2025 EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM QUESTIONS
AND ANSWERS UPDATED
A 20-year-old female client calls the nurse to report a lump she found in her breast.
Which response is the best for the nurse to provide?
A) Check it again in one month, and if it is still there schedule an appointment.
B) Most lumps are benign, but it is always best to come in for an examination.
C) Try not to worry too much about it, because usually, most lumps are benign.
D) If you are in your menstrual period it is not a good time to check for lumps.
B) Most lumps are benign, but it is always best to come in for an examination.
(B) provides the best response because it addresses the client's anxiety most
effectively and encourages prompt and immediate action for a potential problem.
(A) postpones treatment if the lump is malignant, and does not relieve the client's
anxiety. (C and D) provide false reassurance and do not help relieve anxiety.
The nurse is preparing a teaching plan for a client who is newly diagnosed with
Type 1 diabetes mellitus. Which signs and symptoms should the nurse describe
when teaching the client about hypoglycemia?
A) Sweating, trembling, tachycardia.
B) Polyuria, polydipsia, polyphagia.
C) Nausea, vomiting, anorexia.
D) Fruity breath, tachypnea, chest pain.
A) Sweating, trembling, tachycardia.
Sweating, dizziness, and trembling are signs of hypoglycemic reactions related to
the release of epinephrine as a compensatory response to the low blood sugar (A).
(B, C, and D) do not describe common symptoms of hypoglycemia.
The nurse is assessing a client's laboratory values following administration of
chemotherapy. Which lab value leads the nurse to suspect that the client is
experiencing tumor lysis syndrome (TLS)?
A) Serum PTT of 10 seconds.
B) Serum calcium of 5 mg/dl.
C) Oxygen saturation of 90%.
D) Hemoglobin of 10 g/dl.
,B) Serum calcium of 5 mg/dl.
TLS results in hyperkalemia, hypocalcemia, hyperuricemia, and
hyperphosphatemia. A serum calcium level of 5 (B), which is low, is an indicator
of possible tumor lysis syndrome. (A, C, and D) are not particularly related to TLS.
The nurse should be correct in withholding a dose of digoxin in a client with
congestive heart failure without specific instruction from the healthcare provider if
the client's
A) serum digoxin level is 1.5.
B) blood pressure is 104/68.
C) serum potassium level is 3.
D) apical pulse is 68/min.
C) serum potassium level is 3.
Hypokalemia (C) can precipitate digitalis toxicity in persons receiving digoxin
which will increase the chance of dangerous dysrhythmias (normal potassium level
is 3.5 to 5.5 mEq/L). The therapeutic range for digoxin is 0.8 to 2 ng/ml (toxic
levels= >2 ng/ml); (A) is within this range. (B) would not warrant the nurse
withholding the digoxin. The nurse should withhold the digoxin if the apical pulse
is less than 60/min (D).
In assessing a client diagnosed with primary hyperaldosteronism, the nurse expects
the laboratory test results to indicate a decreased serum level of which substance?
A) Sodium.
B) Antidiuretic hormone.
C) Potassium.
D) Glucose.
C) Potassium.
Clients with primary aldosteronism exhibit a profound decline in the serum levels
of potassium (C) (hypokalemia)--hypertension is the most prominent and universal
sign. (A) is normal or elevated, depending on the amount of water reabsorbed with
the sodium. (B) is decreased with diabetes insipidus. (D) is not affected by primary
aldosteronism.
Based on the analysis of the client's atrial fibrillation, the nurse should prepare the
client for which treatment protocol?
, A) Diuretic therapy.
B) Pacemaker implantation.
C) Anticoagulation therapy.
D) Cardiac catheterization.
C) Anticoagulation therapy.
The client is experiencing atrial fibrillation, and the nurse should prepare the client
for anticoagulation therapy (C) which should be prescribed before rhythm control
therapies to prevent cardioembolic events which result from blood pooling in the
fibrillating atria. (A, B, and D) are not indicated.
Which information about mammograms is most important to provide a post-
menopausal female client?
A) Breast self-examinations are not needed if annual mammograms are obtained.
B) Radiation exposure is minimized by shielding the abdomen with a lead-lined
apron.
C) Yearly mammograms should be done regardless of previous normal x-rays.
D) Women at high risk should have annual routine and ultrasound mammograms.
C) Yearly mammograms should be done regardless of previous normal x-rays.
The current breast screening recommendation is a yearly mammogram after age 40
(C). Breast self-exam (A) continues to be a priority recommendation for all women
because a small lump (or tumor) is often first felt by a woman before a
mammogram is obtained. The radiation exposure from a mammogram is low, so
(B) is not normally provided. The frequency of using routine and ultrasound
mammograms (D) in women with high-risk variables, such as a history of breast
cancer, the presence of BRC1 and BRC2 genes, or 2 first-degree relatives with
breast cancer, should be recommended and followed closely by the healthcare
provider.
In assessing cancer risk, the nurse identifies which woman as being at greatest risk
of developing breast cancer?
A) A 35-year-old multipara who never breastfed.
B) A 50-year-old whose mother had unilateral breast cancer.
C) A 55-year-old whose mother-in-law had bilateral breast cancer.
D) A 20-year-old whose menarche occurred at age 9.
