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 caring for a postoperative client who had a total hip
replacement. Which of the following is the priority action for the
nurse to take?
a) Encourage the client to perform deep breathing exercises
b) Provide a high-protein snack
c) Teach the client how to use an incentive spirometer
d) Assess for signs of deep vein thrombosis (DVT)
Answer: d) Assess for signs of deep vein thrombosis (DVT)
Rationale: After a hip replacement surgery, the client is at high risk for
developing deep vein thrombosis (DVT) due to immobility. The priority
is to assess for DVT signs, including swelling, redness, and warmth in
the extremities.
2. A nurse is preparing to administer an IV medication to a client. The
nurse notes that the client’s IV site is red, swollen, and warm to the
touch. Which of the following actions should the nurse take?
a) Continue administering the medication slowly
b) Remove the IV catheter and apply a warm compress
c) Document the findings and inform the healthcare provider
d) Elevate the limb and apply a cold compress
Answer: b) Remove the IV catheter and apply a warm compress
Rationale: The signs of redness, swelling, and warmth indicate possible
phlebitis or infiltration. The nurse should remove the IV catheter and
,apply a warm compress to reduce inflammation. Cold compresses are
not effective for phlebitis.
3. A client with pneumonia is receiving oxygen therapy via nasal
cannula at 4 L/min. The nurse notes that the client is anxious and
short of breath. Which of the following actions should the nurse take?
a) Increase the oxygen flow rate to 6 L/min
b) Notify the healthcare provider of the client's condition
c) Assess the client for signs of hypoxia
d) Place the client in a supine position to promote breathing
Answer: c) Assess the client for signs of hypoxia
Rationale: The client’s anxiety and shortness of breath could indicate
hypoxia. The nurse should assess the client for other signs of hypoxia
(e.g., cyanosis, confusion, restlessness) before making changes to the
oxygen therapy.
4. A nurse is caring for a client who has a potassium level of 3.0
mEq/L. The nurse should anticipate which of the following orders from
the healthcare provider?
a) Administer potassium-sparing diuretics
b) Provide a potassium supplement
c) Encourage foods high in potassium
d) Increase the IV rate to increase urine output
Answer: b) Provide a potassium supplement
Rationale: A potassium level of 3.0 mEq/L is low, and the nurse should
anticipate orders for potassium supplementation. Potassium-sparing
,diuretics are used when potassium levels are elevated, and increasing
urine output would lower potassium further.
5. A nurse is caring for a client with heart failure. Which of the
following interventions is most important to prevent fluid volume
overload?
a) Monitor the client’s blood pressure every 4 hours
b) Assess the client’s daily weight
c) Provide low-sodium meals
d) Administer prescribed diuretics on time
Answer: b) Assess the client’s daily weight
Rationale: Monitoring the client’s daily weight is the most important
intervention to assess for fluid volume overload. A sudden weight gain
is a key indicator of fluid retention and may prompt the need for
adjustments in the treatment plan.
6. A nurse is caring for a client with a new diagnosis of type 2
diabetes. Which of the following statements by the client indicates a
need for further teaching?
a) "I will monitor my blood sugar regularly."
b) "I will eat a balanced diet and exercise regularly."
c) "I can skip a meal if I’m not hungry, as long as I take my insulin."
d) "I will check my feet for sores every day."
Answer: c) "I can skip a meal if I’m not hungry, as long as I take my
insulin."
, Rationale: Skipping meals while on insulin can cause hypoglycemia. The
client should be taught to maintain a consistent eating schedule and
adjust insulin doses accordingly.
7. A nurse is teaching a client who is scheduled for a colonoscopy.
Which of the following instructions should the nurse include in the
teaching?
a) "You will need to fast for 24 hours before the procedure."
b) "You will need to take a laxative the evening before the procedure."
c) "You will be given a local anesthetic to prepare for the procedure."
d) "You will need to remain in a sitting position during the procedure."
Answer: b) "You will need to take a laxative the evening before the
procedure."
Rationale: The client is required to take a laxative or bowel prep to
clean out the colon before a colonoscopy. This is crucial for clear
visualization of the colon during the procedure.
