Evolve med surg hesi quiz exam 2024-
2025 graded A+
A 20-year-old female client calls the nurse to report a lump she found in her breast.
Which response is the best for the nurse to provide?
A) Check it again in one month, and if it is still there schedule an appointment.
B) Most lumps are benign, but it is always best to come in for an examination.
C) Try not to worry too much about it, because usually, most lumps are benign.
D) If you are in your menstrual period it is not a good time to check for lumps. -
CORRECT ANSWERS B) Most lumps are benign, but it is always best to come in for
an examination.
(B) provides the best response because it addresses the client's anxiety most effectively
and encourages prompt and immediate action for a potential problem. (A) postpones
treatment if the lump is malignant, and does not relieve the client's anxiety. (C and D)
provide false reassurance and do not help relieve anxiety.
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?
A) Frequent urinary tract infections.
B) Inability to get pregnant.
C) Premenstrual syndrome.
D) Chronic use of laxatives. - CORRECT ANSWERS B) Inability to get pregnant.
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 (B) is another common
finding associated with endometriosis. Although (A, C, and D) are common, nonspecific
gynecological complaints, the most common complaints of the client with endometriosis
are pain and infertility.
A 49-year-old female client arrives at the clinic for an annual exam and asks the nurse
why she becomes excessively diaphoretic and feels warm during nighttime. What is the
nurse's best response?
A) Explain the effect of the follicle-stimulating and luteinizing hormones.
B) Discuss perimenopause and related comfort measures.
C) Assess lung fields and for a cough productive of blood-tinged mucous.
D) Ask if a fever above 101º F has occurred in the last 24 hours. - CORRECT
ANSWERS B) Discuss perimenopause and related comfort measures.
The perimenopausal period begins about 10 years before menopause with the
cessation of menstruation at the average ages of 52 to 54. Lower estrogen levels
causes FSH and LH secretion in bursts (surges), which triggers vasomotor instability,
,night sweats, and hot flashes, so discussions about the perimenopausal body's
changes, comfort measures (B), and treatment options should be provided. In-depth
pathophysiology of the symptoms (A) may only confuse the client. There is no indication
that the client has tuberculosis and an infection, so (C and D) are not indicated.
A 77-year-old female client is admitted to the hospital. She is confused, has no
appetite, is nauseated and vomiting, and is complaining of a headache. Her pulse rate
is 43 beats per minute. Which question is a priority for the nurse to ask this client or her
family on admission? "Does the client
A) have her own teeth or dentures?"
B) take aspirin and if so, how much?"
C) take nitroglycerin?"
D) take digitalis?" - CORRECT ANSWERS D) take digitalis?"
Elderly persons are particularly susceptible to digitalis intoxication (D) which manifests
itself in such symptoms as anorexia, nausea, vomiting, diarrhea, headache, and fatigue.
Although it is important to obtain a complete medication history (B and C), the
symptoms described are classic for digitalis toxicity, and assessment of this problem
should be made promptly. (A) is irrelevant.
A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry unit.
What initial medication should the nurse anticipate administering to the client?
A) Xylocaine (Lidocaine).
B) Procainamide (Pronestyl).
C) Phenytoin (Dilantin).
D) Digoxin (Lanoxin). - CORRECT ANSWERS D) Digoxin (Lanoxin).
Digoxin (Lanoxin) (D) is administered for uncontrolled, symptomatic atrial fibrillation
resulting in a decreased cardiac output. Digoxin slows the rate of conduction by
prolonging the refractory period of the AV node, thus slowing the ventricular response,
decreasing the heart rate, and effecting cardiac output. (A, B, and C) are not indicated
in the initial treatment of uncontrolled atrial fibrillation.
A client has a staging procedure for cancer of the breast and ask the nurse which type
of breast cancer has the poorest prognosis. Which information should the nurse offer
the client?
A) Stage II.
B) Invasive infiltrating ductal carcinoma.
C) T1N0M0.
D) Inflammatory with peau d'orange. - CORRECT ANSWERS D) Inflammatory with
peau d'orange.
Inflammatory breast cancer, which has a thickened appearance like an orange peel
(peau d'orange), is the most aggressive form of breast malignancies (D). Staging
classifies cancer by the extension or spread of the disease, and (A) indicates limited
local spread. (B) indicates cancer cells have spread from the ducts into the surrounding
, breast tissue only. TNM classification is used to indicate the extent of the disease
process according to tumor size, regional spread lymph nodes involvement, and
metastasis, and (C) indicates early cancer with small in situ involvement, no lymph node
involvement, and no distant metastases.
