EVOLVE MED SURG HESI EXAM 2026-2027
LATEST VERSION QUESTIONS AND VERIFIED
CORRECT ANSWERS JUST RELEASED
The nurse receives the client's next scheduled bag of TPN labeled with the additive NPH insulin.
Which action should the nurse implement?
A.
Hang the solution at the current rate.
B.
Refrigerate the solution until needed.
C.
Prepare the solution with new tubing.
D.
Return the solution to the pharmacy - answer>>>Correct Answer: D
Rationale:Only regular insulin is administered by the IV route, so the TPN solution containing NPH
insulin should be returned to the pharmacy. Options A, B, and C are not indicated because the
solution should not be administered
The nurse observes ventricular fibrillation on telemetry and, on entering the client's bathroom,
finds the client unconscious on the floor. Which action should the nurse take first?
A.
Administer an antidysrhythmic medication.
B.
Start cardiopulmonary resuscitation.
C.
Prepare for mechanical ventilation.
D.
Assess the client's pulse oximetry. - answer>>>Correct Answer: B
Rationale:Ventricular fibrillation is a life-threatening dysrhythmia, and CPR should be started
immediately until the crash cart arrives. Options A and C are appropriate, but CPR is the priority
action until a defibrillator is available, which is the most effective treatment for ventricular
fibrillation. The client is dying, and option D does not address the seriousness of this situation.
,-
A client with a nasogastric tube attached to low suction states that she is nauseated. The nurse
assesses that there has been no drainage through the nasogastric tube in the last 2 hours. Which
action should the nurse take first?
A.
Irrigate the nasogastric tube with sterile normal saline.
B.
Reposition the client on her side.
C.
Advance the nasogastric tube 5 cm.
D.
Administer an intravenous antiemetic as prescribed. - answer>>>Correct Answer: B
Rationale:The immediate priority is to determine if the tube is functioning correctly, which would
then relieve the client's nausea. The least invasive intervention, repositioning the client, should be
attempted first, followed by options A and C, unless either of these interventions is
contraindicated. If these measures are unsuccessful, the client may require option D
The clinic nurse is teaching a client with osteoarthritis to the knees bilaterally about self-care.
Which teaching points will the nurse include in the client's plan of care? (Select all that apply.)
A.
Apply heat packs to your knees as needed for pain.
B.
Support your knees while you are in bed with a pillow or a rolled towel.
C.
Take 1000 mg of acetaminophen every 4 hours, as needed for pain.
D.
Walk no less than 3 miles every day.
E.
Get 7 to 8 hours of sleep every night.
F.
Eat a balanced diet, including fish with Omega-3 fatty acids. - answer>>>Correct Answer: A,B,E,F
Rationale:The maximum daily dose of acetaminophen is 4 g, the instruction includes up to 6 g/per
day. The best type of exercise does not place additional stress on the knee joints, such as biking or
,swimming. Apply heat to increase circulation and ice packs to decrease swelling. Support to the
knees can take the strain off of the joint. Getting rest will help with coping with the pain of the
disease. Eating a balanced diet may help with weight loss; additional weight places strain on the
joint.
The nurse is interviewing a client who is taking interferon-alfa-2a and ribavirin combination
therapy for hepatitis C. The client reports experiencing overwhelming feelings of depression.
Which action should the nurse take first?
A.
Recommend mental health counseling.
B.
Review the medication actions and interactions.
C.
Assess for the client's daily activity level.
D.
Provide information regarding a support group. - answer>>>Correct Answer: B
Rationale:Interferon-alfa-2a and ribavirin combination therapy can cause severe depression;
therefore, it is most important for the nurse to review the medication effects and report these to
the health care provider. Options A, C, and D might be implemented after the physiologic aspects
of the situation have been assessed.
The nurse notes for the client undergoing peritoneal dialysis during the outflow phase the draining
dialysate suddenly stops. The outflow is one liter less than the inflow at this time. What is the next
nursing action?
A.
Take the client's blood pressure.
B.
Take the client's weight.
C.
Call the health care provider (HCP).
D.
Have the client change positions. - answer>>>Correct Answer: D
Rationale:The outflow should match the inflow. With repositioning fluid trapped within the
peritoneum may be repositioned to the proximity of the abdominal catheter. While the vital signs
and the weight may support the additional fluid, they do not address the cause of the reduced
outflow. At this time, there is no medical emergency to notify the HCP.
, -
A client with congestive heart failure and atrial fibrillation develops ventricular ectopy with a
pattern of 8 ectopic beats/min. Which action should the nurse take based on this observation?
A.
Assess for bilateral jugular vein distention.
B.
Increase oxygen flow via nasal cannula.
C.
Administer PRN furosemide.
D.
Auscultate for a pleural friction rub. - answer>>>Correct Answer: B
Rationale:This client should have the oxygen flow immediately increased to promote oxygenation
of the myocardium. Ventricular ectopy, characterized by multiple PVCs, is often caused by
myocardial ischemia exacerbated by hypokalemia. The nurse would expect the client in congestive
heart failure to have some degree of option A, which does not exacerbate the ectopy. Option C
could create a more severe hypokalemia, which could increase the ectopy. The client is not
exhibiting signs of option D.
A client with cirrhosis develops increasing pedal edema and ascites. Which dietary modification is
most important for the nurse to teach this client?
A.
Avoid high-carbohydrate foods.
B.
Decrease intake of fat-soluble vitamins.
C.
Decrease caloric intake.
D.
Restrict salt and fluid intake. - answer>>>Correct Answer: D
Rationale:Salt and fluid restrictions are the first dietary modifications for a client who is retaining
fluid as manifested by edema and ascites. Options A, B, and C will not affect fluid retention
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?
