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
Question 1:
A nurse is assessing a client who is receiving a blood transfusion. The
nurse notices that the client is experiencing chills, fever, and a rash.
What is the nurse's priority action?
A. Slow the transfusion rate
B. Administer antipyretic medication
C. Stop the transfusion immediately
D. Increase the IV fluids
Answer: C. Stop the transfusion immediately
Rationale: These symptoms are indicative of a transfusion reaction. The
nurse's priority is to stop the transfusion immediately to prevent further
complications, such as hemolytic reactions or anaphylaxis. Once the
transfusion is stopped, the nurse should notify the healthcare provider,
assess the client, and administer normal saline as prescribed.
Question 2:
A nurse is caring for a client who is postoperative after a total knee
arthroplasty. The nurse finds that the client has a red, swollen, and
painful knee. Which action should the nurse take first?
A. Assess the client's vital signs
B. Elevate the client's leg
C. Apply an ice pack to the knee
D. Administer pain medication
,Answer: C. Apply an ice pack to the knee
Rationale: Applying an ice pack to the knee will help reduce swelling
and inflammation. Cold therapy is the most effective intervention
immediately after surgery for pain and swelling management. The nurse
can also elevate the leg and administer pain medication, but ice should
be the first step to reduce the inflammation.
Question 3:
A nurse is caring for a client with heart failure. The nurse notices the
client is becoming increasingly short of breath and is producing pink,
frothy sputum. What is the nurse's priority action?
A. Notify the healthcare provider
B. Place the client in a high Fowler’s position
C. Administer oxygen via nasal cannula
D. Administer a diuretic as prescribed
Answer: B. Place the client in a high Fowler’s position
Rationale: Shortness of breath and pink, frothy sputum are signs of
pulmonary edema, a common complication of heart failure. The nurse
should place the client in a high Fowler's position to promote lung
expansion and facilitate breathing. Administering oxygen and notifying
the healthcare provider should also be done but not before positioning
the client.
Question 4:
A nurse is teaching a client with newly diagnosed hypertension about
lifestyle changes. Which of the following statements by the client
indicates understanding of the teaching?
,A. "I will increase my salt intake to prevent dehydration."
B. "I will begin exercising for at least 30 minutes, five times a week."
C. "I will eat a high-fat, low-fiber diet to increase my energy."
D. "I will stop taking my medications once my blood pressure is normal."
Answer: B. "I will begin exercising for at least 30 minutes, five times a
week."
Rationale: Regular exercise is an important lifestyle modification for
managing hypertension. It helps to lower blood pressure and improve
overall cardiovascular health. The other statements reflect poor
understanding: increasing salt intake, eating a high-fat, low-fiber diet,
and stopping medication prematurely are all inappropriate.
Question 5:
A nurse is assessing a client with chronic obstructive pulmonary
disease (COPD). Which of the following findings is most concerning
and requires immediate intervention?
A. Oxygen saturation of 92%
B. Increased respiratory rate
C. Use of accessory muscles to breathe
D. Barrel-shaped chest
Answer: C. Use of accessory muscles to breathe
Rationale: The use of accessory muscles for breathing indicates that the
client is experiencing respiratory distress and struggling to breathe
effectively. This is a more urgent concern compared to the other
findings, which are commonly seen in COPD but are less immediately
alarming.
, Question 6:
A nurse is caring for a client with a history of peptic ulcer disease
(PUD). The nurse should monitor the client for which of the following
complications?
A. Hyperglycemia
B. Hematemesis
C. Hypertension
D. Bradycardia
Answer: B. Hematemesis
Rationale: Hematemesis, or vomiting blood, is a serious complication of
PUD that can occur due to ulcer perforation or bleeding. The nurse
should monitor for this complication as it can lead to shock if left
untreated. Hyperglycemia, hypertension, and bradycardia are not
typically associated with PUD.
Question 7:
A nurse is caring for a client who is 48 hours postoperative after a total
abdominal hysterectomy. The client reports a sudden, sharp
abdominal pain. What should the nurse do first?
A. Assess the client's vital signs
B. Administer pain medication
C. Notify the healthcare provider
D. Assess for signs of internal bleeding
Answer: D. Assess for signs of internal bleeding
Rationale: Sudden, sharp abdominal pain after abdominal surgery may
indicate internal bleeding or a complication like bowel perforation. The
nurse should assess for signs of internal bleeding (e.g., a decrease in
QUESTIONS AND CORRECT ANSWERS WITH WELL-ELABORATED
RATIONALES/ EVOLVE HESI MEDICAL SURGICAL LATEST EXAM 2025
Question 1:
A nurse is assessing a client who is receiving a blood transfusion. The
nurse notices that the client is experiencing chills, fever, and a rash.
