1|Page
HESI MED SURG EVOLVE PRACTICE EXAM|| ACCURATE AND
FREQUENTLY TESTED QUESTIONS AND 100% CORRECT ANSWERS WITH
RATIONALES|| LATEST AND COMPLETE UPDATE WITH EXPERT
VERIFIED SOLUTIONS
The nurse notes that a client who is scheduled for surgery the next morning has an
elevated blood urea nitrogen (BUN) level. Which condition is most likely to have
contributed to this finding?
A. Myocardial infarction 2 months ago
B. Anorexia and vomiting for the past 2 days
C.Recently diagnosed type 2 diabetes mellitus
D. Skeletal traction for a right hip fracture - ANSWER: B
Rationale:The blood urea nitrogen (BUN) level indicates the effectiveness of the
kidneys in filtering waste from the blood. Dehydration, which could be caused by
vomiting, would cause an increased BUN level. Option A would affect serum enzyme
levels, not the BUN level. Option C would primarily affect the blood glucose level;
renal failure that could increase the BUN level would be unlikely in a client newly
diagnosed with type 2 diabetes. Effects of option D might affect the complete blood
count (CBC) but would not directly increase the BUN level.
Which instruction is best for the nurse to provide to a client with emphysema and
chronic fatigue?
A."Pace your activities and schedule rest periods."
B."Increase the amount of oxygen you use at night."
C."Obtain medical evaluation for antibiotic therapy."
D."Reduce your intake of fluids containing caffeine." - ANSWER: A
,2|Page
Rationale:Manifestations of emphysema include an increase in AP diameter (referred to
as a barrel chest), nail bed clubbing, and fatigue. The nurse can provide instructions to
promote energy management, such as pacing activities and scheduling rest periods.
Option B may result in a decreased drive to breathe. The client is not exhibiting any
symptoms of infection, so option C is not necessary.
Option D is less beneficial than option A.
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: 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
,3|Page
D.Intermittent infusion of IV vancomycin - ANSWER: C
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: 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.
, 4|Page
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.
D. Place a pressure dressing on the existing dressing. - 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: A,B,E,F
HESI MED SURG EVOLVE PRACTICE EXAM|| ACCURATE AND
FREQUENTLY TESTED QUESTIONS AND 100% CORRECT ANSWERS WITH
RATIONALES|| LATEST AND COMPLETE UPDATE WITH EXPERT
VERIFIED SOLUTIONS
The nurse notes that a client who is scheduled for surgery the next morning has an
elevated blood urea nitrogen (BUN) level. Which condition is most likely to have
contributed to this finding?
A. Myocardial infarction 2 months ago
B. Anorexia and vomiting for the past 2 days
C.Recently diagnosed type 2 diabetes mellitus
D. Skeletal traction for a right hip fracture - ANSWER: B
Rationale:The blood urea nitrogen (BUN) level indicates the effectiveness of the
kidneys in filtering waste from the blood. Dehydration, which could be caused by
vomiting, would cause an increased BUN level. Option A would affect serum enzyme
levels, not the BUN level. Option C would primarily affect the blood glucose level;
renal failure that could increase the BUN level would be unlikely in a client newly
diagnosed with type 2 diabetes. Effects of option D might affect the complete blood
count (CBC) but would not directly increase the BUN level.
Which instruction is best for the nurse to provide to a client with emphysema and
chronic fatigue?
A."Pace your activities and schedule rest periods."
B."Increase the amount of oxygen you use at night."
C."Obtain medical evaluation for antibiotic therapy."
D."Reduce your intake of fluids containing caffeine." - ANSWER: A
,2|Page
Rationale:Manifestations of emphysema include an increase in AP diameter (referred to
as a barrel chest), nail bed clubbing, and fatigue. The nurse can provide instructions to
promote energy management, such as pacing activities and scheduling rest periods.
Option B may result in a decreased drive to breathe. The client is not exhibiting any
symptoms of infection, so option C is not necessary.
Option D is less beneficial than option A.
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: 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
,3|Page
D.Intermittent infusion of IV vancomycin - ANSWER: C
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: 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.
, 4|Page
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.
D. Place a pressure dressing on the existing dressing. - 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: A,B,E,F
