EVOLVE HESI MED-SURG LATEST 2026 EXAM 100+
QUESTIONS & CORRECT ANSWERS
A client with type 1 diabetes mellitus has a blood glucose level of 620 mg/dL.
After the nurse calls the physician to report the finding and monitors the client
closely for:
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
A. Metabolic acidosis
Rationale: In the scenario described, a client with a blood glucose level of 620
mg/dL and type 1 diabetes mellitus is at risk of developing metabolic acidosis.
In type 1 diabetes, the lack of sufficient circulating insulin leads to an increase
in blood glucose levels. As the body cells utilize all available glucose, the
breakdown of fats for energy results in the production of ketones, leading to
metabolic acidosis.
A client tells the nurse that he has been experiencing frequent heartburn and has
been 'living on antacids.' For which acid-base disturbance does the nurse recognize
a risk?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
B. Metabolic alkalosis
Rationale: In this scenario, the client's frequent use of antacids containing
alkaline components can lead to an excess of bicarbonate in the body, causing
metabolic alkalosis. Oral antacids work by neutralizing stomach acid,
potentially leading to an alkaline shift in the body's pH balance.
A client who has received sodium bicarbonate in large amounts is at risk for
metabolic alkalosis. For which of the following signs and symptoms does the nurse
,assess this client?
A. Disorientation and dyspnea
B. Drowsiness, headache, and tachypnea
C. Tachypnea, dizziness, and paresthesias
D. Dysrhythmias and decreased respiratory rate and depth
D. Dysrhythmias and decreased respiratory rate and depth
Rationale: A client with metabolic alkalosis may present with dysrhythmias
and a decreased respiratory rate and depth as the body tries to compensate by
retaining carbon dioxide.
A client with a diagnosis of hypothermia is being admitted to the hospital by a
nurse. Which of the following signs does the nurse anticipate that this client will
exhibit?
A. Increased heart rate and increased blood pressure
B. Increased heart rate and decreased blood pressure
C. Decreased heart rate and increased blood pressure
D. Decreased heart rate and decreased blood pressure
D. Decreased heart rate and decreased blood pressure
Rationale: Hypothermia decreases the heart rate and blood pressure due to
reduced metabolic needs of the body. With lower metabolic demands, the
heart's workload decreases, leading to reductions in both heart rate and blood
pressure.
A nurse contacts the healthcare provider after reviewing a client's laboratory results
and noting a blood urea nitrogen (BUN) of 35 mg/dL and a creatinine of 1.0
mg/dL. For which action should the nurse recommend a prescription?
A. Intravenous fluids
B. Hemodialysis
C. Fluid restriction
D. Urine culture and sensitivity
A. Intravenous fluids
Rationale: The normal range for BUN is 10 to 20 mg/dL, and for creatinine, it
is 0.6 to 1.2 mg/dL in males and 0.5 to 1.1 mg/dL in females. Creatinine is a
more specific marker for kidney function compared to BUN. In this case, the
client's creatinine level is within the normal range, indicating a non-renal
,cause for the elevated BUN. Dehydration is a common cause of increased
BUN, so the appropriate action would be to recommend intravenous fluids to
address the dehydration.
A nurse reviews a female client's laboratory results. Which result from the client's
urinalysis should the nurse recognize as abnormal?
A. pH 5.6
B. Ketone bodies present
C. Specific gravity of 1.020
D. Clear and yellow color
B. Ketone bodies present
Rationale: Ketone bodies in urine indicate abnormal metabolism, specifically
the incomplete breakdown of fatty acids. Normally, there should be no
ketones present in urine. Ketone bodies are produced when the body uses fat
sources instead of glucose for cellular energy.
A client expresses difficulty voiding in public places. How should the nurse
respond?
A. Offer to turn on the faucet in the bathroom to help stimulate urination.
B. Suggest a prescription for a diuretic to increase urine output.
C. Propose moving to a room with a private bathroom to enhance comfort.
D. Close the curtain to provide maximum privacy.
D. Close the curtain to provide maximum privacy.
Rationale: The nurse should prioritize the client's privacy when addressing
issues related to voiding discomfort in public places. Closing the curtain in the
current room would offer immediate privacy and support the client's needs.
