HESI - Medical Surgical Nursing EXAM
STUDY GUIDE 2026/2027 COMPLETE
QUESTIONS WITH VERIFIED CORRECT
ANSWERS || 100% GUARANTEED PASS
<NEWEST VERSION>
When describing patient education approaches, the nurse educator would explain
that informal teaching is an approach that
a. follows formalized plans
b. has standardized content
c. often occurs one-to-one
d. addresses group needs - ANSWER C. Informal teaching is individualized one on
one teaching which represents the majority of patient education done by nurses that
occurs when an intervention is explained or a question is answered. Group needs
are often the focus of formal patient education courses or classes. Informal
teaching does not necessarily follow a specific formalized plan. It may be planned
with specific content, but it is individualized responses to patient needs. Formal
teaching involves the use of a curriculum/course plan with standardized content.
A patient expresses a strong interest in returning to their work, family, and
hobbies after having a stroke. Which theory type would the nurse use to develop a
plan of care for the best results of this patient's motivation style?
a. field
b. biological
,c. cognitive
d. sociologic - ANSWER C. Cognitive theorists believe that attention, relevance,
confidence, and satisfaction (ARCS) are the conditions that, when integrated,
motivate someone to learn. Field theorists place significance on how achievement,
power, the need for affiliation, and avoidance motives influence individual
behavior. Sociologic theories are not involved in motivation.
The nurse is assessing a group of clients. Which clients are at greater risk for
hypothermia or frostbite? (select all that apply)
a. an older woman with hypertension
b. a young man with a body mass index of 42
c. a young many who has just consumed six martinis
d. an older man who smokes a pack of cigarettes a day
e. a young woman who is anorexic
f. a young woman who is diabetic - ANSWER C, D, E, F
Stroke-Dysphagia - ANSWER Stroke can result in dysphagia (difficulty
swallowing) due to impaired function of the mouth, tongue, palate, larynx,
pharynx, or upper esophagus. Patients must be observed for paroxysms of
coughing, food dribbling out of or pooling in one side of the mouth, food retained
for long periods in the mouth, or nasal regurgitation when swallowing liquids.
Swallowing difficulties place the patient at risk for aspiration, pneumonia,
dehydration, and malnutrition.
Ischemic Stroke- Medications - ANSWER Normalize INR to 2-3 with Warfarin or
anticoagulant
Platelet inhibiting medications like aspirin
After the acute stroke period, antihypertensive medications are also used, if
indicated, for secondary stroke prevention. Preferred drugs include angiotensin-
converting enzyme (ACE) inhibitors and diuretics, or a combination of both
,Thrombolytic agents are used to treat ischemic stroke by dissolving the blood clot
that is blocking blood flow to the brain. Recombinant t-PA is a genetically
engineered form of t-PA (a thrombolytic substance made naturally by the body).
Must be given in a 3 hour window from the start of symptoms.
Benign vs. Neoplasm - ANSWER Benign tumors are not cancerous, thereas
cancerous cells are described as malignant neoplasms
Secondary Tumor - ANSWER Patients who were previously treated for one
cancer are at increased risk for secondary cancers
Chemotherapy-Renal Failure - ANSWER Renal System
Some chemotherapy agents damage the kidneys because they impair water
secretion, leading to syndrome of inappropriate secretion of antidiuretic hormone
(SIADH), decrease renal perfusion, precipitate end products after cell lysis, and
cause interstitial nephritis. Cisplatin (Platinol), methotrexate, and mitomycin
(Mutamycin) are particularly toxic to the kidneys. Rapid tumor cell lysis after
chemotherapy results in increased urinary excretion of uric acid, which can cause
renal damage.
Monitoring laboratory values of blood urea nitrogen (BUN), serum creatinine,
creatinine clearance, and serum electrolytes is essential (Comerford, 2015).
Adequate hydration, diuresis, alkalinization of the urine to prevent formation of
uric acid crystals, and administration of allopurinol (Zyloprim) may be used to
prevent renal toxicity. Amifostine has demonstrated an ability to minimize renal
toxicities associated with cisplatin, cyclophosphamide (Cytoxan), and ifosfamide
(Ifex) therapy.
