EVOLVE ELSEVIER HESI MED SURG EXAM 300 ACTUAL
TESTBANK QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST 2026 ALREADY GRADED A+ ASSURED
PASS
This comprehensive 300-question Evolve Elsevier HESI Med Surg exam bank
provides a rigorous review of essential medical-surgical nursing concepts for
baccalaureate nursing students. Each question is uniquely crafted with
realistic clinical scenarios, multiple-choice options, a definitive correct answer,
and a detailed rationale explaining the underlying pathophysiology,
pharmacology, and nursing interventions. Content spans cardiovascular
disorders (heart failure, PAD, cardiac catheterization, dysrhythmias),
respiratory conditions (COPD, asthma, pneumonia, ARDS, TB, chest tubes),
renal and urinary disorders (AKI, CKD, dialysis, UTI, stones), oncology
(chemotherapy/radiation side effects, tumor lysis syndrome, SIADH,
neutropenic precautions, oncologic emergencies), and fluid/electrolyte
imbalances. Questions emphasize priority nursing actions, clinical judgment,
medication administration safety, patient education, and complication
identification. Designed to align with HESI Med Surg exam blueprints, this
resource promotes critical thinking, identifies knowledge gaps, and enhances
test-taking strategies for successful examination performance.
1. The nurse is assessing a 48-year-old client with a history of smoking who
reports calf pain during exercise that disappears at rest. Which finding requires
further evaluation?
A) Heart rate 57 bpm
B) SpO2 of 94% on room air
C) Blood pressure 134/82
D) Ankle-brachial index of 0.65
Correct Answer: D) Ankle-brachial index of 0.65
Rationale: An Ankle-Brachial Index of 0.65 suggests moderate arterial vascular
disease in a client who is experiencing intermittent claudication . A Doppler
ultrasound is indicated for further evaluation. A normal ABI is 1.0-1.4; values
below 0.90 indicate peripheral artery disease.
,2. A client with peripheral vascular disease has undergone a right femoral popliteal
bypass graft. The blood pressure has decreased from 124/80 to 94/62. What should
the nurse assess first?
A) IV fluid solution
B) Pedal pulses
C) Nasal cannula flow rate
D) Capillary refill
Correct Answer: B) Pedal pulses
Rationale: A drop in blood pressure following vascular surgery may indicate graft
occlusion or hemorrhage . The priority is to assess distal perfusion by checking
pedal pulses. Capillary refill and other assessments are important but pulse
assessment is the most direct indicator of graft patency.
3. An overweight client taking warfarin (Coumadin) has dry skin due to decreased
arterial blood flow. Which instructions should the nurse include? (Select all that
apply)
A) Apply lanolin or petroleum jelly to intact skin
B) Follow a reduced-calorie, reduced-fat diet
C) Inspect the involved areas daily for new ulcerations
D) Instruct the client to limit activities of daily living
E) Use an electric razor to shave
Correct Answer: A, B, C, E
Rationale: Maintaining skin integrity is important in preventing chronic ulcers and
infections . The client should be taught to inspect the skin daily. The client should
reduce weight to promote circulation; a diet lower in calories and fat is
recommended. An electric razor should be used to prevent nicks and cuts. Limiting
ADLs is not appropriate.
4. A client with peripheral artery disease (PAD) is being evaluated. Which
statement by the client indicates understanding of risk factor modification?
A) "I cannot change my family history of heart disease."
B) "My age is a risk factor I can modify."
C) "Diabetes is not related to atherosclerosis."
D) "I can reduce my risk by increasing my intake of saturated fats."
Correct Answer: A) "I cannot change my family history of heart disease."
Rationale: Family history is a non-modifiable risk factor . Age is also non-
modifiable. Diabetes is a significant modifiable risk factor for atherosclerosis.
Saturated fats should be decreased, not increased.
,5. A client with heart failure calls the clinic and reports that he cannot put his shoes
on because they are too tight. Which additional information should the nurse
obtain?
A) What time did he take his medication?
B) Has his weight changed in the last several days?
C) Is he still able to tighten his belt buckle?
D) How many hours did he sleep last night?
Correct Answer: B) Has his weight changed in the last several days?
Rationale: Tight shoes indicate peripheral edema, a sign of fluid retention . The
priority is to assess for weight gain, which is the most reliable indicator of fluid
volume overload in heart failure. A weight gain of 2-3 pounds in 24 hours should
be reported.
6. A male client with heart failure is prescribed digoxin and furosemide. Which
finding suggests digoxin toxicity?
A) Heart rate 62 bpm
B) Anorexia and nausea
C) Pedal edema 1+
D) Dry cough
Correct Answer: B) Anorexia and nausea
Rationale: Anorexia and nausea are early signs of digoxin toxicity . Other signs
include vomiting, visual disturbances (yellow-green halos), and cardiac
dysrhythmias. Furosemide can cause hypokalemia, which increases the risk of
digoxin toxicity.
7. A client with stable angina experiences chest pain that does not resolve after
taking three nitroglycerin tablets. What should the nurse advise?
