Evolve Elsevier HESI Med Surg Exam
Questions and Answers (2026) | Latest
Test Bank with Verified Solutions |
Grade A+
• The nurse should be correct in withholding a dose of digoxin in a client with
congestive heart failure without specific instruction from the healthcare provider if
the client's
A) serum digoxin level is 1.5.
B) blood pressure is 104/68.
C) serum potassium level is 3.
D) apical pulse is 68/min. -✓✓C) serum potassium level is 3.
Hypokalemia (C) can precipitate digitalis toxicity in persons receiving digoxin
which will increase the chance of dangerous dysrhythmias (normal potassium level
is 3.5 to 5.5 mEq/L). The therapeutic range for digoxin is 0.8 to 2 ng/ml (toxic
levels= >2 ng/ml); (A) is within this range. (B) would not warrant the nurse
withholding the digoxin. The nurse should withhold the digoxin if the apical pulse
is less than 60/min (D).
• In assessing a client diagnosed with primary hyperaldosteronism, 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. -✓✓C) Potassium.
Clients with primary aldosteronism exhibit a profound decline in the serum levels
of potassium (C) (hypokalemia)--hypertension is the most prominent and universal
sign. (A) is normal or elevated, depending on the amount of water reabsorbed with
the sodium. (B) is decreased with diabetes insipidus. (D) is not affected by primary
aldosteronism.
• Based on the analysis of the client's atrial fibrillation, the nurse should prepare
the client for which treatment protocol?
A) Diuretic therapy.
,B) Pacemaker implantation.
C) Anticoagulation therapy.
D) Cardiac catheterization. -✓✓C) Anticoagulation therapy.
The client is experiencing atrial fibrillation, and the nurse should prepare the client
for anticoagulation therapy (C) which should be prescribed before rhythm control
therapies to prevent cardioembolic events which result from blood pooling in the
fibrillating atria. (A, B, and D) are not indicated.
• Which information about mammograms is most important to provide a post-
menopausal female client?
A) Breast self-examinations are not needed if annual mammograms are obtained.
B) Radiation exposure is minimized by shielding the abdomen with a lead-lined
apron.
C) Yearly mammograms should be done regardless of previous normal x-rays.
D) Women at high risk should have annual routine and ultrasound mammograms. -
✓✓C) Yearly mammograms should be done regardless of previous normal x-rays.
The current breast screening recommendation is a yearly mammogram after age 40
(C). Breast self-exam (A) continues to be a priority recommendation for all women
because a small lump (or tumor) is often first felt by a woman before a
mammogram is obtained. The radiation exposure from a mammogram is low, so
(B) is not normally provided. The frequency of using routine and ultrasound
mammograms (D) in women with high-risk variables, such as a history of breast
cancer, the presence of BRC1 and BRC2 genes, or 2 first-degree relatives with
breast cancer, should be recommended and followed closely by the healthcare
provider.
• In assessing cancer risk, the nurse identifies which woman as being at greatest
risk of 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. -✓✓B) A 50-year-old whose
mother had unilateral breast cancer.
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, (B) has the greater risk over
(A, C, and D).
• Which reaction should the nurse identify in a client who is responding to
stimulation of the sympathetic nervous system?
A) Pupil constriction.
B) Increased heart rate.
C) Bronchial constriction.
D) Decreased blood pressure. -✓✓B) Increased heart rate.
Any stressor that is perceived as threatening to homeostasis acts to stimulate the
sympathetic nervous system and manifests as a flight-or-fight response, which
includes an increase in heart rate (B). (A, C, and D) are responses of the
parasympathetic nervous system.
• A client receiving cholestyramine (Questran) for hyperlipidemia should be
evaluated for what vitamin deficiency?
A) K.
B) B12.
C) B6.
D) C. -✓✓A) K.
Clients should be monitored for an increased prothrombin time and prolonged
bleeding times which would alert the nurse to a vitamin K deficiency (A). These
drugs reduce absorption of the fat soluble (lipid) vitamins A, D, E, and K. (B, C,
and D) are not fat soluble vitamins.
• A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry
unit. What initial medication should the nurse anticipate administering to the
client?
A) Xylocaine (Lidocaine).
B) Procainamide (Pronestyl).
C) Phenytoin (Dilantin).
D) Digoxin (Lanoxin). -✓✓D) Digoxin (Lanoxin).
