EVOLVE ELSEVIER HESI MED-SURG ACTUAL EXAM
QUESTION BANK | 2025 CURRENTLY TESTING
ACCURATE REAL EXAM QUESTIONS WITH
DETAILED VERIFIED ANSWERS GRADED A+ |
GUARANTEED EXCELLENCE PASS
A 74-year-old male client is admitted to the intensive care unit (ICU) with a
diagnosis of respiratory failure secondary to pneumonia. Currently, the client is
ventilator-dependent, with settings of tidal volume (VT) of 750 mL and an
intermittent mandatory ventilation (IMV) rate of 10 breaths/min. Arterial blood
gas (ABG) results are as follows: pH, 7.48; PaCO2, 30 mm Hg; PaO2, 64 mm Hg;
HCO3, 25 mEq/L; and FiO2, 0.80. Which action should the nurse take first?
A.
Increase the ventilator VT to 850 mL.
B.
Decrease the ventilator IMV to a rate of 8 breaths/min.
C.
Reduce the FiO2 to 0.70 and redraw ABGs.
D.
Add 5 cm positive end-expiratory pressure (PEEP). - ✔✔✔ Correct Answer >
Correct Answer: D
Rationale:
Adding PEEP helps improve oxygenation while reducing FiO2 to a less toxic
level. Options A, B, and C will not result in improved oxygenation and could
,cause further complications for this client, who is experiencing respiratory
failure
The nurse assesses a client who has been prescribed furosemide for cardiac
disease. Which electrocardiographic change would be a concern for a client taking
a diuretic?
A. Tall, spiked T waves
B. A prolonged QT interval
C.A widening QRS complex
D. Presence of a U wave - ✔✔✔ Correct Answer > Correct Answer: D
Rationale: A U wave is a positive deflection following the T wave and is often
present with hypokalemia (low potassium level). Options A, B, and C are all
signs of hyperkalemia.
A 62-year-old client who lives alone tripped on a scatter rug resulting in a
fractured hip. Which predisposing factor most likely contributed to the fracture in
the proximal end of her femur
A. Failing eyesight resulting in an unsafe environment
B. Renal osteodystrophy resulting from chronic kidney disease (CKD)
C.Osteoporosis resulting from declining hormone levels
D.Cerebral vessel changes causing transient ischemic attacks - ✔✔✔ Correct
Answer > Correct Answer: C
Rationale: The most common cause of a fractured hip in older women is
osteoporosis, resulting from reduced calcium in the bones as a result of
hormonal changes in the perimenopausal years. Option A may or may not have
contributed to the accident, but eye changes were not involved in promoting
the hip fracture. Option B is not a common condition of older people but is
,associated with CKD. Although option D may result in transient ischemic attacks
(TIAs) or stroke, it will not result in fragility of the bones, as does osteoporosis.
A nurse is assisting an 82-year-old client with ambulation and is concerned that
the client may fall. Which area contains the older person's center of gravity?
A. Head and neck
B. Upper torso
C. Bilateral arms
D. Feet and legs - ✔✔✔ Correct Answer > Correct Answer: B
Rationale: Stooped posture results in the upper torso becoming the center of
gravity for older persons. The center of gravity for adults is the hips. However,
as a person grows older, a stooped posture is common because of changes
caused by osteoporosis and normal bone degeneration. Furthermore, the knees,
hips, and elbows flex. The head and neck and feet and legs are not the center of
gravity in the older adult. Although the arms comprise a part of the upper torso,
they do not reflect the best and most complete answer.
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 > Correct Answer: A
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
The nurse is providing care for a client diagnosed with trigeminal neuralgia (tic
douloureux). Which symptoms will the nurse be looking for in the focused
assessment related to this condition? (Select all that apply.)
A. Facial muscle spasms
B. Sudden facial pain
C. Unilateral facial weakness
D. Difficulty in chewing
E.Tinnitus
F.Hearing difficulties - ✔✔✔ Correct Answer > Correct Answer: A,B
Rationale: Trigeminal neuralgia is characterized by paroxysms of pain, similar to
an electric shock, in the area innervated by one or more branches of the
trigeminal nerve (cranial V). The remaining symptoms are not related to
trigeminal neuralgia.
In caring for a client with acute diverticulitis, which assessment data warrants an
immediate nursing action?
A. The client has a rigid hard abdomen and elevated WBC.
B. The client has left lower quadrant pain and an elevated temperature.
C.The client is refusing to eat any of the meal and is complaining of nausea.
