EVOLVE ELSEVIER HESI MED SURG LATEST 2025/2026
TEST BANK
COMPLETE 350 REAL EXAM QUESTIONS AND CORRECT
ANSWERS WITH WELL-ELABORATED RATIONALES
1. A client is diagnosed with an acute small bowel obstruction. Which
assessment finding requires the most immediate intervention by the nurse?
A. Fever of 102° F
B. Blood pressure of 150/90 mm Hg
C. Abdominal cramping
D. Dry mucous membranes
Correct Answer: A
Rationale: A sudden increase in temperature is an indicator of peritonitis. The
nurse should notify the health care provider immediately. Options B, C, and D are
also findings that require intervention by the nurse but are of less priority than
option A.
2. In assessing a client diagnosed with primary aldosteronism, the nurse expects
the laboratory test results to indicate a decreased serum level of which
substance?
A. Sodium
B. Phosphate
C. Potassium
D. Glucose
,Correct Answer: C
Rationale: Primary aldosteronism leads to excessive secretion of aldosterone,
which causes increased renal excretion of potassium, resulting in hypokalemia.
Sodium is typically elevated or normal. Phosphate and glucose levels are not
directly affected.
3. A client with chronic kidney disease (CKD) is scheduled for hemodialysis.
Which laboratory value should the nurse report to the healthcare provider
immediately?
A. Serum potassium 6.2 mEq/L
B. Serum calcium 8.5 mg/dL
C. Hemoglobin 11 g/dL
D. Serum sodium 135 mEq/L
Correct Answer: A
Rationale: A serum potassium level of 6.2 mEq/L is critically high and places the
client at risk for life-threatening cardiac dysrhythmias. This requires immediate
intervention, such as urgent dialysis. The other values are within acceptable
ranges.
4. A nurse is caring for a client 4 hours after a thyroidectomy. The client reports
tingling around the mouth and fingertips. Which action should the nurse take
first?
A. Administer oral calcium gluconate
B. Assess for Chvostek's sign
C. Notify the healthcare provider
D. Elevate the head of the bed
,Correct Answer: B
Rationale: Tingling around the mouth and fingertips are early signs of
hypocalcemia due to accidental parathyroid injury or removal during surgery. The
nurse should first assess for Chvostek's sign (facial twitching when the facial nerve
is tapped) to confirm tetany before notifying the provider.
5. A client with heart failure is prescribed furosemide 40 mg IV. Which
assessment finding indicates the medication is effective?
A. Weight gain of 2 kg in 24 hours
B. Decreased crackles in lung bases
C. Blood pressure 90/60 mm Hg
D. Urine output of 20 mL/hour
Correct Answer: B
Rationale: Furosemide is a loop diuretic used to reduce fluid overload in heart
failure. Decreased crackles in the lung bases indicate reduced pulmonary
congestion, demonstrating effectiveness. Weight gain and low urine output
suggest fluid retention.
6. A client with diabetes mellitus type 1 is found unresponsive with cold,
clammy skin. Which action should the nurse take first?
A. Administer glucagon IM
B. Check blood glucose level
C. Give orange juice if able to swallow
D. Start an IV line with dextrose
Correct Answer: B
Rationale: The client is likely experiencing hypoglycemia given the cold, clammy
, skin and unresponsiveness. The priority is to confirm the blood glucose level
before administering any treatment to avoid worsening hyperglycemia if the
cause is diabetic ketoacidosis (DKA).
7. A nurse is assessing a client with cirrhosis. Which finding is most indicative of
hepatic encephalopathy?
A. Asterixis
B. Ascites
C. Spider angiomas
D. Jaundice
Correct Answer: A
Rationale: Asterixis (liver flap) is a motor disturbance characterized by a flapping
tremor of the hands when the wrists are extended. It is a classic sign of hepatic
encephalopathy due to accumulation of neurotoxins.
8. A client receiving chemotherapy reports nausea 2 hours after the infusion.
Which intervention is most appropriate?
A. Offer a large meal to settle the stomach
B. Administer a prescribed antiemetic before the next dose
C. Withhold antiemetics to avoid constipation
D. Encourage clear liquids only for 24 hours
Correct Answer: B
Rationale: Antiemetics should be administered prophylactically before
chemotherapy and on a scheduled basis to prevent nausea and vomiting. Waiting
until symptoms occur is less effective. Antiemetics should not be withheld
without provider order.
