EVOLVE ELSEVIER HESI MED SURG
ACTUAL EXAM WITH 150 REAL EXAM
QUESTIONS AND CORRECT ANSWERS
WITH WELL-ELABORATED RATIONALES/
EVOLVE HESI MEDICAL SURGICAL LATEST
EXAM 2024 (BRAND NEW!!)
A client diagnosed with stable angina secondary to ischemic heart disease
has a prescription for sublingual (SL) nitroglycerin (NTG). The nurse should
tell the client to follow which instructions if chest pain is not relieved after
taking 3 NTG tablets 5 min apart?
a. drive to the nearest emergency department
b. take another NTG SL tablet and lie down until angina subsides
c. call primary healthcare provider
d. call 911 if pain is unrelieved and chew a tablet of aspirin 325mg - ansd.
call 911 if pain is unrelieved and chew a tablet of aspirin 325 mg
A client experiences an ABO incompatibility reaction after multiple blood
transfusions. Which finding should the nurse report immediately to the
health care provider?
a. low back pain and hypotension
b. rhinitis and nasal stuffiness
c. delayed painful rash with urticarial
d. arthritic joint changes and chronic pain - ansa. low back pain and hypotension
A client is discharged with a prescription for warfarin (Coumadin). What
discharge instructions should the nurse emphasize to the client?
a. take a multi vitamin supplement daily
b. use an astringent for superficial bleeding
c. avoid going barefoot especially outside
d. include large amounts of spinach in the diet - ansc. avoid going barefoot,
especially outside
A client subjective data includes dysuria, urgency, and urinary frequency.
What action should the nurse implement next?
a. collect a clean catch specimen
b. palpate the suprapubic region
c. instruct to wipe from front to back
d. inquire about recent sexual activity - ansa. collect a clean catch specimen
A client tells the nurse that her biopsy results indicate that the cancer cells
are well differentiated How should the nurse respond?
a. offer the client reassurance that this information indicates that the clients
cancer cells are benign
, b. explain that these tissue cells often respond more effectively to
radiation than to chemotherapy
c. ask the client if the healthcare provider has given her any
information about the classification of her cancer
d. help the client make plans to begin immediate treatment since her
cancer is likely to spread quickly - ansc. ask the client if the healthcare
provider has given her any information about the classification of her
cancer
A client who had a myocardial infarction is admitted to the coronary critical
care unit (CCU) with a nitroglycerin drip infusing. The clients last blood
pressure measurements was 78/36. What action should the nurse
implement?
a. obtain blood pressure q5 minutes using duranap machine
b. change the dilution of the nitroglycerin infusion
c. reduce the rate of the nitroglycerin infusion
d. begin dopamine infusion at 5mcg/kg per minute - ansc. reduce the
rate of the nitroglycerin infusion
A client who is taking and oral dose of tetracycline complains of
gastrointestinal upset. What snack should the nurse instruct the client to
take with the tetracycline?
a. toasted wheat bread and jelly
b. cheese and crackers
c. cold cereal with skim milk
d. fruit flavored yogurt - ansa.toasted wheat bread and jelly
A client who took a camping vacation two weeks ago in a country with a
tropical climate comes to the clinic describing vague symptoms and diarrhea
for the past week. Which finding is most important for the nurse to report?
a. jaundice sclera
b. intestinal cramping
c. weakness and fatigue
d. weight loss - ansa. jaundice sclera
A client with a chronic kidney disease is treated on hemodialysis. During the 1
treatment clients blood pressure drops from 150/90 to 80/30 Which action
should the nurse take first?
a. monitor bp q45 minutes
b. lower the head of the chair and elevate feet
c. stop dialysis treatment
d. administer 5% albumin IV - ansc. stop dialysis treatment
A client with deep vain thrombosis (DVT) is receiving a continues infusion of
heparin sodium 25,000 unit in 5% dextrose injection 250ml. The
prescription indicates the dosage should be increase 900 units/hr. The
nurse should program the infusion pump to deliver how many ml/hr? - ans9
mL/hour
,A client with hypertension who has been taking labetalol for two weeks,
reports a five pound (2.2 kg) weight gain. Which follow up assessment is
most important for the nurse to obtain?
a. capillary refill
b. body temperature
c. muscle strength
d. breath sounds - ansd. breath sounds
A client with hyperthyroidism is being treated with radioactive iodine (I-131).
