EVOLVE ELSEVIER HESI MED SURG ACTUAL
EXAM WITH 550 test bank EXAM verified
QUESTIONS AND CORRECT ANSWERS WITH
WELL-ELABORATED RATIONALES/ EVOLVE
HESI MEDICAL SURGICAL LATEST EXAM 2025-
2026 (latest) ACE YOUR TEST GRADED A+ -
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The nurse is preparing a 45-year-old client for discharge from a cancer center following ileostomy surgery for
colon cancer. Which discharge goal should the nurse include in this client's discharge plan?
A. Reduce the daily intake of animal fat to 10% of the diet within 6 weeks.
B. Exhibit regular, soft-formed stool within 1 month.
C. Demonstrate the irrigation procedure correctly within 1 week.
D. Attend an ostomy support group within 2 weeks. - ANS :D. Attend an ostomy support group within 2
weeks.
,Rationale:
Attending a support group (D) will be beneficial to the client and should be encouraged because adaptation to the
ostomy can be difficult. This goal is attainable and is measurable. (A) is not specifically related to ileostomy care.
The client with an ileostomy will not be able to accomplish (B). (C) is not necessary.
During assessment of a client in the intensive care unit, the nurse notes that the client's breath sounds are
clear on auscultation, but jugular vein distention and muffled heart sounds are present. Which intervention
should the nurse implement?
A. Prepare the client for a pericardial tap.
B. Administer intravenous furosemide (Lasix).
C. Assist the client to cough and breathe deeply.
D. Instruct the client to restrict the oral fluid intake. - ANS :A. Prepare the client for a pericardial tap.
Rationale:
The client is exhibiting symptoms of cardiac tamponade, a collection of fluid in the pericardial sac that results
in a reduction in cardiac output, which is a potentially fatal complication of pericarditis. Treatment for
tamponade is a pericardial tap (A). Lasix IV is not indicated for treatment of pericarditis (B). Because the
client's breath sounds are clear, (C) is not a priority. Fluids are frequently increased (D) in the initial
treatment of tamponade to compensate for the decrease in cardiac output, but this is not the same priority as
(A).
A central venous catheter has been inserted via a jugular vein, and a radiograph has confirmed placement of
the catheter. A prescription has been received for a medication STAT, but IV fluids have not yet been started.
Which action should the nurse take prior to administering the prescribed medication?
A. Assess for signs of jugular venous distention.
B. Obtain the needed intravenous solution.
C. Flush the line with heparinized solution.
D. Flush the line with normal saline. - ANS :D. Flush the line with normal saline.
Rationale:
,Medication can be administered via a central line without additional IV fluids. The line should first be flushed
with a normal saline solution (D) to ensure patency. Insufficient evidence exists on the effectiveness of flushing
catheters with heparin (C). (A) will not affect the decision to administer the medication and is not a priority.
Administration of the medication STAT is of greater priority than (B).
A 63-year-old client with type 2 diabetes mellitus is admitted for treatment of an ulcer on the heel of the left
foot that has not healed with wound care. The nurse observes that the entire left foot is darker in color than
the right foot. Which additional symptom should the nurse expect to find?
A. Pedal pulses will be weak or absent in the left foot.
B. The client will state that the left foot is usually warm.
C. Flexion and extension of the left foot will be limited.
D. Capillary refill of the client's left toes will be brisk. - ANS :A. Pedal pulses will be weak or absent in the left
foot.
Rationale:
Symptoms associated with decreased blood supply are weak or absent pedal and tibial pulses (A). The client with
diabetes experiences vascular scarring as a result of atherosclerotic changes in the peripheral vessels. This
results in compromised perfusion to the dependent extremities, which further delays wound healing in the
affected foot. Although flexion and extension may be limited (C), depending on the degree of damage, this is not
always the case. (B and D) are signs of adequate perfusion of the foot, which would not be expected in this client.
A home health nurse knows that a 70-year-old male client who is convalescing at home following a hip
replacement is at risk for developing pressure ulcers. Which physical characteristic of aging puts the client at
risk?
