Evolve Fundamentals HESI Questions
and Answers A+ Graded (2025)
An .elderly .client .with .a .fractured .left .hip .is .on .strict .bedrest. .Which .nursing
.measure .is .essential .to .the .client's .nursing .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. .- .CORRECT
.ANSWER-To .avoid .shearing .forces .when .repositioning, .the .client .should .be
.lifted .gently .across .a .surface .(D). .Reddened .areas .should .not .be .massaged .(A)
.since .this .may .increase .the .damage .to .already .traumatized .skin. .To .control .pain
.and .muscle .spasms, .active .range .of .motion .(B) .may .be .limited .on .the .affected
.leg. .The .position .described .in .(C) .is .contraindicated .for .a .client .with .a .fractured
.left .hip.
Correct .Answer: .D
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. .- .CORRECT .ANSWER-The .NGT
.should .be .flushed .before, .after .and .in .between .each .medication .administered
.(B). .Once .all .medications .are .administered, .the .NGT .should .be .clamped .for .20
.minutes .(A). .(C .and .D) .may .be .implemented .only .after .the .tubing .has .been
.flushed.
Correct .Answer: .B
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. .-
.CORRECT .ANSWER-The .most .effective .management .of .pain .is .achieved .using
.an .around-the-clock .schedule .that .provides .analgesic .medications .on .a .regular
.basis .(A) .and .in .a .timely . manner. . Analgesics .are .less .effective .if .pain .persists
.until .it .is .severe, .so .an .analgesic .medication .should .be .administered .before .the
.client's .pain .peaks .(B). .Providing .comfort .is .a .priority .for .the .client .who .is
.dying, .but .sedation .that .impairs .the .client's .ability .to .interact .and .experience .the
.time .before .life .ends .should .be .minimized .(C). .Offering .a .medication-free .period
.allows .the .serum .drug .level .to .fall, .which . is .not .an .effective .method .to .manage
.chronic .pain .(D).
Correct .Answer: .A
When .assessing .a .client .with .wrist .restraints, .the .nurse .observes .that .the
.fingers .on .the .right .hand .are .blue. .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. .- .CORRECT .ANSWER-The .priority .nursing
.action .is .to .restore .circulation .by .loosening .the .restraint .(A), .because .blue
.fingers .(cyanosis) .indicates .decreased .circulation. .(C .and .D) .are .also .important
.nursing .interventions, .but .do .not .have .the .priority .of .(A). .Pulse .oximetry .(B)
.measures .the .saturation .of .hemoglobin .with .oxygen .and .is .not .indicated .in
.situations .where .the .cyanosis .is .related .to .mechanical .compression .(the
.restraints).
Correct .Answer: .A
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. .- .CORRECT .ANSWER-A
.lactating .woman .(B) .has .the .greatest .need .for .additional .protein .intake. .(A, .C,
.and .D) .are .all .conditions .that .require .protein, .but .do .not .have .the .increased
.metabolic .protein .demands .of .lactation.
Correct .Answer: .B
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. .- .CORRECT .ANSWER-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 .accordingly .to .prevent .dangerously
.increasing .the .level .of .the .medication .in .the .bloodstream .(D). .The .nurse .should
.document .the .reason .for .the .late .dose, .but .(A .and .C) .are . not .warranted. .(B)
.could .result .in .increased .blood .levels .of .the .drug.
Correct .Answer: .D
While .instructing .a .male .client's .wife .in .the .performance .of .passive .range-of-
motion .exercises .to .his .contracted .shoulder, .the .nurse .observes .that .she .is
.holding .his .arm .above .and .below .the .elbow. .What .nursing .action .should .the
.nurse .implement?
A. .Acknowledge .that .she .is .supporting .the .arm .correctly. .
B. .Encourage .her .to .keep .the .joint .covered .to .maintain .warmth. .
C. .Reinforce .the .need .to .grip .directly .under .the .joint .for .better .support. .
D. .Instruct .her .to .grip .directly .over .the .joint .for .better .motion. .- .CORRECT
.ANSWER-The .wife .is .performing .the .passive .ROM .correctly, .therefore .the . nurse
.should .acknowledge .this .fact .(A). .The .joint .that .is .being .exercised .should .be
.uncovered .(B) .while .the .rest .of .the .body .should .remain .covered .for .warmth .and
.privacy. .(C .and .D) .do .not .provide .adequate .support .to .the .joint .while .still
.allowing .for .joint .movement.
