EVOLVE ELSEVIER HESI MED SURG
EVOLVE ELSEVIER HESI MED SURG ACTUAL
EXAM WITH 350 REAL EXAM QUESTIONS AND
CORRECT ANSWERS WITH WELL-
ELABORATED RATIONALES/ EVOLVE HESI
MEDICAL SURGICAL LATEST EXAM 2025-2026
(latest) ACE YOUR TEST GRADED A+ -PDF
A central venous catheter has been inserted via a jugular vein, and a radiograph has confirmed placement of
the catheter. A prescription has been received for a medication STAT, but IV fluids have not yet been started.
Which action should the nurse take prior to administering the prescribed medication?
A. Assess for signs of jugular venous distention.
B. Obtain the needed intravenous solution.
C. Flush the line with heparinized solution.
D. Flush the line with normal saline.
D
Rationale:Medication can be administered via a central line without additional IV fluids. The line should first be
flushed with a normal saline solution to ensure patency. Insufficient evidence exists on the effectiveness of
flushing catheters with heparin. Option A will not affect the decision to administer the medication and is not a
priority. Administration of the medication STAT is of greater priority than option B.
Which data would the nurse expect to find when reviewing laboratory values of an 80-year-old man who is in
good health overall?
A. Complete blood count reveals increased white blood cell (WBC) and decreased red blood cell (RBC)
counts.
B. Chemistries reveal an increased serum bilirubin level with slightly increased liver enzyme levels.
C. Urinalysis reveals slight protein in the urine and bacteriuria, with pyuria.
D. Serum electrolytes reveal a decreased sodium level and increased potassium level.
TEST BANK 1
, EVOLVE ELSEVIER HESI MED SURG
C
Rationale: In older adults, the protein found in urine slightly rises, probably as a result of kidney changes or
subclinical urinary tract infections, and clients frequently experience asymptomatic bacteriuria and pyuria as a
result of incomplete bladder emptying. Laboratory findings in options A, B, and D are not considered to be
normal findings in an older adult.
The nurse witnesses a baseball player receive a blunt trauma to the back of the head with a softball. What
assessment data should the nurse collect immediately?
A. Reactivity of deep tendon reflexes, comparing upper with lower extremities
B. Vital sign readings, excluding blood pressure if needed equipment is unavailable
C. Memory of events that occurred before and after the blow to the head
D. Ability to open the eyes spontaneously before any tactile stimuli are given
D
Rationale: The level of consciousness (LOC) should be established immediately when a head injury has occurred.
Spontaneous eye opening is a simple measure of alertness that indicates that arousal mechanisms are intact.
Option A is not the best indicator of LOC. Although option B is important, vital signs are not the best indicators
of LOC and can be evaluated after the client's LOC has been determined. Option C can be assessed after LOC
has been established by assessing eye opening.
A client diagnosed with angina pectoris complains of chest pain while ambulating in the hallway. Which
action should the nurse implement first?
A. Support the client to a sitting position.
B. Ask the client to walk slowly back to the room.
C. Administer a sublingual nitroglycerin tablet.
D. Provide oxygen via nasal cannula.
A
Rationale: The nurse should safely assist the client to a resting position and then perform options C and D. The
client must cease all activity immediately, which will decrease the oxygen requirement of the myocardial muscle.
After these interventions are implemented, the client can be escorted back to the room via wheelchair or stretcher.
!
In assessing a client with an arteriovenous (AV) shunt who is scheduled for dialysis today, the nurse notes the
absence of a thrill or bruit at the shunt site. What action should the nurse take?
A. Advise the client that the shunt is intact and ready for dialysis as scheduled.
B. Encourage the client to keep the shunt site elevated above the level of the heart.
C. Notify the health care provider of the findings immediately.
D. Flush the site at least once with a heparinized saline solution.
C
Rationale: Absence of a thrill or bruit indicates that the shunt may be obstructed. The nurse should notify the
health care provider so that intervention can be initiated to restore function of the shunt. Option A is incorrect.
TEST BANK 2
, EVOLVE ELSEVIER HESI MED SURG
Option B will not resolve the obstruction. An AV shunt is internal and cannot be flushed without access using
special needles.
