EVOLVE ELSEVIER HESI MED SURG EXAM
2026/2027: 300 ACTUAL Test Bank Questions
with Correct Answers & Detailed Rationales |
Guaranteed Pass
1. A client with a gram-positive bacterial skin infection is receiving
daptomycin 500 mg IV every 24 hours. The pharmacy delivers a secondary
infusion of 0.9% sodium chloride with daptomycin 500 mg/100 mL to be
infused in 30 minutes. How many mL/hour should the nurse program the
infusion pump?
A) 100 mL/hour
B) 200 mL/hour
C) 150 mL/hour
D) 250 mL/hour
Answer B: 200 mL/hour
Rationale: 30 minutes = 0.5 hours. Infusion rate = 100 mL / 0.5 hours = 200
mL/hour.
2. A client with a new diagnosis of glaucoma is concerned about going blind.
Which actions should the nurse instruct the client to implement? (Select all
that apply) E) Avoid excessive eye strain by limiting computer screen time
A) Meticulously follow the regimen for administering prescribed eye drops
,B) Schedule regular appointments to measure eye pressure
C) Report any changes in vision perception immediately
D) Maintain a diet high in vegetables, particularly carotene
Answer A: , B, C
Rationale: Managing intraocular pressure with eye drops, regular pressure checks,
and reporting vision changes help prevent optic nerve damage.
3. A client with urolithiasis is preparing for discharge after lithotripsy. Which
intervention should the nurse include in the postoperative discharge
instructions?
A) Monitor the urinary stream for a decrease in output
B) Report when hematuria becomes pink-tinged
C) Use an incentive spirometer
D) Restrict physical activities
Answer A: Monitor the urinary stream for a decrease in output
Rationale: Monitoring for decreased output is crucial to detect complications
such as obstruction or infection after lithotripsy.
4. A client one hour after abdominal surgery in the PACU has a BP of 136/80
mmHg. Fifteen minutes later, it is 114/72 mmHg. Which action should the
nurse take first?
A) Check the abdominal surgical dressing
B) Increase frequency of BP assessment
,C) Administer IV fluid bolus
D) Notify the healthcare provider immediately
Answer B: Increase frequency of BP assessment
Rationale: A significant drop in BP requires closer monitoring to assess for early
signs of shock or bleeding.
5. A client with gouty arthritis reports tenderness and swelling of the right
ankle and great toe. The client receives prescriptions for colchicine and
indomethacin. Which instructions should the nurse include in the discharge
teaching?
A) Return for periodic liver function studies
B) Consume high-protein foods to reach an ideal body weight
C) Use an electric heating pad when the pain is severe
D) Encourage active range-of-motion exercises to prevent stiffness
Answer A: Return for periodic liver function studies
Rationale: Colchicine can affect liver function; periodic monitoring is
recommended.
6. A 34-year-old male client presents to the emergency department for an
acute asthma attack. He reports using a rescue inhaler three times but still
cannot catch his breath. He says symptoms seem worse outdoors and when
exercising. He noticed his inhaler was expired. The nurse reviews the client
, history. Which two pieces of key subjective data indicate the client is in need
of health interventions? E) He noticed that his inhaler was expired
A) The client reports using a rescue inhaler three times, but he just could not catch
his breath
B) The client reports that symptoms seem worse when outdoors and when
exercising
C) Episodes like this make him extremely nervous
D) It has been a couple of months since he had an asthma attack
Answer A: and E
Rationale: Unresolved symptoms despite repeated rescue inhaler use indicate a
need for urgent intervention. An expired inhaler suggests ineffective medication
delivery.
7. A client with gout is prescribed allopurinol. Which instruction should the
nurse include?
A) Consume at least 2 liters of fluid per day
B) Avoid grapefruit juice
C) Report signs of adrenal insufficiency
D) Do not take more than the prescribed dose due to liver toxicity
Answer A: Consume at least 2 liters of fluid per day
Rationale: Allopurinol lowers serum uric acid; high fluid intake prevents urate
nephropathy and stone formation.
