MED SURG HESI CERTIFICATION
EVALUATION 2026 EXAM QUESTIONS AND
SOLUTIONS
◉ HESI HINT: PERCUTANEOUS NEPHROSTOMY.
Answer: A needle or catheter is inserted through the skin into the
calyx of the kidney. The stone may be dissolved by percutaneous
irrigation with a liquid that dissolves the stone or by ultrasonic
sound waves (lithotrpsy) that can be directed through the needle or
catheter to break up the stone, which then van be eliminated
through the urinary tract.
◉ HESI HINT: BLADDER SPASMS.
Answer: Bladder spasms frequently occur after TURP (transurethral
resection of the prostate gland). Inform the client that the presence
of the oversized balloon on the catheter (30-45ml inflated) will
cause a continuous feeling of needing to void. The client should not
try to void around the catheter because this can precipitate bladder
spasms. Medication to reduce or prevent spasms should be given.
◉ HESI HINT: SHIFT IN CELLULAR FLUID.
Answer: Instillation of hypertonic or hypotonic solution into a body
cavity will cause a shift in cellular fluid. Use only sterile saline for
,bladder irrigation after TURP because irrigation must be isotonic to
prevent fluid and electrolyte imbalances.
◉ HESI HINT: RELATIONSHIP OF KIDNEYS TO CARDIOVASCULAR
SYSTEM.
Answer: *Kidneys filter about 1L/blood a min. If cardiac output is
decreased, the amount of blood going through the kidneys is
decreased; urinary output is decreased. Therefore, a decrease
urinary output may be sign of a cardiac problem.
*When the kidneys produce and excrete o.5mL of urine/kg of body
weight or average of 30mL/hr output, the blood supply is
considered to be minimally adequate to perfuse the vital organs.
◉ HESI HINT: ANGINA.
Answer: IS CAUSED BY MYOCARDIAL ISCHEMIA.
◉ HESI HINT: NITROGLYCERIN.
Answer: APPROPRIATE FOR ANGINA; CAUSES DILATION OF THE
CORONARY ARTERIES, ALLOWING MORE O2 TO GET TO THE
HEART MUSCLE
◉ HESI HINT: ATROPINE.
Answer: NOT APPROPRIATE FOR ANGINA; INCREASES HEART RATE
BY BLOCKING VAGAL STIMULATION, WHICH SUPRESSES THE
,HEART RATE; DOES NOT ADDRESS THE LACK OF O2 TO THE
HEART MUSCLE
◉ HESI HINT: PROPRANOLOL (INDERAL).
Answer: NOT APPROPRIATE FOR ACUTE ANGINA ATTACK;
HOWEVER, IS APPROPRIATE FOR LONG-TERM MANAGEMENT OF
STABLE ANGINA BECAUSE IT ACTS AS A BETA BLOCKER TO
CONTROL VASOCONSTRICTION
◉ HESI HINT: MONA.
Answer: REMEMBER MONA WHEN ADMINISTERING MEDICATIONS
AND TREATMENTS IN THE PATIENT WITH MYOCARDIAL
INFARCTION. MONA- MORPHINE, OXYGEN, NITROGLYCERIN,
ASPIRIN
◉ HESI HINT: BLOOD PRESSURE.
Answer: Blood pressure is created by the difference in the pressure
of the blood as it leaves the heart and the resistance it meets flowing
out to the tissues. Therefore, any factor that alters cardiac output or
peripheral vascular resistance will alter blood pressure. Diet and
exercise, smoking cessation, weight control, and stress management
can control many factors that influence the resistance blood meets
as it flows from the heart.
◉ HESI HINT: RISK FACTORS FOR HTN.
, Answer: Heredity, race, age, alcohol abuse, increased salt intake,
obesity, and use of oral contraceptives.
◉ HESI HINT: HYPERTENSION TEACHING.
Answer: The number one cause of a stroke with hypertensive clients
is non-compliance with medication regimen. Hypertension is often
symptomless, and antihypertensive medications are expensive and
have side effects. Studies have shown that the more clients know
about their anti-hypertensive medications, the more likely they are
to take them; teaching is important.
◉ HESI HINT: DECREASED BLOOD FLOW.
Answer: Results in diminished sensation in the lower extremities.
Any heat source can cause severe burns before the client actually
realizes the damage is being done.
◉ HESI HINT: DISSECTING AORTIC ANEURYSM.
Answer: A client is admitted with severe chest pain and states that
he feels a terrible, tearing sensation in his chest. He is diagnosed
with a dissecting aortic aneurysm. What assessment should the
nurse obtain in the first few hours?
