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 who is post-operative following a total
knee arthroplasty. Which of the following interventions should the nurse
implement to prevent deep vein thrombosis (DVT)?
• a) Encourage the client to perform leg exercises every hour while awake
• b) Apply cold compresses to the legs
• c) Restrict fluid intake to reduce swelling
• d) Keep the legs elevated above the level of the heart at all times
Answer: a) Encourage the client to perform leg exercises every hour while awake
Rationale: Leg exercises help promote circulation and prevent the formation of
blood clots, which is a priority in post-operative clients to prevent DVT. Elevating
the legs can be helpful, but promoting activity is key in preventing thrombus
formation.
2. Question: A client is admitted with chest pain and diagnosed with acute
myocardial infarction (MI). Which of the following is the priority intervention?
• a) Administer aspirin as ordered
• b) Provide pain relief with morphine
• c) Initiate oxygen therapy
• d) Monitor vital signs
Answer: c) Initiate oxygen therapy
Rationale: The priority in acute MI is to provide oxygen to reduce the workload of
the heart and prevent further damage. Oxygen helps ensure adequate
oxygenation to the myocardium and reduces ischemia.
,3. Question: A nurse is caring for a client with chronic obstructive pulmonary
disease (COPD) who is receiving oxygen therapy. The nurse notices that the
client's respiratory rate has decreased to 8 breaths per minute. What is the
nurse's first action?
• a) Increase the oxygen flow rate
• b) Call the healthcare provider
• c) Assess the client's level of consciousness
• d) Encourage the client to cough and deep breathe
Answer: c) Assess the client's level of consciousness
Rationale: In patients with COPD, hypoventilation can occur due to high oxygen
levels. Assessing the level of consciousness is essential to determine whether the
patient is experiencing respiratory depression, a common side effect of oxygen
therapy in COPD patients.
4. Question: A client is receiving IV fluids at 125 mL/hour. The nurse notices that
the client's IV site is swollen, warm to the touch, and red. What should the nurse
do first?
• a) Apply a cold compress to the site
• b) Discontinue the IV and restart it in a different location
• c) Increase the IV rate to improve circulation
• d) Document the findings and continue to monitor
Answer: b) Discontinue the IV and restart it in a different location
Rationale: The client's symptoms suggest phlebitis or infiltration. The first step is
to discontinue the IV to prevent further complications, then restart it in a different
site.
, 5. Question: A nurse is caring for a client who has a history of hypertension and
presents with a headache, blurred vision, and nosebleeds. The nurse suspects
hypertensive crisis. Which of the following interventions should the nurse
implement first?
• a) Administer antihypertensive medication as ordered
• b) Place the client in a quiet room
• c) Monitor the client's blood pressure every 15 minutes
• d) Position the client in a semi-Fowler's position
Answer: c) Monitor the client's blood pressure every 15 minutes
Rationale: In a hypertensive crisis, the nurse must closely monitor the blood
pressure to assess the severity of the crisis and determine the effectiveness of any
interventions. Once the blood pressure is assessed, further interventions can be
implemented.
6. Question: A nurse is teaching a client with diabetes mellitus about insulin
administration. Which of the following statements by the client indicates a need
for further teaching?
• a) "I should rotate injection sites to prevent tissue damage."
• b) "I will inject insulin into my thigh for the fastest absorption."
• c) "I need to inject insulin at a 90-degree angle."
• d) "I will not massage the injection site after administering insulin."
Answer: b) "I will inject insulin into my thigh for the fastest absorption."
Rationale: Insulin is absorbed more rapidly when injected into the abdomen, not
the thigh. The abdomen provides faster absorption, which is critical for optimal
blood glucose control.
QUESTIONS AND CORRECT ANSWERS WITH WELL-ELABORATED RATIONALES/
EVOLVE HESI MEDICAL SURGICAL LATEST EXAM 2025
1. Question: A nurse is caring for a client who is post-operative following a total
knee arthroplasty. Which of the following interventions should the nurse
implement to prevent deep vein thrombosis (DVT)?
• a) Encourage the client to perform leg exercises every hour while awake
• b) Apply cold compresses to the legs
• c) Restrict fluid intake to reduce swelling
• d) Keep the legs elevated above the level of the heart at all times
Answer: a) Encourage the client to perform leg exercises every hour while awake
Rationale: Leg exercises help promote circulation and prevent the formation of
blood clots, which is a priority in post-operative clients to prevent DVT. Elevating
the legs can be helpful, but promoting activity is key in preventing thrombus
formation.
2. Question: A client is admitted with chest pain and diagnosed with acute
myocardial infarction (MI). Which of the following is the priority intervention?
• a) Administer aspirin as ordered
• b) Provide pain relief with morphine
• c) Initiate oxygen therapy
• d) Monitor vital signs
Answer: c) Initiate oxygen therapy
Rationale: The priority in acute MI is to provide oxygen to reduce the workload of
the heart and prevent further damage. Oxygen helps ensure adequate
oxygenation to the myocardium and reduces ischemia.
,3. Question: A nurse is caring for a client with chronic obstructive pulmonary
disease (COPD) who is receiving oxygen therapy. The nurse notices that the
client's respiratory rate has decreased to 8 breaths per minute. What is the
nurse's first action?
• a) Increase the oxygen flow rate
• b) Call the healthcare provider
• c) Assess the client's level of consciousness
• d) Encourage the client to cough and deep breathe
Answer: c) Assess the client's level of consciousness
Rationale: In patients with COPD, hypoventilation can occur due to high oxygen
levels. Assessing the level of consciousness is essential to determine whether the
patient is experiencing respiratory depression, a common side effect of oxygen
therapy in COPD patients.
4. Question: A client is receiving IV fluids at 125 mL/hour. The nurse notices that
the client's IV site is swollen, warm to the touch, and red. What should the nurse
do first?
• a) Apply a cold compress to the site
• b) Discontinue the IV and restart it in a different location
• c) Increase the IV rate to improve circulation
• d) Document the findings and continue to monitor
Answer: b) Discontinue the IV and restart it in a different location
Rationale: The client's symptoms suggest phlebitis or infiltration. The first step is
to discontinue the IV to prevent further complications, then restart it in a different
site.
, 5. Question: A nurse is caring for a client who has a history of hypertension and
presents with a headache, blurred vision, and nosebleeds. The nurse suspects
hypertensive crisis. Which of the following interventions should the nurse
implement first?
• a) Administer antihypertensive medication as ordered
• b) Place the client in a quiet room
• c) Monitor the client's blood pressure every 15 minutes
• d) Position the client in a semi-Fowler's position
Answer: c) Monitor the client's blood pressure every 15 minutes
Rationale: In a hypertensive crisis, the nurse must closely monitor the blood
pressure to assess the severity of the crisis and determine the effectiveness of any
interventions. Once the blood pressure is assessed, further interventions can be
implemented.
6. Question: A nurse is teaching a client with diabetes mellitus about insulin
administration. Which of the following statements by the client indicates a need
for further teaching?
• a) "I should rotate injection sites to prevent tissue damage."
• b) "I will inject insulin into my thigh for the fastest absorption."
• c) "I need to inject insulin at a 90-degree angle."
• d) "I will not massage the injection site after administering insulin."
Answer: b) "I will inject insulin into my thigh for the fastest absorption."
Rationale: Insulin is absorbed more rapidly when injected into the abdomen, not
the thigh. The abdomen provides faster absorption, which is critical for optimal
blood glucose control.