Digoxin (Lanoxin) (D) is administered for uncontrolled, symptomatic atrial
fibrillation resulting in a decreased cardiac output. Digoxin slows the rate of
conduction by prolonging the refractory period of the AV node, thus slowing the
Questions and Answers (2026) | Latest
Test Bank with Verified Solutions |
Grade A+
• The nurse should be correct in withholding a dose of digoxin in a client with
congestive heart failure without specific instruction from the healthcare provider if
the client's
A) serum digoxin level is 1.5.
B) blood pressure is 104/68.
C) serum potassium level is 3.
D) apical pulse is 68/min. -✓✓C) serum potassium level is 3.
Hypokalemia (C) can precipitate digitalis toxicity in persons receiving digoxin
which will increase the chance of dangerous dysrhythmias (normal potassium level
is 3.5 to 5.5 mEq/L). The therapeutic range for digoxin is 0.8 to 2 ng/ml (toxic
levels= >2 ng/ml); (A) is within this range. (B) would not warrant the nurse
withholding the digoxin. The nurse should withhold the digoxin if the apical pulse
is less than 60/min (D).
• In assessing a client diagnosed with primary hyperaldosteronism, 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. -✓✓C) Potassium.
Clients with primary aldosteronism exhibit a profound decline in the serum levels
of potassium (C) (hypokalemia)--hypertension is the most prominent and universal
sign. (A) is normal or elevated, depending on the amount of water reabsorbed with
the sodium. (B) is decreased with diabetes insipidus. (D) is not affected by primary
aldosteronism.
• Based on the analysis of the client's atrial fibrillation, the nurse should prepare
the client for which treatment protocol?
A) Diuretic therapy.
,B) Pacemaker implantation.
C) Anticoagulation therapy.
D) Cardiac catheterization. -✓✓C) Anticoagulation therapy.
The client is experiencing atrial fibrillation, and the nurse should prepare the client
for anticoagulation therapy (C) which should be prescribed before rhythm control
therapies to prevent cardioembolic events which result from blood pooling in the
fibrillating atria. (A, B, and D) are not indicated.
• Which information about mammograms is most important to provide a post-
menopausal female client?
A) Breast self-examinations are not needed if annual mammograms are obtained.
B) Radiation exposure is minimized by shielding the abdomen with a lead-lined
apron.
C) Yearly mammograms should be done regardless of previous normal x-rays.
D) Women at high risk should have annual routine and ultrasound mammograms. -
✓✓C) Yearly mammograms should be done regardless of previous normal x-rays.
The current breast screening recommendation is a yearly mammogram after age 40
(C). Breast self-exam (A) continues to be a priority recommendation for all women
because a small lump (or tumor) is often first felt by a woman before a
mammogram is obtained. The radiation exposure from a mammogram is low, so
(B) is not normally provided. The frequency of using routine and ultrasound
mammograms (D) in women with high-risk variables, such as a history of breast
cancer, the presence of BRC1 and BRC2 genes, or 2 first-degree relatives with
breast cancer, should be recommended and followed closely by the healthcare
provider.
• In assessing cancer risk, the nurse identifies which woman as being at greatest
risk of 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. -✓✓B) A 50-year-old whose
mother had unilateral breast cancer.
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, (B) has the greater risk over
(A, C, and D).
• Which reaction should the nurse identify in a client who is responding to
stimulation of the sympathetic nervous system?
A) Pupil constriction.
B) Increased heart rate.
C) Bronchial constriction.
D) Decreased blood pressure. -✓✓B) Increased heart rate.
Any stressor that is perceived as threatening to homeostasis acts to stimulate the
sympathetic nervous system and manifests as a flight-or-fight response, which
includes an increase in heart rate (B). (A, C, and D) are responses of the
parasympathetic nervous system.
• A client receiving cholestyramine (Questran) for hyperlipidemia should be
evaluated for what vitamin deficiency?
A) K.
B) B12.
C) B6.
D) C. -✓✓A) K.
Clients should be monitored for an increased prothrombin time and prolonged
bleeding times which would alert the nurse to a vitamin K deficiency (A). These
drugs reduce absorption of the fat soluble (lipid) vitamins A, D, E, and K. (B, C,
and D) are not fat soluble vitamins.
• A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry
unit. What initial medication should the nurse anticipate administering to the
client?
A) Xylocaine (Lidocaine).
B) Procainamide (Pronestyl).
C) Phenytoin (Dilantin).
D) Digoxin (Lanoxin). -✓✓D) Digoxin (Lanoxin).
Digoxin (Lanoxin) (D) is administered for uncontrolled, symptomatic atrial
fibrillation resulting in a decreased cardiac output. Digoxin slows the rate of
conduction by prolonging the refractory period of the AV node, thus slowing the
