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EVOLVE ELSEVIER HESI MED SURG
ACTUAL EXAM Questions and Answers
(Expert Solutions)
Q: A client with hypertension has been receiving ramipril (Altace), 5 mg PO, daily for 2
weeks and is scheduled to receive a dose at 0900. At 0830, the client's blood pressure is
120/70 mm Hg. Which action should the nurse take?, 🗹🗹: Administer the
prescribed dose at the scheduled time
Rationale: The client's blood pressure is within normal limits, indicating that the
ramipril, an antihypertensive, is having the desired effect and should be administered
Q: Which instruction should the nurse teach a female client about the prevention of toxic
shock syndrome?
A. "Get immunization against HPV
B. "Change your tampon frequently"
C. "Empty your bladder after intercourse"
D. "Obtain a yearly flu vaccination, 🗹🗹: "Change your tampon frequently"
Rationale: Certain strains of Staphylococcus aureus produce a toxin that can enter the
bloodstream through the vaginal mucosa. Changing the tampon frequently reduces the
exposure to these toxins, which are the primary cause of toxic shock syndrome. Option
A helps prevent cervical cancer, not toxic shock syndrome. Option C can lessen the
incidence of urinary tract infection. Option D can help prevent some individuals from
contracting the flu and pneumonia, but no relationship to toxic shock syndrome has
been proven.
Q: The home health nurse is assessing a male client being treated for Parkinson disease
with carbidopa-levodopa. The nurse observes that he does not demonstrate any apparent
emotion when speaking and rarely blinks. Which intervention should the nurse
implement?
A. Perform a complete cranial nerve assessment
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B. Instruct the client that he may be experiencing medication toxicity
C. Document the presence of these assessment findings
D. Advise the client to seek immediate medical evaluation, 🗹🗹: Document the
presence of these assessment findings.
Rationale: A masklike expression and infrequent blinking are common clinical features
of parkinsonism. The nurse should document these expected findings.
Signs of toxicity of levodopa-carbidopa include: dyskinesia, hallucinations, and
psychosis
Q: A female client with a nasogastric tube attached to low suction states that she is
nauseated. The nurse assesses that there has been no drainage through the nasogastric
tube in the last 2 hours. Which action should the nurse take first?
A. Irrigate the nasogastric tube with sterile normal saline
B. Reposition the client on her side
C. Advance the nasgastric tube 5cm
D. Administer an intravenous antiemetic as prescribed, 🗹🗹: Reposition the client on
her side
Rationale: The immediate priority is to determine if the tube is functioning correctly,
which would then relieve the client's nausea. The least invasive intervention,
repositioning the client, should be attempted first, followed by options A and C, unless
either of these interventions is contraindicated. If these measures are unsuccessful, the
client may require option D.
Q: The nurse teaches a client with type 2 diabetes nutritional strategies to decrease
obesity. Which food items chosen by the client indicate understanding of the teaching?
(Select all that apply.)
A. White bread
B. Salmon
C. Broccoli
D. Whole milk
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E. Banana, 🗹🗹: Salmon, Broccoli, and Banana
Rationale: Provides fresh fruits, lean meats and fish, vegetables, whole grains, and low-
fat dairy products.
Q: Which condition should the nurse anticipate as a potential problem in a female client
with a neurogenic bladder?
A. Stress incontinence
B. Infection
C. Painless gross hematuria
D. Peritonitis, 🗹🗹: Infection
B. Infection is the major complication resulting from stasis of urine and subsequent
catheterization. Option A is the involuntary loss of urine through an intact urethra as a
result of a sudden increase in intraabdominal pressure. Option C is the most common
symptom of bladder cancer. Option D is the most common and serious complication of
peritoneal dialysis.
Q: A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid
ventricular response. Based on this finding, the nurse anticipates assisting the physician
with which treatment?
A. Administer lidocaine, 75mg IV push
B. Perform synchronized cardioversion
C. Defibrillate the client as soon as possible
D. Administer atropine, 0.4mg IV push, 🗹🗹: Perform synchronized cardioversion
Rationale: With uncontrolled atrial fibrillation, the treatment of choice is synchronized
cardioversion to convert the cardiac rhythm back to normal sinus rhythm. Option A is a
medication used for ventricular dysrhythmias. Option C is not for a client with atrial
fibrillation; it is reserved for clients with life-threatening dysrhythmias, such as
ventricular fibrillation and unstable ventricular tachycardia. Option D is the drug of
choice in symptomatic sinus bradycardia, not atrial fibrillation.
Q: A 25-year-old client was admitted yesterday after a motor vehicle collision.