Correct .Answer: .A
What .is .the .most .important .reason .for .starting .intravenous .infusions .in .the
.upper .extremities .rather .than .the .lower .extremities .of .adults?
A. .It .is .more .difficult .to .find .a .superficial .vein .in .the .feet .and .ankles. .
B. .A .decreased .flow .rate .could .result .in .the .formation .of .a .thrombosis. .
C. .A .cannulated .extremity .is .more .difficult .to .move .when .the .leg .or .foot .is .used. .
D. .Veins .are .located .deep .in .the .feet .and .ankles, .resulting .in .a .more .painful
.procedure. .- .CORRECT .ANSWER-Venous . return .is .usually .better .in .the .upper
.extremities. .Cannulation .of .the .veins .in .the .lower .extremities .increases .the .risk
.of .thrombus .formation .(B) .which, .if .dislodged, .could .be .life-threatening.
.Superficial .veins .are .often .very .easy .(A) .to .find .in .the .feet .and .legs. .Handling .a
.leg .or .foot .with .an .IV .(C) .is .probably .not .any .more .difficult .than .handling .an .arm
.or .hand. .Even .if .the . nurse .did .believe .moving .a .cannulated .leg .was .more
, difficult, .this .is .not .the .most .important .reason .for .using .the .upper .extremities.
.
Pain .(D) .is .not .a .consideration.
.
Correct .Answer: .B
The .nurse .observes .an .unlicensed .assistive .personnel .(UAP) .taking .a .client's
.blood .pressure .with .a .cuff .that .is .too .small, .but .the .blood .pressure .reading
.obtained .is .within .the .client's .usual .range. .What .action .is .most .important .for .the
.nurse .to .implement?
A. .Tell .the .UAP .to .use .a .larger .cuff .at .the .next .scheduled .assessment. .
B. .Reassess .the .client's .blood .pressure .using .a .larger .cuff. .
C. .Have .the .unit .educator .review .this .procedure .with .the .UAPs. .
D. .Teach .the .UAP .the .correct .technique .for .assessing .blood .pressure. .-
.CORRECT .ANSWER-The .most .important .action .is .to .ensure .that .an .accurate .BP
.reading .is .obtained. .The .nurse .should .reassess .the .BP .with .the .correct .size .cuff
.(B). .Reassessment .should .not .be .postponed .(A). .Though .(C .and .D) .are .likely
.indicated, .these .actions .do .not .have .the .priority .of .(B).
Correct .Answer: .B
Twenty .minutes .after .beginning .a .heat .application, .the .client .states .that .the
.heating .pad .no .longer .feels .warm .enough. .What .is .the .best .response .by .the
.nurse?
A. ."That .means .you .have .derived .the .maximum .benefit, .and .the .heat .can .be
.removed."
B. ."Your .blood .vessels .are .becoming .dilated .and .removing .the .heat .from .the
.site." .
C. ."We .will .increase .the .temperature .5 .degrees .when .the .pad .no .longer .feels
.warm." .
D. ."The .body's .receptors .adapt .over .time .as .they .are .exposed .to .heat." .-
.CORRECT .ANSWER-(D) .describes .thermal .adaptation, .which .occurs .20 .to .30
.minutes .after .heat .application. .(A .and .B) .provide .false .information. .(C) .is .not
.based .on .a .knowledge .of .physiology .and .is .an .unsafe .action .that .may . harm .the
.client.
Correct .Answer: .D
The .nurse .is .instructing .a .client .with .high .cholesterol .about .diet .and .life .style
.modification. .What .comment .from .the .client .indicates .that .the .teaching .has
.been .effective?
