EVOLVE ELSEVIER HESI MED SURG TEST BANK
2026/2027
150 Questions with Verified Answers & Italicized Rationales
SECTION 1: PRIORITIZATION & CLINICAL JUDGMENT
(Questions 1-20)
Question 1: A patient with heart failure is experiencing dyspnea and has a
respiratory rate of 28 breaths per minute. What is the nurse's priority action?
A) Administer a diuretic
B) Encourage deep breathing exercises
C) Position the patient in high Fowler's position
D) Obtain a chest X-ray
Answer: C
Rationale: Positioning the patient in high Fowler's position facilitates lung expansion and
improves oxygenation, which is the priority for a patient with dyspnea due to heart failure.
This intervention can be implemented immediately before other interventions are initiated
.
Question 2: A postoperative patient develops a fever of 101.2°F on day 2. What is
the most likely cause?
A) Urinary tract infection
B) Atelectasis
C) Wound infection
D) Deep vein thrombosis
Answer: B
,Rationale: Atelectasis, a common postoperative complication, often causes fever within the
first 48 hours due to impaired lung expansion. The fever is typically low-grade and
resolves with deep breathing and early ambulation .
Question 3: A client with chronic kidney disease (CKD) has a potassium level of 6.2
mEq/L. What should the nurse anticipate administering?
A) Kayexalate (sodium polystyrene sulfonate)
B) Magnesium sulfate
C) Potassium chloride
D) Sodium bicarbonate
Answer: A
Rationale: Hyperkalemia (potassium >5.0 mEq/L) in CKD requires immediate intervention.
Kayexalate binds potassium in the intestines for excretion, reducing serum potassium
levels .
Question 4: A client is 6 hours post-operative and reports sudden onset of chest
pain and dyspnea. The nurse notes jugular venous distension and hypotension.
Which complication should the nurse suspect?
A) Myocardial infarction
B) Pulmonary embolism
C) Atelectasis
D) Pneumothorax
Answer: B
Rationale: Sudden onset of chest pain, dyspnea, JVD, and hypotension in a postoperative
patient is concerning for pulmonary embolism. This is a life-threatening emergency
requiring immediate intervention .
,Question 5: A patient with COPD has an oxygen saturation of 88% on room air.
The nurse should:
A) Administer oxygen at 4 L/min via nasal cannula
B) Administer oxygen at 2 L/min via nasal cannula
C) Administer oxygen at 6 L/min via mask
D) Keep the patient on room air
Answer: B
Rationale: COPD patients often have a hypoxic drive to breathe. Oxygen should be
administered at low flow rates (1-3 L/min) to maintain SpO2 of 88-92% while avoiding
respiratory depression. Higher oxygen concentrations can suppress the respiratory drive .
Question 6: The nurse is caring for a client with a chest tube. Continuous bubbling
in the water seal chamber indicates:
A) Normal functioning of the chest tube
B) An air leak in the system
C) The lung has re-expanded
D) The chest tube is obstructed
Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak, which
could be from the lung or from the drainage system. This requires immediate assessment
to locate the source of the leak .
Question 7: The nurse is assessing a client who had a radical mastectomy. Which
factor puts this client at greatest risk for developing lymphedema?
A) Sustained an insect bite to the left arm yesterday
B) Has lost twenty pounds since the surgery
C) Prescribed a calcium channel blocker for hypertension
D) Plays classical music on the piano
, Answer: A
Rationale: A radical mastectomy interrupts lymph flow, and the increased lymph flow that
occurs in response to an insect bite increases the risk for the occurrence of lymphedema.
Any injury to the affected arm should be avoided .
Question 8: The nurse is preparing a client for a mammogram. Which information
is most important to provide?
A) Breast self-examinations are not needed if annual mammograms are obtained
B) Radiation exposure is minimized by shielding the abdomen with a lead-lined apron
C) Yearly mammograms should be done regardless of previous normal x-rays
D) Women at high risk should have annual routine and ultrasound mammograms
Answer: C
Rationale: The client should be instructed that a yearly mammogram should be done
regardless of previous normal results. A mammogram can detect breast cancer in its
earliest stage, often before it can be palpated .
Question 9: A client taking furosemide (Lasix) reports difficulty sleeping. What
question is most important for the nurse to ask the client?
A) What dose of medication are you taking?
B) Are you eating foods rich in potassium?
C) Have you lost weight recently?
D) At what time do you take your medication?
Answer: D
Rationale: The nurse needs to determine at what time of day the client takes the Lasix.
Because of the diuretic effect of Lasix, clients should take the medication in the morning to
prevent nocturia .
