COMPLETE TEST BANK WITH ANSWER GUIDE – = = = = = =
=EVOLVE ELSEVIER HESI MED SURG EXAM = = = = = =
2026/2027 =
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Chapter 1: Postoperative Care and Infection Prevention
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Question 1: The nurse is concerned about infection for a client
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after an esophagogastrostomy for esophageal cancer. Which
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actions should the nurse include in the client's plan of care?
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(Select all that apply.)
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A. Frequent oral care every 2 hours while awake.
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B. Use incentive spirometer every 2 hours.
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C. Empty contents from NG tube every 8 hours.
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D. Ambulate within 1 hour of return from the PACU.
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E. Limit visitors until postoperative day 2.
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Correct Answer: A, B, C
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Rationale: One hour post- = = =
op is too soon to ambulate for this client, and visitors help support
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,the patient and are encouraged to visit. Oral care is necessary as
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the client will be NPO. To decrease the risk of infection
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postoperatively, implement routine pulmonary exercises. The client
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will have an NG tube in place, likely to intermittent suction, to deco
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mpress the stomach postsurgery .
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Question 2: A nurse is caring for a client who is 3 days
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postoperative following a cholecystectomy. The nurse suspects the
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client's wound is infected because the drainage from the dressing
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is yellow and thick. Which type of drainage should the nurse
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report? =
A. Sanguineous =
B. Serous =
C. Serosanguineous =
D. Purulent =
Correct Answer: D. Purulent
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Rationale: Purulent drainage is thick, yellow, green, or brown and i
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ndicates infection. Sanguineous drainage contains fresh blood, sero
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us drainage is clear and watery, and serosanguineous drainage is
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pink-
,tinged. The presence of purulent drainage requires prompt reporti
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ng and intervention .
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Question 3: A client is 4 hours postoperative after a femoralpoplit
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eal bypass. The patient reports throbbing leg pain on the affected
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side, rated as 7/10. Which action by the nurse takes priority?
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A. Administer prescribed pain medication = = = =
B. Assess distal pulses and skin color
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C. Elevate the affected extremity = = = =
D. Apply warm compresses = = =
Correct Answer: B. Assess distal pulses and skin color
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Rationale: Throbbing pain in a postoperative vascular surgery pat
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ient may indicate graft occlusion or compartment syndrome. The pri
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ority is to assess distal pulses, skin color, temperature, and capillar
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y refill to evaluate perfusion. Pain medication should be given afte
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r assessment is complete. Elevation may compromise perfusion in ar
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terial cases . = = =
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Question 4: Twenty- = =
four hours after a client returns from surgical gastric bypass, the re
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, gistered nurse (RN) observes large amounts of blood in the nasog
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astric tube (NGT) cannister. Which assessment finding should the R
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N report as early signs of hypovolemic shock?
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A. Tachycardia =
B. Lethargy =
C. Hypertension =
D. Warm, dry skin = = =
Correct Answer: B. Lethargy
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Rationale: Early signs of hypovolemic shock include lethargy, confu
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sion, and altered mental status due to decreased cerebral perfusio
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n. Other early signs include tachycardia, hypotension, and cool, cla
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mmy skin. Lethargy in a postoperative patient with significant bloo
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d loss requires immediate provider notification .
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Question 5: The nurse is assisting a client out of bed for the first ti
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me after surgery. Which action should the nurse do first?
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A. Allow the client to sit with the bed in a high Fowler's position
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B. Apply a gait belt = = = =
C. Lower the bed to the lowest position
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D. Assess for orthostatic hypotension
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=EVOLVE ELSEVIER HESI MED SURG EXAM = = = = = =
2026/2027 =
=
Chapter 1: Postoperative Care and Infection Prevention
= = = = = = =
=
Question 1: The nurse is concerned about infection for a client
= = = = = = = = = = =
after an esophagogastrostomy for esophageal cancer. Which
= = = = = =
actions should the nurse include in the client's plan of care?
= = = = = = = = = = = =
(Select all that apply.)
