EVOLVE ELSEVIER HESI MED SURG LATEST
2025/2026 TEST BANK COMPLETE 100 REAL
EXAM QUESTIONS AND CORRECT ANSWERS WITH
WELL-ELABORATED RATIONALES
EXAM OVERVIEW
The Evolve Elsevier HESI Medical-Surgical (Med-Surg) exam evaluates
nursing students' clinical judgment and knowledge of adult health
nursing concepts across all major body systems. The test bank
includes questions on cardiovascular, respiratory, renal, endocrine,
gastrointestinal, neurological, and musculoskeletal disorders, along
with pharmacology, fluid and electrolyte balance, acid-base
interpretation, prioritization, delegation, and clinical judgment.
SECTION 1: CARDIOVASCULAR DISORDERS
(Questions 1-15)
Q1. A client with heart failure has an ejection fraction of 35%. The
nurse understands that this indicates:
A) Normal cardiac function
B) Mildly reduced cardiac function
C) Moderately to severely reduced cardiac function
D) Hyperdynamic cardiac function
Answer: C) Moderately to severely reduced cardiac function
,Rationale: A normal ejection fraction is 55-70%. An ejection fraction of
35% indicates moderately to severely reduced cardiac function,
consistent with heart failure with reduced ejection fraction (HFrEF). This
finding guides treatment decisions, including the use of medications
such as ACE inhibitors, beta-blockers, and diuretics.
Q2. The nurse is assessing a client with a deep vein thrombosis (DVT).
Which finding is most concerning?
A) Calf pain and swelling
B) Warmth and erythema in the affected leg
C) Sudden onset of chest pain and dyspnea
D) Positive Homan's sign
Answer: C) Sudden onset of chest pain and dyspnea
Rationale: Sudden onset of chest pain and dyspnea suggests a
pulmonary embolism (PE), a life-threatening complication of DVT. The
nurse should notify the provider immediately and prepare for emergency
interventions. Homan's sign is not a reliable indicator of DVT and should
not be used for diagnosis.
Q3. A client is prescribed digoxin for heart failure. Which finding
should the nurse report as a sign of digoxin toxicity?
A) Heart rate of 72 beats per minute
B) Yellow-green halos around lights
C) Blood pressure of 110/70 mmHg
D) Weight gain of 1 lb in 2 days
Answer: B) Yellow-green halos around lights
,Rationale: Yellow-green halos around lights are a classic visual
disturbance associated with digoxin toxicity. Other signs include nausea,
vomiting, bradycardia, and confusion. The heart rate is within normal
limits, and blood pressure and weight are not specific to digoxin toxicity.
Q4. A client with chronic stable angina is prescribed sublingual
nitroglycerin. Which instruction should the nurse include?
A) "Take one tablet at the onset of chest pain; repeat every 5 minutes
up to 3 tablets."
B) "Swallow the tablet with a full glass of water."
C) "Take the tablet 30 minutes before meals."
D) "Store the tablets in the refrigerator."
Answer: A) "Take one tablet at the onset of chest pain; repeat every 5
minutes up to 3 tablets."
Rationale: Sublingual nitroglycerin should be taken at the onset of chest
pain, one tablet every 5 minutes, up to three tablets. If pain persists after
three tablets, the client should call 911. The tablet is placed under the
tongue and not swallowed. Nitroglycerin is sensitive to light and
moisture; it should be stored in its original dark bottle.
Q5. A client is receiving IV heparin therapy. Which laboratory value
should the nurse monitor most closely?
A) Prothrombin time (PT)
B) International normalized ratio (INR)
C) Activated partial thromboplastin time (aPTT)
D) Platelet count
, Answer: C) Activated partial thromboplastin time (aPTT)
Rationale: Heparin therapy is monitored using aPTT, with a therapeutic
goal typically 1.5 to 2.5 times the normal value. Platelet count should
also be monitored for heparin-induced thrombocytopenia (HIT), but
aPTT is the primary monitoring test for heparin dosing. PT/INR monitors
warfarin therapy.
Q6. Which sign is characteristic of right-sided heart failure?
A) Pulmonary crackles
B) Orthopnea
C) Jugular venous distention
D) Paroxysmal nocturnal dyspnea
Answer: C) Jugular venous distention
Rationale: Right-sided heart failure results in systemic venous
congestion. Signs include jugular venous distention, peripheral edema,
hepatomegaly, and ascites. Pulmonary crackles, orthopnea, and
paroxysmal nocturnal dyspnea are signs of left-sided heart failure.
Q7. A client is prescribed an ACE inhibitor for hypertension. Which
adverse effect should the nurse monitor for?
