EVOLVE ELSEVIER HESI MED SURG EXAM (LATEST 2026
UPDATE) COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (GUARANTEE PASS) |ALREADY
GRADED A+
A female 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 nasgastric tube 5cm
D. Administer an intravenous antiemetic as prescribed
Reposition the client on her side
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 nurse teaches a client with type 2 diabetes nutritional strategies to
decrease obesity. Which food items chosen by the client indicate
understanding of the teaching? (Select all that apply.)
A. White bread
B. Salmon
C. Broccoli
D. Whole milk
E. Banana
Salmon, Broccoli, and Banana
pg. 1
,Rationale: Provides fresh fruits, lean meats and fish, vegetables,
whole grains, and low-fat dairy products.
Which condition should the nurse anticipate as a potential problem in
a female client with a neurogenic bladder?
A. Stress incontinence
B. Infection
C. Painless gross hematuria
D. Peritonitis
Infection
B. Infection is the major complication resulting from stasis of urine
and subsequent catheterization. Option A is the involuntary loss of
urine through an intact urethra as a result of a sudden increase in
intraabdominal pressure. Option C is the most common symptom of
bladder cancer. Option D is the most common and serious
complication of peritoneal dialysis.
A client on telemetry has a pattern of uncontrolled atrial fibrillation
with a rapid ventricular response. Based on this finding, the nurse
anticipates assisting the physician with which treatment?
A. Administer lidocaine, 75mg IV push
B. Perform synchronized cardioversion
C. Defibrillate the client as soon as possible
D. Administer atropine, 0.4mg IV push
Perform synchronized cardioversion
Rationale: With uncontrolled atrial fibrillation, the treatment of choice
is synchronized cardioversion to convert the cardiac rhythm back to
normal sinus rhythm. Option A is a medication used for ventricular
pg. 2
,dysrhythmias. Option C is not for a client with atrial fibrillation; it is
reserved for clients with life-threatening dysrhythmias, such as
ventricular fibrillation and unstable ventricular tachycardia. Option D
is the drug of choice in symptomatic sinus bradycardia, not atrial
fibrillation.
A 25-year-old client was admitted yesterday after a motor vehicle
collision. Neurodiagnostic studies have shown a basal skull fracture in
the middle fossa. Assessment on admission revealed both halo and
Battle signs. Which new symptom indicates that the client is likely to
be experiencing a common life-threatening complication associated
with a basal skull fracture?
A. Bilateral jugular venous distention
B. Oral temperature of 102F
C. Intermittent focal motor seizures
D. Intractable pain in the cervical region
Oral temperature of 102F
Rationale: Clients with basilar skull fractures are at high risk for
infection of the brain, as indicated by an increased oral temperature,
because the fracture leaves the meninges open to bacterial invasion.
Clients may experience options C and D, but these findings do not
pose as great a life-threatening risk as infection. Jugular distention is
not a typical complication of basal skull fractures.
A client with type 2 diabetes takes metformin (Glucophage) daily. The
client is scheduled for major surgery requiring general anesthesia the
next day. The nurse anticipates which approach to manage the client's
diabetes best while the client is NPO during the perioperative period?
A. NPO except for metformin and regular
B. NPO except for oral antidiabetic agent
pg. 3
, C. Novolin N insulin SQ BID
D. Regular insulin SQ per sliding scale
Regular insulin SQ per sliding scale
Rationale: Regular insulin dosing based on the client's blood glucose
levels (sliding scale) is the best method to achieve control of the
client's blood glucose while the client is NPO and coping with the
major stress of surgery. Option A increases the risk of vomiting and
aspiration. Options B and C provide less precise control of the blood
glucose level.
During report, the nurse learns that a client with tumor lysis syndrome
is receiving an IV infusion containing insulin. Which assessment
should the nurse complete first?
A. Review the client's history for diabetes mellitus
B. Observe the extremity distal to the IV site
C. Monitor the client's serum potassium and blood glucose levels
D. Evaluate the client's oxygen saturation and breath sounds
Monitor the client's serum potassium and blood glucose levels
Rationale:
Clients with tumor lysis syndrome may experience hyperkalemia,
requiring the addition of insulin to the IV solution to reduce the serum
potassium level. It is most important for the nurse to monitor the
client's serum potassium and blood glucose levels to ensure that they
are not at dangerous levels. Options A, B, and D provide valuable
assessment data but are of less priority than option C.
Which description of symptoms is characteristic of a client diagnosed
with trigeminal neuralgia (tic douloureux)?
