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
1. Question:
A nurse is caring for a client with chronic obstructive pulmonary
disease (COPD) who is receiving oxygen therapy via a nasal
cannula. Which of the following findings should the nurse
report to the provider immediately?
A. Respiratory rate of 16 breaths per minute
B. O2 saturation of 92%
C. Arterial blood gas (ABG) showing pH of 7.34 and PaCO2 of 50
mmHg
D. A change in the client's mental status to confusion
Answer: D. A change in the client's mental status to confusion
Rationale: A change in mental status, especially confusion, may
indicate hypoxia or hypercapnia. This requires immediate
attention and intervention, as it could signify an impending
respiratory crisis in a client with COPD.
2. Question:
1
,A nurse is assessing a client with a history of heart failure.
Which of the following findings should the nurse recognize as
an early indication of fluid retention?
A. Increased blood pressure
B. Decreased urinary output
C. Shortness of breath
D. Weight gain of 1-2 pounds per day
Answer: D. Weight gain of 1-2 pounds per day
Rationale: Weight gain of 1-2 pounds per day is an early sign of
fluid retention, which can indicate worsening heart failure. This
weight gain is primarily due to the retention of fluid in the body.
3. Question:
A nurse is caring for a postoperative client who underwent a
laparotomy. The client is receiving morphine via patient-
controlled analgesia (PCA). Which of the following actions
should the nurse take to prevent complications associated with
this medication?
A. Monitor the client’s respiratory rate frequently
B. Encourage the client to cough and deep breathe every 8
hours
C. Instruct the client to limit fluid intake to prevent nausea
D. Assess the client's bowel sounds every 12 hours
Answer: A. Monitor the client’s respiratory rate frequently
2
,Rationale: Morphine, an opioid, can depress the respiratory
system, and frequent monitoring of the client’s respiratory rate
is critical to detecting early signs of respiratory depression.
4. Question:
A nurse is caring for a client with diabetes mellitus who has a
blood glucose level of 52 mg/dL. Which of the following actions
should the nurse take first?
A. Administer 15 g of glucose in the form of a tablet or juice
B. Administer an intravenous bolus of dextrose 50%
C. Prepare the client for an insulin injection
D. Check the client’s serum electrolyte levels
Answer: A. Administer 15 g of glucose in the form of a tablet or
juice
Rationale: The priority action for a client with hypoglycemia is
to raise their blood glucose levels. Administering 15 grams of
glucose will help rapidly restore the client's glucose levels to a
safe range.
5. Question:
A nurse is assessing a client with a new diagnosis of myocardial
infarction. The client asks what caused the chest pain. The
nurse explains that the pain is caused by:
3
, A. Hypoxia of the heart muscle
B. A rupture of a heart valve
C. The increase in cardiac output during exertion
D. Pericarditis due to inflammation of the heart
Answer: A. Hypoxia of the heart muscle
Rationale: Myocardial infarction (MI) is caused by a blockage of
blood flow to the heart muscle, resulting in hypoxia (lack of
oxygen). This lack of oxygen causes the chest pain associated
with a heart attack.
6. Question:
A nurse is teaching a client with asthma how to use a metered-
dose inhaler (MDI). Which of the following instructions should
the nurse include in the teaching?
A. "Inhale deeply after pressing the canister to release the
medication."
B. "Exhale deeply into the inhaler before using it."
C. "Hold your breath for 10 seconds after inhaling the
medication."
D. "Take a deep breath and then breathe out quickly through
your nose."
Answer: C. "Hold your breath for 10 seconds after inhaling the
medication."
4
REAL EXAM QUESTIONS AND CORRECT ANSWERS WITH WELL-
ELABORATED RATIONALES/ EVOLVE HESI MEDICAL SURGICAL
LATEST EXAM 2025
1. Question:
A nurse is caring for a client with chronic obstructive pulmonary
disease (COPD) who is receiving oxygen therapy via a nasal
cannula. Which of the following findings should the nurse
report to the provider immediately?
A. Respiratory rate of 16 breaths per minute
B. O2 saturation of 92%
C. Arterial blood gas (ABG) showing pH of 7.34 and PaCO2 of 50
mmHg
D. A change in the client's mental status to confusion
Answer: D. A change in the client's mental status to confusion
Rationale: A change in mental status, especially confusion, may
indicate hypoxia or hypercapnia. This requires immediate
attention and intervention, as it could signify an impending
respiratory crisis in a client with COPD.
2. Question:
1
,A nurse is assessing a client with a history of heart failure.
Which of the following findings should the nurse recognize as
an early indication of fluid retention?
A. Increased blood pressure
B. Decreased urinary output
C. Shortness of breath
D. Weight gain of 1-2 pounds per day
Answer: D. Weight gain of 1-2 pounds per day
Rationale: Weight gain of 1-2 pounds per day is an early sign of
fluid retention, which can indicate worsening heart failure. This
weight gain is primarily due to the retention of fluid in the body.
3. Question:
A nurse is caring for a postoperative client who underwent a
laparotomy. The client is receiving morphine via patient-
controlled analgesia (PCA). Which of the following actions
should the nurse take to prevent complications associated with
this medication?
A. Monitor the client’s respiratory rate frequently
B. Encourage the client to cough and deep breathe every 8
hours
C. Instruct the client to limit fluid intake to prevent nausea
D. Assess the client's bowel sounds every 12 hours
Answer: A. Monitor the client’s respiratory rate frequently
2
,Rationale: Morphine, an opioid, can depress the respiratory
system, and frequent monitoring of the client’s respiratory rate
is critical to detecting early signs of respiratory depression.
4. Question:
A nurse is caring for a client with diabetes mellitus who has a
blood glucose level of 52 mg/dL. Which of the following actions
should the nurse take first?
A. Administer 15 g of glucose in the form of a tablet or juice
B. Administer an intravenous bolus of dextrose 50%
C. Prepare the client for an insulin injection
D. Check the client’s serum electrolyte levels
Answer: A. Administer 15 g of glucose in the form of a tablet or
juice
Rationale: The priority action for a client with hypoglycemia is
to raise their blood glucose levels. Administering 15 grams of
glucose will help rapidly restore the client's glucose levels to a
safe range.
5. Question:
A nurse is assessing a client with a new diagnosis of myocardial
infarction. The client asks what caused the chest pain. The
nurse explains that the pain is caused by:
3
, A. Hypoxia of the heart muscle
B. A rupture of a heart valve
C. The increase in cardiac output during exertion
D. Pericarditis due to inflammation of the heart
Answer: A. Hypoxia of the heart muscle
Rationale: Myocardial infarction (MI) is caused by a blockage of
blood flow to the heart muscle, resulting in hypoxia (lack of
oxygen). This lack of oxygen causes the chest pain associated
with a heart attack.
6. Question:
A nurse is teaching a client with asthma how to use a metered-
dose inhaler (MDI). Which of the following instructions should
the nurse include in the teaching?
A. "Inhale deeply after pressing the canister to release the
medication."
B. "Exhale deeply into the inhaler before using it."
C. "Hold your breath for 10 seconds after inhaling the
medication."
D. "Take a deep breath and then breathe out quickly through
your nose."
Answer: C. "Hold your breath for 10 seconds after inhaling the
medication."
4
