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Evolve Comprehensive HESI Exam 2025 –
Complete Question Practice Test, Expert Answer
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1. A client with asthma receives a prescription for high blood pressure during a clinic visit. Which prescription should the nurse anticipate the client to receive that is least likely to exacerbate asthma? A. Pindolol B. Carteolol C. Metoprolol Tartrate (Lopressor) ✓ D. Propranolol Correct Answer: C. Metoprolol Tartrate (Lopressor) Rationale: Metoprolol is a cardioselective β₁-blocker, minimizing bronchoconstriction risk. Pindolol (A) and Propranolol (D) are nonselective β-blockers that block β₂ receptors in the lungs, worsening asthma. Carteolol (B) is also nonselective and can increase bronchoconstriction risk. 2. A male client who has been taking propranolol (Inderal) for 18 months tells the nurse the healthcare provider discontinued the medication because his blood pressure has been normal for the past three months. Which instruction should the nurse provide? A. “Stop taking propranolol immediately.” B. “Discontinue propranolol and do not inform the provider.” C. “Ask the healthcare provider about tapering the dose over the next week.” ✓ D. “Take twice your usual dose for one week to prevent rebound.” Correct Answer: C. “Ask the healthcare provider about tapering the dose over the next week.” Rationale: Abruptly stopping propranolol can precipitate rebound tachycardia, hypertension, and dysrhythmias. Gradual dose reduction over 1–2 weeks is necessary to prevent these complications. Options A and B risk abrupt cessation. Option D is unsafe and not indicated.
3. A client who is taking clonidine (Catapres) reports drowsiness. Which additional assessment should the nurse make? A. “How long have you been taking the medication?” ✓ B. “What is your daily calorie intake?” C. “Have you been exercising for at least 30 minutes daily?” D. “Do you take any multivitamins?” Correct Answer: A. “How long have you been taking the medication?” Rationale: Drowsiness is common during the first weeks of clonidine therapy and often lessens over time. Knowing the duration on clonidine helps determine whether sedation is temporary or warrants intervention. Options B, C, and D are not directly related to clonidine-induced drowsiness. 4. The nurse is preparing to administer atropine (an anticholinergic) to a client scheduled for a cholecystectomy. The client asks why this medication is prescribed. What response should the nurse provide? A. “It will decrease your gastric acid production.” B. “It helps prevent nausea and vomiting postoperatively.” C. “It will decrease the risk of bradycardia during surgery.” ✓ D. “It ensures adequate urine output during anesthesia.” Correct Answer: C. “It will decrease the risk of bradycardia during surgery.” Rationale: Preoperative atropine blocks vagal stimulation, increasing SA node automaticity and preventing excessive bradycardia under anesthesia. Options A and B describe other anticholinergic effects but not the primary intraoperative rationale. Option D is incorrect—atropine does not directly affect urine output. 5. An 80-year-old client is given morphine sulfate for postoperative pain. Which concomitant medication should the nurse question because it poses a potential risk for urinary retention in this geriatric client? A. Diphenhydramine B. Hydrochlorothiazide C. Amitriptyline (a tricyclic antidepressant) ✓ D. Ibuprofen Correct Answer: C. Amitriptyline (a tricyclic antidepressant) Rationale: Tricyclic antidepressants have anticholinergic properties that exacerbate opioid-induced urinary retention, especially in older adults. Diphenhydramine (A) also has anticholinergic effects, but the question specifically highlights TCA risk.
