EVOLVE Elsevier HESI Medical-Surgical (Med-Surg)
Actual Exam Practice Questions | 150 NCLEX-Style
Questions with Detailed Answers and Rationales
LATEST UPDATE THIS YEAR.pdf
Overview
This comprehensive 150-question HESI Medical-Surgical practice exam is
designed to prepare nursing students for the EVOLVE Elsevier HESI Med-Surg
Exam and NCLEX-style testing. The practice questions cover major medical-
surgical concepts, prioritization strategies, clinical judgment, and patient safety
principles frequently tested on nursing examinations.
Topics Covered:
Cardiovascular disorders and heart failure
Respiratory emergencies and oxygenation
Diabetes and endocrine disorders
Renal and electrolyte imbalances
Neurological and stroke management
Gastrointestinal and hepatic disorders
Hematological and oncological conditions
Sepsis, shock, and critical care concepts
Perioperative nursing care
Medication administration and adverse effects
Fluid and electrolyte management
Delegation, prioritization, and ABC nursing principles
NCLEX-style clinical judgment and patient safety strategies
,1. A client with heart failure reports increasing shortness of breath and difficulty
lying flat in bed. Which assessment finding requires immediate nursing
intervention?
A. Weight gain of 1 pound in one week
B. Bilateral ankle edema
C. Oxygen saturation of 86% on room air
D. Fatigue after walking
Answer: C. Oxygen saturation of 86% on room air
Rationale: An oxygen saturation of 86% indicates significant hypoxemia and
impaired gas exchange requiring immediate intervention.
2. A nurse is caring for a client receiving intravenous potassium chloride. Which
assessment finding indicates the medication should be stopped immediately?
A. Heart rate of 58 beats/minute
B. Respiratory rate of 20 breaths/minute
C. Urine output of 15 mL during the past hour
D. Blood pressure of 132/78 mm Hg
Answer: C. Urine output of 15 mL during the past hour
Rationale: Potassium should not be administered to clients with inadequate urine
output because it may result in life-threatening hyperkalemia.
,3. A client with chronic obstructive pulmonary disease (COPD) suddenly
becomes restless and confused. Which action should the nurse take first?
A. Reorient the client
B. Obtain oxygen saturation
C. Administer a sedative
D. Encourage fluid intake
Answer: B. Obtain oxygen saturation
Rationale: Restlessness and confusion are early signs of hypoxemia. Assessment
of oxygenation is the priority.
4. A client who had a thyroidectomy reports tingling around the mouth and
fingers. Which action is most appropriate?
A. Encourage ambulation
B. Assess for Chvostek's sign
C. Place the client in Trendelenburg position
D. Increase oral fluids
Answer: B. Assess for Chvostek's sign
Rationale: Tingling may indicate hypocalcemia resulting from parathyroid gland
injury after thyroidectomy.
5. A client with diabetes mellitus is diaphoretic, shaky, and confused. Which
action should the nurse implement first?
, A. Administer regular insulin
B. Obtain a blood glucose level
C. Restrict oral intake
D. Encourage exercise
Answer: B. Obtain a blood glucose level
Rationale: The symptoms suggest hypoglycemia. Confirming blood glucose guides
appropriate treatment.
6. Which assessment finding in a client with deep vein thrombosis requires
immediate intervention?
A. Calf pain
B. Unilateral leg swelling
C. Sudden shortness of breath
D. Warmth over the affected extremity
Answer: C. Sudden shortness of breath
Rationale: Sudden shortness of breath may indicate a pulmonary embolism, a life-
threatening complication.
7. A client with acute pancreatitis reports severe abdominal pain. Which
intervention should the nurse implement first?
A. Provide a low-fat meal
B. Maintain the client NPO
Actual Exam Practice Questions | 150 NCLEX-Style
Questions with Detailed Answers and Rationales
LATEST UPDATE THIS YEAR.pdf
Overview
This comprehensive 150-question HESI Medical-Surgical practice exam is
designed to prepare nursing students for the EVOLVE Elsevier HESI Med-Surg
Exam and NCLEX-style testing. The practice questions cover major medical-
surgical concepts, prioritization strategies, clinical judgment, and patient safety
principles frequently tested on nursing examinations.
Topics Covered:
Cardiovascular disorders and heart failure
Respiratory emergencies and oxygenation
Diabetes and endocrine disorders
Renal and electrolyte imbalances
Neurological and stroke management
Gastrointestinal and hepatic disorders
Hematological and oncological conditions
Sepsis, shock, and critical care concepts
Perioperative nursing care
Medication administration and adverse effects
Fluid and electrolyte management
Delegation, prioritization, and ABC nursing principles
NCLEX-style clinical judgment and patient safety strategies
,1. A client with heart failure reports increasing shortness of breath and difficulty
lying flat in bed. Which assessment finding requires immediate nursing
intervention?
A. Weight gain of 1 pound in one week
B. Bilateral ankle edema
C. Oxygen saturation of 86% on room air
D. Fatigue after walking
Answer: C. Oxygen saturation of 86% on room air
Rationale: An oxygen saturation of 86% indicates significant hypoxemia and
impaired gas exchange requiring immediate intervention.
2. A nurse is caring for a client receiving intravenous potassium chloride. Which
assessment finding indicates the medication should be stopped immediately?
A. Heart rate of 58 beats/minute
B. Respiratory rate of 20 breaths/minute
C. Urine output of 15 mL during the past hour
D. Blood pressure of 132/78 mm Hg
Answer: C. Urine output of 15 mL during the past hour
Rationale: Potassium should not be administered to clients with inadequate urine
output because it may result in life-threatening hyperkalemia.
,3. A client with chronic obstructive pulmonary disease (COPD) suddenly
becomes restless and confused. Which action should the nurse take first?
A. Reorient the client
B. Obtain oxygen saturation
C. Administer a sedative
D. Encourage fluid intake
Answer: B. Obtain oxygen saturation
Rationale: Restlessness and confusion are early signs of hypoxemia. Assessment
of oxygenation is the priority.
4. A client who had a thyroidectomy reports tingling around the mouth and
fingers. Which action is most appropriate?
A. Encourage ambulation
B. Assess for Chvostek's sign
C. Place the client in Trendelenburg position
D. Increase oral fluids
Answer: B. Assess for Chvostek's sign
Rationale: Tingling may indicate hypocalcemia resulting from parathyroid gland
injury after thyroidectomy.
5. A client with diabetes mellitus is diaphoretic, shaky, and confused. Which
action should the nurse implement first?
, A. Administer regular insulin
B. Obtain a blood glucose level
C. Restrict oral intake
D. Encourage exercise
Answer: B. Obtain a blood glucose level
Rationale: The symptoms suggest hypoglycemia. Confirming blood glucose guides
appropriate treatment.
6. Which assessment finding in a client with deep vein thrombosis requires
immediate intervention?
A. Calf pain
B. Unilateral leg swelling
C. Sudden shortness of breath
D. Warmth over the affected extremity
Answer: C. Sudden shortness of breath
Rationale: Sudden shortness of breath may indicate a pulmonary embolism, a life-
threatening complication.
7. A client with acute pancreatitis reports severe abdominal pain. Which
intervention should the nurse implement first?
A. Provide a low-fat meal
B. Maintain the client NPO
