EVOLVE ELSEVIER HESI MED SURG EXAM LATEST (2026) COMPLETE QUESTIONS
WITH 100% VERIFIED SOLUTIONS||EVOLVE ELSEVIER HESI MED SURG.
Cardiovascular Disorders
1. A 62-year-old male with a history of myocardial infarction presents with chest
pain and dyspnea. BP is 150/90 mm Hg, HR 95 bpm, and SpO₂ is 93%. What is the
nurse’s priority action?
A) Administer nitroglycerin sublingually.
B) Obtain a 12-lead ECG.
C) Administer oxygen therapy.
D) Morphine sulfate IV push.
Answer: C) Administer oxygen therapy
Rationale: Airway, Breathing, and Circulation (ABC) is the priority framework.
Oxygen should be administered first to increase myocardial oxygen supply and
decrease ischemia. While all options are important interventions for an MI,
ensuring adequate oxygenation is the immediate priority.
2. A client with heart failure is prescribed furosemide (Lasix) 40 mg IV. Which
laboratory value should the nurse monitor most closely?
A) Sodium level
,B) Potassium level
C) Calcium level
D) Magnesium level
Answer: B) Potassium level
Rationale: Furosemide is a loop diuretic that causes significant potassium loss in
the urine (hypokalemia). Hypokalemia can lead to life-threatening cardiac
dysrhythmias, especially in clients taking digoxin. While other electrolytes can be
affected, potassium is the priority.
3. A client is admitted with a blood pressure of 220/130 mm Hg and reports a
severe headache, blurred vision, and confusion. The nurse recognizes this as:
A) Essential hypertension
B) Hypertensive crisis (hypertensive emergency)
C) Orthostatic hypotension
D) Secondary hypertension
Answer: B) Hypertensive crisis (hypertensive emergency)
*Rationale: This scenario describes a hypertensive emergency—severely elevated
BP (>180/120) with evidence of target organ damage (CNS symptoms: headache,
,confusion, blurred vision). This requires immediate IV antihypertensive therapy to
prevent stroke or MI.*
4. A client with atrial fibrillation is being discharged on warfarin (Coumadin).
Which statement indicates the client needs additional teaching?
A) "I will have my blood tested regularly."
B) "I should use an electric razor when shaving."
C) "I can take ibuprofen for my headaches."
D) "I will wear a medical alert bracelet."
Answer: C) "I can take ibuprofen for my headaches."
Rationale: NSAIDs like ibuprofen increase the risk of bleeding and can interact
with warfarin, increasing INR and bleeding risk. Clients should use acetaminophen
for pain. The other statements demonstrate correct understanding of warfarin
therapy.
5. A client is receiving a continuous IV heparin infusion. The aPTT result is 95
seconds (normal 25–35). The nurse should:
A) Increase the heparin infusion rate.
B) Decrease the heparin infusion rate.
C) Administer protamine sulfate.
, D) Continue the infusion at the same rate.
Answer: B) Decrease the heparin infusion rate
Rationale: The therapeutic aPTT for heparin is 1.5–2.5 times the normal control
(approximately 60–80 seconds). An aPTT of 95 seconds is supratherapeutic and
increases bleeding risk. The infusion rate should be decreased, and the HCP
notified.
6. A nurse is assessing a client with peripheral arterial disease (PAD). Which
finding would the nurse expect?
A) Edema in the affected extremity
B) Brown discoloration around the ankles
C) Diminished or absent peripheral pulses
D) Warm skin temperature in the legs
Answer: C) Diminished or absent peripheral pulses
Rationale: PAD causes reduced blood flow to extremities, resulting in diminished
or absent pulses, cool/cold skin, pallor, and intermittent claudication. Edema and
brown discoloration (hemosiderin staining) are associated with venous
insufficiency.
WITH 100% VERIFIED SOLUTIONS||EVOLVE ELSEVIER HESI MED SURG.
Cardiovascular Disorders
1. A 62-year-old male with a history of myocardial infarction presents with chest
pain and dyspnea. BP is 150/90 mm Hg, HR 95 bpm, and SpO₂ is 93%. What is the
nurse’s priority action?
A) Administer nitroglycerin sublingually.
B) Obtain a 12-lead ECG.
C) Administer oxygen therapy.
D) Morphine sulfate IV push.
Answer: C) Administer oxygen therapy
Rationale: Airway, Breathing, and Circulation (ABC) is the priority framework.
Oxygen should be administered first to increase myocardial oxygen supply and
decrease ischemia. While all options are important interventions for an MI,
ensuring adequate oxygenation is the immediate priority.
2. A client with heart failure is prescribed furosemide (Lasix) 40 mg IV. Which
laboratory value should the nurse monitor most closely?
A) Sodium level
,B) Potassium level
C) Calcium level
D) Magnesium level
Answer: B) Potassium level
Rationale: Furosemide is a loop diuretic that causes significant potassium loss in
the urine (hypokalemia). Hypokalemia can lead to life-threatening cardiac
dysrhythmias, especially in clients taking digoxin. While other electrolytes can be
affected, potassium is the priority.
3. A client is admitted with a blood pressure of 220/130 mm Hg and reports a
severe headache, blurred vision, and confusion. The nurse recognizes this as:
A) Essential hypertension
B) Hypertensive crisis (hypertensive emergency)
C) Orthostatic hypotension
D) Secondary hypertension
Answer: B) Hypertensive crisis (hypertensive emergency)
*Rationale: This scenario describes a hypertensive emergency—severely elevated
BP (>180/120) with evidence of target organ damage (CNS symptoms: headache,
,confusion, blurred vision). This requires immediate IV antihypertensive therapy to
prevent stroke or MI.*
4. A client with atrial fibrillation is being discharged on warfarin (Coumadin).
Which statement indicates the client needs additional teaching?
A) "I will have my blood tested regularly."
B) "I should use an electric razor when shaving."
C) "I can take ibuprofen for my headaches."
D) "I will wear a medical alert bracelet."
Answer: C) "I can take ibuprofen for my headaches."
Rationale: NSAIDs like ibuprofen increase the risk of bleeding and can interact
with warfarin, increasing INR and bleeding risk. Clients should use acetaminophen
for pain. The other statements demonstrate correct understanding of warfarin
therapy.
5. A client is receiving a continuous IV heparin infusion. The aPTT result is 95
seconds (normal 25–35). The nurse should:
A) Increase the heparin infusion rate.
B) Decrease the heparin infusion rate.
C) Administer protamine sulfate.
, D) Continue the infusion at the same rate.
Answer: B) Decrease the heparin infusion rate
Rationale: The therapeutic aPTT for heparin is 1.5–2.5 times the normal control
(approximately 60–80 seconds). An aPTT of 95 seconds is supratherapeutic and
increases bleeding risk. The infusion rate should be decreased, and the HCP
notified.
6. A nurse is assessing a client with peripheral arterial disease (PAD). Which
finding would the nurse expect?
A) Edema in the affected extremity
B) Brown discoloration around the ankles
C) Diminished or absent peripheral pulses
D) Warm skin temperature in the legs
Answer: C) Diminished or absent peripheral pulses
Rationale: PAD causes reduced blood flow to extremities, resulting in diminished
or absent pulses, cool/cold skin, pallor, and intermittent claudication. Edema and
brown discoloration (hemosiderin staining) are associated with venous
insufficiency.
