MEDICAL SURGICAL
EVOLVE HESI MEDICAL SURGICAL
INTEGRATED TEST ACTUAL EXAM
VERIFIED QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
RATIONALES) |ALREADY GRADED A+ BEST
DOCUMENT FOR FINAL EXAM
Which condition is associated with an oversecretion of renin?
A) Hypertension.
B) Diabetes mellitus.
C) Diabetes insipidus.
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, MEDICAL SURGICAL
D) Alzheimer's disease. –
Correct Answer :Correct Answer(s): A
* Renin is an enzyme synthesized and secreted by the juxtaglomerular cells of the kidney in
response to renal artery blood volume and pressure changes. Low renal perfusion stimulates
the release of renin, which is converted by angiotensinogen into angiotensin I, which causes
the secretion of aldosterone, resulting in renal reabsorption of sodium, water, and
subsequently increases blood pressure (A). (B, C, and D) are not directly related to renin
oversecretion.
The nurse is caring for a client who had an excision of a malignant pituitary tumor. Which
findings should the nurse document that indicate the client is developing syndrome of
inappropriate antidiuretic hormone (SIADH)?
A) Hypernatremia and periorbial edema.
B) Muscle spasticity and hypertension.
C) Weight gain with low serum sodium.
D) Increased urinary output and thirst. –
Correct Answer :Correct Answer(s): C
* SIADH most frequently occurs when cancer cells manufacture and release ADH, which is
manifested by water retention causing weight gain and hyponatremia (C). Other
manifestations include oliguria, weakness, not (A, B, and D), anorexia, nausea, vomiting,
personality changes, seizures, decrease in reflexes, and coma.
The nurse is assessing a postmenopausal woman who is complaining of urinary urgency and
frequency and stress incontinence. She also reports difficulty in emptying her bladder. These
complaints are most likely due to which condition?
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A) Cystocele.
B) Bladder infection.
C) Pyelonephritis.
D) Irritable bladder. –
Correct Answer :Correct Answer(s): A
* This constellation of signs in a postmenopausal woman are characteristic of a cystocele (A).
These symptoms are not characteristic of (B, C, or D).
The nurse is caring for a client who returns to the unit following a colonoscopy. Which finding
should the nurse report to the healthcare provider immediately?
A) Large amounts of expelled flatus with mucus.
B) Tympanic abdomen and hyperactive bowel sounds.
C) Increased abdominal pain with rebound tenderness.
D) Complaint of feeling weak with watery diarrheal stools. –
Correct Answer :Correct Answer(s): C
* Positive rebound tenderness (C) may be an indication of peritonitis or perforation and needs
follow-up immediately. Clients typically experience a large amount of flatus (A) and may have
mucus from bowel irritation from the procedure. A tympanic abdomen on percussion and
hyperactive bowel sounds are typical post procedure findings (B). Weakness and watery
stools are a result from the preparation and are common symptoms experienced after a
colonoscopy (D).
A Korean-American client, who speaks very little English, is being discharged following
surgery. Which nurse should the nurse manager assign to provide the discharge instructions
for the client?
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, MEDICAL SURGICAL
A) A graduate registered nurse (RN) with three weeks of experience.
B) The registered nurse (RN) case manager for the unit with 1 year's experience.
C) A floating registered nurse (RN) with five years of nursing experience.
D) A Korean-American practical nurse (PN) with six years of nursing experience. –
Correct Answer :Correct Answer(s): B
* The RN case manager (B) is the best qualified nurse to assess and provide discharge
educational needs, obtain resources for the client, enhance coordination of care, and prevent
fragmentation of care. The RN graduate (A) lacks the experience to provide individualized
and complete discharge instructions. The float nurse (C) lacks case management expertise to
advocate adequately for the client, coordinate care, and provide community resources. It is
not in the scope of practice for the PN (D) to give discharge instructions.
A client's susceptibility to ulcerative colitis is most likely due to which aspect in the client's
history?
A) Jewish European ancestry.
B) H. pylori bowel infection.
C) Family history of irritable bowel syndrome.
D) Age between 25 and 55 years. - Correct Answer :Correct Answer(s): A
* Ulcerative colitis is 4 to 5 times more common among individuals of Jewish European or
Ashkenazi ancestry (A). H. pylori is associated with stomach inflammation and ulcer
development (B). Irritable bowel syndrome (C) does not progress to inflammatory bowel
disease. UC has a peak between the ages of 15 and 25 years, then a second peak between 55
and 65 years, not (D).
