Evolve Elsevier Hesi Med Surg Newest Exam Preparation With Complete 200
Questions And Correct Answers With Rationales | Already Graded A+||Brand
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Question 1
An adult client who is hospitalized following a surgical procedure reports a sudden onset of
sharp chest pain and severe dyspnea. The client appears anxious, restless, and is noted to have a
bluish tint around the lips. Which condition should the nurse prioritize for further assessment?
A) Myocardial infarction
B) Pneumothorax
C) Pulmonary embolism
D) Atelectasis
E) Congestive heart failure
Correct Answer: C) Pulmonary embolism
Rationale: Post-operative clients are at a significantly high risk for deep vein thrombosis
(DVT) due to immobility and surgical trauma. If a clot dislodges and travels to the lungs
(Pulmonary Embolism), it typically presents with the "classic triad": sudden onset chest
pain, dyspnea, and tachypnea. Restlessness and cyanosis indicate impaired gas exchange
and hypoxia. While MI and pneumothorax are possibilities, the surgical history and sudden
onset of respiratory distress strongly point to PE, requiring immediate intervention.
Question 2
A client presents to the emergency department with a painful ankle injury sustained during a fall.
Which information should the nurse obtain during the initial assessment? (Select all that apply)
A) Quality of the pain
B) Signs of inflammation
C) Ankle range of motion
D) Visible deformities of the joint
E) Previous history of antibiotic use
Correct Answer: A, B, C, D (Quality of the pain, Signs of inflammation, Ankle range of
motion, Visible deformities of the joint)
Rationale: Initial assessment of a musculoskeletal injury focuses on determining the severity
of the trauma. The quality of pain helps differentiate nerve vs. bone pain. Inflammation
(swelling/redness) indicates the acute nature. Range of motion and visible deformities help
the clinician determine if there is a fracture, dislocation, or severe sprain. Previous
antibiotic use (E) is generally irrelevant to an acute trauma assessment.
Question 3
Which description of joint pain is most consistent with a medical diagnosis of rheumatoid
arthritis (RA)?
A) Pain that worsens with activity and improves with rest
, 2
B) Pain that occurs in a single joint, usually the big toe
C) Joint pain that is worse in the morning and involves symmetric joints
D) Sharp pain in the hip that radiates down the leg
E) Pain associated with increased bone density on X-ray
Correct Answer: C) Joint pain is worse in the morning and involves symmetric joints
Rationale: Rheumatoid arthritis is a systemic autoimmune disease characterized by chronic
inflammation of the synovium. Key features that distinguish it from osteoarthritis include
symmetry (both hands, both knees) and "morning stiffness" that typically lasts longer than
30 minutes. Osteoarthritis (A) usually improves with rest and is often asymmetric.
Question 4
A client has been managing gastroesophageal reflux disease (GERD) for several years. During a
physical assessment, the nurse notes a specific finding that suggests the reflux is affecting the
upper airway. Which finding is this?
A) Dysphagia
B) Epigastric tenderness
C) Hoarseness
D) Pyrosis
E) Flatulence
Correct Answer: C) Hoarseness
Rationale: Chronic hoarseness in a GERD client suggests that gastric acid is refluxing high
enough to irritate the larynx and vocal cords (Laryngopharyngeal Reflux). This is a
significant finding as chronic irritation can lead to tissue changes. Pyrosis (heartburn) and
epigastric tenderness are common GERD symptoms but do not indicate laryngeal
involvement.
Question 5
A client presents to the vascular clinic with chronic venous insufficiency. Which assessment
finding should the nurse anticipate during the physical examination?
A) Diminished or absent pedal pulses
B) Bilateral lower leg stasis dermatitis
C) Pale, cool extremities with minimal hair growth
D) Sharp, stabbing pain in the calves when walking
E) Thickened, brittle toenails with fungal growth
Correct Answer: B) Bilateral lower leg stasis dermatitis
Rationale: Chronic venous insufficiency occurs when the valves in the leg veins fail, leading
to blood pooling (venous stasis). This increases hydrostatic pressure, pushing fluid and red
blood cells into the surrounding tissue. The breakdown of these cells leaves a brownish
, 3
discoloration known as stasis dermatitis. Diminished pulses and cool/pale skin (A, C) are
characteristic of peripheral arterial disease (PAD).
