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. A nurse is assessing a client who has left-sided heart failure. Which
of the following findings should the nurse expect?
A) Jugular vein distention
B) Shortness of breath
C) Peripheral edema
D) Hepatomegaly
Answer: B) Shortness of breath
Rationale:
Left-sided heart failure primarily affects the lungs, leading to symptoms
like shortness of breath, pulmonary congestion, and crackles. Right-
sided heart failure, on the other hand, leads to peripheral edema,
jugular vein distention, and hepatomegaly.
2. A nurse is caring for a client who is receiving a blood transfusion.
The client reports chills, back pain, and feeling of tightness in the
chest. Which action should the nurse take first?
A) Slow the infusion rate
B) Administer an antihistamine
C) Stop the transfusion
D) Notify the healthcare provider
Answer: C) Stop the transfusion
Rationale:
These symptoms indicate a possible transfusion reaction, so the nurse
,should immediately stop the transfusion to prevent further
complications. After stopping the transfusion, the nurse should assess
the client and notify the healthcare provider.
3. A nurse is caring for a client who is post-op following a laparoscopic
cholecystectomy. Which of the following findings is the nurse's
priority?
A) Pain at the incision site
B) Bile-colored drainage from the incision
C) Increased abdominal distention
D) Temperature of 101°F (38.3°C)
Answer: C) Increased abdominal distention
Rationale:
Increased abdominal distention can indicate the development of
complications such as bowel perforation or ileus, both of which are life-
threatening. This is a higher priority compared to the other findings,
which are expected postoperatively.
4. A nurse is teaching a client about managing their type 1 diabetes
mellitus. Which of the following statements by the client indicates an
understanding of the teaching?
A) “I should check my blood sugar before meals and at bedtime.”
B) “I will take my insulin only when my blood sugar is elevated.”
C) “If I’m sick, I should skip my insulin dose.”
D) “I should decrease my insulin dose if I exercise.”
Answer: A) “I should check my blood sugar before meals and at
bedtime.”
,Rationale:
Clients with type 1 diabetes should monitor their blood sugar before
meals and at bedtime to ensure proper glycemic control. Insulin doses
should be adjusted based on blood glucose levels and activity level, but
the client should never skip insulin during illness.
5. A nurse is caring for a client with chronic kidney disease (CKD) who
is scheduled for dialysis. Which of the following findings would be
most concerning to the nurse?
A) Blood pressure 160/90 mm Hg
B) Serum potassium level of 6.1 mEq/L
C) Serum albumin level of 3.0 g/dL
D) Weight gain of 2 kg (4.4 lb) in 1 week
Answer: B) Serum potassium level of 6.1 mEq/L
Rationale:
A serum potassium level of 6.1 mEq/L is above the normal range and
indicates hyperkalemia, which can lead to life-threatening arrhythmias.
The nurse should notify the healthcare provider immediately to address
this issue.
6. A nurse is caring for a client with a diagnosis of asthma. The client is
experiencing wheezing and increased work of breathing. Which of the
following is the priority action by the nurse?
A) Administer oxygen via nasal cannula
B) Administer the prescribed short-acting bronchodilator
C) Encourage the client to take slow, deep breaths
D) Position the client in high Fowler's position
, Answer: B) Administer the prescribed short-acting bronchodilator
Rationale:
Administering a short-acting bronchodilator is the priority action to
relieve bronchoconstriction and improve airflow during an asthma
exacerbation. Oxygen and positioning are important, but they are
secondary to addressing the airway obstruction.
7. A nurse is providing discharge teaching to a client with a new
diagnosis of chronic obstructive pulmonary disease (COPD). Which
statement by the client indicates a need for further teaching?
A) “I should avoid large crowds to reduce my risk of infection.”
B) “I should quit smoking and avoid secondhand smoke.”
C) “I can stop taking my inhaler when I’m feeling better.”
D) “I should practice pursed-lip breathing to help with my breathing.”
Answer: C) “I can stop taking my inhaler when I’m feeling better.”
Rationale:
Clients with COPD should continue their prescribed treatments,
including inhalers, even if they are feeling better. Stopping medications
prematurely can lead to worsening symptoms and exacerbations.
8. A nurse is caring for a client who has had a stroke and is being
started on warfarin therapy. Which of the following laboratory values
should the nurse monitor to evaluate the effectiveness of the
medication?
