EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2024
VERIFIED RATIONALE GRADED A+
A 16 -year- o ld m ale c lien t is adm itted to the hosp ita l after fa lling o ff a b ike and susta in ing
a f r ac tu red bone. The hea l thca re prov i de r exp la in s the su rge ry needed to immob i l i ze the
f r ac tu re. Which acti on shou l d be imp lemente d to obta in a va l i d i n fo rmed consent? - ansObta in
the permis s ion of the cus to d ia l parent fo r the su rge r y.
The client is a minor and cannot legally sign his own consent unless he is an emancipated minor, so the
consent should be obtained from the guardian for this client, which is the custodial parent (B). (A) is not
a l e ga l opti on. A s tepparent i s not a l e ga l guard ian fo r a minor un les s the ch i l d has been a dopte d by the
stepparent (C). The non-custodial parent does not need to co-sign this form (D).
A 56 yea r old female client is receiving int racavita r y ra diati on via a ra dium implant. Which nu r se
should be assigned to care for this client? - ansA nurse with marfran's syndrome who is postmenopausal.
A client receiving intracavity radiation poses a radiation hazard as long as the intracavity radiation so
is in place. A nurse's ability to care of this client is not affected by Marfan's syndrome (B), which is a
hered i ta r y d i so rder of connecti ve ti s sues, bones, musc le s, l i gament s an d ske le ta l s t ruc tu res.
The goa l i s to l im i t any one s taff member ' s exposu re to the ca l cu la te d ti me span base d on the ha l f- l i f e of
rad ium, such as the number of minutes at the bed s i d e per day, so (A) shou l d not be ass i gne d. (C) shou l d
not be exposed to the rad iati on due to the poss ib le eff e c t on the fe tus. A ra d iati on exposu re dec reases
the immune response in the client who should not be exposed to the potential inadve rtent t ransmission
of an infectious organism (D).
A 6 year old child is alert but quiet when brought to the emergency center with periobital ecchymosis
and ecchymos i s beh in d the ear s. The nur se suspec t s potenti a l ch i l d abuse an d conti nues to assess the
child for additional manifestations of a basilar skull fracture. What assessment finding would be
consistent with the basilar skull fracture? - ansRhinorrhoea or otorrhoea with halo sign
Raccoon eyes (per io rb i ta l ecchymos i s) and Batt l e ' s s i gn (ecchymos i s beh in d the ea r ove r the masto i d
process) are both s i gns of a bas i l a r sku l l f r ac tu re, so the nurse shou l d assess fo r poss ib le men ingea l tea r
that manifest as a Halo sign with CSF leakage from the ears or nose (D). (A) is consistent with orbital
fractures. (B) occurs with wrenching traumas of the shoulder or arm fractures. (C) occurs with blunt
abdominal injuries.
,EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2024
VERIFIED RATIONALE GRADED A+
A 63-year-old female client whose husband died one month ago is seen in the psychiatric clinic. Her
daughte r te l l s the nur se tha t her mother i s eati ng poor l y, s leeps ve ry l itt l e at n ight, an d conti nues to se
the table for her deceased husband. What nursing problem best describes this problem? - ansDenial
re la te d to the l o s s of a l ove d one.
Based on the data prov i d ed, (C) i s the best nur s ing d iagnos i s. Th i s c l i en t i s exh ib iti ng symptoms of
anxiety and the pain is too great for her to acknowledge, so she is denying the situation. Although she
may seem confused (A), she is actually trying to deal with the pain through the defense mechanism of
denial. (B) occurs after one year or longer following the loss. The client's husband died one month ago.
(D) and depression are often related, and depression is sometimes described as unexpressed anger.
However, this client has not acknowledged her loss (denial) and the anger is not yet realized.
A 9 yea r old is hospitalize d fo r the neut ropenia an d is place d in reve r se isolati on. T h e chil d a s k s the
nurse " why do you have to wear a gown and mask when you are in my room?" How should the nurse
respond? - ans " To protec t you because you can get an i n fecti on ve ry eas i l y
Rever se i so l ati on precauti on imp lement measu res to protec t the c l i en t f rom exposu re to
microorgan i sms f rom other s (B). A l though mic robes a re preva lent i n a l l env i ronments, (A) does not
adequately answer the child's question. Reverse isolation should be implemented until the client's white
blood cell increases (C). Neutropenia in this child does not place others (D) at risk for infection.