2026/2027: 300 ACTUAL Test Bank Questions
with Correct Answers & Detailed Rationales |
Guaranteed Pass
1. A client with a gram-positive bacterial skin infection is receiving
daptomycin 500 mg IV every 24 hours. The pharmacy delivers a secondary
infusion of 0.9% sodium chloride with daptomycin 500 mg/100 mL to be
infused in 30 minutes. How many mL/hour should the nurse program the
infusion pump?
A) 100 mL/hour
B) 200 mL/hour
C) 150 mL/hour
D) 250 mL/hour
Answer B: 200 mL/hour
Rationale: 30 minutes = 0.5 hours. Infusion rate = 100 mL / 0.5 hours = 200
mL/hour.
2. A client with a new diagnosis of glaucoma is concerned about going blind.
Which actions should the nurse instruct the client to implement? (Select all
that apply) E) Avoid excessive eye strain by limiting computer screen time
A) Meticulously follow the regimen for administering prescribed eye drops
,B) Schedule regular appointments to measure eye pressure
C) Report any changes in vision perception immediately
D) Maintain a diet high in vegetables, particularly carotene
Answer A: , B, C
Rationale: Managing intraocular pressure with eye drops, regular pressure checks,
and reporting vision changes help prevent optic nerve damage.
3. A client with urolithiasis is preparing for discharge after lithotripsy. Which
intervention should the nurse include in the postoperative discharge
instructions?
A) Monitor the urinary stream for a decrease in output
B) Report when hematuria becomes pink-tinged
C) Use an incentive spirometer
D) Restrict physical activities
Answer A: Monitor the urinary stream for a decrease in output
Rationale: Monitoring for decreased output is crucial to detect complications
such as obstruction or infection after lithotripsy.
4. A client one hour after abdominal surgery in the PACU has a BP of 136/80
mmHg. Fifteen minutes later, it is 114/72 mmHg. Which action should the
nurse take first?
A) Check the abdominal surgical dressing
B) Increase frequency of BP assessment
,C) Administer IV fluid bolus
D) Notify the healthcare provider immediately
Answer B: Increase frequency of BP assessment
Rationale: A significant drop in BP requires closer monitoring to assess for early
signs of shock or bleeding.
5. A client with gouty arthritis reports tenderness and swelling of the right
ankle and great toe. The client receives prescriptions for colchicine and
indomethacin. Which instructions should the nurse include in the discharge
teaching?
A) Return for periodic liver function studies
B) Consume high-protein foods to reach an ideal body weight
C) Use an electric heating pad when the pain is severe
D) Encourage active range-of-motion exercises to prevent stiffness
Answer A: Return for periodic liver function studies
Rationale: Colchicine can affect liver function; periodic monitoring is
recommended.
6. A 34-year-old male client presents to the emergency department for an
acute asthma attack. He reports using a rescue inhaler three times but still
cannot catch his breath. He says symptoms seem worse outdoors and when
exercising. He noticed his inhaler was expired. The nurse reviews the client
, history. Which two pieces of key subjective data indicate the client is in need
of health interventions? E) He noticed that his inhaler was expired
A) The client reports using a rescue inhaler three times, but he just could not catch
his breath
B) The client reports that symptoms seem worse when outdoors and when
exercising
C) Episodes like this make him extremely nervous
D) It has been a couple of months since he had an asthma attack
Answer A: and E
Rationale: Unresolved symptoms despite repeated rescue inhaler use indicate a
need for urgent intervention. An expired inhaler suggests ineffective medication
delivery.
7. A client with gout is prescribed allopurinol. Which instruction should the
nurse include?
A) Consume at least 2 liters of fluid per day
B) Avoid grapefruit juice
C) Report signs of adrenal insufficiency
D) Do not take more than the prescribed dose due to liver toxicity
Answer A: Consume at least 2 liters of fluid per day
Rationale: Allopurinol lowers serum uric acid; high fluid intake prevents urate
nephropathy and stone formation.