8. A nurse is caring for a client with an abdominal wound that has a
large amount of serosanguineous drainage. Which of the following
actions should the nurse take?
a) Reinforce the dressing and document the findings
b) Apply a dry dressing and check the wound every 8 hours
c) Remove the dressing and notify the healthcare provider
d) Increase the frequency of dressing changes
Answer: a) Reinforce the dressing and document the findings
Rationale: Serosanguineous drainage is a normal type of wound
drainage and typically indicates the healing process. The nurse should
QUESTIONS AND CORRECT ANSWERS WITH WELL-ELABORATED
RATIONALES/ EVOLVE HESI MEDICAL SURGICAL LATEST EXAM 2025
1. A nurse is caring for a postoperative client who had a total hip
replacement. Which of the following is the priority action for the
nurse to take?
a) Encourage the client to perform deep breathing exercises
b) Provide a high-protein snack
c) Teach the client how to use an incentive spirometer
d) Assess for signs of deep vein thrombosis (DVT)
Answer: d) Assess for signs of deep vein thrombosis (DVT)
Rationale: After a hip replacement surgery, the client is at high risk for
developing deep vein thrombosis (DVT) due to immobility. The priority
is to assess for DVT signs, including swelling, redness, and warmth in
the extremities.
2. A nurse is preparing to administer an IV medication to a client. The
nurse notes that the client’s IV site is red, swollen, and warm to the
touch. Which of the following actions should the nurse take?
a) Continue administering the medication slowly
b) Remove the IV catheter and apply a warm compress
c) Document the findings and inform the healthcare provider
d) Elevate the limb and apply a cold compress
Answer: b) Remove the IV catheter and apply a warm compress
Rationale: The signs of redness, swelling, and warmth indicate possible
phlebitis or infiltration. The nurse should remove the IV catheter and
,apply a warm compress to reduce inflammation. Cold compresses are
not effective for phlebitis.
3. A client with pneumonia is receiving oxygen therapy via nasal
cannula at 4 L/min. The nurse notes that the client is anxious and
short of breath. Which of the following actions should the nurse take?
a) Increase the oxygen flow rate to 6 L/min
b) Notify the healthcare provider of the client's condition
c) Assess the client for signs of hypoxia
d) Place the client in a supine position to promote breathing
Answer: c) Assess the client for signs of hypoxia
Rationale: The client’s anxiety and shortness of breath could indicate
hypoxia. The nurse should assess the client for other signs of hypoxia
(e.g., cyanosis, confusion, restlessness) before making changes to the
oxygen therapy.
4. A nurse is caring for a client who has a potassium level of 3.0
mEq/L. The nurse should anticipate which of the following orders from
the healthcare provider?
a) Administer potassium-sparing diuretics
b) Provide a potassium supplement
c) Encourage foods high in potassium
d) Increase the IV rate to increase urine output
Answer: b) Provide a potassium supplement
Rationale: A potassium level of 3.0 mEq/L is low, and the nurse should
anticipate orders for potassium supplementation. Potassium-sparing
,diuretics are used when potassium levels are elevated, and increasing
urine output would lower potassium further.
5. A nurse is caring for a client with heart failure. Which of the
following interventions is most important to prevent fluid volume
overload?
a) Monitor the client’s blood pressure every 4 hours
b) Assess the client’s daily weight
c) Provide low-sodium meals
d) Administer prescribed diuretics on time
Answer: b) Assess the client’s daily weight
Rationale: Monitoring the client’s daily weight is the most important
intervention to assess for fluid volume overload. A sudden weight gain
is a key indicator of fluid retention and may prompt the need for
adjustments in the treatment plan.
6. A nurse is caring for a client with a new diagnosis of type 2
diabetes. Which of the following statements by the client indicates a
need for further teaching?
a) "I will monitor my blood sugar regularly."
b) "I will eat a balanced diet and exercise regularly."
c) "I can skip a meal if I’m not hungry, as long as I take my insulin."
d) "I will check my feet for sores every day."
Answer: c) "I can skip a meal if I’m not hungry, as long as I take my
insulin."
, Rationale: Skipping meals while on insulin can cause hypoglycemia. The
client should be taught to maintain a consistent eating schedule and
adjust insulin doses accordingly.
7. A nurse is teaching a client who is scheduled for a colonoscopy.
Which of the following instructions should the nurse include in the
teaching?
a) "You will need to fast for 24 hours before the procedure."
b) "You will need to take a laxative the evening before the procedure."
c) "You will be given a local anesthetic to prepare for the procedure."
d) "You will need to remain in a sitting position during the procedure."
Answer: b) "You will need to take a laxative the evening before the
procedure."
Rationale: The client is required to take a laxative or bowel prep to
clean out the colon before a colonoscopy. This is crucial for clear
visualization of the colon during the procedure.
8. A nurse is caring for a client with an abdominal wound that has a
large amount of serosanguineous drainage. Which of the following
actions should the nurse take?
a) Reinforce the dressing and document the findings
b) Apply a dry dressing and check the wound every 8 hours
c) Remove the dressing and notify the healthcare provider
d) Increase the frequency of dressing changes
Answer: a) Reinforce the dressing and document the findings
Rationale: Serosanguineous drainage is a normal type of wound
drainage and typically indicates the healing process. The nurse should
