Evolve Elsevier HESI Medical-Surgical
Nursing Practice Exam Questions and
correct Answers (Verified Answers) Plus
Rationales 2025
1. A patient with chronic obstructive pulmonary disease (COPD) is admitted
with increased shortness of breath and productive cough. Which nursing
intervention is the priority?
a) Encourage bed rest
b) Administer oxygen therapy as prescribed
c) Restrict oral fluids
d) Place the patient in a supine position
,Answer: b) Administer oxygen therapy as prescribed
Rationale: Oxygen therapy helps improve oxygenation in COPD exacerbations.
Bed rest and supine position may worsen ventilation. Oral fluids are encouraged
to thin secretions.
2. A client with a history of myocardial infarction complains of sudden chest
pain radiating to the left arm. What is the nurse’s first action?
a) Obtain a 12-lead ECG
b) Administer nitroglycerin sublingually
c) Call the healthcare provider
d) Assess vital signs
Answer: d) Assess vital signs
Rationale: Assessment is the first step to determine the patient’s current status
and to guide further interventions. Administering medications or diagnostic tests
follows initial assessment.
3. The nurse is caring for a client with heart failure who reports increased
swelling in the legs and shortness of breath. Which finding requires immediate
intervention?
a) 2+ pitting edema in ankles
b) Weight gain of 2 pounds in 1 day
c) Crackles heard in the lungs
d) Elevated blood pressure of 140/90 mm Hg
,Answer: c) Crackles heard in the lungs
Rationale: Crackles indicate pulmonary congestion, which is a sign of worsening
heart failure and requires immediate intervention to prevent respiratory
compromise.
4. A patient is prescribed warfarin after a deep vein thrombosis. Which
laboratory test should the nurse monitor?
a) Prothrombin time (PT) and International Normalized Ratio (INR)
b) Activated partial thromboplastin time (aPTT)
c) Complete blood count (CBC)
d) Platelet count
Answer: a) Prothrombin time (PT) and International Normalized Ratio (INR)
Rationale: Warfarin affects the extrinsic pathway of clotting; PT and INR monitor
its therapeutic effectiveness and bleeding risk.
5. Which dietary recommendation should the nurse provide to a client with
chronic kidney disease?
a) Increase protein intake
b) Limit potassium and phosphorus intake
c) Consume high sodium foods
d) Increase fluid intake without restrictions
Answer: b) Limit potassium and phosphorus intake
Rationale: Kidney impairment decreases the ability to excrete potassium and
, phosphorus, so dietary restrictions prevent hyperkalemia and
hyperphosphatemia.
6. A client is diagnosed with diabetic ketoacidosis (DKA). Which lab value would
the nurse expect to see?
a) Blood glucose 90 mg/dL
b) pH 7.30
c) Serum potassium low
d) Bicarbonate level high
Answer: b) pH 7.30
Rationale: DKA causes metabolic acidosis, leading to low blood pH (<7.35).
Potassium is often high or normal due to acidosis, and bicarbonate is low.
7. The nurse is teaching a patient about prevention of deep vein thrombosis
(DVT). Which instruction is appropriate?
a) Avoid leg exercises
b) Increase daily ambulation
c) Limit fluid intake
d) Cross legs when sitting
Answer: b) Increase daily ambulation
Rationale: Ambulation promotes venous return and reduces the risk of clot
formation. Crossing legs and immobility increase risk.
Nursing Practice Exam Questions and
correct Answers (Verified Answers) Plus
Rationales 2025
1. A patient with chronic obstructive pulmonary disease (COPD) is admitted
with increased shortness of breath and productive cough. Which nursing
intervention is the priority?
a) Encourage bed rest
b) Administer oxygen therapy as prescribed
c) Restrict oral fluids
d) Place the patient in a supine position
,Answer: b) Administer oxygen therapy as prescribed
Rationale: Oxygen therapy helps improve oxygenation in COPD exacerbations.
Bed rest and supine position may worsen ventilation. Oral fluids are encouraged
to thin secretions.
2. A client with a history of myocardial infarction complains of sudden chest
pain radiating to the left arm. What is the nurse’s first action?
a) Obtain a 12-lead ECG
b) Administer nitroglycerin sublingually
c) Call the healthcare provider
d) Assess vital signs
Answer: d) Assess vital signs
Rationale: Assessment is the first step to determine the patient’s current status
and to guide further interventions. Administering medications or diagnostic tests
follows initial assessment.
3. The nurse is caring for a client with heart failure who reports increased
swelling in the legs and shortness of breath. Which finding requires immediate
intervention?
a) 2+ pitting edema in ankles
b) Weight gain of 2 pounds in 1 day
c) Crackles heard in the lungs
d) Elevated blood pressure of 140/90 mm Hg
,Answer: c) Crackles heard in the lungs
Rationale: Crackles indicate pulmonary congestion, which is a sign of worsening
heart failure and requires immediate intervention to prevent respiratory
compromise.
4. A patient is prescribed warfarin after a deep vein thrombosis. Which
laboratory test should the nurse monitor?
a) Prothrombin time (PT) and International Normalized Ratio (INR)
b) Activated partial thromboplastin time (aPTT)
c) Complete blood count (CBC)
d) Platelet count
Answer: a) Prothrombin time (PT) and International Normalized Ratio (INR)
Rationale: Warfarin affects the extrinsic pathway of clotting; PT and INR monitor
its therapeutic effectiveness and bleeding risk.
5. Which dietary recommendation should the nurse provide to a client with
chronic kidney disease?
a) Increase protein intake
b) Limit potassium and phosphorus intake
c) Consume high sodium foods
d) Increase fluid intake without restrictions
Answer: b) Limit potassium and phosphorus intake
Rationale: Kidney impairment decreases the ability to excrete potassium and
, phosphorus, so dietary restrictions prevent hyperkalemia and
hyperphosphatemia.
6. A client is diagnosed with diabetic ketoacidosis (DKA). Which lab value would
the nurse expect to see?
a) Blood glucose 90 mg/dL
b) pH 7.30
c) Serum potassium low
d) Bicarbonate level high
Answer: b) pH 7.30
Rationale: DKA causes metabolic acidosis, leading to low blood pH (<7.35).
Potassium is often high or normal due to acidosis, and bicarbonate is low.
7. The nurse is teaching a patient about prevention of deep vein thrombosis
(DVT). Which instruction is appropriate?
a) Avoid leg exercises
b) Increase daily ambulation
c) Limit fluid intake
d) Cross legs when sitting
Answer: b) Increase daily ambulation
Rationale: Ambulation promotes venous return and reduces the risk of clot
formation. Crossing legs and immobility increase risk.