= = = =
A. Frequent oral care every 2 hours while awake.
= = = = = = = =
B. Use incentive spirometer every 2 hours.
= = = = = =
C. Empty contents from NG tube every 8 hours.
= = = = = = = =
D. Ambulate within 1 hour of return from the PACU.
= = = = = = = = =
E. Limit visitors until postoperative day 2.
= = = = = =
Correct Answer: A, B, C
= = = = =
Rationale: One hour post- = = =
op is too soon to ambulate for this client, and visitors help support
= = = = = = = = = = = = =
,the patient and are encouraged to visit. Oral care is necessary as
= = = = = = = = = = =
the client will be NPO. To decrease the risk of infection
= = = = = = = = = = = =
postoperatively, implement routine pulmonary exercises. The client
= = = = = = =
will have an NG tube in place, likely to intermittent suction, to deco
= = = = = = = = = = = =
mpress the stomach postsurgery .
= = = = =
=
Question 2: A nurse is caring for a client who is 3 days
= = = = = = = = = = = = =
postoperative following a cholecystectomy. The nurse suspects the
= = = = = = = =
client's wound is infected because the drainage from the dressing
= = = = = = = = =
is yellow and thick. Which type of drainage should the nurse
= = = = = = = = = = = =
report? =
A. Sanguineous =
B. Serous =
C. Serosanguineous =
D. Purulent =
Correct Answer: D. Purulent
= = = =
Rationale: Purulent drainage is thick, yellow, green, or brown and i
= = = = = = = = = =
ndicates infection. Sanguineous drainage contains fresh blood, sero
= = = = = = =
us drainage is clear and watery, and serosanguineous drainage is
= = = = = = = = = =
pink-
,tinged. The presence of purulent drainage requires prompt reporti
= = = = = = = =
ng and intervention .
= = = =
=
Question 3: A client is 4 hours postoperative after a femoralpoplit
= = = = = = = = = =
eal bypass. The patient reports throbbing leg pain on the affected
= = = = = = = = = =
side, rated as 7/10. Which action by the nurse takes priority?
= = = = = = = = = = = =
A. Administer prescribed pain medication = = = =
B. Assess distal pulses and skin color
= = = = = =
C. Elevate the affected extremity = = = =
D. Apply warm compresses = = =
Correct Answer: B. Assess distal pulses and skin color
= = = = = = = = =
Rationale: Throbbing pain in a postoperative vascular surgery pat
= = = = = = = =
ient may indicate graft occlusion or compartment syndrome. The pri
= = = = = = = = =
ority is to assess distal pulses, skin color, temperature, and capillar
= = = = = = = = = =
y refill to evaluate perfusion. Pain medication should be given afte
= = = = = = = = = =
r assessment is complete. Elevation may compromise perfusion in ar
= = = = = = = = =
terial cases . = = =
=
Question 4: Twenty- = =
four hours after a client returns from surgical gastric bypass, the re
= = = = = = = = = = =
, gistered nurse (RN) observes large amounts of blood in the nasog
= = = = = = = = = =
astric tube (NGT) cannister. Which assessment finding should the R
= = = = = = = = =
N report as early signs of hypovolemic shock?
= = = = = = = =
A. Tachycardia =
B. Lethargy =
C. Hypertension =
D. Warm, dry skin = = =
Correct Answer: B. Lethargy
= = = =
Rationale: Early signs of hypovolemic shock include lethargy, confu
= = = = = = = =
sion, and altered mental status due to decreased cerebral perfusio
= = = = = = = = =
n. Other early signs include tachycardia, hypotension, and cool, cla
= = = = = = = = =
mmy skin. Lethargy in a postoperative patient with significant bloo
= = = = = = = = =
d loss requires immediate provider notification .
= = = = = = =
=
Question 5: The nurse is assisting a client out of bed for the first ti
= = = = = = = = = = = = = =
me after surgery. Which action should the nurse do first?
= = = = = = = = = =
A. Allow the client to sit with the bed in a high Fowler's position
= = = = = = = = = = = = =
B. Apply a gait belt = = = =
C. Lower the bed to the lowest position
= = = = = = =
D. Assess for orthostatic hypotension
= = = =
