1
EVOLVE ELSEVIER HESI RN MEDICAL
SURGICAL FINAL EXAM PRACTICE
2025/ACTUAL EXAM 150 QUESTIONS WITH
CORRECT VERIFIED ANSWERS WITH
RATIONALES/ EVOLVE ELSEVIER HESI RN
MED-SURG NEWEST EXAM 2025
Which assessment is most important for the nurse to perform on a client
who is hospitalized for Guillain-Barre syndrome that is rapidly progressing?
A: Respiratory
effort.
B: Unsteady
gait.
C: Intensity of
pain. D: Ability
to eat.
A: Respiratory Effort
Rationale:(Guillain-Barre syndrome causes paralysis or weakness that typically
starts at the feet and progresses upwards. As the condition progresses, the nurse
must ensure that the client is able to breathe effectively.)
A male client comes into the clinic with a history of penile discharge with painful,
burning urination. Which action should the nurse implement?
A: Collect a culture of the penile
discharge. B: Palpate the inguinal
lymph nodes gently. C: Observe for
scrotal swelling and redness. D:
Express the discharge to determine
color.
A: Collect a culture of the penile
discharge.
Rationale: (Penile discharge with painful urination is commonly associated with
gonorrhea. The nurse should collect a culture of the penile discharge to determine
the cause of these symptoms. The cause must be determined or confirmed through
culture to identify the organism and ensure effective treatment.)
A client with history of atrial fibrillation is admitted to the telemetry unit with
sudden onset of shortness of breath. The nurse observes a new irregular heart
rhythm and should perform which assessment at this time?
A: Check for a pulse
deficit. B: Palpate the
apical impulse. C:
, 2
Inspect jugular vein
pulse.
D: Examine for a carotid
bruit. A: Check for a
pulse deficit.
Rationale: (A client with a past history of atrial fibrillation may return to that
rhythm. Any signs of atrial fibrillation, such as sudden onset shortness of breath,
requires further investigation. The nurse should assess this client for a pulse
deficit because this condition occurs with atrial fibrillation.)
Which client should be further assessed for an ectopic
pregnancy? A: A 24-year-old with shoulder and lower
abdominal quadrant pain. B: A 33-year-old with
intermittent lower abdominal cramping.
C: A 20-year-old with fever and right lower abdominal colic.
D: A 40-year-old with jaundice and right lower abdominal pain.
A: A 24-year-old with shoulder and lower abdominal quadrant pain.
Rationale: (A 24-year-old with sudden onset of lower abdominal quadrant pain should
be assessed for an ectopic pregnancy. The pain can also be referred to the shoulder
and may be associated with vaginal bleeding.)
Which dietary assessment finding is most important for the nurse to address when
caring for a client with diabetic nephropathy?
A: Drinks a six pack of beer
every day. B: Enjoys a
hamburger once a month. C:
Eats fortified breakfast cereal
daily. D: Consumes beans and
rice every day. A: Drinks a six
pack of beer every day.
Rationale: (Drinking six beers every day is the dietary assessment finding most
important for the nurse to address when caring for a client with diabetic
nephropathy. The usual can of beer is 12 ounces (355 mL). Clients with diabetes
are recommended to drink no more than 12 ounces of beer per day because beer
contains carbohydrates that can create unhealthy fluctuations in blood glucose and
promote poorglucose control. Nephropathy is exacerbated by poor blood glucose
control.)
Which assessment finding is of greatest concern to the nurse who is caring for a client
with stomatitis?
A: Cough brought on by
swallowing.
B: Sore throat caused by
, 3
speaking. C: Painful and dry
oral cavity.
D: Unintended weight loss.
A: Cough brought on by swallowing.
Rationale:A cough brought on by swallowing is a sign of dysphagia, which is a
finding of particular concern in a client with stomatitis. Dysphagia can cause
numerous problems, including airway obstruction, and should be reported to the
healthcare provider immediately.
The nurse is teaching a client diagnosed with peripheral arterial disease. Which
genitourinary system complication should the nurse include in the teaching?
A: Altered sexual
response. B: Sterility.
C: Urinary incontinence.
D: Decreased pelvic
muscle tone. A: Altered
sexual response.
Rationale:
Peripheral arterial disease (PAD) is a cardiovascular condition characterized by
narrowing of the arteries and reduced blood flow to the extremities. PAD is known to
alter the blood flow to the male's penis and is associated with erectile dysfunction in
men.
A 40-year-old female client has a history of smoking. Which finding should the
nurse identify as a risk factor for myocardia infarction?
