Elsevier / Evolve (HESI) - Used by multiple nursing
programs nationwide RN HESI Fundamentals of
Nursing
EXAM: 2026 EVOLVE HESI FUNDAMENTALS REAL EXAM TEST BANK
TOTAL QUESTIONS: 400 (Complete Test Bank)
FORMAT: Multiple Choice with Verified Answers & Detailed Rationales
VERSIONS COVERED: Version 1, Version 2, & Version 3
STATUS: A+ Graded | Verified for 2025-2026 Academic Year
TOPIC 1: MOBILITY, SAFETY & BASIC CARE
1. An elderly client with a fractured left hip is on strict bedrest. Which nursing measure is
essential to the client's care?
A) Massage any reddened areas for at least five minutes.
B) Encourage active range of motion exercises on extremities.
C) Position the client laterally, prone, and dorsally in sequence.
D) Gently lift the client when moving into a desired position.
Answer: D
Rationale: To avoid shearing forces when repositioning, the client should be lifted gently
across a surface. Reddened areas should not be massaged as this may increase damage to
already traumatized skin. Active range of motion may be limited on the affected leg, and the
positioning described in C is contraindicated for a client with a fractured left hip.
2. The nurse is administering medications through a nasogastric tube (NGT) which is connected
to suction. After ensuring correct tube placement, what action should the nurse take next?
A) Clamp the tube for 20 minutes.
B) Flush the tube with water.
C) Administer the medications as prescribed.
D) Crush the tablets and dissolve in sterile water.
Answer: B
Rationale: The NGT should be flushed before, after, and in between each medication
administered. Once all medications are administered, the NGT should be clamped for 20
minutes. Options C and D may be implemented only after the tubing has been flushed.
,3. A client who is in hospice care complains of increasing amounts of pain. The healthcare
provider prescribes an analgesic every four hours as needed. Which action should the nurse
implement?
A) Give an around-the-clock schedule for administration of analgesics.
B) Administer analgesic medication as needed when the pain is severe.
C) Provide medication to keep the client sedated and unaware of stimuli.
D) Offer a medication-free period so that the client can do daily activities.
Answer: A
Rationale: For clients in hospice care, around-the-clock (ATC) scheduling of analgesics is
preferred to maintain consistent pain relief and prevent breakthrough pain, rather than waiting
for severe pain as with PRN dosing.
4. While assessing a client's right wrist, the nurse notes that the client's right hand is cool, with a
blue tint and capillary refill greater than 3 seconds. The right wrist restraint is in place. What
action should the nurse implement first?
A) Loosen the right wrist restraint.
B) Apply a pulse oximeter to the right hand.
C) Compare hand color bilaterally.
D) Palpate the right radial pulse.
Answer: A
Rationale: The priority nursing action is to restore circulation by loosening the restraint,
because blue fingers (cyanosis) indicate decreased circulation. While comparing hand color and
palpating the pulse are also important interventions, they do not have the priority of loosening
the restraint.
5. The nurse is assessing the nutritional status of several clients. Which client has the greatest
nutritional need for additional intake of protein?
A) A college-age track runner with a sprained ankle.
B) A lactating woman nursing her 3-day-old infant.
C) A school-aged child with Type 2 diabetes.
D) An elderly man being treated for a peptic ulcer.
Answer: B
Rationale: A lactating woman has the greatest need for additional protein intake due to the
increased metabolic demands of milk production. The other conditions require protein but do not
have the same increased metabolic demands.
6. A client is in the radiology department at 0900 when the prescription levofloxacin (Levaquin)
500 mg IV q24h is scheduled to be administered. The client returns to the unit at 1300. What is
the best intervention for the nurse to implement?
A) Contact the healthcare provider and complete a medication variance form.
B) Administer the Levaquin at 1300 and resume the 0900 schedule in the morning.
, C) Notify the charge nurse and complete an incident report to explain the missed dose.
D) Give the missed dose at 1300 and change the schedule to administer daily at 1300.
Answer: D
Rationale: To ensure that a therapeutic level of medication is maintained, the nurse should
administer the missed dose as soon as possible and revise the administration schedule to
reflect the new time. This maintains the 24-hour dosing interval.
