HESI RN MEDICAL SURGICAL EXAM P
s s s s s
ACK 2024 QUESTIONS AND ANSWERS
s s s s
AnsERsnursesisscompletingsansassessmentsonsaspatientsthatsissalertsbutsstrugglesstosanswer
questions.sWhensshesattemptsstostalk,sshesslursshersspeechsandsappearssverysfrightened.s
s
Whatsadditionalsclinicalsmanifestationsdoessthesnursesexpectstosfindsifsnacy'sssysmptomssh
avesbeenscausedsbysasbrainsattacks(stroke)?
A.sAscarotidsbruit
B.sAshypotensivesbloodspressure
C.shyperreflexicsdeepstendonsrelexes.
D.sDecreasedsbowelssoundss–sanswersA)sAscarotidsbruit.
Rationale:sthescarotidsarterys(arterystosthesbrain)sissnarrowedsinsclientsswithsasbrainsattack.s
Asbruitsissansabnormalssoundsheardsonsauscultationsresultingsfromsinterferenceswithsnormal
bloodsflow.sUsuallysthesbloodspressuresisshypertensive.sInitiallysflaccidsparalysissoccurs,sre
s
sultingsinshyporefkexicsdeepstendonsreflexes.sBowelssoundssaresnotsindicativesofsasbrainsatt
ack.
Whichsclinicalsmanifestationsfurtherssupportssansassessmentsofsasleft-sidedsbrainsattack?
A)sVisualsfieldsdeficitsonsthesleftsside.
B)sSpatial-perceptualsdeficits.
C)sParesthesiasofsthesleftsside.
D)sGlobalsaphasia.
D)sGlobalsaphasia.s–sanswersD)sGlobalsaphasia.
Rationale:sGlobalsaphasiasrefersstosdifficultysspeaking,slistening,sandsunderstanding,sassw
ellsassdifficultysreadingsandswriting.sSymptomssvarysfromspersonstosperson.sAphasiasmayso
ccurssecondarystosanysbrainsinjurysinvolvingsthesleftshemisphere.sVisualsfieldsdeficits,sspati
,al-perceptualsdeficits,sandsparesthsiasofsthesleftssidesusuallysoccurswithsright-
sidedsbrainsattack.
Whenspreparingsaspatientsforsasnoncontrastscomputedstomographys(CT)sscansSTAT,swhats
nursingsinterventionsshouldsthesnursesimplement?
A)sDeterminesifsthesclientshassanysallergiesstosiodine
B)sExplainsthatsthesclientswillsnotsbesablestosmoveshersheadsthroughoutsthesCTsscan.
C)sPremedicatesthesclientstosdecreasespainspriorstoshavingsthesprocedure.
D)sProvidesansexplanationsofsrelaxationsexercisesspriorstosthesprocedure.s–
answersB)sExplainsthatsthesclientswillsnotsbesablestosmoveshersheadsthroughoutsthesCTsscan
s
.
Rationale:sBecausesheadsmotionswillsdistortsthesimages,sNancyswillshavestosremainsstillsthro
ughoutsthesprocedure.sAllergiesstosiodinesissimportantsifscontrastsdyesissbeingsusedsforsthes
CTsscan.sPremedicatingsthesclientstosdecreasespainspriorstosthesproceduresissunnecessarys
becausesCTsscanningsissasnoninvasivesandspainlesssprocedure.sProvidingsansexplanations
ofsrelaxationsexercisesspriorstosthesproceduresissasworthwhilesinterventionstosdecreasesanxi
etysbutsissnotsofshighestspriority.
Asneurologistsprescribessasmagneticsresonancesimagings(MRI)sofsthesheadsSTATsforsaspati
ent.sWhichsdataswarrantssimmediatesinterventionsbysthesnursesconcerningsthissdiagnosticst
est?
A)sElevatedsbloodspressure.
B)sAllergystosshellsfish.
C)sRightshipsreplacement.
D)sHistorysofsatrialsfibrillation.s–sanswersC)sRightshipsreplacement.
ThesmagneticsfieldsgeneratedsbysthesMRIsisssosstrongsthatsmetal-
containingsitemssaresstronglysattractedstosthesmagnet.sBecausestheshipsjointsissmadesofsmet
,al,sasleadsshieldsmustsbesusedsduringsthesprocedure.sElevatedsbloodspressure,sansallergyst
osshellsfish,sandsashistorysofsatrialsfibrillationswouldsnotsaffectsthesMRI.