AND ANSWERS UPDATED
A 20-year-old female client calls the nurse to report a lump she found in her breast.
Which response is the best for the nurse to provide?
A) Check it again in one month, and if it is still there schedule an appointment.
B) Most lumps are benign, but it is always best to come in for an examination.
C) Try not to worry too much about it, because usually, most lumps are benign.
D) If you are in your menstrual period it is not a good time to check for lumps.
B) Most lumps are benign, but it is always best to come in for an examination.
(B) provides the best response because it addresses the client's anxiety most
effectively and encourages prompt and immediate action for a potential problem.
(A) postpones treatment if the lump is malignant, and does not relieve the client's
anxiety. (C and D) provide false reassurance and do not help relieve anxiety.
The nurse is preparing a teaching plan for a client who is newly diagnosed with
Type 1 diabetes mellitus. Which signs and symptoms should the nurse describe
when teaching the client about hypoglycemia?
A) Sweating, trembling, tachycardia.
B) Polyuria, polydipsia, polyphagia.
C) Nausea, vomiting, anorexia.
D) Fruity breath, tachypnea, chest pain.
A) Sweating, trembling, tachycardia.
Sweating, dizziness, and trembling are signs of hypoglycemic reactions related to
the release of epinephrine as a compensatory response to the low blood sugar (A).
(B, C, and D) do not describe common symptoms of hypoglycemia.
The nurse is assessing a client's laboratory values following administration of
chemotherapy. Which lab value leads the nurse to suspect that the client is
experiencing tumor lysis syndrome (TLS)?
A) Serum PTT of 10 seconds.
B) Serum calcium of 5 mg/dl.
C) Oxygen saturation of 90%.
D) Hemoglobin of 10 g/dl.
,B) Serum calcium of 5 mg/dl.
TLS results in hyperkalemia, hypocalcemia, hyperuricemia, and
hyperphosphatemia. A serum calcium level of 5 (B), which is low, is an indicator
of possible tumor lysis syndrome. (A, C, and D) are not particularly related to TLS.
The nurse should be correct in withholding a dose of digoxin in a client with
congestive heart failure without specific instruction from the healthcare provider if
the client's
A) serum digoxin level is 1.5.
B) blood pressure is 104/68.
C) serum potassium level is 3.
D) apical pulse is 68/min.
C) serum potassium level is 3.
Hypokalemia (C) can precipitate digitalis toxicity in persons receiving digoxin
which will increase the chance of dangerous dysrhythmias (normal potassium level
is 3.5 to 5.5 mEq/L). The therapeutic range for digoxin is 0.8 to 2 ng/ml (toxic
levels= >2 ng/ml); (A) is within this range. (B) would not warrant the nurse
withholding the digoxin. The nurse should withhold the digoxin if the apical pulse
is less than 60/min (D).
In assessing a client diagnosed with primary hyperaldosteronism, the nurse expects
the laboratory test results to indicate a decreased serum level of which substance?
A) Sodium.
B) Antidiuretic hormone.
C) Potassium.
D) Glucose.
C) Potassium.
Clients with primary aldosteronism exhibit a profound decline in the serum levels
of potassium (C) (hypokalemia)--hypertension is the most prominent and universal
sign. (A) is normal or elevated, depending on the amount of water reabsorbed with
the sodium. (B) is decreased with diabetes insipidus. (D) is not affected by primary
aldosteronism.
Based on the analysis of the client's atrial fibrillation, the nurse should prepare the
client for which treatment protocol?
, A) Diuretic therapy.
B) Pacemaker implantation.
C) Anticoagulation therapy.
D) Cardiac catheterization.
C) Anticoagulation therapy.
The client is experiencing atrial fibrillation, and the nurse should prepare the client
for anticoagulation therapy (C) which should be prescribed before rhythm control
therapies to prevent cardioembolic events which result from blood pooling in the
fibrillating atria. (A, B, and D) are not indicated.
Which information about mammograms is most important to provide a post-
menopausal female client?
A) Breast self-examinations are not needed if annual mammograms are obtained.
B) Radiation exposure is minimized by shielding the abdomen with a lead-lined
apron.
C) Yearly mammograms should be done regardless of previous normal x-rays.
D) Women at high risk should have annual routine and ultrasound mammograms.
C) Yearly mammograms should be done regardless of previous normal x-rays.
The current breast screening recommendation is a yearly mammogram after age 40
(C). Breast self-exam (A) continues to be a priority recommendation for all women
because a small lump (or tumor) is often first felt by a woman before a
mammogram is obtained. The radiation exposure from a mammogram is low, so
(B) is not normally provided. The frequency of using routine and ultrasound
mammograms (D) in women with high-risk variables, such as a history of breast
cancer, the presence of BRC1 and BRC2 genes, or 2 first-degree relatives with
breast cancer, should be recommended and followed closely by the healthcare
provider.
In assessing cancer risk, the nurse identifies which woman as being at greatest risk
of developing breast cancer?
A) A 35-year-old multipara who never breastfed.
B) A 50-year-old whose mother had unilateral breast cancer.
C) A 55-year-old whose mother-in-law had bilateral breast cancer.
D) A 20-year-old whose menarche occurred at age 9.