7. The nurse is teaching a client with elevated cholesterol levels about various food choices.
Which statement indicates that the client understands the dietary modifications?
A) "If I exercise at least two times weekly for one hour, I will lower my cholesterol."
B) "I need to avoid eating proteins, including red meat."
C) "I will limit my intake of beef to 4 ounces per week."
D) "My blood level of low density lipoproteins needs to increase."
Answer: C
Rationale: Limiting saturated fat from animal food sources to no more than 4 ounces per week
is an important diet modification for lowering cholesterol. To be effective in reducing cholesterol,
the client should exercise 30 minutes per day, at least 4 to 6 times per week. Red meat and all
proteins do not need to be eliminated but should be restricted to lean cuts and smaller portions.
LDL levels need to decrease, not increase.
8. The unlicensed assistive personnel (UAP) working on a chronic neuro unit ask the nurse to
help them determine the safest way to transfer an elderly client with left-sided weakness from
the bed to the chair. What method describes the correct transfer procedure for this client?
A) Place the chair at a right angle to the bed on the client's left side before moving.
B) Assist the client to a standing position, then place the right hand on the armrest.
C) Have the client place the left foot next to the chair and pivot to the left before sitting.
D) Move the chair parallel to the right side of the bed, and stand the client on the right foot.
Answer: D
Rationale: This method uses the client's stronger side (the right side) for weight-bearing during
the transfer and is the safest approach. The other options are unsafe methods and include the
use of poor body mechanics by the caregiver.
9. An unlicensed assistive personnel (UAP) places a client in a left lateral position prior to
administering a soap suds enema. Which instruction should the nurse provide the UAP?
A) Position the client on the right side of the bed in reverse Trendelenburg.
B) Fill the enema container with 1000 ml of warm water and 5 ml of castile soap.
C) Reposition in a Sim's position with the client's weight on the anterior ilium.
D) Raise the side rails and keep the client flat for 30 minutes after administration.
Answer: C
, Rationale: Sim's position (left side-lying with the right knee flexed) is the recommended
position for enema administration as it allows the solution to flow downward by gravity along the
sigmoid colon. Option A is incorrect; Option B describes the incorrect solution preparation;
Option D describes the post-administration action.
10. The nurse observes that a male client has removed the covering from an ice pack applied to
his knee. What action should the nurse take first?
A) Observe the appearance of the skin under the ice pack.
B) Instruct the client regarding the need for the covering.
C) Reapply the covering after filling with fresh ice.
D) Ask the client how long the ice was applied to the skin.
Answer: A
Rationale: The first action taken by the nurse should be to assess the skin for any possible
thermal injury. If no injury has occurred, the nurse can take the other actions as needed.
TOPIC 2: MEDICATION ADMINISTRATION & CALCULATIONS
11. The nurse mixes 50 mg of Nipride in 250 ml of D5W and plans to administer the solution at a
rate of 5 mcg/kg/min to a client weighing 182 pounds. Using a drip factor of 60 gtt/ml, how many
drops per minute should the client receive?
A) 31 gtt/min
B) 62 gtt/min
C) 93 gtt/min
D) 124 gtt/min
Answer: D
Rationale: Convert lbs to kg: .2 = 82.73 kg. Determine dosage: 5 mcg × 82.73 =
413.65 mcg/min. Determine mcg per ml: 250 ml / 50,000 mcg = 200 mcg per ml. Client receives
2.07 ml per minute. With drip factor 60 gtt/ml: 60 × 2.07 = 124.28 gtt/min.
12. A hospitalized male client is receiving nasogastric tube feedings via a small-bore tube and a
continuous pump infusion. He reports that he had a bad bout of severe coughing a few minutes
ago but feels fine now. What action is best for the nurse to take?
A) Record the coughing incident. No further action is required at this time.
B) Stop the feeding, explain to the family why it is being stopped, and notify the healthcare
provider.
C) Assess for respiratory distress, verify placement of the tube, and obtain an order for a
chest x-ray.
