2026 EVOLVE ELSEVIER HESI MED SURG EXAM NEWEST 2026
COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+||BRAND NEW!!
The nurse is caring for a client with deep vein thrombosis who is on a continuous
IV heparin infusion. The activated partial prothrombin time (aPTT) is 120 seconds.
Which action should the nurse take?
A. Increase the rate of the heparin infusion using a nomogram.
B. Decrease the heparin infusion rate and give vitamin K IM.
C. Continue the heparin infusion at the current prescribed rate.
D. Stop the heparin drip and prepare to administer protamine sulfate.
D
Rationale:
An aPTT more than 100 seconds is a critically high value; therefore, the heparin
should be stopped. The antidote for heparin is protamine sulfate (D). Increasing
the rate would increase the risk for hemorrhage (A). The infusion should be
stopped, and vitamin K is the antidote for warfarin (Coumadin) (B). Keeping the
infusion at the current rate would increase the risk for hemorrhage (C).
While assessing a client with recurring chest pain, the unit secretary notifies the
nurse that the client's health care provider is on the telephone. What action should
the nurse instruct the unit secretary to implement?
A. Transfer the call into the room of the client.
B.Instruct the secretary to explain reason for the call.
C. Ask another nurse to take the phone call.
D. Ask the health care provider to see the client on the unit.
C
Rationale:
Another nurse should be asked to take the phone call (C), which allows the nurse
to stay at the bedside to complete the assessment of the client's chest pain. (A
and B) should not be done during an acute change in the client's condition.
Requesting the health care provider (D) to come to the unit is premature until the
nurse completes assessment of the client's status.
,Which instruction(s) should the nurse include in the discharge teaching plan of a
male client who has had a myocardial infarction and who has a new prescription
for nitroglycerin (NTG)? (Select all that apply.)
A. Keep the medication in your pocket so that it can be accessed quickly.
B. Call 911 if chest pain is not relieved after one nitroglycerin.
C. Store the medication in its original container and protect it from light.
D. Activate the emergency medical system after three doses of medication.
E. Do not use within 1 hour of taking sildenafil citrate (Viagra).
B,C
Rationale:
Emergency action should be taken if chest pain is not relieved after one
nitroglycerin tablet (B). The medication should be kept in the original container to
protect from light
(C). Keeping the medication in the shirt pocket provides an environment that is too warm
(A). The newest guidelines recommend calling 911 after one nitroglycerin tablet if
chest pain is not relieved (D). Nitroglycerin and other nitrates should never be
taken with Viagra (E).
,The nurse prepares to administer 3 units of regular insulin and 20 units of NPH
insulin subcutaneously to a client with an elevated blood glucose level. Which
procedure is correct?
A.Using one syringe, first insert air into the regular vial and then insert air into
the NPH vial.
B.Using one syringe, add the regular insulin into the syringe and then add the NPH
insulin.
C.Avoid combining the two insulins because incompatibility could cause an
adverse reaction.
D.Administer the regular insulin subcutaneously and then give the NPH IV to
prevent a separate stick.
B
Rationale:
The regular or "clear" insulin should be withdrawn into the syringe first, followed
by the NPH (B). Air should first be injected into the NPH vial and then air should
be inserted into the regular vial (A). NPH and regular insulin are compatible, and
combining will reduce the number of injections (C). The insulin is ordered
subcutaneously and NPH cannot be given IV (D).
, 3/2/26, 6:09 PM EXIT HESI Comprehensive B Evolve Practice
An 8-year-old child is receiving digoxin (Lanoxin) for congestive heart failure
(CHF). In assessing the child, the nurse finds that her apical heart rate is 80
beats/min, she complains of being slightly nauseated, and her serum digoxin level
is 1.2 ng/mL. What action should the nurse take?
A.Because the child's heart rate and digoxin level are within normal range, assess
for the cause of the nausea.
B.Hold the next dose of digoxin until the health care provider can be notified
because the serum digoxin level is elevated.
C.Administer the next dose of digoxin and notify the health care provider that the
child is showing signs of toxicity.
D.Notify the health care provider that the child's pulse rate is below normal for her
age group.
A
Rationale:
Nausea and vomiting are early signs of digoxin toxicity. However, the normal
resting heart rate for a child 8 to 10 years of age is 70 to 110 beats/min and the
therapeutic range of serum digoxin levels is 0.5 to 2 ng/mL. Based on the
objective data, (A) is the best of the choices provided because the serum digoxin
level is within normal levels. (B) is not warranted by the data presented. The
digoxin level is within the therapeutic range and the child is not showing signs of
toxicity (C). The child's pulse rate is within normal range for her age group (D).
