HESI Case Studies – Stroke Exam Reviewed in 2026/2027 |Real Questions with Definite Rationaled Answers (Brand New!!)

HESI Stroke Case Study Answers & Nursing Interventions | NCLEX Review This comprehensive HESI case study focuses on a patient, Mr. Jones, who experiences an ischemic right-sided stroke. It provides evidence-based nursing interventions, prioritization strategies, and clinical reasoning for stroke care. Key topics include: managing shoulder pain and joint deformities, delegating tasks to UAP, calculating infusion rates (e.g., 75 ml/hr for enteral feeding), recognizing stroke manifestations (e.g., carotid bruit, spatial-perceptual deficits), interpreting diagnostic test precautions (MRI with hip replacement), administering enoxaparin (77 mg dose calculation), addressing dysphagia, homonymous hemianopsia, and modifiable risk factors such as atrial fibrillation and high cholesterol. Perfect for nursing students preparing for HESI, NCLEX, or clinical simulations. HESI Case Studies – Stroke Exam Reviewed in 2026/2027 |Real Questions with Definite Rationaled Answers (Brand New!!) 1. Mr. Jones is experiencing pain in his left shoulder. The nurse is aware that up to 70% of clients with a stroke experience severe pain in the shoulder that prevents them from learning new skills. Shoulder function helps clients achieve balance, perform transfer skills, and participate in self-care activities. Which intervention should the nurse implement when addressing this condition? - ANSWER️-Instruct Mr. Jones to clasp the left hand with the right hand and raise both hands above the head. 2. How should the nurse respond? - ANSWER️-"That procedure is only done with small strokes, not like the one your dad had." 3. Which nursing care task should the nurse delegate to the UAP? (Select all the apply.) - ANSWER️-Take Mr. Jones' vital signs Give Mr. Jones a bed bath and change the bed linens Measure Mr. Jones' intake and output each shift (I&O) 4. A physical therapist (PT) places a gait belt on Mr. Jones and assists him with ambulation from the bed to the chair. As he gets up out of the bed, Mr. Jones says he is dizzy and begins to fall. The PT carefully allows him to fall back to the bed and notifies the primary nurse. Which written documentation should the nurse put in the client's record? - ANSWER️-PT reported that client stated he felt dizzy and was lowered to the bed assisted by the PT using a gait belt. 5. Which interventions should the nurse implement to prevent joint deformities? - ANSWER️-Apply splints the arms and legs at night Place the elbow higher than the shoulder and the wrist higher than the elbow on the affected side Place in prone position for 15 min for at least 4 times a day 6. What action should the nurse implement to address this situation? - ANSWER️-discuss how to use a communication board with Mr. Jones and Barry 7. Which rehabilitation team member is responsible for evaluating Mr. Jones' dysphagia? - ANSWER️-speech therapist 8. Which intervention should the nurse prior to beginning a feeding? - ANSWER️-Elevate HOB to 30 or 40 degrees 9. The HCP orders 360 ml of liquid nourishment diluted with one can of water to be infused over 8 hours. The feeding will be administered through an infusion pump, which infuses in ml/hr. At what rate would the nurse set the infusion pump? (Enter numerical value only. If rounding is necessary, round to the whole number.) - ANSWER️-75 360 ml + 240 ml (8 oz x 30 ml)= 600 ml/8 hrs= 75 ml/hr 10. The Emergency Department (ED) nurse completes the admission assessment. Mr. Jones is alert but struggles to answer questions. When he attempts to talk, he slurs his speech and appears very frightened. Which additional clinical manifestations should the nurse expect to find if Mr. Jones' symptoms have been caused by a stroke? - ANSWER️-carotid bruit Elevated BP Hyporeflexia DTR 11. Which assessment finding warrants immediate intervention by the RN? (Select all) - ANSWER️-Mr. Jones' Glasgow Coma Scale (GCS) score changes from 12 to 9 Mr. Jones has a positive Babinski's reflex bilaterally Mr. Jones is unable to verbalize responses to the nurse's questions 12. Due to his deteriorating condition, the neurologist is consulted to see Mr. Jones immediately. The nurse suspects that Mr. Jones has probably suffered a right-sided stroke. Which clinical manifestations further support this assessment? - ANSWER️-increased distractibility Visual deficit on left side Spatial-perceptual deficits Paresthesia on left side 13. The neurologist writes a diagnosis of "suspected stroke" and prescribes a computed tomography (CT) scan without contrast STAT. Which intervention should the nurse implement when preparing Mr. Jones and his son for this procedure? - ANSWER️-Explain procedure requires client to lie completely still 14. The neurologist also prescribes a magnetic resonance imaging (MRI) of the head STAT. Which data warrants immediate intervention by the nurse concerning this diagnostic test? - ANSWER️-left hip replacement 15. Which explanation by the nurse is the most therapeutic response? - ANSWER️-"Your father has had a stroke, and the blood supply to the brain has been compromised." 16. Barry is visibly upset and states, "Dad has been fine all week. We even went out to dinner. I love him so much and I am scared." How should the nurse respond? - ANSWER️-"I know this is scary for you. Would you like to sit and talk?" 17. The neurologist diagnoses an ischemic right-sided stroke. The neurologist determines that Mr. Jones is not a candidate for tissue plasminogen activator (tpa). Enoxaparin 1 mg/kg subcutaneously every 12 hours is prescribed. Mr. Jones weighs 170 pounds. How many mg of enoxaparin will the nurse administer in each dose? (Enter the numerical value only. If rounding is required, round to the whole number). - ANSWER️-77 170/2.2= 77.27 18. With a diagnosis of a stroke, which priority intervention should the nurse include in Mr. Jones' plan of care? - ANSWER️-monitor glucose daily Elevate HOB Assess neuro status every hour Monitor PTT daily 19. The nurse continues to monitor Mr. Jones' condition closely. Which finding would require immediate intervention by the nurse? - ANSWER️-Serum glucose is 150 Potassium is 3.0 Pulse ox has been 90% for the past two hours