EVOLVE HESI MED-SURG II QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026/2027 Q&A | INSTANT
DOWNLOAD PDF.
Core Domains
• Cardiovascular Disorders
• Respiratory Disorders
• Neurological Disorders
• Endocrine Disorders
• Gastrointestinal Disorders
• Renal and Urinary Disorders
• Musculoskeletal Disorders
• Oncology and Hematology
• Perioperative Care
• Emergency and Critical Care
Introduction
The Evolve HESI Med-Surg II examination evaluates the clinical judgment and nursing knowledge
essential for safe, effective medical-surgical practice. It assesses comprehension of pathophysiology,
assessment skills, prioritization, and evidence-based interventions across diverse patient populations.
The assessment utilizes multiple-choice and scenario-based questions to simulate real-world clinical
decision-making. Emphasis is placed on application of knowledge, patient safety, and adherence to
professional standards. This practice tool provides comprehensive preparation to identify strengths and
areas requiring further study, ensuring readiness for licensure examinations and clinical practice. It
promotes critical thinking and clinical reasoning across all core domains.
Section One: Questions 1–100
Question 1
A nurse is caring for a client who underwent a total hip replacement. Which of the following
interventions is most important to prevent dislocation in the immediate postoperative period?
A. Maintain the affected hip in a position of adduction
B. Keep the affected leg in a neutral position with a pillow between the legs
C. Encourage the client to flex the hip past 90 degrees
D. Position the client on the operative side immediately after surgery
, Correct answer
B. Keep the affected leg in a neutral position with a pillow between the legs
RATIONALE: Abduction with a pillow between the legs prevents dislocation of the new hip
prosthesis. Adduction, flexion beyond 90 degrees, and side-lying on the operative side increase the risk
of dislocation.
Question 2
A nurse is assessing a client with heart failure. Which of the following findings indicates fluid overload?
A. Decreased urine output
B. Distended jugular veins
C. Dry mucous membranes
D. Weight loss of 2 kg in 24 hours
Correct answer
B. Distended jugular veins
RATIONALE: Jugular venous distention is a classic sign of fluid overload in heart failure due to
increased central venous pressure. Decreased urine output and dry mucous membranes suggest
dehydration.
Question 3
A client with chronic obstructive pulmonary disease is receiving oxygen therapy. Which oxygen delivery
method is most appropriate to prevent carbon dioxide retention?
A. High-flow nasal cannula at 10 L/min
B. Non-rebreather mask at 15 L/min
C. Venturi mask at 2 to 4 L/min
D. Simple face mask at 8 L/min
Correct answer
C. Venturi mask at 2 to 4 L/min
RATIONALE: A Venturi mask delivers precise low-flow oxygen concentrations, reducing the risk of
carbon dioxide retention in clients with chronic obstructive pulmonary disease.
Question 4
A nurse is caring for a client with acute pancreatitis. Which of the following laboratory findings is most
indicative of this condition?
A. Elevated serum amylase and lipase
B. Decreased serum calcium
C. Elevated blood urea nitrogen
D. Decreased serum potassium
Correct answer
A. Elevated serum amylase and lipase
RATIONALE: Elevated serum amylase and lipase are hallmark laboratory findings in acute
pancreatitis due to pancreatic inflammation and enzyme release.
, Question 5
A client with diabetes mellitus is admitted with diabetic ketoacidosis. Which of the following arterial
blood gas findings is expected?
A. pH 7.50, PaCO2 50 mm Hg, HCO3 30 mEq/L
B. pH 7.30, PaCO2 30 mm Hg, HCO3 15 mEq/L
C. pH 7.40, PaCO2 40 mm Hg, HCO3 24 mEq/L
D. pH 7.25, PaCO2 50 mm Hg, HCO3 28 mEq/L
Correct answer
B. pH 7.30, PaCO2 30 mm Hg, HCO3 15 mEq/L
RATIONALE: Diabetic ketoacidosis presents with metabolic acidosis, indicated by low pH, low
bicarbonate, and compensatory low PaCO2 due to Kussmaul respirations.
Question 6
A nurse is teaching a client about warfarin therapy. Which statement by the client indicates a need for
further teaching?
A. I will avoid eating large amounts of green leafy vegetables.
B. I will use a soft toothbrush to prevent bleeding.
C. I will take aspirin for headaches.
D. I will have my INR checked regularly.
Correct answer
C. I will take aspirin for headaches.
RATIONALE: Aspirin increases the risk of bleeding when taken with warfarin. Clients should avoid
aspirin and other antiplatelet agents unless prescribed.
Question 7
A client is admitted with a suspected pulmonary embolism. Which of the following is the priority nursing
action?
A. Administer intravenous fluids
B. Apply supplemental oxygen
C. Obtain a chest X-ray
D. Administer a bronchodilator
Correct answer
B. Apply supplemental oxygen
RATIONALE: Pulmonary embolism impairs gas exchange, leading to hypoxemia. Applying
supplemental oxygen is the priority to maintain adequate oxygenation.
Question 8
A nurse is caring for a client with increased intracranial pressure. Which of the following positions is
most appropriate?