A: Oral
contraceptives.
B: Senile
osteopenia.
C: Levothyroxine
therapy. D:
Pernicious anemia.
A: Oral contraceptives.
Women older than 35 years old who smoke and take oral contraceptives have an
increased risk of myocardial infarction or stroke.
A client has been told that there is cataract formation over both eyes. Which
finding should the nurse expect when assessing the client?
A: Decreased color
perception. B: Presence
of floaters.
C: Loss of central vision.
, 4
D: Reduced peripheral
vision. A: Decreased
color perception.
Rationale:Decreased color perception occurs with cataract formation. Cataract
formation is also associated with blurred vision and a global loss of vision so
gradual that the client may not be aware of it.
Which assessment finding should most concern the nurse who is monitoring a client
two hours after a thoracentesis?
A: New onset of
coughing. B: Low
resting heart rate.
C: Distended neck
veins.
D: Decreased shallow
respirations. A: New onset
of coughing.
Rationale:A pneumothorax (partial or complete lung collapse) is the potential
complication of a thoracentesis. Manifestations of a pneumothorax include new onset
of a nagging cough, tachycardia, and an increased shallow respiration rate.
While caring for a client who has esophageal varices, which nursing intervention is
most important for the registered nurse (RN) to implement?
A: Monitor infusing IV fluids and any replacement
blood products. B: Prepare for
esophagogastroduodenoscopy (EGD).
C: Maintain the client on strict bedrest.
D: Insert a nasogastric tube (NGT) for intermittent suction.
A: Monitor infusing IV fluids and any replacement blood products
Rationale: (Maintaining hemodynamic stability in a client with esophageal varices
can precipitate a life-threatening crisis if esophageal varies leak or rupture and
can result in hemorrhage. The priority is assessing and monitoring infusions of IV
fluids and any replacement blood products.)
The registered nurse (RN) is caring for a client who developed oliguria and was
diagnosed with sepsis and dehydration 48 hours ago. Which assessment finding
indicates to the RN that the client is stabilizing?
A: Urine output of 40 mL/hour.
B: Apical pulse 100 and blood
pressure 76/42. C: Urine specific
gravity 1.001.
D: Tented skin on dorsal surface
EVOLVE ELSEVIER HESI RN MEDICAL
SURGICAL FINAL EXAM PRACTICE
2025/ACTUAL EXAM 150 QUESTIONS WITH
CORRECT VERIFIED ANSWERS WITH
RATIONALES/ EVOLVE ELSEVIER HESI RN
MED-SURG NEWEST EXAM 2025
Which assessment is most important for the nurse to perform on a client
who is hospitalized for Guillain-Barre syndrome that is rapidly progressing?
A: Respiratory
effort.
B: Unsteady
gait.
C: Intensity of
pain. D: Ability
to eat.
A: Respiratory Effort
Rationale:(Guillain-Barre syndrome causes paralysis or weakness that typically
starts at the feet and progresses upwards. As the condition progresses, the nurse
must ensure that the client is able to breathe effectively.)
A male client comes into the clinic with a history of penile discharge with painful,
burning urination. Which action should the nurse implement?
A: Collect a culture of the penile
discharge. B: Palpate the inguinal
lymph nodes gently. C: Observe for
scrotal swelling and redness. D:
Express the discharge to determine
color.
A: Collect a culture of the penile
discharge.
Rationale: (Penile discharge with painful urination is commonly associated with
gonorrhea. The nurse should collect a culture of the penile discharge to determine
the cause of these symptoms. The cause must be determined or confirmed through
culture to identify the organism and ensure effective treatment.)
A client with history of atrial fibrillation is admitted to the telemetry unit with
sudden onset of shortness of breath. The nurse observes a new irregular heart
rhythm and should perform which assessment at this time?
A: Check for a pulse
deficit. B: Palpate the
apical impulse. C:
, 2
Inspect jugular vein
pulse.
D: Examine for a carotid
bruit. A: Check for a
pulse deficit.
Rationale: (A client with a past history of atrial fibrillation may return to that
rhythm. Any signs of atrial fibrillation, such as sudden onset shortness of breath,
requires further investigation. The nurse should assess this client for a pulse
deficit because this condition occurs with atrial fibrillation.)
Which client should be further assessed for an ectopic
pregnancy? A: A 24-year-old with shoulder and lower
abdominal quadrant pain. B: A 33-year-old with
intermittent lower abdominal cramping.
