Evolve HESI med surg Exam 2025 Prep Test Bank
EVOLVE HESI MED SURG EXAM 2025 PREP TEST BANK WITH
400 REAL EXAM PRACTICE QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES/ PN HESI MED SURG EVOLVE
EXAM 2025—2026/ EVOLVE MED SURG (PN)
A central venous catheter has been inserted via a jugular vein, and a radiograph
has confirmed placement of the catheter. A prescription has been received for a
medication STAT, but IV fluids have not yet been started. Which action should the
nurse take prior to administering the prescribed medication?
A. Assess for signs of jugular venous distention.
B. Obtain the needed intravenous solution.
C. Flush the line with heparinized solution.
D. Flush the line with normal saline.
D
Rationale:Medication can be administered via a central line without additional IV
fluids. The line should first be flushed with a normal saline solution to ensure
patency. Insufficient evidence exists on the effectiveness of flushing catheters with
heparin. Option A will not affect the decision to administer the medication and is
not a priority. Administration of the medication STAT is of greater priority than
option B.
Which data would the nurse expect to find when reviewing laboratory values of an
80-year-old man who is in good health overall?
A. Complete blood count reveals increased white blood cell (WBC) and decreased
red blood cell (RBC) counts.
B. Chemistries reveal an increased serum bilirubin level with slightly increased
liver enzyme levels.
C. Urinalysis reveals slight protein in the urine and bacteriuria, with pyuria.
D. Serum electrolytes reveal a decreased sodium level and increased potassium
level.
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, Evolve HESI med surg Exam 2025 Prep Test Bank
C
Rationale: In older adults, the protein found in urine slightly rises, probably as a
result of kidney changes or subclinical urinary tract infections, and clients
frequently experience asymptomatic bacteriuria and pyuria as a result of
incomplete bladder emptying. Laboratory findings in options A, B, and D are not
considered to be normal findings in an older adult.
The nurse witnesses a baseball player receive a blunt trauma to the back of the
head with a softball. What assessment data should the nurse collect immediately?
A. Reactivity of deep tendon reflexes, comparing upper with lower extremities
B. Vital sign readings, excluding blood pressure if needed equipment is unavailable
C. Memory of events that occurred before and after the blow to the head
D. Ability to open the eyes spontaneously before any tactile stimuli are given
D
Rationale: The level of consciousness (LOC) should be established immediately
when a head injury has occurred. Spontaneous eye opening is a simple measure
of alertness that indicates that arousal mechanisms are intact. Option A is not the
best indicator of LOC. Although option B is important, vital signs are not the best
indicators of LOC and can be evaluated after the client's LOC has been
determined. Option C can be assessed after LOC has been established by assessing
eye opening.
A client diagnosed with angina pectoris complains of chest pain while ambulating
in the hallway. Which action should the nurse implement first?
A. Support the client to a sitting position.
B. Ask the client to walk slowly back to the room.
C. Administer a sublingual nitroglycerin tablet.
D. Provide oxygen via nasal cannula.
A
Rationale: The nurse should safely assist the client to a resting position and then
perform options C and D. The client must cease all activity immediately, which will
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, Evolve HESI med surg Exam 2025 Prep Test Bank
decrease the oxygen requirement of the myocardial muscle. After these
interventions are implemented, the client can be escorted back to the room via
wheelchair or stretcher.
In assessing a client with an arteriovenous (AV) shunt who is scheduled for dialysis
today, the nurse notes the absence of a thrill or bruit at the shunt site. What
action should the nurse take?
A. Advise the client that the shunt is intact and ready for dialysis as scheduled.
B. Encourage the client to keep the shunt site elevated above the level of the
heart.
C. Notify the health care provider of the findings immediately.
D. Flush the site at least once with a heparinized saline solution.
C
Rationale: Absence of a thrill or bruit indicates that the shunt may be obstructed.
The nurse should notify the health care provider so that intervention can be
initiated to restore function of the shunt. Option A is incorrect. Option B will not
resolve the obstruction. An AV shunt is internal and cannot be flushed without
access using special needles
The nurse initiates neurologic checks for a client who is at risk for neurologic
compromise. Which manifestation typically provides the first indication of altered
neurologic function?
