EVOLVE ELSEVIER HESI MED-SURG EXAM LATEST
2026/2027
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES
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
deterioration, confusion, increased heart rate, and/or increased respiratory rate
(D). (A, B, and C) are often absent in the older client with bacterial pneumonia
,The nurse assesses a postoperative client whose skin is cool, pale, and moist. The
client is very restless and has scant urine output. Oxygen is being administered at
2 L/min, and a saline lock is in place. Which intervention should the nurse
implement first?
A. Measure the urine specific gravity.
B. Obtain IV fluids for infusion per protocol.
C. Prepare for insertion of a central venous catheter.
D.Auscultate the client's breath sounds.
B
The client is at risk for hypovolemic shock because of the postoperative status and
is exhibiting early signs of shock. A priority intervention is the initiation of IV
fluids
(B) to restore tissue perfusion. (A, C, and D) are all important interventions, but
are of less priority than (B).
,During a health fair, a male client with emphysema tells the nurse that he fatigues
easily. Assessment reveals marked clubbing of the fingernails and an increased
anteroposterior chest diameter. Which instruction is best to provide the client?
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."
A
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
(A). (B) may result in a decreased drive to breathe. The client is not exhibiting any
symptoms of infection, so (C) is not necessary. (D) is less beneficial than (A).
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 ofmagnesium
B.One-time infusion of albumin
, C. Continuous epidural infusion of morphine
D.Intermittent infusion of IV vancomycin
C
All four of these clients have the potential to have significant complications. The
client with the morphine epidural infusion (C) is at highest risk for respiratory
depression and should be assessed first. (A) can cause hypotension. The client
receiving (B) is at lowest risk for serious complications. Although (D) can cause
nephrotoxicity and phlebitis, these problems are not as immediately life threatening
as (C).
The nurse is planning care for a client with diabetes mellitus who has gangrene of
the toes to the midfoot. Which goal should be included in this client's plan of care?
A.Restore skin integrity.
B.Prevent infection.
C.Promote healing.
D.Improve nutrition.
B
The prevention of infection is a priority goal for this client (B). Gangrene is the
result of necrosis (tissue death). If infection develops, there is insufficient
circulation to fight the infection and the infection can result in osteomyelitis or
sepsis. Because tissue death has already occurred, (A and C) are unattainable goals.
(D) is important but of less priority than (B).
2026/2027
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES
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
deterioration, confusion, increased heart rate, and/or increased respiratory rate
(D). (A, B, and C) are often absent in the older client with bacterial pneumonia
,The nurse assesses a postoperative client whose skin is cool, pale, and moist. The
client is very restless and has scant urine output. Oxygen is being administered at
2 L/min, and a saline lock is in place. Which intervention should the nurse
implement first?
A. Measure the urine specific gravity.
B. Obtain IV fluids for infusion per protocol.
C. Prepare for insertion of a central venous catheter.
D.Auscultate the client's breath sounds.
B
The client is at risk for hypovolemic shock because of the postoperative status and
is exhibiting early signs of shock. A priority intervention is the initiation of IV
fluids
(B) to restore tissue perfusion. (A, C, and D) are all important interventions, but
are of less priority than (B).
,During a health fair, a male client with emphysema tells the nurse that he fatigues
easily. Assessment reveals marked clubbing of the fingernails and an increased
anteroposterior chest diameter. Which instruction is best to provide the client?
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."
A
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
(A). (B) may result in a decreased drive to breathe. The client is not exhibiting any
symptoms of infection, so (C) is not necessary. (D) is less beneficial than (A).
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 ofmagnesium
B.One-time infusion of albumin
, C. Continuous epidural infusion of morphine
D.Intermittent infusion of IV vancomycin
C
All four of these clients have the potential to have significant complications. The
client with the morphine epidural infusion (C) is at highest risk for respiratory
depression and should be assessed first. (A) can cause hypotension. The client
receiving (B) is at lowest risk for serious complications. Although (D) can cause
nephrotoxicity and phlebitis, these problems are not as immediately life threatening
as (C).
The nurse is planning care for a client with diabetes mellitus who has gangrene of
the toes to the midfoot. Which goal should be included in this client's plan of care?
A.Restore skin integrity.
B.Prevent infection.
C.Promote healing.
D.Improve nutrition.
B
The prevention of infection is a priority goal for this client (B). Gangrene is the
result of necrosis (tissue death). If infection develops, there is insufficient
circulation to fight the infection and the infection can result in osteomyelitis or
sepsis. Because tissue death has already occurred, (A and C) are unattainable goals.
(D) is important but of less priority than (B).
