Medical-Surgical Nursing HESI 2023
Communication Strategies - CORRECT ANSWERS A. Assess client for hearing
deficits or hearing loss
B. Determine whether the client understands questions
C. Take time to ask yes/no questions if the client is having difficulty communicating
D. Observe client's nonverbal communication cues (grimacing indicating pain, fear in a
child)
E. When possible, provide continuity of care by assigning the same nurse
F. Encourage presence of family members to reassure client
Primary prevention - CORRECT ANSWERS Intended to reduce health risks and
increase healthy behaviors
e.g. Providing immunizations, teaching nutrition classes, and requiring smoke-free
zones
Secondary prevention - CORRECT ANSWERS Intended to detect disease (through
screening) and treat the disease as early as possible
e.g. Colonoscopy allows colon cancer to be detected so that an intervention can be
initiated as early as possible
Tertiary prevention - CORRECT ANSWERS Intended to prevent disability and
complications and to provide for a peaceful death. Tertiary prevention includes
rehabilitation
e.g. Rehabilitation after a stroke or hip replacement surgery, hospice care
Herbal medication: Bitter orange - CORRECT ANSWERS Application: Weight
reduction
Mechanism of action: CNS stimulant catecholaminergic
Side effects: High BP and tachycardia in healthy adults with normal BP
Drug interaction: It can interact with many drugs
Efficacy: Unproven
Herbal medication: Black cohosh - CORRECT ANSWERS Application: Alleviate hot
flashes of menopause
,Mechanism of action: Acts on neurotransmitter systems; binds with serotonin receptor
subtypes
Side effects: No evidence of severe side effects
Herbal medication: Echinacea - CORRECT ANSWERS Application: Reduction in
duration of common cold
Mechanism of action: Stimulation of immune cell function and cytokine production
Side effects: Allergic reactions
Drug interaction: Potential inhibition of CYP450 isoforms
Efficacy: Proven
Herbal medication: Ephedra - CORRECT ANSWERS Application: Reduction of
fatigue; weight reduction
Mechanism of action: CNS stimulation; CNS stimulant catecholaminergic
Side effects: Excessive adrenergic stimulation, HTN, MI, stroke, extensive CNS
stimulation, agitation, sleep disturbances, psychosis
Drug interaction: Synergistic interaction with methylxanthines, synergistic interaction
with monoamine oxidase inhibitors (MAOIs), inhibition of antihypertensive effects
Efficacy: Proven
Herbal medication: Garlic - CORRECT ANSWERS Application: Reduction of
hyperlipidemia
Mechanism of action: HMG-CoA reductase inhibitor
Side effects: Odor, diaphoresis, bleeding
Drug interactions: Potentiation of anticoagulant and antiplatelet medications, decreased
plasma levels of protease inhibitor drug saquinavir
Herbal medication: Ginger - CORRECT ANSWERS Application: Treatment of nausea
in motion sickness and pregnancy
Mechanism of action: Serotonin antagonist
Side effects: No major adverse side effects
, Drug interaction: Potential potentiation of anticoagulant antiplatelet drugs (controversial)
Efficacy: Proven
Herbal medication: Gingko - CORRECT ANSWERS Application: Enhancement of
mental performance
Mechanism of action: Vasodilator
Side effects: No major adverse side effects
Drug interaction: Synergistic interaction with other stimulants (e.g. caffeine)
Efficacy: Unproven
Herbal medication: Ginseng - CORRECT ANSWERS Application: Treatment of erectile
disfunction; reduction of fatigue; enhancement of mental performance
Mechanism of action: Antiandrogen
Side effects: No major adverse side effects
Drug interaction: No consistent reports
Efficacy: Supportive
Herbal medication: Hoodia gordonii (aka Hoodia, Veldkos, Slimming cactus,
Trichocaulon gordonii, Stapelia gordonii) - CORRECT ANSWERS Application: Weight
reduction
Mechanism of action: P57, the main ingredient cannot actively reach the brain to
suppress the appetite
Side effects: May be mildly toxic (confirmed in mice but not humans), increased heart
rate, possible hepatotoxic as evidenced by increase in alkaline phosphatase (ALP) in
healthy women
Efficacy: Unproven
Herbal medication: Kava - CORRECT ANSWERS Application: Treatment of anxiety
Mechanism of action: Modulatory effect at GABA receptors
