EVOLVE ELSEVIER HESI MEDICAL-SURGICAL
EXAM QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF
1. A patient with chronic kidney disease has a serum potassium level
of 6.2 mEq/L. Which intervention should the nurse anticipate first?
a. Administer IV furosemide
b. Administer sodium polystyrene sulfonate (Kayexalate)
c. Prepare the patient for dialysis
d. Encourage a high-potassium diet
b. Administer sodium polystyrene sulfonate (Kayexalate)
This medication binds potassium in the intestines and helps lower serum
potassium levels quickly, which is critical to prevent cardiac
complications.
2. A client with heart failure is prescribed furosemide. Which
assessment finding would indicate a possible adverse effect?
a. Peripheral edema
b. Dry cough
c. Hypokalemia
d. Hypertension
c. Hypokalemia
Furosemide is a loop diuretic that can cause potassium loss, leading to
hypokalemia.
, 3. The nurse is caring for a patient with cirrhosis who has ascites.
Which dietary instruction is most appropriate?
a. High-protein diet
b. Low-sodium diet
c. High-potassium diet
d. Fluid restriction only
b. Low-sodium diet
Reducing sodium intake helps decrease fluid retention and accumulation
of ascites.
4. A client with a history of deep vein thrombosis is started on
heparin therapy. Which laboratory test should the nurse monitor?
a. PT/INR
b. aPTT
c. Platelet count only
d. Serum fibrinogen
b. aPTT
Heparin therapy is monitored by activated partial thromboplastin time
(aPTT) to ensure therapeutic anticoagulation.
5. A patient is admitted with acute pancreatitis. Which symptom is
most characteristic?
a. Right lower quadrant pain
b. Epigastric pain radiating to the back
c. Sharp left shoulder pain
d. Midabdominal cramping relieved by defecation
b. Epigastric pain radiating to the back
Pancreatitis typically causes severe epigastric pain that may radiate to
the back due to pancreatic inflammation.
, 6. Which electrolyte imbalance is commonly associated with chronic
alcohol use?
a. Hyperkalemia
b. Hypomagnesemia
c. Hypercalcemia
d. Hyponatremia
b. Hypomagnesemia
Chronic alcohol use often causes malnutrition and magnesium loss,
leading to hypomagnesemia.
7. A patient with COPD is experiencing dyspnea. Which position
should the nurse encourage?
a. Supine with pillows under the knees
b. Prone on a firm mattress
c. High Fowler’s position
d. Trendelenburg position
c. High Fowler’s position
High Fowler’s position maximizes lung expansion and facilitates easier
breathing in patients with COPD.
8. The nurse is preparing to administer a blood transfusion. Which
action is a priority?
a. Document vital signs after 30 minutes
b. Verify patient identification and blood compatibility
c. Begin the transfusion slowly and increase rate gradually
d. Pre-medicate with acetaminophen
b. Verify patient identification and blood compatibility
Correct identification and blood type matching is essential to prevent
transfusion reactions.
, 9. A patient with myocardial infarction reports chest pain rated 8/10.
Which intervention should the nurse implement first?
a. Administer prescribed nitroglycerin
b. Obtain a 12-lead ECG
c. Assess vital signs
d. Administer morphine
c. Assess vital signs
Assessing vital signs first ensures patient stability and guides the safe
implementation of interventions like medications.
10. A client has a nasogastric tube connected to low intermittent
suction. Which nursing action is appropriate?
a. Irrigate tube every 2 hours
b. Monitor tube placement every 8 hours
c. Assess for abdominal distention and output
d. Remove tube after 24 hours
c. Assess for abdominal distention and output
Monitoring for distention and drainage ensures the tube is functioning
and prevents complications such as obstruction or perforation.