C: A 20-year-old with fever and right lower abdominal colic.
D: A 40-year-old with jaundice and right lower abdominal pain.
A: A 24-year-old with shoulder and lower abdominal quadrant pain.
Rationale: (A 24-year-old with sudden onset of lower abdominal quadrant pain should
be assessed for an ectopic pregnancy. The pain can also be referred to the shoulder
and may be associated with vaginal bleeding.)
Which dietary assessment finding is most important for the nurse to address when
caring for a client with diabetic nephropathy?
A: Drinks a six pack of beer
every day. B: Enjoys a
hamburger once a month. C:
Eats fortified breakfast cereal
daily. D: Consumes beans and
rice every day. A: Drinks a six
pack of beer every day.
Rationale: (Drinking six beers every day is the dietary assessment finding most
important for the nurse to address when caring for a client with diabetic
nephropathy. The usual can of beer is 12 ounces (355 mL). Clients with diabetes
are recommended to drink no more than 12 ounces of beer per day because beer
contains carbohydrates that can create unhealthy fluctuations in blood glucose and
promote poorglucose control. Nephropathy is exacerbated by poor blood glucose
control.)
Which assessment finding is of greatest concern to the nurse who is caring for a client
with stomatitis?
A: Cough brought on by
swallowing.
B: Sore throat caused by
, 3
speaking. C: Painful and dry
oral cavity.
D: Unintended weight loss.
A: Cough brought on by swallowing.
Rationale:A cough brought on by swallowing is a sign of dysphagia, which is a
finding of particular concern in a client with stomatitis. Dysphagia can cause
numerous problems, including airway obstruction, and should be reported to the
healthcare provider immediately.
The nurse is teaching a client diagnosed with peripheral arterial disease. Which
genitourinary system complication should the nurse include in the teaching?
A: Altered sexual
response. B: Sterility.
C: Urinary incontinence.
D: Decreased pelvic
muscle tone. A: Altered
sexual response.
Rationale:
Peripheral arterial disease (PAD) is a cardiovascular condition characterized by
narrowing of the arteries and reduced blood flow to the extremities. PAD is known to
alter the blood flow to the male's penis and is associated with erectile dysfunction in
men.
A 40-year-old female client has a history of smoking. Which finding should the
nurse identify as a risk factor for myocardia infarction?
A: Oral
contraceptives.
B: Senile
osteopenia.
C: Levothyroxine
therapy. D:
Pernicious anemia.
A: Oral contraceptives.
Women older than 35 years old who smoke and take oral contraceptives have an
increased risk of myocardial infarction or stroke.
A client has been told that there is cataract formation over both eyes. Which
finding should the nurse expect when assessing the client?
A: Decreased color
perception. B: Presence
of floaters.
C: Loss of central vision.
, 4
D: Reduced peripheral
vision. A: Decreased
color perception.
Rationale:Decreased color perception occurs with cataract formation. Cataract
formation is also associated with blurred vision and a global loss of vision so
gradual that the client may not be aware of it.
Which assessment finding should most concern the nurse who is monitoring a client
two hours after a thoracentesis?
A: New onset of
coughing. B: Low
resting heart rate.
C: Distended neck
veins.
D: Decreased shallow
respirations. A: New onset
of coughing.
Rationale:A pneumothorax (partial or complete lung collapse) is the potential
complication of a thoracentesis. Manifestations of a pneumothorax include new onset
of a nagging cough, tachycardia, and an increased shallow respiration rate.
While caring for a client who has esophageal varices, which nursing intervention is
most important for the registered nurse (RN) to implement?
A: Monitor infusing IV fluids and any replacement
blood products. B: Prepare for
esophagogastroduodenoscopy (EGD).
C: Maintain the client on strict bedrest.
D: Insert a nasogastric tube (NGT) for intermittent suction.
A: Monitor infusing IV fluids and any replacement blood products
Rationale: (Maintaining hemodynamic stability in a client with esophageal varices
can precipitate a life-threatening crisis if esophageal varies leak or rupture and
can result in hemorrhage. The priority is assessing and monitoring infusions of IV
fluids and any replacement blood products.)
The registered nurse (RN) is caring for a client who developed oliguria and was
diagnosed with sepsis and dehydration 48 hours ago. Which assessment finding
indicates to the RN that the client is stabilizing?
A: Urine output of 40 mL/hour.
B: Apical pulse 100 and blood
pressure 76/42. C: Urine specific
gravity 1.001.
D: Tented skin on dorsal surface