Asclient'ssdaughtersisssittingsbyshersmother'ssbedsideswhoswassrecentlystransferredstosthesIn
termediatesCaresUnit.sShesstatess"Isdon'tsunderstandswhatsasbrainsattacksis.sTheshealthcar
esproviderstoldsmesmysmothersissinsserioussconditionsandstheysaresgoingstosrunsseveralstests
.sIsjustsdon'tsknowswhatsissgoingson.sWhatshappenedstosmysmother?"sWhatsissthesbestsrespo
nsesbysthesnurse?
A)s"Isamssorry,sbutsaccordingstosthesHealthsInsurancesPortabilitysandsAccountingsActs(HIPA
A),sIscannotsgivesyousanysinformation."
B)s"Yoursmothershasshadsasstroke,sandsthesbloodssupplystosthesbrainshassbeensblocked."
C)s"Howsdosyousfeelsaboutswhatstheshealthcaresproviderssaid?"
D)s"Iswillscallstheshealthcaresproviderssoshe/shescanstalkstosyousaboutsyoursmother'ssseriouss
condition."s–
answersB)s"Yoursmothershasshadsasstroke,sandsthesbloodssupplystosthesbrainshassbeensbloc
s
ked."
Rationale:sThesnursescansdiscussswhatsasdiagnosissmeans.sNancysissunablestosmakesdecis
ions,ssosthesnextsofskin,shersdaughter,sGail,sneedsssufficientsinformationstosmakesinformeds
decisions.sThesnurseshassthesknowledge,sandsthesresponsibility,stosexplainsNancy'ssconditi
onstosGail.sThesnursesshouldsgivesfactssfirst,sandsthensaddressshersfeelingssaftersthesinform
ationsissprovided.
Whatsissthesnormalsrangesforscardiacsoutput?s–
answersThesnormalsrangesforscardiacsoutputstosensurescerebralsbloodsflowsandsoxygensdel
s
iverysiss4stos8sL/min.
Asclientswassadmittedswithsthesdiagnosissofsasbrainsattack.sTheirssymptomssbegans24shours
beforesbeingsadmitted.sWhyswouldsthissclientsnotsbesascandidatesforsforsthrombolyticstherap
s
y?s–
, answersThrombolyticstherapysisscontraindicatedsinsclientsswithssymptomsonsetslongersthan
s
3shoursspriorstosadmission.sThissclientshadssymptomssfors24shourssbeforesbeingsbroughtstos
s
thesmedicalscenter
Whatsaresplatesguards?s–
answersPlatesguardsspreventsfoodsfromsbeingspushedsoffsthesplate.sUsingsplatesguardssan
s
dsothersassistivesdevicesswillsencouragesindependencesinsasclientswithsasself-caresdeficit.
Whichsconditionsissconsideredsasnon-modifiablesrisksfactorsforsasbrainsattack?
A)sHighscholesterolslevels.
B)sObesity.
C)sHistorysofsatrialsfibrillation.
D)sAdvancedsage.s–sanswersD)sAdvancedsage.
Rationale:sPeoplesoversages55saresashigh-
risksgroupsforsasbrainsattacksbecausesthesincidencesofsstrokesmoresthansdoublessinseachssu
ccessivesdecadesofslife.sNon-
modifiablesmeanssthesclientscannotsdosanythingstoschangesthesrisksfactor.sAllsthesothersopti
onssaresmodifiablesrisksfactors.
Asclientsissexperiencingshomonymousshemianopsiasassthesresultsofsasbrainsattack.sWhichsn
ursingsinterventionswouldsthesnursesimplementstosaddresssthisscondition?
A)sTurnsNancyseverystwoshourssandsperformsactivesrangesofsmotionsexercises.
B)sPlacesthesobjectssNancysneedssforsactivitiessofsdailyslivingsonsthesleftssidesofsthestable.
C)sSpeaksslowlysandsclearlystosassistsNancysinsformingssoundsstoswords.
