EVOLVE ELSEVIER HESI MED SURG 2026 TEST BANK – COMPLETE 400
REAL EXAM QUESTIONS WITH CORRECT ANSWERS & FULLY
ELABORATED RATIONALES | BRAND-NEW UPDATED MEDICAL-
SURGICAL EXAM PREP | PDF
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
action should the nurse take first?
A.Perform a complete cranial nerve assessment.
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.
Correct Answer: C
Rationale:A masklike expression and infrequent blinking are common clinical
features of parkinsonism. The nurse should document these expected findings.
Options A and D are not necessary. Signs of toxicity of levodopa-carbidopa include
dyskinesia, hallucinations, and psychosis.
A client who is receiving an angiotensin-converting enzyme (ACE) inhibitor for
hypertension calls the clinic and reports the recent onset of a cough to the
nurse. Which action should the nurse take first?
.
A. Advise the client to come to the clinic immediately for further assessment.
B. Instruct the client to discontinue use of the drug and to make an appointment
at the clinic.
C. Suggest that the client learn to accept the cough as a side effect to a
necessary prescription.
D. Encourage the client to keep taking the drug until seen by the health care
provider.
,Correct Answer: D
Rationale: Coughing is a common side effect of ACE inhibitors and is not an
indication to discontinue the medication. Immediate evaluation is not needed.
Antihypertensive medications should not be stopped abruptly because rebound
hypertension may occur. Option C is demeaning because the cough may be very
disruptive to the client, and other antihypertensive medications may produce the
desired effect without the adverse effect.
An emaciated homeless client presents to the emergency department
complaining of a productive cough, with blood-tinged sputum and night sweats.
Which action is most important for the emergency department triage nurse to
take for this client?
A. Initiate airborne infection precautions.
B. Place a surgical mask on the client.
C.Don an isolation gown and latex gloves.
D. Start protective (reverse) isolation precautions
Correct Answer: A
Rationale: This client is exhibiting classic symptoms of tuberculosis (TB), and the
client is from a high-risk population for TB. Therefore, airborne infection
precautions, which are indicated for TB, should be used with this client. Option B
is used with droplet precautions. There is no evidence that option C or D would be
warranted at this time.
The nurse is providing care to a client admitted to the emergency room with a
blood glucose level of 40 mg/dL and is semiconscious. What are the nurse's next
actions? (Select all that apply.)
A. Place 4 sugar cubes under the tongue.
B. Place 1 tablespoon of honey in the client's cheek.
C. Start an IV of Normal Saline.
D. Obtain a 50% dextrose solution.
E. Administer glucagon as per the standing order.
F. Turn the client to the side.
,Correct Answer: C,D,E,F
Rationale: Oral carbohydrates, such as sugar and honey, should never be given to
the semiconscious or unconscious clients with low blood sugar levels, for concern
for aspiration. Glucagon can be administered immediately, followed by starting an
IV. Await the orders for the 50% dextrose solution. Place the client in a side lying
position as there is a risk for vomiting and aspiration with these clients.
The nurse is assessing a client with acute pancreatitis. Which finding requires
the most immediate intervention by the nurse?
A. The client's amylase level is three times higher than the normal level.
B. The client has a carpal spasm when taking a blood pressure.
C. On a 1 to 10 scale, the client tells the nurse that her epigastric pain is at 7.
D. The client states that she will continue to drink alcohol after going home.
Correct Answer: B
Rationale: A positive Trousseau sign indicates hypocalcemia and always requires
further assessment and intervention, regardless of the cause (40% to 75% of
those with acute pancreatitis experience hypocalcemia, which can have serious,
systemic effects). A key diagnostic finding of pancreatitis is serum amylase and
lipase levels that are two to five times higher than the normal value. Severe
boring pain is an expected symptom for this diagnosis, but dealing with the
hypocalcemia is a priority over administering an analgesic. Long-term planning
and teaching do not have the same immediate importance as a positive
Trousseau sign.
Which content about self-care should the nurse include in the teaching plan of a
female client who has genital herpes? (Select all that apply.)
A.Encourage annual physical and Pap smear.
B. Take antiviral medication as prescribed.
C.Use condoms to avoid transmission to others.
D.Warm sitz baths may relieve itching.
E.Use Nystatin suppositories to control itching.
F.Use a douche with weak vinegar solution to decrease itching
, Correct Answer: A,B,C,D
Rationale: The nurse should include (A, B, C, and D) in the teaching plan of a
female client with genital herpes. (E) is specific for Candida infections, and option
(F) is used to treat Trichomonas.
The nurse is assessing a 75-year-old client for symptoms of hyperglycemia.
Which symptom of hyperglycemia is an older adult most likely to exhibit?
A. Polyuria
B. Polydipsia
C. Weight loss
D. Infection
Correct Answer: D
Rationale: Signs and symptoms of hyperglycemia in older adults may include
fatigue, infection, and evidence of neuropathy (e.g., sensory changes). The nurse
needs to remember that classic signs and symptoms of hyperglycemia, such as
options A, B, and C and polyphagia, may be absent in older adults.
The nurse on a medical-surgical unit is receiving a client from the postanesthesia
care unit (PACU) with a Penrose drain. Before choosing a room for this client,
which information is most important for the nurse to obtain?
A. If suctioning will be needed for drainage of the wound
B.If the family would prefer a private or semiprivate room
C.If the client also has a Hemovac in place
D. If the client's wound is infected
Correct Answer: D
Rationale: The fact that the client has a Penrose drain should alert the nurse to
the possibility that the surgical wound is infected. Penrose drains provide a sinus
tract or opening and are often used to provide drainage of an abscess. To avoid
contamination of another postoperative client, it is most important to place any
client with an infected wound in a private room. A Penrose drain does not require
option A. Although option B is helpful information, it does not have the priority of
REAL EXAM QUESTIONS WITH CORRECT ANSWERS & FULLY
ELABORATED RATIONALES | BRAND-NEW UPDATED MEDICAL-
SURGICAL EXAM PREP | PDF
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
action should the nurse take first?
