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 patient who has just undergone a total knee
replacement. The nurse should monitor for which of the following
complications during the immediate postoperative period?
A. Hypertension
B. Deep vein thrombosis
C. Pneumothorax
D. Hyperkalemia
Answer: B. Deep vein thrombosis
Rationale: Patients who undergo joint replacement surgery are at
increased risk for deep vein thrombosis (DVT) due to immobility and
surgery. Nurses should monitor for signs of DVT such as swelling,
redness, and warmth in the leg.
2. A nurse is providing care for a patient who is 2 days postoperative
following a cholecystectomy. The patient complains of pain in the
right shoulder. Which of the following actions should the nurse take?
A. Administer prescribed pain medication.
B. Instruct the patient to lie on the left side.
C. Apply a heating pad to the right shoulder.
D. Encourage the patient to ambulate.
Answer: A. Administer prescribed pain medication.
Rationale: Right shoulder pain is a common side effect of laparoscopic
cholecystectomy due to irritation of the diaphragm. It can be relieved
by analgesics and should be managed with medication as prescribed.
,3. A nurse is providing discharge teaching to a patient with new-onset
atrial fibrillation. Which of the following instructions should the nurse
include in the teaching?
A. "Take your pulse daily and report any changes."
B. "You will need to discontinue your anticoagulant therapy."
C. "Your heart rate should never exceed 100 beats per minute."
D. "You should avoid all physical activity for the next 6 months."
Answer: A. "Take your pulse daily and report any changes."
Rationale: Patients with atrial fibrillation need to monitor their pulse
for irregularities. Anticoagulation therapy is typically required, and
activity restrictions are not usually this extensive.
4. A nurse is caring for a patient with chronic renal failure. The nurse
observes the patient’s skin has a yellowish tint. What is the most likely
cause of this change?
A. Jaundice due to liver failure
B. Uremic frost
C. Vitamin D deficiency
D. Uremia causing hyperpigmentation
Answer: D. Uremia causing hyperpigmentation
Rationale: In patients with chronic renal failure, the accumulation of
waste products (uremia) can lead to skin changes, including a yellowish
or bronzed appearance.
, 5. A nurse is caring for a patient with a history of peptic ulcer disease.
The patient reports sudden, severe abdominal pain radiating to the
back. Which of the following should the nurse suspect?
A. Gastrointestinal bleeding
B. Perforation of the ulcer
C. Gastric cancer
D. Biliary colic
Answer: B. Perforation of the ulcer
Rationale: Sudden, severe abdominal pain radiating to the back can
indicate a perforated ulcer. This is a medical emergency and requires
immediate intervention.
6. A nurse is caring for a patient with pneumonia who has been
prescribed ceftriaxone IV. The nurse notices the patient develops a
rash. What is the most appropriate action for the nurse to take?
A. Administer an antihistamine.
B. Hold the medication and notify the provider.
C. Continue the medication and monitor the rash.
D. Discontinue the medication and apply a cool compress to the rash.
Answer: B. Hold the medication and notify the provider.
Rationale: A rash can be a sign of an allergic reaction to ceftriaxone, and
it is important to stop the medication and notify the provider for further
evaluation and management.
7. A nurse is caring for a patient who is 3 hours postoperative
following a total abdominal hysterectomy. The nurse should assess for
which of the following signs of a potential complication?
QUESTIONS AND CORRECT ANSWERS WITH WELL-ELABORATED RATIONALES/
EVOLVE HESI MEDICAL SURGICAL LATEST EXAM 2025
1. A nurse is caring for a patient who has just undergone a total knee
replacement. The nurse should monitor for which of the following
complications during the immediate postoperative period?
A. Hypertension
B. Deep vein thrombosis
C. Pneumothorax
D. Hyperkalemia
Answer: B. Deep vein thrombosis
Rationale: Patients who undergo joint replacement surgery are at
increased risk for deep vein thrombosis (DVT) due to immobility and
surgery. Nurses should monitor for signs of DVT such as swelling,
redness, and warmth in the leg.
2. A nurse is providing care for a patient who is 2 days postoperative
following a cholecystectomy. The patient complains of pain in the
right shoulder. Which of the following actions should the nurse take?
A. Administer prescribed pain medication.
B. Instruct the patient to lie on the left side.
C. Apply a heating pad to the right shoulder.
D. Encourage the patient to ambulate.
Answer: A. Administer prescribed pain medication.
Rationale: Right shoulder pain is a common side effect of laparoscopic
cholecystectomy due to irritation of the diaphragm. It can be relieved
by analgesics and should be managed with medication as prescribed.
,3. A nurse is providing discharge teaching to a patient with new-onset
atrial fibrillation. Which of the following instructions should the nurse
include in the teaching?
A. "Take your pulse daily and report any changes."
B. "You will need to discontinue your anticoagulant therapy."
C. "Your heart rate should never exceed 100 beats per minute."
D. "You should avoid all physical activity for the next 6 months."
Answer: A. "Take your pulse daily and report any changes."
Rationale: Patients with atrial fibrillation need to monitor their pulse
for irregularities. Anticoagulation therapy is typically required, and
activity restrictions are not usually this extensive.
4. A nurse is caring for a patient with chronic renal failure. The nurse
observes the patient’s skin has a yellowish tint. What is the most likely
cause of this change?
A. Jaundice due to liver failure
B. Uremic frost
C. Vitamin D deficiency
D. Uremia causing hyperpigmentation
Answer: D. Uremia causing hyperpigmentation
Rationale: In patients with chronic renal failure, the accumulation of
waste products (uremia) can lead to skin changes, including a yellowish
or bronzed appearance.
, 5. A nurse is caring for a patient with a history of peptic ulcer disease.
The patient reports sudden, severe abdominal pain radiating to the
back. Which of the following should the nurse suspect?
A. Gastrointestinal bleeding
B. Perforation of the ulcer
C. Gastric cancer
D. Biliary colic
Answer: B. Perforation of the ulcer
Rationale: Sudden, severe abdominal pain radiating to the back can
indicate a perforated ulcer. This is a medical emergency and requires
immediate intervention.
6. A nurse is caring for a patient with pneumonia who has been
prescribed ceftriaxone IV. The nurse notices the patient develops a
rash. What is the most appropriate action for the nurse to take?
A. Administer an antihistamine.
B. Hold the medication and notify the provider.
C. Continue the medication and monitor the rash.
D. Discontinue the medication and apply a cool compress to the rash.
Answer: B. Hold the medication and notify the provider.
Rationale: A rash can be a sign of an allergic reaction to ceftriaxone, and
it is important to stop the medication and notify the provider for further
evaluation and management.
7. A nurse is caring for a patient who is 3 hours postoperative
following a total abdominal hysterectomy. The nurse should assess for
which of the following signs of a potential complication?
