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
A client with hypertension has been receiving ramipril, 5 mg PO, daily for
2 weeks and is scheduled to receive a dose at 0900. At 0830, the client's
blood pressure is 120/70 mm Hg. Which action should the nurse take?
A. Administer the prescribed dose at the scheduled time.
B. Hold the dose and contact the health care provider.
C. Hold the dose and recheck the blood pressure in 1 hour.
D. Check the health care provider's prescription to clarify the dose.
- Correct Answer - A.
Administer the prescribed dose at the scheduled time.
Rationale: The client's blood pressure is within normal limits, indicating
that the ramipril, an antihypertensive, is having the desired effect and
should be administered. Options B and C would be appropriate if the
client's blood pressure was excessively low (<100 mm Hg systolic) or if
the client were exhibiting signs of hypotension such as dizziness. This
prescribed dose is within the normal dosage range, as defined by the
manufacturer; therefore, option D is not necessary.
,For the client with a prescription for enteral feeding after surgery, the
nurse checks the gastric aspirate and notes the pH is 5.2. What is the
next nurse's action?
A. Call for a chest x-ray.
B. Initiate the procedures for the feeding.
C. Tell the client the feeding will be delayed.
D. Inject 10 mL of air down the NG tube.
- Correct Answer - B.
Initiate the procedures for the feeding.
Rationale: Other than taking a chest x-ray before initiating every enteral
feeding, checking the pH of the stomach contents is another way of
determining if the NG tube is still in the stomach. As long as the aspirate
is less than 5.5 and the tube has remained secure, the reasonable
assumption is the tube is in the stomach. Procedures to start the feeding
can begin. Calling for a chest x-ray is appropriate if the nurse suspects
the NG tube has been dislodged. There is no need to delay the feeding.
Injecting air into a NG tube only determines patency, not placement.
Which content about self-care should the nurse include in the teaching
plan of a female client who has genital herpes? (Select all that apply.)
A. Encourage annual physical and Pap smear.
B. Take antiviral medication as prescribed.
C. Use condoms to avoid transmission to others.
D. Warm sitz baths may relieve itching.
E. Use Nystatin suppositories to control itching.
Use a douche with weak vinegar solution to decrease itching.
,- Correct Answer -
Encourage annual physical and Pap smear.
Take antiviral medication as prescribed.
Use condoms to avoid transmission to others.
Warm sitz baths may relieve itching.
Rationale: The nurse should include (A, B, C, and D) in the teaching plan
of a female client with genital herpes. (E) is specific for Candida
infections, and option (F) is used to treat Trichomonas.
The nurse is caring for a critically ill client with cirrhosis of the liver who
has a nasogastric tube draining bright red blood. The nurse notes that
the client's serum hemoglobin and hematocrit levels are decreased.
Which additional change in laboratory data should the nurse expect?
A. Increased serum albumin level
B. Decreased serum creatinine
C. Decreased serum ammonia level
D. Increased liver function test results
- Correct Answer - C.
Decreased serum ammonia level
Rationale: The breakdown of glutamine in the intestine and the
increased activity of colonic bacteria from the digestion of proteins
increase ammonia levels in clients with advanced liver disease, so
removal of blood, a protein source, from the intestine results in a
reduced level of ammonia. Options A, B, and D will not be significantly
affected by the removal of blood.
, The nurse is administering a nystatin suspension for stomatitis. Which
instruction will the nurse provide to the client when administering this
medication?
A. "Hold the medication in your mouth for a few minutes before
swallowing it."
B. "Do not drink or eat milk products for 1 hour prior to taking this
medication."
C. "Dilute the medication with juice to reduce the unpleasant taste
and odor."
D. "Take the medication before meals to promote increased
absorption."
- Correct Answer - A.
"Hold the medication in your mouth for a few minutes before swallowing
it."
Rationale: Nystatin suspension is prescribed for fungal infections of the
mouth. The client should swish the medication in the mouth for 2
minutes and then swallow. Option B does not affect administration of this
medication. The medication should not be diluted because this will
reduce its effectiveness. Option D is not necessary.
Which condition should the nurse anticipate as a potential problem in a
female client with a neurogenic bladder?