Side effects: Hepatotoxicity
Communication Strategies - CORRECT ANSWERS A. Assess client for hearing
deficits or hearing loss
B. Determine whether the client understands questions
C. Take time to ask yes/no questions if the client is having difficulty communicating
D. Observe client's nonverbal communication cues (grimacing indicating pain, fear in a
child)
E. When possible, provide continuity of care by assigning the same nurse
F. Encourage presence of family members to reassure client
Primary prevention - CORRECT ANSWERS Intended to reduce health risks and
increase healthy behaviors
e.g. Providing immunizations, teaching nutrition classes, and requiring smoke-free
zones
Secondary prevention - CORRECT ANSWERS Intended to detect disease (through
screening) and treat the disease as early as possible
e.g. Colonoscopy allows colon cancer to be detected so that an intervention can be
initiated as early as possible
Tertiary prevention - CORRECT ANSWERS Intended to prevent disability and
complications and to provide for a peaceful death. Tertiary prevention includes
rehabilitation
e.g. Rehabilitation after a stroke or hip replacement surgery, hospice care
Herbal medication: Bitter orange - CORRECT ANSWERS Application: Weight
reduction
Mechanism of action: CNS stimulant catecholaminergic
Side effects: High BP and tachycardia in healthy adults with normal BP
Drug interaction: It can interact with many drugs
Efficacy: Unproven
Herbal medication: Black cohosh - CORRECT ANSWERS Application: Alleviate hot
flashes of menopause
,Mechanism of action: Acts on neurotransmitter systems; binds with serotonin receptor
subtypes
Side effects: No evidence of severe side effects
Herbal medication: Echinacea - CORRECT ANSWERS Application: Reduction in
duration of common cold
Mechanism of action: Stimulation of immune cell function and cytokine production
Side effects: Allergic reactions
Drug interaction: Potential inhibition of CYP450 isoforms
Efficacy: Proven
Herbal medication: Ephedra - CORRECT ANSWERS Application: Reduction of
fatigue; weight reduction
Mechanism of action: CNS stimulation; CNS stimulant catecholaminergic
Side effects: Excessive adrenergic stimulation, HTN, MI, stroke, extensive CNS
stimulation, agitation, sleep disturbances, psychosis
Drug interaction: Synergistic interaction with methylxanthines, synergistic interaction
with monoamine oxidase inhibitors (MAOIs), inhibition of antihypertensive effects
Efficacy: Proven
Herbal medication: Garlic - CORRECT ANSWERS Application: Reduction of
hyperlipidemia
Mechanism of action: HMG-CoA reductase inhibitor
Side effects: Odor, diaphoresis, bleeding
Drug interactions: Potentiation of anticoagulant and antiplatelet medications, decreased
plasma levels of protease inhibitor drug saquinavir
Herbal medication: Ginger - CORRECT ANSWERS Application: Treatment of nausea
in motion sickness and pregnancy
Mechanism of action: Serotonin antagonist
Side effects: No major adverse side effects
, Drug interaction: Potential potentiation of anticoagulant antiplatelet drugs (controversial)
Efficacy: Proven
Herbal medication: Gingko - CORRECT ANSWERS Application: Enhancement of
mental performance
Mechanism of action: Vasodilator
Side effects: No major adverse side effects
Drug interaction: Synergistic interaction with other stimulants (e.g. caffeine)
Efficacy: Unproven
Herbal medication: Ginseng - CORRECT ANSWERS Application: Treatment of erectile
disfunction; reduction of fatigue; enhancement of mental performance
Mechanism of action: Antiandrogen
Side effects: No major adverse side effects
Drug interaction: No consistent reports
Efficacy: Supportive
Herbal medication: Hoodia gordonii (aka Hoodia, Veldkos, Slimming cactus,
Trichocaulon gordonii, Stapelia gordonii) - CORRECT ANSWERS Application: Weight
reduction
Mechanism of action: P57, the main ingredient cannot actively reach the brain to
suppress the appetite
Side effects: May be mildly toxic (confirmed in mice but not humans), increased heart
rate, possible hepatotoxic as evidenced by increase in alkaline phosphatase (ALP) in
healthy women
Efficacy: Unproven
Herbal medication: Kava - CORRECT ANSWERS Application: Treatment of anxiety
Mechanism of action: Modulatory effect at GABA receptors
Side effects: Hepatotoxicity