Which explanation should be included in preparing this client for this
treatment?
a. describe radioactive iodine as a tasteless, colorless medication
administered by the healthcare provider
b. explain the need for using lead shields for 2 to 3 weeks after the treatment
c. describe the signs of goiter because this is a common side effects of
radioactive iodine
d. explain that relief of the signs/ symptoms of hyperthyroidism will occur
immediately - ansa. describe radioactive iodine as a tasteless, colorless
medication administered by the healthcare provider
A client with sickle cell anemia develops a fever during the last hour of
administration of a unit of packed red blood cell. When notifying the
healthcare provider what information should the nurse provide first using
the SBAR communication process?
a. explain specific reason for urgent notification
b. preface the report by stating the clients name and admitting diagnosis
c. communicate the pre-transfusion temperatures
d. optain prn prescription for acetaminophen for fever 101f - ansa.
explain specific reason for urgent notification
A client with symptoms of influenza that started the previous day ask the
clinic nurse about taking oseltamivir (Tamiflu) to treat the infection. Which
response should the nurse provide?
a. Advise the client once symptoms occur is too late to receive an influenza
vaccination
b. Refer the client to the healthcare provider at the clinic to obtain a
medication prescription
c. Explain to the client that antibiotics are not useful in treating viral
infections such as influenza
d. Instruct the client that over the counter medications are sufficient to
manage influenza symptoms - ansb. refer the client to the healthcare
provider at the clinic to obtain a medication prescription
A female client is being treated for tuberculosis with rifampin (rifadin) which
statement indicates that further teaching is needed? - ansI will take my
usual contraceptive for birth control
A glucagon emergency kit is prescribed for a client with type 1 diabetes
mellitus. When should the nurse instruct the client to take the glucagon?
, a. after meals to increase endogenous insulin secretion
b. after insulin administration to prevent hypoglycemia
c. when recognized signs of severe hypoglycemia occur
d. when unable to eat during sick days - ansc. when recognized signs
of severe hypoglycemia occur
A male adult comes to the urgent care clinic 5 days after being diagnosed
with influenza. He is short of breath, febrile, and coughing green colored
sputum. Which intervention should the nurse implement first?
a. Obtain a sputum sample for culture
b. Check his oxygen saturation level
c. Administer an oral antipyretic
d. Auscultate bilateral lung sound - ansa. obtain a sputum sample for culture
A male client is receiving pilocarpine hydrochloride (Isopto Carpine)
ophthalmic drops for glaucoma. He calls the clinic and ask the nurse why he
has difficulty seeing at night. What explanation should the nurse provide?
a. The eye drops slow pupil response to accommodate for darkness
b. The drops increase the fluid in the eyes and cloud the visual field ( possible
answer)
c. The drug can cause lens to become more opaque
d. The medication causes pupils to dilate which reduces night vision -
ansa. the eye drops slow pupil response to accommodate for darkness
A male client reports to the nurse that he is experiencing GI distress from
high dose of a corticosteroid and is planning to stop taking the medication. In
response to the client's statement what nursing action is most important for
the nurse to take?
a. Encourage the client to take medication with food to decrease GI distress
b. Advice the client that the medication should be stopped gradually
rather than abruptly.
c. Review the clients dosing schedule to ensure he is taking the prescribed
amount
d. Assess the client for other indication of adverse effects of corticosteroid
- ansb. advise the client that the medication should be stopped gradually
rather than abruptly
A male client who is 24hr post operative for an exploratory laparoctomy
complains that he is starving because he has had no real food since before
surgery. Prior to advancing his diet which intervention should the nurse
implememt?
a. discontinue intravenous therapy
b. Assess for abdominal distension and tenderness
c. Obtain a prescription for a diet change
d. Auscultate bowel sound in all four quadrants - ansd. auscultate bowel
sounds in all four quadrants
A young adult male who has had type 2 diabetes mellitus (DM) is admitted to
the intensive care unit with hyperglycemic nonketotic syndrome (HHNS). A
sliding scale protocol for an isotonic IV solution with regular insulin is
ACTUAL EXAM WITH 150 REAL EXAM
QUESTIONS AND CORRECT ANSWERS
WITH WELL-ELABORATED RATIONALES/
EVOLVE HESI MEDICAL SURGICAL LATEST
EXAM 2024 (BRAND NEW!!)