A child is receiving maintainance intravenous (IV) fluids at the rate of 1000 mL for the first 10
kg of body weight, plus 50 mL/kg per day for each kilogram between 10 and 20. How many milliliters per
hour should the nurse program the infusion pump for a child who weighs 19.5 kg? (Enter numeric value
only. If rounding is required, round to the nearest whole number.) - ans 6 1
T h e fo rmula fo r calculati n g daily fl ui d requi r ements is: 0 to 1 0 k g, 1 0 0 m L/k g pe r day; o r
10 to 20 kg, 1
0 0
0 mL for the first 1
0 kg of body weight plus 5 0 mL/kg per day for each kilogram between
10 and 2 0.To determine an hour ly rate, d iv i d e the to ta l mi l l i l i t e r s per day by 2
4.
19.5 k g x 50 m L/kg = 475 m L + 1000 m L = 1475 m L / 24 hour s =
61 mL/hour
,EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2024
VERIFIED RATIONALE GRADED A+
A child with bacterial conjunctivitis receives a prescription for erythromycin eye drops. Which
information is most important for the nurse to include in the teaching plan? - ansAvoid sharing towels
and washcloths with siblings
A l l of the i n fo rmati on i s impor tant to i n c lu de i n the teach ing p lan, but i t i s most impor tant to avo i d
spreading the bacterial infection. The child should avoid sharing towels and washcloths (D) and should
s tay home f rom schoo l fo r the fir s t 2 4 hours a ft e r anti b io ti c s a re s ta r te d, to p revent
contaminati on of other s. (A, B, and C) a re impor tant measures to reduce the ch i l d ' s d i s comfo r t,
but i nh ib iti ng the sp read of the i n fecti on i s the pr io r i t y i n te rventi on.
A child with tetrology of ballot suffers a hyper cyanotic episode. Which immediate action by the nurse
can lessen the symptoms of this " TET" spell? - ansPlace child in knee-chest positionThis pressu re
reduces the rush of blood flow through the septal hole and improves blood circulation.
The ch i l d shou l d be p lace d on h i s or her back i n the knee-to-ches t pos iti on (B) to i n c rease b loo d vesse l
res i s tance. The i n c rease d pressu re reduces the rush of b lood th rough the sep ta l ho le an d improves
blood circulation. (A) has nominal effects in hypercyanosis. (C) is self-regulating. (D) is not indicated for
imme d iate relief of tet spells. It is use d to imp rove ca rdiac output.
A client assigned to a female practical nurse (PN) needs total morning care and sterile wound packing
with a wet to dry dressing. The PN tells the nurse that she has never performed a wound packing. Which
intervention should the charge nurse implement? - ansDemonstrate the wound care procedure to the
PN while the PN assists
It is within the PN's scope of practice to perform sterile wound care. The best learning of skills is through
demonstration and return demonstration, therefore (D) promotes safe practice while allowing the PN
the best opportunity to learn. (A) does not allow the PN to gain the experience nee ded to perform he r
role. (B) does not provide the best learning opportunity for the PN, or ensure safe practice. While (C)
would provide a safe method for learning the wet-to-dry procedure, it doesn't address the problem
immediately and is a more costly way for the PN to learn.
A c l i en t i s admitt e d to the hosp i ta l fo r a l coho l dependency. What i s the pr io r i t y nurs ing i n te rventi on
during the fir st 48 hours following a dmission? - ans Monito r fo r inc rease d bloo d p ressu re an d pulse
, EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2024
VERIFIED RATIONALE GRADED A+
Clients with alcohol dependency experience withdrawal symptoms, which inclu de elevate d bloo d
pressure, pulse, and temperature, so (B) has the highest priority. (A) will prevent Korsakoff's syndrome
(secondary dementia caused by thiamine deficiency, associated with malnutrition secondary to excessive
alcohol intake), but this intervention does not have the priority of (B). (C and D) are important for alcohol
detox ifi c ati on, but do not have the pr io r i t y of (B).
