[STUDY GUIDE] • HIGH-YIELD PRACTICE & REVIEW EDITION
EVOLVE ELSEVIER HESI MED SURG
LATEST UPDATE 2026/2027 EXAM
QUESTIONS WITH RATIONALIZED
ACCURATE ANSWERS
Comprehensive Examination Question Bank • In-Depth Rationales • Concept Mapping
TOTAL QUESTIONS EXAM TOPICS RATIONALES
100 Questions 12 Modules 100% Verified
DOCUMENT OVERVIEW
This 2026/2027 study guide compiles 100 comprehensive curriculum-aligned clinical practice questions for
EVOLVE ELSEVIER HESI MED, coupling 100% verified correct answers alongside in-depth explanatory
rationales that clarify diagnostic reasoning. Each section organizes related questions into focused clinical
topics and specialized subtopics spanning Blood Cell Count, Total Hip Arthroplasty, and emergency care
standards, pairing verified solutions with clinical rationales. Learners can use this resource to strengthen
clinical judgment skills, validate bedside decision-making through active self-assessment, and systematically
master high-yield concepts prior to examination day.
EXAM BLUEPRINT & TOPIC DISTRIBUTION
Systematic breakdown of subject domains and exam coverage.
Topic Module Scope & Core Focus Questions Share (%)
This topic covers postoperative care and complications
Total Hip Arthroplasty related to total hip arthroplasty. 9 Qs 9.0%
This topic focuses on the diagnosis, management, and
Acute Pancreatitis complications of acute pancreatitis. 9 Qs 9.0%
This topic addresses respiratory rate, interventions, and
Respiratory Assessment complications in patients with respiratory distress. 9 Qs 9.0%
This topic examines acute complications and management
Diabetes Management strategies for patients with diabetes. 9 Qs 9.0%
Confidential • Student Study Edition • Practice & Review Guide Page 1 of 67
,STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
This topic includes assessment and management of acute
Cardiac Emergencies cardiac conditions. 8 Qs 8.0%
This topic covers various gastrointestinal conditions and their
Gastrointestinal Disorders management. 8 Qs 8.0%
This topic focuses on neurological evaluations and
Neurological Assessment interventions in acute care settings. 8 Qs 8.0%
This topic addresses infection management and prevention
Infection Control strategies in clinical settings. 8 Qs 8.0%
This topic examines the management of fluid and electrolyte
Fluid and Electrolyte Balance imbalances in patients. 8 Qs 8.0%
This topic covers potential complications following surgical
Surgical Complications procedures. 8 Qs 8.0%
This topic focuses on pain assessment and management
Pain Management strategies in various patient populations. 8 Qs 8.0%
This topic includes critical interventions required in
Emergency Interventions emergency situations. 8 Qs 8.0%
Total Exam Coverage 12 Integrated Topic Modules 100 Qs 100.0%
Confidential • Student Study Edition • Practice & Review Guide Page 2 of 67
,STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
TOPIC 1: TOTAL HIP ARTHROPLASTY
9 Questions • 9.0% of Exam • This topic covers postoperative care and complications related to total hip arthroplasty.
QUESTION 1
A 68-year-old man underwent a total hip arthroplasty three days ago. He has been
ambulating with assistance but suddenly becomes short of breath while seated,
reporting a sharp, pleuritic chest pain that worsens with deep inspiration. His vital
signs are: temperature 37.2 °C (99 °F), pulse 118/min, respirations 28/min, blood
pressure 138/84 mmHg, and oxygen saturation 86% on room air. Physical examination
reveals clear lung fields bilaterally, mild calf tenderness on the left, and a faint,
low-grade murmur over the left lower sternal border. The surgical team is on call, and a
portable chest X-ray is pending. Which of the following actions should the nurse take
first?
[A] Administer intravenous morphine for pain control.
[B] Obtain a stat chest computed tomography angiography.
[C] Initiate an intravenous heparin bolus.
[D] Place the patient in the Trendelenburg position.
Correct Answer: Initiate an intravenous heparin bolus.
Rationale: The presentation suggests a pulmonary embolism, a life-threatening event requiring rapid anticoagulation to
prevent clot propagation. Administering a heparin bolus provides immediate therapeutic effect while diagnostic imaging is
arranged. Morphine treats pain but does not address the underlying obstruction, and Trendelenburg worsens
ventilation-perfusion mismatch.
Confidential • Student Study Edition • Practice & Review Guide Page 3 of 67
, STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
QUESTION 2
A 62-year-old man is on postoperative day three after a total hip arthroplasty. He has
been receiving subcutaneous low-molecular-weight heparin for deep-vein thrombosis
prophylaxis. Suddenly, he becomes dyspneic, reports sharp pleuritic chest pain, and
his heart rate accelerates to 118 beats per minute while his oxygen saturation falls to
88% on room air. Physical examination reveals clear lung fields and a mildly distended
neck vein. The nurse suspects a pulmonary embolism. Which diagnostic test should be
performed first to obtain the most rapid and definitive confirmation of the suspected
embolus?
[A] D-dimer assay
[B] Ventilation-perfusion (V/Q) scan
[C] Computed tomography pulmonary angiography (CTPA)
[D] Lower-extremity duplex ultrasound
Correct Answer: Computed tomography pulmonary angiography (CTPA)
Rationale: CTPA directly visualizes intraluminal thrombus in the pulmonary arteries and provides the quickest definitive
diagnosis, essential for urgent anticoagulation. D-dimer is nonspecific, V/Q scans are less accurate in postoperative
patients, and duplex ultrasound evaluates leg veins, not pulmonary vessels.