A client diagnosed with stable angina secondary to ischemic heart disease
has a prescription for sublingual (SL) nitroglycerin (NTG). The nurse should
tell the client to follow which instructions if chest pain is not relieved after
taking 3 NTG tablets 5 min apart?
a. drive to the nearest emergency department
b. take another NTG SL tablet and lie down until angina subsides
c. call primary healthcare provider
d. call 911 if pain is unrelieved and chew a tablet of aspirin 325mg - ansd.
call 911 if pain is unrelieved and chew a tablet of aspirin 325 mg
A client experiences an ABO incompatibility reaction after multiple blood
transfusions. Which finding should the nurse report immediately to the
health care provider?
a. low back pain and hypotension
b. rhinitis and nasal stuffiness
c. delayed painful rash with urticarial
d. arthritic joint changes and chronic pain - ansa. low back pain and hypotension
A client is discharged with a prescription for warfarin (Coumadin). What
discharge instructions should the nurse emphasize to the client?
a. take a multi vitamin supplement daily
b. use an astringent for superficial bleeding
c. avoid going barefoot especially outside
d. include large amounts of spinach in the diet - ansc. avoid going barefoot,
especially outside
A client subjective data includes dysuria, urgency, and urinary frequency.
What action should the nurse implement next?
a. collect a clean catch specimen
b. palpate the suprapubic region
c. instruct to wipe from front to back
d. inquire about recent sexual activity - ansa. collect a clean catch specimen
A client tells the nurse that her biopsy results indicate that the cancer cells
are well differentiated How should the nurse respond?
a. offer the client reassurance that this information indicates that the clients
cancer cells are benign
, b. explain that these tissue cells often respond more effectively to
radiation than to chemotherapy
c. ask the client if the healthcare provider has given her any
information about the classification of her cancer
d. help the client make plans to begin immediate treatment since her
cancer is likely to spread quickly - ansc. ask the client if the healthcare
provider has given her any information about the classification of her
cancer
A client who had a myocardial infarction is admitted to the coronary critical
care unit (CCU) with a nitroglycerin drip infusing. The clients last blood
pressure measurements was 78/36. What action should the nurse
implement?
a. obtain blood pressure q5 minutes using duranap machine
b. change the dilution of the nitroglycerin infusion
c. reduce the rate of the nitroglycerin infusion
d. begin dopamine infusion at 5mcg/kg per minute - ansc. reduce the
rate of the nitroglycerin infusion
A client who is taking and oral dose of tetracycline complains of
gastrointestinal upset. What snack should the nurse instruct the client to
take with the tetracycline?
a. toasted wheat bread and jelly
b. cheese and crackers
c. cold cereal with skim milk
d. fruit flavored yogurt - ansa.toasted wheat bread and jelly
A client who took a camping vacation two weeks ago in a country with a
tropical climate comes to the clinic describing vague symptoms and diarrhea
for the past week. Which finding is most important for the nurse to report?
a. jaundice sclera
b. intestinal cramping
c. weakness and fatigue
d. weight loss - ansa. jaundice sclera
A client with a chronic kidney disease is treated on hemodialysis. During the 1
treatment clients blood pressure drops from 150/90 to 80/30 Which action
should the nurse take first?
a. monitor bp q45 minutes
b. lower the head of the chair and elevate feet
c. stop dialysis treatment
d. administer 5% albumin IV - ansc. stop dialysis treatment
A client with deep vain thrombosis (DVT) is receiving a continues infusion of
heparin sodium 25,000 unit in 5% dextrose injection 250ml. The
prescription indicates the dosage should be increase 900 units/hr. The
nurse should program the infusion pump to deliver how many ml/hr? - ans9
mL/hour
,A client with hypertension who has been taking labetalol for two weeks,
reports a five pound (2.2 kg) weight gain. Which follow up assessment is
most important for the nurse to obtain?
a. capillary refill
b. body temperature
c. muscle strength
d. breath sounds - ansd. breath sounds
A client with hyperthyroidism is being treated with radioactive iodine (I-131).
