Page 1 of 56
31 May 2026
EVOLVE MED SURG HESI Latest PREP
EXAM with 150 Questions and Correct
Answers WITH RATIONALES/ HESI Exam
COVERING RECENT AND MOST TESTED
QUESTIONS.
The nurse is preparing a client for discharge after a right total knee replacement. Which client
statements about use of a walker indicate to the nurse the teaching was effective? (Select all that
apply.)
A."I will walk in the middle of the walker."
B."I will make sure all four feet of the walker are on the floor before I use the hand pieces."
C."I will move my right foot forward into the walker, and then my left foot."
D."I will collapse the walker and put it in the chair opposite the bed at night."
E."I will use a silicone-based cleaning product to clean the hand pieces and rubber tips." - correct
answer-Correct Answer: A,B,C
Rationale:The nurse is teaching about use of a walker. Having the walker collapsed at night does not
help with nighttime ambulation to the restroom. The client is at risk for falling. Silicone is a slippery
material and placing silicone on the rubber tips of the walker places the client at risk for falling. The
remaining client statements about use of a walker are correct.
A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid ventricular
response. Based on this finding, the nurse anticipates assisting the physician with which
treatment?
A.Administer lidocaine, 75 mg intravenous push.
B.Perform synchronized cardioversion.
C.Defibrillate the client as soon as possible.
D.Administer atropine, 0.4 mg intravenous push. - correct answer-Correct Answer: B
Rationale:With uncontrolled atrial fibrillation, the treatment of choice is synchronized cardioversion
to convert the cardiac rhythm back to normal sinus rhythm. Option A is a medication used for
ventricular dysrhythmias. Option C is not for a client with atrial fibrillation; it is reserved for clients
with life-threatening dysrhythmias, such as ventricular fibrillation and unstable ventricular
tachycardia. Option D is the drug of choice in symptomatic sinus bradycardia, not atrial fibrillation.
, Page 2 of 56
31 May 2026
Which change in laboratory values indicates to the nurse that a client with rheumatoid arthritis
may be experiencing an adverse effect of methotrexate therapy?
A.Increase in rheumatoid factor
B.Decrease in hemoglobin level
C.Increase in blood glucose level
D.Decrease in erythrocyte sedimentation rate (ESR; sed rate) - correct answer-Correct Answer: B
Rationale:Methotrexate is an immunosuppressant. A common side effect is bone marrow
depression, which would be reflected by a decrease in the hemoglobin level. Option A indicates
disease progression but is not a side effect of the medication. Option C is not related to
methotrexate. Option D indicates that inflammation associated with the disease has diminished.
A client is diagnosed with an acute small bowel obstruction and suddenly spikes a temperature of
102°F/38.9°C. What other assessments should the nurse include in the client's focused
assessment? (Select all that apply.)
A.Nausea and vomiting
B.Loss of appetite
C.Abdominal cramping
D.Guarding with abdominal palpation
E.Low urine output
F.Cool, clammy skin - correct answer-Correct Answer: A,B,C,D
Rationale:The client is showing signs of peritonitis with the sudden spike in temperature. Low urine
output and cool clammy skin are not seen with peritonitis. Peritonitis is a medical emergency and
the health care provider must be notified immediately.
Which nursing action is necessary for the client with a flail chest? A.Withhold
prescribed analgesic medications.
B.Percuss the fractured rib area with light taps.
C.Avoid implementing pulmonary suctioning.
D.Encourage coughing and deep breathing. - correct answer-Correct Answer: D
Rationale:Treatment of flail chest is focused on preventing atelectasis and related complications of
compromised ventilation by encouraging coughing and deep breathing. This condition is typically
diagnosed in clients with three or more rib fractures, resulting in paradoxic movement of a segment
of the chest wall. Option C should not be avoided because suctioning is necessary to maintain
pulmonary toilet in clients who require mechanical ventilation. Option A should not be withheld.
Option B should not be applied because the fractures are clearly visible on the chest radiograph.