A. Change in level of consciousness
B. Increasing muscular weakness
C. Changes in pupil size bilaterally
D. Progressive nuchal rigidity
A
Rationale: A decrease or change in the level of consciousness is usually the first
indication of neurologic deterioration. Options B and C may also occur but are
much less likely to be the first sign of neurologic compromise. Option D is often a
sign of meningitis.
3|Page
, Evolve HESI med surg Exam 2025 Prep Test Bank
What is the most important nursing priority for a client who has been admitted for
a possible kidney stone?
A. Reducing dairy products in the diet
B. Straining all urine
C. Measuring intake and output
D. Increasing fluid intake
B
Rationale: Straining all urine is the most important nursing action to take in this
case. Encouraging fluid intake is important for any client who may have a kidney
stone, but it is even more important to strain all urine. Straining urine will enable
the nurse to determine when the kidney stone has been passed and may prevent
the need for surgery. Option C is not the highest priority action. Option A is usually
not recommended until the stone is obtained and the content of the stone is
determined. Even then, dietary restrictions are controversial
During the shift report, the charge nurse informs a nurse that she has been
assigned to another unit for the day. The nurse begins to sigh deeply and tosses
about her belongings as she prepares to leave, making it known that she is very
unhappy about being floated to the other unit. What is the best immediate action
for the charge nurse to take?
A. Continue with the shift report and talk to the nurse about the incident at a later
time.
B. Ask the nurse to call the house supervisor to see if she must be reassigned.
C. Stop the shift report and remind the nurse that all staff are floated equally.
D. Inform the nurse that her behavior is disruptive to the rest of the staff.
A
Rationale: Continuing with the shift report is the best immediate action because it
allows the nurse who was floated some cooling off time. At a later time (after the
nurse has cooled off) the charge nurse should discuss the conduct of the nurse in
private. Option B encourages the nurse to shirk the float assignment. Option C is
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EVOLVE HESI MED SURG EXAM 2025 PREP TEST BANK WITH
400 REAL EXAM PRACTICE QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES/ PN HESI MED SURG EVOLVE
EXAM 2025—2026/ EVOLVE MED SURG (PN)
A central venous catheter has been inserted via a jugular vein, and a radiograph
has confirmed placement of the catheter. A prescription has been received for a
medication STAT, but IV fluids have not yet been started. Which action should the
nurse take prior to administering the prescribed medication?
A. Assess for signs of jugular venous distention.
B. Obtain the needed intravenous solution.
C. Flush the line with heparinized solution.
D. Flush the line with normal saline.
D
Rationale:Medication can be administered via a central line without additional IV
fluids. The line should first be flushed with a normal saline solution to ensure
patency. Insufficient evidence exists on the effectiveness of flushing catheters with
heparin. Option A will not affect the decision to administer the medication and is
not a priority. Administration of the medication STAT is of greater priority than
option B.
Which data would the nurse expect to find when reviewing laboratory values of an
80-year-old man who is in good health overall?
A. Complete blood count reveals increased white blood cell (WBC) and decreased
red blood cell (RBC) counts.
B. Chemistries reveal an increased serum bilirubin level with slightly increased
liver enzyme levels.
C. Urinalysis reveals slight protein in the urine and bacteriuria, with pyuria.
D. Serum electrolytes reveal a decreased sodium level and increased potassium
level.
1|Page
, Evolve HESI med surg Exam 2025 Prep Test Bank
C
Rationale: In older adults, the protein found in urine slightly rises, probably as a
result of kidney changes or subclinical urinary tract infections, and clients
frequently experience asymptomatic bacteriuria and pyuria as a result of
incomplete bladder emptying. Laboratory findings in options A, B, and D are not
considered to be normal findings in an older adult.
The nurse witnesses a baseball player receive a blunt trauma to the back of the
head with a softball. What assessment data should the nurse collect immediately?