D. The client has not had a bowel movement in 2 days and has a soft abdomen. -
✔✔✔ Correct Answer > Correct Answer: A
QUESTION BANK | 2025 CURRENTLY TESTING
ACCURATE REAL EXAM QUESTIONS WITH
DETAILED VERIFIED ANSWERS GRADED A+ |
GUARANTEED EXCELLENCE PASS
A 74-year-old male client is admitted to the intensive care unit (ICU) with a
diagnosis of respiratory failure secondary to pneumonia. Currently, the client is
ventilator-dependent, with settings of tidal volume (VT) of 750 mL and an
intermittent mandatory ventilation (IMV) rate of 10 breaths/min. Arterial blood
gas (ABG) results are as follows: pH, 7.48; PaCO2, 30 mm Hg; PaO2, 64 mm Hg;
HCO3, 25 mEq/L; and FiO2, 0.80. Which action should the nurse take first?
A.
Increase the ventilator VT to 850 mL.
B.
Decrease the ventilator IMV to a rate of 8 breaths/min.
C.
Reduce the FiO2 to 0.70 and redraw ABGs.
D.
Add 5 cm positive end-expiratory pressure (PEEP). - ✔✔✔ Correct Answer >
Correct Answer: D
Rationale:
Adding PEEP helps improve oxygenation while reducing FiO2 to a less toxic
level. Options A, B, and C will not result in improved oxygenation and could
,cause further complications for this client, who is experiencing respiratory
failure
The nurse assesses a client who has been prescribed furosemide for cardiac
disease. Which electrocardiographic change would be a concern for a client taking
a diuretic?
A. Tall, spiked T waves
B. A prolonged QT interval
C.A widening QRS complex
D. Presence of a U wave - ✔✔✔ Correct Answer > Correct Answer: D
Rationale: A U wave is a positive deflection following the T wave and is often
present with hypokalemia (low potassium level). Options A, B, and C are all
signs of hyperkalemia.
A 62-year-old client who lives alone tripped on a scatter rug resulting in a
fractured hip. Which predisposing factor most likely contributed to the fracture in
the proximal end of her femur
A. Failing eyesight resulting in an unsafe environment
B. Renal osteodystrophy resulting from chronic kidney disease (CKD)
C.Osteoporosis resulting from declining hormone levels
D.Cerebral vessel changes causing transient ischemic attacks - ✔✔✔ Correct
Answer > Correct Answer: C
Rationale: The most common cause of a fractured hip in older women is
osteoporosis, resulting from reduced calcium in the bones as a result of
hormonal changes in the perimenopausal years. Option A may or may not have
contributed to the accident, but eye changes were not involved in promoting
the hip fracture. Option B is not a common condition of older people but is
,associated with CKD. Although option D may result in transient ischemic attacks
(TIAs) or stroke, it will not result in fragility of the bones, as does osteoporosis.
A nurse is assisting an 82-year-old client with ambulation and is concerned that
the client may fall. Which area contains the older person's center of gravity?
A. Head and neck
B. Upper torso
C. Bilateral arms
D. Feet and legs - ✔✔✔ Correct Answer > Correct Answer: B
Rationale: Stooped posture results in the upper torso becoming the center of
gravity for older persons. The center of gravity for adults is the hips. However,
as a person grows older, a stooped posture is common because of changes
caused by osteoporosis and normal bone degeneration. Furthermore, the knees,
hips, and elbows flex. The head and neck and feet and legs are not the center of
gravity in the older adult. Although the arms comprise a part of the upper torso,
they do not reflect the best and most complete answer.
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 > Correct Answer: A
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
The nurse is providing care for a client diagnosed with trigeminal neuralgia (tic
douloureux). Which symptoms will the nurse be looking for in the focused
assessment related to this condition? (Select all that apply.)
A. Facial muscle spasms
B. Sudden facial pain
C. Unilateral facial weakness
D. Difficulty in chewing
E.Tinnitus
F.Hearing difficulties - ✔✔✔ Correct Answer > Correct Answer: A,B
Rationale: Trigeminal neuralgia is characterized by paroxysms of pain, similar to
an electric shock, in the area innervated by one or more branches of the
trigeminal nerve (cranial V). The remaining symptoms are not related to
trigeminal neuralgia.
In caring for a client with acute diverticulitis, which assessment data warrants an
immediate nursing action?
A. The client has a rigid hard abdomen and elevated WBC.
B. The client has left lower quadrant pain and an elevated temperature.
C.The client is refusing to eat any of the meal and is complaining of nausea.
D. The client has not had a bowel movement in 2 days and has a soft abdomen. -
✔✔✔ Correct Answer > Correct Answer: A