.!
The nurse initiates neurologic checks for a client who is at risk for neurologic compromise. Which
manifestation typically provides the first indication of altered neurologic function?
A. Change in level of consciousness
B. Increasing muscular weakness
C. Changes in pupil size bilaterally
D. Progressive nuchal rigidity
A
Rationale: A decrease or change in the level of consciousness is usually the first indication of neurologic
deterioration. Options B and C may also occur but are much less likely to be the first sign of neurologic
compromise. Option D is often a sign of meningitis.
What is the most important nursing priority for a client who has been admitted for a possible kidney stone?
A. Reducing dairy products in the diet
B. Straining all urine
C. Measuring intake and output
D. Increasing fluid intake
B
Rationale: Straining all urine is the most important nursing action to take in this case. Encouraging fluid intake
is important for any client who may have a kidney stone, but it is even more important to strain all urine.
Straining urine will enable the nurse to determine when the kidney stone has been passed and may prevent the
need for surgery. Option C is not the highest priority action. Option A is usually not recommended until the stone
is obtained and the content of the stone is determined. Even then, dietary restrictions are controversial.
.!
During the shift report, the charge nurse informs a nurse that she has been assigned to another unit for the
day. The nurse begins to sigh deeply and tosses about her belongings as she prepares to leave, making it
known that she is very unhappy about being floated to the other unit. What is the best immediate action for
the charge nurse to take?
A. Continue with the shift report and talk to the nurse about the incident at a later time.
B. Ask the nurse to call the house supervisor to see if she must be reassigned.
C. Stop the shift report and remind the nurse that all staff are floated equally.
D. Inform the nurse that her behavior is disruptive to the rest of the staff.
A
Rationale: Continuing with the shift report is the best immediate action because it allows the nurse who was
floated some cooling off time. At a later time (after the nurse has cooled off) the charge nurse should discuss the
conduct of the nurse in private. Option B encourages the nurse to shirk the float assignment. Option C is
TEST BANK 3
, EVOLVE ELSEVIER HESI MED SURG
disruptive. Reprimanding the nurse in front of the staff would increase the nurse's hostility, so the nurse should
be counseled in private.
The nurse is counseling a healthy 30-year-old female client regarding osteoporosis prevention. Which activity
would be most beneficial in achieving the client's goal of osteoporosis prevention?
A. Cross-country skiing
B. Scuba diving
C. Horseback riding
D. Kayaking
A
Rationale: Weight-bearing exercise is an important measure to reduce the risk of osteoporosis. Of the activities
listed, cross-country skiing includes the most weight-bearing, whereas options B, C, and D involve less.
The nurse is interviewing a client who is taking interferon-alfa-2a (Roferon-A) and ribavirin (Virazole)
combination therapy for hepatitis C. The client reports experiencing overwhelming feelings of depression.
Which action should the nurse implement first?
A.Recommend mental health counseling.
B. Review the medication actions and interactions.
C. Assess for the client's daily activity level.
D. Provide information regarding a support group.
B
Rationale: Interferon-alfa-2a and ribavirin combination therapy can cause severe depression; therefore, it is
most important for the nurse to review the medication effects and report these to the health care provider. Options
A, C, and D might be implemented after the physiologic aspects of the situation have been assessed.
The nurse is giving preoperative instructions to a 14-year-old client scheduled for surgery to correct a spinal
curvature. Which statement by the client best demonstrates that learning has taken place?
A.
"I will read all the teaching booklets you gave me before surgery."
B.
"I have had surgery before, so I know what to expect afterward."
C.
"All the things people have told me will help me take care of my back."
D.
"Let me show you the method of turning I will use after surgery."
D
Rationale: The outcome of learning is best demonstrated when the client not only verbalizes an understanding
but can also provide a return demonstration. A 14-year-old client may or may not follow through with option A,
and there is no measurement of learning. Option B may help the client understand the surgical process, but the
type of surgery may have been very different, with differing postoperative care. In option C, the client may be
saying what the nurse wants to hear without expressing any real understanding of what to do after surgery.
Client census is often used to determine staffing needs. Which method of obtaining census determination for a
particular unit provides the best formula for determining long-range staffing patterns?