LATEST VERSION QUESTIONS AND VERIFIED
CORRECT ANSWERS JUST RELEASED
The nurse receives the client's next scheduled bag of TPN labeled with the additive NPH insulin.
Which action should the nurse implement?
A.
Hang the solution at the current rate.
B.
Refrigerate the solution until needed.
C.
Prepare the solution with new tubing.
D.
Return the solution to the pharmacy - answer>>>Correct Answer: D
Rationale:Only regular insulin is administered by the IV route, so the TPN solution containing NPH
insulin should be returned to the pharmacy. Options A, B, and C are not indicated because the
solution should not be administered
The nurse observes ventricular fibrillation on telemetry and, on entering the client's bathroom,
finds the client unconscious on the floor. Which action should the nurse take first?
A.
Administer an antidysrhythmic medication.
B.
Start cardiopulmonary resuscitation.
C.
Prepare for mechanical ventilation.
D.
Assess the client's pulse oximetry. - answer>>>Correct Answer: B
Rationale:Ventricular fibrillation is a life-threatening dysrhythmia, and CPR should be started
immediately until the crash cart arrives. Options A and C are appropriate, but CPR is the priority
action until a defibrillator is available, which is the most effective treatment for ventricular
fibrillation. The client is dying, and option D does not address the seriousness of this situation.
,-
A client with a nasogastric tube attached to low suction states that she is nauseated. The nurse
assesses that there has been no drainage through the nasogastric tube in the last 2 hours. Which
action should the nurse take first?
A.
Irrigate the nasogastric tube with sterile normal saline.
B.
Reposition the client on her side.
C.
Advance the nasogastric tube 5 cm.
D.
Administer an intravenous antiemetic as prescribed. - answer>>>Correct Answer: B
Rationale:The immediate priority is to determine if the tube is functioning correctly, which would
then relieve the client's nausea. The least invasive intervention, repositioning the client, should be
attempted first, followed by options A and C, unless either of these interventions is
contraindicated. If these measures are unsuccessful, the client may require option D
The clinic nurse is teaching a client with osteoarthritis to the knees bilaterally about self-care.
Which teaching points will the nurse include in the client's plan of care? (Select all that apply.)
A.
Apply heat packs to your knees as needed for pain.
B.
Support your knees while you are in bed with a pillow or a rolled towel.
C.
Take 1000 mg of acetaminophen every 4 hours, as needed for pain.
D.
Walk no less than 3 miles every day.
E.
Get 7 to 8 hours of sleep every night.
F.
Eat a balanced diet, including fish with Omega-3 fatty acids. - answer>>>Correct Answer: A,B,E,F
Rationale:The maximum daily dose of acetaminophen is 4 g, the instruction includes up to 6 g/per
day. The best type of exercise does not place additional stress on the knee joints, such as biking or
,swimming. Apply heat to increase circulation and ice packs to decrease swelling. Support to the
knees can take the strain off of the joint. Getting rest will help with coping with the pain of the
disease. Eating a balanced diet may help with weight loss; additional weight places strain on the
joint.
The nurse is interviewing a client who is taking interferon-alfa-2a and ribavirin combination
therapy for hepatitis C. The client reports experiencing overwhelming feelings of depression.
Which action should the nurse take first?
A.
Recommend mental health counseling.
B.
Review the medication actions and interactions.
C.
Assess for the client's daily activity level.
D.
Provide information regarding a support group. - answer>>>Correct Answer: B
Rationale:Interferon-alfa-2a and ribavirin combination therapy can cause severe depression;
therefore, it is most important for the nurse to review the medication effects and report these to
the health care provider. Options A, C, and D might be implemented after the physiologic aspects
of the situation have been assessed.
The nurse notes for the client undergoing peritoneal dialysis during the outflow phase the draining
dialysate suddenly stops. The outflow is one liter less than the inflow at this time. What is the next
nursing action?
A.
Take the client's blood pressure.
B.
Take the client's weight.
C.
Call the health care provider (HCP).
D.
Have the client change positions. - answer>>>Correct Answer: D
Rationale:The outflow should match the inflow. With repositioning fluid trapped within the
peritoneum may be repositioned to the proximity of the abdominal catheter. While the vital signs
and the weight may support the additional fluid, they do not address the cause of the reduced
outflow. At this time, there is no medical emergency to notify the HCP.
, -
A client with congestive heart failure and atrial fibrillation develops ventricular ectopy with a
pattern of 8 ectopic beats/min. Which action should the nurse take based on this observation?
A.
Assess for bilateral jugular vein distention.
B.
Increase oxygen flow via nasal cannula.
C.
Administer PRN furosemide.
D.
Auscultate for a pleural friction rub. - answer>>>Correct Answer: B
Rationale:This client should have the oxygen flow immediately increased to promote oxygenation
of the myocardium. Ventricular ectopy, characterized by multiple PVCs, is often caused by
myocardial ischemia exacerbated by hypokalemia. The nurse would expect the client in congestive
heart failure to have some degree of option A, which does not exacerbate the ectopy. Option C
could create a more severe hypokalemia, which could increase the ectopy. The client is not
exhibiting signs of option D.
A client with cirrhosis develops increasing pedal edema and ascites. Which dietary modification is
most important for the nurse to teach this client?
A.
Avoid high-carbohydrate foods.
B.
Decrease intake of fat-soluble vitamins.
C.
Decrease caloric intake.
D.
Restrict salt and fluid intake. - answer>>>Correct Answer: D
Rationale:Salt and fluid restrictions are the first dietary modifications for a client who is retaining
fluid as manifested by edema and ascites. Options A, B, and C will not affect fluid retention
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?
