MEDICAL-SURGICAL NURSING
EVOLVE ELSEVIER HESI MED SURG
2026/2027 ACTUAL EXAM WITH REAL
EXAM QUESTIONS AND CORRECT A+
ANSWERS WITH WELL-ELABORATED
RATIONALES
EVOLVE HESI MEDICAL SURGICAL LATEST EXAM 2026/2027 (BRAND NEW!!)
A+ QUESTIONS 5 SECTIONS 100% RATIONALES
VERIFIED COVERED INCLUDED
CATEGORIES
1. Cardiovascular & Respiratory Disorders
2. Endocrine, Fluid/Electrolyte & Acid-Base Balance
3. Gastrointestinal, Hepatic & Renal Disorders
4. Neurologic, Musculoskeletal & Perioperative Care
5. Oncology, Immunity, Hematology & Infection
Difficulty Level: Advanced (Application / Analysis)
Question Format: Multiple Choice (A–D) | 1 Mark each
Passing Score: 80% | Total Marks: 50
Aligned to standard HESI Medical-Surgical Nursing content domains
All questions original | Answer key with rationales included
STUVIAACTUALEXAM
EVOLVE ELSEVIER HESI MED SURG 2026/2027 | Official Exam Style Preparation
, EVOLVE ELSEVIER HESI MED SURG 2026/2027 STUVIAACTUALEXAM
SECTION 1: Cardiovascular & Respiratory Disorders
Q1. A 62-year-old client is admitted with acute coronary syndrome. The nurse notes the client is diaphoretic, reports crushing
substernal pain radiating to the left arm, and has a blood pressure of 88/54 mm Hg. The provider orders nitroglycerin IV.
Before initiating the infusion the nurse must first complete which assessment?
A. Administer a fluid bolus of 500 mL normal saline
B. Obtain a 12-lead ECG and confirm that systolic blood pressure is at least 90 mm Hg
C. Apply sequential compression devices to both lower extremities
D. Request a portable chest radiograph
Correct Answer: B
Rationale: Nitroglycerin is a potent vasodilator that can further lower blood pressure. Current guidelines require verification that systolic BP
is ≥90 mm Hg (and that no recent phosphodiesterase-5 inhibitor has been taken) before administration. A baseline ECG is also essential
for diagnosis and monitoring.
Q2. A client with chronic heart failure is receiving digoxin 0.125 mg daily. The nurse reviews the morning laboratory results
and notes a serum potassium of 3.1 mEq/L. Which action is the priority?
A. Administer the digoxin as scheduled and recheck potassium in the evening
B. Hold the digoxin dose and notify the provider of the hypokalemia
C. Give an extra dose of digoxin to compensate for the low potassium
D. Encourage the client to eat a banana and then give the digoxin
Correct Answer: B
Rationale: Hypokalemia potentiates digoxin toxicity. The nurse must withhold the digoxin and report the potassium value so that
replacement can be ordered and the digoxin level evaluated before the next dose.
Q3. A client returns to the progressive-care unit after a cardiac catheterization via the right femoral artery. Four hours later
the nurse observes a rapidly expanding hematoma at the puncture site and the client reports severe back pain. Which
complication should the nurse suspect?
A. Allergic reaction to contrast dye
B. Retroperitoneal hemorrhage
C. Vasovagal response
D. Femoral nerve injury
Correct Answer: B
Rationale: Expanding hematoma accompanied by severe back or flank pain after femoral access is classic for retroperitoneal bleeding.
Immediate notification of the provider, vital-sign monitoring, and preparation for possible volume resuscitation or return to the
catheterization laboratory are required.
Q4. A client with atrial fibrillation of unknown duration is scheduled for elective cardioversion. The nurse reviews the chart
and notes that the client has not been anticoagulated. Which action is most appropriate?
A. Notify the provider; cardioversion may be deferred until adequate anticoagulation or a transesophageal echocardiogram rules
out thrombus
B. Proceed with cardioversion because the rhythm is not life-threatening
C. Administer a loading dose of heparin and cardiovert within 30 minutes
D. Cancel the procedure permanently
Correct Answer: A
Rationale: In atrial fibrillation lasting longer than 48 hours (or of unknown duration), cardioversion without adequate anticoagulation or TEE
exclusion of left-atrial appendage thrombus risks embolization. The nurse must alert the provider so that the plan can be adjusted.