, Page 3 of 56
31 May 2026
One day after a Billroth II surgery, the client suddenly grabs his right chest and becomes pale and
diaphoretic. Vital signs are assessed as blood pressure 100/80 mm Hg, pulse 110 beats/min, and
respirations 36 breaths/min. Which action is most important for the nurse to take? A.Provide a
paper bag for his hyperventilation.
B.Administer a prescribed PRN analgesic.
C.Have the client drink a glass of sweetened fruit juice.
D.Apply oxygen at 2 L via nasal cannula. - correct answer-Correct Answer: D
Rationale:Pulmonary embolism and pneumothorax are risks associated with major abdominal
surgery. The nurse should immediately provide oxygen while performing further assessment. A rapid
respiratory rate should not be treated as hyperventilation. Option B should not be administered
until more ominous causes are ruled out or treated. There is no evidence that the client is
hypoglycemic.
Which instruction should the nurse teach a female client about the prevention of toxic shock
syndrome?
A."Get immunization against human papillomavirus (HPV)."
B."Change your tampon frequently."
C."Empty your bladder after intercourse."
D."Obtain a yearly flu vaccination." - correct answer-Correct Answer: B
Rationale:Certain strains of Staphylococcus aureus produce a toxin that can enter the bloodstream
through the vaginal mucosa. Changing the tampon frequently reduces the exposure to these toxins,
which are the primary cause of toxic shock syndrome. Option A helps prevent cervical cancer, not
toxic shock syndrome. Option C can lessen the incidence of urinary tract infection. Option D can help
prevent some individuals from contracting the flu and pneumonia, but no relationship to toxic shock
syndrome has been proven.
The nurse observes the chest tube drainage has exceeded 300 mL of bright red bloody fluid for the
past 30 minutes in the client after a coronary artery bypass graft. What is the nurse's next action?
A.Notify the healthcare provider.
B.Assess for restlessness.
C.Assess for pallor.
D.Tell the charge nurse. - correct answer-Correct Answer: A
Rationale:This client is showing signs of hemorrhage, and must be evaluated by a health care
provider. Pallor and restlessness indicate decreased oxygenation, and support the finding of a
, Page 4 of 56
31 May 2026
possible hemorrhage. The charge nurse will need to be notified, in the event that this client needs to
return to the operating room
During the shift report, the charge nurse informs a nurse of a reassignment to another unit for the
day. The nurse begins to sigh deeply and tosses about her belongings when preparing to leave.
What is the best immediate action for the charge nurse to take?
A.Continue with the shift report and talk to the nurse about the incident at a later time.
B.Ask the nurse to call the house supervisor to see if she must be reassigned.
C.Stop the shift report and remind the nurse that all staff are floated equally.
D.Inform the nurse that her behavior is disruptive to the rest of the staff. - correct answer-Correct
Answer: A
Rationale:Continuing with the shift report is the best immediate action because it allows the nurse
who was floated some cooling off time. At a later time (after the nurse has cooled off) the charge
nurse should discuss the conduct of the nurse in private. Option B encourages the nurse to shirk the
float assignment. Option C is disruptive. Reprimanding the nurse in front of the staff would increase
the nurse's hostility, so the nurse should be counseled in private.
The nurse is counseling a healthy 30-year-old female client regarding osteoporosis prevention.
Which activity would be most beneficial in achieving the client's goal of osteoporosis prevention?
A.Cross-country skiing
B.Scuba diving
C.Horseback riding
D.Kayaking - correct answer-Correct Answer: A
Rationale:Weight-bearing exercise is an important measure to reduce the risk of osteoporosis. Of
the activities listed, cross-country skiing includes the most weight-bearing, whereas options B, C, and
D involve less
The nurse is observing an unlicensed assistive personnel (UAP) performing care for a bedridden
client with advanced Huntington disease. Which care measures are most important for the nurse
to supervise? (Select all that apply.)