11. A patient receiving morphine for postoperative pain has a
respiratory rate of 8 breaths/min. Which action should the nurse
take?
a. Administer naloxone
b. Increase oxygen flow
c. Encourage deep breathing
d. Document and monitor
EXAM QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF
1. A patient with chronic kidney disease has a serum potassium level
of 6.2 mEq/L. Which intervention should the nurse anticipate first?
a. Administer IV furosemide
b. Administer sodium polystyrene sulfonate (Kayexalate)
c. Prepare the patient for dialysis
d. Encourage a high-potassium diet
b. Administer sodium polystyrene sulfonate (Kayexalate)
This medication binds potassium in the intestines and helps lower serum
potassium levels quickly, which is critical to prevent cardiac
complications.
2. A client with heart failure is prescribed furosemide. Which
assessment finding would indicate a possible adverse effect?
a. Peripheral edema
b. Dry cough
c. Hypokalemia
d. Hypertension
c. Hypokalemia
Furosemide is a loop diuretic that can cause potassium loss, leading to
hypokalemia.
, 3. The nurse is caring for a patient with cirrhosis who has ascites.
Which dietary instruction is most appropriate?
a. High-protein diet
b. Low-sodium diet
c. High-potassium diet
d. Fluid restriction only
b. Low-sodium diet
Reducing sodium intake helps decrease fluid retention and accumulation
of ascites.
4. A client with a history of deep vein thrombosis is started on
heparin therapy. Which laboratory test should the nurse monitor?
a. PT/INR
b. aPTT
c. Platelet count only
d. Serum fibrinogen
b. aPTT
Heparin therapy is monitored by activated partial thromboplastin time
(aPTT) to ensure therapeutic anticoagulation.
5. A patient is admitted with acute pancreatitis. Which symptom is
most characteristic?
a. Right lower quadrant pain
b. Epigastric pain radiating to the back
c. Sharp left shoulder pain
d. Midabdominal cramping relieved by defecation
b. Epigastric pain radiating to the back
Pancreatitis typically causes severe epigastric pain that may radiate to
the back due to pancreatic inflammation.
, 6. Which electrolyte imbalance is commonly associated with chronic
alcohol use?
a. Hyperkalemia
b. Hypomagnesemia
c. Hypercalcemia
d. Hyponatremia
b. Hypomagnesemia
Chronic alcohol use often causes malnutrition and magnesium loss,
leading to hypomagnesemia.
7. A patient with COPD is experiencing dyspnea. Which position
should the nurse encourage?
a. Supine with pillows under the knees
b. Prone on a firm mattress
c. High Fowler’s position
d. Trendelenburg position
c. High Fowler’s position
High Fowler’s position maximizes lung expansion and facilitates easier
breathing in patients with COPD.
8. The nurse is preparing to administer a blood transfusion. Which
action is a priority?
a. Document vital signs after 30 minutes
b. Verify patient identification and blood compatibility
c. Begin the transfusion slowly and increase rate gradually
d. Pre-medicate with acetaminophen
b. Verify patient identification and blood compatibility
Correct identification and blood type matching is essential to prevent
transfusion reactions.
, 9. A patient with myocardial infarction reports chest pain rated 8/10.
Which intervention should the nurse implement first?
a. Administer prescribed nitroglycerin
b. Obtain a 12-lead ECG
c. Assess vital signs
d. Administer morphine
c. Assess vital signs
Assessing vital signs first ensures patient stability and guides the safe
implementation of interventions like medications.
10. A client has a nasogastric tube connected to low intermittent
suction. Which nursing action is appropriate?
a. Irrigate tube every 2 hours
b. Monitor tube placement every 8 hours
c. Assess for abdominal distention and output
d. Remove tube after 24 hours
c. Assess for abdominal distention and output
Monitoring for distention and drainage ensures the tube is functioning
and prevents complications such as obstruction or perforation.
11. A patient receiving morphine for postoperative pain has a
respiratory rate of 8 breaths/min. Which action should the nurse
take?
a. Administer naloxone
b. Increase oxygen flow
c. Encourage deep breathing
d. Document and monitor