TEST BANK
COMPLETE 350 REAL EXAM QUESTIONS AND CORRECT
ANSWERS WITH WELL-ELABORATED RATIONALES
1. A client is diagnosed with an acute small bowel obstruction. Which
assessment finding requires the most immediate intervention by the nurse?
A. Fever of 102° F
B. Blood pressure of 150/90 mm Hg
C. Abdominal cramping
D. Dry mucous membranes
Correct Answer: A
Rationale: A sudden increase in temperature is an indicator of peritonitis. The
nurse should notify the health care provider immediately. Options B, C, and D are
also findings that require intervention by the nurse but are of less priority than
option A.
2. In assessing a client diagnosed with primary aldosteronism, the nurse expects
the laboratory test results to indicate a decreased serum level of which
substance?
A. Sodium
B. Phosphate
C. Potassium
D. Glucose
,Correct Answer: C
Rationale: Primary aldosteronism leads to excessive secretion of aldosterone,
which causes increased renal excretion of potassium, resulting in hypokalemia.
Sodium is typically elevated or normal. Phosphate and glucose levels are not
directly affected.
3. A client with chronic kidney disease (CKD) is scheduled for hemodialysis.
Which laboratory value should the nurse report to the healthcare provider
immediately?
A. Serum potassium 6.2 mEq/L
B. Serum calcium 8.5 mg/dL
C. Hemoglobin 11 g/dL
D. Serum sodium 135 mEq/L
Correct Answer: A
Rationale: A serum potassium level of 6.2 mEq/L is critically high and places the
client at risk for life-threatening cardiac dysrhythmias. This requires immediate
intervention, such as urgent dialysis. The other values are within acceptable
ranges.
4. A nurse is caring for a client 4 hours after a thyroidectomy. The client reports
tingling around the mouth and fingertips. Which action should the nurse take
first?
A. Administer oral calcium gluconate
B. Assess for Chvostek's sign
C. Notify the healthcare provider
D. Elevate the head of the bed
,Correct Answer: B
Rationale: Tingling around the mouth and fingertips are early signs of
hypocalcemia due to accidental parathyroid injury or removal during surgery. The
nurse should first assess for Chvostek's sign (facial twitching when the facial nerve
is tapped) to confirm tetany before notifying the provider.
5. A client with heart failure is prescribed furosemide 40 mg IV. Which
assessment finding indicates the medication is effective?
A. Weight gain of 2 kg in 24 hours
B. Decreased crackles in lung bases
C. Blood pressure 90/60 mm Hg
D. Urine output of 20 mL/hour
Correct Answer: B
Rationale: Furosemide is a loop diuretic used to reduce fluid overload in heart
failure. Decreased crackles in the lung bases indicate reduced pulmonary
congestion, demonstrating effectiveness. Weight gain and low urine output
suggest fluid retention.
6. A client with diabetes mellitus type 1 is found unresponsive with cold,
clammy skin. Which action should the nurse take first?
A. Administer glucagon IM
B. Check blood glucose level
C. Give orange juice if able to swallow
D. Start an IV line with dextrose
Correct Answer: B
Rationale: The client is likely experiencing hypoglycemia given the cold, clammy
, skin and unresponsiveness. The priority is to confirm the blood glucose level
before administering any treatment to avoid worsening hyperglycemia if the
cause is diabetic ketoacidosis (DKA).
7. A nurse is assessing a client with cirrhosis. Which finding is most indicative of
hepatic encephalopathy?
A. Asterixis
B. Ascites
C. Spider angiomas
D. Jaundice
Correct Answer: A
Rationale: Asterixis (liver flap) is a motor disturbance characterized by a flapping
tremor of the hands when the wrists are extended. It is a classic sign of hepatic
encephalopathy due to accumulation of neurotoxins.
8. A client receiving chemotherapy reports nausea 2 hours after the infusion.
Which intervention is most appropriate?
A. Offer a large meal to settle the stomach
B. Administer a prescribed antiemetic before the next dose
C. Withhold antiemetics to avoid constipation
D. Encourage clear liquids only for 24 hours
Correct Answer: B
Rationale: Antiemetics should be administered prophylactically before
chemotherapy and on a scheduled basis to prevent nausea and vomiting. Waiting
until symptoms occur is less effective. Antiemetics should not be withheld
without provider order.
