Exam Preparation With Complete 200 Questions

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Evolve Elsevier Hesi Med Surg Newest 2026-2027 Exam Preparation With Complete 200 Questions And Correct Answers With Rationales | Already Graded A+||Brand New Version!!

A client with gastroesophageal reflux disease (GERD) has been experiencing severe reflux during sleep. Which recommendation by the nurse is most effective to assist the client?

• Losing weight.
• Decreasing caffeine intake.
• Avoiding large meals.
• Raising the head of the bed on blocks. - CORRECT

ANSWER-D) Raising the head of the bed on blocks.

Rationale: Raising the head of the bed on blocks (D) (reverse

Trendelenburg position) to reduce reflux and subsequent aspiration is the most effective recommendation for a client experiencing severe gastroesophageal reflux during sleep. (A, B and C) may be effective recommendations but raising the head of the bed is more effective for relief during sleep.

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The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH), which is manifested by which symptoms?

• Loss of thirst, weight gain.
• Dependent edema, fever.
• Polydipsia, polyuria.
• Hypernatremia, tachypnea. - CORRECT ANSWER -A)

Loss of thirst, weight gain.

Rationale: SIADH occurs when the posterior pituitary gland

releases too much ADH, causing water retention, a urine output of less than 20 ml/hour, and dilutional hyponatremia. Other indications of SIADH are loss of thirst, weight gain (A), irritability, muscle weakness, and decreased level of consciousness. (B) is not associated with SIADH. (C) is a finding associated with diabetes insipidus (a water metabolism problem caused by an ADH deficiency), not SIADH. The increase in plasma volume causes an increase in the glomerular filtration rate that inhibits the release of rennin and aldosterone, 2 / 4

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which results in an increased sodium loss in urine, leading to greater hyponatremia, not (D).

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The nurse is planning care for a client with newly diagnosed diabetes mellitus that requires insulin. Which assessment should the nurse identify before beginning the teaching session?

• Present knowledge related to the skill of injection.
• Intelligence and developmental level of the client.
• Willingness of the client to learn the injection sites.
• Financial resources available for the equipment. -

CORRECT ANSWER -C) Willingness of the client to learn the injection sites.

Rationale: If a client is incapable or does not want to learn, it is

unlikely that learning will occur, so motivation is the first factor the nurse should assess before teaching (C). To determine learning needs, the nurse should assess (A), but this is not the most important factor for the nurse to assess. (B and D) are factors to consider, but not as vital as (C).

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The nurse is caring for a client who has taken a large quantity of furosemide (Lasix) to promote weight loss. The nurse anticipates the finding of which acid-base imbalance?

• PO2 of 78 mm Hg

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• HCO3 of 34 mEq/L
• PCO2 of 56 mm Hg
• pH of 7.31 - CORRECT ANSWER -B) HCO3 of 34 mEq/L

Rationale: Diuretics (non-potassium sparing) cause metabolic

alkalosis. A) PO2 of 78 mm Hg: This Po2 demonstrates mild

hypoxemia, consistent with respiratory disorders, not with

diuretic use. C) PCO2 of 56 mm Hg: CO2 retention results from

hypoventilation, which is not consistent with diuretic use. D) pH

of 7.31: This pH is acidotic; diuretics promote metabolic

alkalosis.

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?

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