A.Oral care
B.Bathing
C.Foot care
D.Catheter care
E.Enteral feeding - correct answer-Correct Answer: A,E
31 May 2026
EVOLVE MED SURG HESI Latest PREP
EXAM with 150 Questions and Correct
Answers WITH RATIONALES/ HESI Exam
COVERING RECENT AND MOST TESTED
QUESTIONS.
The nurse is preparing a client for discharge after a right total knee replacement. Which client
statements about use of a walker indicate to the nurse the teaching was effective? (Select all that
apply.)
A."I will walk in the middle of the walker."
B."I will make sure all four feet of the walker are on the floor before I use the hand pieces."
C."I will move my right foot forward into the walker, and then my left foot."
D."I will collapse the walker and put it in the chair opposite the bed at night."
E."I will use a silicone-based cleaning product to clean the hand pieces and rubber tips." - correct
answer-Correct Answer: A,B,C
Rationale:The nurse is teaching about use of a walker. Having the walker collapsed at night does not
help with nighttime ambulation to the restroom. The client is at risk for falling. Silicone is a slippery
material and placing silicone on the rubber tips of the walker places the client at risk for falling. The
remaining client statements about use of a walker are correct.
A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid ventricular
response. Based on this finding, the nurse anticipates assisting the physician with which
treatment?
A.Administer lidocaine, 75 mg intravenous push.
B.Perform synchronized cardioversion.
C.Defibrillate the client as soon as possible.
D.Administer atropine, 0.4 mg intravenous push. - correct answer-Correct Answer: B
Rationale:With uncontrolled atrial fibrillation, the treatment of choice is synchronized cardioversion
to convert the cardiac rhythm back to normal sinus rhythm. Option A is a medication used for
ventricular dysrhythmias. Option C is not for a client with atrial fibrillation; it is reserved for clients
with life-threatening dysrhythmias, such as ventricular fibrillation and unstable ventricular
tachycardia. Option D is the drug of choice in symptomatic sinus bradycardia, not atrial fibrillation.
, Page 2 of 56
31 May 2026
Which change in laboratory values indicates to the nurse that a client with rheumatoid arthritis
may be experiencing an adverse effect of methotrexate therapy?
A.Increase in rheumatoid factor
B.Decrease in hemoglobin level
C.Increase in blood glucose level
D.Decrease in erythrocyte sedimentation rate (ESR; sed rate) - correct answer-Correct Answer: B
Rationale:Methotrexate is an immunosuppressant. A common side effect is bone marrow
depression, which would be reflected by a decrease in the hemoglobin level. Option A indicates
disease progression but is not a side effect of the medication. Option C is not related to
methotrexate. Option D indicates that inflammation associated with the disease has diminished.
A client is diagnosed with an acute small bowel obstruction and suddenly spikes a temperature of
102°F/38.9°C. What other assessments should the nurse include in the client's focused
assessment? (Select all that apply.)
A.Nausea and vomiting
B.Loss of appetite
C.Abdominal cramping
D.Guarding with abdominal palpation
E.Low urine output
F.Cool, clammy skin - correct answer-Correct Answer: A,B,C,D
Rationale:The client is showing signs of peritonitis with the sudden spike in temperature. Low urine
output and cool clammy skin are not seen with peritonitis. Peritonitis is a medical emergency and
the health care provider must be notified immediately.
Which nursing action is necessary for the client with a flail chest? A.Withhold
prescribed analgesic medications.
B.Percuss the fractured rib area with light taps.
C.Avoid implementing pulmonary suctioning.
D.Encourage coughing and deep breathing. - correct answer-Correct Answer: D
Rationale:Treatment of flail chest is focused on preventing atelectasis and related complications of
compromised ventilation by encouraging coughing and deep breathing. This condition is typically
diagnosed in clients with three or more rib fractures, resulting in paradoxic movement of a segment
of the chest wall. Option C should not be avoided because suctioning is necessary to maintain
pulmonary toilet in clients who require mechanical ventilation. Option A should not be withheld.
Option B should not be applied because the fractures are clearly visible on the chest radiograph.
