EVOLVE ELSEVIER HESI MED SURG LATEST 2026/ 2027
TEST BANK| COMPLETE 350 REAL EXAM QUESTIONS
AND CORRECT ANSWERS WITH WELL-ELABORATED
RATIONALES/ GRADED A+| EVOLVE HESI MEDICAL
SURGICAL LATEST EXAM
QUESTION 1
An adult client who is hospitalized after surgery reports sudden onset of chest pain and
dyspnea. The client appears anxious, restless, and mildly cyanotic. The nurse should
further assess the client for which condition?
A. Atelectasis
B. Pulmonary embolism
C. Myocardial infarction
D. Pneumothorax
Answer: B. Pulmonary embolism
Rationale: The sudden onset of chest pain, dyspnea, anxiety, restlessness, and cyanosis in a
postoperative client are classic signs of a pulmonary embolism. Postoperative clients are at
increased risk for venous thromboembolism due to immobility and the hypercoagulable
state associated with surgery .
QUESTION 2
The nurse is caring for a client with an acute myocardial infarction (MI). Which
laboratory value is most specific for myocardial necrosis?
A. Creatine kinase-MB (CK-MB)
B. Troponin I
C. Myoglobin
D. C-reactive protein (CRP)
Answer: B. Troponin I
,Rationale: Troponin I is the most specific and sensitive cardiac biomarker for myocardial
necrosis. Elevated troponin levels indicate myocardial injury and are the preferred marker
for diagnosing acute MI. CK-MB rises later and is less specific; myoglobin is early but non-
specific; CRP is an inflammatory marker .
QUESTION 3
A client with heart failure is prescribed furosemide (Lasix). Which laboratory value
should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Answer: B. Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia can
lead to cardiac arrhythmias, especially in clients taking digoxin. The nurse should monitor
potassium levels and assess for signs of hypokalemia such as muscle weakness, cramping,
and ECG changes .
QUESTION 4
A client with hypertension is prescribed lisinopril. Which adverse effect should the nurse
monitor for?
A. Dry, non-productive cough
B. Peripheral edema
C. Hyperkalemia
D. Both A and C
Answer: D. Both A and C
Rationale: ACE inhibitors like lisinopril can cause a persistent dry cough (due to bradykinin
accumulation) and hyperkalemia (due to reduced aldosterone secretion). Peripheral
edema is not typical with ACE inhibitors .
,QUESTION 5
A client is receiving IV heparin for a deep vein thrombosis. The aPTT is 110 seconds
(normal 25-35). Which action should the nurse take first?
A. Stop the heparin infusion immediately
B. Prepare to administer protamine sulfate
C. Decrease the infusion rate by 100 units per hour
D. Obtain a repeat blood sample for aPTT analysis
Answer: A. Stop the heparin infusion immediately
Rationale: The therapeutic range for aPTT during heparin therapy is typically 1.5 to 2.5
times the normal control value (approximately 60-80 seconds). An aPTT of 110 seconds
indicates critical over-anticoagulation and extreme bleeding risk. The immediate action is
to stop the infusion to prevent hemorrhage. Protamine sulfate is held unless active, severe
hemorrhage occurs .
QUESTION 6
A client with heart failure is prescribed digoxin. Which finding indicates digoxin toxicity?
A. Heart rate of 72 bpm
B. Serum potassium 4.2 mEq/L
C. Nausea and vomiting
D. Blood pressure 120/80 mm Hg
Answer: C. Nausea and vomiting
Rationale: Nausea, vomiting, anorexia, and visual disturbances (yellow-green halos) are
early signs of digoxin toxicity. Bradycardia (not a normal heart rate) is also a sign, but
nausea/vomiting are classic. Hypokalemia increases the risk of digoxin toxicity, so
potassium levels should be monitored .
QUESTION 7
A client with unstable angina is prescribed nitroglycerin sublingual. Which instruction
should the nurse include?
, A. "Take a tablet every 5 minutes until the pain is relieved, up to 3 tablets."
B. "Take one tablet at the first sign of chest pain, then call 911 if pain persists."
C. "Swallow the tablet with a full glass of water."
D. "Store the tablets in the refrigerator."
Answer: B. "Take one tablet at the first sign of chest pain, then call 911 if pain
persists."
Rationale: The client should take one nitroglycerin tablet at the onset of chest pain. If pain
is not relieved after one tablet, they should call 911 immediately (may take a second tablet
while waiting). Tablets are placed under the tongue, not swallowed. Nitroglycerin should
be stored in a dark, dry place and replaced every 6 months .
QUESTION 8
A client with peripheral arterial disease (PAD) complains of calf pain when walking that
resolves with rest. This symptom is known as:
A. Rest pain
B. Intermittent claudication
C. Venous stasis
D. Neuropathy
Answer: B. Intermittent claudication
Rationale: Intermittent claudication is muscle pain (usually in the calf) that occurs with
exercise and is relieved by rest. It is caused by inadequate blood flow due to arterial
narrowing from atherosclerosis. Rest pain occurs at night and indicates severe arterial
insufficiency .
QUESTION 9
A client with chronic venous insufficiency is being discharged. Which instruction should
the nurse include to promote venous return?