A nurse plans care for an older adult client. Which interventions should the nurse
include in this client's plan of care to promote kidney health? (Select all that
apply.)
A. Ensure adequate fluid intake.
B. Leave the bathroom light on at night.
C. Encourage use of the toilet every 6 hours.
D. A & B
D. A & B
, Rationale: The correct interventions to promote kidney health in an older
adult client include ensuring adequate fluid intake to maintain hydration and
leaving the bathroom light on at night to promote safe ambulation. Adequate
hydration supports kidney function and helps prevent urinary tract
infections.
A nurse cares for adult clients who experience urge incontinence. For which client
should the nurse plan a habit training program?
A. A 78-year-old female who is confused
B. A 65-year-old male with diabetes mellitus
C. A 52-year-old female with kidney failure
D. A 47-year-old male with arthritis
A. A 78-year-old female who is confused
Rationale: For a bladder training program to succeed in a client with urge
incontinence, the client must be alert, aware, and able to resist the urge to
urinate. Habit training will work best for a confused client. This includes
going to the bathroom (or being assisted to the bathroom) at set times. A
confused client may need structured assistance to establish a regular
bathroom routine, which can help manage urge incontinence effectively.
A client recovering from extracorporeal shock wave lithotripsy for renal calculi has
an ecchymotic area on the right lower back. What action should the nurse take?
A. Administer fresh-frozen plasma.
B. Apply an ice pack to the site.
C. Place the client in the prone position.
D. Obtain serum coagulation test results.
B. Apply an ice pack to the site.
Rationale: After extracorporeal shock wave lithotripsy, ecchymosis can occur
due to bleeding into the tissues from the shock waves. Applying an ice pack
helps reduce the extent and discomfort of bruising.
A young female client prescribed amoxicillin (Amoxil) for a urinary tract infection
is being taught by a nurse. Which statement should the nurse include in this client's
teaching?
A. Use a second form of birth control while taking this medication.
B. You will experience increased menstrual bleeding while on this medication.
QUESTIONS & CORRECT ANSWERS
A client with type 1 diabetes mellitus has a blood glucose level of 620 mg/dL.
After the nurse calls the physician to report the finding and monitors the client
closely for:
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
A. Metabolic acidosis
Rationale: In the scenario described, a client with a blood glucose level of 620
mg/dL and type 1 diabetes mellitus is at risk of developing metabolic acidosis.
In type 1 diabetes, the lack of sufficient circulating insulin leads to an increase
in blood glucose levels. As the body cells utilize all available glucose, the
breakdown of fats for energy results in the production of ketones, leading to
metabolic acidosis.
A client tells the nurse that he has been experiencing frequent heartburn and has
been 'living on antacids.' For which acid-base disturbance does the nurse recognize
a risk?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
B. Metabolic alkalosis
Rationale: In this scenario, the client's frequent use of antacids containing
alkaline components can lead to an excess of bicarbonate in the body, causing
metabolic alkalosis. Oral antacids work by neutralizing stomach acid,
potentially leading to an alkaline shift in the body's pH balance.
A client who has received sodium bicarbonate in large amounts is at risk for
metabolic alkalosis. For which of the following signs and symptoms does the nurse
,assess this client?
A. Disorientation and dyspnea
B. Drowsiness, headache, and tachypnea
C. Tachypnea, dizziness, and paresthesias
D. Dysrhythmias and decreased respiratory rate and depth
D. Dysrhythmias and decreased respiratory rate and depth
Rationale: A client with metabolic alkalosis may present with dysrhythmias
and a decreased respiratory rate and depth as the body tries to compensate by
retaining carbon dioxide.
A client with a diagnosis of hypothermia is being admitted to the hospital by a
nurse. Which of the following signs does the nurse anticipate that this client will
exhibit?