A. 16% increase in overall body fat
B. Reduced melanin production
C. Thinning of the skin, with loss of elasticity
D. Calcium loss in the bones - ANS :C. Thinning of the skin, with loss of elasticity
Rationale:
, Thin nonelastic skin (C) is an important factor in pressure formation. The proportion of body fat to lean mass
increases with age (A) and might help decrease ulcer tendency. (B) causes gray hair. (D) can contribute to broken
bones, but it is probably not a factor in pressure ulcer formation.
During a health fair, a male client with emphysema tells the nurse that he fatigues easily. Assessment reveals
marked clubbing of the fingernails and an increased anteroposterior chest diameter. Which instruction is best
to provide the client?
A. "Pace your activities and schedule rest periods."
B. "Increase the amount of oxygen you use at night."
C. "Obtain medical evaluation for antibiotic therapy."
D. "Reduce your intake of fluids containing caffeine." - ANS :A. "Pace your activities and schedule rest
periods."
Rationale:
Manifestations of emphysema include an increase in AP diameter (referred to as a barrel chest), nail bed
clubbing, and fatigue. The nurse can provide instructions to promote energy management, such as pacing
activities and scheduling rest periods (A). (B) may result in a decreased drive to breathe. The client is not
exhibiting any symptoms of infection, so (C) is not necessary. (D) is less beneficial than (A).
A 43-year-old homeless, malnourished female client with a history of alcoholism is transferred to the ICU. She
is placed on telemetry, and the rhythm strip shown is obtained. The nurse palpates a heart rate of 160
beats/min, and the client's blood pressure is 90/54 mm Hg. Based on these findings, which IV medication
should the nurse administer?
A. Amiodarone (Cordarone)
B. Magnesium sulfate
C. Lidocaine (Xylocaine)
D. Procainamide (Pronestyl) - ANS :B. Magnesium sulfate
Rationale:
Because the client has chronic alcoholism, she is likely to have hypomagnesemia. (B) is the recommended drug
for torsades de pointes, which is a form of polymorphic ventricular tachycardia (VT) usually associated with a
prolonged QT interval that occurs with hypomagnesemia. (A and D) increase the QT interval, which can cause
EXAM WITH 550 test bank EXAM verified
QUESTIONS AND CORRECT ANSWERS WITH
WELL-ELABORATED RATIONALES/ EVOLVE
HESI MEDICAL SURGICAL LATEST EXAM 2025-
2026 (latest) ACE YOUR TEST GRADED A+ -
The nurse is preparing a 45-year-old client for discharge from a cancer center following ileostomy surgery for
colon cancer. Which discharge goal should the nurse include in this client's discharge plan?
A. Reduce the daily intake of animal fat to 10% of the diet within 6 weeks.
B. Exhibit regular, soft-formed stool within 1 month.
C. Demonstrate the irrigation procedure correctly within 1 week.
D. Attend an ostomy support group within 2 weeks. - ANS :D. Attend an ostomy support group within 2
weeks.
,Rationale:
Attending a support group (D) will be beneficial to the client and should be encouraged because adaptation to the
ostomy can be difficult. This goal is attainable and is measurable. (A) is not specifically related to ileostomy care.
The client with an ileostomy will not be able to accomplish (B). (C) is not necessary.
During assessment of a client in the intensive care unit, the nurse notes that the client's breath sounds are
clear on auscultation, but jugular vein distention and muffled heart sounds are present. Which intervention
should the nurse implement?
A. Prepare the client for a pericardial tap.
B. Administer intravenous furosemide (Lasix).
C. Assist the client to cough and breathe deeply.
D. Instruct the client to restrict the oral fluid intake. - ANS :A. Prepare the client for a pericardial tap.
Rationale:
The client is exhibiting symptoms of cardiac tamponade, a collection of fluid in the pericardial sac that results
in a reduction in cardiac output, which is a potentially fatal complication of pericarditis. Treatment for
tamponade is a pericardial tap (A). Lasix IV is not indicated for treatment of pericarditis (B). Because the
client's breath sounds are clear, (C) is not a priority. Fluids are frequently increased (D) in the initial
treatment of tamponade to compensate for the decrease in cardiac output, but this is not the same priority as
(A).
