HESI Medical-
CDOVA
A
2026
NextMGeneration
NPCREEDHC|ELWith
Updated NINCLEX
NSI ICComplete
VA EL (NGN)
JSUTDU
GDM Y
E NG U| NI DG ENwith
Tstudies
Solutions
Grading Rubric and Solution Key Included
case
complete solutions aligned to 2026-2027 academic and
C| A5S0E 0S TQUU
D IEESS T I O N S A N D A N S W E R S
Surgical
NCLEX standards. Covers cardiovascular, respiratory,
neurological, endocrine, renal, and gastrointestinal
Nursing 2
disorders with evidence-based nursing interventions.
, Table of Contents
Grading Rubric and Solution Key 2
Section 1: Cardiovascular and Hematologic Disorders (Q1-Q100) 4
Section 2: Respiratory and Critical Care Disorders (Q101-Q200) 24
Section 3: Neurological and Sensory Disorders (Q201-Q300) 46
Section 4: Endocrine, Renal, and Gastrointestinal Disorders (Q301-Q400) 65
Section 5: Next Generation NCLEX (NGN) Unfolding Case Studies and Matrix Questions
(Q401-Q500) 86
, HESI Med Surg 2 Comprehensive Study Guide | 2026 Updated
Grading Rubric and Solution Key
This comprehensive study guide consists of 500 questions distributed across five major content areas aligned with the
HESI Medical-Surgical Nursing 2 curriculum and 2026-2027 NCLEX standards. Each question is worth 0.2 points for
a total of 100 points. The following rubric defines scoring criteria, mastery thresholds, and partial credit policies for
NGN-format items.
Point Allocation
Standard multiple-choice questions (Q1-Q400): 0.2 points each. NGN case study questions (Q401-Q500) are scored
using a grid/matrix framework where 0.2 points are awarded when the primary pathophysiological concept or safety
priority is correctly identified. Partial credit of 0.1 points is awarded if the candidate selects an intervention that is
clinically appropriate but represents a lower-priority action within the NCJMM framework (e.g., selecting "Assess
vital signs" when the priority is "Administer oxygen per ABC").
Mastery Thresholds
Proficient: 85-100 points (85%+). This score indicates readiness for the HESI Med Surg 2 examination and
demonstrates consistent application of clinical judgment, safe nursing prioritization, and evidence-based intervention
selection across all content domains. Achieving this threshold reflects the ability to manage complex, unfolding
clinical scenarios with appropriate delegation and rapid identification of life-threatening complications.
Approaching Proficiency: 75-84 points (75-84%). The candidate demonstrates adequate foundational knowledge but
exhibits inconsistencies in prioritization, particularly in distinguishing acute from chronic presentations and applying
the NCJMM model to multi-step clinical scenarios. Focused review of the weaker content sections is recommended
before retesting.
Below Proficiency: Below 75 points (<75%). This score indicates significant knowledge gaps requiring
comprehensive remediation. The candidate should complete a systematic review of pathophysiology, pharmacology,
and the nursing process for each content area before attempting the HESI Med Surg 2 examination.
NGN Partial Credit Framework
For NGN unfolding case studies (Section 5), the NCSBN Clinical Judgment Measurement Model (NCJMM) is
applied. Full credit (0.2 points) requires the candidate to correctly identify the priority nursing action that aligns with
the highest-level cognitive step in the NCJMM (Evaluate Outcomes > Take Action > Generate Solutions > Prioritize
Hypotheses > Analyze Cues > Recognize Cues). Partial credit (0.1 points) is awarded when the candidate
demonstrates accurate pathophysiological reasoning or identifies the correct clinical concern but selects a nursing
intervention that is safe but not the highest priority based on ABC, Maslow, or acute-versus-chronic frameworks.
Cognitive Level Distribution
Recall (30%, ~150 questions): Tests fundamental knowledge of definitions, normal values, medication mechanisms,
and pathophysiological concepts. Application (50%, ~250 questions): Requires the candidate to apply knowledge to
clinical scenarios, select priority interventions, and interpret assessment data. Analysis (20%, ~100 questions):
Demands interpretation of complex, multi-system clinical data, evaluation of trends, and synthesis of information to
make clinical judgments consistent with the NCJMM framework.