A) Continue taking nitroglycerin every 5 minutes
B) Drive to the nearest hospital immediately
C) Chew a tablet of aspirin 325 mg while waiting for emergency services
D) Call a friend for assistance instead of emergency services
Correct Answer: C) Chew a tablet of aspirin 325 mg while waiting for emergency
services
Rationale: Unrelieved chest pain after three sublingual nitroglycerin tablets
indicates possible acute myocardial infarction . The client should chew 325 mg of
aspirin (if not contraindicated) while waiting for emergency services. The standard
protocol is one tablet every 5 minutes for up to 3 doses; if pain persists, call 911.
, 8. A client is receiving Cilostazol (Pletal) for peripheral arterial disease causing
intermittent claudication. The nurse determines this medication is effective when
the client reports:
A) "I am having fewer aches and pains."
B) "I do not have headaches anymore."
C) "I can walk farther now without leg pain."
D) "My blood pressure is lower."
Correct Answer: C) "I can walk farther now without leg pain."
Rationale: Cilostazol is a phosphodiesterase inhibitor that increases blood flow to
the extremities and reduces platelet aggregation . Effectiveness is measured by
increased walking distance (improved claudication). It also has antiplatelet effects.
9. The nurse is caring for a client who has just returned from a cardiac
catheterization via the right femoral artery. Which assessment finding requires
immediate action?
A) Blood pressure 130/80
B) Apical pulse 68 bpm
C) Small amount of drainage at the insertion site
D) The client reports feeling a "pop" in the groin
Correct Answer: D) The client reports feeling a "pop" in the groin
Rationale: A "pop" sensation in the groin may indicate bleeding or hematoma
formation at the catheterization site . This requires immediate assessment and
intervention. A small amount of drainage may be normal; vital signs are stable.
10. A client with hypertension continues to experience headaches and dizziness
after antihypertensive medication. What should the nurse prioritize?
A) Encouraging the client to rest more
B) Scheduling a follow-up appointment with a physician
C) Reassessing blood pressure and neurological status
D) Administering additional pain medication
Correct Answer: C) Reassessing blood pressure and neurological status
Rationale: Headaches and dizziness in a hypertensive client may indicate
uncontrolled hypertension or adverse medication effects . The priority is to
reassess blood pressure and neurological status to determine the cause. Pain
medication and rest are not appropriate without further assessment.
11. A client with Cholelithiasis develops yellow sclera. What should the nurse do?
A) Administer an antiemetic medication
B) Notify the healthcare provider about the jaundice
C) Encourage the patient to drink fluids
TESTBANK QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST 2026 ALREADY GRADED A+ ASSURED
PASS
This comprehensive 300-question Evolve Elsevier HESI Med Surg exam bank
provides a rigorous review of essential medical-surgical nursing concepts for
baccalaureate nursing students. Each question is uniquely crafted with
realistic clinical scenarios, multiple-choice options, a definitive correct answer,
and a detailed rationale explaining the underlying pathophysiology,
pharmacology, and nursing interventions. Content spans cardiovascular
disorders (heart failure, PAD, cardiac catheterization, dysrhythmias),
respiratory conditions (COPD, asthma, pneumonia, ARDS, TB, chest tubes),
renal and urinary disorders (AKI, CKD, dialysis, UTI, stones), oncology
(chemotherapy/radiation side effects, tumor lysis syndrome, SIADH,
neutropenic precautions, oncologic emergencies), and fluid/electrolyte
imbalances. Questions emphasize priority nursing actions, clinical judgment,
medication administration safety, patient education, and complication
identification. Designed to align with HESI Med Surg exam blueprints, this
resource promotes critical thinking, identifies knowledge gaps, and enhances
test-taking strategies for successful examination performance.
1. The nurse is assessing a 48-year-old client with a history of smoking who
reports calf pain during exercise that disappears at rest. Which finding requires
further evaluation?
A) Heart rate 57 bpm
B) SpO2 of 94% on room air
C) Blood pressure 134/82
D) Ankle-brachial index of 0.65
Correct Answer: D) Ankle-brachial index of 0.65
Rationale: An Ankle-Brachial Index of 0.65 suggests moderate arterial vascular
disease in a client who is experiencing intermittent claudication . A Doppler
ultrasound is indicated for further evaluation. A normal ABI is 1.0-1.4; values
below 0.90 indicate peripheral artery disease.
,2. A client with peripheral vascular disease has undergone a right femoral popliteal
bypass graft. The blood pressure has decreased from 124/80 to 94/62. What should
the nurse assess first?
A) IV fluid solution
B) Pedal pulses
C) Nasal cannula flow rate
D) Capillary refill
Correct Answer: B) Pedal pulses
Rationale: A drop in blood pressure following vascular surgery may indicate graft
occlusion or hemorrhage . The priority is to assess distal perfusion by checking
pedal pulses. Capillary refill and other assessments are important but pulse
assessment is the most direct indicator of graft patency.
