EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM
EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM WITH 200 +
REAL EXAM QUESTIONS AND CORRECT ANSWERS WITH WELL-
ELABORATED RATIONALES/ EVOLVE HESI MEDICAL SURGICAL
LATEST EXAM 2025 (latest) Ace Your Exam
Which nursing action would be appropriate for a client who is newly diagnosed with Cushing
syndrome?
A.Monitor blood glucose levels daily.
B.Increase intake of fluids high in potassium.
C.Encourage adequate rest between activities.
D.Offer the client a sodium-enriched menu. - ANSWER-Correct Answer: A
Rationale: Cushing syndrome results from a hypersecretion of glucocorticoids in the adrenal
cortex. Clients with Cushing syndrome often develop diabetes mellitus. Monitoring of serum
glucose levels assesses for increased blood glucose levels so that treatment can begin early. A
common finding in Cushing syndrome is generalized edema. Although potassium is needed, it is
generally obtained from food intake, not by offering potassium-enhanced fluids. Fatigue is
usually not an overwhelming factor in Cushing syndrome, so an emphasis on the need for rest is
not indicated. A low-calorie, low-carbohydrate, low-sodium diet is not recommended.
During the change of shift report, the charge nurse reviews the infusions being received by
clients on the oncology unit. The client receiving which infusion should be assessed first?
A.Continuous IV infusion of magnesium
B.One-time infusion of albumin
C.Continuous epidural infusion of morphine
D.Intermittent infusion of IV vancomycin - ANSWER-Correct Answer: C
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, EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM
Rationale: All four of these clients have the potential to have significant complications. The
client with the morphine epidural infusion is at highest risk for respiratory depression and
should be assessed first. Option A can cause hypotension. The client receiving option B is at
lowest risk for serious complications. Although option D can cause nephrotoxicity and phlebitis,
these problems are not as immediately life threatening as option C.
A client who received a nephrotoxic drug is admitted with acute renal failure and asks the nurse
if dialysis will always be needed. Which pathophysiologic consequence should the nurse explain
that supports the need for temporary dialysis until acute tubular necrosis subsides?
.
A. Azotemia
B. Oliguria
C. Hyperkalemia
D. Nephron obstruction - ANSWER-Correct Answer: D
Rationale:CKD is characterized by progressive and irreversible destruction of nephrons,
frequently caused by hypertension and diabetes mellitus. Nephrotoxins cause acute tubular
necrosis, a reversible acute renal failure, which creates renal tubular obstruction from
endothelial cells that are sloughed or become edematous. The obstruction of urine flow will
resolve with the return of an adequate glomerular filtration rate, and when it does, dialysis will
no longer be needed. Options A, B, and C are manifestations seen in the acute and chronic
forms of kidney disease.
The client returns to the unit after abdominal surgery with a 5″ × 9″ absorbent dressing in place
to the mid abdomen. The nurse notes a spot of red staining centrally on the dressing. What is
the nurse's next action?
A. Note the size of the stain in the chart.
B. Circle the stain with an ink pen.
C. Remove the dressing to assess the source of the bleeding.
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, EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM
D. Place a pressure dressing on the existing dressing. - ANSWER-Correct Answer: B
Rationale:By circling the existing stain upon admission to the unit, the nurse can then assess any
increase, though subtle, in the amount of drainage over time. The size of the stain will need to
be noted in the chart, but it is not the first action. The nurse removes the dressing under the
prescription of the health care provider or in an emergency. Neither of those conditions exist in
the question. The dressing in place is an absorbent dressing. There is no need for a further
dressing until the existing dressing becomes saturated.
While at a home game, the mother of a 6-year-old is heard screaming, "My child is having an
asthma attack! Can anyone help?" The nurse arrives and finds the child gasping for breath with
circumoral cyanosis. What are the nurse's next actions? (Select all that apply.)
