1|Page
EVOLVE Elsevier HESI Medical-Surgical Exit Exam
Version 3 Study Guide 2025 | HESI Med-Surg Practice
Questions, Answers, and NCLEX Review
Ace your HESI Med-Surg Exit Exam Version 3 (2025) with this Elsevier Evolve-aligned
review. Covers adult health, clinical judgment, pharmacology, critical care, and nursing
priorities. Includes NCLEX-style and Next Gen (NGN) questions with rationales, scoring
guidance, and updated 2025 exam content.
• HESI Med Surg Exit Exam Version 3
• Elsevier Evolve HESI Med Surg 2025
• HESI Exit Exam Version 3 answers
• HESI Med Surg Version 3 study guide
•
A client with cirrhosis develops increasing pedal edema and ascites. What dietary modification is most
important for the nurse to teach this client? - ANSWER-Restrict salt and fluid intake.
Rationale
Salt and fluid restrictions are the first dietary modifications for a client who is retaining fluid as
manifested by edema and ascites.
A client's susceptibility to ulcerative colitis is most likely due to which aspect in the client's history? -
ANSWER-Jewish European ancestry.
Rationale
,2|Page
Ulcerative colitis is 4 to 5 times more common among individuals of Jewish European or Ashkenazi
ancestry.
A 32-year-old female client complains of severe abdominal pain each month before her menstrual
period, painful intercourse, and painful defecation. Which additional history should the nurse obtain that
is consistent with the client's complaints? - ANSWER-Inability to get pregnant.
Rationale
Dysmenorrhea, dyspareunia, and difficulty or painful defecation are common symptoms of
endometriosis, which is the abnormal displacement of endometrial tissue in the dependent areas of the
pelvic peritoneum. A history of infertility is another common finding associated with endometriosis.
A splint is prescribed for nighttime use by a client with rheumatoid arthritis. Which statement by the
nurse provides the most accurate explanation for use of the splints? - ANSWER-Prevention of
deformities.
Rationale
Splints may be used at night by clients with rheumatoid arthritis to prevent deformities caused by
muscle spasms and contractures.
The nurse knows that lab values sometimes vary for the older client. Which data would the nurse expect
to find when reviewing laboratory values of an 80-year-old male? - ANSWER-Increased protein in the
urine, slightly increased serum glucose levels.
Rationale
As older adults aged, the protein found in urine slightly rises as a result of kidney changes and the serum
glucose increases slightly, also due to changes in the kidney. The specific gravity declines by age 80 from
1.032 to 1.024.
,3|Page
A client with a completed ischemic stroke has a blood pressure of 180/90 mm Hg. Which action should
the nurse implement? - ANSWER-Give an antihypertensive medication.
Rationale
Most ischemic strokes occur during sleep when baseline blood pressure declines or blood viscosity
increases due to minimal fluid intake. Completed strokes usually produce neurologic deficits within an
hour, and the client's current elevated blood pressure requires antihypertensive medication.
A client with early breast cancer receives the results of a breast biopsy and asks the nurse to explain the
meaning of staging and the type of receptors found on the cancer cells. Which explanation should the
nurse provide? - ANSWER-The tumor's estrogen receptor guides treatment options.
Rationale
Treatment decisions and prediction of prognosis are related to the tumor's receptor status, such as
estrogen and progesterone receptor status which commonly are well-differentiated, have a lower chance
of recurrence, and are receptive to hormonal therapy. Tumor staging designates tumor size and spread
of breast cancer cells into axillary lymph nodes, which is one of the most important prognostic factors in
early-stage breast cancer.
In preparing a discharge plan for a 22-year-old male client diagnosed with Buerger's disease
(thromboangiitis obliterans), which referral is most important? - ANSWER-Smoking cessation program.
Rationale
Buerger's disease is strongly related to smoking or the use of some other form of tobacco which affects
the circulation in the arms and legs leading to infection and gangrene and sometimes amputation of the
affected area. The most effective means of controlling symptoms and disease progression is through
smoking cessation. The cause of Buerger's disease is unknown; a genetic predisposition is possible, but
unproven.
, 4|Page
A 57-year-old male client is scheduled to have a stress-thallium test the following morning and is NPO
after midnight. At 0130, he is agitated because he cannot eat and is demanding food. Which response is
best for the nurse to provide to this client? - ANSWER-"The test you are having tomorrow requires that
you have nothing by mouth tonight."
Rationale
Being direct and explaining to the client that the test requires him to be NPO, is the most therapeutic
statement because the nurse is responding to the client's question and providing him the reason why.
A female client is brought to the clinic by her daughter for a flu shot. She has lost significant weight since
the last visit. She has poor personal hygiene and inadequate clothing for the weather. The client states
that she lives alone and denies problems or concerns. What action should the nurse implement? -
ANSWER-Collect further data to determine whether self-neglect is occurring.
Rationale
Changes in weight and hygiene may be indicators of self-neglect or neglect by family members. Further
assessment is needed before notifying social services or discussing a need for counseling.
Which intervention should the nurse plan to implement when caring for a client who has just undergone
a right above-the-knee amputation? - ANSWER-Place a large tourniquet at the client's bedside.
Rationale
A large tourniquet should be placed in plain sight at the client's bedside, in the event severe bleeding
occurs. The purpose is to have the tourniquet available to applied to the residual limb to control
bleeding if hemorrhaging was to occur. The residual limb should not be placed on a pillow because a
flexion contracture of the hip may result and the client should be encouraged to lie in the prone position
to prevent flexion contracture of the hip.
An elderly client is admitted with a diagnosis of bacterial pneumonia. The nurse's assessment of the
client will most likely reveal which sign/symptom? - ANSWER-Confusion and tachycardia.