Confidential • Student Study Edition • Practice & Review Guide Page 4 of 67
EVOLVE ELSEVIER HESI MED SURG
LATEST UPDATE 2026/2027 EXAM
QUESTIONS WITH RATIONALIZED
ACCURATE ANSWERS
Comprehensive Examination Question Bank • In-Depth Rationales • Concept Mapping
TOTAL QUESTIONS EXAM TOPICS RATIONALES
100 Questions 12 Modules 100% Verified
DOCUMENT OVERVIEW
This 2026/2027 study guide compiles 100 comprehensive curriculum-aligned clinical practice questions for
EVOLVE ELSEVIER HESI MED, coupling 100% verified correct answers alongside in-depth explanatory
rationales that clarify diagnostic reasoning. Each section organizes related questions into focused clinical
topics and specialized subtopics spanning Blood Cell Count, Total Hip Arthroplasty, and emergency care
standards, pairing verified solutions with clinical rationales. Learners can use this resource to strengthen
clinical judgment skills, validate bedside decision-making through active self-assessment, and systematically
master high-yield concepts prior to examination day.
EXAM BLUEPRINT & TOPIC DISTRIBUTION
Systematic breakdown of subject domains and exam coverage.
Topic Module Scope & Core Focus Questions Share (%)
This topic covers postoperative care and complications
Total Hip Arthroplasty related to total hip arthroplasty. 9 Qs 9.0%
This topic focuses on the diagnosis, management, and
Acute Pancreatitis complications of acute pancreatitis. 9 Qs 9.0%
This topic addresses respiratory rate, interventions, and
Respiratory Assessment complications in patients with respiratory distress. 9 Qs 9.0%
This topic examines acute complications and management
Diabetes Management strategies for patients with diabetes. 9 Qs 9.0%
Confidential • Student Study Edition • Practice & Review Guide Page 1 of 67
,STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
This topic includes assessment and management of acute
Cardiac Emergencies cardiac conditions. 8 Qs 8.0%
This topic covers various gastrointestinal conditions and their
Gastrointestinal Disorders management. 8 Qs 8.0%
This topic focuses on neurological evaluations and
Neurological Assessment interventions in acute care settings. 8 Qs 8.0%
This topic addresses infection management and prevention
Infection Control strategies in clinical settings. 8 Qs 8.0%
This topic examines the management of fluid and electrolyte
Fluid and Electrolyte Balance imbalances in patients. 8 Qs 8.0%
This topic covers potential complications following surgical
Surgical Complications procedures. 8 Qs 8.0%
This topic focuses on pain assessment and management
Pain Management strategies in various patient populations. 8 Qs 8.0%
This topic includes critical interventions required in
Emergency Interventions emergency situations. 8 Qs 8.0%
Total Exam Coverage 12 Integrated Topic Modules 100 Qs 100.0%
Confidential • Student Study Edition • Practice & Review Guide Page 2 of 67
,STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
TOPIC 1: TOTAL HIP ARTHROPLASTY
9 Questions • 9.0% of Exam • This topic covers postoperative care and complications related to total hip arthroplasty.
QUESTION 1
A 68-year-old man underwent a total hip arthroplasty three days ago. He has been
ambulating with assistance but suddenly becomes short of breath while seated,
reporting a sharp, pleuritic chest pain that worsens with deep inspiration. His vital
signs are: temperature 37.2 °C (99 °F), pulse 118/min, respirations 28/min, blood
pressure 138/84 mmHg, and oxygen saturation 86% on room air. Physical examination
reveals clear lung fields bilaterally, mild calf tenderness on the left, and a faint,
low-grade murmur over the left lower sternal border. The surgical team is on call, and a
portable chest X-ray is pending. Which of the following actions should the nurse take
first?
[A] Administer intravenous morphine for pain control.
[B] Obtain a stat chest computed tomography angiography.
[C] Initiate an intravenous heparin bolus.
[D] Place the patient in the Trendelenburg position.
Correct Answer: Initiate an intravenous heparin bolus.
Rationale: The presentation suggests a pulmonary embolism, a life-threatening event requiring rapid anticoagulation to
prevent clot propagation. Administering a heparin bolus provides immediate therapeutic effect while diagnostic imaging is
arranged. Morphine treats pain but does not address the underlying obstruction, and Trendelenburg worsens
ventilation-perfusion mismatch.
Confidential • Student Study Edition • Practice & Review Guide Page 3 of 67
, STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
QUESTION 2
A 62-year-old man is on postoperative day three after a total hip arthroplasty. He has
been receiving subcutaneous low-molecular-weight heparin for deep-vein thrombosis
prophylaxis. Suddenly, he becomes dyspneic, reports sharp pleuritic chest pain, and
his heart rate accelerates to 118 beats per minute while his oxygen saturation falls to
88% on room air. Physical examination reveals clear lung fields and a mildly distended
neck vein. The nurse suspects a pulmonary embolism. Which diagnostic test should be
performed first to obtain the most rapid and definitive confirmation of the suspected
embolus?
[A] D-dimer assay
[B] Ventilation-perfusion (V/Q) scan
[C] Computed tomography pulmonary angiography (CTPA)
[D] Lower-extremity duplex ultrasound
Correct Answer: Computed tomography pulmonary angiography (CTPA)
Rationale: CTPA directly visualizes intraluminal thrombus in the pulmonary arteries and provides the quickest definitive
diagnosis, essential for urgent anticoagulation. D-dimer is nonspecific, V/Q scans are less accurate in postoperative
patients, and duplex ultrasound evaluates leg veins, not pulmonary vessels.
Confidential • Student Study Edition • Practice & Review Guide Page 4 of 67