A. Yell, "Call 911."
B. Ask the mother if she has the child's bronchodilator.
C. Start cardiopulmonary respirations.
D. Ask the mother if the child is allergic to bee stings.
E. Stay with the child and mother until the ambulance arrives.
F. Sit the child straight up in Fowler's position. - ANSWER-Correct Answer: A,B,E,F
Rationale: CPR is not needed at this time as the child is still moving air. An allergy to bee stings is
related to anaphylactic shock, which is not the situation here. The remaining actions are correct
for asthma.
The nurse is providing care to a client after a percutaneous transluminal coronary angioplasty
(PTCA). What actions will the nurse include in the client's plan of care? (Select all that apply.)
A. Frequent vital signs.
B. Determine if the client is allergic to aspirin.
C. Assist out of bed 2 hours after return from the procedure.
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, EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM
D. Offer fluids of choice.
E. Assess distal pulses on the side of the procedure.
F. Monitor infusion of IV nitroglycerine. - ANSWER-Correct Answer: A,B,D,F
Rationale: The client's incisional leg needs to stay straight for 6 to 8 hours to decrease the risk of
hemorrhage from the incision site. Pulses must be assessed bilaterally for a point of
comparison. The remaining actions are included in the care plan for the client after a PTCA
A male client has just undergone a laryngectomy and has a cuffed tracheostomy tube in place.
When initiating bolus tube feedings postoperatively, when should the nurse inflate the cuff?
.
A. Immediately after feeding
B. Just prior to tube feeding
C.Continuous inflation is required
D. Inflation is not required - ANSWER-Correct Answer: B
Rationale:The cuff should be inflated before the feeding to block the trachea and prevent food
from entering if oral feedings are started while a cuffed tracheostomy tube is in place. It should
remain inflated throughout the feeding to prevent aspiration of food into the respiratory
system. Options A and D place the client at risk for aspiration. Option C places the client at risk
for tracheal wall necrosis.
A practical nurse (PN) tells the charge nurse in a long-term facility that she does not want to be
assigned to one particular resident. She reports that the male client keeps insisting that she is
his daughter and begs her to stay in his room. What is the best managerial decision?
A. Notify the family that the resident will have to be discharged if his behavior does not
improve.
4|Page
EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM WITH 200 +
REAL EXAM QUESTIONS AND CORRECT ANSWERS WITH WELL-
ELABORATED RATIONALES/ EVOLVE HESI MEDICAL SURGICAL
LATEST EXAM 2025 (latest) Ace Your Exam
Which nursing action would be appropriate for a client who is newly diagnosed with Cushing
syndrome?
A.Monitor blood glucose levels daily.
B.Increase intake of fluids high in potassium.
C.Encourage adequate rest between activities.
D.Offer the client a sodium-enriched menu. - ANSWER-Correct Answer: A
Rationale: Cushing syndrome results from a hypersecretion of glucocorticoids in the adrenal
cortex. Clients with Cushing syndrome often develop diabetes mellitus. Monitoring of serum
glucose levels assesses for increased blood glucose levels so that treatment can begin early. A
common finding in Cushing syndrome is generalized edema. Although potassium is needed, it is
generally obtained from food intake, not by offering potassium-enhanced fluids. Fatigue is
usually not an overwhelming factor in Cushing syndrome, so an emphasis on the need for rest is
not indicated. A low-calorie, low-carbohydrate, low-sodium diet is not recommended.
During the change of shift report, the charge nurse reviews the infusions being received by
clients on the oncology unit. The client receiving which infusion should be assessed first?
A.Continuous IV infusion of magnesium
B.One-time infusion of albumin
C.Continuous epidural infusion of morphine
D.Intermittent infusion of IV vancomycin - ANSWER-Correct Answer: C
1|Page
, EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM
Rationale: All four of these clients have the potential to have significant complications. The
client with the morphine epidural infusion is at highest risk for respiratory depression and
should be assessed first. Option A can cause hypotension. The client receiving option B is at
lowest risk for serious complications. Although option D can cause nephrotoxicity and phlebitis,
these problems are not as immediately life threatening as option C.
A client who received a nephrotoxic drug is admitted with acute renal failure and asks the nurse
if dialysis will always be needed. Which pathophysiologic consequence should the nurse explain
that supports the need for temporary dialysis until acute tubular necrosis subsides?