D)sRequeststhatsthesdietarysdepartmentsthickensallsliquidssonsNancy'ssmealsandssnackstray
s.s–
answersB)sPlacesthesobjectssNancysneedssforsactivitiessofsdailyslivingsonsthesleftssidesofsthes
s
table.
s s s s s
ACK 2024 QUESTIONS AND ANSWERS
s s s s
AnsERsnursesisscompletingsansassessmentsonsaspatientsthatsissalertsbutsstrugglesstosanswer
questions.sWhensshesattemptsstostalk,sshesslursshersspeechsandsappearssverysfrightened.s
s
Whatsadditionalsclinicalsmanifestationsdoessthesnursesexpectstosfindsifsnacy'sssysmptomssh
avesbeenscausedsbysasbrainsattacks(stroke)?
A.sAscarotidsbruit
B.sAshypotensivesbloodspressure
C.shyperreflexicsdeepstendonsrelexes.
D.sDecreasedsbowelssoundss–sanswersA)sAscarotidsbruit.
Rationale:sthescarotidsarterys(arterystosthesbrain)sissnarrowedsinsclientsswithsasbrainsattack.s
Asbruitsissansabnormalssoundsheardsonsauscultationsresultingsfromsinterferenceswithsnormal
bloodsflow.sUsuallysthesbloodspressuresisshypertensive.sInitiallysflaccidsparalysissoccurs,sre
s
sultingsinshyporefkexicsdeepstendonsreflexes.sBowelssoundssaresnotsindicativesofsasbrainsatt
ack.
Whichsclinicalsmanifestationsfurtherssupportssansassessmentsofsasleft-sidedsbrainsattack?
A)sVisualsfieldsdeficitsonsthesleftsside.
B)sSpatial-perceptualsdeficits.
C)sParesthesiasofsthesleftsside.
D)sGlobalsaphasia.
D)sGlobalsaphasia.s–sanswersD)sGlobalsaphasia.
Rationale:sGlobalsaphasiasrefersstosdifficultysspeaking,slistening,sandsunderstanding,sassw
ellsassdifficultysreadingsandswriting.sSymptomssvarysfromspersonstosperson.sAphasiasmayso
ccurssecondarystosanysbrainsinjurysinvolvingsthesleftshemisphere.sVisualsfieldsdeficits,sspati
,al-perceptualsdeficits,sandsparesthsiasofsthesleftssidesusuallysoccurswithsright-
sidedsbrainsattack.
Whenspreparingsaspatientsforsasnoncontrastscomputedstomographys(CT)sscansSTAT,swhats
nursingsinterventionsshouldsthesnursesimplement?
A)sDeterminesifsthesclientshassanysallergiesstosiodine
B)sExplainsthatsthesclientswillsnotsbesablestosmoveshersheadsthroughoutsthesCTsscan.
C)sPremedicatesthesclientstosdecreasespainspriorstoshavingsthesprocedure.
D)sProvidesansexplanationsofsrelaxationsexercisesspriorstosthesprocedure.s–
answersB)sExplainsthatsthesclientswillsnotsbesablestosmoveshersheadsthroughoutsthesCTsscan
s
.
Rationale:sBecausesheadsmotionswillsdistortsthesimages,sNancyswillshavestosremainsstillsthro
ughoutsthesprocedure.sAllergiesstosiodinesissimportantsifscontrastsdyesissbeingsusedsforsthes
CTsscan.sPremedicatingsthesclientstosdecreasespainspriorstosthesproceduresissunnecessarys
becausesCTsscanningsissasnoninvasivesandspainlesssprocedure.sProvidingsansexplanations
ofsrelaxationsexercisesspriorstosthesproceduresissasworthwhilesinterventionstosdecreasesanxi
etysbutsissnotsofshighestspriority.
Asneurologistsprescribessasmagneticsresonancesimagings(MRI)sofsthesheadsSTATsforsaspati
ent.sWhichsdataswarrantssimmediatesinterventionsbysthesnursesconcerningsthissdiagnosticst
est?
A)sElevatedsbloodspressure.
B)sAllergystosshellsfish.
C)sRightshipsreplacement.
D)sHistorysofsatrialsfibrillation.s–sanswersC)sRightshipsreplacement.
ThesmagneticsfieldsgeneratedsbysthesMRIsisssosstrongsthatsmetal-
containingsitemssaresstronglysattractedstosthesmagnet.sBecausestheshipsjointsissmadesofsmet
,al,sasleadsshieldsmustsbesusedsduringsthesprocedure.sElevatedsbloodspressure,sansallergyst
osshellsfish,sandsashistorysofsatrialsfibrillationswouldsnotsaffectsthesMRI.
