(2024/2025) EVOLVE HESI MEDICAL SURGICAL EXAM | EVOLVE ELSEVIER HESI
MED SURG ACTUAL LATEST EXAM QUESTIONS AND 100% CORRECT
ANSWERS WITH RATIONALES, GUARANTEEED PASS
A client with hypertension has been receiving ramipril, 5 mg PO, daily for 2 weeks and is
scheduled to receive a dose at 0900. At 0830, the client's blood pressure is 120/70 mm Hg.
Which action should the nurse take?
A. Administer the prescribed dose at the scheduled time.
B. Hold the dose and contact the health care provider.
C. Hold the dose and recheck the blood pressure in 1 hour.
D. Check the health care provider's prescription to clarify the dose.
ANSWER - A.
Administer the prescribed dose at the scheduled time.
Rationale: The client's blood pressure is within normal limits, indicating that the ramipril, an
antihypertensive, is having the desired effect and should be administered. Options B and C
would be appropriate if the client's blood pressure was excessively low (<100 mm Hg systolic)
or if the client were exhibiting signs of hypotension such as dizziness. This prescribed dose is
within the normal dosage range, as defined by the manufacturer; therefore, option D is not
necessary
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? SATA
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.
ANSWER A, B, C.
Frequent oral care every 2 hours while awake. B. Use incentive spirometer every 2 hours. C.
Empty contents from NG tube every 8 hours.
Rationale: One hour post op is too soon to ambulate for this client. 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 post operativey, implement routine pulmonary exercises. The
client will have an NG tube in place, likely to intermittent suction, to decompress the stomach
post-surgery.
,The client is return demonstrating wrapping of the left limb amputated above the knee. The nurse
evaluates the client is starting the wrapping method correctly when the client places the end of
the bandage at which point?
A. Around the waist
B. At the inner aspect of the left stump
C. At the outer aspect of the left stump
D. At the left groin area
ANSWER A.
Around the waist
Rationale: The waist is the anchor point for the bandage for an above the knee amputation.
A nurse is assisting an 82-year-old client with ambulation and is concerned that the client may
fall. Which area contains the older person's center of gravity?
A. Head and neck
B. Upper torso
C. Bilateral arms
D. Feet and legs
ANSWER B.
Upper torso
Rationale: Stooped posture results in the upper torso becoming the center of gravity for older
persons. The center of gravity for adults is the hips. However, as a person grows older, a
stooped posture is common because of changes caused by osteoporosis and normal bone
degeneration. Furthermore, the knees, hips, and elbows flex. The head and neck and feet and
legs are not the center of gravity in the older adult. Although the arms comprise a part of the
upper torso, they do not reflect the best and most complete answer.
,The nurse is providing care for a client diagnosed with trigeminal neuralgia (tic douloureux).
Which symptoms will the nurse be looking for in the focused assessment related to this
condition? SATA
A. Facial muscle spasms
B. Sudden facial pain
C. Unilateral facial weakness
D. Difficulty in chewing
E. Tinnitus
F. Hearing difficulties
ANSWER A, B
A. Facial muscle spasms B. Sudden facial pain
Rationale: Trigeminal neuralgia is characterized by paroxysms of pain, similar to an electric
shock, in the area innervated by one or more branches of the trigeminal nerve (cranial V). The
remaining symptoms are not related to trigeminal neuralgia.
In caring for a client with acute diverticulitis, which assessment data warrants an immediate
nursing action?
A. The client has a rigid hard abdomen and elevated WBC.
B. The client has left lower quadrant pain and an elevated temperature.
C. The client is refusing to eat any of the meal and is complaining of nausea.
D. The client has not had a bowel movement in 2 days and has a soft abdomen.
ANSWER A.
The client has a rigid hard abdomen and elevated WBC.
Rationale: A hard rigid abdomen and elevated WBC is indicative of peritonitis, which is a
medical emergency and should be reported to the health care provider immediately. Options B
and C are expected clinical manifestations of diverticulitis. Option D does not warrant
immediate intervention.
, The nurse is caring for a client with a fractured right elbow. Which assessment finding has the
highest priority and requires immediate intervention?
A. Ecchymosis over the right elbow area
B. Deep unrelenting pain in the right arm
C. An edematous right elbow
D. The presence of crepitus in the right elbow
ANSWER B.
Deep unrelenting pain in the right arm
Rationale: Compartment syndrome is a condition involving increased pressure and
constriction of the nerves and vessels within an anatomic compartment, causing pain
uncontrolled by opioids and neurovascular compromise. Option A is an expected finding.
Option C related to compartment syndrome cannot be seen, and any visible edema is an
expected finding related to the injury. Option D is an expected finding.
The nurse notes that a client who is scheduled for surgery the next morning has an elevated
blood urea nitrogen (BUN) level. Which condition is most likely to have contributed to this
finding?
A. Myocardial infarction 2 months ago
B. Anorexia and vomiting for the past 2 days
C. Recently diagnosed type 2 diabetes mellitus
D. Skeletal traction for a right hip fracture
ANSWER B.
Anorexia and vomiting for the past 2 days
Rationale: The blood urea nitrogen (BUN) level indicates the effectiveness of the kidneys in
filtering waste from the blood. Dehydration, which could be caused by vomiting, would cause
an increased BUN level. Option A would affect serum enzyme levels, not the BUN level.
Option C would primarily affect the blood glucose level; renal failure that could increase the
BUN level would be unlikely in a client newly diagnosed with type 2 diabetes. Effects of option
D might affect the complete blood count (CBC) but would not directly increase the BUN level.