Page 2
EVOLVE ELSEVIER HESI MED SURG
2026/2027 ACTUAL EXAM WITH REAL
EXAM QUESTIONS AND CORRECT A+
ANSWERS WITH WELL-ELABORATED
RATIONALES
EVOLVE HESI MEDICAL SURGICAL LATEST EXAM 2026/2027 (BRAND NEW!!)
A+ QUESTIONS 5 SECTIONS 100% RATIONALES
VERIFIED COVERED INCLUDED
CATEGORIES
1. Cardiovascular & Respiratory Disorders
2. Endocrine, Fluid/Electrolyte & Acid-Base Balance
3. Gastrointestinal, Hepatic & Renal Disorders
4. Neurologic, Musculoskeletal & Perioperative Care
5. Oncology, Immunity, Hematology & Infection
Difficulty Level: Advanced (Application / Analysis)
Question Format: Multiple Choice (A–D) | 1 Mark each
Passing Score: 80% | Total Marks: 50
Aligned to standard HESI Medical-Surgical Nursing content domains
All questions original | Answer key with rationales included
STUVIAACTUALEXAM
EVOLVE ELSEVIER HESI MED SURG 2026/2027 | Official Exam Style Preparation
, EVOLVE ELSEVIER HESI MED SURG 2026/2027 STUVIAACTUALEXAM
SECTION 1: Cardiovascular & Respiratory Disorders
Q1. A 62-year-old client is admitted with acute coronary syndrome. The nurse notes the client is diaphoretic, reports crushing
substernal pain radiating to the left arm, and has a blood pressure of 88/54 mm Hg. The provider orders nitroglycerin IV.
Before initiating the infusion the nurse must first complete which assessment?
A. Administer a fluid bolus of 500 mL normal saline
B. Obtain a 12-lead ECG and confirm that systolic blood pressure is at least 90 mm Hg
C. Apply sequential compression devices to both lower extremities
D. Request a portable chest radiograph
Correct Answer: B
Rationale: Nitroglycerin is a potent vasodilator that can further lower blood pressure. Current guidelines require verification that systolic BP
is ≥90 mm Hg (and that no recent phosphodiesterase-5 inhibitor has been taken) before administration. A baseline ECG is also essential
for diagnosis and monitoring.
Q2. A client with chronic heart failure is receiving digoxin 0.125 mg daily. The nurse reviews the morning laboratory results
and notes a serum potassium of 3.1 mEq/L. Which action is the priority?
A. Administer the digoxin as scheduled and recheck potassium in the evening
B. Hold the digoxin dose and notify the provider of the hypokalemia
C. Give an extra dose of digoxin to compensate for the low potassium
D. Encourage the client to eat a banana and then give the digoxin
Correct Answer: B
Rationale: Hypokalemia potentiates digoxin toxicity. The nurse must withhold the digoxin and report the potassium value so that
replacement can be ordered and the digoxin level evaluated before the next dose.
Q3. A client returns to the progressive-care unit after a cardiac catheterization via the right femoral artery. Four hours later
the nurse observes a rapidly expanding hematoma at the puncture site and the client reports severe back pain. Which
complication should the nurse suspect?
A. Allergic reaction to contrast dye
B. Retroperitoneal hemorrhage
C. Vasovagal response
D. Femoral nerve injury
Correct Answer: B
Rationale: Expanding hematoma accompanied by severe back or flank pain after femoral access is classic for retroperitoneal bleeding.
Immediate notification of the provider, vital-sign monitoring, and preparation for possible volume resuscitation or return to the
catheterization laboratory are required.
Q4. A client with atrial fibrillation of unknown duration is scheduled for elective cardioversion. The nurse reviews the chart
and notes that the client has not been anticoagulated. Which action is most appropriate?
A. Notify the provider; cardioversion may be deferred until adequate anticoagulation or a transesophageal echocardiogram rules
out thrombus
B. Proceed with cardioversion because the rhythm is not life-threatening
C. Administer a loading dose of heparin and cardiovert within 30 minutes
D. Cancel the procedure permanently
Correct Answer: A
Rationale: In atrial fibrillation lasting longer than 48 hours (or of unknown duration), cardioversion without adequate anticoagulation or TEE
exclusion of left-atrial appendage thrombus risks embolization. The nurse must alert the provider so that the plan can be adjusted.
Page 2