, Page 3 of 56
31 May 2026
One day after a Billroth II surgery, the client suddenly grabs his right chest and becomes pale and
diaphoretic. Vital signs are assessed as blood pressure 100/80 mm Hg, pulse 110 beats/min, and
respirations 36 breaths/min. Which action is most important for the nurse to take? A.Provide a
paper bag for his hyperventilation.
B.Administer a prescribed PRN analgesic.
C.Have the client drink a glass of sweetened fruit juice.
D.Apply oxygen at 2 L via nasal cannula. - correct answer-Correct Answer: D
Rationale:Pulmonary embolism and pneumothorax are risks associated with major abdominal
surgery. The nurse should immediately provide oxygen while performing further assessment. A rapid
respiratory rate should not be treated as hyperventilation. Option B should not be administered
until more ominous causes are ruled out or treated. There is no evidence that the client is
hypoglycemic.
Which instruction should the nurse teach a female client about the prevention of toxic shock
syndrome?
A."Get immunization against human papillomavirus (HPV)."
B."Change your tampon frequently."
C."Empty your bladder after intercourse."
D."Obtain a yearly flu vaccination." - correct answer-Correct Answer: B
Rationale:Certain strains of Staphylococcus aureus produce a toxin that can enter the bloodstream
through the vaginal mucosa. Changing the tampon frequently reduces the exposure to these toxins,
which are the primary cause of toxic shock syndrome. Option A helps prevent cervical cancer, not
toxic shock syndrome. Option C can lessen the incidence of urinary tract infection. Option D can help
prevent some individuals from contracting the flu and pneumonia, but no relationship to toxic shock
syndrome has been proven.
The nurse observes the chest tube drainage has exceeded 300 mL of bright red bloody fluid for the
past 30 minutes in the client after a coronary artery bypass graft. What is the nurse's next action?
A.Notify the healthcare provider.
B.Assess for restlessness.
C.Assess for pallor.
D.Tell the charge nurse. - correct answer-Correct Answer: A
Rationale:This client is showing signs of hemorrhage, and must be evaluated by a health care
provider. Pallor and restlessness indicate decreased oxygenation, and support the finding of a
, Page 4 of 56
31 May 2026
possible hemorrhage. The charge nurse will need to be notified, in the event that this client needs to
return to the operating room
During the shift report, the charge nurse informs a nurse of a reassignment to another unit for the
day. The nurse begins to sigh deeply and tosses about her belongings when preparing to leave.
What is the best immediate action for the charge nurse to take?
A.Continue with the shift report and talk to the nurse about the incident at a later time.
B.Ask the nurse to call the house supervisor to see if she must be reassigned.
C.Stop the shift report and remind the nurse that all staff are floated equally.
D.Inform the nurse that her behavior is disruptive to the rest of the staff. - correct answer-Correct
Answer: A
Rationale:Continuing with the shift report is the best immediate action because it allows the nurse
who was floated some cooling off time. At a later time (after the nurse has cooled off) the charge
nurse should discuss the conduct of the nurse in private. Option B encourages the nurse to shirk the
float assignment. Option C is disruptive. Reprimanding the nurse in front of the staff would increase
the nurse's hostility, so the nurse should be counseled in private.
The nurse is counseling a healthy 30-year-old female client regarding osteoporosis prevention.
Which activity would be most beneficial in achieving the client's goal of osteoporosis prevention?
A.Cross-country skiing
B.Scuba diving
C.Horseback riding
D.Kayaking - correct answer-Correct Answer: A
Rationale:Weight-bearing exercise is an important measure to reduce the risk of osteoporosis. Of
the activities listed, cross-country skiing includes the most weight-bearing, whereas options B, C, and
D involve less
The nurse is observing an unlicensed assistive personnel (UAP) performing care for a bedridden
client with advanced Huntington disease. Which care measures are most important for the nurse
to supervise? (Select all that apply.)
A.Oral care
B.Bathing
C.Foot care
D.Catheter care
E.Enteral feeding - correct answer-Correct Answer: A,E