TEST BANK 4
EVOLVE ELSEVIER HESI MED SURG ACTUAL
EXAM WITH 350 REAL EXAM QUESTIONS AND
CORRECT ANSWERS WITH WELL-
ELABORATED RATIONALES/ EVOLVE HESI
MEDICAL SURGICAL LATEST EXAM 2025-2026
(latest) ACE YOUR TEST GRADED A+ -PDF
A central venous catheter has been inserted via a jugular vein, and a radiograph has confirmed placement of
the catheter. A prescription has been received for a medication STAT, but IV fluids have not yet been started.
Which action should the nurse take prior to administering the prescribed medication?
A. Assess for signs of jugular venous distention.
B. Obtain the needed intravenous solution.
C. Flush the line with heparinized solution.
D. Flush the line with normal saline.
D
Rationale:Medication can be administered via a central line without additional IV fluids. The line should first be
flushed with a normal saline solution to ensure patency. Insufficient evidence exists on the effectiveness of
flushing catheters with heparin. Option A will not affect the decision to administer the medication and is not a
priority. Administration of the medication STAT is of greater priority than option B.
Which data would the nurse expect to find when reviewing laboratory values of an 80-year-old man who is in
good health overall?
A. Complete blood count reveals increased white blood cell (WBC) and decreased red blood cell (RBC)
counts.
B. Chemistries reveal an increased serum bilirubin level with slightly increased liver enzyme levels.
C. Urinalysis reveals slight protein in the urine and bacteriuria, with pyuria.
D. Serum electrolytes reveal a decreased sodium level and increased potassium level.
TEST BANK 1
, EVOLVE ELSEVIER HESI MED SURG
C
Rationale: In older adults, the protein found in urine slightly rises, probably as a result of kidney changes or
subclinical urinary tract infections, and clients frequently experience asymptomatic bacteriuria and pyuria as a
result of incomplete bladder emptying. Laboratory findings in options A, B, and D are not considered to be
normal findings in an older adult.
The nurse witnesses a baseball player receive a blunt trauma to the back of the head with a softball. What
assessment data should the nurse collect immediately?
A. Reactivity of deep tendon reflexes, comparing upper with lower extremities
B. Vital sign readings, excluding blood pressure if needed equipment is unavailable
C. Memory of events that occurred before and after the blow to the head
D. Ability to open the eyes spontaneously before any tactile stimuli are given
D
Rationale: The level of consciousness (LOC) should be established immediately when a head injury has occurred.
Spontaneous eye opening is a simple measure of alertness that indicates that arousal mechanisms are intact.
Option A is not the best indicator of LOC. Although option B is important, vital signs are not the best indicators
of LOC and can be evaluated after the client's LOC has been determined. Option C can be assessed after LOC
has been established by assessing eye opening.
A client diagnosed with angina pectoris complains of chest pain while ambulating in the hallway. Which
action should the nurse implement first?
A. Support the client to a sitting position.
B. Ask the client to walk slowly back to the room.
C. Administer a sublingual nitroglycerin tablet.
D. Provide oxygen via nasal cannula.
A
Rationale: The nurse should safely assist the client to a resting position and then perform options C and D. The
client must cease all activity immediately, which will decrease the oxygen requirement of the myocardial muscle.
After these interventions are implemented, the client can be escorted back to the room via wheelchair or stretcher.
!
In assessing a client with an arteriovenous (AV) shunt who is scheduled for dialysis today, the nurse notes the
absence of a thrill or bruit at the shunt site. What action should the nurse take?
A. Advise the client that the shunt is intact and ready for dialysis as scheduled.
B. Encourage the client to keep the shunt site elevated above the level of the heart.
C. Notify the health care provider of the findings immediately.
D. Flush the site at least once with a heparinized saline solution.
C
Rationale: Absence of a thrill or bruit indicates that the shunt may be obstructed. The nurse should notify the
health care provider so that intervention can be initiated to restore function of the shunt. Option A is incorrect.
TEST BANK 2
, EVOLVE ELSEVIER HESI MED SURG
Option B will not resolve the obstruction. An AV shunt is internal and cannot be flushed without access using
special needles.
.!
