1|Page
EVOLVE ELSEVIER HESI MED SURG PRACTICE EXAM|| ACCURATE AND
FREQUENTLY TESTED QUESTIONS AND 100% CORRECT ANSWERS
WITH RATIONALES|| LATEST AND COMPLETE UPDATE WITH EXPERT
VERIFIED SOLUTIONS
Which instruction should the nurse teach a female client about the prevention of toxic
shock syndrome?
A. "Get immunization against human papillomavirus (HPV)."
B. "Change your tampon frequently."
C. "Empty your bladder after intercourse."
D. "Obtain a yearly flu vaccination." B
Certain strains of Staphylococcus aureus produce a toxin that can enter the
bloodstream through the vaginal mucosa. Changing the tampon frequently (B) reduces
the exposure to these toxins, which are the primary cause of toxic shock syndrome. (A)
helps prevent cervical cancer, not toxic shock syndrome. (C) can lessen the incidence of
urinary tract infection. (D) can help prevent some
individuals from contracting the flu and pneumonia, but no relationship to toxic shock
syndrome has been proven.
The nurse is caring for a critically ill client with cirrhosis of the liver who has a
nasogastric tube draining bright red blood. The nurse notes that the client's serum
hemoglobin and hematocrit levels are decreased. Which additional change in
laboratory data should the nurse expect?
A. Increased serum albumin level
B. Decreased serum creatinine
C. Decreased serum ammonia level
D. Increased liver function test results C
,2|Page
The breakdown of glutamine in the intestine and the increased activity of colonic
bacteria from the digestion of proteins increase ammonia levels in
clients with advanced liver disease, so removal of blood, a protein source, from the
intestine results in a reduced level of ammonia (C). (A, B, and D) will not be significantly
affected by the removal of blood.
An 81-year-old male client has emphysema. He lives at home with his cat and
manages self-care with no difficulty. When making a home visit, the nurse notices that
this client's tongue is somewhat cracked and his eyeballs appear sunken into his head.
Which nursing intervention is indicated?
A. Help the client determine ways to increase his fluid intake.
B. Obtain an appointment for the client to have an eye examination.
C. Instruct the client to use oxygen at night and increase the humidification.
D. Schedule the client for tests to determine his sensitivity to cat hair. A Clients
with COPD should ingest 3 L of fluids daily but may experience a fluid
deficit because of shortness of breath. The nurse should suggest creative methods
to increase the intake of fluids (A), such as having fruit juices in disposable containers
readily available. (B) is not indicated. Humidified oxygen will not effectively treat the
client's fluid deficit, and there is no indication that the client needs supplemental
oxygen at night (C). These symptoms are not indicative of (D) and may unnecessarily
upset the client, who depends on his pet for socialization.
A postoperative client receives a Schedule II opioid analgesic for pain. Which assessment
finding requires the most immediate intervention by the nurse?
A. Hypoactive bowel sounds with abdominal distention
B. Client reports continued pain of 8 on a 10-point scale
C. Respiratory rate of 12 breaths/min, with O2 saturation of 85%
D. Client reports nausea after receiving the medication C
,3|Page
Administration of a Schedule II opioid analgesic can result in respiratory
depression (C), which requires immediate intervention by the nurse to prevent
respiratory arrest. (A, B, and D) require action by the nurse but are of less priority than
(C).
A client is being discharged following radioactive seed implantation for prostate
cancer. What is the most important information that the nurse should provide to
this client's family?
A. Follow exposure precautions.
B. Encourage regular meals.
C. Collect all urine.
D. Avoid touching the client.
Clients being treated for prostate cancer with radioactive seed implants should be
instructed regarding the amount of time and distance needed to prevent excessive
exposure (A) that would pose a hazard to others. (B) is a good suggestion to
promote adequate nutrition but is not as important as (A). (C) is unnecessary. Contact
with the client (D) IS permitted but should be BRIEF to limit radiation exposure.
An emaciated homeless client presents to the emergency department complaining of a
productive cough, with blood-tinged sputum and night sweats. Which action is most
important for the emergency department triage nurse to implement for this client?
A. Initiate airborne infection precautions.
B. Place a surgical mask on the client.
C. Don an isolation gown and latex gloves.
D. Start protective (reverse) isolation precautions.
, 4|Page
This client is exhibiting classic symptoms of tuberculosis (TB), and the client is from a
high-risk population for TB. Therefore, airborne infection precautions (A), which are
indicated for TB, should be used with this client. (B) is used with DROPLET precautions.
There is no evidence that (C or D) would be warranted at this time.
Which abnormal laboratory finding indicates that a client with diabetes needs further
evaluation for diabetic nephropathy?
A. Hypokalemia
B. Microalbuminuria
C. Elevated serum lipid levels
D. Ketonuria
B
Microalbuminuria (B) is the earliest sign of diabetic nephropathy and indicates the
need for follow-up evaluation. Hyperkalemia, not (A), is associated with end-stage
renal disease caused by diabetic nephropathy. (C) may be elevated in end-stage renal
disease. (D) may signal the onset of diabetic ketoacidosis (DKA).
An older client is admitted with a diagnosis of bacterial pneumonia. Which symptom
should the nurse report to the health care provider after assessing the client?