A) Prothrombin time (PT)
B) Activated partial thromboplastin time (aPTT)
QUESTIONS AND CORRECT ANSWERS WITH WELL-ELABORATED
RATIONALES/ EVOLVE HESI MEDICAL SURGICAL LATEST EXAM 2025
1. A nurse is assessing a client who has left-sided heart failure. Which
of the following findings should the nurse expect?
A) Jugular vein distention
B) Shortness of breath
C) Peripheral edema
D) Hepatomegaly
Answer: B) Shortness of breath
Rationale:
Left-sided heart failure primarily affects the lungs, leading to symptoms
like shortness of breath, pulmonary congestion, and crackles. Right-
sided heart failure, on the other hand, leads to peripheral edema,
jugular vein distention, and hepatomegaly.
2. A nurse is caring for a client who is receiving a blood transfusion.
The client reports chills, back pain, and feeling of tightness in the
chest. Which action should the nurse take first?
A) Slow the infusion rate
B) Administer an antihistamine
C) Stop the transfusion
D) Notify the healthcare provider
Answer: C) Stop the transfusion
Rationale:
These symptoms indicate a possible transfusion reaction, so the nurse
,should immediately stop the transfusion to prevent further
complications. After stopping the transfusion, the nurse should assess
the client and notify the healthcare provider.
3. A nurse is caring for a client who is post-op following a laparoscopic
cholecystectomy. Which of the following findings is the nurse's
priority?
A) Pain at the incision site
B) Bile-colored drainage from the incision
C) Increased abdominal distention
D) Temperature of 101°F (38.3°C)
Answer: C) Increased abdominal distention
Rationale:
Increased abdominal distention can indicate the development of
complications such as bowel perforation or ileus, both of which are life-
threatening. This is a higher priority compared to the other findings,
which are expected postoperatively.
4. A nurse is teaching a client about managing their type 1 diabetes
mellitus. Which of the following statements by the client indicates an
understanding of the teaching?
A) “I should check my blood sugar before meals and at bedtime.”
B) “I will take my insulin only when my blood sugar is elevated.”
C) “If I’m sick, I should skip my insulin dose.”
D) “I should decrease my insulin dose if I exercise.”
Answer: A) “I should check my blood sugar before meals and at
bedtime.”
,Rationale:
Clients with type 1 diabetes should monitor their blood sugar before
meals and at bedtime to ensure proper glycemic control. Insulin doses
should be adjusted based on blood glucose levels and activity level, but
the client should never skip insulin during illness.
5. A nurse is caring for a client with chronic kidney disease (CKD) who
is scheduled for dialysis. Which of the following findings would be
most concerning to the nurse?
A) Blood pressure 160/90 mm Hg
B) Serum potassium level of 6.1 mEq/L
C) Serum albumin level of 3.0 g/dL
D) Weight gain of 2 kg (4.4 lb) in 1 week
Answer: B) Serum potassium level of 6.1 mEq/L
Rationale:
A serum potassium level of 6.1 mEq/L is above the normal range and
indicates hyperkalemia, which can lead to life-threatening arrhythmias.
The nurse should notify the healthcare provider immediately to address
this issue.
6. A nurse is caring for a client with a diagnosis of asthma. The client is
experiencing wheezing and increased work of breathing. Which of the
following is the priority action by the nurse?
A) Administer oxygen via nasal cannula
B) Administer the prescribed short-acting bronchodilator
C) Encourage the client to take slow, deep breaths
D) Position the client in high Fowler's position
, Answer: B) Administer the prescribed short-acting bronchodilator
Rationale:
Administering a short-acting bronchodilator is the priority action to
relieve bronchoconstriction and improve airflow during an asthma
exacerbation. Oxygen and positioning are important, but they are
secondary to addressing the airway obstruction.
7. A nurse is providing discharge teaching to a client with a new
diagnosis of chronic obstructive pulmonary disease (COPD). Which
statement by the client indicates a need for further teaching?
A) “I should avoid large crowds to reduce my risk of infection.”
B) “I should quit smoking and avoid secondhand smoke.”
C) “I can stop taking my inhaler when I’m feeling better.”
D) “I should practice pursed-lip breathing to help with my breathing.”
Answer: C) “I can stop taking my inhaler when I’m feeling better.”
Rationale:
Clients with COPD should continue their prescribed treatments,
including inhalers, even if they are feeling better. Stopping medications
prematurely can lead to worsening symptoms and exacerbations.
8. A nurse is caring for a client who has had a stroke and is being
started on warfarin therapy. Which of the following laboratory values
should the nurse monitor to evaluate the effectiveness of the
medication?
A) Prothrombin time (PT)
B) Activated partial thromboplastin time (aPTT)