A.Perform a complete cranial nerve assessment.
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.
Correct Answer: C
Rationale:A masklike expression and infrequent blinking are common clinical
features of parkinsonism. The nurse should document these expected findings.
Options A and D are not necessary. Signs of toxicity of levodopa-carbidopa include
dyskinesia, hallucinations, and psychosis.
A client who is receiving an angiotensin-converting enzyme (ACE) inhibitor for
hypertension calls the clinic and reports the recent onset of a cough to the
nurse. Which action should the nurse take first?
.
A. Advise the client to come to the clinic immediately for further assessment.
B. Instruct the client to discontinue use of the drug and to make an appointment
at the clinic.
C. Suggest that the client learn to accept the cough as a side effect to a
necessary prescription.
D. Encourage the client to keep taking the drug until seen by the health care
provider.
,Correct Answer: D
Rationale: Coughing is a common side effect of ACE inhibitors and is not an
indication to discontinue the medication. Immediate evaluation is not needed.
Antihypertensive medications should not be stopped abruptly because rebound
hypertension may occur. Option C is demeaning because the cough may be very
disruptive to the client, and other antihypertensive medications may produce the
desired effect without the adverse effect.
An emaciated homeless client presents to the emergency department
complaining of a productive cough, with blood-tinged sputum and night sweats.
Which action is most important for the emergency department triage nurse to
take for this client?
A. Initiate airborne infection precautions.
B. Place a surgical mask on the client.
C.Don an isolation gown and latex gloves.
D. Start protective (reverse) isolation precautions
Correct Answer: A
Rationale: This client is exhibiting classic symptoms of tuberculosis (TB), and the
client is from a high-risk population for TB. Therefore, airborne infection
precautions, which are indicated for TB, should be used with this client. Option B
is used with droplet precautions. There is no evidence that option C or D would be
warranted at this time.
The nurse is providing care to a client admitted to the emergency room with a
blood glucose level of 40 mg/dL and is semiconscious. What are the nurse's next
actions? (Select all that apply.)
A. Place 4 sugar cubes under the tongue.
B. Place 1 tablespoon of honey in the client's cheek.
C. Start an IV of Normal Saline.
D. Obtain a 50% dextrose solution.
E. Administer glucagon as per the standing order.
F. Turn the client to the side.
,Correct Answer: C,D,E,F
Rationale: Oral carbohydrates, such as sugar and honey, should never be given to
the semiconscious or unconscious clients with low blood sugar levels, for concern
for aspiration. Glucagon can be administered immediately, followed by starting an
IV. Await the orders for the 50% dextrose solution. Place the client in a side lying
position as there is a risk for vomiting and aspiration with these clients.
The nurse is assessing a client with acute pancreatitis. Which finding requires
the most immediate intervention by the nurse?
A. The client's amylase level is three times higher than the normal level.
B. The client has a carpal spasm when taking a blood pressure.
C. On a 1 to 10 scale, the client tells the nurse that her epigastric pain is at 7.
D. The client states that she will continue to drink alcohol after going home.
Correct Answer: B
Rationale: A positive Trousseau sign indicates hypocalcemia and always requires
further assessment and intervention, regardless of the cause (40% to 75% of
those with acute pancreatitis experience hypocalcemia, which can have serious,
systemic effects). A key diagnostic finding of pancreatitis is serum amylase and
lipase levels that are two to five times higher than the normal value. Severe
boring pain is an expected symptom for this diagnosis, but dealing with the
hypocalcemia is a priority over administering an analgesic. Long-term planning
and teaching do not have the same immediate importance as a positive
Trousseau sign.
Which content about self-care should the nurse include in the teaching plan of a
female client who has genital herpes? (Select all that apply.)
A.Encourage annual physical and Pap smear.
B. Take antiviral medication as prescribed.
C.Use condoms to avoid transmission to others.
D.Warm sitz baths may relieve itching.
E.Use Nystatin suppositories to control itching.
F.Use a douche with weak vinegar solution to decrease itching
, Correct Answer: A,B,C,D
Rationale: The nurse should include (A, B, C, and D) in the teaching plan of a
female client with genital herpes. (E) is specific for Candida infections, and option
(F) is used to treat Trichomonas.
The nurse is assessing a 75-year-old client for symptoms of hyperglycemia.
Which symptom of hyperglycemia is an older adult most likely to exhibit?
A. Polyuria
B. Polydipsia
C. Weight loss
D. Infection
Correct Answer: D
Rationale: Signs and symptoms of hyperglycemia in older adults may include
fatigue, infection, and evidence of neuropathy (e.g., sensory changes). The nurse
needs to remember that classic signs and symptoms of hyperglycemia, such as
options A, B, and C and polyphagia, may be absent in older adults.
The nurse on a medical-surgical unit is receiving a client from the postanesthesia
care unit (PACU) with a Penrose drain. Before choosing a room for this client,
which information is most important for the nurse to obtain?
A. If suctioning will be needed for drainage of the wound
B.If the family would prefer a private or semiprivate room
C.If the client also has a Hemovac in place
D. If the client's wound is infected
Correct Answer: D
Rationale: The fact that the client has a Penrose drain should alert the nurse to
the possibility that the surgical wound is infected. Penrose drains provide a sinus
tract or opening and are often used to provide drainage of an abscess. To avoid
contamination of another postoperative client, it is most important to place any
client with an infected wound in a private room. A Penrose drain does not require
option A. Although option B is helpful information, it does not have the priority of