Question 6
A client is hospitalized with a femur fracture and is being treated with skeletal traction. Which
nursing action is the priority for this client?
A) Clean the pin sites every 24 hours
B) Perform passive range of motion on the affected limb
C) Assess the client's neurovascular status
D) Provide a high-fiber diet to prevent constipation
E) Administer prescribed prophylactic antibiotics
Correct Answer: C) Assess neurovascular status
Rationale: The priority in fracture management is ensuring limb viability. The nurse must
assess the "6 Ps" (Pain, Pulse, Pallor, Paresthesia, Paralysis, and Poikilothermia) to detect
compartment syndrome or vascular compromise. While pin care (A) and nutrition (D) are
important, they do not take priority over the potential loss of a limb due to neurovascular
damage.
Question 7
The nurse is providing discharge education to a client with chronic pancreatitis. Which statement
by the client indicates that further teaching is required?
A) "I will stick to a low-fat diet to avoid triggering pain."
B) "I need to take my pancreatic enzymes with every meal."
C) "I will cut back on smoking cigarettes daily."
D) "I will completely avoid alcohol for the rest of my life."
E) "I will report any fatty or foul-smelling stools to my doctor."
Correct Answer: C) I will cut back on smoking cigarettes daily
Rationale: In chronic pancreatitis, smoking is a major risk factor for the development of
pancreatic cancer and accelerates the progression of the disease. The client should be told
to quit entirely, not just "cut back." The other statements (A, B, D, E) reflect correct
understanding of the management of chronic pancreatitis.
Question 8
A female client is being taught how to use a contraceptive diaphragm to reduce the risk of Toxic
Shock Syndrome (TSS). Which instructions should the nurse include? (Select all that apply)
A) Do not leave the diaphragm in place longer than 8 hours after intercourse
B) Replace the old diaphragm every 3 months
C) Clean the diaphragm with alcohol after each use
D) Avoid using oil-based lubricants with the diaphragm
E) Use the diaphragm even during menstruation
, 4
Correct Answer: A, B, D (Do not leave the diaphragm in place longer than 8 hours, Replace
every 3 months, Avoid oil-based lubricants)
Rationale: Leaving a diaphragm in too long (over 8 hours) promotes bacterial growth,
increasing the risk of TSS. Regular replacement (B) ensures the integrity of the
latex/silicone. Oil-based lubricants (D) can degrade the material. Alcohol (C) should not be
used for cleaning, and the diaphragm should never be used during a menstrual period (E)
due to the risk of TSS.
Question 9
A male client reports difficulty conceiving and asks if his lifestyle choices are a factor. He
currently smokes two packs of cigarettes a day and consumes alcohol socially. Which
information should the nurse provide? (Select all that apply)
A) Alcohol consumption can cause erectile dysfunction
B) Low testosterone levels affect sperm production
C) Cessation of smoking improves general health and fertility
D) Smoking increases the motility of sperm
E) Alcohol increases the quality of sperm
Correct Answer: A, B, C (Alcohol consumption can cause ED, Low testosterone affects
sperm, Cessation of smoking improves fertility)
Rationale: Smoking and alcohol are both detrimental to male fertility. Smoking decreases
sperm count and motility (making D false). Alcohol can lower testosterone and lead to
erectile dysfunction. Quitting smoking is a primary intervention for improving both
general health and the ability to conceive.
Question 10
Twenty-four hours after a surgical gastric bypass, a client has large amounts of bright red blood
in the nasogastric tube (NGT) canister. Which assessment finding should the nurse report as
an early sign of hypovolemic shock?
A) Bradycardia
B) Lethargy
C) Hypertension
D) Decreased respiratory rate
E) Warm, flushed skin
Correct Answer: B) lethargy
Rationale: Early signs of hypovolemic shock include restlessness, anxiety, and lethargy
because the brain is highly sensitive to even minor drops in oxygen delivery and perfusion.
Tachycardia (not A) and hypotension (not C) follow as the body attempts to compensate.