-Vital signs every hour
-Neurological vital signs
-Respiratory status
-Urinary output
EVALUATION 2026 EXAM QUESTIONS AND
SOLUTIONS
◉ HESI HINT: PERCUTANEOUS NEPHROSTOMY.
Answer: A needle or catheter is inserted through the skin into the
calyx of the kidney. The stone may be dissolved by percutaneous
irrigation with a liquid that dissolves the stone or by ultrasonic
sound waves (lithotrpsy) that can be directed through the needle or
catheter to break up the stone, which then van be eliminated
through the urinary tract.
◉ HESI HINT: BLADDER SPASMS.
Answer: Bladder spasms frequently occur after TURP (transurethral
resection of the prostate gland). Inform the client that the presence
of the oversized balloon on the catheter (30-45ml inflated) will
cause a continuous feeling of needing to void. The client should not
try to void around the catheter because this can precipitate bladder
spasms. Medication to reduce or prevent spasms should be given.
◉ HESI HINT: SHIFT IN CELLULAR FLUID.
Answer: Instillation of hypertonic or hypotonic solution into a body
cavity will cause a shift in cellular fluid. Use only sterile saline for
,bladder irrigation after TURP because irrigation must be isotonic to
prevent fluid and electrolyte imbalances.
◉ HESI HINT: RELATIONSHIP OF KIDNEYS TO CARDIOVASCULAR
SYSTEM.
Answer: *Kidneys filter about 1L/blood a min. If cardiac output is
decreased, the amount of blood going through the kidneys is
decreased; urinary output is decreased. Therefore, a decrease
urinary output may be sign of a cardiac problem.
*When the kidneys produce and excrete o.5mL of urine/kg of body
weight or average of 30mL/hr output, the blood supply is
considered to be minimally adequate to perfuse the vital organs.
◉ HESI HINT: ANGINA.
Answer: IS CAUSED BY MYOCARDIAL ISCHEMIA.
◉ HESI HINT: NITROGLYCERIN.
Answer: APPROPRIATE FOR ANGINA; CAUSES DILATION OF THE
CORONARY ARTERIES, ALLOWING MORE O2 TO GET TO THE
HEART MUSCLE
◉ HESI HINT: ATROPINE.
Answer: NOT APPROPRIATE FOR ANGINA; INCREASES HEART RATE
BY BLOCKING VAGAL STIMULATION, WHICH SUPRESSES THE
,HEART RATE; DOES NOT ADDRESS THE LACK OF O2 TO THE
HEART MUSCLE
◉ HESI HINT: PROPRANOLOL (INDERAL).
Answer: NOT APPROPRIATE FOR ACUTE ANGINA ATTACK;
HOWEVER, IS APPROPRIATE FOR LONG-TERM MANAGEMENT OF
STABLE ANGINA BECAUSE IT ACTS AS A BETA BLOCKER TO
CONTROL VASOCONSTRICTION
◉ HESI HINT: MONA.
Answer: REMEMBER MONA WHEN ADMINISTERING MEDICATIONS
AND TREATMENTS IN THE PATIENT WITH MYOCARDIAL
INFARCTION. MONA- MORPHINE, OXYGEN, NITROGLYCERIN,
ASPIRIN
◉ HESI HINT: BLOOD PRESSURE.
Answer: Blood pressure is created by the difference in the pressure
of the blood as it leaves the heart and the resistance it meets flowing
out to the tissues. Therefore, any factor that alters cardiac output or
peripheral vascular resistance will alter blood pressure. Diet and
exercise, smoking cessation, weight control, and stress management
can control many factors that influence the resistance blood meets
as it flows from the heart.
◉ HESI HINT: RISK FACTORS FOR HTN.
, Answer: Heredity, race, age, alcohol abuse, increased salt intake,
obesity, and use of oral contraceptives.
◉ HESI HINT: HYPERTENSION TEACHING.
Answer: The number one cause of a stroke with hypertensive clients
is non-compliance with medication regimen. Hypertension is often
symptomless, and antihypertensive medications are expensive and
have side effects. Studies have shown that the more clients know
about their anti-hypertensive medications, the more likely they are
to take them; teaching is important.
◉ HESI HINT: DECREASED BLOOD FLOW.
Answer: Results in diminished sensation in the lower extremities.
Any heat source can cause severe burns before the client actually
realizes the damage is being done.
◉ HESI HINT: DISSECTING AORTIC ANEURYSM.
Answer: A client is admitted with severe chest pain and states that
he feels a terrible, tearing sensation in his chest. He is diagnosed
with a dissecting aortic aneurysm. What assessment should the
nurse obtain in the first few hours?
-Vital signs every hour
-Neurological vital signs
-Respiratory status
-Urinary output