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." .- .CORRECT
.ANSWER-Limiting .saturated .fat .from .animal .food .sources .to .no .more .than .4
and Answers A+ Graded (2025)
An .elderly .client .with .a .fractured .left .hip .is .on .strict .bedrest. .Which .nursing
.measure .is .essential .to .the .client's .nursing .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. .- .CORRECT
.ANSWER-To .avoid .shearing .forces .when .repositioning, .the .client .should .be
.lifted .gently .across .a .surface .(D). .Reddened .areas .should .not .be .massaged .(A)
.since .this .may .increase .the .damage .to .already .traumatized .skin. .To .control .pain
.and .muscle .spasms, .active .range .of .motion .(B) .may .be .limited .on .the .affected
.leg. .The .position .described .in .(C) .is .contraindicated .for .a .client .with .a .fractured
.left .hip.
Correct .Answer: .D
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. .- .CORRECT .ANSWER-The .NGT
.should .be .flushed .before, .after .and .in .between .each .medication .administered
.(B). .Once .all .medications .are .administered, .the .NGT .should .be .clamped .for .20
.minutes .(A). .(C .and .D) .may .be .implemented .only .after .the .tubing .has .been
.flushed.
Correct .Answer: .B
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. .-
.CORRECT .ANSWER-The .most .effective .management .of .pain .is .achieved .using
.an .around-the-clock .schedule .that .provides .analgesic .medications .on .a .regular
.basis .(A) .and .in .a .timely . manner. . Analgesics .are .less .effective .if .pain .persists
.until .it .is .severe, .so .an .analgesic .medication .should .be .administered .before .the
.client's .pain .peaks .(B). .Providing .comfort .is .a .priority .for .the .client .who .is
.dying, .but .sedation .that .impairs .the .client's .ability .to .interact .and .experience .the
.time .before .life .ends .should .be .minimized .(C). .Offering .a .medication-free .period
.allows .the .serum .drug .level .to .fall, .which . is .not .an .effective .method .to .manage
.chronic .pain .(D).
Correct .Answer: .A
When .assessing .a .client .with .wrist .restraints, .the .nurse .observes .that .the
.fingers .on .the .right .hand .are .blue. .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. .- .CORRECT .ANSWER-The .priority .nursing
.action .is .to .restore .circulation .by .loosening .the .restraint .(A), .because .blue
.fingers .(cyanosis) .indicates .decreased .circulation. .(C .and .D) .are .also .important
.nursing .interventions, .but .do .not .have .the .priority .of .(A). .Pulse .oximetry .(B)
.measures .the .saturation .of .hemoglobin .with .oxygen .and .is .not .indicated .in
.situations .where .the .cyanosis .is .related .to .mechanical .compression .(the
.restraints).
Correct .Answer: .A
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. .- .CORRECT .ANSWER-A
.lactating .woman .(B) .has .the .greatest .need .for .additional .protein .intake. .(A, .C,
.and .D) .are .all .conditions .that .require .protein, .but .do .not .have .the .increased
.metabolic .protein .demands .of .lactation.
Correct .Answer: .B
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. .- .CORRECT .ANSWER-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 .accordingly .to .prevent .dangerously
.increasing .the .level .of .the .medication .in .the .bloodstream .(D). .The .nurse .should
.document .the .reason .for .the .late .dose, .but .(A .and .C) .are . not .warranted. .(B)
.could .result .in .increased .blood .levels .of .the .drug.
Correct .Answer: .D
While .instructing .a .male .client's .wife .in .the .performance .of .passive .range-of-
motion .exercises .to .his .contracted .shoulder, .the .nurse .observes .that .she .is
.holding .his .arm .above .and .below .the .elbow. .What .nursing .action .should .the
.nurse .implement?
A. .Acknowledge .that .she .is .supporting .the .arm .correctly. .
B. .Encourage .her .to .keep .the .joint .covered .to .maintain .warmth. .
C. .Reinforce .the .need .to .grip .directly .under .the .joint .for .better .support. .
D. .Instruct .her .to .grip .directly .over .the .joint .for .better .motion. .- .CORRECT
.ANSWER-The .wife .is .performing .the .passive .ROM .correctly, .therefore .the . nurse
.should .acknowledge .this .fact .(A). .The .joint .that .is .being .exercised .should .be
.uncovered .(B) .while .the .rest .of .the .body .should .remain .covered .for .warmth .and
.privacy. .(C .and .D) .do .not .provide .adequate .support .to .the .joint .while .still
.allowing .for .joint .movement.
