RN Evolve Hesi Medical Surgical Exam
Versions A & B
RN EVOLVE HESI MEDICAL SURGICAL
EXAM VERSIONS A & B EACH Questions
and Correct Answers with Detailed
Rationales Already Graded A+ Brand New
2025
An older adult with coronary artery disease and hypertension was brought to the Emergency
Department by her daughter because she has become increasingly weak and confused. The
client was found by a neighbor wandering her neighborhood unable to locate her home. The
client's daughter tells the nurse that her mother takes a "water pill" for her blood pressure 2
or 3 times a day. The label on the medication bottle that she brought to the hospital states,
"hydrochlorothiazide. Take 1 tablet daily." T - Correct Answer :
Page 1
Vital Signs: Orthostatic Changes
1. Since the client has a fluid volume deficit, the nurse anticipates a decrease in which vital
sign when she changes position?
A. Respiratory Rate
B. Blood Pressure.
C. Temperature.
D. Pulse Rate - Correct Answer :B. Blood Pressure
A+ TEST BANK 1
, RN Evolve Hesi Medical Surgical Exam
Versions A & B
Fluid volume deficit often causes orthostatic hypotension and tachycardia. Because the client
may experience dizziness with orthostatic hypotension, the nurse should take additional
safety precautions during this assessment.
2. The nurse plans to assess the client for orthostatic vital sign changes. Which action will the
nurse take first?
A. Assist the client to a standing position.
B. Position the client in a supine position.
C. Elevate the head of the client's bed.
D. Dangle the clients feet at the bedside. –
Correct Answer :B. Position the client in a supine position.
Orthostatic vital signs are measured in each position: lying, sitting, and standing. The client's
vital signs are first assessed in the supine position so that changes that occur when the client
sits and stands can be determined.
3. The nurse takes the first blood pressure measurement. After recording the first blood
pressure measurement, what action will the nurse take?
A. Count the client's radial pulse rate.
B. Remove the blood pressure cuff.
C. Help the client change positions.
D. Assess for an auscultatory gap
. - Correct Answer :A. Count the client's radial pulse.
Both the blood pressure and pulse rate are typically measured in each position: lying, sitting,
and standing.
A+ TEST BANK 2
, RN Evolve Hesi Medical Surgical Exam
Versions A & B
Page 2
Age-related Risk Factors
The nurse discusses factors that contributed to the client's fluid volume deficit with her
daughter, and receives orders for labs to be obtained.
1. Which problem often occurs in older client's and may have contributed to the fluid volume
deficit the client is experiencing?
A. Decreased hepatic blood flow.
B. Decreased drug absorption.
C. Decreased drug half-life.
D. Decreased GI acidity.
- Correct Answer :A. Decreased hepatic blood flow.
Decreased hepatic blood flow commonly occurs in older clients. This decreases drug
metabolism, which allows drugs to remain in the body longer and produces a greater drug
effect.
The nurse is aware that older clients often experience an increased in the amount of free,
unbound drug molecules, which has the potential to increase the pharmacological effects of
the drug.
2. Which lab test will the nurse monitor to determine if this may be a factor contributing to
the client's problem?
A. Serum creatinine.
B. Serum protein.
C. AST.
A+ TEST BANK 3
, RN Evolve Hesi Medical Surgical Exam
Versions A & B
D. BUN.
- Correct Answer :B. Serum Protein.
Drug molecules may be distributed throughout the body bound to plasma protein molecules.
A decrease in serum protein levels is an indication that there may be an increase in free,
unbound drug molecules in the bloodstream.
3. Which labs would the nurse expect the Healthcare Provider (HCP) to order? (Choose all
that apply)
A. BUN
B. Serum creatinine
C. Urine specific gravity and osmolality
D. Liver function panel
E. None of the above –
Correct Answer :A. BUN
Increased level could indicate renal disease or dehydration.
B. Serum creatinine
Increase indicates renal disease.
C. Urine specific gravity and osmolality
Dehydration, reduced renal blood flow, and increase in ADH secretion elevate specific gravity.
Overhydration, early renal disease, and inadequate ADH secretion reduce specific gravity.
D. Liver function panel
If a decrease in liver function occurs such as with aging or liver disease, a medication is usually
eliminated more slowly, resulting in its accumulation. Patients are at risk for medication
toxicity if organs that metabolize medications are not functioning correctly.