Which explanation should be included in preparing this client for this
treatment?
a. describe radioactive iodine as a tasteless, colorless medication
administered by the healthcare provider
b. explain the need for using lead shields for 2 to 3 weeks after the treatment
c. describe the signs of goiter because this is a common side effects of
radioactive iodine
d. explain that relief of the signs/ symptoms of hyperthyroidism will occur
immediately - ansa. describe radioactive iodine as a tasteless, colorless
medication administered by the healthcare provider
A client with sickle cell anemia develops a fever during the last hour of
administration of a unit of packed red blood cell. When notifying the
healthcare provider what information should the nurse provide first using
the SBAR communication process?
a. explain specific reason for urgent notification
b. preface the report by stating the clients name and admitting diagnosis
c. communicate the pre-transfusion temperatures
d. optain prn prescription for acetaminophen for fever 101f - ansa.
explain specific reason for urgent notification
A client with symptoms of influenza that started the previous day ask the
clinic nurse about taking oseltamivir (Tamiflu) to treat the infection. Which
response should the nurse provide?
a. Advise the client once symptoms occur is too late to receive an influenza
vaccination
b. Refer the client to the healthcare provider at the clinic to obtain a
medication prescription
c. Explain to the client that antibiotics are not useful in treating viral
infections such as influenza
d. Instruct the client that over the counter medications are sufficient to
manage influenza symptoms - ansb. refer the client to the healthcare
provider at the clinic to obtain a medication prescription
A female client is being treated for tuberculosis with rifampin (rifadin) which
statement indicates that further teaching is needed? - ansI will take my
usual contraceptive for birth control
A glucagon emergency kit is prescribed for a client with type 1 diabetes
mellitus. When should the nurse instruct the client to take the glucagon?
, a. after meals to increase endogenous insulin secretion
b. after insulin administration to prevent hypoglycemia
c. when recognized signs of severe hypoglycemia occur
d. when unable to eat during sick days - ansc. when recognized signs
of severe hypoglycemia occur
A male adult comes to the urgent care clinic 5 days after being diagnosed
with influenza. He is short of breath, febrile, and coughing green colored
sputum. Which intervention should the nurse implement first?
a. Obtain a sputum sample for culture
b. Check his oxygen saturation level
c. Administer an oral antipyretic
d. Auscultate bilateral lung sound - ansa. obtain a sputum sample for culture
A male client is receiving pilocarpine hydrochloride (Isopto Carpine)
ophthalmic drops for glaucoma. He calls the clinic and ask the nurse why he
has difficulty seeing at night. What explanation should the nurse provide?
a. The eye drops slow pupil response to accommodate for darkness
b. The drops increase the fluid in the eyes and cloud the visual field ( possible
answer)
c. The drug can cause lens to become more opaque
d. The medication causes pupils to dilate which reduces night vision -
ansa. the eye drops slow pupil response to accommodate for darkness
A male client reports to the nurse that he is experiencing GI distress from
high dose of a corticosteroid and is planning to stop taking the medication. In
response to the client's statement what nursing action is most important for
the nurse to take?
a. Encourage the client to take medication with food to decrease GI distress
b. Advice the client that the medication should be stopped gradually
rather than abruptly.
c. Review the clients dosing schedule to ensure he is taking the prescribed
amount
d. Assess the client for other indication of adverse effects of corticosteroid
- ansb. advise the client that the medication should be stopped gradually
rather than abruptly
A male client who is 24hr post operative for an exploratory laparoctomy
complains that he is starving because he has had no real food since before
surgery. Prior to advancing his diet which intervention should the nurse
implememt?
a. discontinue intravenous therapy
b. Assess for abdominal distension and tenderness
c. Obtain a prescription for a diet change
d. Auscultate bowel sound in all four quadrants - ansd. auscultate bowel
sounds in all four quadrants
A young adult male who has had type 2 diabetes mellitus (DM) is admitted to
the intensive care unit with hyperglycemic nonketotic syndrome (HHNS). A
sliding scale protocol for an isotonic IV solution with regular insulin is
