?
A) Examine dependent body areas.
B) Notify the physician.
C) Document the finding and continue to monitor.
D) Assess turgor on the client's forehead. Answer: D
Skin turgor cannot be accurately assessed on an older adult client's hands because of
age-related loss of tissue elasticity in this area. Areas that more accurately show skin
turgor status on an older client include the skin of the forehead, chest, and abdomen.
These should also be assessed, rather than merely examining dependent body areas.
Further assessment is needed rather than only documenting, monitoring, and notifying
the physician.
▶ The nurse is assessing a client who has undergone a transurethral resection of the
prostate (TURP). Which assessment finding requires immediate action by the nurse?
A) Having the urge to void continuously while the catheter is inserted
B) Passing small blood clots after catheter removal
C) Having bright red drainage with multiple blood clots
D) Experiencing urinary frequency after catheter removal Answer: C
A client who undergoes a TURP is at risk for bleeding during the first 24 hours after
surgery. Passage of small blood clots and tissue debris, urinary frequency and leakage,
and the urge to void continuously while the client still has the catheter inserted are all
considered to be expected complications of the procedure. They will resolve as the
client continues to recover and the catheter is removed. However, the presence of
bright red blood with clots indicates arterial bleeding and should be reported to the
provider.
▶ Which finding puts a client at greatest risk for wound infection?
A) Presence of a deep wound
B) Coexisting medical conditions
C) Immune compromised status
D) Severely reddened skin Answer: C
