EVOLVE Elsevier HESI Med-Surg Exam 2025 – Real Exam
Questions with Rationales | Verified NGN Prep | Original
Copy
Medical-Surgical Questions
Perioperative Care
Question 1: (NGN Case Study) A 68-year-old client is scheduled for a total hip replacement. Past
medical history includes hypertension and type 2 diabetes. Vital signs: BP 150/90 mmHg,
HR 88 bpm, RR 16 breaths/min, SpO2 98%.
Part A: Select all that apply. Which preoperative interventions should the nurse priori-
tize?
a) Administer insulin per sliding scale
b) Verify surgical consent
c) Administer antihypertensive medication
d) Teach incentive spirometry
e) Restrict all oral intake
f) Assess for latex allergy
Part B: The client’s blood glucose is 220 mg/dL. What is the nurse’s best action?
a) Proceed with surgery
b) Notify the surgeon
c) Administer oral hypoglycemics
d) Encourage fluid intake
Answers:
Part A: b, c, d, e, f
Part B: b
Rationale: (See Rationale Section)
Question 2: A client post-appendectomy reports pain at 8/10. The nurse notes a heart rate of 110 bpm
and a temperature of 100.4°F. What is the nurse’s priority action?
a) Administer PRN morphine
b) Assess the surgical site
c) Apply a cool compress
d) Encourage ambulation
Answer: b
Rationale: (See Rationale Section)
Question 3: A nurse is preparing a client for coronary artery bypass grafting (CABG). Which labora-
tory result requires immediate action?
a) Potassium 3.8 mEq/L
b) Hemoglobin 9.2 g/dL
c) INR 2.5
d) Creatinine 1.0 mg/dL
Answer: b
Rationale: (See Rationale Section)
Question 4: (NGN Bowtie) A client is 6 hours post-cholecystectomy and develops nausea, tachycar-
dia, and hypotension. Drag and drop to complete the bowtie:
1
, Condition: Surgical complication
Actions: Administer IV fluids, Notify surgeon
Parameters: Monitor BP, Assess abdomen
Potential Outcomes: Stabilization, Further intervention
Rationale: (See Rationale Section)
Chronic Illness
Question 5: A client with rheumatoid arthritis reports increased joint stiffness. Which intervention
should the nurse recommend?
a) Apply ice packs to joints
b) Perform high-impact exercise
c) Take NSAIDs as prescribed
d) Avoid all physical activity
Answer: c
Rationale: (See Rationale Section)
Question 6: (NGN Case Study) A 55-year-old client with COPD presents with dyspnea and fatigue.
Vital signs: RR 28 breaths/min, SpO2 88%, HR 100 bpm.
Part A: Select all that apply. Which interventions are appropriate?
a) Administer oxygen at 2 L/min
b) Encourage pursed-lip breathing
c) Administer IV corticosteroids
d) Position in high Fowler’s
e) Restrict fluid intake
f) Teach smoking cessation
Part B: The client’s SpO2 improves to 92%. What should the nurse do next?
a) Discontinue oxygen
b) Continue monitoring
c) Increase oxygen to 4 L/min
d) Administer a bronchodilator
Answers:
Part A: a, b, d, f
Part B: b
Rationale: (See Rationale Section)
Question 7: A client with chronic kidney disease is prescribed a low-potassium diet. Which food
should the nurse instruct the client to avoid?
a) Apples
b) Bananas
c) Carrots
d) Rice
Answer: b
Rationale: (See Rationale Section)
Question 8: (NGN Matrix) For a client with multiple sclerosis, indicate whether each intervention is
appropriate or inappropriate:
2
Questions with Rationales | Verified NGN Prep | Original
Copy
Medical-Surgical Questions
Perioperative Care
Question 1: (NGN Case Study) A 68-year-old client is scheduled for a total hip replacement. Past
medical history includes hypertension and type 2 diabetes. Vital signs: BP 150/90 mmHg,
HR 88 bpm, RR 16 breaths/min, SpO2 98%.
Part A: Select all that apply. Which preoperative interventions should the nurse priori-
tize?
a) Administer insulin per sliding scale
b) Verify surgical consent
c) Administer antihypertensive medication
d) Teach incentive spirometry
e) Restrict all oral intake
f) Assess for latex allergy
Part B: The client’s blood glucose is 220 mg/dL. What is the nurse’s best action?
a) Proceed with surgery
b) Notify the surgeon
c) Administer oral hypoglycemics
d) Encourage fluid intake
Answers:
Part A: b, c, d, e, f
Part B: b
Rationale: (See Rationale Section)
Question 2: A client post-appendectomy reports pain at 8/10. The nurse notes a heart rate of 110 bpm
and a temperature of 100.4°F. What is the nurse’s priority action?
a) Administer PRN morphine
b) Assess the surgical site
c) Apply a cool compress
d) Encourage ambulation
Answer: b
Rationale: (See Rationale Section)
Question 3: A nurse is preparing a client for coronary artery bypass grafting (CABG). Which labora-
tory result requires immediate action?
a) Potassium 3.8 mEq/L
b) Hemoglobin 9.2 g/dL
c) INR 2.5
d) Creatinine 1.0 mg/dL
Answer: b
Rationale: (See Rationale Section)
Question 4: (NGN Bowtie) A client is 6 hours post-cholecystectomy and develops nausea, tachycar-
dia, and hypotension. Drag and drop to complete the bowtie:
1
, Condition: Surgical complication
Actions: Administer IV fluids, Notify surgeon
Parameters: Monitor BP, Assess abdomen
Potential Outcomes: Stabilization, Further intervention
Rationale: (See Rationale Section)
Chronic Illness
Question 5: A client with rheumatoid arthritis reports increased joint stiffness. Which intervention
should the nurse recommend?
a) Apply ice packs to joints
b) Perform high-impact exercise
c) Take NSAIDs as prescribed
d) Avoid all physical activity
Answer: c
Rationale: (See Rationale Section)
Question 6: (NGN Case Study) A 55-year-old client with COPD presents with dyspnea and fatigue.
Vital signs: RR 28 breaths/min, SpO2 88%, HR 100 bpm.
Part A: Select all that apply. Which interventions are appropriate?
a) Administer oxygen at 2 L/min
b) Encourage pursed-lip breathing
c) Administer IV corticosteroids
d) Position in high Fowler’s
e) Restrict fluid intake
f) Teach smoking cessation
Part B: The client’s SpO2 improves to 92%. What should the nurse do next?
a) Discontinue oxygen
b) Continue monitoring
c) Increase oxygen to 4 L/min
d) Administer a bronchodilator
Answers:
Part A: a, b, d, f
Part B: b
Rationale: (See Rationale Section)
Question 7: A client with chronic kidney disease is prescribed a low-potassium diet. Which food
should the nurse instruct the client to avoid?
a) Apples
b) Bananas
c) Carrots
d) Rice
Answer: b
Rationale: (See Rationale Section)
Question 8: (NGN Matrix) For a client with multiple sclerosis, indicate whether each intervention is
appropriate or inappropriate:
2