3. An overweight client taking warfarin (Coumadin) has dry skin due to decreased
arterial blood flow. Which instructions should the nurse include? (Select all that
apply)
A) Apply lanolin or petroleum jelly to intact skin
B) Follow a reduced-calorie, reduced-fat diet
C) Inspect the involved areas daily for new ulcerations
D) Instruct the client to limit activities of daily living
E) Use an electric razor to shave
Correct Answer: A, B, C, E
Rationale: Maintaining skin integrity is important in preventing chronic ulcers and
infections . The client should be taught to inspect the skin daily. The client should
reduce weight to promote circulation; a diet lower in calories and fat is
recommended. An electric razor should be used to prevent nicks and cuts. Limiting
ADLs is not appropriate.
4. A client with peripheral artery disease (PAD) is being evaluated. Which
statement by the client indicates understanding of risk factor modification?
A) "I cannot change my family history of heart disease."
B) "My age is a risk factor I can modify."
C) "Diabetes is not related to atherosclerosis."
D) "I can reduce my risk by increasing my intake of saturated fats."
Correct Answer: A) "I cannot change my family history of heart disease."
Rationale: Family history is a non-modifiable risk factor . Age is also non-
modifiable. Diabetes is a significant modifiable risk factor for atherosclerosis.
Saturated fats should be decreased, not increased.
,5. A client with heart failure calls the clinic and reports that he cannot put his shoes
on because they are too tight. Which additional information should the nurse
obtain?
A) What time did he take his medication?
B) Has his weight changed in the last several days?
C) Is he still able to tighten his belt buckle?
D) How many hours did he sleep last night?
Correct Answer: B) Has his weight changed in the last several days?
Rationale: Tight shoes indicate peripheral edema, a sign of fluid retention . The
priority is to assess for weight gain, which is the most reliable indicator of fluid
volume overload in heart failure. A weight gain of 2-3 pounds in 24 hours should
be reported.
6. A male client with heart failure is prescribed digoxin and furosemide. Which
finding suggests digoxin toxicity?
A) Heart rate 62 bpm
B) Anorexia and nausea
C) Pedal edema 1+
D) Dry cough
Correct Answer: B) Anorexia and nausea
Rationale: Anorexia and nausea are early signs of digoxin toxicity . Other signs
include vomiting, visual disturbances (yellow-green halos), and cardiac
dysrhythmias. Furosemide can cause hypokalemia, which increases the risk of
digoxin toxicity.
7. A client with stable angina experiences chest pain that does not resolve after
taking three nitroglycerin tablets. What should the nurse advise?
A) Continue taking nitroglycerin every 5 minutes
B) Drive to the nearest hospital immediately
C) Chew a tablet of aspirin 325 mg while waiting for emergency services
D) Call a friend for assistance instead of emergency services
Correct Answer: C) Chew a tablet of aspirin 325 mg while waiting for emergency
services
Rationale: Unrelieved chest pain after three sublingual nitroglycerin tablets
indicates possible acute myocardial infarction . The client should chew 325 mg of
aspirin (if not contraindicated) while waiting for emergency services. The standard
protocol is one tablet every 5 minutes for up to 3 doses; if pain persists, call 911.
, 8. A client is receiving Cilostazol (Pletal) for peripheral arterial disease causing
intermittent claudication. The nurse determines this medication is effective when
the client reports:
A) "I am having fewer aches and pains."
B) "I do not have headaches anymore."
C) "I can walk farther now without leg pain."
D) "My blood pressure is lower."
Correct Answer: C) "I can walk farther now without leg pain."
Rationale: Cilostazol is a phosphodiesterase inhibitor that increases blood flow to
the extremities and reduces platelet aggregation . Effectiveness is measured by
increased walking distance (improved claudication). It also has antiplatelet effects.
9. The nurse is caring for a client who has just returned from a cardiac
catheterization via the right femoral artery. Which assessment finding requires
immediate action?
A) Blood pressure 130/80
B) Apical pulse 68 bpm
C) Small amount of drainage at the insertion site
D) The client reports feeling a "pop" in the groin
Correct Answer: D) The client reports feeling a "pop" in the groin
Rationale: A "pop" sensation in the groin may indicate bleeding or hematoma
formation at the catheterization site . This requires immediate assessment and
intervention. A small amount of drainage may be normal; vital signs are stable.
10. A client with hypertension continues to experience headaches and dizziness
after antihypertensive medication. What should the nurse prioritize?
A) Encouraging the client to rest more
B) Scheduling a follow-up appointment with a physician
C) Reassessing blood pressure and neurological status
D) Administering additional pain medication
Correct Answer: C) Reassessing blood pressure and neurological status
Rationale: Headaches and dizziness in a hypertensive client may indicate
uncontrolled hypertension or adverse medication effects . The priority is to
reassess blood pressure and neurological status to determine the cause. Pain
medication and rest are not appropriate without further assessment.
11. A client with Cholelithiasis develops yellow sclera. What should the nurse do?
A) Administer an antiemetic medication
B) Notify the healthcare provider about the jaundice
C) Encourage the patient to drink fluids
