Evolve Elsevier Med-Surg PN HESI

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Sample questions from Evolve Elsevier Med-Surg PN HESI

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 68-year-old client with heart failure reports increasing shortness of breath and is unable to lie flat. Which assessment finding requires the nurse to act first?

   • A.Oxygen saturation of 86% on room air
   • B.Bilateral ankle edema of 1+
   • C.Weight gain of 0.5 kg (1.1 lb) in 1 week
   • D.Blood pressure of 148/86 mm Hg

   Rationale: An oxygen saturation of 86% indicates impaired oxygenation and requires prompt assessment and intervention, such as positioning upright and applying oxygen as prescribed. Mild ankle edema and a small weekly weight gain suggest fluid retention but are less immediately urgent; the elevated blood pressure should be reassessed and managed but does not take priority over hypoxemia. In heart failure, prioritize airway and breathing changes.

2. 2.A client taking furosemide for heart failure reports muscle weakness. Which laboratory result is most important for the nurse to report?

   • A.Potassium 2.9 mEq/L
   • B.Sodium 138 mEq/L
   • C.Calcium 9.2 mg/dL
   • D.Glucose 112 mg/dL

   Rationale: Furosemide can cause potassium loss, and a potassium of 2.9 mEq/L increases the risk of dysrhythmias and muscle weakness. The listed sodium and calcium values are within typical reference ranges, and a glucose of 112 mg/dL is not the urgent concern in this situation. Monitor potassium and cardiac rhythm, and report significant hypokalemia promptly.

3. 3.A client arrives at the clinic with crushing chest pain, diaphoresis, and nausea. Which action should the nurse take first?

   • A.Obtain vital signs and assess oxygenation while initiating emergency evaluation
   • B.Ask the client to walk to determine whether activity worsens the pain
   • C.Offer a meal to prevent nausea from becoming worse
   • D.Schedule a routine appointment for later in the day

   Rationale: Chest pain with diaphoresis and nausea may indicate acute coronary syndrome, so the nurse should rapidly assess stability and activate the appropriate emergency evaluation. Walking could increase cardiac workload, and food is inappropriate while urgent assessment or treatment may be needed. Delaying evaluation risks missing a time-sensitive cardiac event.

4. 4.A client with atrial fibrillation is prescribed warfarin. Which statement indicates that the client understands the teaching?

   • A.I will use an electric razor and report unusual bleeding.
   • B.I should stop eating all foods that contain vitamin K.
   • C.I can take aspirin whenever I have a headache.
   • D.I do not need blood tests once my dose is established.

   Answer and rationale are in the full material.

5. 5.A nurse is teaching a client with hypertension about home blood pressure measurement. Which instruction is best?

   • A.Sit quietly for several minutes with feet flat and the arm supported at heart level.
   • B.Measure the pressure immediately after climbing stairs for a more accurate result.
   • C.Place the cuff over clothing to avoid irritating the skin.
   • D.Use a different arm at each reading and compare the values without recording them.

   Answer and rationale are in the full material.