Correct .Answer: .A
What .is .the .most .important .reason .for .starting .intravenous .infusions .in .the
.upper .extremities .rather .than .the .lower .extremities .of .adults?
A. .It .is .more .difficult .to .find .a .superficial .vein .in .the .feet .and .ankles. .
B. .A .decreased .flow .rate .could .result .in .the .formation .of .a .thrombosis. .
C. .A .cannulated .extremity .is .more .difficult .to .move .when .the .leg .or .foot .is .used. .
D. .Veins .are .located .deep .in .the .feet .and .ankles, .resulting .in .a .more .painful
.procedure. .- .CORRECT .ANSWER-Venous . return .is .usually .better .in .the .upper
.extremities. .Cannulation .of .the .veins .in .the .lower .extremities .increases .the .risk
.of .thrombus .formation .(B) .which, .if .dislodged, .could .be .life-threatening.
.Superficial .veins .are .often .very .easy .(A) .to .find .in .the .feet .and .legs. .Handling .a
.leg .or .foot .with .an .IV .(C) .is .probably .not .any .more .difficult .than .handling .an .arm
.or .hand. .Even .if .the . nurse .did .believe .moving .a .cannulated .leg .was .more
, difficult, .this .is .not .the .most .important .reason .for .using .the .upper .extremities.
.
Pain .(D) .is .not .a .consideration.
.
Correct .Answer: .B
The .nurse .observes .an .unlicensed .assistive .personnel .(UAP) .taking .a .client's
.blood .pressure .with .a .cuff .that .is .too .small, .but .the .blood .pressure .reading
.obtained .is .within .the .client's .usual .range. .What .action .is .most .important .for .the
.nurse .to .implement?
A. .Tell .the .UAP .to .use .a .larger .cuff .at .the .next .scheduled .assessment. .
B. .Reassess .the .client's .blood .pressure .using .a .larger .cuff. .
C. .Have .the .unit .educator .review .this .procedure .with .the .UAPs. .
D. .Teach .the .UAP .the .correct .technique .for .assessing .blood .pressure. .-
.CORRECT .ANSWER-The .most .important .action .is .to .ensure .that .an .accurate .BP
.reading .is .obtained. .The .nurse .should .reassess .the .BP .with .the .correct .size .cuff
.(B). .Reassessment .should .not .be .postponed .(A). .Though .(C .and .D) .are .likely
.indicated, .these .actions .do .not .have .the .priority .of .(B).
Correct .Answer: .B
Twenty .minutes .after .beginning .a .heat .application, .the .client .states .that .the
.heating .pad .no .longer .feels .warm .enough. .What .is .the .best .response .by .the
.nurse?
A. ."That .means .you .have .derived .the .maximum .benefit, .and .the .heat .can .be
.removed."
B. ."Your .blood .vessels .are .becoming .dilated .and .removing .the .heat .from .the
.site." .
C. ."We .will .increase .the .temperature .5 .degrees .when .the .pad .no .longer .feels
.warm." .
D. ."The .body's .receptors .adapt .over .time .as .they .are .exposed .to .heat." .-
.CORRECT .ANSWER-(D) .describes .thermal .adaptation, .which .occurs .20 .to .30
.minutes .after .heat .application. .(A .and .B) .provide .false .information. .(C) .is .not
.based .on .a .knowledge .of .physiology .and .is .an .unsafe .action .that .may . harm .the
.client.
Correct .Answer: .D
The .nurse .is .instructing .a .client .with .high .cholesterol .about .diet .and .life .style
.modification. .What .comment .from .the .client .indicates .that .the .teaching .has
.been .effective?
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." .- .CORRECT
.ANSWER-Limiting .saturated .fat .from .animal .food .sources .to .no .more .than .4