Asclient'ssdaughtersisssittingsbyshersmother'ssbedsideswhoswassrecentlystransferredstosthesIn
termediatesCaresUnit.sShesstatess"Isdon'tsunderstandswhatsasbrainsattacksis.sTheshealthcar
esproviderstoldsmesmysmothersissinsserioussconditionsandstheysaresgoingstosrunsseveralstests
.sIsjustsdon'tsknowswhatsissgoingson.sWhatshappenedstosmysmother?"sWhatsissthesbestsrespo
nsesbysthesnurse?
A)s"Isamssorry,sbutsaccordingstosthesHealthsInsurancesPortabilitysandsAccountingsActs(HIPA
A),sIscannotsgivesyousanysinformation."
B)s"Yoursmothershasshadsasstroke,sandsthesbloodssupplystosthesbrainshassbeensblocked."
C)s"Howsdosyousfeelsaboutswhatstheshealthcaresproviderssaid?"
D)s"Iswillscallstheshealthcaresproviderssoshe/shescanstalkstosyousaboutsyoursmother'ssseriouss
condition."s–
answersB)s"Yoursmothershasshadsasstroke,sandsthesbloodssupplystosthesbrainshassbeensbloc
s
ked."
Rationale:sThesnursescansdiscussswhatsasdiagnosissmeans.sNancysissunablestosmakesdecis
ions,ssosthesnextsofskin,shersdaughter,sGail,sneedsssufficientsinformationstosmakesinformeds
decisions.sThesnurseshassthesknowledge,sandsthesresponsibility,stosexplainsNancy'ssconditi
onstosGail.sThesnursesshouldsgivesfactssfirst,sandsthensaddressshersfeelingssaftersthesinform
ationsissprovided.
Whatsissthesnormalsrangesforscardiacsoutput?s–
answersThesnormalsrangesforscardiacsoutputstosensurescerebralsbloodsflowsandsoxygensdel
s
iverysiss4stos8sL/min.
Asclientswassadmittedswithsthesdiagnosissofsasbrainsattack.sTheirssymptomssbegans24shours
beforesbeingsadmitted.sWhyswouldsthissclientsnotsbesascandidatesforsforsthrombolyticstherap
s
y?s–
, answersThrombolyticstherapysisscontraindicatedsinsclientsswithssymptomsonsetslongersthan
s
3shoursspriorstosadmission.sThissclientshadssymptomssfors24shourssbeforesbeingsbroughtstos
s
thesmedicalscenter
Whatsaresplatesguards?s–
answersPlatesguardsspreventsfoodsfromsbeingspushedsoffsthesplate.sUsingsplatesguardssan
s
dsothersassistivesdevicesswillsencouragesindependencesinsasclientswithsasself-caresdeficit.
Whichsconditionsissconsideredsasnon-modifiablesrisksfactorsforsasbrainsattack?
A)sHighscholesterolslevels.
B)sObesity.
C)sHistorysofsatrialsfibrillation.
D)sAdvancedsage.s–sanswersD)sAdvancedsage.
Rationale:sPeoplesoversages55saresashigh-
risksgroupsforsasbrainsattacksbecausesthesincidencesofsstrokesmoresthansdoublessinseachssu
ccessivesdecadesofslife.sNon-
modifiablesmeanssthesclientscannotsdosanythingstoschangesthesrisksfactor.sAllsthesothersopti
onssaresmodifiablesrisksfactors.
Asclientsissexperiencingshomonymousshemianopsiasassthesresultsofsasbrainsattack.sWhichsn
ursingsinterventionswouldsthesnursesimplementstosaddresssthisscondition?
A)sTurnsNancyseverystwoshourssandsperformsactivesrangesofsmotionsexercises.
B)sPlacesthesobjectssNancysneedssforsactivitiessofsdailyslivingsonsthesleftssidesofsthestable.
C)sSpeaksslowlysandsclearlystosassistsNancysinsformingssoundsstoswords.
D)sRequeststhatsthesdietarysdepartmentsthickensallsliquidssonsNancy'ssmealsandssnackstray
s.s–
answersB)sPlacesthesobjectssNancysneedssforsactivitiessofsdailyslivingsonsthesleftssidesofsthes
s
table.
