LATEST EVOLVE HESI MED SURG EXAM 2025
NEWEST TEST BANK WITH 500 REAL EXAM PREP
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES (100% CORRECT ANSWERS) HESI MED
SURG EVOLVE ELSEVIER EXAM 2025 (NEW)
During suctioning, a client with an uncuffed tracheostomy tube begins to cough
violently and dislodges the tracheostomy tube. Which action should the nurse
implement first?
A) Notify the healthcare provider for reinsertion.
B) Attempt to reinsert the tracheostomy tube.
C) Position the client in a lateral position with the neck extended.
D) Ventilate client's tracheostomy stoma with a manual bag-mask.
B) Attempt to reinsert the tracheostomy tube.
The nurse should attempt to reinsert the tracheostomy tube (B) by using a hemostat
to open the tracheostomy or by grasping the retention sutures (if present) to spread
the opening in insert a replacement tube (with its obturator) into the stoma. Once in
place, the obturator should immediately be removed. (A, C, and D) place the client
at risk of airway obstruction.
A male client who has never smoked but has had COPD for the past 5 years is now
being assessed for cancer of the lung. The nurse knows that he is most likely to
develop which type of lung cancer?
A) Adenocarcinoma.
B) Oat-cell carcinoma.
C) Malignant melanoma.
D) Squamous-cell carcinoma.
A) Adenocarcinoma.
Adenocarcinoma is the only lung cancer not related to cigarette smoking (A). It has
been found to be directly related to lung scarring and fibrosis from preexisting
pulmonary disease such as TB or COPD. Both (B and D) are malignant lung
pg. 1
,cancers related to cigarette smoking. (C) is a skin cancer and is related to exposure
to sunlight, not to lung problems.
The nurse assesses a client with advanced cirrhosis of the liver for signs of hepatic
encephalopathy. Which finding should the nurse consider an indication of
progressive hepatic encephalopathy?
A) An increase in abdominal girth.
B) Hypertension and a bounding pulse.
C) Decreased bowel sounds.
D) Difficulty in handwriting.
D) Difficulty in handwriting.
A daily record in handwriting may provide evidence of progression or reversal of
hepatic encephalopathy leading to coma (D). (A) is a sign of ascites. (B) are not
seen with hepatic encephalopathy. (C) does not indicate an increase in serum
ammonia level which is the primary cause of hepatic encephalopathy.
During the first 36 hours after the insertion of chest tubes, when assessing the
function of a three-chamber, closed-chest drainage system, the nurse identifies that
the water in the underwater seal tube is not fluctuating. What initial action should
the nurse take?
Take the client's vital signs.
Inform the healthcare provider.
Turn the client to the unaffected side.
Check the tube to ensure that it is not kinked
Check the tube to ensure that it is not kinked
Once the drainage tube is patent, the fluctuation in the water column will resume; a
lack of fluctuation because of lung re-expansion is unlikely 36 hours after a
traumatic open chest injury. Taking the client's vital signs may be done eventually
but is not the priority at this time. Informing the healthcare provider is unnecessary
at this time; the chest tube is occluded, and nursing interventions should be
attempted first. Turning the client to the unaffected side will compromise aeration
of the unaffected lung.
pg. 2
,The home health nurse provides education to a client with cancer of the tongue
who will begin gastrostomy feedings at home. Which statement by the client
indicates teaching by the nurse is effective?
"Before I start the procedure, I will don sterile gloves."
"Before I start the procedure, I will obtain my body weight."
"Before I start the procedure, I will measure the residual volume."
"Before I start the procedure, I will instill one ounce (30 mL) of a carbonated
liquid."
"Before I start the procedure, I will measure the residual volume."
Measuring the residual volume establishes whether an adequate volume of the
previous feeding was absorbed. If a residual exceeds the parameter identified by
the healthcare provider or is over 200 mL, a feeding may be held. This prevents
adding excess feeding solution that may lead to abdominal distention, nausea,
vomiting, and aspiration. Clean, not sterile, gloves are necessary to protect the
client from contamination with gastric secretions. Weights are taken and reported
weekly or monthly depending on the client's condition and clinical goals. A
carbonated beverage may be used if the tube becomes clogged; it is not used
routinely.
The nurse is preparing to administer a nasogastric tube feeding to a client via
infusion pump. What is the most important assessment the nurse needs to perform
before beginning the pump?
Checking for the last bowel movement
Checking for residual stomach contents
Checking to determine time of last medication for nausea
Checking to make sure the head of bed is elevated at least 15 degrees
Checking for residual stomach contents
Checking for any residual feeding not absorbed in the client's stomach must be
done before introducing any more feeding. Aspiration can occur if a feeding is
pg. 3
, started with excessive residual. Checking for last bowel movement is important but
not as crucial as checking for gastric residual. Knowledge of last nausea
medication is not necessary at this time. Clients receiving nasogastric tube feedings
must have the head of their bed elevated to at least 30 degrees.
administered intravenously.
Which drug can cause diabetes insipidus?
Cabergoline
Metyrapone
Demeclocycline
Aminoglutethimide
Demeclocycline
Prolonged administration of demeclocycline may cause diabetes insipidus, as this
drug decreases the production of antidiuretic hormone by the kidneys. Cabergoline
inhibits the release of growth hormone and prolactin by stimulating dopamine
receptors in the brain. Metyrapone and aminoglutethimide decrease cortisol
production.
A nurse is evaluating a client's understanding of peritoneal dialysis. Which
information in the client's response indicates an understanding of the purpose of
the procedure?