A client has undergone insertion of a permanent pacemaker. When developing a
discharge teaching plan, the nurse writes a goal of, "The client will verbalize symptoms
of pacemaker failure." Which symptoms are most important to teach the client?
A) Facial flushing.
B) Fever.
C) Pounding headache.
D) Feelings of dizziness. - CORRECT ANSWERS D) Feelings of dizziness.
Feelings of dizziness may occur as the result of a decreased heart rate, leading to
decreased cardiac output (D). (A and C) will not occur as the result of pacemaker
failure. (B) may be an indication of infection postoperatively, but is not an indication of
pacemaker failure.
A client is admitted to the hospital with a diagnosis of severe acute diverticulitis. Which
assessment finding should the nurse expect this client to exhibit?
A) Lower left quadrant pain and a low-grade fever.
B) Severe pain at McBurney's point and nausea.
C) Abdominal pain and intermittent tenesmus.
D) Exacerbations of severe diarrhea. - CORRECT ANSWERS A) Lower left quadrant
pain and a low-grade fever.
Left lower quadrant pain occurs with diverticulitis because the sigmoid colon is the most
common area for diverticula, and the inflammation of diverticula causes a low-grade
fever (A). (B) would be indicative of appendicitis. (C and D) are symptoms exhibited with
ulcerative colitis.
A client receiving cholestyramine (Questran) for hyperlipidemia should be evaluated for
what vitamin deficiency?
A) K.
B) B12.
C) B6.
D) C. - CORRECT ANSWERS A) K.
Clients should be monitored for an increased prothrombin time and prolonged bleeding
times which would alert the nurse to a vitamin K deficiency (A). These drugs reduce
absorption of the fat soluble (lipid) vitamins A, D, E, and K. (B, C, and D) are not fat
soluble vitamins.
A client reports unprotected sexual intercourse one week ago and is worried about HIV
exposure. An initial HIV antibody screen (ELISA) is obtained. The nurse teaches the
client that seroconversion to HIV positive relies on antibody production by B
2025 graded A+
A 20-year-old female client calls the nurse to report a lump she found in her breast.
Which response is the best for the nurse to provide?
A) Check it again in one month, and if it is still there schedule an appointment.
B) Most lumps are benign, but it is always best to come in for an examination.
C) Try not to worry too much about it, because usually, most lumps are benign.
D) If you are in your menstrual period it is not a good time to check for lumps. -
CORRECT ANSWERS B) Most lumps are benign, but it is always best to come in for
an examination.
(B) provides the best response because it addresses the client's anxiety most effectively
and encourages prompt and immediate action for a potential problem. (A) postpones
treatment if the lump is malignant, and does not relieve the client's anxiety. (C and D)
provide false reassurance and do not help relieve anxiety.
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?
A) Frequent urinary tract infections.
B) Inability to get pregnant.
C) Premenstrual syndrome.
D) Chronic use of laxatives. - CORRECT ANSWERS B) Inability to get pregnant.
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 (B) is another common
finding associated with endometriosis. Although (A, C, and D) are common, nonspecific
gynecological complaints, the most common complaints of the client with endometriosis
are pain and infertility.
A 49-year-old female client arrives at the clinic for an annual exam and asks the nurse
why she becomes excessively diaphoretic and feels warm during nighttime. What is the
nurse's best response?
A) Explain the effect of the follicle-stimulating and luteinizing hormones.
B) Discuss perimenopause and related comfort measures.
C) Assess lung fields and for a cough productive of blood-tinged mucous.
D) Ask if a fever above 101º F has occurred in the last 24 hours. - CORRECT
ANSWERS B) Discuss perimenopause and related comfort measures.
The perimenopausal period begins about 10 years before menopause with the
cessation of menstruation at the average ages of 52 to 54. Lower estrogen levels
causes FSH and LH secretion in bursts (surges), which triggers vasomotor instability,
,night sweats, and hot flashes, so discussions about the perimenopausal body's
changes, comfort measures (B), and treatment options should be provided. In-depth
pathophysiology of the symptoms (A) may only confuse the client. There is no indication
that the client has tuberculosis and an infection, so (C and D) are not indicated.
