EVOLVE ELSEVIER HESI MED SURG EXIT EXAM

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EVOLVE ELSEVIER HESI MED SURG EXIT EXAM

VERSION 3 / MED SURG HESI EVOLVE ELSEVIER

NEWEST 2025/2026 COMPLETE QUESTIONS AND

CORRECT ANSWERS (VERIFIED ANSWERS)

|ALREADY GRADED A+||BRAND NEW VERSION!!

A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry unit. What initial medication should the nurse anticipate administering to the client?

• Xylocaine (Lidocaine).
• Procainamide (Pronestyl).
• Phenytoin (Dilantin).
• Digoxin (Lanoxin). - ANSWER-D) Digoxin (Lanoxin).

Rationale; Digoxin (Lanoxin) (D) is administered for uncontrolled, symptomatic atrial fibrillation resulting in a decreased cardiac output.Digoxin slows the rate of conduction by prolonging the refractory period of the AV node, thus slowing the ventricular response, decreasing the heart rate, and effecting cardiac output. (A, B, and C) are not indicated in the initial treatment of uncontrolled atrial fibrillation.

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What instruction should the nurse give a client who is diagnosed with fibrocystic changes of the breast?

• Observe cyst size fluctuations as a sign of malignancy.
• Use estrogen supplements to reduce breast discomfort.
• Notify the healthcare provider if whitish nipple discharge occurs.
• Perform a breast self-exam (BSE) procedure monthly. - ANSWER-D)

Perform a breast self-exam (BSE) procedure monthly.

Rationale; Fibrocystic changes in the breast are related to excess fibrous tissue, proliferation of mammary ducts and cyst formation that cause edema and nerve irritation. These changes obscure typical diagnostic tests, such as mammography, due to an increased breast density. Women with fibrocystic breasts should be instructed to carefully perform monthly BSE (D) and consider changes in any previous "lumpiness." Fibrocystic disease does not increase the risk of breast cancer (A). Cyst size fluctuates with the menstrual cycle, and typically lessens after menopause, and responds with a heightened sensitivity to circulating estrogen (B), which is not indicated. Nipple discharge associated with fibrocystic breasts is often milky or watery- milky and is an expected finding (C).

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)?

• Serum PTT of 10 seconds. 2 / 4

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• Serum calcium of 5 mg/dl.
• Oxygen saturation of 90%.
• Hemoglobin of 10 g/dl. - ANSWER-B) Serum calcium of 5 mg/dl.

Rationale; 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.

A client has undergone insertion of a permanent pacemaker. When developing a discharge teaching plan, the nurse writes a goal of, "The client will verbalize symptoms of pacemaker failure." Which symptoms are most important to teach the client?

• Facial flushing.
• Fever.
• Pounding headache.
• Feelings of dizziness. - ANSWER-D) Feelings of dizziness.

Rationale; Feelings of dizziness may occur as the result of a decreased heart rate, leading to decreased cardiac output (D). (A and C) will not occur as the result of pacemaker failure. (B) may be an indication of infection postoperatively, but is not an indication of pacemaker failure.

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A client taking a thiazide diuretic for the past six months has a serum potassium level of 3. The nurse anticipates which change in prescription for the client?

• The dosage of the diuretic will be decreased.
• The diuretic will be discontinued.
• A potassium supplement will be prescribed.
• The dosage of the diuretic will be increased. - ANSWER-C) A

potassium supplement will be prescribed.

Rationale; This client's potassium level is too low (normal is 3.5 to 5).Taking a thiazide diuretic often results in a loss of potassium, so a potassium supplement needs to be prescribed to restore a normal serum potassium level (C). (A, B, and D) are not recommended actions for restoring a normal serum potassium level.

A client taking furosemide (Lasix), reports difficulty sleeping. What question is important for the nurse to ask the client?

• What dose of medication are you taking?
• Are you eating foods rich in potassium?
• Have you lost weight recently?
• At what time do you take your medication? - ANSWER-D) At what

time do you take your medication?

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