EVOLVE ELSEVIER HESI MED SURG
LATEST 2025/ 2026 TEST BANK|
COMPLETE 350 REAL EXAM
QUESTIONS AND CORRECT ANSWERS
WITH WELL-ELABORATED
RATIONALES/ GRADED A+| EVOLVE
HESI MEDICAL SURGICAL LATEST
EXAM (BRAND NEW!!)
1. A client with heart failure is prescribed furosemide. Which
assessment finding requires the nurse to take immediate
action?
A. Blood pressure of 110/70 mmHg
B. Potassium level of 3.2 mEq/L
C. Urine output of 40 mL/hr
D. Weight loss of 1 kg in 24 hours
Correct Answer: B. Potassium level of 3.2 mEq/L
Rationale: Furosemide is a loop diuretic that causes
excretion of potassium. A serum potassium of 3.2 mEq/L is
below the normal range (3.5–5.0 mEq/L), indicating
hypokalemia. This is a critical finding because hypokalemia
, can lead to life-threatening cardiac dysrhythmias (e.g.,
ventricular tachycardia, torsades de pointes), especially in a
client with pre-existing heart failure. The nurse should notify
the healthcare provider immediately and expect potassium
replacement.
Distractor Analysis:
o A: A BP of 110/70 mmHg is within normal limits and an
expected response to diuretic therapy.
o C: Urine output of 40 mL/hr is adequate (normal >30 mL/hr).
o D: Weight loss of 1 kg (2.2 lbs) in 24 hours reflects expected
fluid loss and is a therapeutic goal.
2. A nurse is caring for a client 2 hours post-operative
following a total knee arthroplasty. Which finding should be
reported to the surgeon immediately?
A. Pain rating of 6/10 at the surgical site
B. Capillary refill of 3 seconds in the operative leg
C. Small amount of serosanguinous drainage on the dressing
D. Cool, pale foot with an absent pedal pulse on the operative
side
Correct Answer: D. Cool, pale foot with an absent pedal pulse
on the operative side
Rationale: This classic sign of compartment syndrome or a
postoperative arterial thrombus indicates a lack of perfusion
to the extremity. Compartment syndrome can develop after
orthopedic surgery due to swelling within a confined fascial
, space, leading to ischemia and nerve damage. Absent pulse
is a late sign. Without immediate intervention (such as
fasciotomy or embolectomy), the client risks permanent
tissue necrosis and potential limb loss.
Distractor Analysis:
o A: Moderate to severe pain is expected after major
orthopedic surgery and should be managed with prescribed
analgesics.
o B: Capillary refill of 3 seconds is at the upper limit of normal
but not an emergent finding on its own.
o C: A small amount of serosanguinous (pink-tinged) drainage
is expected in the immediate post-op period.
3. A client with chronic kidney disease (CKD) has a potassium
level of 6.8 mEq/L. Which ECG change should the nurse
anticipate?
A. Prolonged PR interval
B. Peaked T waves
C. Prominent U waves
D. ST-segment depression
Correct Answer: B. Peaked T waves
Rationale: Hyperkalemia (elevated serum potassium >5.0
mEq/L) has a characteristic and progressive effect on the ECG.
The earliest and most classic sign is the development of tall,
"peaked" or "tented" T waves, especially in precordial leads.
As potassium levels rise further (>6.5–7.0 mEq/L), the QRS
, complex widens, the PR interval prolongs, the P wave flattens
or disappears, and eventually a sine wave pattern appears,
leading to ventricular fibrillation or asystole.
Distractor Analysis:
o A: A prolonged PR interval can occur in later stages of
hyperkalemia, but peaked T waves are the earliest and most
specific sign.
o C: Prominent U waves are characteristically seen
in hypokalemia (low potassium).
o D: ST-segment depression is commonly associated with
myocardial ischemia or hypokalemia, not hyperkalemia.
4. A client who had a myocardial infarction (MI) is now on a
telemetry monitor. The nurse notes new-onset atrial
fibrillation. What is the priority nursing action?
A. Administer amiodarone as a PRN order.
B. Prepare for immediate defibrillation.
C. Notify the healthcare provider.
D. Check the client's blood pressure and level of consciousness.
Correct Answer: D. Check the client's blood pressure and level
of consciousness
Rationale: New-onset atrial fibrillation (AF) with a rapid
ventricular response can cause a significant drop in cardiac
output due to loss of atrial kick and irregular ventricular
filling. The nurse's priority is to perform a rapid assessment to
determine if the client is stable or unstable. The client's blood
LATEST 2025/ 2026 TEST BANK|
COMPLETE 350 REAL EXAM
QUESTIONS AND CORRECT ANSWERS
WITH WELL-ELABORATED
RATIONALES/ GRADED A+| EVOLVE
HESI MEDICAL SURGICAL LATEST
EXAM (BRAND NEW!!)