Neurodiagnostic studies have shown a basal skull fracture in the middle fossa. Assessment
on admission revealed both halo and Battle signs. Which new symptom indicates that the
EVOLVE ELSEVIER HESI MED SURG
ACTUAL EXAM Questions and Answers
(Expert Solutions)
Q: A client with hypertension has been receiving ramipril (Altace), 5 mg PO, daily for 2
weeks and is scheduled to receive a dose at 0900. At 0830, the client's blood pressure is
120/70 mm Hg. Which action should the nurse take?, 🗹🗹: Administer the
prescribed dose at the scheduled time
Rationale: The client's blood pressure is within normal limits, indicating that the
ramipril, an antihypertensive, is having the desired effect and should be administered
Q: Which instruction should the nurse teach a female client about the prevention of toxic
shock syndrome?
A. "Get immunization against HPV
B. "Change your tampon frequently"
C. "Empty your bladder after intercourse"
D. "Obtain a yearly flu vaccination, 🗹🗹: "Change your tampon frequently"
Rationale: Certain strains of Staphylococcus aureus produce a toxin that can enter the
bloodstream through the vaginal mucosa. Changing the tampon frequently reduces the
exposure to these toxins, which are the primary cause of toxic shock syndrome. Option
A helps prevent cervical cancer, not toxic shock syndrome. Option C can lessen the
incidence of urinary tract infection. Option D can help prevent some individuals from
contracting the flu and pneumonia, but no relationship to toxic shock syndrome has
been proven.
Q: The home health nurse is assessing a male client being treated for Parkinson disease
with carbidopa-levodopa. The nurse observes that he does not demonstrate any apparent
emotion when speaking and rarely blinks. Which intervention should the nurse
implement?
A. Perform a complete cranial nerve assessment
, Page | 2
B. Instruct the client that he may be experiencing medication toxicity
C. Document the presence of these assessment findings
D. Advise the client to seek immediate medical evaluation, 🗹🗹: Document the
presence of these assessment findings.
Rationale: A masklike expression and infrequent blinking are common clinical features
of parkinsonism. The nurse should document these expected findings.
Signs of toxicity of levodopa-carbidopa include: dyskinesia, hallucinations, and
psychosis
Q: A female client with a nasogastric tube attached to low suction states that she is
nauseated. The nurse assesses that there has been no drainage through the nasogastric
tube in the last 2 hours. Which action should the nurse take first?
A. Irrigate the nasogastric tube with sterile normal saline
B. Reposition the client on her side
C. Advance the nasgastric tube 5cm
D. Administer an intravenous antiemetic as prescribed, 🗹🗹: Reposition the client on
her side
Rationale: The immediate priority is to determine if the tube is functioning correctly,
which would then relieve the client's nausea. The least invasive intervention,
repositioning the client, should be attempted first, followed by options A and C, unless
either of these interventions is contraindicated. If these measures are unsuccessful, the
client may require option D.
Q: The nurse teaches a client with type 2 diabetes nutritional strategies to decrease
obesity. Which food items chosen by the client indicate understanding of the teaching?
(Select all that apply.)
A. White bread
B. Salmon
C. Broccoli
D. Whole milk
, Page | 3
E. Banana, 🗹🗹: Salmon, Broccoli, and Banana
Rationale: Provides fresh fruits, lean meats and fish, vegetables, whole grains, and low-
fat dairy products.
Q: Which condition should the nurse anticipate as a potential problem in a female client
with a neurogenic bladder?
A. Stress incontinence
B. Infection
C. Painless gross hematuria
D. Peritonitis, 🗹🗹: Infection
B. Infection is the major complication resulting from stasis of urine and subsequent
catheterization. Option A is the involuntary loss of urine through an intact urethra as a
result of a sudden increase in intraabdominal pressure. Option C is the most common
symptom of bladder cancer. Option D is the most common and serious complication of
peritoneal dialysis.
Q: A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid
ventricular response. Based on this finding, the nurse anticipates assisting the physician
with which treatment?
A. Administer lidocaine, 75mg IV push
B. Perform synchronized cardioversion
C. Defibrillate the client as soon as possible
D. Administer atropine, 0.4mg IV push, 🗹🗹: Perform synchronized cardioversion
Rationale: With uncontrolled atrial fibrillation, the treatment of choice is synchronized
cardioversion to convert the cardiac rhythm back to normal sinus rhythm. Option A is a
medication used for ventricular dysrhythmias. Option C is not for a client with atrial
fibrillation; it is reserved for clients with life-threatening dysrhythmias, such as
ventricular fibrillation and unstable ventricular tachycardia. Option D is the drug of
choice in symptomatic sinus bradycardia, not atrial fibrillation.
Q: A 25-year-old client was admitted yesterday after a motor vehicle collision.
Neurodiagnostic studies have shown a basal skull fracture in the middle fossa. Assessment
on admission revealed both halo and Battle signs. Which new symptom indicates that the