EVOLVE Elsevier HESI Medical-Surgical Exit Exam
Version 3 Study Guide 2025 | HESI Med-Surg Practice
Questions, Answers, and NCLEX Review
Ace your HESI Med-Surg Exit Exam Version 3 (2025) with this Elsevier Evolve-aligned
review. Covers adult health, clinical judgment, pharmacology, critical care, and nursing
priorities. Includes NCLEX-style and Next Gen (NGN) questions with rationales, scoring
guidance, and updated 2025 exam content.
• HESI Med Surg Exit Exam Version 3
• Elsevier Evolve HESI Med Surg 2025
• HESI Exit Exam Version 3 answers
• HESI Med Surg Version 3 study guide
•
A client with cirrhosis develops increasing pedal edema and ascites. What dietary modification is most
important for the nurse to teach this client? - ANSWER-Restrict salt and fluid intake.
Rationale
Salt and fluid restrictions are the first dietary modifications for a client who is retaining fluid as
manifested by edema and ascites.
A client's susceptibility to ulcerative colitis is most likely due to which aspect in the client's history? -
ANSWER-Jewish European ancestry.
Rationale
,2|Page
Ulcerative colitis is 4 to 5 times more common among individuals of Jewish European or Ashkenazi
ancestry.
A 32-year-old female client complains of severe abdominal pain each month before her menstrual
period, painful intercourse, and painful defecation. Which additional history should the nurse obtain that
is consistent with the client's complaints? - ANSWER-Inability to get pregnant.
Rationale
Dysmenorrhea, dyspareunia, and difficulty or painful defecation are common symptoms of
endometriosis, which is the abnormal displacement of endometrial tissue in the dependent areas of the
pelvic peritoneum. A history of infertility is another common finding associated with endometriosis.
A splint is prescribed for nighttime use by a client with rheumatoid arthritis. Which statement by the
nurse provides the most accurate explanation for use of the splints? - ANSWER-Prevention of
deformities.
Rationale
Splints may be used at night by clients with rheumatoid arthritis to prevent deformities caused by
muscle spasms and contractures.
The nurse knows that lab values sometimes vary for the older client. Which data would the nurse expect
to find when reviewing laboratory values of an 80-year-old male? - ANSWER-Increased protein in the
urine, slightly increased serum glucose levels.
Rationale
As older adults aged, the protein found in urine slightly rises as a result of kidney changes and the serum
glucose increases slightly, also due to changes in the kidney. The specific gravity declines by age 80 from
1.032 to 1.024.
,3|Page
A client with a completed ischemic stroke has a blood pressure of 180/90 mm Hg. Which action should
the nurse implement? - ANSWER-Give an antihypertensive medication.
Rationale
Most ischemic strokes occur during sleep when baseline blood pressure declines or blood viscosity
increases due to minimal fluid intake. Completed strokes usually produce neurologic deficits within an
hour, and the client's current elevated blood pressure requires antihypertensive medication.
A client with early breast cancer receives the results of a breast biopsy and asks the nurse to explain the
meaning of staging and the type of receptors found on the cancer cells. Which explanation should the
nurse provide? - ANSWER-The tumor's estrogen receptor guides treatment options.
Rationale
Treatment decisions and prediction of prognosis are related to the tumor's receptor status, such as
estrogen and progesterone receptor status which commonly are well-differentiated, have a lower chance
of recurrence, and are receptive to hormonal therapy. Tumor staging designates tumor size and spread
of breast cancer cells into axillary lymph nodes, which is one of the most important prognostic factors in
early-stage breast cancer.
In preparing a discharge plan for a 22-year-old male client diagnosed with Buerger's disease
(thromboangiitis obliterans), which referral is most important? - ANSWER-Smoking cessation program.
Rationale
Buerger's disease is strongly related to smoking or the use of some other form of tobacco which affects
the circulation in the arms and legs leading to infection and gangrene and sometimes amputation of the
affected area. The most effective means of controlling symptoms and disease progression is through
smoking cessation. The cause of Buerger's disease is unknown; a genetic predisposition is possible, but
unproven.
, 4|Page
A 57-year-old male client is scheduled to have a stress-thallium test the following morning and is NPO
after midnight. At 0130, he is agitated because he cannot eat and is demanding food. Which response is
best for the nurse to provide to this client? - ANSWER-"The test you are having tomorrow requires that
you have nothing by mouth tonight."
Rationale
Being direct and explaining to the client that the test requires him to be NPO, is the most therapeutic
statement because the nurse is responding to the client's question and providing him the reason why.
A female client is brought to the clinic by her daughter for a flu shot. She has lost significant weight since
the last visit. She has poor personal hygiene and inadequate clothing for the weather. The client states
that she lives alone and denies problems or concerns. What action should the nurse implement? -
ANSWER-Collect further data to determine whether self-neglect is occurring.
Rationale
Changes in weight and hygiene may be indicators of self-neglect or neglect by family members. Further
assessment is needed before notifying social services or discussing a need for counseling.
Which intervention should the nurse plan to implement when caring for a client who has just undergone
a right above-the-knee amputation? - ANSWER-Place a large tourniquet at the client's bedside.
Rationale
A large tourniquet should be placed in plain sight at the client's bedside, in the event severe bleeding
occurs. The purpose is to have the tourniquet available to applied to the residual limb to control
bleeding if hemorrhaging was to occur. The residual limb should not be placed on a pillow because a
flexion contracture of the hip may result and the client should be encouraged to lie in the prone position
to prevent flexion contracture of the hip.
An elderly client is admitted with a diagnosis of bacterial pneumonia. The nurse's assessment of the
client will most likely reveal which sign/symptom? - ANSWER-Confusion and tachycardia.