MED SURG ACTUAL LATEST EXAM QUESTIONS AND 100% CORRECT
ANSWERS WITH RATIONALES, GUARANTEEED PASS
A client with hypertension has been receiving ramipril, 5 mg PO, daily for 2 weeks and is
scheduled to receive a dose at 0900. At 0830, the client's blood pressure is 120/70 mm Hg.
Which action should the nurse take?
A. Administer the prescribed dose at the scheduled time.
B. Hold the dose and contact the health care provider.
C. Hold the dose and recheck the blood pressure in 1 hour.
D. Check the health care provider's prescription to clarify the dose.
ANSWER - A.
Administer the prescribed dose at the scheduled time.
Rationale: The client's blood pressure is within normal limits, indicating that the ramipril, an
antihypertensive, is having the desired effect and should be administered. Options B and C
would be appropriate if the client's blood pressure was excessively low (<100 mm Hg systolic)
or if the client were exhibiting signs of hypotension such as dizziness. This prescribed dose is
within the normal dosage range, as defined by the manufacturer; therefore, option D is not
necessary
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? SATA
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.
ANSWER A, B, C.
Frequent oral care every 2 hours while awake. B. Use incentive spirometer every 2 hours. C.
Empty contents from NG tube every 8 hours.
Rationale: One hour post op is too soon to ambulate for this client. 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 post operativey, implement routine pulmonary exercises. The
client will have an NG tube in place, likely to intermittent suction, to decompress the stomach
post-surgery.
,The client is return demonstrating wrapping of the left limb amputated above the knee. The nurse
evaluates the client is starting the wrapping method correctly when the client places the end of
the bandage at which point?
A. Around the waist
B. At the inner aspect of the left stump
C. At the outer aspect of the left stump
D. At the left groin area
ANSWER A.
Around the waist
Rationale: The waist is the anchor point for the bandage for an above the knee amputation.
A nurse is assisting an 82-year-old client with ambulation and is concerned that the client may
fall. Which area contains the older person's center of gravity?
A. Head and neck
B. Upper torso
C. Bilateral arms
D. Feet and legs
ANSWER B.
Upper torso
Rationale: Stooped posture results in the upper torso becoming the center of gravity for older
persons. The center of gravity for adults is the hips. However, as a person grows older, a
stooped posture is common because of changes caused by osteoporosis and normal bone
degeneration. Furthermore, the knees, hips, and elbows flex. The head and neck and feet and
legs are not the center of gravity in the older adult. Although the arms comprise a part of the
upper torso, they do not reflect the best and most complete answer.
,The nurse is providing care for a client diagnosed with trigeminal neuralgia (tic douloureux).
Which symptoms will the nurse be looking for in the focused assessment related to this
condition? SATA
A. Facial muscle spasms
B. Sudden facial pain
C. Unilateral facial weakness
D. Difficulty in chewing
E. Tinnitus
F. Hearing difficulties
ANSWER A, B
A. Facial muscle spasms B. Sudden facial pain
Rationale: Trigeminal neuralgia is characterized by paroxysms of pain, similar to an electric
shock, in the area innervated by one or more branches of the trigeminal nerve (cranial V). The
remaining symptoms are not related to trigeminal neuralgia.
In caring for a client with acute diverticulitis, which assessment data warrants an immediate
nursing action?
A. The client has a rigid hard abdomen and elevated WBC.
B. The client has left lower quadrant pain and an elevated temperature.
C. The client is refusing to eat any of the meal and is complaining of nausea.
D. The client has not had a bowel movement in 2 days and has a soft abdomen.
ANSWER A.
The client has a rigid hard abdomen and elevated WBC.
Rationale: A hard rigid abdomen and elevated WBC is indicative of peritonitis, which is a
medical emergency and should be reported to the health care provider immediately. Options B
and C are expected clinical manifestations of diverticulitis. Option D does not warrant
immediate intervention.
, The nurse is caring for a client with a fractured right elbow. Which assessment finding has the
highest priority and requires immediate intervention?
A. Ecchymosis over the right elbow area
B. Deep unrelenting pain in the right arm
C. An edematous right elbow
D. The presence of crepitus in the right elbow
ANSWER B.
Deep unrelenting pain in the right arm
Rationale: Compartment syndrome is a condition involving increased pressure and
constriction of the nerves and vessels within an anatomic compartment, causing pain
uncontrolled by opioids and neurovascular compromise. Option A is an expected finding.
Option C related to compartment syndrome cannot be seen, and any visible edema is an
expected finding related to the injury. Option D is an expected finding.
The nurse notes that a client who is scheduled for surgery the next morning has an elevated
blood urea nitrogen (BUN) level. Which condition is most likely to have contributed to this
finding?
A. Myocardial infarction 2 months ago
B. Anorexia and vomiting for the past 2 days
C. Recently diagnosed type 2 diabetes mellitus
D. Skeletal traction for a right hip fracture
ANSWER B.
Anorexia and vomiting for the past 2 days
Rationale: The blood urea nitrogen (BUN) level indicates the effectiveness of the kidneys in
filtering waste from the blood. Dehydration, which could be caused by vomiting, would cause
an increased BUN level. Option A would affect serum enzyme levels, not the BUN level.
Option C would primarily affect the blood glucose level; renal failure that could increase the
BUN level would be unlikely in a client newly diagnosed with type 2 diabetes. Effects of option
D might affect the complete blood count (CBC) but would not directly increase the BUN level.