C. “The client will consume 100% of three regular meals daily within 3 days.” D. “The client’s weight will increase by 15 pounds in two months.” Correct Answer: A. “The client will eat 50% of six small meals each day by the end of the week.” Rationale: A short-term goal should be realistic, client-centered, and measurable within 7– 10 days. Eating half of six small meals is attainable for a confused patient and addresses increased intake. Option B is nurse-oriented (not client-focused). Option C may be too ambitious for someone with mental impairment. Option D is a long-term goal, not a short-term objective. the nursie is caring for a client who is unable to void. The plan of care establishes an objective for the client to ingest at least 1000 mL of fluid between 7:00 am and 3:30pm. Which client response should the nurse document that indicates a successful outcome? - - correct ans- - Drinks 240 mL of fluid five times during the shift. The nurse should evaluate the client's outcome by observing the client's performance of each expected behavior, so drinking 240 mL of fluid five or six times during the shift (D) indicates a fluid intake of 1200 to 1440 mL, which meets the objective of at least 1000 mL during the designated period. (A) uses the term "adequate," which is not quantified. (B) is not the objective, which establishes an intake of at least 1000 mL. (C) is not an evaluation of the specific fluid intake. a client who has active tuberculosis ( TB) is admitted to the medical unit. What action is most important for the nurse to implement? - - correct ans- - Assign the client to a negative air-flow room Active tuberculosis requires implementation of airborne precautions, so the client should be assigned to a negative pressure air-flow room (D). Although (A and C) should be implemented for clients in isolation with contact precautions, it is most important that air flow from the room is minimized when the client has TB. (B) should be implemented when the client leaves the isolation environment.
A client is receiving atonal (tenormin) 25 mg PO after a myocardial infraction. The nurse determines the clinents apical pulse is 65 beats per minute. What action should the nurse implement next? - - correct ans- - Administer the medication Atenolol, a beta-blocker, blocks the beta receptors of the sinoatrial node to reduce the heart rate, so the medication should be administered (C) because the client's apical pulse is greater than 60. (A, B, and D) are not indicated at this time. A 6 year old child is alert but quiet when brought to the emergency center with periobital ecchymosis and ecchymosis behind the ears. The nurse suspects potential child abuse and continues to assess the child for additional manifestations of a basilar skull fracture. What assessment finding would be consistent with the basilar skull fracture? -
- correct ans- - Rhinorrhoea or otorrhoea with halo sign Raccoon eyes (periorbital ecchymosis) and Battle's sign (ecchymosis behind the ear over the mastoid process) are both signs of a basilar skull fracture, so the nurse should assess for possible meningeal tears 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. The nurse is assessing a client who complains of weight loss, racing heart rate and difficulty sleeping. The nurse determines the client has moist skin with fine hair, prominent eyes, lid retrace, and a staring expression. These findings are consistent with which disorder? - - correct ans- - Graves disease This client is exhibiting symptoms associated with hyperthyroidism or Grave's disease (A), which is an autoimmune condition affecting the thyroid. (B, C, and D) are not associated with these symptoms. The nurse is assessing an older adult client and determines that the client's left upper eyelid droops, covering more of the iris than the right eyelid. Which description should the nurse use to document this finding? - - correct ans- - Ptosis on the left eyelid
A male client who had abdominal surgery has a nasogastric tube to suction, oxygen per nasal cannula, and complains of dry mouth. Which action should the nurse implement?
- correct ans- - Apply a water soluble lubricant to the lips, oral mucosa and nares. To ease the client's discomfort, a water soluble lubricant to the lips and nares assists to keep the mucous membranes moist (D). (A) is a petroleum-based product and should not be used because it is flammable. (B and C) should not be given to the client with a nasogastric tube to suction because it can cause further distension and interfere with fluid and electrolyte balance. The nurse is assessing the laboratory results for a client who is admitted with renal failure and osteodystrophy. Which findings are consistent with this client's clincail picture? - - correct ans- - Serum potassium of 5.5 mEq and total calcium of 6 mg/dl. In renal failure, normal serum electrolyte balance is altered because the kidneys fail to activate vitamin D, calcium absorption is impaired, and serum calcium decreases, which stimulates the release of PTH causing resorption of calcium and phosphate from the bone. A decreased tubular excretion and a decreased glomerular filtration rate results in hypocalcemia, hyperphosphatemia, and hyperkalemia (C). (A) is reflective of a non-renal cause, such as dehydration or liver pathology. (B) is more indicative of infection. Renal failure causes anemia and hyperphosphatemia, not (D). A 56 year old female client is receiving intracavitary radiation via a radium implant. Which nurse should be assigned to care for this client? - - correct ans- - A nurse with marfran's syndrome who is postmenopausal. A client receiving intracavity radiation poses a radiation hazard as long as the intracavity radiation source is in place. A nurse's ability to care of this client is not affected by Marfan's syndrome (B), which is a hereditary disorder of connective tissues, bones, muscles, ligaments and skeletal structures. The goal is to limit any one staff member's exposure to the calculated time span based on the half-life of radium, such as the number of minutes at the bedside per day, so (A) should not be assigned. (C) should not be exposed to the radiation due to the possible effect on the fetus. A radiation exposure decreases the immune response in the client who should not be exposed to the potential inadvertent transmission of an infectious organism (D).
