EVOLVE ELSEVIER HESI MEDICAL-SURGICAL LATEST 2026/2027 TEST BANK | COMPLETE 200 REAL EXAM-STYLE QUESTIONS WITH CORRECT ANSWERS & ELABORATED RATIONALES | GRADED A+ | COVERS ALL TOPICS (CARDIAC, RESPIRATORY, NEURO, GI, RENAL, ENDOCRINE, & CRITICAL CARE) | B

EVOLVE ELSEVIER HESI MEDICAL-SURGICAL LATEST 2026/2027 TEST BANK | COMPLETE 200 REAL EXAM-STYLE QUESTIONS WITH CORRECT ANSWERS & ELABORATED RATIONALES | GRADED A+ | COVERS ALL TOPICS (CARDIAC, RESPIRATORY, NEURO, GI, RENAL, ENDOCRINE, & CRITICAL CARE) | BRAND NEW & UPDATED FOR NCLEX/HESI SUCCESS 1. A client with chronic heart failure is receiving furosemide (Lasix) and digoxin (Lanoxin). Which laboratory value is most important for the nurse to monitor? A. Serum sodium B. Serum potassium C. Serum calcium D. Serum magnesium Correct Answer: B Rationale: Furosemide is a loop diuretic that can cause significant potassium loss, leading to hypokalemia. Hypokalemia increases the risk of digoxin toxicity, making serum potassium the most critical value to monitor. While other electrolytes may be affected, potassium has the most direct relationship with digoxin safety. ________________________________________ 2. A client is admitted with diabetic ketoacidosis (DKA). Which assessment finding requires the most immediate action by the nurse? A. Blood glucose of 350 mg/dL B. Serum potassium of 5.5 mEq/L C. Deep, rapid respirations D. Fruity odor to the breath Correct Answer: C Rationale: Deep, rapid respirations (Kussmaul respirations) indicate the body's attempt to compensate for metabolic acidosis by blowing off carbon dioxide. This is a sign of severe acidosis and requires immediate intervention. Hyperglycemia and fruity breath are expected findings in DKA, but the respiratory pattern signals a critical acid-base imbalance that requires urgent treatment. ________________________________________ 3. A client with cirrhosis develops ascites. Which intervention should the nurse implement to monitor the effectiveness of treatment? A. Measure abdominal girth daily B. Monitor serum albumin levels C. Record intake and output D. Assess for peripheral edema Correct Answer: A Rationale: Daily measurement of abdominal girth is the most direct and sensitive indicator of changes in ascites accumulation or resolution. While monitoring albumin, intake/output, and edema provide supporting data, abdominal girth provides the most specific measurement of ascites progression or regression. ________________________________________ 4. Which clinical manifestation is the earliest sign of increased intracranial pressure (ICP)? A. Pupillary changes B. Vomiting C. Decreased level of consciousness D. Cushing's triad Correct Answer: C Rationale: A decrease in level of consciousness is the earliest and most sensitive indicator of increased ICP. Pupillary changes, vomiting, and Cushing's triad (hypertension, bradycardia, irregular respirations) are late signs that occur as ICP becomes critically elevated. ________________________________________ 5. The nurse is caring for a client with a chest tube connected to a water-seal drainage system. Which observation indicates that the system is functioning correctly? A. Continuous bubbling in the water-seal chamber B. Tidaling in the water-seal chamber with respirations C. Vigorous bubbling in the suction control chamber D. No fluctuation in the water-seal chamber Correct Answer: B Rationale: Tidaling (fluctuation) in the water-seal chamber with respirations indicates that the chest tube is patent and functioning properly. Continuous bubbling in the water-seal chamber indicates an air leak, while vigorous bubbling in the suction control chamber is normal only if suction is applied. No fluctuation suggests obstruction or lung re-expansion. ________________________________________ 6. A client with acute pancreatitis is experiencing severe abdominal pain. Which position should the nurse encourage to help decrease the pain? A. Prone position B. Supine position with legs extended C. Side-lying position with knees flexed D. Sitting upright leaning forward Correct Answer: D Rationale: Sitting upright and leaning forward helps decrease pain in acute pancreatitis by reducing pressure on the pancreas and allowing the abdominal muscles to relax. The other positions do not provide the same relief and may increase tension on the pancreas. ________________________________________ 7. The nurse is assessing a client with a suspected pulmonary embolism. Which finding is most consistent with this diagnosis? A. Bradycardia and hypertension B. Sudden chest pain and dyspnea C. Productive cough with green sputum D. Peripheral edema and jugular vein distention Correct Answer: B Rationale: Sudden onset of chest pain and dyspnea are classic manifestations of a pulmonary embolism. Tachycardia (not bradycardia) and hypotension are more common. Productive cough with green sputum suggests infection, and peripheral edema with jugular distention indicates right-sided heart failure. ________________________________________ 8. A client with chronic kidney disease is prescribed epoetin alfa (Epogen). What laboratory value should the nurse monitor to evaluate the effectiveness of this medication? A. White blood cell count B. Hemoglobin and hematocrit C. Serum creatinine D. Platelet count Correct Answer: B Rationale: Epoetin alfa is administered to stimulate red blood cell production in clients with anemia secondary to chronic kidney disease. Monitoring hemoglobin and hematocrit directly measures the effectiveness of the medication in treating anemia. The other values are not indicators of epoetin alfa effectiveness. ________________________________________ 9. The nurse is caring for a client who had a radical mastectomy. Which postoperative exercise should the nurse teach the client to prevent lymphedema? A. Shoulder shrugs B. Hand squeezing C. Elbow flexion and extension D. Wrist flexion and extension Correct Answer: A Rationale: Shoulder shrugs help promote lymphatic drainage and prevent lymphedema following radical mastectomy. While all exercises promote mobility, shoulder shrugs specifically facilitate lymphatic flow from the arm and chest wall. Hand and wrist exercises do not address the lymphatic channels in the axilla.