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EVOLVE HESI MEDICAL SURGICAL
INTEGRATED TEST ACTUAL EXAM
VERIFIED QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
RATIONALES) |ALREADY GRADED A+ BEST
DOCUMENT FOR FINAL EXAM
Which condition is associated with an oversecretion of renin?
A) Hypertension.
B) Diabetes mellitus.
C) Diabetes insipidus.
1|Page
, MEDICAL SURGICAL
D) Alzheimer's disease. –
Correct Answer :Correct Answer(s): A
* Renin is an enzyme synthesized and secreted by the juxtaglomerular cells of the kidney in
response to renal artery blood volume and pressure changes. Low renal perfusion stimulates
the release of renin, which is converted by angiotensinogen into angiotensin I, which causes
the secretion of aldosterone, resulting in renal reabsorption of sodium, water, and
subsequently increases blood pressure (A). (B, C, and D) are not directly related to renin
oversecretion.
The nurse is caring for a client who had an excision of a malignant pituitary tumor. Which
findings should the nurse document that indicate the client is developing syndrome of
inappropriate antidiuretic hormone (SIADH)?
A) Hypernatremia and periorbial edema.
B) Muscle spasticity and hypertension.
C) Weight gain with low serum sodium.
D) Increased urinary output and thirst. –
Correct Answer :Correct Answer(s): C
* SIADH most frequently occurs when cancer cells manufacture and release ADH, which is
manifested by water retention causing weight gain and hyponatremia (C). Other
manifestations include oliguria, weakness, not (A, B, and D), anorexia, nausea, vomiting,
personality changes, seizures, decrease in reflexes, and coma.
The nurse is assessing a postmenopausal woman who is complaining of urinary urgency and
frequency and stress incontinence. She also reports difficulty in emptying her bladder. These
complaints are most likely due to which condition?
2|Page
, MEDICAL SURGICAL
A) Cystocele.
B) Bladder infection.
C) Pyelonephritis.
D) Irritable bladder. –
Correct Answer :Correct Answer(s): A
* This constellation of signs in a postmenopausal woman are characteristic of a cystocele (A).
These symptoms are not characteristic of (B, C, or D).
The nurse is caring for a client who returns to the unit following a colonoscopy. Which finding
should the nurse report to the healthcare provider immediately?
A) Large amounts of expelled flatus with mucus.
B) Tympanic abdomen and hyperactive bowel sounds.
C) Increased abdominal pain with rebound tenderness.
D) Complaint of feeling weak with watery diarrheal stools. –
Correct Answer :Correct Answer(s): C
* Positive rebound tenderness (C) may be an indication of peritonitis or perforation and needs
follow-up immediately. Clients typically experience a large amount of flatus (A) and may have
mucus from bowel irritation from the procedure. A tympanic abdomen on percussion and
hyperactive bowel sounds are typical post procedure findings (B). Weakness and watery
stools are a result from the preparation and are common symptoms experienced after a
colonoscopy (D).
A Korean-American client, who speaks very little English, is being discharged following
surgery. Which nurse should the nurse manager assign to provide the discharge instructions
for the client?
3|Page
, MEDICAL SURGICAL
A) A graduate registered nurse (RN) with three weeks of experience.
B) The registered nurse (RN) case manager for the unit with 1 year's experience.
C) A floating registered nurse (RN) with five years of nursing experience.
D) A Korean-American practical nurse (PN) with six years of nursing experience. –
Correct Answer :Correct Answer(s): B
* The RN case manager (B) is the best qualified nurse to assess and provide discharge
educational needs, obtain resources for the client, enhance coordination of care, and prevent
fragmentation of care. The RN graduate (A) lacks the experience to provide individualized
and complete discharge instructions. The float nurse (C) lacks case management expertise to
advocate adequately for the client, coordinate care, and provide community resources. It is
not in the scope of practice for the PN (D) to give discharge instructions.
A client's susceptibility to ulcerative colitis is most likely due to which aspect in the client's
history?
A) Jewish European ancestry.
B) H. pylori bowel infection.
C) Family history of irritable bowel syndrome.
D) Age between 25 and 55 years. - Correct Answer :Correct Answer(s): A
* Ulcerative colitis is 4 to 5 times more common among individuals of Jewish European or
Ashkenazi ancestry (A). H. pylori is associated with stomach inflammation and ulcer
development (B). Irritable bowel syndrome (C) does not progress to inflammatory bowel
disease. UC has a peak between the ages of 15 and 25 years, then a second peak between 55
and 65 years, not (D).
4|Page
