EVOLVE ELSEVIER HESI MED SURG
LATEST 2025 TEST BANK| COMPLETE
REAL EXAM QUESTIONS AND CORRECT
ANSWERS WITH WELL-ELABORATED
RATIONALES/ EVOLVE HESI MEDICAL
SURGICAL LATEST EXAM 2025 (BRAND
NEW!!)
Instructions: Most items are single-best-answer multiple
choice; a few are SATA or short calculations. Read each
rationale carefully — they’re intentionally thorough.
1. A patient arrives with crushing anterior chest pain
radiating to the left arm, diaphoresis, and nausea. ECG shows
ST-segment elevation in leads V2–V5. The nurse’s highest
priority action is:
A. Draw a lipid panel.
B. Administer sublingual nitroglycerin and prepare for
reperfusion therapy.
C. Give oral aspirin and schedule exercise stress test.
D. Obtain sputum culture.
Answer: B.
,Rationale: ST-elevation in V2–V5 suggests an acute anterior
STEMI (left anterior descending artery). Immediate
reperfusion is critical — nitroglycerin may relieve ischemic
pain (unless hypotensive or on PDE-5 inhibitors) and rapid
activation of cath lab/PCI or fibrinolysis as indicated is
essential. Aspirin is also given emergently (chewable), but
waiting for stress test or noncardiac tests is inappropriate.
Sputum culture irrelevant.
2. A client with heart failure has BNP of 1200 pg/mL (normal
<100). Which statement best reflects BNP interpretation?
A. BNP is low; heart failure is unlikely.
B. Elevated BNP correlates with increased ventricular
stretch and supports diagnosis of heart failure and severity.
C. BNP measures liver function.
D. BNP increases only with renal failure but not heart failure.
Answer: B.
Rationale: Brain natriuretic peptide (BNP) is released from
ventricles in response to stretch; very elevated levels
support diagnosis of HF and correlate with severity. Renal
impairment can raise BNP but it remains a cardiac marker;
it’s not a liver test.
3. A client is prescribed lisinopril for hypertension. Which
assessment finding requires immediate nursing action?
A. Dry cough that started after medication began.
B. Serum potassium of 6.1 mEq/L.
C. Mild lightheadedness on standing.
,D. Controlled blood pressure 118/72 mm Hg.
Answer: B.
Rationale: ACE inhibitors can cause hyperkalemia through
decreased aldosterone; K+ of 6.1 is life-threatening (risk of
arrhythmia) and requires immediate action. Dry cough is a
common side effect but not emergent. Orthostatic symptoms
should be evaluated but are less urgent than severe
hyperkalemia.
4. A patient with atrial fibrillation (AFib) is on warfarin. INR
values should typically be maintained in which therapeutic
range for nonvalvular AFib anticoagulation?
A. 0.5–1.0
B. 1.0–1.5
C. 2.0–3.0
D. 4.5–5.5
Answer: C.
Rationale: Standard therapeutic INR for most indications,
including nonvalvular AFib, is 2.0–3.0. Lower ranges are
subtherapeutic; higher ranges increase bleeding risk unless
specific indications require higher INR.
5. A nurse is caring for a post-op CABG patient with chest
tube drainage of 500 mL in the last hour and increasing
heart rate and low urine output. The nurse should:
A. Continue current care; chest tube output is acceptable.
B. Notify the surgeon immediately — this may indicate
postoperative hemorrhage.
C. Clamp the chest tube to slow bleeding.
D. Give IV fluids only and observe.
Answer: B.
, Rationale: Excessive chest tube drainage (e.g., >200 mL/hr
sustained, or sudden large amounts) plus tachycardia and
oliguria suggests possible hemorrhagic shock — immediate
surgical notification and preparation for intervention (e.g.,
return to OR) is required. Do NOT clamp chest tube (can
cause tamponade). IV fluids may be needed but surgeon
must be notified.
6. A patient with a new diagnosis of heart failure asks which
lifestyle measure is most important to prevent fluid
overload. Best response:
A. Limit daily sodium intake, weigh daily, and report >2 lb
gain in 24 hours.
B. Eliminate protein in diet.
C. Avoid all fluids completely.
D. Take ibuprofen for any muscle aches.
Answer: A.
Rationale: Sodium restriction, daily weights, and early
reporting of weight gain are key self-management actions in
HF. Protein elimination not indicated; unrestricted NSAIDs
can cause sodium retention and worsen HF.
7. A 68-year-old patient with peripheral arterial disease
(PAD) reports severe calf pain after walking 4 blocks, but
pain resolves when resting. This is best described as:
A. Rest pain.
B. Intermittent claudication.
C. Phlebitis.
D. Deep venous thrombosis.
Answer: B.
