EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM WITH 50 REAL EXAM
QUESTIONS AND CORRECT ANSWERS WITH WELL-ELABORATED RATIONALES/
EVOLVE HESI MEDICAL SURGICAL LATEST EXAM 2025
1. A nurse is caring for a client who has chronic obstructive pulmonary
disease (COPD) and is receiving oxygen therapy. The nurse notes that
the oxygen flow rate is set to 2 L/min via nasal cannula. Which of the
following is an appropriate action by the nurse?
A. Increase the flow rate to 4 L/min
B. Decrease the flow rate to 1 L/min
C. Continue the current oxygen flow rate
D. Notify the healthcare provider to change the oxygen therapy
Answer: C. Continue the current oxygen flow rate
Rationale: Clients with COPD require low-flow oxygen to avoid the risk
of suppressing their respiratory drive. The typical starting flow rate is 1
to 2 L/min, and it should be adjusted based on the client’s oxygen
saturation. Increasing the flow rate could lead to carbon dioxide
retention.
2. A nurse is providing discharge instructions to a client with heart
failure who is prescribed furosemide. Which of the following
instructions should the nurse include?
A. "You may take this medication in the morning or at bedtime."
B. "Be sure to monitor your blood pressure every day."
C. "Increase your intake of potassium-rich foods."
D. "Limit your fluid intake to 1 liter per day."
Answer: C. "Increase your intake of potassium-rich foods."
Rationale: Furosemide is a loop diuretic that can cause potassium loss.
,The nurse should instruct the client to eat potassium-rich foods like
bananas, oranges, and potatoes to prevent hypokalemia.
3. A nurse is caring for a postoperative client who has a wound drain
in place. The nurse notes that the drainage is thick, yellow, and has a
strong odor. What is the most appropriate action?
A. Notify the healthcare provider immediately.
B. Document the drainage characteristics.
C. Change the dressing and monitor for further changes.
D. Increase the frequency of the dressing changes.
Answer: A. Notify the healthcare provider immediately.
Rationale: Thick, yellow drainage with a strong odor is indicative of
infection. The nurse should report this finding to the healthcare
provider so that further action (such as culture and sensitivity testing or
antibiotics) can be taken.
4. A nurse is caring for a client with a diagnosis of deep vein
thrombosis (DVT). The client is prescribed warfarin. Which of the
following laboratory results should the nurse monitor to evaluate the
effectiveness of warfarin therapy?
A. Partial thromboplastin time (PTT)
B. International normalized ratio (INR)
C. Platelet count
D. Prothrombin time (PT)
Answer: B. International normalized ratio (INR)
Rationale: Warfarin is an anticoagulant, and its effectiveness is
monitored using the INR. The INR measures the clotting tendency of the
, blood, with a therapeutic range typically between 2.0 and 3.0 for clients
receiving warfarin.
5. A nurse is assessing a client with acute pancreatitis. The nurse notes
that the client has a rigid abdomen and absent bowel sounds. What is
the most appropriate action for the nurse to take?
A. Encourage the client to eat small, frequent meals.
B. Notify the healthcare provider immediately.
C. Administer a dose of the prescribed pain medication.
D. Insert a nasogastric (NG) tube.
Answer: B. Notify the healthcare provider immediately.
Rationale: A rigid abdomen and absent bowel sounds are signs of
peritonitis, a potential complication of pancreatitis. The nurse should
notify the healthcare provider immediately to prevent further
complications.
6. A nurse is caring for a client with a urinary tract infection (UTI). The
nurse knows that which of the following is a common manifestation of
a UTI in an older adult?
A. Fever and chills
B. Dysuria and urinary frequency
C. Incontinence and confusion
D. Abdominal pain and nausea
Answer: C. Incontinence and confusion
Rationale: In older adults, UTIs can present with atypical symptoms,
such as confusion or incontinence, rather than the typical fever, dysuria,
and urinary frequency seen in younger individuals.
