NURS MED SURG PRACTICE EXAM QUESTIONS FROM
EVOLVE HESI Q & AS BEST EXAM SOLUTION LATEST
UPDATE 2025/2026 RATED A+
Questions
□ The nurse is assessing a client's laboratory
valuesfollowing administration of chemotherapy. Which
lab value leads the nurse to suspect that the client is
experiencing tumor lysis syndrome (TLS)?
A Serum PTT of 10 seconds.
B Serum calcium of 5 mg/dl. Correct
C Oxygen saturation of 90%.
D Hemoglobin of 10 g/dl.
□ TLS results in hyperkalemia, hypocalcemia,
hyperuricemia, and hyperphosphatemia. A serum
calcium level of 5 (B), which is low, is an indicator of
possible tumorlysis syndrome. (A, C, and D) are not
particularly related to TLS. Awarded 0.0 points out of 1.0
possible points.
□ 2.ID: 6974889585A client is admitted to the hospital
with a diagnosis of severe acute diverticulitis. Which
assessment finding should the nurse expect this client to
exhibit?
A Lower left quadrant pain and a low-grade fever. Correct
,B Severe pain at McBurney's point and
nausea.C Abdominal pain and intermittent tenesmus.
D Exacerbations of severe diarrhea.
□ Left lower quadrant pain occurs with diverticulitis
because the sigmoid colon is the most common area for
diverticula, and the inflammation of diverticula causes a
low-grade fever (A). (B) would be indicative of
appendicitis. (C and D) are symptoms exhibited with
ulcerative colitis.
Awarded 0.0 points out of 1.0 possible points.
□ Hypokalemia (C) can precipitate digitalis toxicity in
persons receiving digoxin which will increase the chance
ofdangerous dysrhythmias (normal potassium level is
3.5 to
5.5 mEq/L). The therapeutic range for digoxin is 0.8 to 2
ng/ml (toxic levels=>2 ng/ml); (A) is within this range. (B)
would not warrant the nurse withholding the digoxin. The
nurse should withhold the digoxin if the apical pulse is
lessthan 60/min (D). Awarded 0.0 points out of 1.0
possible points.
□ 8.ID: 6974890473After the fourth dose of
gentamicin sulfate (Garamycin) IV, the nurse plans to
draw blood samples to determine peak and trough levels.
When are thebest times to draw these samples?
A 15 minutes before and 15 minutes after the next
dose.B One hour before and one hour after the next dose.
C 5 minutes before and 30 minutes after the next dose.
, Correct
D 30 minutes before and 30 minutes after the next dose.
□ Peak drug serum levels are achieved 30 minutes
after IV administration of aminoglycosides. The best time
to drawa trough is the closest time to the next
administration (C). (A, B, and D) are not as good a time to
draw the trough as (C). (B and D) are not the best times
to draw the peak of anaminoglycoside that has been
administered IV. Awarded 0.0points out of 1.0 possible
points.
□ 9.ID: 6974891711A client has undergone insertion of
a permanent pacemaker. When developing a discharge
teaching plan, the nurse writes a goal of, "The client will
verbalize symptoms of pacemaker failure." Which
symptomsare most important to teach the client?
A Facial flushing.
B Fever.
C Pounding headache.
D Feelings of dizziness. Correct
□ Feelings of dizziness (D) may occur as the result of
a decreased heart rate, leading to decreased cardiac
output.(A and C) will not occur as the result of
pacemaker failure.
(A) may be an indication of infection postoperatively, but
isnot an indication of pacemaker failure. Awarded 0.0
points out of 1.0 possible points.
□ 10.ID: 6974890487A client with heart disease is
, on acontinuous telemetry monitor and has
developed sinus bradycardia. In determining the
possible cause of the
bradycardia, the nurse assesses the client's
medication record. Which medication is most likely
the cause of the bradycardia?
A Propanolol (Inderal). Correct
B Captopril (Capoten).
C Furosemide (Lasix).
D Dobutamine (Dobutrex).
□ Inderal (A) is a beta adrenergic blocking agent,
whichcauses decreased heart rate and decreased
contractility.
Neither (B), an ACE inhibitor, nor (C), a loop diuretic,
causesbradycardia. (D) is a sympathomimetic, direct acting
cardiacstimulant, which would increase the heart rate.
Awarded 0.0points out of 1.0 possible points.
□ 11.ID: 6974890493In preparing a discharge plan for
a 22-year-old male client diagnosed with Buerger's
disease (thromboangiitis obliterans), which referral is
most important?
A Genetic counseling.
B Twelve-step recovery program.
C Clinical nutritionist.
D Smoking cessation program. Correct
□ Buerger's disease is strongly related to smoking.
