Latest Evolve HESI Med Surg Actual
Exam 2025 – 50 Real Questions &
Answers with Well-Elaborated
Rationales (Proventus)
1. Multiple-Choice
Question: A client with a blood glucose level of 40 mg/dL is semiconscious. What is the
nurse’s priority action?
A) Administer oral glucose gel
B) Start an IV of normal saline
C) Administer glucagon IM
D) Offer a high-carbohydrate snack
Answer: C) Administer glucagon IM
Rationale: For a semiconscious client, oral glucose is contraindicated due to aspiration
risk. Glucagon IM is the priority to rapidly increase blood glucose. IV saline is supportive
but not immediate.
2. Multiple-Response
Question: Which interventions should the nurse include for a client post-
esophagogastrostomy for esophageal cancer? (Select all that apply.)
A) Frequent oral care every 2 hours
B) Use incentive spirometer every 2 hours
C) Elevate head of bed 30 degrees
D) Administer IV antibiotics prophylactically
E) Restrict oral intake completely
Answers: A, B, C
Rationale: Oral care prevents infection, incentive spirometry promotes lung expansion,
and elevating the head reduces aspiration risk. Prophylactic antibiotics and complete oral
restriction depend on specific orders.
3. Fill-in-the-Blank
Question: The nurse administers morphine sulfate 4 mg IM STAT, available as 8
mg/mL. The nurse should administer __________ mL.
Answer: 0.5
Rationale: Dose calculation: 4 mg ÷ 8 mg/mL = 0.5 mL.
4. Drag-and-Drop
Question: Arrange the pathophysiological events of atherosclerosis in order:
A) Foam cells release growth factors
B) Arterial endothelium injury
C) Smooth muscle grows over fatty streaks
D) Macrophages consume LDL, forming foam cells
, E) Fibrous plaques form
Answer: B, D, A, C, E
Rationale: Atherosclerosis begins with endothelial injury, followed by LDL uptake,
growth factor release, smooth muscle proliferation, and plaque formation.
5. NGN Case Study - Bow-Tie
Question: A client with acute pancreatitis presents with severe epigastric pain and
vomiting. Complete the bow-tie diagram for actions, monitoring, and complications.
o Actions: Administer IV fluids, provide pain management, maintain NPO status.
o Monitor: Vital signs, amylase/lipase levels, fluid balance.
o Complications: Pancreatic necrosis, hypovolemic shock, infection.
Rationale: IV fluids address dehydration, pain management improves comfort,
and NPO prevents pancreatic stimulation. Monitoring detects complications early.
6. Multiple-Choice
Question: A client with trigeminal neuralgia reports sudden facial pain. What should the
nurse assess for?
A) Unilateral facial weakness
B) Facial muscle spasms
C) Hearing difficulties
D) Tinnitus
Answer: B) Facial muscle spasms
Rationale: Trigeminal neuralgia causes paroxysmal pain and spasms in the trigeminal
nerve distribution. Other symptoms are unrelated.
7. Multiple-Response
Question: Which findings indicate peritonitis in a client with acute diverticulitis? (Select
all that apply.)
A) Rigid hard abdomen
B) Elevated WBC
C) Left lower quadrant pain
D) Low-grade fever
Answers: A, B
Rationale: Peritonitis presents with a rigid abdomen and elevated WBC, indicating a
medical emergency. Pain and fever are expected in diverticulitis but not specific to
peritonitis.
8. Multiple-Choice
Question: A client with a fractured right elbow has ecchymosis. What requires
immediate intervention?
A) Swelling at the fracture site
B) Pain on movement
C) Absent distal pulses
D) Bruising over the elbow
Answer: C) Absent distal pulses
Rationale: Absent pulses suggest vascular compromise, requiring urgent intervention to
prevent tissue ischemia.
9. Fill-in-the-Blank
Question: A client with primary aldosteronism is expected to have a decreased serum
level of __________.