Content Area Distribution
Page 2
, HESI Med Surg 2 Comprehensive Study Guide | 2026 Updated
Section Topic Area Questions Points
1 Cardiovascular and Hematologic Disorders Q1-Q100 20
2 Respiratory and Critical Care Disorders Q101-Q200 20
3 Neurological and Sensory Disorders Q201-Q300 20
4 Endocrine, Renal, and Gastrointestinal Disorders Q301-Q400 20
5 NGN Unfolding Case Studies and Matrix Questions Q401-Q500 20
Total 500 100
Page 3
CDOVA
A
2026
NextMGeneration
NPCREEDHC|ELWith
Updated NINCLEX
NSI ICComplete
VA EL (NGN)
JSUTDU
GDM Y
E NG U| NI DG ENwith
Tstudies
Solutions
Grading Rubric and Solution Key Included
case
complete solutions aligned to 2026-2027 academic and
C| A5S0E 0S TQUU
D IEESS T I O N S A N D A N S W E R S
Surgical
NCLEX standards. Covers cardiovascular, respiratory,
neurological, endocrine, renal, and gastrointestinal
Nursing 2
disorders with evidence-based nursing interventions.
, Table of Contents
Grading Rubric and Solution Key 2
Section 1: Cardiovascular and Hematologic Disorders (Q1-Q100) 4
Section 2: Respiratory and Critical Care Disorders (Q101-Q200) 24
Section 3: Neurological and Sensory Disorders (Q201-Q300) 46
Section 4: Endocrine, Renal, and Gastrointestinal Disorders (Q301-Q400) 65
Section 5: Next Generation NCLEX (NGN) Unfolding Case Studies and Matrix Questions
(Q401-Q500) 86
, HESI Med Surg 2 Comprehensive Study Guide | 2026 Updated
Grading Rubric and Solution Key
This comprehensive study guide consists of 500 questions distributed across five major content areas aligned with the
HESI Medical-Surgical Nursing 2 curriculum and 2026-2027 NCLEX standards. Each question is worth 0.2 points for
a total of 100 points. The following rubric defines scoring criteria, mastery thresholds, and partial credit policies for
NGN-format items.
Point Allocation
Standard multiple-choice questions (Q1-Q400): 0.2 points each. NGN case study questions (Q401-Q500) are scored
using a grid/matrix framework where 0.2 points are awarded when the primary pathophysiological concept or safety
priority is correctly identified. Partial credit of 0.1 points is awarded if the candidate selects an intervention that is
clinically appropriate but represents a lower-priority action within the NCJMM framework (e.g., selecting "Assess
vital signs" when the priority is "Administer oxygen per ABC").
Mastery Thresholds
Proficient: 85-100 points (85%+). This score indicates readiness for the HESI Med Surg 2 examination and
demonstrates consistent application of clinical judgment, safe nursing prioritization, and evidence-based intervention
selection across all content domains. Achieving this threshold reflects the ability to manage complex, unfolding
clinical scenarios with appropriate delegation and rapid identification of life-threatening complications.
Approaching Proficiency: 75-84 points (75-84%). The candidate demonstrates adequate foundational knowledge but
exhibits inconsistencies in prioritization, particularly in distinguishing acute from chronic presentations and applying
the NCJMM model to multi-step clinical scenarios. Focused review of the weaker content sections is recommended
before retesting.
Below Proficiency: Below 75 points (<75%). This score indicates significant knowledge gaps requiring
comprehensive remediation. The candidate should complete a systematic review of pathophysiology, pharmacology,
and the nursing process for each content area before attempting the HESI Med Surg 2 examination.
NGN Partial Credit Framework
For NGN unfolding case studies (Section 5), the NCSBN Clinical Judgment Measurement Model (NCJMM) is
applied. Full credit (0.2 points) requires the candidate to correctly identify the priority nursing action that aligns with
the highest-level cognitive step in the NCJMM (Evaluate Outcomes > Take Action > Generate Solutions > Prioritize
Hypotheses > Analyze Cues > Recognize Cues). Partial credit (0.1 points) is awarded when the candidate
demonstrates accurate pathophysiological reasoning or identifies the correct clinical concern but selects a nursing
intervention that is safe but not the highest priority based on ABC, Maslow, or acute-versus-chronic frameworks.
Cognitive Level Distribution
Recall (30%, ~150 questions): Tests fundamental knowledge of definitions, normal values, medication mechanisms,
and pathophysiological concepts. Application (50%, ~250 questions): Requires the candidate to apply knowledge to
clinical scenarios, select priority interventions, and interpret assessment data. Analysis (20%, ~100 questions):
Demands interpretation of complex, multi-system clinical data, evaluation of trends, and synthesis of information to
make clinical judgments consistent with the NCJMM framework.
Content Area Distribution
Page 2
, HESI Med Surg 2 Comprehensive Study Guide | 2026 Updated
Section Topic Area Questions Points
1 Cardiovascular and Hematologic Disorders Q1-Q100 20
2 Respiratory and Critical Care Disorders Q101-Q200 20
3 Neurological and Sensory Disorders Q201-Q300 20
4 Endocrine, Renal, and Gastrointestinal Disorders Q301-Q400 20
5 NGN Unfolding Case Studies and Matrix Questions Q401-Q500 20
Total 500 100
Page 3