D) Flush the tubing with 30 ml of water, check the residual volume, and restart the infusion at
a slower rate.
programs nationwide RN HESI Fundamentals of
Nursing
EXAM: 2026 EVOLVE HESI FUNDAMENTALS REAL EXAM TEST BANK
TOTAL QUESTIONS: 400 (Complete Test Bank)
FORMAT: Multiple Choice with Verified Answers & Detailed Rationales
VERSIONS COVERED: Version 1, Version 2, & Version 3
STATUS: A+ Graded | Verified for 2025-2026 Academic Year
TOPIC 1: MOBILITY, SAFETY & BASIC CARE
1. An elderly client with a fractured left hip is on strict bedrest. Which nursing measure is
essential to the client's care?
A) Massage any reddened areas for at least five minutes.
B) Encourage active range of motion exercises on extremities.
C) Position the client laterally, prone, and dorsally in sequence.
D) Gently lift the client when moving into a desired position.
Answer: D
Rationale: To avoid shearing forces when repositioning, the client should be lifted gently
across a surface. Reddened areas should not be massaged as this may increase damage to
already traumatized skin. Active range of motion may be limited on the affected leg, and the
positioning described in C is contraindicated for a client with a fractured left hip.
2. The nurse is administering medications through a nasogastric tube (NGT) which is connected
to suction. After ensuring correct tube placement, what action should the nurse take next?
A) Clamp the tube for 20 minutes.
B) Flush the tube with water.
C) Administer the medications as prescribed.
D) Crush the tablets and dissolve in sterile water.
Answer: B
Rationale: The NGT should be flushed before, after, and in between each medication
administered. Once all medications are administered, the NGT should be clamped for 20
minutes. Options C and D may be implemented only after the tubing has been flushed.
,3. A client who is in hospice care complains of increasing amounts of pain. The healthcare
provider prescribes an analgesic every four hours as needed. Which action should the nurse
implement?
A) Give an around-the-clock schedule for administration of analgesics.
B) Administer analgesic medication as needed when the pain is severe.
C) Provide medication to keep the client sedated and unaware of stimuli.
D) Offer a medication-free period so that the client can do daily activities.
Answer: A
Rationale: For clients in hospice care, around-the-clock (ATC) scheduling of analgesics is
preferred to maintain consistent pain relief and prevent breakthrough pain, rather than waiting
for severe pain as with PRN dosing.
4. While assessing a client's right wrist, the nurse notes that the client's right hand is cool, with a
blue tint and capillary refill greater than 3 seconds. The right wrist restraint is in place. What
action should the nurse implement first?
A) Loosen the right wrist restraint.
B) Apply a pulse oximeter to the right hand.
C) Compare hand color bilaterally.
D) Palpate the right radial pulse.
Answer: A
Rationale: The priority nursing action is to restore circulation by loosening the restraint,
because blue fingers (cyanosis) indicate decreased circulation. While comparing hand color and
palpating the pulse are also important interventions, they do not have the priority of loosening
the restraint.
5. The nurse is assessing the nutritional status of several clients. Which client has the greatest
nutritional need for additional intake of protein?
A) A college-age track runner with a sprained ankle.
B) A lactating woman nursing her 3-day-old infant.
C) A school-aged child with Type 2 diabetes.
D) An elderly man being treated for a peptic ulcer.
Answer: B
Rationale: A lactating woman has the greatest need for additional protein intake due to the
increased metabolic demands of milk production. The other conditions require protein but do not
have the same increased metabolic demands.
6. A client is in the radiology department at 0900 when the prescription levofloxacin (Levaquin)
500 mg IV q24h is scheduled to be administered. The client returns to the unit at 1300. What is
the best intervention for the nurse to implement?
A) Contact the healthcare provider and complete a medication variance form.
B) Administer the Levaquin at 1300 and resume the 0900 schedule in the morning.
, C) Notify the charge nurse and complete an incident report to explain the missed dose.
D) Give the missed dose at 1300 and change the schedule to administer daily at 1300.
Answer: D
Rationale: To ensure that a therapeutic level of medication is maintained, the nurse should
administer the missed dose as soon as possible and revise the administration schedule to
reflect the new time. This maintains the 24-hour dosing interval.