Reestablishing kidney function
Cleaning the peritoneal membrane
Providing fluid for intracellular spaces
Removing toxins in addition to other metabolic wastes
Removing toxins in addition to other metabolic wastes
pg. 4
NEWEST TEST BANK WITH 500 REAL EXAM PREP
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES (100% CORRECT ANSWERS) HESI MED
SURG EVOLVE ELSEVIER EXAM 2025 (NEW)
During suctioning, a client with an uncuffed tracheostomy tube begins to cough
violently and dislodges the tracheostomy tube. Which action should the nurse
implement first?
A) Notify the healthcare provider for reinsertion.
B) Attempt to reinsert the tracheostomy tube.
C) Position the client in a lateral position with the neck extended.
D) Ventilate client's tracheostomy stoma with a manual bag-mask.
B) Attempt to reinsert the tracheostomy tube.
The nurse should attempt to reinsert the tracheostomy tube (B) by using a hemostat
to open the tracheostomy or by grasping the retention sutures (if present) to spread
the opening in insert a replacement tube (with its obturator) into the stoma. Once in
place, the obturator should immediately be removed. (A, C, and D) place the client
at risk of airway obstruction.
A male client who has never smoked but has had COPD for the past 5 years is now
being assessed for cancer of the lung. The nurse knows that he is most likely to
develop which type of lung cancer?
A) Adenocarcinoma.
B) Oat-cell carcinoma.
C) Malignant melanoma.
D) Squamous-cell carcinoma.
A) Adenocarcinoma.
Adenocarcinoma is the only lung cancer not related to cigarette smoking (A). It has
been found to be directly related to lung scarring and fibrosis from preexisting
pulmonary disease such as TB or COPD. Both (B and D) are malignant lung
pg. 1
,cancers related to cigarette smoking. (C) is a skin cancer and is related to exposure
to sunlight, not to lung problems.
The nurse assesses a client with advanced cirrhosis of the liver for signs of hepatic
encephalopathy. Which finding should the nurse consider an indication of
progressive hepatic encephalopathy?
A) An increase in abdominal girth.
B) Hypertension and a bounding pulse.
C) Decreased bowel sounds.
D) Difficulty in handwriting.
D) Difficulty in handwriting.
A daily record in handwriting may provide evidence of progression or reversal of
hepatic encephalopathy leading to coma (D). (A) is a sign of ascites. (B) are not
seen with hepatic encephalopathy. (C) does not indicate an increase in serum
ammonia level which is the primary cause of hepatic encephalopathy.
During the first 36 hours after the insertion of chest tubes, when assessing the
function of a three-chamber, closed-chest drainage system, the nurse identifies that
the water in the underwater seal tube is not fluctuating. What initial action should
the nurse take?
Take the client's vital signs.
Inform the healthcare provider.
Turn the client to the unaffected side.
Check the tube to ensure that it is not kinked
Check the tube to ensure that it is not kinked
Once the drainage tube is patent, the fluctuation in the water column will resume; a
lack of fluctuation because of lung re-expansion is unlikely 36 hours after a
traumatic open chest injury. Taking the client's vital signs may be done eventually
but is not the priority at this time. Informing the healthcare provider is unnecessary
at this time; the chest tube is occluded, and nursing interventions should be
attempted first. Turning the client to the unaffected side will compromise aeration
of the unaffected lung.
pg. 2
,The home health nurse provides education to a client with cancer of the tongue
who will begin gastrostomy feedings at home. Which statement by the client
indicates teaching by the nurse is effective?
"Before I start the procedure, I will don sterile gloves."
"Before I start the procedure, I will obtain my body weight."
"Before I start the procedure, I will measure the residual volume."
"Before I start the procedure, I will instill one ounce (30 mL) of a carbonated
liquid."
"Before I start the procedure, I will measure the residual volume."
Measuring the residual volume establishes whether an adequate volume of the
previous feeding was absorbed. If a residual exceeds the parameter identified by
the healthcare provider or is over 200 mL, a feeding may be held. This prevents
adding excess feeding solution that may lead to abdominal distention, nausea,
vomiting, and aspiration. Clean, not sterile, gloves are necessary to protect the
client from contamination with gastric secretions. Weights are taken and reported
weekly or monthly depending on the client's condition and clinical goals. A
carbonated beverage may be used if the tube becomes clogged; it is not used
routinely.
The nurse is preparing to administer a nasogastric tube feeding to a client via
infusion pump. What is the most important assessment the nurse needs to perform
before beginning the pump?
Checking for the last bowel movement
Checking for residual stomach contents
Checking to determine time of last medication for nausea
Checking to make sure the head of bed is elevated at least 15 degrees
Checking for residual stomach contents
Checking for any residual feeding not absorbed in the client's stomach must be
done before introducing any more feeding. Aspiration can occur if a feeding is
pg. 3
, started with excessive residual. Checking for last bowel movement is important but
not as crucial as checking for gastric residual. Knowledge of last nausea
medication is not necessary at this time. Clients receiving nasogastric tube feedings
must have the head of their bed elevated to at least 30 degrees.
administered intravenously.
Which drug can cause diabetes insipidus?
Cabergoline
Metyrapone
Demeclocycline
Aminoglutethimide
Demeclocycline
Prolonged administration of demeclocycline may cause diabetes insipidus, as this
drug decreases the production of antidiuretic hormone by the kidneys. Cabergoline
inhibits the release of growth hormone and prolactin by stimulating dopamine
receptors in the brain. Metyrapone and aminoglutethimide decrease cortisol
production.
A nurse is evaluating a client's understanding of peritoneal dialysis. Which
information in the client's response indicates an understanding of the purpose of
the procedure?
Reestablishing kidney function
Cleaning the peritoneal membrane
Providing fluid for intracellular spaces
Removing toxins in addition to other metabolic wastes
Removing toxins in addition to other metabolic wastes
pg. 4