A. Leukocytosis and febrile
B. Polycythemia and crackles
C. Pharyngitis and sputum production
D. Confusion and tachycardia
D
The onset of pneumonia in the older client may be signaled by general
EVOLVE ELSEVIER HESI MED SURG PRACTICE EXAM|| ACCURATE AND
FREQUENTLY TESTED QUESTIONS AND 100% CORRECT ANSWERS
WITH RATIONALES|| LATEST AND COMPLETE UPDATE WITH EXPERT
VERIFIED SOLUTIONS
Which instruction should the nurse teach a female client about the prevention of toxic
shock syndrome?
A. "Get immunization against human papillomavirus (HPV)."
B. "Change your tampon frequently."
C. "Empty your bladder after intercourse."
D. "Obtain a yearly flu vaccination." B
Certain strains of Staphylococcus aureus produce a toxin that can enter the
bloodstream through the vaginal mucosa. Changing the tampon frequently (B) reduces
the exposure to these toxins, which are the primary cause of toxic shock syndrome. (A)
helps prevent cervical cancer, not toxic shock syndrome. (C) can lessen the incidence of
urinary tract infection. (D) can help prevent some
individuals from contracting the flu and pneumonia, but no relationship to toxic shock
syndrome has been proven.
The nurse is caring for a critically ill client with cirrhosis of the liver who has a
nasogastric tube draining bright red blood. The nurse notes that the client's serum
hemoglobin and hematocrit levels are decreased. Which additional change in
laboratory data should the nurse expect?
A. Increased serum albumin level
B. Decreased serum creatinine
C. Decreased serum ammonia level
D. Increased liver function test results C
,2|Page
The breakdown of glutamine in the intestine and the increased activity of colonic
bacteria from the digestion of proteins increase ammonia levels in
clients with advanced liver disease, so removal of blood, a protein source, from the
intestine results in a reduced level of ammonia (C). (A, B, and D) will not be significantly
affected by the removal of blood.
An 81-year-old male client has emphysema. He lives at home with his cat and
manages self-care with no difficulty. When making a home visit, the nurse notices that
this client's tongue is somewhat cracked and his eyeballs appear sunken into his head.
Which nursing intervention is indicated?
A. Help the client determine ways to increase his fluid intake.
B. Obtain an appointment for the client to have an eye examination.
C. Instruct the client to use oxygen at night and increase the humidification.
D. Schedule the client for tests to determine his sensitivity to cat hair. A Clients
with COPD should ingest 3 L of fluids daily but may experience a fluid
deficit because of shortness of breath. The nurse should suggest creative methods
to increase the intake of fluids (A), such as having fruit juices in disposable containers
readily available. (B) is not indicated. Humidified oxygen will not effectively treat the
client's fluid deficit, and there is no indication that the client needs supplemental
oxygen at night (C). These symptoms are not indicative of (D) and may unnecessarily
upset the client, who depends on his pet for socialization.
A postoperative client receives a Schedule II opioid analgesic for pain. Which assessment
finding requires the most immediate intervention by the nurse?
A. Hypoactive bowel sounds with abdominal distention
B. Client reports continued pain of 8 on a 10-point scale
C. Respiratory rate of 12 breaths/min, with O2 saturation of 85%
D. Client reports nausea after receiving the medication C
,3|Page
Administration of a Schedule II opioid analgesic can result in respiratory
depression (C), which requires immediate intervention by the nurse to prevent
respiratory arrest. (A, B, and D) require action by the nurse but are of less priority than
(C).
A client is being discharged following radioactive seed implantation for prostate
cancer. What is the most important information that the nurse should provide to
this client's family?
A. Follow exposure precautions.
B. Encourage regular meals.
C. Collect all urine.
D. Avoid touching the client.
Clients being treated for prostate cancer with radioactive seed implants should be
instructed regarding the amount of time and distance needed to prevent excessive
exposure (A) that would pose a hazard to others. (B) is a good suggestion to
promote adequate nutrition but is not as important as (A). (C) is unnecessary. Contact
with the client (D) IS permitted but should be BRIEF to limit radiation exposure.
An emaciated homeless client presents to the emergency department complaining of a
productive cough, with blood-tinged sputum and night sweats. Which action is most
important for the emergency department triage nurse to implement for this client?
A. Initiate airborne infection precautions.
B. Place a surgical mask on the client.
C. Don an isolation gown and latex gloves.
D. Start protective (reverse) isolation precautions.
, 4|Page
This client is exhibiting classic symptoms of tuberculosis (TB), and the client is from a
high-risk population for TB. Therefore, airborne infection precautions (A), which are
indicated for TB, should be used with this client. (B) is used with DROPLET precautions.
There is no evidence that (C or D) would be warranted at this time.
Which abnormal laboratory finding indicates that a client with diabetes needs further
evaluation for diabetic nephropathy?
A. Hypokalemia
B. Microalbuminuria
C. Elevated serum lipid levels
D. Ketonuria
B
Microalbuminuria (B) is the earliest sign of diabetic nephropathy and indicates the
need for follow-up evaluation. Hyperkalemia, not (A), is associated with end-stage
renal disease caused by diabetic nephropathy. (C) may be elevated in end-stage renal
disease. (D) may signal the onset of diabetic ketoacidosis (DKA).
An older client is admitted with a diagnosis of bacterial pneumonia. Which symptom
should the nurse report to the health care provider after assessing the client?
A. Leukocytosis and febrile
B. Polycythemia and crackles
C. Pharyngitis and sputum production
D. Confusion and tachycardia
D
The onset of pneumonia in the older client may be signaled by general
