EVOLVE ELSEVIER HESI MED SURG
ACTUAL EXAM WITH 150 REAL EXAM
QUESTIONS AND CORRECT ANSWERS
WITH WELL-ELABORATED RATIONALES /
EVOLVE HESI MEDICAL SURGICAL
LATEST EXAM 2026 (BRAND NEW!!)
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) Acute myocardial infarction
B) Pneumonia
C) Pulmonary embolism
D) Pleurisy
E) Angina pectoris
Correct Answer: C) Pulmonary embolism
Rationale: Sudden onset of chest pain, dyspnea, anxiety, restlessness,
and cyanosis are classic symptoms of a pulmonary embolism, which is a
life-threatening complication that can occur post-surgery.
,Question 2
Which information should the nurse obtain when performing an initial
assessment of a client who presents to the emergency department with a
painful ankle injury? (Select all that apply)
A) Quality of the pain
B) Signs of inflammation
C) Ankle range of motion
D) Visible deformities of the joint
E) Client's weight history
Correct Answer: A) Quality of the pain, B) Signs of inflammation, C)
Ankle range of motion, D) Visible deformities of the joint
Rationale: When assessing an ankle injury, it's crucial to gather details
about the pain, inspect for signs of inflammation (swelling, redness,
warmth), evaluate range of motion (though cautiously if pain is severe),
and note any visible deformities to determine the extent and nature of
the injury.
Question 3
Which description of pain is consistent with a diagnosis of rheumatoid
arthritis?
A) Joint pain is worse with activity and improves with rest.
B) Joint pain is worse in the evening and involves asymmetric joints.
C) Joint pain is worse in the morning and involves symmetric joints.
D) Joint pain is localized to one joint and accompanied by redness.
E) Joint pain is relieved by NSAIDs only.
Correct Answer: C) Joint pain is worse in the morning and involves
symmetric joints
,Rationale: Rheumatoid arthritis is characterized by chronic,
symmetrical joint inflammation, often with significant morning stiffness
that improves throughout the day.
Question 4
Which physical assessment finding should the nurse anticipate in a client
with long-term gastroesophageal reflux disease (GERD)?
A) Abdominal distension
B) Increased bowel sounds
C) Hoarseness
D) Jaundice
E) Weight gain
Correct Answer: C) Hoarseness
Rationale: Long-term GERD can lead to chronic irritation of the vocal
cords and larynx due to reflux of stomach acid, resulting in symptoms
like hoarseness, chronic cough, and laryngitis.
Question 5
A client presents with chronic venous insufficiency. Which assessment
finding should the nurse anticipate?
A) Cold, pale extremities
B) Intermittent claudication
C) Bilateral lower leg stasis dermatitis
D) Absent peripheral pulses
E) Hair loss on the lower legs
Correct Answer: C) Bilateral lower leg stasis dermatitis
, Rationale: Chronic venous insufficiency leads to venous hypertension,
causing fluid and blood components to leak into the interstitial tissue,
resulting in characteristic skin changes like stasis dermatitis (reddish-
brown discoloration) in the lower legs.
Question 6
A client has been hospitalized with a femur fracture and is being treated
with traction. Which action by the nurse is the priority when caring for
this client?
A) Provide pain medication as ordered.
B) Assess neurovascular status.
C) Ensure proper body alignment.
D) Monitor skin integrity around pins.
E) Encourage deep breathing and coughing.
Correct Answer: B) Assess neurovascular status
Rationale: Neurovascular compromise (impaired circulation, sensation,
or movement) is a critical and potentially limb-threatening complication
of fractures and traction. Therefore, frequent neurovascular assessment
is the highest priority.
Question 7
A nurse is caring for a client 24 hours after a total hip arthroplasty.
Which assessment finding requires the nurse's immediate intervention?
ACTUAL EXAM WITH 150 REAL EXAM
QUESTIONS AND CORRECT ANSWERS
WITH WELL-ELABORATED RATIONALES /
EVOLVE HESI MEDICAL SURGICAL
LATEST EXAM 2026 (BRAND NEW!!)
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) Acute myocardial infarction
B) Pneumonia
C) Pulmonary embolism
D) Pleurisy
E) Angina pectoris
Correct Answer: C) Pulmonary embolism
Rationale: Sudden onset of chest pain, dyspnea, anxiety, restlessness,
and cyanosis are classic symptoms of a pulmonary embolism, which is a
life-threatening complication that can occur post-surgery.
,Question 2
Which information should the nurse obtain when performing an initial
assessment of a client who presents to the emergency department with a
painful ankle injury? (Select all that apply)
A) Quality of the pain
B) Signs of inflammation
C) Ankle range of motion
D) Visible deformities of the joint
E) Client's weight history
Correct Answer: A) Quality of the pain, B) Signs of inflammation, C)
Ankle range of motion, D) Visible deformities of the joint
Rationale: When assessing an ankle injury, it's crucial to gather details
about the pain, inspect for signs of inflammation (swelling, redness,
warmth), evaluate range of motion (though cautiously if pain is severe),
and note any visible deformities to determine the extent and nature of
the injury.
Question 3
Which description of pain is consistent with a diagnosis of rheumatoid
arthritis?
A) Joint pain is worse with activity and improves with rest.
B) Joint pain is worse in the evening and involves asymmetric joints.
C) Joint pain is worse in the morning and involves symmetric joints.
D) Joint pain is localized to one joint and accompanied by redness.
E) Joint pain is relieved by NSAIDs only.
Correct Answer: C) Joint pain is worse in the morning and involves
symmetric joints
,Rationale: Rheumatoid arthritis is characterized by chronic,
symmetrical joint inflammation, often with significant morning stiffness
that improves throughout the day.
Question 4
Which physical assessment finding should the nurse anticipate in a client
with long-term gastroesophageal reflux disease (GERD)?
A) Abdominal distension
B) Increased bowel sounds
C) Hoarseness
D) Jaundice
E) Weight gain
Correct Answer: C) Hoarseness
Rationale: Long-term GERD can lead to chronic irritation of the vocal
cords and larynx due to reflux of stomach acid, resulting in symptoms
like hoarseness, chronic cough, and laryngitis.
Question 5
A client presents with chronic venous insufficiency. Which assessment
finding should the nurse anticipate?
A) Cold, pale extremities
B) Intermittent claudication
C) Bilateral lower leg stasis dermatitis
D) Absent peripheral pulses
E) Hair loss on the lower legs
Correct Answer: C) Bilateral lower leg stasis dermatitis
, Rationale: Chronic venous insufficiency leads to venous hypertension,
causing fluid and blood components to leak into the interstitial tissue,
resulting in characteristic skin changes like stasis dermatitis (reddish-
brown discoloration) in the lower legs.
Question 6
A client has been hospitalized with a femur fracture and is being treated
with traction. Which action by the nurse is the priority when caring for
this client?
A) Provide pain medication as ordered.
B) Assess neurovascular status.
C) Ensure proper body alignment.
D) Monitor skin integrity around pins.
E) Encourage deep breathing and coughing.
Correct Answer: B) Assess neurovascular status
Rationale: Neurovascular compromise (impaired circulation, sensation,
or movement) is a critical and potentially limb-threatening complication
of fractures and traction. Therefore, frequent neurovascular assessment
is the highest priority.
Question 7
A nurse is caring for a client 24 hours after a total hip arthroplasty.
Which assessment finding requires the nurse's immediate intervention?