2026/2027
150 Questions with Verified Answers & Italicized Rationales
SECTION 1: PRIORITIZATION & CLINICAL JUDGMENT
(Questions 1-20)
Question 1: A patient with heart failure is experiencing dyspnea and has a
respiratory rate of 28 breaths per minute. What is the nurse's priority action?
A) Administer a diuretic
B) Encourage deep breathing exercises
C) Position the patient in high Fowler's position
D) Obtain a chest X-ray
Answer: C
Rationale: Positioning the patient in high Fowler's position facilitates lung expansion and
improves oxygenation, which is the priority for a patient with dyspnea due to heart failure.
This intervention can be implemented immediately before other interventions are initiated
.
Question 2: A postoperative patient develops a fever of 101.2°F on day 2. What is
the most likely cause?
A) Urinary tract infection
B) Atelectasis
C) Wound infection
D) Deep vein thrombosis
Answer: B
,Rationale: Atelectasis, a common postoperative complication, often causes fever within the
first 48 hours due to impaired lung expansion. The fever is typically low-grade and
resolves with deep breathing and early ambulation .
Question 3: A client with chronic kidney disease (CKD) has a potassium level of 6.2
mEq/L. What should the nurse anticipate administering?
A) Kayexalate (sodium polystyrene sulfonate)
B) Magnesium sulfate
C) Potassium chloride
D) Sodium bicarbonate
Answer: A
Rationale: Hyperkalemia (potassium >5.0 mEq/L) in CKD requires immediate intervention.
Kayexalate binds potassium in the intestines for excretion, reducing serum potassium
levels .
Question 4: A client is 6 hours post-operative and reports sudden onset of chest
pain and dyspnea. The nurse notes jugular venous distension and hypotension.
Which complication should the nurse suspect?
A) Myocardial infarction
B) Pulmonary embolism
C) Atelectasis
D) Pneumothorax
Answer: B
Rationale: Sudden onset of chest pain, dyspnea, JVD, and hypotension in a postoperative
patient is concerning for pulmonary embolism. This is a life-threatening emergency
requiring immediate intervention .
,Question 5: A patient with COPD has an oxygen saturation of 88% on room air.
The nurse should:
A) Administer oxygen at 4 L/min via nasal cannula
B) Administer oxygen at 2 L/min via nasal cannula
C) Administer oxygen at 6 L/min via mask
D) Keep the patient on room air
Answer: B
Rationale: COPD patients often have a hypoxic drive to breathe. Oxygen should be
administered at low flow rates (1-3 L/min) to maintain SpO2 of 88-92% while avoiding
respiratory depression. Higher oxygen concentrations can suppress the respiratory drive .
Question 6: The nurse is caring for a client with a chest tube. Continuous bubbling
in the water seal chamber indicates:
A) Normal functioning of the chest tube
B) An air leak in the system
C) The lung has re-expanded
D) The chest tube is obstructed
Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak, which
could be from the lung or from the drainage system. This requires immediate assessment
to locate the source of the leak .
Question 7: The nurse is assessing a client who had a radical mastectomy. Which
factor puts this client at greatest risk for developing lymphedema?
A) Sustained an insect bite to the left arm yesterday
B) Has lost twenty pounds since the surgery
C) Prescribed a calcium channel blocker for hypertension
D) Plays classical music on the piano
, Answer: A
Rationale: A radical mastectomy interrupts lymph flow, and the increased lymph flow that
occurs in response to an insect bite increases the risk for the occurrence of lymphedema.
Any injury to the affected arm should be avoided .
Question 8: The nurse is preparing a client for a mammogram. Which information
is most important to provide?
A) Breast self-examinations are not needed if annual mammograms are obtained
B) Radiation exposure is minimized by shielding the abdomen with a lead-lined apron
C) Yearly mammograms should be done regardless of previous normal x-rays
D) Women at high risk should have annual routine and ultrasound mammograms
Answer: C
Rationale: The client should be instructed that a yearly mammogram should be done
regardless of previous normal results. A mammogram can detect breast cancer in its
earliest stage, often before it can be palpated .
Question 9: A client taking furosemide (Lasix) reports difficulty sleeping. What
question is most important for the nurse to ask the client?
A) What dose of medication are you taking?
B) Are you eating foods rich in potassium?
C) Have you lost weight recently?
D) At what time do you take your medication?
Answer: D
Rationale: The nurse needs to determine at what time of day the client takes the Lasix.
Because of the diuretic effect of Lasix, clients should take the medication in the morning to
prevent nocturia .