Hemorrhagic cystitis is a bladder toxicity that can result from cyclophosphamide
and ifosfamide therapy. Hematuria can range from microscopic to frank bleeding
with symptoms ranging from transient irritation during urination, dysuria, and
suprapubic pain to life-threatening hemorrhage. Protection of the bladder focuses
on aggressive IV hydration, frequent voiding, and diuresis. Mesna (Mesnex) is a
cytoprotectant agent that binds with the toxic metabolites of cyclophosphamide or
ifosfamide in the kidneys to prevent hemorrhagic cystitis
, Chemotherapy Teach - ANSWER Nurses provide patient and family education
that emphasizes two key points: the importance of adhering to prescribed self-
administered premedication before presenting to the infusion center, and
recognizing and reporting the signs and symptoms to the nurse once the infusion
has started. Patients and families are also educated about signs and symptoms that
may occur at home following discharge from the infusion area that may warrant
medication administration or immediate transport to the emergency department for
further assessment and treatment.
Radiation Mouth - ANSWER Alterations in oral mucosa secondary to radiation
therapy in the head and neck region include stomatitis (inflammation of the oral
tissues), decreased salivation and xerostomia (dryness of the mouth), and change in
or loss of taste. Depending on the targeted region, any portion of the
gastrointestinal mucosa may be involved, causing mucositis (inflammation of the
lining of the mouth, throat, and gastrointestinal tract).
Meningitis Symptoms and Hyponatremia - ANSWER Nuchal rigidity
Kernig's sign, thigh flexed up to abdomen, cannot complete extend
Brudzinski: neck flexed
Vomiting due to increased ICP, hyponatremia can cause brain swelling, increased
ICP
Guillain Barre- Swallow - ANSWER Patients are at risk for aspiration and
dysphagia
Guillain Barre- Paralysis - ANSWER Ascending weakness, but they can recover.
Good chance they will be intubated
Myasthenia Gravis- Cold - ANSWER Avoid Cold, can make symptoms worse
STUDY GUIDE 2026/2027 COMPLETE
QUESTIONS WITH VERIFIED CORRECT
ANSWERS || 100% GUARANTEED PASS
<NEWEST VERSION>
When describing patient education approaches, the nurse educator would explain
that informal teaching is an approach that
a. follows formalized plans
b. has standardized content
c. often occurs one-to-one
d. addresses group needs - ANSWER C. Informal teaching is individualized one on
one teaching which represents the majority of patient education done by nurses that
occurs when an intervention is explained or a question is answered. Group needs
are often the focus of formal patient education courses or classes. Informal
teaching does not necessarily follow a specific formalized plan. It may be planned
with specific content, but it is individualized responses to patient needs. Formal
teaching involves the use of a curriculum/course plan with standardized content.
A patient expresses a strong interest in returning to their work, family, and
hobbies after having a stroke. Which theory type would the nurse use to develop a
plan of care for the best results of this patient's motivation style?
a. field
b. biological
,c. cognitive
d. sociologic - ANSWER C. Cognitive theorists believe that attention, relevance,
confidence, and satisfaction (ARCS) are the conditions that, when integrated,
motivate someone to learn. Field theorists place significance on how achievement,
power, the need for affiliation, and avoidance motives influence individual
behavior. Sociologic theories are not involved in motivation.
The nurse is assessing a group of clients. Which clients are at greater risk for
hypothermia or frostbite? (select all that apply)
a. an older woman with hypertension
b. a young man with a body mass index of 42
c. a young many who has just consumed six martinis
d. an older man who smokes a pack of cigarettes a day
e. a young woman who is anorexic
f. a young woman who is diabetic - ANSWER C, D, E, F
Stroke-Dysphagia - ANSWER Stroke can result in dysphagia (difficulty
swallowing) due to impaired function of the mouth, tongue, palate, larynx,
pharynx, or upper esophagus. Patients must be observed for paroxysms of
coughing, food dribbling out of or pooling in one side of the mouth, food retained
for long periods in the mouth, or nasal regurgitation when swallowing liquids.