… 4/56
COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+||BRAND NEW!!
The nurse is caring for a client with deep vein thrombosis who is on a continuous
IV heparin infusion. The activated partial prothrombin time (aPTT) is 120 seconds.
Which action should the nurse take?
A. Increase the rate of the heparin infusion using a nomogram.
B. Decrease the heparin infusion rate and give vitamin K IM.
C. Continue the heparin infusion at the current prescribed rate.
D. Stop the heparin drip and prepare to administer protamine sulfate.
D
Rationale:
An aPTT more than 100 seconds is a critically high value; therefore, the heparin
should be stopped. The antidote for heparin is protamine sulfate (D). Increasing
the rate would increase the risk for hemorrhage (A). The infusion should be
stopped, and vitamin K is the antidote for warfarin (Coumadin) (B). Keeping the
infusion at the current rate would increase the risk for hemorrhage (C).
While assessing a client with recurring chest pain, the unit secretary notifies the
nurse that the client's health care provider is on the telephone. What action should
the nurse instruct the unit secretary to implement?
A. Transfer the call into the room of the client.
B.Instruct the secretary to explain reason for the call.
C. Ask another nurse to take the phone call.
D. Ask the health care provider to see the client on the unit.
C
Rationale:
Another nurse should be asked to take the phone call (C), which allows the nurse
to stay at the bedside to complete the assessment of the client's chest pain. (A
and B) should not be done during an acute change in the client's condition.
Requesting the health care provider (D) to come to the unit is premature until the
nurse completes assessment of the client's status.
,Which instruction(s) should the nurse include in the discharge teaching plan of a
male client who has had a myocardial infarction and who has a new prescription
for nitroglycerin (NTG)? (Select all that apply.)
A. Keep the medication in your pocket so that it can be accessed quickly.
B. Call 911 if chest pain is not relieved after one nitroglycerin.
C. Store the medication in its original container and protect it from light.
D. Activate the emergency medical system after three doses of medication.
E. Do not use within 1 hour of taking sildenafil citrate (Viagra).
B,C
Rationale:
Emergency action should be taken if chest pain is not relieved after one
nitroglycerin tablet (B). The medication should be kept in the original container to
protect from light
(C). Keeping the medication in the shirt pocket provides an environment that is too warm
(A). The newest guidelines recommend calling 911 after one nitroglycerin tablet if
chest pain is not relieved (D). Nitroglycerin and other nitrates should never be
taken with Viagra (E).
,The nurse prepares to administer 3 units of regular insulin and 20 units of NPH
insulin subcutaneously to a client with an elevated blood glucose level. Which
procedure is correct?
A.Using one syringe, first insert air into the regular vial and then insert air into
the NPH vial.
B.Using one syringe, add the regular insulin into the syringe and then add the NPH
insulin.
C.Avoid combining the two insulins because incompatibility could cause an
adverse reaction.
D.Administer the regular insulin subcutaneously and then give the NPH IV to
prevent a separate stick.
B
Rationale:
The regular or "clear" insulin should be withdrawn into the syringe first, followed
by the NPH (B). Air should first be injected into the NPH vial and then air should
be inserted into the regular vial (A). NPH and regular insulin are compatible, and
combining will reduce the number of injections (C). The insulin is ordered
subcutaneously and NPH cannot be given IV (D).
, 3/2/26, 6:09 PM EXIT HESI Comprehensive B Evolve Practice
An 8-year-old child is receiving digoxin (Lanoxin) for congestive heart failure
(CHF). In assessing the child, the nurse finds that her apical heart rate is 80
beats/min, she complains of being slightly nauseated, and her serum digoxin level
is 1.2 ng/mL. What action should the nurse take?
A.Because the child's heart rate and digoxin level are within normal range, assess
for the cause of the nausea.
B.Hold the next dose of digoxin until the health care provider can be notified
because the serum digoxin level is elevated.
C.Administer the next dose of digoxin and notify the health care provider that the
child is showing signs of toxicity.
D.Notify the health care provider that the child's pulse rate is below normal for her
age group.
A
Rationale:
Nausea and vomiting are early signs of digoxin toxicity. However, the normal
resting heart rate for a child 8 to 10 years of age is 70 to 110 beats/min and the
therapeutic range of serum digoxin levels is 0.5 to 2 ng/mL. Based on the
objective data, (A) is the best of the choices provided because the serum digoxin
level is within normal levels. (B) is not warranted by the data presented. The
digoxin level is within the therapeutic range and the child is not showing signs of
toxicity (C). The child's pulse rate is within normal range for her age group (D).
… 4/56