The nurse initiates neurologic checks for a client who is at risk for neurologic compromise. Which
manifestation typically provides the first indication of altered neurologic function?
A. Change in level of consciousness
B. Increasing muscular weakness
C. Changes in pupil size bilaterally
D. Progressive nuchal rigidity
A
Rationale: A decrease or change in the level of consciousness is usually the first indication of neurologic
deterioration. Options B and C may also occur but are much less likely to be the first sign of neurologic
compromise. Option D is often a sign of meningitis.
What is the most important nursing priority for a client who has been admitted for a possible kidney stone?
A. Reducing dairy products in the diet
B. Straining all urine
C. Measuring intake and output
D. Increasing fluid intake
B
Rationale: Straining all urine is the most important nursing action to take in this case. Encouraging fluid intake
is important for any client who may have a kidney stone, but it is even more important to strain all urine.
Straining urine will enable the nurse to determine when the kidney stone has been passed and may prevent the
need for surgery. Option C is not the highest priority action. Option A is usually not recommended until the stone
is obtained and the content of the stone is determined. Even then, dietary restrictions are controversial.
.!
During the shift report, the charge nurse informs a nurse that she has been assigned to another unit for the
day. The nurse begins to sigh deeply and tosses about her belongings as she prepares to leave, making it
known that she is very unhappy about being floated to the other unit. What is the best immediate action for
the charge nurse to take?
A. Continue with the shift report and talk to the nurse about the incident at a later time.
B. Ask the nurse to call the house supervisor to see if she must be reassigned.
C. Stop the shift report and remind the nurse that all staff are floated equally.
D. Inform the nurse that her behavior is disruptive to the rest of the staff.
A
Rationale: Continuing with the shift report is the best immediate action because it allows the nurse who was
floated some cooling off time. At a later time (after the nurse has cooled off) the charge nurse should discuss the
conduct of the nurse in private. Option B encourages the nurse to shirk the float assignment. Option C is
TEST BANK 3
, EVOLVE ELSEVIER HESI MED SURG
disruptive. Reprimanding the nurse in front of the staff would increase the nurse's hostility, so the nurse should
be counseled in private.
The nurse is counseling a healthy 30-year-old female client regarding osteoporosis prevention. Which activity
would be most beneficial in achieving the client's goal of osteoporosis prevention?
A. Cross-country skiing
B. Scuba diving
C. Horseback riding
D. Kayaking
A
Rationale: Weight-bearing exercise is an important measure to reduce the risk of osteoporosis. Of the activities
listed, cross-country skiing includes the most weight-bearing, whereas options B, C, and D involve less.
The nurse is interviewing a client who is taking interferon-alfa-2a (Roferon-A) and ribavirin (Virazole)
combination therapy for hepatitis C. The client reports experiencing overwhelming feelings of depression.
Which action should the nurse implement first?
A.Recommend mental health counseling.
B. Review the medication actions and interactions.
C. Assess for the client's daily activity level.
D. Provide information regarding a support group.
B
Rationale: Interferon-alfa-2a and ribavirin combination therapy can cause severe depression; therefore, it is
most important for the nurse to review the medication effects and report these to the health care provider. Options
A, C, and D might be implemented after the physiologic aspects of the situation have been assessed.
The nurse is giving preoperative instructions to a 14-year-old client scheduled for surgery to correct a spinal
curvature. Which statement by the client best demonstrates that learning has taken place?
A.
"I will read all the teaching booklets you gave me before surgery."
B.
"I have had surgery before, so I know what to expect afterward."
C.
"All the things people have told me will help me take care of my back."
D.
"Let me show you the method of turning I will use after surgery."
D
Rationale: The outcome of learning is best demonstrated when the client not only verbalizes an understanding
but can also provide a return demonstration. A 14-year-old client may or may not follow through with option A,
and there is no measurement of learning. Option B may help the client understand the surgical process, but the
type of surgery may have been very different, with differing postoperative care. In option C, the client may be
saying what the nurse wants to hear without expressing any real understanding of what to do after surgery.
Client census is often used to determine staffing needs. Which method of obtaining census determination for a
particular unit provides the best formula for determining long-range staffing patterns?
TEST BANK 4