A. Tinnitus, vertigo, and hearing difficulties
pg. 4
UPDATE) COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (GUARANTEE PASS) |ALREADY
GRADED A+
A female 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 nasgastric tube 5cm
D. Administer an intravenous antiemetic as prescribed
Reposition the client on her side
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 nurse teaches a client with type 2 diabetes nutritional strategies to
decrease obesity. Which food items chosen by the client indicate
understanding of the teaching? (Select all that apply.)
A. White bread
B. Salmon
C. Broccoli
D. Whole milk
E. Banana
Salmon, Broccoli, and Banana
pg. 1
,Rationale: Provides fresh fruits, lean meats and fish, vegetables,
whole grains, and low-fat dairy products.
Which condition should the nurse anticipate as a potential problem in
a female client with a neurogenic bladder?
A. Stress incontinence
B. Infection
C. Painless gross hematuria
D. Peritonitis
Infection
B. Infection is the major complication resulting from stasis of urine
and subsequent catheterization. Option A is the involuntary loss of
urine through an intact urethra as a result of a sudden increase in
intraabdominal pressure. Option C is the most common symptom of
bladder cancer. Option D is the most common and serious
complication of peritoneal dialysis.
A client on telemetry has a pattern of uncontrolled atrial fibrillation
with a rapid ventricular response. Based on this finding, the nurse
anticipates assisting the physician with which treatment?
A. Administer lidocaine, 75mg IV push
B. Perform synchronized cardioversion
C. Defibrillate the client as soon as possible
D. Administer atropine, 0.4mg IV push
Perform synchronized cardioversion
Rationale: With uncontrolled atrial fibrillation, the treatment of choice
is synchronized cardioversion to convert the cardiac rhythm back to
normal sinus rhythm. Option A is a medication used for ventricular
pg. 2
,dysrhythmias. Option C is not for a client with atrial fibrillation; it is
reserved for clients with life-threatening dysrhythmias, such as
ventricular fibrillation and unstable ventricular tachycardia. Option D
is the drug of choice in symptomatic sinus bradycardia, not atrial
fibrillation.
A 25-year-old client was admitted yesterday after a motor vehicle
collision. Neurodiagnostic studies have shown a basal skull fracture in
the middle fossa. Assessment on admission revealed both halo and
Battle signs. Which new symptom indicates that the client is likely to
be experiencing a common life-threatening complication associated
with a basal skull fracture?
A. Bilateral jugular venous distention
B. Oral temperature of 102F
C. Intermittent focal motor seizures
D. Intractable pain in the cervical region
Oral temperature of 102F
Rationale: Clients with basilar skull fractures are at high risk for
infection of the brain, as indicated by an increased oral temperature,
because the fracture leaves the meninges open to bacterial invasion.
Clients may experience options C and D, but these findings do not
pose as great a life-threatening risk as infection. Jugular distention is
not a typical complication of basal skull fractures.
A client with type 2 diabetes takes metformin (Glucophage) daily. The
client is scheduled for major surgery requiring general anesthesia the
next day. The nurse anticipates which approach to manage the client's
diabetes best while the client is NPO during the perioperative period?
A. NPO except for metformin and regular
B. NPO except for oral antidiabetic agent
pg. 3
, C. Novolin N insulin SQ BID
D. Regular insulin SQ per sliding scale
Regular insulin SQ per sliding scale
Rationale: Regular insulin dosing based on the client's blood glucose
levels (sliding scale) is the best method to achieve control of the
client's blood glucose while the client is NPO and coping with the
major stress of surgery. Option A increases the risk of vomiting and
aspiration. Options B and C provide less precise control of the blood
glucose level.
During report, the nurse learns that a client with tumor lysis syndrome
is receiving an IV infusion containing insulin. Which assessment
should the nurse complete first?
A. Review the client's history for diabetes mellitus
B. Observe the extremity distal to the IV site
C. Monitor the client's serum potassium and blood glucose levels
D. Evaluate the client's oxygen saturation and breath sounds
Monitor the client's serum potassium and blood glucose levels
Rationale:
Clients with tumor lysis syndrome may experience hyperkalemia,
requiring the addition of insulin to the IV solution to reduce the serum
potassium level. It is most important for the nurse to monitor the
client's serum potassium and blood glucose levels to ensure that they
are not at dangerous levels. Options A, B, and D provide valuable
assessment data but are of less priority than option C.
Which description of symptoms is characteristic of a client diagnosed
with trigeminal neuralgia (tic douloureux)?
A. Tinnitus, vertigo, and hearing difficulties
pg. 4
