EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM WITH 50 REAL EXAM
QUESTIONS AND CORRECT ANSWERS WITH WELL-ELABORATED RATIONALES/
EVOLVE HESI MEDICAL SURGICAL LATEST EXAM 2025 (BRAND NEW!!)
1. Question:
A 68-year-old client is scheduled for an abdominal surgery. Which preoperative
action is most important to minimize the risk of a postoperative complication?
A) Encourage deep breathing exercises. B) Administer a preoperative sedative. C)
Ask the client to refrain from eating for 12 hours before surgery. D) Apply
antiembolic stockings.
Answer: A) Encourage deep breathing exercises.
Rationale: Deep breathing exercises help reduce the risk of respiratory
complications such as pneumonia and atelectasis after surgery. It is essential to
improve lung ventilation and oxygenation, especially in elderly patients.
2. Question:
The nurse is caring for a client with a diagnosis of acute pancreatitis. Which of the
following findings is most indicative of a complication?
A) Increased abdominal pain after eating. B) Jaundice with pale stools. C)
Hypotension and tachycardia. D) Decreased urine output.
Answer: C) Hypotension and tachycardia.
Rationale: Hypotension and tachycardia are signs of hypovolemic shock, which
can result from severe fluid loss in acute pancreatitis due to third-space fluid
shifts. It is a critical complication and requires immediate attention.
3. Question:
,A client is receiving intravenous (IV) potassium chloride at 10 mEq/hr for
hypokalemia. The nurse notices the IV site is red, swollen, and warm. What is the
nurse’s priority action?
A) Discontinue the IV infusion. B) Lower the IV infusion rate. C) Notify the
healthcare provider. D) Apply a warm compress to the site.
Answer: A) Discontinue the IV infusion.
Rationale: The signs of redness, swelling, and warmth indicate possible phlebitis
or infiltration. The nurse should immediately discontinue the infusion to prevent
further tissue damage and then assess the site and notify the healthcare provider
for further evaluation.
4. Question:
A client with a history of heart failure is admitted with shortness of breath and
bilateral lower extremity edema. What is the most likely cause of these
symptoms?
A) Pulmonary embolism. B) Left-sided heart failure. C) Right-sided heart failure. D)
Chronic obstructive pulmonary disease (COPD).
Answer: C) Right-sided heart failure.
Rationale: Right-sided heart failure often presents with symptoms such as
bilateral lower extremity edema, ascites, and jugular vein distention. Fluid backs
up into the peripheral veins and tissues, causing swelling in the lower extremities.
5. Question:
A patient is being discharged after a total knee replacement. Which of the
following instructions should the nurse emphasize to prevent complications?
A) Perform passive range-of-motion exercises to prevent stiffness. B) Avoid
weight-bearing on the affected leg for at least 6 weeks. C) Apply ice to the knee
for 15-20 minutes every 2-4 hours. D) Keep the affected leg elevated above the
heart at all times.
,Answer: C) Apply ice to the knee for 15-20 minutes every 2-4 hours.
Rationale: Ice helps reduce inflammation and swelling after a total knee
replacement. The patient should also be encouraged to perform prescribed
exercises to promote mobility and strength, but avoiding prolonged elevation of
the leg is key for circulation.
6. Question:
A client with a diagnosis of cirrhosis of the liver develops ascites. The nurse should
expect which of the following to be prescribed?
A) Albumin infusion. B) Antihypertensive medication. C) Insulin therapy. D)
Diuretic therapy.
Answer: D) Diuretic therapy.
Rationale: Diuretics help reduce fluid retention in clients with cirrhosis and
ascites. Albumin may also be given to help maintain oncotic pressure, but
diuretics are typically the first-line treatment for ascites in cirrhosis.
7. Question:
The nurse is caring for a patient who has recently undergone a thyroidectomy.
Which complication is most important for the nurse to monitor for in the
immediate postoperative period?
A) Hypocalcemia. B) Hypotension. C) Hyperglycemia. D) Infection.
Answer: A) Hypocalcemia.
Rationale: After a thyroidectomy, there is a risk of accidental removal or damage
to the parathyroid glands, which can lead to hypocalcemia. The nurse should
monitor for signs of hypocalcemia, such as tingling around the mouth and in the
fingers and toes, and check calcium levels.
8. Question:
, A client with chronic kidney disease (CKD) is receiving hemodialysis. Which
laboratory value is most important to assess before the dialysis treatment?
A) Hemoglobin. B) Serum creatinine. C) Potassium. D) Glucose.
Answer: C) Potassium.
Rationale: Elevated potassium levels are a significant concern in clients
undergoing hemodialysis. Dialysis will remove potassium from the blood, and
elevated levels can lead to life-threatening arrhythmias. It is important to assess
potassium levels prior to dialysis.
9. Question:
A nurse is teaching a client with chronic obstructive pulmonary disease (COPD)
about proper use of a metered-dose inhaler (MDI). Which instruction should the
nurse include?
A) Shake the inhaler before use. B) Exhale forcefully after using the inhaler. C)
Inhale the medication quickly. D) Hold the inhaler upside down during use.
Answer: A) Shake the inhaler before use.
Rationale: Shaking the inhaler ensures that the medication is properly mixed
before use. Inhalers should be used with a slow, deep breath, not forceful
exhalation. The inhaler should be held upright, not upside down.
10. Question:
A client is diagnosed with a peptic ulcer and is prescribed omeprazole. Which
information should the nurse include in the teaching plan for this medication?
A) Take the medication with meals. B) Avoid taking the medication before
bedtime. C) Swallow the capsule whole. D) Drink alcohol while taking the
medication to improve absorption.
Answer: C) Swallow the capsule whole.