Which info should the nurse provide a client who has undergone cryrosyrgery for stage 1A cerviacl cancer? - - correct ans- - Use a sanitary napkin instead of a tampon. Clients should avoid the use of tampons for 3 to 6 weeks (D) after the procedure to reduce the risk of infection. A heavy, watery vaginal discharge is expected during this time, so (A) is unnecessary. Sexual intercourse should be avoided for up to 6 weeks, so (B) is inaccurate. (C) is not a side effect of the procedure but may indicate human papillomavirus or a cancerous lesion and should be reported. the nurse is preparing a client for schedules surgical procedure. What client statement should the nurse report to the healthcare provider.? - - correct ans- - Recalls drinking a glass of juice after midnight. Because there is a risk of aspiration while under general anesthesia The risk of aspiration while under general anesthesia is increased when the stomach is not empty prior to a surgical procedure, so the client's intake of juice (B) after midnight should be reported the healthcare provider. Preoperative fear and anxiety (A) are common and should be further explored by the nurse. (C) should be communicated using allergy identification tags on the client's records and bracelets on the client's wrist. (D) is a common and expected side effect of perioperative medications. The nurse determines that a clients body weight is 105A% above the standardized height-weight scale. Which related factor should the nurse include in the nursing problem, " Imbalanced nutrition: More than body requirements? " - - correct ans- - Inadequate lifesyle changes in diet and exercise Obesity is a body weight that is 20% above desirable weight for a person's age, sex, height, body build, and calculated body mass index (BMI). (C) best identifies factors that contribute to the formulation of the nursing diagnosis. (A and B) are medical classifications for a client's weight. Although the client is at an increased risk for several chronic illnesses (D), such as heart disease, diabetes mellitus, hypertension, coronary artery disease and hyperlipidemia, this is not a contributing cause or related factor that supports the nursing diagnosis.
The nurse attempts to notify the healthcare provider about a client who is exhibiting an extrapyramidal reaction to psychotropic medications. When the receptionist for the answering service offers to take a message , which nursing action is best for the nurse to take? - - correct ans- - Tell the receptionist to have the healthcare provider return the phone call. The best nursing action is to ask for a return call from the healthcare provider (B) because the nurse must maintain the client's confidentiality. (A) is acceptable, but the best action is to leave a telephone number and request a return call. (C or D) do not promote confidentiality. A primipara with a breech presentation is in the transition phase pf labor. The nurse visualizes the perineum and sees the umbilical cord extruding from the introitus. In which position should the nurse place the client? - - correct ans- - Supine with the foot of the bed raised The supine position with the foot of the bed elevated (D) (Trendelenburg) is one position used to alleviate gravitational pressure by the fetus on the prolapsed umbilical cord, (A, B, and C) do not alleviate pressure on the umbilical cord. The nurse is developing a series of childbirth preparation classes for primigravida women and their significant others. what is the priority expected outcome for these classes? - - correct ans- - Participants can identify at least three coping strategies to use during labor An expected outcome is a specific, measurable change in a client's status that occurs in response to nursing interventions. (B) meets the criteria for an expected outcome. (A, C, and D) are nursing interventions that should lead to the expected outcome. Clinical portfolios are being introduced into the performance apprasial process for the nurses employed at the hospital. What should the nurse-manager request that each staff nurse include in the portfolio? - - correct ans- - A self evaluation that identifies how the nurse has met professional objectives and goals.