Swallowing difficulties place the patient at risk for aspiration, pneumonia,
dehydration, and malnutrition.
Ischemic Stroke- Medications - ANSWER Normalize INR to 2-3 with Warfarin or
anticoagulant
Platelet inhibiting medications like aspirin
After the acute stroke period, antihypertensive medications are also used, if
indicated, for secondary stroke prevention. Preferred drugs include angiotensin-
converting enzyme (ACE) inhibitors and diuretics, or a combination of both
,Thrombolytic agents are used to treat ischemic stroke by dissolving the blood clot
that is blocking blood flow to the brain. Recombinant t-PA is a genetically
engineered form of t-PA (a thrombolytic substance made naturally by the body).
Must be given in a 3 hour window from the start of symptoms.
Benign vs. Neoplasm - ANSWER Benign tumors are not cancerous, thereas
cancerous cells are described as malignant neoplasms
Secondary Tumor - ANSWER Patients who were previously treated for one
cancer are at increased risk for secondary cancers
Chemotherapy-Renal Failure - ANSWER Renal System
Some chemotherapy agents damage the kidneys because they impair water
secretion, leading to syndrome of inappropriate secretion of antidiuretic hormone
(SIADH), decrease renal perfusion, precipitate end products after cell lysis, and
cause interstitial nephritis. Cisplatin (Platinol), methotrexate, and mitomycin
(Mutamycin) are particularly toxic to the kidneys. Rapid tumor cell lysis after
chemotherapy results in increased urinary excretion of uric acid, which can cause
renal damage.
Monitoring laboratory values of blood urea nitrogen (BUN), serum creatinine,
creatinine clearance, and serum electrolytes is essential (Comerford, 2015).
Adequate hydration, diuresis, alkalinization of the urine to prevent formation of
uric acid crystals, and administration of allopurinol (Zyloprim) may be used to
prevent renal toxicity. Amifostine has demonstrated an ability to minimize renal
toxicities associated with cisplatin, cyclophosphamide (Cytoxan), and ifosfamide
(Ifex) therapy.
Hemorrhagic cystitis is a bladder toxicity that can result from cyclophosphamide
and ifosfamide therapy. Hematuria can range from microscopic to frank bleeding
with symptoms ranging from transient irritation during urination, dysuria, and
suprapubic pain to life-threatening hemorrhage. Protection of the bladder focuses
on aggressive IV hydration, frequent voiding, and diuresis. Mesna (Mesnex) is a
cytoprotectant agent that binds with the toxic metabolites of cyclophosphamide or
ifosfamide in the kidneys to prevent hemorrhagic cystitis
, Chemotherapy Teach - ANSWER Nurses provide patient and family education
that emphasizes two key points: the importance of adhering to prescribed self-
administered premedication before presenting to the infusion center, and
recognizing and reporting the signs and symptoms to the nurse once the infusion
has started. Patients and families are also educated about signs and symptoms that
may occur at home following discharge from the infusion area that may warrant
medication administration or immediate transport to the emergency department for
further assessment and treatment.
Radiation Mouth - ANSWER Alterations in oral mucosa secondary to radiation
therapy in the head and neck region include stomatitis (inflammation of the oral
tissues), decreased salivation and xerostomia (dryness of the mouth), and change in
or loss of taste. Depending on the targeted region, any portion of the
gastrointestinal mucosa may be involved, causing mucositis (inflammation of the
lining of the mouth, throat, and gastrointestinal tract).
Meningitis Symptoms and Hyponatremia - ANSWER Nuchal rigidity
Kernig's sign, thigh flexed up to abdomen, cannot complete extend
Brudzinski: neck flexed
Vomiting due to increased ICP, hyponatremia can cause brain swelling, increased
ICP
Guillain Barre- Swallow - ANSWER Patients are at risk for aspiration and
dysphagia
Guillain Barre- Paralysis - ANSWER Ascending weakness, but they can recover.
Good chance they will be intubated
Myasthenia Gravis- Cold - ANSWER Avoid Cold, can make symptoms worse
