EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM WITH 50 REAL EXAM
QUESTIONS AND CORRECT ANSWERS WITH WELL-ELABORATED
RATIONALES/ EVOLVE HESI MEDICAL SURGICAL LATEST EXAM 2025
1. A nurse is caring for a postoperative client who has a nasogastric
tube in place. Which of the following actions should the nurse take to
ensure the tube is correctly positioned?
A) Irrigate the tube with normal saline
B) Auscultate for bowel sounds
C) Check the pH of the aspirate
D) Administer a dose of an antacid
Answer: C) Check the pH of the aspirate
Rationale: The pH of the aspirate helps determine the placement of the
nasogastric tube. Gastric aspirate should have a pH of 4 or less. Other
methods, such as auscultation or irrigation, do not confirm placement
as accurately as checking pH.
2. A nurse is assessing a client with a history of hypertension. Which
of the following findings should be reported to the healthcare
provider immediately?
A) Pulse rate of 72 beats/min
B) Blood pressure of 150/95 mm Hg
C) Complaints of headache and blurry vision
D) Respiratory rate of 18 breaths/min
Answer: C) Complaints of headache and blurry vision
Rationale: Headache and blurry vision can be signs of a hypertensive
emergency, which requires immediate medical intervention. A blood
,pressure of 150/95 mm Hg, while elevated, does not necessarily
indicate an emergency, and the other vital signs are within normal
limits.
3. A nurse is teaching a client with chronic obstructive pulmonary
disease (COPD) how to use an inhaler. Which of the following
statements by the client indicates a need for further teaching?
A) "I should exhale fully before inhaling the medication."
B) "I need to hold my breath for about 10 seconds after inhaling."
C) "I should wait 2 minutes before using a second puff of the
medication."
D) "I will inhale quickly after pressing the inhaler."
Answer: D) "I will inhale quickly after pressing the inhaler."
Rationale: The client should inhale slowly and deeply after pressing the
inhaler, not quickly. Inhaling slowly allows the medication to reach
deeper into the lungs.
4. A nurse is caring for a client with a newly inserted central venous
catheter (CVC). Which of the following actions is the most important
to prevent infection?
A) Apply an alcohol-based hand rub before handling the CVC
B) Change the dressing around the insertion site every 24 hours
C) Use a sterile technique when accessing the CVC
D) Flush the CVC with heparin after every use
Answer: C) Use a sterile technique when accessing the CVC
Rationale: Using sterile technique when accessing the CVC is critical to
preventing infection. Other actions, such as hand hygiene, are
, important but sterile technique directly impacts infection control during
catheter access.
5. A nurse is monitoring a client after an appendectomy. Which of the
following findings should be reported to the healthcare provider
immediately?
A) Abdominal distension
B) Pain at the surgical site
C) Slight fever (100.4°F/38°C)
D) Tachycardia and hypotension
Answer: D) Tachycardia and hypotension
Rationale: Tachycardia and hypotension could indicate hemorrhage or
sepsis, both of which require immediate intervention. Abdominal
distension and mild fever can be expected postoperatively but should
still be monitored.
6. A nurse is teaching a client with diabetes mellitus about preventing
diabetic foot ulcers. Which of the following statements by the client
indicates a need for further teaching?
A) "I will check my feet every day for cuts or blisters."
B) "I should wear tight-fitting shoes to prevent blisters."
C) "I will keep my feet clean and dry, especially between my toes."
D) "I should avoid walking barefoot, even indoors."
Answer: B) "I should wear tight-fitting shoes to prevent blisters."
Rationale: Tight-fitting shoes can cause pressure and lead to blisters or
ulcers. Properly fitted shoes, along with regular foot checks and
hygiene, are essential in preventing diabetic foot ulcers.
QUESTIONS AND CORRECT ANSWERS WITH WELL-ELABORATED
RATIONALES/ EVOLVE HESI MEDICAL SURGICAL LATEST EXAM 2025
1. A nurse is caring for a postoperative client who has a nasogastric
tube in place. Which of the following actions should the nurse take to
ensure the tube is correctly positioned?
A) Irrigate the tube with normal saline
B) Auscultate for bowel sounds
C) Check the pH of the aspirate
D) Administer a dose of an antacid
Answer: C) Check the pH of the aspirate
Rationale: The pH of the aspirate helps determine the placement of the
nasogastric tube. Gastric aspirate should have a pH of 4 or less. Other
methods, such as auscultation or irrigation, do not confirm placement
as accurately as checking pH.
2. A nurse is assessing a client with a history of hypertension. Which
of the following findings should be reported to the healthcare
provider immediately?
A) Pulse rate of 72 beats/min
B) Blood pressure of 150/95 mm Hg
C) Complaints of headache and blurry vision
D) Respiratory rate of 18 breaths/min
Answer: C) Complaints of headache and blurry vision
Rationale: Headache and blurry vision can be signs of a hypertensive
emergency, which requires immediate medical intervention. A blood
,pressure of 150/95 mm Hg, while elevated, does not necessarily
indicate an emergency, and the other vital signs are within normal
limits.
3. A nurse is teaching a client with chronic obstructive pulmonary
disease (COPD) how to use an inhaler. Which of the following
statements by the client indicates a need for further teaching?
A) "I should exhale fully before inhaling the medication."
B) "I need to hold my breath for about 10 seconds after inhaling."
C) "I should wait 2 minutes before using a second puff of the
medication."
D) "I will inhale quickly after pressing the inhaler."
Answer: D) "I will inhale quickly after pressing the inhaler."
Rationale: The client should inhale slowly and deeply after pressing the
inhaler, not quickly. Inhaling slowly allows the medication to reach
deeper into the lungs.
4. A nurse is caring for a client with a newly inserted central venous
catheter (CVC). Which of the following actions is the most important
to prevent infection?
A) Apply an alcohol-based hand rub before handling the CVC
B) Change the dressing around the insertion site every 24 hours
C) Use a sterile technique when accessing the CVC
D) Flush the CVC with heparin after every use
Answer: C) Use a sterile technique when accessing the CVC
Rationale: Using sterile technique when accessing the CVC is critical to
preventing infection. Other actions, such as hand hygiene, are
, important but sterile technique directly impacts infection control during
catheter access.
5. A nurse is monitoring a client after an appendectomy. Which of the
following findings should be reported to the healthcare provider
immediately?
A) Abdominal distension
B) Pain at the surgical site
C) Slight fever (100.4°F/38°C)
D) Tachycardia and hypotension
Answer: D) Tachycardia and hypotension
Rationale: Tachycardia and hypotension could indicate hemorrhage or
sepsis, both of which require immediate intervention. Abdominal
distension and mild fever can be expected postoperatively but should
still be monitored.
6. A nurse is teaching a client with diabetes mellitus about preventing
diabetic foot ulcers. Which of the following statements by the client
indicates a need for further teaching?
A) "I will check my feet every day for cuts or blisters."
B) "I should wear tight-fitting shoes to prevent blisters."
C) "I will keep my feet clean and dry, especially between my toes."
D) "I should avoid walking barefoot, even indoors."
Answer: B) "I should wear tight-fitting shoes to prevent blisters."
Rationale: Tight-fitting shoes can cause pressure and lead to blisters or
ulcers. Properly fitted shoes, along with regular foot checks and
hygiene, are essential in preventing diabetic foot ulcers.