Exam 2025 – 50 Real Questions &
Answers with Well-Elaborated
Rationales (Proventus)
1. Multiple-Choice
Question: A client with a blood glucose level of 40 mg/dL is semiconscious. What is the
nurse’s priority action?
A) Administer oral glucose gel
B) Start an IV of normal saline
C) Administer glucagon IM
D) Offer a high-carbohydrate snack
Answer: C) Administer glucagon IM
Rationale: For a semiconscious client, oral glucose is contraindicated due to aspiration
risk. Glucagon IM is the priority to rapidly increase blood glucose. IV saline is supportive
but not immediate.
2. Multiple-Response
Question: Which interventions should the nurse include for a client post-
esophagogastrostomy for esophageal cancer? (Select all that apply.)
A) Frequent oral care every 2 hours
B) Use incentive spirometer every 2 hours
C) Elevate head of bed 30 degrees
D) Administer IV antibiotics prophylactically
E) Restrict oral intake completely
Answers: A, B, C
Rationale: Oral care prevents infection, incentive spirometry promotes lung expansion,
and elevating the head reduces aspiration risk. Prophylactic antibiotics and complete oral
restriction depend on specific orders.
3. Fill-in-the-Blank
Question: The nurse administers morphine sulfate 4 mg IM STAT, available as 8
mg/mL. The nurse should administer __________ mL.
Answer: 0.5
Rationale: Dose calculation: 4 mg ÷ 8 mg/mL = 0.5 mL.
4. Drag-and-Drop
Question: Arrange the pathophysiological events of atherosclerosis in order:
A) Foam cells release growth factors
B) Arterial endothelium injury
C) Smooth muscle grows over fatty streaks
D) Macrophages consume LDL, forming foam cells
, E) Fibrous plaques form
Answer: B, D, A, C, E
Rationale: Atherosclerosis begins with endothelial injury, followed by LDL uptake,
growth factor release, smooth muscle proliferation, and plaque formation.
5. NGN Case Study - Bow-Tie
Question: A client with acute pancreatitis presents with severe epigastric pain and
vomiting. Complete the bow-tie diagram for actions, monitoring, and complications.
o Actions: Administer IV fluids, provide pain management, maintain NPO status.
o Monitor: Vital signs, amylase/lipase levels, fluid balance.
o Complications: Pancreatic necrosis, hypovolemic shock, infection.
Rationale: IV fluids address dehydration, pain management improves comfort,
and NPO prevents pancreatic stimulation. Monitoring detects complications early.
6. Multiple-Choice
Question: A client with trigeminal neuralgia reports sudden facial pain. What should the
nurse assess for?
A) Unilateral facial weakness
B) Facial muscle spasms
C) Hearing difficulties
D) Tinnitus
Answer: B) Facial muscle spasms
Rationale: Trigeminal neuralgia causes paroxysmal pain and spasms in the trigeminal
nerve distribution. Other symptoms are unrelated.
7. Multiple-Response
Question: Which findings indicate peritonitis in a client with acute diverticulitis? (Select
all that apply.)
A) Rigid hard abdomen
B) Elevated WBC
C) Left lower quadrant pain
D) Low-grade fever
Answers: A, B
Rationale: Peritonitis presents with a rigid abdomen and elevated WBC, indicating a
medical emergency. Pain and fever are expected in diverticulitis but not specific to
peritonitis.
8. Multiple-Choice
Question: A client with a fractured right elbow has ecchymosis. What requires
immediate intervention?
A) Swelling at the fracture site
B) Pain on movement
C) Absent distal pulses
D) Bruising over the elbow
Answer: C) Absent distal pulses
Rationale: Absent pulses suggest vascular compromise, requiring urgent intervention to
prevent tissue ischemia.
9. Fill-in-the-Blank
Question: A client with primary aldosteronism is expected to have a decreased serum
level of __________.
