Evolve Elsevier HESI Med Surg Medical-
Surgical Nursing 2026/2027 Questions
and Answers | Comprehensive Exam
Review with Detailed Rationales
Guaranteed Pass (GRADED A+)
Question 1
A client with heart failure reports increasing shortness of breath
and has bilateral crackles. Which assessment finding requires
the nurse's immediate attention?
A. 1+ bilateral ankle edema
B. Heart rate of 92/min
C. Oxygen saturation of 86%
D. Weight gain of 1 kg over 3 days
Answer: C. Oxygen saturation of 86%
Rationale: An oxygen saturation of 86% indicates significant
hypoxemia and impaired oxygenation. The nurse should
immediately assess airway and breathing and initiate
appropriate oxygen therapy according to the prescribed plan.
Peripheral edema and gradual weight gain are important
indicators of worsening fluid retention but are not as
immediately life-threatening as severe hypoxemia.
Question 2
,A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen therapy. Which nursing action is most
appropriate?
A. Maintain oxygen at the highest possible flow rate
B. Monitor respiratory status and oxygen saturation closely
C. Encourage prolonged breath-holding exercises
D. Restrict fluids to prevent pulmonary edema
Answer: B. Monitor respiratory status and oxygen saturation
closely
Rationale: Clients with COPD require careful oxygen
administration and ongoing assessment of respiratory status.
Excessive oxygen administration may contribute to worsening
hypercapnia in susceptible clients. Oxygen should be titrated
according to the prescribed target and clinical condition.
Question 3
A client with diabetes mellitus is awake, diaphoretic, and
trembling. The blood glucose level is 52 mg/dL. What should
the nurse do first?
A. Administer regular insulin
B. Give 15 g of a rapid-acting carbohydrate
C. Encourage the client to ambulate
D. Administer glucagon intramuscularly immediately
Answer: B. Give 15 g of a rapid-acting carbohydrate
,Rationale: The client has symptomatic hypoglycemia and is
conscious and able to swallow. A rapid-acting carbohydrate
should be given promptly, followed by reassessment of blood
glucose according to the hypoglycemia protocol. Glucagon is
generally reserved for severe hypoglycemia when the client
cannot safely consume carbohydrates.
Question 4
A client with chronic kidney disease is receiving hemodialysis.
Which laboratory value should the nurse recognize as requiring
close monitoring?
A. Potassium
B. Hemoglobin A1c
C. Amylase
D. Bilirubin
Answer: A. Potassium
Rationale: Impaired renal function decreases potassium
excretion, placing the client at risk for hyperkalemia. Severe
hyperkalemia can produce life-threatening cardiac
dysrhythmias, making potassium monitoring a major priority in
clients with advanced kidney disease.
Question 5
, The nurse assesses a client with an arteriovenous fistula before
hemodialysis and cannot detect a thrill or bruit. What is the
priority action?
A. Apply a warm compress
B. Notify the healthcare provider promptly
C. Elevate the extremity for 30 minutes
D. Obtain the client's temperature
Answer: B. Notify the healthcare provider promptly
Rationale: A palpable thrill and audible bruit indicate blood
flow through the vascular access. Absence of both may indicate
thrombosis or obstruction. The finding requires prompt
evaluation to protect the dialysis access.
Question 6
A client with a suspected stroke arrives in the emergency
department. Which assessment is most important before
administering food or oral medications?
A. Ability to walk
B. Swallowing ability
C. Pupillary size
D. Bowel sounds
Answer: B. Swallowing ability
Rationale: Dysphagia is common after stroke and increases the
risk for aspiration. The nurse should ensure that swallowing
Surgical Nursing 2026/2027 Questions
and Answers | Comprehensive Exam
Review with Detailed Rationales
Guaranteed Pass (GRADED A+)
Question 1
A client with heart failure reports increasing shortness of breath
and has bilateral crackles. Which assessment finding requires
the nurse's immediate attention?
A. 1+ bilateral ankle edema
B. Heart rate of 92/min
C. Oxygen saturation of 86%
D. Weight gain of 1 kg over 3 days
Answer: C. Oxygen saturation of 86%
Rationale: An oxygen saturation of 86% indicates significant
hypoxemia and impaired oxygenation. The nurse should
immediately assess airway and breathing and initiate
appropriate oxygen therapy according to the prescribed plan.
Peripheral edema and gradual weight gain are important
indicators of worsening fluid retention but are not as
immediately life-threatening as severe hypoxemia.
Question 2
,A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen therapy. Which nursing action is most
appropriate?
A. Maintain oxygen at the highest possible flow rate
B. Monitor respiratory status and oxygen saturation closely
C. Encourage prolonged breath-holding exercises
D. Restrict fluids to prevent pulmonary edema
Answer: B. Monitor respiratory status and oxygen saturation
closely
Rationale: Clients with COPD require careful oxygen
administration and ongoing assessment of respiratory status.
Excessive oxygen administration may contribute to worsening
hypercapnia in susceptible clients. Oxygen should be titrated
according to the prescribed target and clinical condition.
Question 3
A client with diabetes mellitus is awake, diaphoretic, and
trembling. The blood glucose level is 52 mg/dL. What should
the nurse do first?
A. Administer regular insulin
B. Give 15 g of a rapid-acting carbohydrate
C. Encourage the client to ambulate
D. Administer glucagon intramuscularly immediately
Answer: B. Give 15 g of a rapid-acting carbohydrate
,Rationale: The client has symptomatic hypoglycemia and is
conscious and able to swallow. A rapid-acting carbohydrate
should be given promptly, followed by reassessment of blood
glucose according to the hypoglycemia protocol. Glucagon is
generally reserved for severe hypoglycemia when the client
cannot safely consume carbohydrates.
Question 4
A client with chronic kidney disease is receiving hemodialysis.
Which laboratory value should the nurse recognize as requiring
close monitoring?
A. Potassium
B. Hemoglobin A1c
C. Amylase
D. Bilirubin
Answer: A. Potassium
Rationale: Impaired renal function decreases potassium
excretion, placing the client at risk for hyperkalemia. Severe
hyperkalemia can produce life-threatening cardiac
dysrhythmias, making potassium monitoring a major priority in
clients with advanced kidney disease.
Question 5
, The nurse assesses a client with an arteriovenous fistula before
hemodialysis and cannot detect a thrill or bruit. What is the
priority action?
A. Apply a warm compress
B. Notify the healthcare provider promptly
C. Elevate the extremity for 30 minutes
D. Obtain the client's temperature
Answer: B. Notify the healthcare provider promptly
Rationale: A palpable thrill and audible bruit indicate blood
flow through the vascular access. Absence of both may indicate
thrombosis or obstruction. The finding requires prompt
evaluation to protect the dialysis access.
Question 6
A client with a suspected stroke arrives in the emergency
department. Which assessment is most important before
administering food or oral medications?
A. Ability to walk
B. Swallowing ability
C. Pupillary size
D. Bowel sounds
Answer: B. Swallowing ability
Rationale: Dysphagia is common after stroke and increases the
risk for aspiration. The nurse should ensure that swallowing