EVOLVE HESI Q & AS BEST EXAM SOLUTION LATEST
UPDATE 2025/2026 RATED A+
Questions
□ The nurse is assessing a client's laboratory
valuesfollowing administration of chemotherapy. Which
lab value leads the nurse to suspect that the client is
experiencing tumor lysis syndrome (TLS)?
A Serum PTT of 10 seconds.
B Serum calcium of 5 mg/dl. Correct
C Oxygen saturation of 90%.
D Hemoglobin of 10 g/dl.
□ TLS results in hyperkalemia, hypocalcemia,
hyperuricemia, and hyperphosphatemia. A serum
calcium level of 5 (B), which is low, is an indicator of
possible tumorlysis syndrome. (A, C, and D) are not
particularly related to TLS. Awarded 0.0 points out of 1.0
possible points.
□ 2.ID: 6974889585A client is admitted to the hospital
with a diagnosis of severe acute diverticulitis. Which
assessment finding should the nurse expect this client to
exhibit?
A Lower left quadrant pain and a low-grade fever. Correct
,B Severe pain at McBurney's point and
nausea.C Abdominal pain and intermittent tenesmus.
D Exacerbations of severe diarrhea.
□ Left lower quadrant pain occurs with diverticulitis
because the sigmoid colon is the most common area for
diverticula, and the inflammation of diverticula causes a
low-grade fever (A). (B) would be indicative of
appendicitis. (C and D) are symptoms exhibited with
ulcerative colitis.
Awarded 0.0 points out of 1.0 possible points.
□ Hypokalemia (C) can precipitate digitalis toxicity in
persons receiving digoxin which will increase the chance
ofdangerous dysrhythmias (normal potassium level is
3.5 to
5.5 mEq/L). The therapeutic range for digoxin is 0.8 to 2
ng/ml (toxic levels=>2 ng/ml); (A) is within this range. (B)
would not warrant the nurse withholding the digoxin. The
nurse should withhold the digoxin if the apical pulse is
lessthan 60/min (D). Awarded 0.0 points out of 1.0
possible points.
□ 8.ID: 6974890473After the fourth dose of
gentamicin sulfate (Garamycin) IV, the nurse plans to
draw blood samples to determine peak and trough levels.
When are thebest times to draw these samples?
A 15 minutes before and 15 minutes after the next
dose.B One hour before and one hour after the next dose.
C 5 minutes before and 30 minutes after the next dose.
, Correct
D 30 minutes before and 30 minutes after the next dose.
□ Peak drug serum levels are achieved 30 minutes
after IV administration of aminoglycosides. The best time
to drawa trough is the closest time to the next
administration (C). (A, B, and D) are not as good a time to
draw the trough as (C). (B and D) are not the best times
to draw the peak of anaminoglycoside that has been
administered IV. Awarded 0.0points out of 1.0 possible
points.
□ 9.ID: 6974891711A client has undergone insertion of
a permanent pacemaker. When developing a discharge
teaching plan, the nurse writes a goal of, "The client will
verbalize symptoms of pacemaker failure." Which
symptomsare most important to teach the client?
A Facial flushing.
B Fever.
C Pounding headache.
D Feelings of dizziness. Correct
□ Feelings of dizziness (D) may occur as the result of
a decreased heart rate, leading to decreased cardiac
output.(A and C) will not occur as the result of
pacemaker failure.
(A) may be an indication of infection postoperatively, but
isnot an indication of pacemaker failure. Awarded 0.0
points out of 1.0 possible points.
□ 10.ID: 6974890487A client with heart disease is
, on acontinuous telemetry monitor and has
developed sinus bradycardia. In determining the
possible cause of the
bradycardia, the nurse assesses the client's
medication record. Which medication is most likely
the cause of the bradycardia?
A Propanolol (Inderal). Correct
B Captopril (Capoten).
C Furosemide (Lasix).
D Dobutamine (Dobutrex).
□ Inderal (A) is a beta adrenergic blocking agent,
whichcauses decreased heart rate and decreased
contractility.
Neither (B), an ACE inhibitor, nor (C), a loop diuretic,
causesbradycardia. (D) is a sympathomimetic, direct acting
cardiacstimulant, which would increase the heart rate.
Awarded 0.0points out of 1.0 possible points.
□ 11.ID: 6974890493In preparing a discharge plan for
a 22-year-old male client diagnosed with Buerger's
disease (thromboangiitis obliterans), which referral is
most important?
A Genetic counseling.
B Twelve-step recovery program.
C Clinical nutritionist.
D Smoking cessation program. Correct
□ Buerger's disease is strongly related to smoking.
