EVOLVE ELSEVIER HESI MED SURG ACTUAL
EXAM | EVOLVE HESI MEDICAL SURGICAL
EXAM | 150 EXAM QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES | LATEST EXAM
2025 | 2026 GUIDE
The x-ray for the client in the emergency department (ED) reveals a
right-sided rib fracture. What information will the nurse include in the
client's discharge instructions? (Select all that apply.)
A. Splint your right side with your right arm.
B. You may have to sleep sitting up for a while.
C. Return to the ED if you develop difficulty in breathing.
D. Use shallow breaths until the pain subsides.
E. Use 2 L of oxygen by nasal cannula when you have shortness of
breath.
- Correct Answer -
Splint your right side with your right arm.
You may have to sleep sitting up for a while.
Return to the ED if you develop difficulty in breathing.
Rationale: Shallow breaths do not promote adequate oxygenation. The
client should splint the area and breathe as normally as possible to
maintain adequate oxygenation. Shortness of breath should not occur
with a rib fracture and is a sign of a pneumothorax. The client will not be
,sent home with O2 by nasal cannula if the only health issue is a
fractured rib.
The nurse is caring for a client who is one day post-acute myocardial
infarction. The client is receiving oxygen at 2 L/min via nasal cannula
and has a peripheral saline lock. The nurse notes that the client is
having eight premature ventricular contractions (PVCs) per minute.
Which action should the nurse take first?
Obtain an IV pump for antiarrhythmic infusion.
Increase the client's oxygen flow rate.
Prepare for immediate countershock.
Gather equipment for endotracheal intubation.
- Correct Answer - B.
Increase the client's oxygen flow rate.
Rationale: Increasing the oxygen flow rate provides more oxygen to the
client's myocardium and may decrease myocardial irritability as
manifested by the frequent PVCs. Option A can be delegated and is a
lower priority action than option B. Defibrillation may eventually be
necessary, but option C is not the immediate treatment for frequent
PVCs. Option D may become necessary if the client stops breathing but
is not indicated at this time.
The nurse notes for the client undergoing peritoneal dialysis during the
outflow phase the draining dialysate suddenly stops. The outflow is one
liter less than the inflow at this time. What is the next nursing action?
, A. Take the client's blood pressure.
B. Take the client's weight.
C. Call the health care provider (HCP).
D. Have the client change positions.
- Correct Answer - D.
Have the client change positions.
Rationale: The outflow should match the inflow. With repositioning fluid
trapped within the peritoneum may be repositioned to the proximity of
the abdominal catheter. While the vital signs and the weight may support
the additional fluid, they do not address the cause of the reduced
outflow. At this time, there is no medical emergency to notify the HCP.
The nurse is preparing a 45-year-old client for discharge from a cancer
center following ileostomy surgery for colon cancer. Which discharge
goal should the nurse include in this client's discharge plan?Select an
option, then click Submit.
A. Reduce the daily intake of animal fat to 10% of the diet within 6
weeks.
B. Exhibit regular, soft-formed stool within 1 month.
C. Demonstrate the irrigation procedure correctly within 1 week.
D. Attend an ostomy support group within 2 weeks.
- Correct Answer - D.
Attend an ostomy support group within 2 weeks.
Rationale: Attending a support group will be beneficial to the client and
should be encouraged because adaptation to the ostomy can be difficult.
This goal is attainable and is measurable. Option A is not specifically
, related to ileostomy care. The client with an ileostomy will not be able to
accomplish option B. Option C is not necessary.
A client with cirrhosis develops increasing pedal edema and ascites.
Which dietary modification is most important for the nurse to teach this
client?
A. Avoid high-carbohydrate foods.
B. Decrease intake of fat-soluble vitamins.
C. Decrease caloric intake.
D. Restrict salt and fluid intake.
- Correct Answer - D.
Restrict salt and fluid intake.
Rationale: Salt and fluid restrictions are the first dietary modifications for
a client who is retaining fluid as manifested by edema and ascites.
Options A, B, and C will not affect fluid retention.
A client who is receiving an angiotensin-converting enzyme (ACE)
inhibitor for hypertension calls the clinic and reports the recent onset of a
cough to the nurse. Which action should the nurse take first?
A. Advise the client to come to the clinic immediately for further
assessment.
B. Instruct the client to discontinue use of the drug and to make an
appointment at the clinic.
C. Suggest that the client learn to accept the cough as a side effect to
a necessary prescription.