A) Hyperkalemia and cough
B) Hypokalemia and edema
C) Hypertension and tachycardia
D) Hyponatremia and hyperglycemia
Answer: A) Hyperkalemia and cough
2025/2026 TEST BANK COMPLETE 100 REAL
EXAM QUESTIONS AND CORRECT ANSWERS WITH
WELL-ELABORATED RATIONALES
EXAM OVERVIEW
The Evolve Elsevier HESI Medical-Surgical (Med-Surg) exam evaluates
nursing students' clinical judgment and knowledge of adult health
nursing concepts across all major body systems. The test bank
includes questions on cardiovascular, respiratory, renal, endocrine,
gastrointestinal, neurological, and musculoskeletal disorders, along
with pharmacology, fluid and electrolyte balance, acid-base
interpretation, prioritization, delegation, and clinical judgment.
SECTION 1: CARDIOVASCULAR DISORDERS
(Questions 1-15)
Q1. A client with heart failure has an ejection fraction of 35%. The
nurse understands that this indicates:
A) Normal cardiac function
B) Mildly reduced cardiac function
C) Moderately to severely reduced cardiac function
D) Hyperdynamic cardiac function
Answer: C) Moderately to severely reduced cardiac function
,Rationale: A normal ejection fraction is 55-70%. An ejection fraction of
35% indicates moderately to severely reduced cardiac function,
consistent with heart failure with reduced ejection fraction (HFrEF). This
finding guides treatment decisions, including the use of medications
such as ACE inhibitors, beta-blockers, and diuretics.
Q2. The nurse is assessing a client with a deep vein thrombosis (DVT).
Which finding is most concerning?
A) Calf pain and swelling
B) Warmth and erythema in the affected leg
C) Sudden onset of chest pain and dyspnea
D) Positive Homan's sign
Answer: C) Sudden onset of chest pain and dyspnea
Rationale: Sudden onset of chest pain and dyspnea suggests a
pulmonary embolism (PE), a life-threatening complication of DVT. The
nurse should notify the provider immediately and prepare for emergency
interventions. Homan's sign is not a reliable indicator of DVT and should
not be used for diagnosis.
Q3. A client is prescribed digoxin for heart failure. Which finding
should the nurse report as a sign of digoxin toxicity?
A) Heart rate of 72 beats per minute
B) Yellow-green halos around lights
C) Blood pressure of 110/70 mmHg
D) Weight gain of 1 lb in 2 days
Answer: B) Yellow-green halos around lights
,Rationale: Yellow-green halos around lights are a classic visual
disturbance associated with digoxin toxicity. Other signs include nausea,
vomiting, bradycardia, and confusion. The heart rate is within normal
limits, and blood pressure and weight are not specific to digoxin toxicity.
Q4. A client with chronic stable angina is prescribed sublingual
nitroglycerin. Which instruction should the nurse include?
A) "Take one tablet at the onset of chest pain; repeat every 5 minutes
up to 3 tablets."
B) "Swallow the tablet with a full glass of water."
C) "Take the tablet 30 minutes before meals."
D) "Store the tablets in the refrigerator."
Answer: A) "Take one tablet at the onset of chest pain; repeat every 5
minutes up to 3 tablets."
Rationale: Sublingual nitroglycerin should be taken at the onset of chest
pain, one tablet every 5 minutes, up to three tablets. If pain persists after
three tablets, the client should call 911. The tablet is placed under the
tongue and not swallowed. Nitroglycerin is sensitive to light and
moisture; it should be stored in its original dark bottle.
Q5. A client is receiving IV heparin therapy. Which laboratory value
should the nurse monitor most closely?
A) Prothrombin time (PT)
B) International normalized ratio (INR)
C) Activated partial thromboplastin time (aPTT)
D) Platelet count
, Answer: C) Activated partial thromboplastin time (aPTT)
Rationale: Heparin therapy is monitored using aPTT, with a therapeutic
goal typically 1.5 to 2.5 times the normal value. Platelet count should
also be monitored for heparin-induced thrombocytopenia (HIT), but
aPTT is the primary monitoring test for heparin dosing. PT/INR monitors
warfarin therapy.
Q6. Which sign is characteristic of right-sided heart failure?
A) Pulmonary crackles
B) Orthopnea
C) Jugular venous distention
D) Paroxysmal nocturnal dyspnea
Answer: C) Jugular venous distention
Rationale: Right-sided heart failure results in systemic venous
congestion. Signs include jugular venous distention, peripheral edema,
hepatomegaly, and ascites. Pulmonary crackles, orthopnea, and
paroxysmal nocturnal dyspnea are signs of left-sided heart failure.
Q7. A client is prescribed an ACE inhibitor for hypertension. Which
adverse effect should the nurse monitor for?
A) Hyperkalemia and cough
B) Hypokalemia and edema
C) Hypertension and tachycardia
D) Hyponatremia and hyperglycemia
Answer: A) Hyperkalemia and cough