QUESTIONS AND CORRECT ANSWERS WITH WELL-ELABORATED RATIONALES/
EVOLVE HESI MEDICAL SURGICAL LATEST EXAM 2025 (BRAND NEW!!)
1. Question:
A 68-year-old client is scheduled for an abdominal surgery. Which preoperative
action is most important to minimize the risk of a postoperative complication?
A) Encourage deep breathing exercises. B) Administer a preoperative sedative. C)
Ask the client to refrain from eating for 12 hours before surgery. D) Apply
antiembolic stockings.
Answer: A) Encourage deep breathing exercises.
Rationale: Deep breathing exercises help reduce the risk of respiratory
complications such as pneumonia and atelectasis after surgery. It is essential to
improve lung ventilation and oxygenation, especially in elderly patients.
2. Question:
The nurse is caring for a client with a diagnosis of acute pancreatitis. Which of the
following findings is most indicative of a complication?
A) Increased abdominal pain after eating. B) Jaundice with pale stools. C)
Hypotension and tachycardia. D) Decreased urine output.
Answer: C) Hypotension and tachycardia.
Rationale: Hypotension and tachycardia are signs of hypovolemic shock, which
can result from severe fluid loss in acute pancreatitis due to third-space fluid
shifts. It is a critical complication and requires immediate attention.
3. Question:
,A client is receiving intravenous (IV) potassium chloride at 10 mEq/hr for
hypokalemia. The nurse notices the IV site is red, swollen, and warm. What is the
nurse’s priority action?
A) Discontinue the IV infusion. B) Lower the IV infusion rate. C) Notify the
healthcare provider. D) Apply a warm compress to the site.
Answer: A) Discontinue the IV infusion.
Rationale: The signs of redness, swelling, and warmth indicate possible phlebitis
or infiltration. The nurse should immediately discontinue the infusion to prevent
further tissue damage and then assess the site and notify the healthcare provider
for further evaluation.
4. Question:
A client with a history of heart failure is admitted with shortness of breath and
bilateral lower extremity edema. What is the most likely cause of these
symptoms?
A) Pulmonary embolism. B) Left-sided heart failure. C) Right-sided heart failure. D)
Chronic obstructive pulmonary disease (COPD).
Answer: C) Right-sided heart failure.
Rationale: Right-sided heart failure often presents with symptoms such as
bilateral lower extremity edema, ascites, and jugular vein distention. Fluid backs
up into the peripheral veins and tissues, causing swelling in the lower extremities.
5. Question:
A patient is being discharged after a total knee replacement. Which of the
following instructions should the nurse emphasize to prevent complications?
A) Perform passive range-of-motion exercises to prevent stiffness. B) Avoid
weight-bearing on the affected leg for at least 6 weeks. C) Apply ice to the knee
for 15-20 minutes every 2-4 hours. D) Keep the affected leg elevated above the
heart at all times.
,Answer: C) Apply ice to the knee for 15-20 minutes every 2-4 hours.
Rationale: Ice helps reduce inflammation and swelling after a total knee
replacement. The patient should also be encouraged to perform prescribed
exercises to promote mobility and strength, but avoiding prolonged elevation of
the leg is key for circulation.
6. Question:
A client with a diagnosis of cirrhosis of the liver develops ascites. The nurse should
expect which of the following to be prescribed?
A) Albumin infusion. B) Antihypertensive medication. C) Insulin therapy. D)
Diuretic therapy.
Answer: D) Diuretic therapy.
Rationale: Diuretics help reduce fluid retention in clients with cirrhosis and
ascites. Albumin may also be given to help maintain oncotic pressure, but
diuretics are typically the first-line treatment for ascites in cirrhosis.
7. Question:
The nurse is caring for a patient who has recently undergone a thyroidectomy.
Which complication is most important for the nurse to monitor for in the
immediate postoperative period?
A) Hypocalcemia. B) Hypotension. C) Hyperglycemia. D) Infection.
Answer: A) Hypocalcemia.
Rationale: After a thyroidectomy, there is a risk of accidental removal or damage
to the parathyroid glands, which can lead to hypocalcemia. The nurse should
monitor for signs of hypocalcemia, such as tingling around the mouth and in the
fingers and toes, and check calcium levels.
8. Question:
, A client with chronic kidney disease (CKD) is receiving hemodialysis. Which
laboratory value is most important to assess before the dialysis treatment?
A) Hemoglobin. B) Serum creatinine. C) Potassium. D) Glucose.
Answer: C) Potassium.
Rationale: Elevated potassium levels are a significant concern in clients
undergoing hemodialysis. Dialysis will remove potassium from the blood, and
elevated levels can lead to life-threatening arrhythmias. It is important to assess
potassium levels prior to dialysis.
9. Question:
A nurse is teaching a client with chronic obstructive pulmonary disease (COPD)
about proper use of a metered-dose inhaler (MDI). Which instruction should the
nurse include?
A) Shake the inhaler before use. B) Exhale forcefully after using the inhaler. C)
Inhale the medication quickly. D) Hold the inhaler upside down during use.
Answer: A) Shake the inhaler before use.
Rationale: Shaking the inhaler ensures that the medication is properly mixed
before use. Inhalers should be used with a slow, deep breath, not forceful
exhalation. The inhaler should be held upright, not upside down.
10. Question:
A client is diagnosed with a peptic ulcer and is prescribed omeprazole. Which
information should the nurse include in the teaching plan for this medication?
A) Take the medication with meals. B) Avoid taking the medication before
bedtime. C) Swallow the capsule whole. D) Drink alcohol while taking the
medication to improve absorption.
Answer: C) Swallow the capsule whole.
