EVOLVE MED SURG HESI ACTUAL EXAM QUESTIONS AND
VERIFIED CORRECT ANSWERS ALREADY GRADED A+
WITH RATIONALES |GUARANTEED SUCCESS |EVOLVE:
HESI MED SURG PRACTICE EXAM 475
LATEST UPDATE 2025/2026 | [BRAND NEW!!]
A client with chronic asthma is admitted to the PACU complaining of pain at a level of 8 on a 1
to 10 scale, with a blood pressure of 124/78 mm Hg, pulse of 88 beats/min, and respirations of
20 breaths/min. The PACU recovery prescription is "Morphine, 2 to 4 mg IV push, while in
recovery for pain level over 5." Which action should the nurse take first?
A. Give the medication as prescribed to decrease the client's pain.
B. Call the anesthesia provider for a different medication for pain.
C. Use nonpharmacologic techniques before giving the medication.
D. Reassess the pain level in 30 minutes and medicate if it remains elevated. - ANSWER-
Correct Answer: B
Rationale:
The nurse should call the provider for a different medication because morphine is a histamine-
releasing opioid and should be avoided when the client has asthma. Option A is unsafe because it
puts the client at risk for an asthma exacerbation. Even if the drug were safe for the client,
options C and D both disregard the prescription and the client's need for pain relief in the
immediate postoperative period.
The nurse is performing a skin assessment on a client who is transferred from a long-term care
facility to an in-patient hospital unit. The client is unable to move independently while in bed.
The nurse observes reddened areas to the sacrum and on the heals bilaterally. What is the next
nursing action?
A.Document the size and shape of the reddened areas.
B.Massage the reddened areas with a hospital-approved lotion.
C.Call the nurse from the transferring facility to determine the client's baseline.
,D.Culture the wounds. - ANSWER- Correct Answer: A
Rationale:
The nurse must document any pressure wounds upon admission to establish the client's baseline
and for insurance purposes. Insurance will not reimburse from hospital-acquired pressure ulcers.
Massaging is not recommended as it may dislodge the existing tissue. A call is not a good use of
the nurse's time as the pressure ulcers exist upon transfer, and the baseline is determined upon
admission. The health care provider will order cultures, if needed
The nurse is performing hourly neurologic checks for a client with a head injury. Which new
assessment finding warrants immediate action by the nurse?
A.A unilateral pupil that is dilated and nonreactive to light
B.Client cries out when awakened by a verbal stimulus.
C.Client demonstrates a loss of memory of the events leading up to the injury.
D.Onset of nausea, headache, and vertigo - ANSWER- Correct Answer: A
Rationale:
Any change in pupil size and reactivity is an indication of increasing intracranial pressure and
should be reported to the health care provider immediately. Option B is a normal response to
being awakened. Options C and D are common manifestations of head injury and are of less
immediacy than option A.
For the client with a prescription for enteral feeding after surgery, the nurse checks the gastric
aspirate and notes the pH is 5.2. What is the next nurse's action?
A.Call for a chest x-ray.
B.Initiate the procedures for the feeding.
C.Tell the client the feeding will be delayed.
D.Inject 10 mL of air down the NG tube. - ANSWER- Correct Answer: B
Rationale:
Other than taking a chest x-ray before initiating every enteral feeding, checking the pH of the
stomach contents is another way of determining if the NG tube is still in the stomach. As long as
,the aspirate is less than 5.5 and the tube has remained secure, the reasonable assumption is the
tube is in the stomach. Procedures to start the feeding can begin. Calling for a chest x-ray is
appropriate if the nurse suspects the NG tube has been dislodged. There is no need to delay the
feeding. Injecting air into a NG tube only determines patency, not placement.
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-
Correct Answer: A
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- Correct Answer: B
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- Correct Answer: B
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.
Which instruction is best for the nurse to provide to a client with emphysema and chronic
fatigue?
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." - ANSWER- Correct Answer: A
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. Option B may result
in a decreased drive to breathe. The client is not exhibiting any symptoms of infection, so option
C is not necessary. Option D is less beneficial than option A.
Which nursing action would be appropriate for a client who is newly diagnosed with Cushing
syndrome?
A.Monitor blood glucose levels daily.
