Evolve Med Surg HESI Exam 2026 Practice Questions & Verified Answers
Medical-Surgical Nursing Review.
.
Cardiovascular Disorders (Questions 1–15)
1. Based on the analysis of a 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
Answer: C
Rationale: The client experiencing atrial fibrillation should be prepared for
anticoagulation therapy, which should be prescribed before rhythm control
therapies to prevent cardioembolic events resulting from blood pooling in the
fibrillating atria .
2. Which post-menopausal client's complaint should the nurse refer to the HCP?
A) Mild hot flashes
,B) Vaginal dryness
C) Episodes of vaginal bleeding
D) Difficulty sleeping
Answer: C
Rationale: Any episodes of vaginal bleeding in a post-menopausal client should be
referred to the healthcare provider immediately, as this may indicate endometrial
pathology. The other options are typical menopausal symptoms .
3. A client on telemetry has a pattern of uncontrolled atrial fibrillation with a
rapid ventricular response. Based on this finding, the nurse anticipates assisting
the physician with which treatment?
A) Defibrillation
B) Pacemaker insertion
C) Synchronized cardioversion
D) Cardiac catheterization
Answer: C
Rationale: With uncontrolled atrial fibrillation, the treatment of choice is
synchronized cardioversion to convert the cardiac rhythm back to normal sinus
rhythm .
,4. The nurse is teaching a female client about the best time to plan sexual
intercourse to conceive. Which information should the nurse provide?
A) During menstruation
B) One week before menstruation
C) Two weeks before menstruation
D) Immediately after menstruation
Answer: C
Rationale: Ovulation typically occurs approximately 14 days before the next
menstrual period. The most fertile time is about two weeks before menstruation .
5. A client with heart failure is admitted with a serum potassium level of 2.9
mEq/L (2.9 mmol/L). Which action is most important for the nurse to implement?
A) Administer oral potassium supplements
B) Initiate continuous cardiac monitoring
C) Increase IV fluid rate
D) Notify the healthcare provider
Answer: B
, Rationale: Hypokalemia (normal range 3.5-5.0 mEq/L) places the client at high risk
for cardiac dysrhythmias. Continuous cardiac monitoring is the priority action to
detect potentially life-threatening rhythm disturbances. While notification and
replacement are important, monitoring for complications comes first .
6. The nurse is caring for a client who is one day post-acute myocardial infarction.
The client is receiving oxygen at 2 L/min via nasal cannula and has a peripheral
saline lock. The nurse notes that the client is having eight premature ventricular
contractions (PVCs) per minute. Which action should the nurse take first?
A) Increase the client's oxygen flow rate
B) Administer lidocaine IV push
C) Notify the healthcare provider immediately
D) Document the finding and continue monitoring
Answer: A
Rationale: The priority action is to increase oxygen to treat potential hypoxemia,
which can cause PVCs. Optimizing oxygenation may reduce ventricular irritability
without additional medications .
7. A client is receiving Cilostazol (Pletal) for peripheral arterial disease causing
intermittent claudication. The nurse determines this medication is effective when
the client reports which of the following?
Medical-Surgical Nursing Review.
.
Cardiovascular Disorders (Questions 1–15)
1. Based on the analysis of a 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
Answer: C
Rationale: The client experiencing atrial fibrillation should be prepared for
anticoagulation therapy, which should be prescribed before rhythm control
therapies to prevent cardioembolic events resulting from blood pooling in the
fibrillating atria .
2. Which post-menopausal client's complaint should the nurse refer to the HCP?
A) Mild hot flashes
,B) Vaginal dryness
C) Episodes of vaginal bleeding
D) Difficulty sleeping
Answer: C
Rationale: Any episodes of vaginal bleeding in a post-menopausal client should be
referred to the healthcare provider immediately, as this may indicate endometrial
pathology. The other options are typical menopausal symptoms .
3. A client on telemetry has a pattern of uncontrolled atrial fibrillation with a
rapid ventricular response. Based on this finding, the nurse anticipates assisting
the physician with which treatment?
A) Defibrillation
B) Pacemaker insertion
C) Synchronized cardioversion
D) Cardiac catheterization
Answer: C
Rationale: With uncontrolled atrial fibrillation, the treatment of choice is
synchronized cardioversion to convert the cardiac rhythm back to normal sinus
rhythm .
,4. The nurse is teaching a female client about the best time to plan sexual
intercourse to conceive. Which information should the nurse provide?
A) During menstruation
B) One week before menstruation
C) Two weeks before menstruation
D) Immediately after menstruation
Answer: C
Rationale: Ovulation typically occurs approximately 14 days before the next
menstrual period. The most fertile time is about two weeks before menstruation .
5. A client with heart failure is admitted with a serum potassium level of 2.9
mEq/L (2.9 mmol/L). Which action is most important for the nurse to implement?
A) Administer oral potassium supplements
B) Initiate continuous cardiac monitoring
C) Increase IV fluid rate
D) Notify the healthcare provider
Answer: B
, Rationale: Hypokalemia (normal range 3.5-5.0 mEq/L) places the client at high risk
for cardiac dysrhythmias. Continuous cardiac monitoring is the priority action to
detect potentially life-threatening rhythm disturbances. While notification and
replacement are important, monitoring for complications comes first .
6. The nurse is caring for a client who is one day post-acute myocardial infarction.
The client is receiving oxygen at 2 L/min via nasal cannula and has a peripheral
saline lock. The nurse notes that the client is having eight premature ventricular
contractions (PVCs) per minute. Which action should the nurse take first?
A) Increase the client's oxygen flow rate
B) Administer lidocaine IV push
C) Notify the healthcare provider immediately
D) Document the finding and continue monitoring
Answer: A
Rationale: The priority action is to increase oxygen to treat potential hypoxemia,
which can cause PVCs. Optimizing oxygenation may reduce ventricular irritability
without additional medications .
7. A client is receiving Cilostazol (Pletal) for peripheral arterial disease causing
intermittent claudication. The nurse determines this medication is effective when
the client reports which of the following?