A central venous catheter has been inserted via a jugular vein, and a radiograph has confirmed placement of
the catheter. A prescription has been received for a medication STAT, but IV fluids have not yet been started.
Which action should the nurse take prior to administering the prescribed medication?
A. Assess for signs of jugular venous distention.
B. Obtain the needed intravenous solution.
C. Flush the line with heparinized solution.
D. Flush the line with normal saline. - ANS :D. Flush the line with normal saline.
Rationale:
,Medication can be administered via a central line without additional IV fluids. The line should first be flushed
with a normal saline solution (D) to ensure patency. Insufficient evidence exists on the effectiveness of flushing
catheters with heparin (C). (A) will not affect the decision to administer the medication and is not a priority.
Administration of the medication STAT is of greater priority than (B).
A 63-year-old client with type 2 diabetes mellitus is admitted for treatment of an ulcer on the heel of the left
foot that has not healed with wound care. The nurse observes that the entire left foot is darker in color than
the right foot. Which additional symptom should the nurse expect to find?
A. Pedal pulses will be weak or absent in the left foot.
B. The client will state that the left foot is usually warm.
C. Flexion and extension of the left foot will be limited.
D. Capillary refill of the client's left toes will be brisk. - ANS :A. Pedal pulses will be weak or absent in the left
foot.
Rationale:
Symptoms associated with decreased blood supply are weak or absent pedal and tibial pulses (A). The client with
diabetes experiences vascular scarring as a result of atherosclerotic changes in the peripheral vessels. This
results in compromised perfusion to the dependent extremities, which further delays wound healing in the
affected foot. Although flexion and extension may be limited (C), depending on the degree of damage, this is not
always the case. (B and D) are signs of adequate perfusion of the foot, which would not be expected in this client.
A home health nurse knows that a 70-year-old male client who is convalescing at home following a hip
replacement is at risk for developing pressure ulcers. Which physical characteristic of aging puts the client at
risk?
A. 16% increase in overall body fat
B. Reduced melanin production
C. Thinning of the skin, with loss of elasticity
D. Calcium loss in the bones - ANS :C. Thinning of the skin, with loss of elasticity
Rationale:
, Thin nonelastic skin (C) is an important factor in pressure formation. The proportion of body fat to lean mass
increases with age (A) and might help decrease ulcer tendency. (B) causes gray hair. (D) can contribute to broken
bones, but it is probably not a factor in pressure ulcer formation.
During a health fair, a male client with emphysema tells the nurse that he fatigues easily. Assessment reveals
marked clubbing of the fingernails and an increased anteroposterior chest diameter. Which instruction is best
to provide the client?
A. "Pace your activities and schedule rest periods."
B. "Increase the amount of oxygen you use at night."
C. "Obtain medical evaluation for antibiotic therapy."
D. "Reduce your intake of fluids containing caffeine." - ANS :A. "Pace your activities and schedule rest
periods."
Rationale:
Manifestations of emphysema include an increase in AP diameter (referred to as a barrel chest), nail bed
clubbing, and fatigue. The nurse can provide instructions to promote energy management, such as pacing
activities and scheduling rest periods (A). (B) may result in a decreased drive to breathe. The client is not
exhibiting any symptoms of infection, so (C) is not necessary. (D) is less beneficial than (A).
A 43-year-old homeless, malnourished female client with a history of alcoholism is transferred to the ICU. She
is placed on telemetry, and the rhythm strip shown is obtained. The nurse palpates a heart rate of 160
beats/min, and the client's blood pressure is 90/54 mm Hg. Based on these findings, which IV medication
should the nurse administer?
A. Amiodarone (Cordarone)
B. Magnesium sulfate
C. Lidocaine (Xylocaine)
D. Procainamide (Pronestyl) - ANS :B. Magnesium sulfate
Rationale:
Because the client has chronic alcoholism, she is likely to have hypomagnesemia. (B) is the recommended drug
for torsades de pointes, which is a form of polymorphic ventricular tachycardia (VT) usually associated with a
prolonged QT interval that occurs with hypomagnesemia. (A and D) increase the QT interval, which can cause