A client is admitted to the hospital with a diagnosis of Type 2 diabetes mellitus and influenza. Which
ca tegor ie s of i l l ness shou l d the nur se deve lop goa l s fo r the c l i en t ' s p lan of ca re? - ansOne
chronic and one acute illness
The p lan of ca re shou l d i n c lu de goa l s tha t a re spec ifi c fo r ch ron i c an d acu te i l l nesses. Adu l t- onset
diabetes is a life-long chronic disease, whereas influenza is an acute illness with a short te rm duration
(C). (A, B, and D) do not include the correct duration categories for this situation.
A client is admitted with a medical diagnosis of addisonian crisis. When completing the admission
assessment, the nurse expects this client to exhibit which clinical manifestations? - ansHypotension,
rapid weak pulse, and rapid respiratory rate
The c l i n i ca l man i fe s tati ons of Add i son ian c r i s i s a re oft en the man i fe s tati ons of shock (C); the c l i en t i s
r i sk fo r c i r cu la to r y co l l apse and shock. (A) i n d i ca tes c l in i ca l man i fe s tati ons of Cush ing ' s syn drome, (B)
pheochromocytoma (tumor of adrenal medulla), and (D) of thyroid storm (thyrotoxic crisis).
A client is being admitted to the medical unit form the emergency department after having a
che st tube inse rte d. What equipment shoul d be b rought to this client's room? - ansRubbe r -
tipped clamps
Rubber-ti pped c lamps (C) shou l d be kept at the c l i en t ' s bed s i de fo r assessment of poss ib le ches t tube a i r
leaks, with the prescription of the healthcare provider. (A), used during a respiratory or cardiac arrest,
does not need to be brought to the c l i en t ' s roomas a routi ne precauti on. (B) i s use d to i n tuba te a c l i en t
and is not indicated for routine care of the client with a chest tube. (D) is indicated by the client's oxygen
saturation or arterial blood gases, and is not routinely placed in the room of a client with a chest tube.
QUESTIONS AND ANSWERS LATEST VERSION 2024
VERIFIED RATIONALE GRADED A+
A 16 -year- o ld m ale c lien t is adm itted to the hosp ita l after fa lling o ff a b ike and susta in ing
a f r ac tu red bone. The hea l thca re prov i de r exp la in s the su rge ry needed to immob i l i ze the
f r ac tu re. Which acti on shou l d be imp lemente d to obta in a va l i d i n fo rmed consent? - ansObta in
the permis s ion of the cus to d ia l parent fo r the su rge r y.
The client is a minor and cannot legally sign his own consent unless he is an emancipated minor, so the
consent should be obtained from the guardian for this client, which is the custodial parent (B). (A) is not
a l e ga l opti on. A s tepparent i s not a l e ga l guard ian fo r a minor un les s the ch i l d has been a dopte d by the
stepparent (C). The non-custodial parent does not need to co-sign this form (D).
A 56 yea r old female client is receiving int racavita r y ra diati on via a ra dium implant. Which nu r se
should be assigned to care for this client? - ansA nurse with marfran's syndrome who is postmenopausal.
A client receiving intracavity radiation poses a radiation hazard as long as the intracavity radiation so
is in place. A nurse's ability to care of this client is not affected by Marfan's syndrome (B), which is a
hered i ta r y d i so rder of connecti ve ti s sues, bones, musc le s, l i gament s an d ske le ta l s t ruc tu res.
The goa l i s to l im i t any one s taff member ' s exposu re to the ca l cu la te d ti me span base d on the ha l f- l i f e of
rad ium, such as the number of minutes at the bed s i d e per day, so (A) shou l d not be ass i gne d. (C) shou l d
not be exposed to the rad iati on due to the poss ib le eff e c t on the fe tus. A ra d iati on exposu re dec reases
the immune response in the client who should not be exposed to the potential inadve rtent t ransmission
of an infectious organism (D).