Rationale: Intermittent claudication is exertional muscle
LATEST 2025 TEST BANK| COMPLETE
REAL EXAM QUESTIONS AND CORRECT
ANSWERS WITH WELL-ELABORATED
RATIONALES/ EVOLVE HESI MEDICAL
SURGICAL LATEST EXAM 2025 (BRAND
NEW!!)
Instructions: Most items are single-best-answer multiple
choice; a few are SATA or short calculations. Read each
rationale carefully — they’re intentionally thorough.
1. A patient arrives with crushing anterior chest pain
radiating to the left arm, diaphoresis, and nausea. ECG shows
ST-segment elevation in leads V2–V5. The nurse’s highest
priority action is:
A. Draw a lipid panel.
B. Administer sublingual nitroglycerin and prepare for
reperfusion therapy.
C. Give oral aspirin and schedule exercise stress test.
D. Obtain sputum culture.
Answer: B.
,Rationale: ST-elevation in V2–V5 suggests an acute anterior
STEMI (left anterior descending artery). Immediate
reperfusion is critical — nitroglycerin may relieve ischemic
pain (unless hypotensive or on PDE-5 inhibitors) and rapid
activation of cath lab/PCI or fibrinolysis as indicated is
essential. Aspirin is also given emergently (chewable), but
waiting for stress test or noncardiac tests is inappropriate.
Sputum culture irrelevant.
2. A client with heart failure has BNP of 1200 pg/mL (normal
<100). Which statement best reflects BNP interpretation?
A. BNP is low; heart failure is unlikely.
B. Elevated BNP correlates with increased ventricular
stretch and supports diagnosis of heart failure and severity.
C. BNP measures liver function.
D. BNP increases only with renal failure but not heart failure.
Answer: B.
Rationale: Brain natriuretic peptide (BNP) is released from
ventricles in response to stretch; very elevated levels
support diagnosis of HF and correlate with severity. Renal
impairment can raise BNP but it remains a cardiac marker;
it’s not a liver test.
3. A client is prescribed lisinopril for hypertension. Which
assessment finding requires immediate nursing action?
A. Dry cough that started after medication began.
B. Serum potassium of 6.1 mEq/L.
C. Mild lightheadedness on standing.
,D. Controlled blood pressure 118/72 mm Hg.
Answer: B.
Rationale: ACE inhibitors can cause hyperkalemia through
decreased aldosterone; K+ of 6.1 is life-threatening (risk of
arrhythmia) and requires immediate action. Dry cough is a
common side effect but not emergent. Orthostatic symptoms
should be evaluated but are less urgent than severe
hyperkalemia.
4. A patient with atrial fibrillation (AFib) is on warfarin. INR
values should typically be maintained in which therapeutic
range for nonvalvular AFib anticoagulation?
A. 0.5–1.0
B. 1.0–1.5
C. 2.0–3.0
D. 4.5–5.5
Answer: C.
Rationale: Standard therapeutic INR for most indications,
including nonvalvular AFib, is 2.0–3.0. Lower ranges are
subtherapeutic; higher ranges increase bleeding risk unless
specific indications require higher INR.
5. A nurse is caring for a post-op CABG patient with chest
tube drainage of 500 mL in the last hour and increasing
heart rate and low urine output. The nurse should:
A. Continue current care; chest tube output is acceptable.
B. Notify the surgeon immediately — this may indicate
postoperative hemorrhage.
C. Clamp the chest tube to slow bleeding.
D. Give IV fluids only and observe.
Answer: B.
, Rationale: Excessive chest tube drainage (e.g., >200 mL/hr
sustained, or sudden large amounts) plus tachycardia and
oliguria suggests possible hemorrhagic shock — immediate
surgical notification and preparation for intervention (e.g.,
return to OR) is required. Do NOT clamp chest tube (can
cause tamponade). IV fluids may be needed but surgeon
must be notified.
6. A patient with a new diagnosis of heart failure asks which
lifestyle measure is most important to prevent fluid
overload. Best response:
A. Limit daily sodium intake, weigh daily, and report >2 lb
gain in 24 hours.
B. Eliminate protein in diet.
C. Avoid all fluids completely.
D. Take ibuprofen for any muscle aches.
Answer: A.
Rationale: Sodium restriction, daily weights, and early
reporting of weight gain are key self-management actions in
HF. Protein elimination not indicated; unrestricted NSAIDs
can cause sodium retention and worsen HF.
7. A 68-year-old patient with peripheral arterial disease
(PAD) reports severe calf pain after walking 4 blocks, but
pain resolves when resting. This is best described as:
A. Rest pain.
B. Intermittent claudication.
C. Phlebitis.
D. Deep venous thrombosis.
Answer: B.
Rationale: Intermittent claudication is exertional muscle