A clinical portfolio should include pertinent information that assists in providing a comprehensive view of the employee's performance. A self-evaluation (D) provides an important assessment of the nurse's strengths, weaknesses, and progress toward the achievement of professional goals. (A) is not pertinent nor useful evaluative data regarding current performance. While documentation of continuing education and any certifications achieved are important to include in a clinical portfolio, (B) is not necessary. (C) is not a significant component of a clinical portfolio. a work group is to be formed to determine a care map for a new surgical intervention that is being conducted at the hospital. Which group is likely to besot effective in developing the new care map? - - correct ans- - Multisicipilinary group In a multidisciplinary work group (B), a number of individuals from a variety of disciplines are involved in developing the care map, but each works independently to implement the care plan. Single-discipline work groups (C), such as (A or D), are likely to focus on the aspects of the care map related only to their specific discipline. the scope of professional nursing practice is determined by rules promulgated by which organization.? - - correct ans- - State's board of nursing The state's Board of Nursing (A) is authorized to promulgate rules and regulations that carry the weight of law. The State Legislature delegates its law-making authority to this administrative law body. (B and C) are influential in defining and describing nursing standards of care, but neither have the authority to pass laws that legally define the professional scope of nursing practice. Although (D) may rule on issues important to nursing practice, the scope of professional nursing practice is determined by the laws, rules, and regulations promulgated by state Boards of Nursing. An older client who has been bedridden for a month is admitted with a pressure ulcer on the left trochanter area. The nurse determines that the ulcer extends into the subcutaneous tissue. At which stage should the nurse document this finding? - - correct ans- - Stage 3 Pressure ulcers develop over skin surfaces usually covering bony prominences and are caused by external pressure that impedes blood flow, causing ischemia of the skin and
groups. Servings of foods containing less than 150 mg of potassium, such as (A, B, and C), are good choices for a low potassium diet. 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? - - correct ans- - Hypotension, rapid weak pulse, and rapid respiratory rate The clinical manifestations of Addisonian crisis are often the manifestations of shock (C); the client is at risk for circulatory collapse and shock. (A) indicates clinical manifestations of Cushing's syndrome, (B) of pheochromocytoma (tumor of adrenal medulla), and (D) of thyroid storm (thyrotoxic crisis). The nurse plans to suction a male client. Who has just undergone right pneumonectomy for cancer of th lung. Secretions can be seen around the endotracheal tube and the nurse osculates rattling in the lungs. What safety factors should the nurse consider when suctioning this client? - - correct ans- - Use a soft tip rubber suction catheter and avoid deep vigorous suctioning. A soft rubber catheter with a blunt tip is preferable (B) and deep, vigorous suctioning (D) should be avoided. The client should not hold his breath (A) whether he has one or two lungs and 5 seconds of suctioning is not enough to justify the trauma caused by suctioning. Having another person available for restraint is a good idea if the client is combative or confused, but (C) is not the best answer to this question. It is important to avoid (D) in order to avoid perforating the sutures on the bronchial stump following a pneumonectomy. The nurse is conducting a drug education class for junior high school students. Which statement, provided by one of the student participants, best describes the primary characteristic of addiction? - - correct ans- - wanting the drug is all that matter to an addict The hallmark characteristic of addiction is impaired control (D): all that matters is obtaining the drug of choice. (A) may or may not be true, but is not the primary characteristic of addiction. (B) is a manifestation of impaired control. Addiction is not
caused by being unhappy with one's self, but such unhappiness is usually a result of addiction (C). the nurse is caring for critically ill clients. Which should be monitored for the development of neutogenic shock? A client with? - - correct ans- - Spinal cord injury Spinal cord injuries (C) place the client at high risk for the development of neurogenic distributive shock. The development to watch for in (A) is cardiogenic shock, in (B) is hemorrhagic shock, and in (D) is hypovolemic shock. Which statement by the community health nurse is most helpful to an adult who is in a crisis situation? - - correct ans- - You seem to be more tense these days. Would you like to talk about the problem and how you are dealing with it? (D) acknowledges the stress and encourages the client to discuss options to deal with the problems. Recognizing early signs/symptoms of heightened stress can help to avert a crisis. (A and C) deny the client the opportunity to take control of the problem and use problem solving techniques to resolve the situation. (B) may be offering false reassurance. The nurse is teaching staff in a long term - facility home the principles of caring for clients with essential hypertension. Which comment should the nurse include in the inservice presentation about the care of clients with hypertension? - - correct ans- - Frequent blood pressure checks, including readings taken automated machines are recommended Frequent blood pressure checks (D) are recommended for hypertensive clients to evaluate the effectiveness of treatment. Symptoms such as (A) are not typical of essential hypertension, which is an asymptomatic disease. Treatment (B) usually includes dietary modifications and exercise, which should not be discontinued when medications are added to the treatment plan. While the RN is ultimately responsible for the assessment of blood pressures (C), caregivers are not restricted from obtaining the blood pressure readings.