A 77-year-old female client is admitted to the hospital. She is confused, has no
appetite, is nauseated and vomiting, and is complaining of a headache. Her pulse rate
is 43 beats per minute. Which question is a priority for the nurse to ask this client or her
family on admission? "Does the client
A) have her own teeth or dentures?"
B) take aspirin and if so, how much?"
C) take nitroglycerin?"
D) take digitalis?" - CORRECT ANSWERS D) take digitalis?"
Elderly persons are particularly susceptible to digitalis intoxication (D) which manifests
itself in such symptoms as anorexia, nausea, vomiting, diarrhea, headache, and fatigue.
Although it is important to obtain a complete medication history (B and C), the
symptoms described are classic for digitalis toxicity, and assessment of this problem
should be made promptly. (A) is irrelevant.
A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry unit.
What initial medication should the nurse anticipate administering to the client?
A) Xylocaine (Lidocaine).
B) Procainamide (Pronestyl).
C) Phenytoin (Dilantin).
D) Digoxin (Lanoxin). - CORRECT ANSWERS D) Digoxin (Lanoxin).
Digoxin (Lanoxin) (D) is administered for uncontrolled, symptomatic atrial fibrillation
resulting in a decreased cardiac output. Digoxin slows the rate of conduction by
prolonging the refractory period of the AV node, thus slowing the ventricular response,
decreasing the heart rate, and effecting cardiac output. (A, B, and C) are not indicated
in the initial treatment of uncontrolled atrial fibrillation.
A client has a staging procedure for cancer of the breast and ask the nurse which type
of breast cancer has the poorest prognosis. Which information should the nurse offer
the client?
A) Stage II.
B) Invasive infiltrating ductal carcinoma.
C) T1N0M0.
D) Inflammatory with peau d'orange. - CORRECT ANSWERS D) Inflammatory with
peau d'orange.
Inflammatory breast cancer, which has a thickened appearance like an orange peel
(peau d'orange), is the most aggressive form of breast malignancies (D). Staging
classifies cancer by the extension or spread of the disease, and (A) indicates limited
local spread. (B) indicates cancer cells have spread from the ducts into the surrounding
, breast tissue only. TNM classification is used to indicate the extent of the disease
process according to tumor size, regional spread lymph nodes involvement, and
metastasis, and (C) indicates early cancer with small in situ involvement, no lymph node
involvement, and no distant metastases.
A client has undergone insertion of a permanent pacemaker. When developing a
discharge teaching plan, the nurse writes a goal of, "The client will verbalize symptoms
of pacemaker failure." Which symptoms are most important to teach the client?
A) Facial flushing.
B) Fever.
C) Pounding headache.
D) Feelings of dizziness. - CORRECT ANSWERS D) Feelings of dizziness.
Feelings of dizziness may occur as the result of a decreased heart rate, leading to
decreased cardiac output (D). (A and C) will not occur as the result of pacemaker
failure. (B) may be an indication of infection postoperatively, but is not an indication of
pacemaker failure.
A client is admitted to the hospital with a diagnosis of severe acute diverticulitis. Which
assessment finding should the nurse expect this client to exhibit?
A) Lower left quadrant pain and a low-grade fever.
B) Severe pain at McBurney's point and nausea.
C) Abdominal pain and intermittent tenesmus.
D) Exacerbations of severe diarrhea. - CORRECT ANSWERS A) Lower left quadrant
pain and a low-grade fever.
Left lower quadrant pain occurs with diverticulitis because the sigmoid colon is the most
common area for diverticula, and the inflammation of diverticula causes a low-grade
fever (A). (B) would be indicative of appendicitis. (C and D) are symptoms exhibited with
ulcerative colitis.
A client receiving cholestyramine (Questran) for hyperlipidemia should be evaluated for
what vitamin deficiency?
A) K.
B) B12.
C) B6.
D) C. - CORRECT ANSWERS A) K.
Clients should be monitored for an increased prothrombin time and prolonged bleeding
times which would alert the nurse to a vitamin K deficiency (A). These drugs reduce
absorption of the fat soluble (lipid) vitamins A, D, E, and K. (B, C, and D) are not fat
soluble vitamins.
A client reports unprotected sexual intercourse one week ago and is worried about HIV
exposure. An initial HIV antibody screen (ELISA) is obtained. The nurse teaches the
client that seroconversion to HIV positive relies on antibody production by B