B.Increase intake of fluids high in potassium.
VERIFIED CORRECT ANSWERS ALREADY GRADED A+
WITH RATIONALES |GUARANTEED SUCCESS |EVOLVE:
HESI MED SURG PRACTICE EXAM 475
LATEST UPDATE 2025/2026 | [BRAND NEW!!]
A client with chronic asthma is admitted to the PACU complaining of pain at a level of 8 on a 1
to 10 scale, with a blood pressure of 124/78 mm Hg, pulse of 88 beats/min, and respirations of
20 breaths/min. The PACU recovery prescription is "Morphine, 2 to 4 mg IV push, while in
recovery for pain level over 5." Which action should the nurse take first?
A. Give the medication as prescribed to decrease the client's pain.
B. Call the anesthesia provider for a different medication for pain.
C. Use nonpharmacologic techniques before giving the medication.
D. Reassess the pain level in 30 minutes and medicate if it remains elevated. - ANSWER-
Correct Answer: B
Rationale:
The nurse should call the provider for a different medication because morphine is a histamine-
releasing opioid and should be avoided when the client has asthma. Option A is unsafe because it
puts the client at risk for an asthma exacerbation. Even if the drug were safe for the client,
options C and D both disregard the prescription and the client's need for pain relief in the
immediate postoperative period.
The nurse is performing a skin assessment on a client who is transferred from a long-term care
facility to an in-patient hospital unit. The client is unable to move independently while in bed.
The nurse observes reddened areas to the sacrum and on the heals bilaterally. What is the next
nursing action?
A.Document the size and shape of the reddened areas.
B.Massage the reddened areas with a hospital-approved lotion.
C.Call the nurse from the transferring facility to determine the client's baseline.
,D.Culture the wounds. - ANSWER- Correct Answer: A
Rationale:
The nurse must document any pressure wounds upon admission to establish the client's baseline
and for insurance purposes. Insurance will not reimburse from hospital-acquired pressure ulcers.
Massaging is not recommended as it may dislodge the existing tissue. A call is not a good use of
the nurse's time as the pressure ulcers exist upon transfer, and the baseline is determined upon
admission. The health care provider will order cultures, if needed
The nurse is performing hourly neurologic checks for a client with a head injury. Which new
assessment finding warrants immediate action by the nurse?
A.A unilateral pupil that is dilated and nonreactive to light
B.Client cries out when awakened by a verbal stimulus.
C.Client demonstrates a loss of memory of the events leading up to the injury.
D.Onset of nausea, headache, and vertigo - ANSWER- Correct Answer: A
Rationale:
Any change in pupil size and reactivity is an indication of increasing intracranial pressure and
should be reported to the health care provider immediately. Option B is a normal response to
being awakened. Options C and D are common manifestations of head injury and are of less
immediacy than option A.
For the client with a prescription for enteral feeding after surgery, the nurse checks the gastric
aspirate and notes the pH is 5.2. What is the next nurse's action?
A.Call for a chest x-ray.
B.Initiate the procedures for the feeding.
C.Tell the client the feeding will be delayed.
D.Inject 10 mL of air down the NG tube. - ANSWER- Correct Answer: B
Rationale:
Other than taking a chest x-ray before initiating every enteral feeding, checking the pH of the
stomach contents is another way of determining if the NG tube is still in the stomach. As long as
,the aspirate is less than 5.5 and the tube has remained secure, the reasonable assumption is the
tube is in the stomach. Procedures to start the feeding can begin. Calling for a chest x-ray is
appropriate if the nurse suspects the NG tube has been dislodged. There is no need to delay the
feeding. Injecting air into a NG tube only determines patency, not placement.
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-
Correct Answer: A
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- Correct Answer: B
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- Correct Answer: B
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.
Which instruction is best for the nurse to provide to a client with emphysema and chronic
fatigue?
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." - ANSWER- Correct Answer: A
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. Option B may result
in a decreased drive to breathe. The client is not exhibiting any symptoms of infection, so option
C is not necessary. Option D is less beneficial than option A.
Which nursing action would be appropriate for a client who is newly diagnosed with Cushing
syndrome?
A.Monitor blood glucose levels daily.
B.Increase intake of fluids high in potassium.