description is accurate? - - correct ans- - It will identify someone that can make the decisions for you health care if you are ever in a coma or vegetative state. This is a legal document that allows individuals to identify someone to make decisions for health care, identifies how aggressive treatment should be if the client should ever be in a coma or persistent vegetative state, and lists any medical treatments they would never want performed (B). (A) is the definition of the "Living Will"; some states and Canada do not consider Living Wills legal documents. A durable power of attorney is a legal document (C), and it is not a hospital form (D). After eye drops are instilled, which instruction should the nurse provide to the client? - - correct ans- - Close your eyelids Gently closing the eyelids (C) without blinking (D) allows the medication to spread over the eye. It is usually helpful for the client to tilt their head back (A) while the eye drops are being instilled. (B) will not assist in medication distribution or absorption. the nurse is preparing to administer IV fluid to a client with strict fluid restriction. IV tubing with which feature is most important for the nurse to select? - - correct ans- - A Buretrol Attachment A buretrol attachment is used to restrict the total volume of IV fluids that a client receives (D). (A and B) control the rate of administration, but not the total volume infused. (C) reduces the risk of infusion of particulates but does not control the volume infused. Lasix 20 mg PO is prescirbed for a client at 0600. the medication is available in a sound tablet of 40 mg. Before breaking the tablet, what action should the nurse take? - - correct ans- - Preform hand hygiene Before breaking a scored tablet, the nurse should perform hand hygiene (B) to ensure medical asepsis. (A and C) are unnecessary. The nurse should administer the medication before charting (D).
Which assessment finding should make the nurse suspect that a 21 year old male client is taking anabolic steroids - - correct ans- - Describes working hard to develop muscles Anabolic steroids, exogenous androgens, increase muscle mass (C). (A) is an adverse effect that occurs with females that are taking anabolic steroids, but not in males. Acne (B) is a potential side effect of anabolic steroids, but it is such a common occurrence in young males that it should not be the main indication of steroid use. A 10-pound weight gain (D) does not mean the young man is using steroids unless the weight gain is due to increased muscle mass. Which instruction should the nurse include in the discharge teaching for a client who is taking an antipsycotioc medication? - - correct ans- - Increase daily intake of raw fruits and veggies A common side effect of antipsychotic medications is constipation, and increasing high-fiber foods in the diet (A) can help to alleviate this problem. (B and C) have no particular effect on possible side effects from taking antipsychotic medications. While some antipsychotic medications cause urinary retention, which should be reported to the healthcare provider, urine output increase (D) is likely to occur if additional fluids are consumed to overcome a dry mouth, which is a common side effect of antipsychotic medications. Prior ro the discharge of a family 4-day old newborn the nurse is collecting the blood specimens to screen for phenylketonuria(PKU), the Guthrie inhibition assay blood test. What action should the nurse implement to ensure the validity of the test? - - correct ans- - Assess the newborns feeding patterns of formula or breast milk which has come in PKU screening is mandatory in most states and requires that the newborn has ingested adequate amounts (2 to 3 days) of milk proteins (C) to detect metabolism errors, which result in abnormal phenylalanine (an amino acid) in the newborn's blood and predisposes the infant to mental retardation. (A and D) are not necessary. (B) is commonly practiced when infants are discharged at 24-hours of age or before adequate milk proteins have been ingested.