Tachypnea (not D) is also an early sign.
Questions And Correct Answers With Rationales | Already Graded A+||Brand
New Version!!
Question 1
An adult client who is hospitalized following a surgical procedure reports a sudden onset of
sharp chest pain and severe dyspnea. The client appears anxious, restless, and is noted to have a
bluish tint around the lips. Which condition should the nurse prioritize for further assessment?
A) Myocardial infarction
B) Pneumothorax
C) Pulmonary embolism
D) Atelectasis
E) Congestive heart failure
Correct Answer: C) Pulmonary embolism
Rationale: Post-operative clients are at a significantly high risk for deep vein thrombosis
(DVT) due to immobility and surgical trauma. If a clot dislodges and travels to the lungs
(Pulmonary Embolism), it typically presents with the "classic triad": sudden onset chest
pain, dyspnea, and tachypnea. Restlessness and cyanosis indicate impaired gas exchange
and hypoxia. While MI and pneumothorax are possibilities, the surgical history and sudden
onset of respiratory distress strongly point to PE, requiring immediate intervention.
Question 2
A client presents to the emergency department with a painful ankle injury sustained during a fall.
Which information should the nurse obtain during the initial assessment? (Select all that apply)
A) Quality of the pain
B) Signs of inflammation
C) Ankle range of motion
D) Visible deformities of the joint
E) Previous history of antibiotic use
Correct Answer: A, B, C, D (Quality of the pain, Signs of inflammation, Ankle range of
motion, Visible deformities of the joint)
Rationale: Initial assessment of a musculoskeletal injury focuses on determining the severity
of the trauma. The quality of pain helps differentiate nerve vs. bone pain. Inflammation
(swelling/redness) indicates the acute nature. Range of motion and visible deformities help
the clinician determine if there is a fracture, dislocation, or severe sprain. Previous
antibiotic use (E) is generally irrelevant to an acute trauma assessment.
Question 3
Which description of joint pain is most consistent with a medical diagnosis of rheumatoid
arthritis (RA)?
A) Pain that worsens with activity and improves with rest
, 2
B) Pain that occurs in a single joint, usually the big toe
C) Joint pain that is worse in the morning and involves symmetric joints
D) Sharp pain in the hip that radiates down the leg
E) Pain associated with increased bone density on X-ray
Correct Answer: C) Joint pain is worse in the morning and involves symmetric joints
Rationale: Rheumatoid arthritis is a systemic autoimmune disease characterized by chronic
inflammation of the synovium. Key features that distinguish it from osteoarthritis include
symmetry (both hands, both knees) and "morning stiffness" that typically lasts longer than
30 minutes. Osteoarthritis (A) usually improves with rest and is often asymmetric.
Question 4
A client has been managing gastroesophageal reflux disease (GERD) for several years. During a
physical assessment, the nurse notes a specific finding that suggests the reflux is affecting the
upper airway. Which finding is this?
A) Dysphagia
B) Epigastric tenderness
C) Hoarseness
D) Pyrosis
E) Flatulence
Correct Answer: C) Hoarseness
Rationale: Chronic hoarseness in a GERD client suggests that gastric acid is refluxing high
enough to irritate the larynx and vocal cords (Laryngopharyngeal Reflux). This is a
significant finding as chronic irritation can lead to tissue changes. Pyrosis (heartburn) and
epigastric tenderness are common GERD symptoms but do not indicate laryngeal
involvement.
Question 5
A client presents to the vascular clinic with chronic venous insufficiency. Which assessment
finding should the nurse anticipate during the physical examination?
A) Diminished or absent pedal pulses
B) Bilateral lower leg stasis dermatitis
C) Pale, cool extremities with minimal hair growth
D) Sharp, stabbing pain in the calves when walking
E) Thickened, brittle toenails with fungal growth
Correct Answer: B) Bilateral lower leg stasis dermatitis
Rationale: Chronic venous insufficiency occurs when the valves in the leg veins fail, leading
to blood pooling (venous stasis). This increases hydrostatic pressure, pushing fluid and red
blood cells into the surrounding tissue. The breakdown of these cells leaves a brownish
, 3
discoloration known as stasis dermatitis. Diminished pulses and cool/pale skin (A, C) are
characteristic of peripheral arterial disease (PAD).