A. Reactivity of deep tendon reflexes, comparing upper with lower extremities
B. Vital sign readings, excluding blood pressure if needed equipment is unavailable
C. Memory of events that occurred before and after the blow to the head
D. Ability to open the eyes spontaneously before any tactile stimuli are given
D
Rationale: The level of consciousness (LOC) should be established immediately
when a head injury has occurred. Spontaneous eye opening is a simple measure
of alertness that indicates that arousal mechanisms are intact. Option A is not the
best indicator of LOC. Although option B is important, vital signs are not the best
indicators of LOC and can be evaluated after the client's LOC has been
determined. Option C can be assessed after LOC has been established by assessing
eye opening.
A client diagnosed with angina pectoris complains of chest pain while ambulating
in the hallway. Which action should the nurse implement first?
A. Support the client to a sitting position.
B. Ask the client to walk slowly back to the room.
C. Administer a sublingual nitroglycerin tablet.
D. Provide oxygen via nasal cannula.
A
Rationale: The nurse should safely assist the client to a resting position and then
perform options C and D. The client must cease all activity immediately, which will
2|Page
, Evolve HESI med surg Exam 2025 Prep Test Bank
decrease the oxygen requirement of the myocardial muscle. After these
interventions are implemented, the client can be escorted back to the room via
wheelchair or stretcher.
In assessing a client with an arteriovenous (AV) shunt who is scheduled for dialysis
today, the nurse notes the absence of a thrill or bruit at the shunt site. What
action should the nurse take?
A. Advise the client that the shunt is intact and ready for dialysis as scheduled.
B. Encourage the client to keep the shunt site elevated above the level of the
heart.
C. Notify the health care provider of the findings immediately.
D. Flush the site at least once with a heparinized saline solution.
C
Rationale: Absence of a thrill or bruit indicates that the shunt may be obstructed.
The nurse should notify the health care provider so that intervention can be
initiated to restore function of the shunt. Option A is incorrect. Option B will not
resolve the obstruction. An AV shunt is internal and cannot be flushed without
access using special needles
The nurse initiates neurologic checks for a client who is at risk for neurologic
compromise. Which manifestation typically provides the first indication of altered
neurologic function?
A. Change in level of consciousness
B. Increasing muscular weakness
C. Changes in pupil size bilaterally
D. Progressive nuchal rigidity
A
Rationale: A decrease or change in the level of consciousness is usually the first
indication of neurologic deterioration. Options B and C may also occur but are
much less likely to be the first sign of neurologic compromise. Option D is often a
sign of meningitis.
3|Page
, Evolve HESI med surg Exam 2025 Prep Test Bank
What is the most important nursing priority for a client who has been admitted for
a possible kidney stone?
A. Reducing dairy products in the diet
B. Straining all urine
C. Measuring intake and output
D. Increasing fluid intake
B
Rationale: Straining all urine is the most important nursing action to take in this
case. Encouraging fluid intake is important for any client who may have a kidney
stone, but it is even more important to strain all urine. Straining urine will enable
the nurse to determine when the kidney stone has been passed and may prevent
the need for surgery. Option C is not the highest priority action. Option A is usually
not recommended until the stone is obtained and the content of the stone is
determined. Even then, dietary restrictions are controversial
During the shift report, the charge nurse informs a nurse that she has been
assigned to another unit for the day. The nurse begins to sigh deeply and tosses
about her belongings as she prepares to leave, making it known that she is very
unhappy about being floated to the other unit. What is the best immediate action
for the charge nurse to take?
A. Continue with the shift report and talk to the nurse about the incident at a later
time.
B. Ask the nurse to call the house supervisor to see if she must be reassigned.
C. Stop the shift report and remind the nurse that all staff are floated equally.
D. Inform the nurse that her behavior is disruptive to the rest of the staff.
A
Rationale: Continuing with the shift report is the best immediate action because it
allows the nurse who was floated some cooling off time. At a later time (after the
nurse has cooled off) the charge nurse should discuss the conduct of the nurse in
private. Option B encourages the nurse to shirk the float assignment. Option C is
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