EVOLVE ELSEVIER HESI MED-SURG 2026/2027 | 350
Practice Questions & Answers with Detailed Rationales
| Cardiac, Respiratory, GI, Renal, Endocrine, Neuro,
Oncology & More
,Q1. A client is diagnosed with an acute small bowel obstruction. Which assessment finding
requires the most immediate intervention by the nurse?
A. Fever of 102°F
B. Blood pressure of 150/90 mm Hg
C. Abdominal cramping
D. Dry mucous membranes
ANSWER: A. Fever of 102°F
Rationale: A sudden elevation in temperature in a client with a bowel obstruction may indicate
peritonitis or bowel perforation, which requires immediate intervention. Abdominal cramping
is expected with obstruction, while dry mucous membranes indicate fluid-volume deficit that
requires treatment but is generally less immediately life-threatening. Mild hypertension is not
the priority.
Q2. When assessing a client with primary aldosteronism, the nurse expects which laboratory
finding?
A. Increased serum sodium
B. Increased serum phosphate
C. Decreased serum potassium
D. Decreased serum glucose
ANSWER: C. Decreased serum potassium
Rationale: Excess aldosterone promotes sodium and water retention while increasing
potassium excretion by the kidneys. Therefore, hypokalemia is a characteristic finding of
primary aldosteronism.
Q3.
A client with heart failure reports increasing shortness of breath and wakes at night feeling
unable to breathe. Which finding is most concerning?
,A. 1+ bilateral ankle edema
B. Weight gain of 1 kg in 24 hours
C. Oxygen saturation of 86%
D. Blood pressure of 138/84 mm Hg
ANSWER: C. Oxygen saturation of 86%
Rationale: An oxygen saturation of 86% indicates significant hypoxemia and requires immediate
assessment and intervention. The weight gain and edema suggest fluid retention but are not as
immediately threatening as impaired oxygenation.
Q4.
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen. Which oxygen
saturation is generally an appropriate target for many clients with chronic CO₂ retention?
A. 70%–75%
B. 80%–84%
C. 88%–92%
D. 98%–100%
ANSWER: C. 88%–92%
Rationale: Many clients with COPD who are at risk for hypercapnia are maintained around 88%–
92%, unless a different target is prescribed. Excessive oxygen administration can worsen
hypercapnia in susceptible clients.
Q5.
A client with suspected myocardial infarction reports severe crushing chest pain. Which
medication should the nurse anticipate administering unless contraindicated?
A. Acetaminophen
B. Aspirin
C. Warfarin
D. Furosemide
ANSWER: B. Aspirin
Rationale: Aspirin inhibits platelet aggregation and is a key early treatment for suspected acute
coronary syndrome when there is no contraindication.
, Q6.
A client receiving digoxin has an apical pulse of 52 beats/minute. What should the nurse do
first?
A. Administer the medication with food
B. Give an additional dose
C. Hold the medication and notify the provider
D. Encourage ambulation
ANSWER: C. Hold the medication and notify the provider
Rationale: Digoxin can cause bradycardia. An adult apical pulse below the commonly accepted
threshold of 60 beats/minute warrants holding the medication and further evaluation.
Q7.
Which assessment finding is most consistent with hypokalemia?
A. Muscle weakness
B. Bounding pulse
C. Hyperactive reflexes
D. Severe hypertension
ANSWER: A. Muscle weakness
Rationale: Hypokalemia can cause muscle weakness, fatigue, dysrhythmias, and decreased
gastrointestinal motility.
Q8.
A client with diabetes is confused, diaphoretic, and trembling. Which condition should the nurse
suspect?
A. Hypernatremia
B. Hypoglycemia
C. Hypercalcemia
D. Hyperglycemia
ANSWER: B. Hypoglycemia
Practice Questions & Answers with Detailed Rationales
| Cardiac, Respiratory, GI, Renal, Endocrine, Neuro,
Oncology & More
,Q1. A client is diagnosed with an acute small bowel obstruction. Which assessment finding
requires the most immediate intervention by the nurse?
A. Fever of 102°F
B. Blood pressure of 150/90 mm Hg
C. Abdominal cramping
D. Dry mucous membranes
ANSWER: A. Fever of 102°F
Rationale: A sudden elevation in temperature in a client with a bowel obstruction may indicate
peritonitis or bowel perforation, which requires immediate intervention. Abdominal cramping
is expected with obstruction, while dry mucous membranes indicate fluid-volume deficit that
requires treatment but is generally less immediately life-threatening. Mild hypertension is not
the priority.
Q2. When assessing a client with primary aldosteronism, the nurse expects which laboratory
finding?
A. Increased serum sodium
B. Increased serum phosphate
C. Decreased serum potassium
D. Decreased serum glucose
ANSWER: C. Decreased serum potassium
Rationale: Excess aldosterone promotes sodium and water retention while increasing
potassium excretion by the kidneys. Therefore, hypokalemia is a characteristic finding of
primary aldosteronism.
Q3.
A client with heart failure reports increasing shortness of breath and wakes at night feeling
unable to breathe. Which finding is most concerning?
,A. 1+ bilateral ankle edema
B. Weight gain of 1 kg in 24 hours
C. Oxygen saturation of 86%
D. Blood pressure of 138/84 mm Hg
ANSWER: C. Oxygen saturation of 86%
Rationale: An oxygen saturation of 86% indicates significant hypoxemia and requires immediate
assessment and intervention. The weight gain and edema suggest fluid retention but are not as
immediately threatening as impaired oxygenation.
Q4.
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen. Which oxygen
saturation is generally an appropriate target for many clients with chronic CO₂ retention?
A. 70%–75%
B. 80%–84%
C. 88%–92%
D. 98%–100%
ANSWER: C. 88%–92%
Rationale: Many clients with COPD who are at risk for hypercapnia are maintained around 88%–
92%, unless a different target is prescribed. Excessive oxygen administration can worsen
hypercapnia in susceptible clients.
Q5.
A client with suspected myocardial infarction reports severe crushing chest pain. Which
medication should the nurse anticipate administering unless contraindicated?
A. Acetaminophen
B. Aspirin
C. Warfarin
D. Furosemide
ANSWER: B. Aspirin
Rationale: Aspirin inhibits platelet aggregation and is a key early treatment for suspected acute
coronary syndrome when there is no contraindication.
, Q6.
A client receiving digoxin has an apical pulse of 52 beats/minute. What should the nurse do
first?
A. Administer the medication with food
B. Give an additional dose
C. Hold the medication and notify the provider
D. Encourage ambulation
ANSWER: C. Hold the medication and notify the provider
Rationale: Digoxin can cause bradycardia. An adult apical pulse below the commonly accepted
threshold of 60 beats/minute warrants holding the medication and further evaluation.
Q7.
Which assessment finding is most consistent with hypokalemia?
A. Muscle weakness
B. Bounding pulse
C. Hyperactive reflexes
D. Severe hypertension
ANSWER: A. Muscle weakness
Rationale: Hypokalemia can cause muscle weakness, fatigue, dysrhythmias, and decreased
gastrointestinal motility.
Q8.
A client with diabetes is confused, diaphoretic, and trembling. Which condition should the nurse
suspect?
A. Hypernatremia
B. Hypoglycemia
C. Hypercalcemia
D. Hyperglycemia
ANSWER: B. Hypoglycemia