EXAM | EVOLVE HESI MEDICAL SURGICAL
EXAM | 150 EXAM QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES | LATEST EXAM
2025 | 2026 GUIDE
The x-ray for the client in the emergency department (ED) reveals a
right-sided rib fracture. What information will the nurse include in the
client's discharge instructions? (Select all that apply.)
A. Splint your right side with your right arm.
B. You may have to sleep sitting up for a while.
C. Return to the ED if you develop difficulty in breathing.
D. Use shallow breaths until the pain subsides.
E. Use 2 L of oxygen by nasal cannula when you have shortness of
breath.
- Correct Answer -
Splint your right side with your right arm.
You may have to sleep sitting up for a while.
Return to the ED if you develop difficulty in breathing.
Rationale: Shallow breaths do not promote adequate oxygenation. The
client should splint the area and breathe as normally as possible to
maintain adequate oxygenation. Shortness of breath should not occur
with a rib fracture and is a sign of a pneumothorax. The client will not be
,sent home with O2 by nasal cannula if the only health issue is a
fractured rib.
The nurse is caring for a client who is one day post-acute myocardial
infarction. The client is receiving oxygen at 2 L/min via nasal cannula
and has a peripheral saline lock. The nurse notes that the client is
having eight premature ventricular contractions (PVCs) per minute.
Which action should the nurse take first?
Obtain an IV pump for antiarrhythmic infusion.
Increase the client's oxygen flow rate.
Prepare for immediate countershock.
Gather equipment for endotracheal intubation.
- Correct Answer - B.
Increase the client's oxygen flow rate.
Rationale: Increasing the oxygen flow rate provides more oxygen to the
client's myocardium and may decrease myocardial irritability as
manifested by the frequent PVCs. Option A can be delegated and is a
lower priority action than option B. Defibrillation may eventually be
necessary, but option C is not the immediate treatment for frequent
PVCs. Option D may become necessary if the client stops breathing but
is not indicated at this time.
The nurse notes for the client undergoing peritoneal dialysis during the
outflow phase the draining dialysate suddenly stops. The outflow is one
liter less than the inflow at this time. What is the next nursing action?
, A. Take the client's blood pressure.
B. Take the client's weight.
C. Call the health care provider (HCP).
D. Have the client change positions.
- Correct Answer - D.
Have the client change positions.
Rationale: The outflow should match the inflow. With repositioning fluid
trapped within the peritoneum may be repositioned to the proximity of
the abdominal catheter. While the vital signs and the weight may support
the additional fluid, they do not address the cause of the reduced
outflow. At this time, there is no medical emergency to notify the HCP.
The nurse is preparing a 45-year-old client for discharge from a cancer
center following ileostomy surgery for colon cancer. Which discharge
goal should the nurse include in this client's discharge plan?Select an
option, then click Submit.
A. Reduce the daily intake of animal fat to 10% of the diet within 6
weeks.
B. Exhibit regular, soft-formed stool within 1 month.
C. Demonstrate the irrigation procedure correctly within 1 week.
D. Attend an ostomy support group within 2 weeks.
- Correct Answer - D.
Attend an ostomy support group within 2 weeks.
Rationale: Attending a support group will be beneficial to the client and
should be encouraged because adaptation to the ostomy can be difficult.
This goal is attainable and is measurable. Option A is not specifically
, related to ileostomy care. The client with an ileostomy will not be able to
accomplish option B. Option C is not necessary.
A client with cirrhosis develops increasing pedal edema and ascites.
Which dietary modification is most important for the nurse to teach this
client?
A. Avoid high-carbohydrate foods.
B. Decrease intake of fat-soluble vitamins.
C. Decrease caloric intake.
D. Restrict salt and fluid intake.
- Correct Answer - D.
Restrict salt and fluid intake.
Rationale: Salt and fluid restrictions are the first dietary modifications for
a client who is retaining fluid as manifested by edema and ascites.
Options A, B, and C will not affect fluid retention.
A client who is receiving an angiotensin-converting enzyme (ACE)
inhibitor for hypertension calls the clinic and reports the recent onset of a
cough to the nurse. Which action should the nurse take first?
A. Advise the client to come to the clinic immediately for further
assessment.
B. Instruct the client to discontinue use of the drug and to make an
appointment at the clinic.
C. Suggest that the client learn to accept the cough as a side effect to
a necessary prescription.