A+ TEST BANK 4
Versions A & B
RN EVOLVE HESI MEDICAL SURGICAL
EXAM VERSIONS A & B EACH Questions
and Correct Answers with Detailed
Rationales Already Graded A+ Brand New
2025
An older adult with coronary artery disease and hypertension was brought to the Emergency
Department by her daughter because she has become increasingly weak and confused. The
client was found by a neighbor wandering her neighborhood unable to locate her home. The
client's daughter tells the nurse that her mother takes a "water pill" for her blood pressure 2
or 3 times a day. The label on the medication bottle that she brought to the hospital states,
"hydrochlorothiazide. Take 1 tablet daily." T - Correct Answer :
Page 1
Vital Signs: Orthostatic Changes
1. Since the client has a fluid volume deficit, the nurse anticipates a decrease in which vital
sign when she changes position?
A. Respiratory Rate
B. Blood Pressure.
C. Temperature.
D. Pulse Rate - Correct Answer :B. Blood Pressure
A+ TEST BANK 1
, RN Evolve Hesi Medical Surgical Exam
Versions A & B
Fluid volume deficit often causes orthostatic hypotension and tachycardia. Because the client
may experience dizziness with orthostatic hypotension, the nurse should take additional
safety precautions during this assessment.
2. The nurse plans to assess the client for orthostatic vital sign changes. Which action will the
nurse take first?
A. Assist the client to a standing position.
B. Position the client in a supine position.
C. Elevate the head of the client's bed.
D. Dangle the clients feet at the bedside. –
Correct Answer :B. Position the client in a supine position.
Orthostatic vital signs are measured in each position: lying, sitting, and standing. The client's
vital signs are first assessed in the supine position so that changes that occur when the client
sits and stands can be determined.
3. The nurse takes the first blood pressure measurement. After recording the first blood
pressure measurement, what action will the nurse take?
A. Count the client's radial pulse rate.
B. Remove the blood pressure cuff.
C. Help the client change positions.
D. Assess for an auscultatory gap
. - Correct Answer :A. Count the client's radial pulse.
Both the blood pressure and pulse rate are typically measured in each position: lying, sitting,
and standing.
A+ TEST BANK 2
, RN Evolve Hesi Medical Surgical Exam
Versions A & B
Page 2
Age-related Risk Factors
The nurse discusses factors that contributed to the client's fluid volume deficit with her
daughter, and receives orders for labs to be obtained.
1. Which problem often occurs in older client's and may have contributed to the fluid volume
deficit the client is experiencing?
A. Decreased hepatic blood flow.
B. Decreased drug absorption.
C. Decreased drug half-life.
D. Decreased GI acidity.
- Correct Answer :A. Decreased hepatic blood flow.
Decreased hepatic blood flow commonly occurs in older clients. This decreases drug
metabolism, which allows drugs to remain in the body longer and produces a greater drug
effect.
The nurse is aware that older clients often experience an increased in the amount of free,
unbound drug molecules, which has the potential to increase the pharmacological effects of
the drug.
2. Which lab test will the nurse monitor to determine if this may be a factor contributing to
the client's problem?
A. Serum creatinine.
B. Serum protein.
C. AST.
A+ TEST BANK 3
, RN Evolve Hesi Medical Surgical Exam
Versions A & B
D. BUN.
- Correct Answer :B. Serum Protein.
Drug molecules may be distributed throughout the body bound to plasma protein molecules.
A decrease in serum protein levels is an indication that there may be an increase in free,
unbound drug molecules in the bloodstream.
3. Which labs would the nurse expect the Healthcare Provider (HCP) to order? (Choose all
that apply)
A. BUN
B. Serum creatinine
C. Urine specific gravity and osmolality
D. Liver function panel
E. None of the above –
Correct Answer :A. BUN
Increased level could indicate renal disease or dehydration.
B. Serum creatinine
Increase indicates renal disease.
C. Urine specific gravity and osmolality
Dehydration, reduced renal blood flow, and increase in ADH secretion elevate specific gravity.
Overhydration, early renal disease, and inadequate ADH secretion reduce specific gravity.
D. Liver function panel
If a decrease in liver function occurs such as with aging or liver disease, a medication is usually
eliminated more slowly, resulting in its accumulation. Patients are at risk for medication
toxicity if organs that metabolize medications are not functioning correctly.
A+ TEST BANK 4