A. Flat supine
B. Trendelenburg
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026/2027 Q&A | INSTANT
DOWNLOAD PDF.
Core Domains
• Cardiovascular Disorders
• Respiratory Disorders
• Neurological Disorders
• Endocrine Disorders
• Gastrointestinal Disorders
• Renal and Urinary Disorders
• Musculoskeletal Disorders
• Oncology and Hematology
• Perioperative Care
• Emergency and Critical Care
Introduction
The Evolve HESI Med-Surg II examination evaluates the clinical judgment and nursing knowledge
essential for safe, effective medical-surgical practice. It assesses comprehension of pathophysiology,
assessment skills, prioritization, and evidence-based interventions across diverse patient populations.
The assessment utilizes multiple-choice and scenario-based questions to simulate real-world clinical
decision-making. Emphasis is placed on application of knowledge, patient safety, and adherence to
professional standards. This practice tool provides comprehensive preparation to identify strengths and
areas requiring further study, ensuring readiness for licensure examinations and clinical practice. It
promotes critical thinking and clinical reasoning across all core domains.
Section One: Questions 1–100
Question 1
A nurse is caring for a client who underwent a total hip replacement. Which of the following
interventions is most important to prevent dislocation in the immediate postoperative period?
A. Maintain the affected hip in a position of adduction
B. Keep the affected leg in a neutral position with a pillow between the legs
C. Encourage the client to flex the hip past 90 degrees
D. Position the client on the operative side immediately after surgery
, Correct answer
B. Keep the affected leg in a neutral position with a pillow between the legs
RATIONALE: Abduction with a pillow between the legs prevents dislocation of the new hip
prosthesis. Adduction, flexion beyond 90 degrees, and side-lying on the operative side increase the risk
of dislocation.
Question 2
A nurse is assessing a client with heart failure. Which of the following findings indicates fluid overload?
A. Decreased urine output
B. Distended jugular veins
C. Dry mucous membranes
D. Weight loss of 2 kg in 24 hours
Correct answer
B. Distended jugular veins
RATIONALE: Jugular venous distention is a classic sign of fluid overload in heart failure due to
increased central venous pressure. Decreased urine output and dry mucous membranes suggest
dehydration.
Question 3
A client with chronic obstructive pulmonary disease is receiving oxygen therapy. Which oxygen delivery
method is most appropriate to prevent carbon dioxide retention?
A. High-flow nasal cannula at 10 L/min
B. Non-rebreather mask at 15 L/min
C. Venturi mask at 2 to 4 L/min
D. Simple face mask at 8 L/min
Correct answer
C. Venturi mask at 2 to 4 L/min
RATIONALE: A Venturi mask delivers precise low-flow oxygen concentrations, reducing the risk of
carbon dioxide retention in clients with chronic obstructive pulmonary disease.
Question 4
A nurse is caring for a client with acute pancreatitis. Which of the following laboratory findings is most
indicative of this condition?
A. Elevated serum amylase and lipase
B. Decreased serum calcium
C. Elevated blood urea nitrogen
D. Decreased serum potassium
Correct answer
A. Elevated serum amylase and lipase
RATIONALE: Elevated serum amylase and lipase are hallmark laboratory findings in acute
pancreatitis due to pancreatic inflammation and enzyme release.
, Question 5
A client with diabetes mellitus is admitted with diabetic ketoacidosis. Which of the following arterial
blood gas findings is expected?
A. pH 7.50, PaCO2 50 mm Hg, HCO3 30 mEq/L
B. pH 7.30, PaCO2 30 mm Hg, HCO3 15 mEq/L
C. pH 7.40, PaCO2 40 mm Hg, HCO3 24 mEq/L
D. pH 7.25, PaCO2 50 mm Hg, HCO3 28 mEq/L
Correct answer
B. pH 7.30, PaCO2 30 mm Hg, HCO3 15 mEq/L
RATIONALE: Diabetic ketoacidosis presents with metabolic acidosis, indicated by low pH, low
bicarbonate, and compensatory low PaCO2 due to Kussmaul respirations.
Question 6
A nurse is teaching a client about warfarin therapy. Which statement by the client indicates a need for
further teaching?
A. I will avoid eating large amounts of green leafy vegetables.
B. I will use a soft toothbrush to prevent bleeding.
C. I will take aspirin for headaches.
D. I will have my INR checked regularly.
Correct answer
C. I will take aspirin for headaches.
RATIONALE: Aspirin increases the risk of bleeding when taken with warfarin. Clients should avoid
aspirin and other antiplatelet agents unless prescribed.
Question 7
A client is admitted with a suspected pulmonary embolism. Which of the following is the priority nursing
action?
A. Administer intravenous fluids
B. Apply supplemental oxygen
C. Obtain a chest X-ray
D. Administer a bronchodilator
Correct answer
B. Apply supplemental oxygen
RATIONALE: Pulmonary embolism impairs gas exchange, leading to hypoxemia. Applying
supplemental oxygen is the priority to maintain adequate oxygenation.
Question 8
A nurse is caring for a client with increased intracranial pressure. Which of the following positions is
most appropriate?
A. Flat supine
B. Trendelenburg