The nurse is planning care for a client who is having abdominal surgery. To achieve postoperative outcomes, the nurse includes interventions that promote progressive mobilization, such a turn, cough, deep breathe, and early ambulation. Which additional intervention should the nurse include? - - correct ans- - Administer analgesics prior to encouraging progressive activities and ambulation Effective pain management in the postoperative period promotes the client's participation in exercises that promote optimal healing and prevent complications, so the client should be given an analgesic prior to mobilization (C). Although (A) promotes client understanding, it is more important that the client's pain is managed to promote cooperation and compliance in the care plan. (B) is helpful but is not as useful if the client is in pain. (D) may unduly scare the client. Prior to a cardiac cauterization, which activity should the nurse have the client practice?
- correct ans- - Valsalva's maneuver and coughing Before the cardiac catheterization, the client should practice techniques (e.g., Valsalva's maneuver, coughing, deep breathing) that will be used during the procedure (B). The client should keep the leg straight, not (A), for the prescribed number of hours post cardiac catheterization to prevent bleeding from the arterial access site. (C) is not used in this procedure. The client may be asked to change position during the procedure, so (D) is not necessary. The nurse is caring for a client who is one day postoperative after a left total knee arthroplasty (TKA) which intervention should the nurse include in the plan of care? - - correct ans- - Progressive leg exercises to obtain 90-degree flexion Isometric quadriceps setting begins the first day after TKA surgery and progresses to straight-leg raises, then gentle ROM to increase muscle strength until 90-degree knee flexion is obtained (A). Bed rest and immobilization is contraindicated to prevent scar tissue, which limits mobility (C). Active flexion exercises through the use of a continuous passive motion (CPM) machine postoperatively promotes joint mobility. Postoperative exercise progresses to full weight-bearing before discharge, but not the first postoperative day (B). Joint mobility is a priority outcome, and dislocation is not typical with TKA (D).
A client with osteomyelitis is scheduled for surgery to treat the infection which has not responded to three months of intravenous antibiotic therapy. The client asks the nurse why surgery is necessary. Which is the best response for the nurse to provide? - - correct ans- - The infection has walled off into an area of infected bone creating a barrier to antibiotics A sequestrum (dead bone) is separated from the living bone and has no blood supply, so neither antibiotics nor white blood cells can reach the infected area (D). (A and B) do not address the encasement of the necrotic tissue. Although a sinus tract may occur, (C) does not address the purpose of the surgery. After one month of short-term corticosteroid therapy, a client with an acute exacerbation of rheumatiod arthritis returns to the clinic for a follow up visit. Which laboratory finding should the nurse review for a therapeutic response? - - correct ans- - Erythrocyte sedimentation rate. An elevated erythrocyte sedimentation rate (ESR) is indicative of active inflammation, so the nurse should determine if the ESR has normalized (D). Although corticosteroids influence glucose metabolism, an elevation in (A) may indicate a side-effect response to exogenous corticosteroids, not a desired effect. (B and C) do not indicate a therapeutic response to the corticosteroid therapy. A male client who lives in an area endemic with lyme disease asks the nurse what to do if he thinks he may have been exposed. Which response should the nurse provide? - - correct ans- - Look for early signs of lesion that increases in size with a red border, clear center. The client should look for the early signs of localized Lyme disease known as erythema migrans, a skin lesion that slowly expands to form a large round lesion with a bright red border and clear center (B) at the site of the tick bite. A tick should be removed with tweezers by pulling straight from its insertion away from the skin, and not compressing its body or covering it with oil (A). Lyme disease is caused by the spirochete, Borrelia burgdorferi, which is transmitted by the bite of an infected deer tick, and antiviral agents (D) are ineffective. Symptoms, such as fever, chills, headache, stiff neck, fatigue, and swollen lymph nodes are more typical, not nausea and vomiting (C).
