HESI Med-Surg Practice Exam Questions and
Answers (2026) | Complete Exam Review Pack |
Verified Q&A | A+
• Stroke-Dysphagia -✓✓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 -✓✓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 -✓✓Benign tumors are not cancerous, thereas cancerous
cells are described as malignant neoplasms
• Secondary Tumor -✓✓Patients who were previously treated for one cancer are at
increased risk for secondary cancers
• Chemotherapy-Renal Failure -✓✓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 -✓✓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 -✓✓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
Answers (2026) | Complete Exam Review Pack |
Verified Q&A | A+
• Stroke-Dysphagia -✓✓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 -✓✓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 -✓✓Benign tumors are not cancerous, thereas cancerous
cells are described as malignant neoplasms
• Secondary Tumor -✓✓Patients who were previously treated for one cancer are at
increased risk for secondary cancers
• Chemotherapy-Renal Failure -✓✓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 -✓✓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 -✓✓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