A. Stress incontinence
B. Infection
EXAM | EVOLVE HESI MEDICAL SURGICAL
EXAM | 150 EXAM QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES | LATEST EXAM
2025 | 2026 GUIDE
A client with hypertension has been receiving ramipril, 5 mg PO, daily for
2 weeks and is scheduled to receive a dose at 0900. At 0830, the client's
blood pressure is 120/70 mm Hg. Which action should the nurse take?
A. Administer the prescribed dose at the scheduled time.
B. Hold the dose and contact the health care provider.
C. Hold the dose and recheck the blood pressure in 1 hour.
D. Check the health care provider's prescription to clarify the dose.
- Correct Answer - A.
Administer the prescribed dose at the scheduled time.
Rationale: The client's blood pressure is within normal limits, indicating
that the ramipril, an antihypertensive, is having the desired effect and
should be administered. Options B and C would be appropriate if the
client's blood pressure was excessively low (<100 mm Hg systolic) or if
the client were exhibiting signs of hypotension such as dizziness. This
prescribed dose is within the normal dosage range, as defined by the
manufacturer; therefore, option D is not necessary.
,For the client with a prescription for enteral feeding after surgery, the
nurse checks the gastric aspirate and notes the pH is 5.2. What is the
next nurse's action?
A. Call for a chest x-ray.
B. Initiate the procedures for the feeding.
C. Tell the client the feeding will be delayed.
D. Inject 10 mL of air down the NG tube.
- Correct Answer - B.
Initiate the procedures for the feeding.
Rationale: Other than taking a chest x-ray before initiating every enteral
feeding, checking the pH of the stomach contents is another way of
determining if the NG tube is still in the stomach. As long as the aspirate
is less than 5.5 and the tube has remained secure, the reasonable
assumption is the tube is in the stomach. Procedures to start the feeding
can begin. Calling for a chest x-ray is appropriate if the nurse suspects
the NG tube has been dislodged. There is no need to delay the feeding.
Injecting air into a NG tube only determines patency, not placement.
Which content about self-care should the nurse include in the teaching
plan of a female client who has genital herpes? (Select all that apply.)
A. Encourage annual physical and Pap smear.
B. Take antiviral medication as prescribed.
C. Use condoms to avoid transmission to others.
D. Warm sitz baths may relieve itching.
E. Use Nystatin suppositories to control itching.
Use a douche with weak vinegar solution to decrease itching.
,- Correct Answer -
Encourage annual physical and Pap smear.
Take antiviral medication as prescribed.
Use condoms to avoid transmission to others.
Warm sitz baths may relieve itching.
Rationale: The nurse should include (A, B, C, and D) in the teaching plan
of a female client with genital herpes. (E) is specific for Candida
infections, and option (F) is used to treat Trichomonas.
The nurse is caring for a critically ill client with cirrhosis of the liver who
has a nasogastric tube draining bright red blood. The nurse notes that
the client's serum hemoglobin and hematocrit levels are decreased.
Which additional change in laboratory data should the nurse expect?
A. Increased serum albumin level
B. Decreased serum creatinine
C. Decreased serum ammonia level
D. Increased liver function test results
- Correct Answer - C.
Decreased serum ammonia level
Rationale: The breakdown of glutamine in the intestine and the
increased activity of colonic bacteria from the digestion of proteins
increase ammonia levels in clients with advanced liver disease, so
removal of blood, a protein source, from the intestine results in a
reduced level of ammonia. Options A, B, and D will not be significantly
affected by the removal of blood.
, The nurse is administering a nystatin suspension for stomatitis. Which
instruction will the nurse provide to the client when administering this
medication?
A. "Hold the medication in your mouth for a few minutes before
swallowing it."
B. "Do not drink or eat milk products for 1 hour prior to taking this
medication."
C. "Dilute the medication with juice to reduce the unpleasant taste
and odor."
D. "Take the medication before meals to promote increased
absorption."
- Correct Answer - A.
"Hold the medication in your mouth for a few minutes before swallowing
it."
Rationale: Nystatin suspension is prescribed for fungal infections of the
mouth. The client should swish the medication in the mouth for 2
minutes and then swallow. Option B does not affect administration of this
medication. The medication should not be diluted because this will
reduce its effectiveness. Option D is not necessary.
Which condition should the nurse anticipate as a potential problem in a
female client with a neurogenic bladder?
A. Stress incontinence
B. Infection