Question 6
A client is hospitalized with a femur fracture and is being treated with skeletal traction. Which
nursing action is the priority for this client?
A) Clean the pin sites every 24 hours
B) Perform passive range of motion on the affected limb
C) Assess the client's neurovascular status
D) Provide a high-fiber diet to prevent constipation
E) Administer prescribed prophylactic antibiotics
Correct Answer: C) Assess neurovascular status
Rationale: The priority in fracture management is ensuring limb viability. The nurse must
assess the "6 Ps" (Pain, Pulse, Pallor, Paresthesia, Paralysis, and Poikilothermia) to detect
compartment syndrome or vascular compromise. While pin care (A) and nutrition (D) are
important, they do not take priority over the potential loss of a limb due to neurovascular
damage.
Question 7
The nurse is providing discharge education to a client with chronic pancreatitis. Which statement
by the client indicates that further teaching is required?
A) "I will stick to a low-fat diet to avoid triggering pain."
B) "I need to take my pancreatic enzymes with every meal."
C) "I will cut back on smoking cigarettes daily."
D) "I will completely avoid alcohol for the rest of my life."
E) "I will report any fatty or foul-smelling stools to my doctor."
Correct Answer: C) I will cut back on smoking cigarettes daily
Rationale: In chronic pancreatitis, smoking is a major risk factor for the development of
pancreatic cancer and accelerates the progression of the disease. The client should be told
to quit entirely, not just "cut back." The other statements (A, B, D, E) reflect correct
understanding of the management of chronic pancreatitis.
Question 8
A female client is being taught how to use a contraceptive diaphragm to reduce the risk of Toxic
Shock Syndrome (TSS). Which instructions should the nurse include? (Select all that apply)
A) Do not leave the diaphragm in place longer than 8 hours after intercourse
B) Replace the old diaphragm every 3 months
C) Clean the diaphragm with alcohol after each use
D) Avoid using oil-based lubricants with the diaphragm
E) Use the diaphragm even during menstruation
, 4
Correct Answer: A, B, D (Do not leave the diaphragm in place longer than 8 hours, Replace
every 3 months, Avoid oil-based lubricants)
Rationale: Leaving a diaphragm in too long (over 8 hours) promotes bacterial growth,
increasing the risk of TSS. Regular replacement (B) ensures the integrity of the
latex/silicone. Oil-based lubricants (D) can degrade the material. Alcohol (C) should not be
used for cleaning, and the diaphragm should never be used during a menstrual period (E)
due to the risk of TSS.
Question 9
A male client reports difficulty conceiving and asks if his lifestyle choices are a factor. He
currently smokes two packs of cigarettes a day and consumes alcohol socially. Which
information should the nurse provide? (Select all that apply)
A) Alcohol consumption can cause erectile dysfunction
B) Low testosterone levels affect sperm production
C) Cessation of smoking improves general health and fertility
D) Smoking increases the motility of sperm
E) Alcohol increases the quality of sperm
Correct Answer: A, B, C (Alcohol consumption can cause ED, Low testosterone affects
sperm, Cessation of smoking improves fertility)
Rationale: Smoking and alcohol are both detrimental to male fertility. Smoking decreases
sperm count and motility (making D false). Alcohol can lower testosterone and lead to
erectile dysfunction. Quitting smoking is a primary intervention for improving both
general health and the ability to conceive.
Question 10
Twenty-four hours after a surgical gastric bypass, a client has large amounts of bright red blood
in the nasogastric tube (NGT) canister. Which assessment finding should the nurse report as
an early sign of hypovolemic shock?
A) Bradycardia
B) Lethargy
C) Hypertension
D) Decreased respiratory rate
E) Warm, flushed skin
Correct Answer: B) lethargy
Rationale: Early signs of hypovolemic shock include restlessness, anxiety, and lethargy
because the brain is highly sensitive to even minor drops in oxygen delivery and perfusion.
Tachycardia (not A) and hypotension (not C) follow as the body attempts to compensate.
Tachypnea (not D) is also an early sign.