What is the nurse's priority action?
A. Slow the transfusion rate
B. Administer antipyretic medication
C. Stop the transfusion immediately
D. Increase the IV fluids
Answer: C. Stop the transfusion immediately
Rationale: These symptoms are indicative of a transfusion reaction. The
nurse's priority is to stop the transfusion immediately to prevent further
complications, such as hemolytic reactions or anaphylaxis. Once the
transfusion is stopped, the nurse should notify the healthcare provider,
assess the client, and administer normal saline as prescribed.
Question 2:
A nurse is caring for a client who is postoperative after a total knee
arthroplasty. The nurse finds that the client has a red, swollen, and
painful knee. Which action should the nurse take first?
A. Assess the client's vital signs
B. Elevate the client's leg
C. Apply an ice pack to the knee
D. Administer pain medication
,Answer: C. Apply an ice pack to the knee
Rationale: Applying an ice pack to the knee will help reduce swelling
and inflammation. Cold therapy is the most effective intervention
immediately after surgery for pain and swelling management. The nurse
can also elevate the leg and administer pain medication, but ice should
be the first step to reduce the inflammation.
Question 3:
A nurse is caring for a client with heart failure. The nurse notices the
client is becoming increasingly short of breath and is producing pink,
frothy sputum. What is the nurse's priority action?
A. Notify the healthcare provider
B. Place the client in a high Fowler’s position
C. Administer oxygen via nasal cannula
D. Administer a diuretic as prescribed
Answer: B. Place the client in a high Fowler’s position
Rationale: Shortness of breath and pink, frothy sputum are signs of
pulmonary edema, a common complication of heart failure. The nurse
should place the client in a high Fowler's position to promote lung
expansion and facilitate breathing. Administering oxygen and notifying
the healthcare provider should also be done but not before positioning
the client.
Question 4:
A nurse is teaching a client with newly diagnosed hypertension about
lifestyle changes. Which of the following statements by the client
indicates understanding of the teaching?
,A. "I will increase my salt intake to prevent dehydration."
B. "I will begin exercising for at least 30 minutes, five times a week."
C. "I will eat a high-fat, low-fiber diet to increase my energy."
D. "I will stop taking my medications once my blood pressure is normal."
Answer: B. "I will begin exercising for at least 30 minutes, five times a
week."
Rationale: Regular exercise is an important lifestyle modification for
managing hypertension. It helps to lower blood pressure and improve
overall cardiovascular health. The other statements reflect poor
understanding: increasing salt intake, eating a high-fat, low-fiber diet,
and stopping medication prematurely are all inappropriate.
Question 5:
A nurse is assessing a client with chronic obstructive pulmonary
disease (COPD). Which of the following findings is most concerning
and requires immediate intervention?
A. Oxygen saturation of 92%
B. Increased respiratory rate
C. Use of accessory muscles to breathe
D. Barrel-shaped chest
Answer: C. Use of accessory muscles to breathe
Rationale: The use of accessory muscles for breathing indicates that the
client is experiencing respiratory distress and struggling to breathe
effectively. This is a more urgent concern compared to the other
findings, which are commonly seen in COPD but are less immediately
alarming.
, Question 6:
A nurse is caring for a client with a history of peptic ulcer disease
(PUD). The nurse should monitor the client for which of the following
complications?
A. Hyperglycemia
B. Hematemesis
C. Hypertension
D. Bradycardia
Answer: B. Hematemesis
Rationale: Hematemesis, or vomiting blood, is a serious complication of
PUD that can occur due to ulcer perforation or bleeding. The nurse
should monitor for this complication as it can lead to shock if left
untreated. Hyperglycemia, hypertension, and bradycardia are not
typically associated with PUD.
Question 7:
A nurse is caring for a client who is 48 hours postoperative after a total
abdominal hysterectomy. The client reports a sudden, sharp
abdominal pain. What should the nurse do first?
A. Assess the client's vital signs
B. Administer pain medication
C. Notify the healthcare provider
D. Assess for signs of internal bleeding
Answer: D. Assess for signs of internal bleeding
Rationale: Sudden, sharp abdominal pain after abdominal surgery may
indicate internal bleeding or a complication like bowel perforation. The
nurse should assess for signs of internal bleeding (e.g., a decrease in