1. A client with heart failure is prescribed furosemide. Which
assessment finding requires the nurse to take immediate
action?
A. Blood pressure of 110/70 mmHg
B. Potassium level of 3.2 mEq/L
C. Urine output of 40 mL/hr
D. Weight loss of 1 kg in 24 hours
Correct Answer: B. Potassium level of 3.2 mEq/L
Rationale: Furosemide is a loop diuretic that causes
excretion of potassium. A serum potassium of 3.2 mEq/L is
below the normal range (3.5–5.0 mEq/L), indicating
hypokalemia. This is a critical finding because hypokalemia
, can lead to life-threatening cardiac dysrhythmias (e.g.,
ventricular tachycardia, torsades de pointes), especially in a
client with pre-existing heart failure. The nurse should notify
the healthcare provider immediately and expect potassium
replacement.
Distractor Analysis:
o A: A BP of 110/70 mmHg is within normal limits and an
expected response to diuretic therapy.
o C: Urine output of 40 mL/hr is adequate (normal >30 mL/hr).
o D: Weight loss of 1 kg (2.2 lbs) in 24 hours reflects expected
fluid loss and is a therapeutic goal.
2. A nurse is caring for a client 2 hours post-operative
following a total knee arthroplasty. Which finding should be
reported to the surgeon immediately?
A. Pain rating of 6/10 at the surgical site
B. Capillary refill of 3 seconds in the operative leg
C. Small amount of serosanguinous drainage on the dressing
D. Cool, pale foot with an absent pedal pulse on the operative
side
Correct Answer: D. Cool, pale foot with an absent pedal pulse
on the operative side
Rationale: This classic sign of compartment syndrome or a
postoperative arterial thrombus indicates a lack of perfusion
to the extremity. Compartment syndrome can develop after
orthopedic surgery due to swelling within a confined fascial
, space, leading to ischemia and nerve damage. Absent pulse
is a late sign. Without immediate intervention (such as
fasciotomy or embolectomy), the client risks permanent
tissue necrosis and potential limb loss.
Distractor Analysis:
o A: Moderate to severe pain is expected after major
orthopedic surgery and should be managed with prescribed
analgesics.
o B: Capillary refill of 3 seconds is at the upper limit of normal
but not an emergent finding on its own.
o C: A small amount of serosanguinous (pink-tinged) drainage
is expected in the immediate post-op period.
3. A client with chronic kidney disease (CKD) has a potassium
level of 6.8 mEq/L. Which ECG change should the nurse
anticipate?
A. Prolonged PR interval
B. Peaked T waves
C. Prominent U waves
D. ST-segment depression
Correct Answer: B. Peaked T waves
Rationale: Hyperkalemia (elevated serum potassium >5.0
mEq/L) has a characteristic and progressive effect on the ECG.
The earliest and most classic sign is the development of tall,
"peaked" or "tented" T waves, especially in precordial leads.
As potassium levels rise further (>6.5–7.0 mEq/L), the QRS
, complex widens, the PR interval prolongs, the P wave flattens
or disappears, and eventually a sine wave pattern appears,
leading to ventricular fibrillation or asystole.
Distractor Analysis:
o A: A prolonged PR interval can occur in later stages of
hyperkalemia, but peaked T waves are the earliest and most
specific sign.
o C: Prominent U waves are characteristically seen
in hypokalemia (low potassium).
o D: ST-segment depression is commonly associated with
myocardial ischemia or hypokalemia, not hyperkalemia.
4. A client who had a myocardial infarction (MI) is now on a
telemetry monitor. The nurse notes new-onset atrial
fibrillation. What is the priority nursing action?
A. Administer amiodarone as a PRN order.
B. Prepare for immediate defibrillation.
C. Notify the healthcare provider.
D. Check the client's blood pressure and level of consciousness.
Correct Answer: D. Check the client's blood pressure and level
of consciousness
Rationale: New-onset atrial fibrillation (AF) with a rapid
ventricular response can cause a significant drop in cardiac
output due to loss of atrial kick and irregular ventricular
filling. The nurse's priority is to perform a rapid assessment to
determine if the client is stable or unstable. The client's blood