A 6 year old child is alert but quiet when brought to the emergency center with periobital ecchymosis
and ecchymos i s beh in d the ear s. The nur se suspec t s potenti a l ch i l d abuse an d conti nues to assess the
child for additional manifestations of a basilar skull fracture. What assessment finding would be
consistent with the basilar skull fracture? - ansRhinorrhoea or otorrhoea with halo sign
Raccoon eyes (per io rb i ta l ecchymos i s) and Batt l e ' s s i gn (ecchymos i s beh in d the ea r ove r the masto i d
process) are both s i gns of a bas i l a r sku l l f r ac tu re, so the nurse shou l d assess fo r poss ib le men ingea l tea r
that manifest as a Halo sign with CSF leakage from the ears or nose (D). (A) is consistent with orbital
fractures. (B) occurs with wrenching traumas of the shoulder or arm fractures. (C) occurs with blunt
abdominal injuries.
,EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2024
VERIFIED RATIONALE GRADED A+
A 63-year-old female client whose husband died one month ago is seen in the psychiatric clinic. Her
daughte r te l l s the nur se tha t her mother i s eati ng poor l y, s leeps ve ry l itt l e at n ight, an d conti nues to se
the table for her deceased husband. What nursing problem best describes this problem? - ansDenial
re la te d to the l o s s of a l ove d one.
Based on the data prov i d ed, (C) i s the best nur s ing d iagnos i s. Th i s c l i en t i s exh ib iti ng symptoms of
anxiety and the pain is too great for her to acknowledge, so she is denying the situation. Although she
may seem confused (A), she is actually trying to deal with the pain through the defense mechanism of
denial. (B) occurs after one year or longer following the loss. The client's husband died one month ago.
(D) and depression are often related, and depression is sometimes described as unexpressed anger.
However, this client has not acknowledged her loss (denial) and the anger is not yet realized.
A 9 yea r old is hospitalize d fo r the neut ropenia an d is place d in reve r se isolati on. T h e chil d a s k s the
nurse " why do you have to wear a gown and mask when you are in my room?" How should the nurse
respond? - ans " To protec t you because you can get an i n fecti on ve ry eas i l y
Rever se i so l ati on precauti on imp lement measu res to protec t the c l i en t f rom exposu re to
microorgan i sms f rom other s (B). A l though mic robes a re preva lent i n a l l env i ronments, (A) does not
adequately answer the child's question. Reverse isolation should be implemented until the client's white
blood cell increases (C). Neutropenia in this child does not place others (D) at risk for infection.
A child is receiving maintainance intravenous (IV) fluids at the rate of 1000 mL for the first 10
kg of body weight, plus 50 mL/kg per day for each kilogram between 10 and 20. How many milliliters per
hour should the nurse program the infusion pump for a child who weighs 19.5 kg? (Enter numeric value
only. If rounding is required, round to the nearest whole number.) - ans 6 1
T h e fo rmula fo r calculati n g daily fl ui d requi r ements is: 0 to 1 0 k g, 1 0 0 m L/k g pe r day; o r
10 to 20 kg, 1
0 0
0 mL for the first 1
0 kg of body weight plus 5 0 mL/kg per day for each kilogram between
10 and 2 0.To determine an hour ly rate, d iv i d e the to ta l mi l l i l i t e r s per day by 2
4.
19.5 k g x 50 m L/kg = 475 m L + 1000 m L = 1475 m L / 24 hour s =
61 mL/hour
,EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2024
VERIFIED RATIONALE GRADED A+
A child with bacterial conjunctivitis receives a prescription for erythromycin eye drops. Which
information is most important for the nurse to include in the teaching plan? - ansAvoid sharing towels
and washcloths with siblings
A l l of the i n fo rmati on i s impor tant to i n c lu de i n the teach ing p lan, but i t i s most impor tant to avo i d
spreading the bacterial infection. The child should avoid sharing towels and washcloths (D) and should
s tay home f rom schoo l fo r the fir s t 2 4 hours a ft e r anti b io ti c s a re s ta r te d, to p revent
contaminati on of other s. (A, B, and C) a re impor tant measures to reduce the ch i l d ' s d i s comfo r t,
but i nh ib iti ng the sp read of the i n fecti on i s the pr io r i t y i n te rventi on.
A child with tetrology of ballot suffers a hyper cyanotic episode. Which immediate action by the nurse
can lessen the symptoms of this " TET" spell? - ansPlace child in knee-chest positionThis pressu re
reduces the rush of blood flow through the septal hole and improves blood circulation.
