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EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM
WITH 150 REAL EXAM QUESTIONS AND CORRECT
ANSWERS WITH WELL-ELABORATED
RATIONALES||VERIFIED EXAM!!/ EVOLVE HESI
MEDICAL SURGICAL LATEST EXAM 2026 (NEWEST
EXAM!!!)
A client is diagnosed with an acute small bowel
obstruction. Which assessment finding requires the most
immediate intervention by the nurse?
A. Fever of 102° F
B. Blood pressure of 150/90 mm Hg
C. Abdominal cramping
D. Dry mucous membranes - Answers-A
Rationale:A sudden increase in temperature is an indicator
of peritonitis. The nurse should notify the health care
provider immediately. Options B, C, and D are also
findings that require intervention by the nurse but are of
less priority than option A. Option B may indicate a
hypertensive condition but is not as acute a condition as
peritonitis. Option C is an expected finding in clients with
small bowel obstruction and may require medication.
Option D indicates probable fluid volume deficit, which
requires fluid volume replacement.
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In assessing a client diagnosed with primary
aldosteronism, the nurse expects the laboratory test
results to indicate a decreased serum level of which
substance?
A. Sodium
B. Phosphate
C. Potassium
D. Glucose - Answers-C
Rationale: Clients with primary aldosteronism exhibit a
profound decline in serum levels of potassium;
hypokalemia; hypertension is the most prominent and
universal sign. The serum sodium level is normal or
elevated, depending on the amount of water resorbed with
the sodium. Option B is influenced by parathyroid
hormone (PTH). Option D is not affected by primary
aldosteronism.
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.
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B. Administer intravenous furosemide (Lasix).
C. Assist the client to cough and breathe deeply.
D. Instruct the client to restrict oral fluid intake. - Answers-
A
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. Lasix IV is not indicated for
treatment of pericarditis. Because the client's breath
sounds are clear, option C is not a priority. Fluids are
frequently increased in the initial treatment of tamponade
to compensate for the decrease in cardiac output, but this
is not the same priority as option 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.
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D. Flush the line with normal saline. - Answers-D
Rationale:Medication can be administered via a central
line without additional IV fluids. The line should first be
flushed with a normal saline solution to ensure patency.
Insufficient evidence exists on the effectiveness of flushing
catheters with heparin. Option 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 option B.
Which data would the nurse expect to find when reviewing
laboratory values of an 80-year-old man who is in good
health overall?
A. Complete blood count reveals increased white blood
cell (WBC) and decreased red blood cell (RBC) counts.
B. Chemistries reveal an increased serum bilirubin level
with slightly increased liver enzyme levels.
C. Urinalysis reveals slight protein in the urine and
bacteriuria, with pyuria.
D. Serum electrolytes reveal a decreased sodium level
and increased potassium level. - Answers-C
Rationale: In older adults, the protein found in urine
slightly rises, probably as a result of kidney changes or
subclinical urinary tract infections, and clients frequently
EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM
WITH 150 REAL EXAM QUESTIONS AND CORRECT
ANSWERS WITH WELL-ELABORATED
RATIONALES||VERIFIED EXAM!!/ EVOLVE HESI
MEDICAL SURGICAL LATEST EXAM 2026 (NEWEST
EXAM!!!)
A client is diagnosed with an acute small bowel
obstruction. Which assessment finding requires the most
immediate intervention by the nurse?
A. Fever of 102° F
B. Blood pressure of 150/90 mm Hg
C. Abdominal cramping
D. Dry mucous membranes - Answers-A
Rationale:A sudden increase in temperature is an indicator
of peritonitis. The nurse should notify the health care
provider immediately. Options B, C, and D are also
findings that require intervention by the nurse but are of
less priority than option A. Option B may indicate a
hypertensive condition but is not as acute a condition as
peritonitis. Option C is an expected finding in clients with
small bowel obstruction and may require medication.
Option D indicates probable fluid volume deficit, which
requires fluid volume replacement.
,2|Page
In assessing a client diagnosed with primary
aldosteronism, the nurse expects the laboratory test
results to indicate a decreased serum level of which
substance?
A. Sodium
B. Phosphate
C. Potassium
D. Glucose - Answers-C
Rationale: Clients with primary aldosteronism exhibit a
profound decline in serum levels of potassium;
hypokalemia; hypertension is the most prominent and
universal sign. The serum sodium level is normal or
elevated, depending on the amount of water resorbed with
the sodium. Option B is influenced by parathyroid
hormone (PTH). Option D is not affected by primary
aldosteronism.
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.
,3|Page
B. Administer intravenous furosemide (Lasix).
C. Assist the client to cough and breathe deeply.
D. Instruct the client to restrict oral fluid intake. - Answers-
A
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. Lasix IV is not indicated for
treatment of pericarditis. Because the client's breath
sounds are clear, option C is not a priority. Fluids are
frequently increased in the initial treatment of tamponade
to compensate for the decrease in cardiac output, but this
is not the same priority as option 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.
, 4|Page
D. Flush the line with normal saline. - Answers-D
Rationale:Medication can be administered via a central
line without additional IV fluids. The line should first be
flushed with a normal saline solution to ensure patency.
Insufficient evidence exists on the effectiveness of flushing
catheters with heparin. Option 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 option B.
Which data would the nurse expect to find when reviewing
laboratory values of an 80-year-old man who is in good
health overall?
A. Complete blood count reveals increased white blood
cell (WBC) and decreased red blood cell (RBC) counts.
B. Chemistries reveal an increased serum bilirubin level
with slightly increased liver enzyme levels.
C. Urinalysis reveals slight protein in the urine and
bacteriuria, with pyuria.
D. Serum electrolytes reveal a decreased sodium level
and increased potassium level. - Answers-C
Rationale: In older adults, the protein found in urine
slightly rises, probably as a result of kidney changes or
subclinical urinary tract infections, and clients frequently
