EVOLVE ELSEVIER HESI MED SURG EXAM QUESTIONS AND
CORRECT DETAILED VERIFIED ANSWERS (GRADED A+)
Question: 1
In assessing a client diagnosed with primary aldosteronism, the nurse
expects the laboratory test results to indicate a decreased serum level
of which substance?
A. Sodium
B. Antidiuretic hormone
C. Potassium
D. Glucose - VERIFIED ANSWER - C. Potassium
Rationale: Clients with primary aldosteronism exhibit a profound
decline in the serum levels of potassium (C) (hypokalemia)—
hypertension is the most prominent and universal sign. Sodium (A) is
normal or elevated, depending on the amount of water reabsorbed with
the sodium. Antidiuretic hormone (B) is decreased with diabetes
insipidus. Glucose (D) is not affected by primary aldosteronism.
Question: 2
The most predictive risk factors for development of breast cancer are
over 40 years of age and a positive family history. Which client has the
greatest risk for developing breast cancer?
A. A 35-year-old multipara who never breastfed
B. A 50-year-old whose mother had unilateral breast cancer
,C. A 55-year-old whose mother-in-law had bilateral breast cancer
D. A 20-year-old whose menarche occurred at age 9 - VERIFIED
ANSWER - B. A 50-year-old whose mother had unilateral breast
cancer
Rationale: The most predictive risk factors for development of breast
cancer are over 40 years of age and a positive family history
(occurrence in the immediate family, i.e., mother or sister). Other risk
factors include nulliparity, no history of breastfeeding, early menarche
and late menopause. Although all of the women described have one of
the risk factors for developing breast cancer, option B has the greater
risk over options A, C, and D.
Question: 3
The nurse notes that a client who is scheduled for surgery the next
morning has an elevated blood urea nitrogen (BUN) level. Which
condition is most likely to have contributed to this finding?
A. Myocardial infarction 2 months ago
B. Anorexia and vomiting for the past 2 days
C. Recently diagnosed type 2 diabetes mellitus
D. Skeletal traction for a right hip fracture - VERIFIED ANSWER - B.
Anorexia and vomiting for the past 2 days
Rationale: The blood urea nitrogen (BUN) level indicates the
effectiveness of the kidneys in filtering waste from the blood.
Dehydration, which could be caused by vomiting, would cause an
increased BUN level. Option A would affect serum enzyme levels, not
the BUN level. Option C would primarily affect the blood glucose level;
,renal failure that could increase the BUN level would be unlikely in a
client newly diagnosed with type 2 diabetes. Effects of option D might
affect the complete blood count (CBC) but would not directly increase
the BUN level.
Question: 4
The nurse is planning care for a client with diabetes mellitus who has
gangrene of the toes to the midfoot. Which goal should be included in
this client's plan of care?
A. Restore skin integrity
B. Prevent infection
C. Promote healing
D. Improve nutrition - VERIFIED ANSWER - B. Prevent infection
Rationale: The prevention of infection is a priority goal for this client.
Gangrene is the result of necrosis (tissue death). If infection develops,
there is insufficient circulation to fight the infection and the infection
can result in osteomyelitis or sepsis. Because tissue death has already
occurred, options A and C are unattainable goals. Option D is important
but of less priority than option B.
Question: 5
The nurse assesses a client who has been prescribed furosemide
(Lasix) for cardiac disease. Which electrocardiographic change would
be a concern for a client taking a diuretic?
, A. Tall, spiked T waves
B. A prolonged QT interval
C. A widening QRS complex
D. Presence of a U wave - VERIFIED ANSWER - D. Presence of a U
wave
Rationale: A U wave is a positive deflection following the T wave and is
often present with hypokalemia (low potassium level). Options A, B, and
C are all signs of hyperkalemia (high potassium level).
Question: 6
A client in the emergency department is bleeding profusely from a
gunshot wound to the abdomen. What action should the nurse
immediately take to promote maintenance of the client's blood
pressure above a systolic pressure of 90 mm Hg?
A. Place the client in a 45-degree Trendelenburg position to promote
cerebral blood flow
B. Turn the client prone to place pressure on the abdominal wound to
help staunch the bleeding
C. Maintain the client in a supine position to reduce diaphragmatic
pressure and visualize the wound
D. Put the client on the right side to apply pressure to the liver and
spleen to stop hemorrhaging - VERIFIED ANSWER - C. Maintain the
client in a supine position to reduce diaphragmatic pressure and
visualize the wound
Rationale: Placing the client in a supine position reduces
diaphragmatic pressure, thereby enhancing oxygenation, and allows for
CORRECT DETAILED VERIFIED ANSWERS (GRADED A+)
Question: 1
In assessing a client diagnosed with primary aldosteronism, the nurse
expects the laboratory test results to indicate a decreased serum level
of which substance?