The ch i l d shou l d be p lace d on h i s or her back i n the knee-to-ches t pos iti on (B) to i n c rease b loo d vesse l
res i s tance. The i n c rease d pressu re reduces the rush of b lood th rough the sep ta l ho le an d improves
blood circulation. (A) has nominal effects in hypercyanosis. (C) is self-regulating. (D) is not indicated for
imme d iate relief of tet spells. It is use d to imp rove ca rdiac output.
A client assigned to a female practical nurse (PN) needs total morning care and sterile wound packing
with a wet to dry dressing. The PN tells the nurse that she has never performed a wound packing. Which
intervention should the charge nurse implement? - ansDemonstrate the wound care procedure to the
PN while the PN assists
It is within the PN's scope of practice to perform sterile wound care. The best learning of skills is through
demonstration and return demonstration, therefore (D) promotes safe practice while allowing the PN
the best opportunity to learn. (A) does not allow the PN to gain the experience nee ded to perform he r
role. (B) does not provide the best learning opportunity for the PN, or ensure safe practice. While (C)
would provide a safe method for learning the wet-to-dry procedure, it doesn't address the problem
immediately and is a more costly way for the PN to learn.
A c l i en t i s admitt e d to the hosp i ta l fo r a l coho l dependency. What i s the pr io r i t y nurs ing i n te rventi on
during the fir st 48 hours following a dmission? - ans Monito r fo r inc rease d bloo d p ressu re an d pulse
, EVOLVE COMPREHENSIVE EXAM (HESI) 1
QUESTIONS AND ANSWERS LATEST VERSION 2024
VERIFIED RATIONALE GRADED A+
Clients with alcohol dependency experience withdrawal symptoms, which inclu de elevate d bloo d
pressure, pulse, and temperature, so (B) has the highest priority. (A) will prevent Korsakoff's syndrome
(secondary dementia caused by thiamine deficiency, associated with malnutrition secondary to excessive
alcohol intake), but this intervention does not have the priority of (B). (C and D) are important for alcohol
detox ifi c ati on, but do not have the pr io r i t y of (B).
A client is admitted to the hospital with a diagnosis of Type 2 diabetes mellitus and influenza. Which
ca tegor ie s of i l l ness shou l d the nur se deve lop goa l s fo r the c l i en t ' s p lan of ca re? - ansOne
chronic and one acute illness
The p lan of ca re shou l d i n c lu de goa l s tha t a re spec ifi c fo r ch ron i c an d acu te i l l nesses. Adu l t- onset
diabetes is a life-long chronic disease, whereas influenza is an acute illness with a short te rm duration
(C). (A, B, and D) do not include the correct duration categories for this situation.
A client is admitted with a medical diagnosis of addisonian crisis. When completing the admission
assessment, the nurse expects this client to exhibit which clinical manifestations? - ansHypotension,
rapid weak pulse, and rapid respiratory rate
The c l i n i ca l man i fe s tati ons of Add i son ian c r i s i s a re oft en the man i fe s tati ons of shock (C); the c l i en t i s
r i sk fo r c i r cu la to r y co l l apse and shock. (A) i n d i ca tes c l in i ca l man i fe s tati ons of Cush ing ' s syn drome, (B)
pheochromocytoma (tumor of adrenal medulla), and (D) of thyroid storm (thyrotoxic crisis).
A client is being admitted to the medical unit form the emergency department after having a
che st tube inse rte d. What equipment shoul d be b rought to this client's room? - ansRubbe r -
tipped clamps
Rubber-ti pped c lamps (C) shou l d be kept at the c l i en t ' s bed s i de fo r assessment of poss ib le ches t tube a i r
leaks, with the prescription of the healthcare provider. (A), used during a respiratory or cardiac arrest,
does not need to be brought to the c l i en t ' s roomas a routi ne precauti on. (B) i s use d to i n tuba te a c l i en t
and is not indicated for routine care of the client with a chest tube. (D) is indicated by the client's oxygen
saturation or arterial blood gases, and is not routinely placed in the room of a client with a chest tube.