.
A. Azotemia
B. Oliguria
C. Hyperkalemia
D. Nephron obstruction - ANSWER-Correct Answer: D
Rationale:CKD is characterized by progressive and irreversible destruction of nephrons,
frequently caused by hypertension and diabetes mellitus. Nephrotoxins cause acute tubular
necrosis, a reversible acute renal failure, which creates renal tubular obstruction from
endothelial cells that are sloughed or become edematous. The obstruction of urine flow will
resolve with the return of an adequate glomerular filtration rate, and when it does, dialysis will
no longer be needed. Options A, B, and C are manifestations seen in the acute and chronic
forms of kidney disease.
The client returns to the unit after abdominal surgery with a 5″ × 9″ absorbent dressing in place
to the mid abdomen. The nurse notes a spot of red staining centrally on the dressing. What is
the nurse's next action?
A. Note the size of the stain in the chart.
B. Circle the stain with an ink pen.
C. Remove the dressing to assess the source of the bleeding.
2|Page
, EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM
D. Place a pressure dressing on the existing dressing. - ANSWER-Correct Answer: B
Rationale:By circling the existing stain upon admission to the unit, the nurse can then assess any
increase, though subtle, in the amount of drainage over time. The size of the stain will need to
be noted in the chart, but it is not the first action. The nurse removes the dressing under the
prescription of the health care provider or in an emergency. Neither of those conditions exist in
the question. The dressing in place is an absorbent dressing. There is no need for a further
dressing until the existing dressing becomes saturated.
While at a home game, the mother of a 6-year-old is heard screaming, "My child is having an
asthma attack! Can anyone help?" The nurse arrives and finds the child gasping for breath with
circumoral cyanosis. What are the nurse's next actions? (Select all that apply.)
A. Yell, "Call 911."
B. Ask the mother if she has the child's bronchodilator.
C. Start cardiopulmonary respirations.
D. Ask the mother if the child is allergic to bee stings.
E. Stay with the child and mother until the ambulance arrives.
F. Sit the child straight up in Fowler's position. - ANSWER-Correct Answer: A,B,E,F
Rationale: CPR is not needed at this time as the child is still moving air. An allergy to bee stings is
related to anaphylactic shock, which is not the situation here. The remaining actions are correct
for asthma.
The nurse is providing care to a client after a percutaneous transluminal coronary angioplasty
(PTCA). What actions will the nurse include in the client's plan of care? (Select all that apply.)
A. Frequent vital signs.
B. Determine if the client is allergic to aspirin.
C. Assist out of bed 2 hours after return from the procedure.
3|Page
, EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM
D. Offer fluids of choice.
E. Assess distal pulses on the side of the procedure.
F. Monitor infusion of IV nitroglycerine. - ANSWER-Correct Answer: A,B,D,F
Rationale: The client's incisional leg needs to stay straight for 6 to 8 hours to decrease the risk of
hemorrhage from the incision site. Pulses must be assessed bilaterally for a point of
comparison. The remaining actions are included in the care plan for the client after a PTCA
A male client has just undergone a laryngectomy and has a cuffed tracheostomy tube in place.
When initiating bolus tube feedings postoperatively, when should the nurse inflate the cuff?
.
A. Immediately after feeding
B. Just prior to tube feeding
C.Continuous inflation is required
D. Inflation is not required - ANSWER-Correct Answer: B
Rationale:The cuff should be inflated before the feeding to block the trachea and prevent food
from entering if oral feedings are started while a cuffed tracheostomy tube is in place. It should
remain inflated throughout the feeding to prevent aspiration of food into the respiratory
system. Options A and D place the client at risk for aspiration. Option C places the client at risk
for tracheal wall necrosis.
A practical nurse (PN) tells the charge nurse in a long-term facility that she does not want to be
assigned to one particular resident. She reports that the male client keeps insisting that she is
his daughter and begs her to stay in his room. What is the best managerial decision?
A. Notify the family that the resident will have to be discharged if his behavior does not
improve.
4|Page