A. Sodium
B. Antidiuretic hormone
C. Potassium
D. Glucose - VERIFIED ANSWER - C. Potassium
Rationale: Clients with primary aldosteronism exhibit a profound
decline in the serum levels of potassium (C) (hypokalemia)—
hypertension is the most prominent and universal sign. Sodium (A) is
normal or elevated, depending on the amount of water reabsorbed with
the sodium. Antidiuretic hormone (B) is decreased with diabetes
insipidus. Glucose (D) is not affected by primary aldosteronism.
Question: 2
The most predictive risk factors for development of breast cancer are
over 40 years of age and a positive family history. Which client has the
greatest risk for developing breast cancer?
A. A 35-year-old multipara who never breastfed
B. A 50-year-old whose mother had unilateral breast cancer
,C. A 55-year-old whose mother-in-law had bilateral breast cancer
D. A 20-year-old whose menarche occurred at age 9 - VERIFIED
ANSWER - B. A 50-year-old whose mother had unilateral breast
cancer
Rationale: The most predictive risk factors for development of breast
cancer are over 40 years of age and a positive family history
(occurrence in the immediate family, i.e., mother or sister). Other risk
factors include nulliparity, no history of breastfeeding, early menarche
and late menopause. Although all of the women described have one of
the risk factors for developing breast cancer, option B has the greater
risk over options A, C, and D.
Question: 3
The nurse notes that a client who is scheduled for surgery the next
morning has an elevated blood urea nitrogen (BUN) level. Which
condition is most likely to have contributed to this finding?
A. Myocardial infarction 2 months ago
B. Anorexia and vomiting for the past 2 days
C. Recently diagnosed type 2 diabetes mellitus
D. Skeletal traction for a right hip fracture - VERIFIED ANSWER - B.
Anorexia and vomiting for the past 2 days
Rationale: The blood urea nitrogen (BUN) level indicates the
effectiveness of the kidneys in filtering waste from the blood.
Dehydration, which could be caused by vomiting, would cause an
increased BUN level. Option A would affect serum enzyme levels, not
the BUN level. Option C would primarily affect the blood glucose level;
,renal failure that could increase the BUN level would be unlikely in a
client newly diagnosed with type 2 diabetes. Effects of option D might
affect the complete blood count (CBC) but would not directly increase
the BUN level.
Question: 4
The nurse is planning care for a client with diabetes mellitus who has
gangrene of the toes to the midfoot. Which goal should be included in
this client's plan of care?
A. Restore skin integrity
B. Prevent infection
C. Promote healing
D. Improve nutrition - VERIFIED ANSWER - B. Prevent infection
Rationale: The prevention of infection is a priority goal for this client.
Gangrene is the result of necrosis (tissue death). If infection develops,
there is insufficient circulation to fight the infection and the infection
can result in osteomyelitis or sepsis. Because tissue death has already
occurred, options A and C are unattainable goals. Option D is important
but of less priority than option B.
Question: 5
The nurse assesses a client who has been prescribed furosemide
(Lasix) for cardiac disease. Which electrocardiographic change would
be a concern for a client taking a diuretic?
, A. Tall, spiked T waves
B. A prolonged QT interval
C. A widening QRS complex
D. Presence of a U wave - VERIFIED ANSWER - D. Presence of a U
wave
Rationale: A U wave is a positive deflection following the T wave and is
often present with hypokalemia (low potassium level). Options A, B, and
C are all signs of hyperkalemia (high potassium level).
Question: 6
A client in the emergency department is bleeding profusely from a
gunshot wound to the abdomen. What action should the nurse
immediately take to promote maintenance of the client's blood
pressure above a systolic pressure of 90 mm Hg?
A. Place the client in a 45-degree Trendelenburg position to promote
cerebral blood flow
B. Turn the client prone to place pressure on the abdominal wound to
help staunch the bleeding
C. Maintain the client in a supine position to reduce diaphragmatic
pressure and visualize the wound
D. Put the client on the right side to apply pressure to the liver and
spleen to stop hemorrhaging - VERIFIED ANSWER - C. Maintain the
client in a supine position to reduce diaphragmatic pressure and
visualize the wound
Rationale: Placing the client in a supine position reduces
diaphragmatic pressure, thereby enhancing oxygenation, and allows for