QUESTIONS AND CORRECT ANSWERS WITH WELL-ELABORATED RATIONALES/
EVOLVE HESI MEDICAL SURGICAL LATEST EXAM 2025
1. A nurse is caring for a client who has chronic obstructive pulmonary
disease (COPD) and is receiving oxygen therapy. The nurse notes that
the oxygen flow rate is set to 2 L/min via nasal cannula. Which of the
following is an appropriate action by the nurse?
A. Increase the flow rate to 4 L/min
B. Decrease the flow rate to 1 L/min
C. Continue the current oxygen flow rate
D. Notify the healthcare provider to change the oxygen therapy
Answer: C. Continue the current oxygen flow rate
Rationale: Clients with COPD require low-flow oxygen to avoid the risk
of suppressing their respiratory drive. The typical starting flow rate is 1
to 2 L/min, and it should be adjusted based on the client’s oxygen
saturation. Increasing the flow rate could lead to carbon dioxide
retention.
2. A nurse is providing discharge instructions to a client with heart
failure who is prescribed furosemide. Which of the following
instructions should the nurse include?
A. "You may take this medication in the morning or at bedtime."
B. "Be sure to monitor your blood pressure every day."
C. "Increase your intake of potassium-rich foods."
D. "Limit your fluid intake to 1 liter per day."
Answer: C. "Increase your intake of potassium-rich foods."
Rationale: Furosemide is a loop diuretic that can cause potassium loss.
,The nurse should instruct the client to eat potassium-rich foods like
bananas, oranges, and potatoes to prevent hypokalemia.
3. A nurse is caring for a postoperative client who has a wound drain
in place. The nurse notes that the drainage is thick, yellow, and has a
strong odor. What is the most appropriate action?
A. Notify the healthcare provider immediately.
B. Document the drainage characteristics.
C. Change the dressing and monitor for further changes.
D. Increase the frequency of the dressing changes.
Answer: A. Notify the healthcare provider immediately.
Rationale: Thick, yellow drainage with a strong odor is indicative of
infection. The nurse should report this finding to the healthcare
provider so that further action (such as culture and sensitivity testing or
antibiotics) can be taken.
4. A nurse is caring for a client with a diagnosis of deep vein
thrombosis (DVT). The client is prescribed warfarin. Which of the
following laboratory results should the nurse monitor to evaluate the
effectiveness of warfarin therapy?
A. Partial thromboplastin time (PTT)
B. International normalized ratio (INR)
C. Platelet count
D. Prothrombin time (PT)
Answer: B. International normalized ratio (INR)
Rationale: Warfarin is an anticoagulant, and its effectiveness is
monitored using the INR. The INR measures the clotting tendency of the
, blood, with a therapeutic range typically between 2.0 and 3.0 for clients
receiving warfarin.
5. A nurse is assessing a client with acute pancreatitis. The nurse notes
that the client has a rigid abdomen and absent bowel sounds. What is
the most appropriate action for the nurse to take?
A. Encourage the client to eat small, frequent meals.
B. Notify the healthcare provider immediately.
C. Administer a dose of the prescribed pain medication.
D. Insert a nasogastric (NG) tube.
Answer: B. Notify the healthcare provider immediately.
Rationale: A rigid abdomen and absent bowel sounds are signs of
peritonitis, a potential complication of pancreatitis. The nurse should
notify the healthcare provider immediately to prevent further
complications.
6. A nurse is caring for a client with a urinary tract infection (UTI). The
nurse knows that which of the following is a common manifestation of
a UTI in an older adult?
A. Fever and chills
B. Dysuria and urinary frequency
C. Incontinence and confusion
D. Abdominal pain and nausea
Answer: C. Incontinence and confusion
Rationale: In older adults, UTIs can present with atypical symptoms,
such as confusion or incontinence, rather than the typical fever, dysuria,
and urinary frequency seen in younger individuals.