A. Increased heart rate and increased blood pressure
B. Increased heart rate and decreased blood pressure
C. Decreased heart rate and increased blood pressure
D. Decreased heart rate and decreased blood pressure
D. Decreased heart rate and decreased blood pressure
Rationale: Hypothermia decreases the heart rate and blood pressure due to
reduced metabolic needs of the body. With lower metabolic demands, the
heart's workload decreases, leading to reductions in both heart rate and blood
pressure.
A nurse contacts the healthcare provider after reviewing a client's laboratory results
and noting a blood urea nitrogen (BUN) of 35 mg/dL and a creatinine of 1.0
mg/dL. For which action should the nurse recommend a prescription?
A. Intravenous fluids
B. Hemodialysis
C. Fluid restriction
D. Urine culture and sensitivity
A. Intravenous fluids
Rationale: The normal range for BUN is 10 to 20 mg/dL, and for creatinine, it
is 0.6 to 1.2 mg/dL in males and 0.5 to 1.1 mg/dL in females. Creatinine is a
more specific marker for kidney function compared to BUN. In this case, the
client's creatinine level is within the normal range, indicating a non-renal
,cause for the elevated BUN. Dehydration is a common cause of increased
BUN, so the appropriate action would be to recommend intravenous fluids to
address the dehydration.
A nurse reviews a female client's laboratory results. Which result from the client's
urinalysis should the nurse recognize as abnormal?
A. pH 5.6
B. Ketone bodies present
C. Specific gravity of 1.020
D. Clear and yellow color
B. Ketone bodies present
Rationale: Ketone bodies in urine indicate abnormal metabolism, specifically
the incomplete breakdown of fatty acids. Normally, there should be no
ketones present in urine. Ketone bodies are produced when the body uses fat
sources instead of glucose for cellular energy.
A client expresses difficulty voiding in public places. How should the nurse
respond?
A. Offer to turn on the faucet in the bathroom to help stimulate urination.
B. Suggest a prescription for a diuretic to increase urine output.
C. Propose moving to a room with a private bathroom to enhance comfort.
D. Close the curtain to provide maximum privacy.
D. Close the curtain to provide maximum privacy.
Rationale: The nurse should prioritize the client's privacy when addressing
issues related to voiding discomfort in public places. Closing the curtain in the
current room would offer immediate privacy and support the client's needs.
A nurse plans care for an older adult client. Which interventions should the nurse
include in this client's plan of care to promote kidney health? (Select all that
apply.)
A. Ensure adequate fluid intake.
B. Leave the bathroom light on at night.
C. Encourage use of the toilet every 6 hours.
D. A & B
D. A & B
, Rationale: The correct interventions to promote kidney health in an older
adult client include ensuring adequate fluid intake to maintain hydration and
leaving the bathroom light on at night to promote safe ambulation. Adequate
hydration supports kidney function and helps prevent urinary tract
infections.
A nurse cares for adult clients who experience urge incontinence. For which client
should the nurse plan a habit training program?
A. A 78-year-old female who is confused
B. A 65-year-old male with diabetes mellitus
C. A 52-year-old female with kidney failure
D. A 47-year-old male with arthritis
A. A 78-year-old female who is confused
Rationale: For a bladder training program to succeed in a client with urge
incontinence, the client must be alert, aware, and able to resist the urge to
urinate. Habit training will work best for a confused client. This includes
going to the bathroom (or being assisted to the bathroom) at set times. A
confused client may need structured assistance to establish a regular
bathroom routine, which can help manage urge incontinence effectively.
A client recovering from extracorporeal shock wave lithotripsy for renal calculi has
an ecchymotic area on the right lower back. What action should the nurse take?
A. Administer fresh-frozen plasma.
B. Apply an ice pack to the site.
C. Place the client in the prone position.
D. Obtain serum coagulation test results.
B. Apply an ice pack to the site.
Rationale: After extracorporeal shock wave lithotripsy, ecchymosis can occur
due to bleeding into the tissues from the shock waves. Applying an ice pack
helps reduce the extent and discomfort of bruising.
A young female client prescribed amoxicillin (Amoxil) for a urinary tract infection
is being taught by a nurse. Which statement should the nurse include in this client's
teaching?
A. Use a second form of birth control while taking this medication.
B. You will experience increased menstrual bleeding while on this medication.