A. Wear compression stockings only at night
B. Sit with legs crossed at the knees
TEST BANK| COMPLETE 350 REAL EXAM QUESTIONS
AND CORRECT ANSWERS WITH WELL-ELABORATED
RATIONALES/ GRADED A+| EVOLVE HESI MEDICAL
SURGICAL LATEST EXAM
QUESTION 1
An adult client who is hospitalized after surgery reports sudden onset of chest pain and
dyspnea. The client appears anxious, restless, and mildly cyanotic. The nurse should
further assess the client for which condition?
A. Atelectasis
B. Pulmonary embolism
C. Myocardial infarction
D. Pneumothorax
Answer: B. Pulmonary embolism
Rationale: The sudden onset of chest pain, dyspnea, anxiety, restlessness, and cyanosis in a
postoperative client are classic signs of a pulmonary embolism. Postoperative clients are at
increased risk for venous thromboembolism due to immobility and the hypercoagulable
state associated with surgery .
QUESTION 2
The nurse is caring for a client with an acute myocardial infarction (MI). Which
laboratory value is most specific for myocardial necrosis?
A. Creatine kinase-MB (CK-MB)
B. Troponin I
C. Myoglobin
D. C-reactive protein (CRP)
Answer: B. Troponin I
,Rationale: Troponin I is the most specific and sensitive cardiac biomarker for myocardial
necrosis. Elevated troponin levels indicate myocardial injury and are the preferred marker
for diagnosing acute MI. CK-MB rises later and is less specific; myoglobin is early but non-
specific; CRP is an inflammatory marker .
QUESTION 3
A client with heart failure is prescribed furosemide (Lasix). Which laboratory value
should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Answer: B. Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia can
lead to cardiac arrhythmias, especially in clients taking digoxin. The nurse should monitor
potassium levels and assess for signs of hypokalemia such as muscle weakness, cramping,
and ECG changes .
QUESTION 4
A client with hypertension is prescribed lisinopril. Which adverse effect should the nurse
monitor for?
A. Dry, non-productive cough
B. Peripheral edema
C. Hyperkalemia
D. Both A and C
Answer: D. Both A and C
Rationale: ACE inhibitors like lisinopril can cause a persistent dry cough (due to bradykinin
accumulation) and hyperkalemia (due to reduced aldosterone secretion). Peripheral
edema is not typical with ACE inhibitors .
,QUESTION 5
A client is receiving IV heparin for a deep vein thrombosis. The aPTT is 110 seconds
(normal 25-35). Which action should the nurse take first?
A. Stop the heparin infusion immediately
B. Prepare to administer protamine sulfate
C. Decrease the infusion rate by 100 units per hour
D. Obtain a repeat blood sample for aPTT analysis
Answer: A. Stop the heparin infusion immediately
Rationale: The therapeutic range for aPTT during heparin therapy is typically 1.5 to 2.5
times the normal control value (approximately 60-80 seconds). An aPTT of 110 seconds
indicates critical over-anticoagulation and extreme bleeding risk. The immediate action is
to stop the infusion to prevent hemorrhage. Protamine sulfate is held unless active, severe
hemorrhage occurs .
QUESTION 6
A client with heart failure is prescribed digoxin. Which finding indicates digoxin toxicity?
A. Heart rate of 72 bpm
B. Serum potassium 4.2 mEq/L
C. Nausea and vomiting
D. Blood pressure 120/80 mm Hg
Answer: C. Nausea and vomiting
Rationale: Nausea, vomiting, anorexia, and visual disturbances (yellow-green halos) are
early signs of digoxin toxicity. Bradycardia (not a normal heart rate) is also a sign, but
nausea/vomiting are classic. Hypokalemia increases the risk of digoxin toxicity, so
potassium levels should be monitored .
QUESTION 7
A client with unstable angina is prescribed nitroglycerin sublingual. Which instruction
should the nurse include?
, A. "Take a tablet every 5 minutes until the pain is relieved, up to 3 tablets."
B. "Take one tablet at the first sign of chest pain, then call 911 if pain persists."
C. "Swallow the tablet with a full glass of water."
D. "Store the tablets in the refrigerator."
Answer: B. "Take one tablet at the first sign of chest pain, then call 911 if pain
persists."
Rationale: The client should take one nitroglycerin tablet at the onset of chest pain. If pain
is not relieved after one tablet, they should call 911 immediately (may take a second tablet
while waiting). Tablets are placed under the tongue, not swallowed. Nitroglycerin should
be stored in a dark, dry place and replaced every 6 months .
QUESTION 8
A client with peripheral arterial disease (PAD) complains of calf pain when walking that
resolves with rest. This symptom is known as:
A. Rest pain
B. Intermittent claudication
C. Venous stasis
D. Neuropathy
Answer: B. Intermittent claudication
Rationale: Intermittent claudication is muscle pain (usually in the calf) that occurs with
exercise and is relieved by rest. It is caused by inadequate blood flow due to arterial
narrowing from atherosclerosis. Rest pain occurs at night and indicates severe arterial
insufficiency .
QUESTION 9
A client with chronic venous insufficiency is being discharged. Which instruction should
the nurse include to promote venous return?
A. Wear compression stockings only at night
B. Sit with legs crossed at the knees