7. The nurse is teaching a client with elevated cholesterol levels about various food choices.
Which statement indicates that the client understands the dietary modifications?
A) "If I exercise at least two times weekly for one hour, I will lower my cholesterol."
B) "I need to avoid eating proteins, including red meat."
C) "I will limit my intake of beef to 4 ounces per week."
D) "My blood level of low density lipoproteins needs to increase."
Answer: C
Rationale: Limiting saturated fat from animal food sources to no more than 4 ounces per week
is an important diet modification for lowering cholesterol. To be effective in reducing cholesterol,
the client should exercise 30 minutes per day, at least 4 to 6 times per week. Red meat and all
proteins do not need to be eliminated but should be restricted to lean cuts and smaller portions.
LDL levels need to decrease, not increase.
8. The unlicensed assistive personnel (UAP) working on a chronic neuro unit ask the nurse to
help them determine the safest way to transfer an elderly client with left-sided weakness from
the bed to the chair. What method describes the correct transfer procedure for this client?
A) Place the chair at a right angle to the bed on the client's left side before moving.
B) Assist the client to a standing position, then place the right hand on the armrest.
C) Have the client place the left foot next to the chair and pivot to the left before sitting.
D) Move the chair parallel to the right side of the bed, and stand the client on the right foot.
Answer: D
Rationale: This method uses the client's stronger side (the right side) for weight-bearing during
the transfer and is the safest approach. The other options are unsafe methods and include the
use of poor body mechanics by the caregiver.
9. An unlicensed assistive personnel (UAP) places a client in a left lateral position prior to
administering a soap suds enema. Which instruction should the nurse provide the UAP?
A) Position the client on the right side of the bed in reverse Trendelenburg.
B) Fill the enema container with 1000 ml of warm water and 5 ml of castile soap.
C) Reposition in a Sim's position with the client's weight on the anterior ilium.
D) Raise the side rails and keep the client flat for 30 minutes after administration.
Answer: C
, Rationale: Sim's position (left side-lying with the right knee flexed) is the recommended
position for enema administration as it allows the solution to flow downward by gravity along the
sigmoid colon. Option A is incorrect; Option B describes the incorrect solution preparation;
Option D describes the post-administration action.
10. The nurse observes that a male client has removed the covering from an ice pack applied to
his knee. What action should the nurse take first?
A) Observe the appearance of the skin under the ice pack.
B) Instruct the client regarding the need for the covering.
C) Reapply the covering after filling with fresh ice.
D) Ask the client how long the ice was applied to the skin.
Answer: A
Rationale: The first action taken by the nurse should be to assess the skin for any possible
thermal injury. If no injury has occurred, the nurse can take the other actions as needed.
TOPIC 2: MEDICATION ADMINISTRATION & CALCULATIONS
11. The nurse mixes 50 mg of Nipride in 250 ml of D5W and plans to administer the solution at a
rate of 5 mcg/kg/min to a client weighing 182 pounds. Using a drip factor of 60 gtt/ml, how many
drops per minute should the client receive?
A) 31 gtt/min
B) 62 gtt/min
C) 93 gtt/min
D) 124 gtt/min
Answer: D
Rationale: Convert lbs to kg: .2 = 82.73 kg. Determine dosage: 5 mcg × 82.73 =
413.65 mcg/min. Determine mcg per ml: 250 ml / 50,000 mcg = 200 mcg per ml. Client receives
2.07 ml per minute. With drip factor 60 gtt/ml: 60 × 2.07 = 124.28 gtt/min.
12. A hospitalized male client is receiving nasogastric tube feedings via a small-bore tube and a
continuous pump infusion. He reports that he had a bad bout of severe coughing a few minutes
ago but feels fine now. What action is best for the nurse to take?
A) Record the coughing incident. No further action is required at this time.
B) Stop the feeding, explain to the family why it is being stopped, and notify the healthcare
provider.
C) Assess for respiratory distress, verify placement of the tube, and obtain an order for a
chest x-ray.
D) Flush the tubing with 30 ml of water, check the residual volume, and restart the infusion at
a slower rate.
