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Exam (elaborations)

2023 CRITICAL CARE HESI EXAM WITH COMPLETE SOLUTIONS

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2023 CRITICAL CARE HESI EXAM WITH COMPLETE SOLUTIONS 2023 CRITICAL CARE HESI EXAM WITH COMPLETE SOLUTIONS 2023 CRITICAL CARE HESI EXAM WITH COMPLETE SOLUTIONS 2023 CRITICAL CARE HESI EXAM WITH COMPLETE SOLUTIONS

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  • October 7, 2023
  • 6
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers
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Drcynthia
Critical Care HESI Exam with complete
solutions
The nurses calculating fluid resuscitation for young adult male who was burned in a
bloody accident at 1200 and is seen in the ER at 1400. The HCP determines that the
client has burn over 30% of his body, mainly over his arms and chest. Using the
Parkland formula for fluid resuscitation, the client is to receive 7000 mL of fluid in 24
hours. Which goal should the nurse establish for this clients plan of care? - ANSWER-
By 2000, the client will have received 3500 mL of fluid

When caring for a client on a vent, which finding provides the greatest indication that the
client has an open airway? - ANSWER-Bilateral breath sounds can be auscultated

The nurse performs a prescribed a neurological check at the beginning of the shift on a
client who was admitted with a subarachnoid brain attack (Stroke). The client's GCS is
9. What information is most important for the nurse to determine? - ANSWER-The
client's previous GCS score

An adult female with a history of type 1 diabetes has been vomiting for the past 48
hours and is admitted to the ICU with DKA. Which assessment finding warrants
immediate intervention by the nurse? - ANSWER-Excessive thirst

A client admitted to the ICU after a colon resection with the formation of the loop
colostomy. The nurse determines that the clients abdominal dressing is clean and dry.
Vital signs are: HR: 130, temperature: 100, BP: 88/65, and urine output of 10 mL/hr.
What interventions should the nurse implement? - ANSWER-Give a 500 mL IV fluid
bolus challenge

A client is admitted with syncopal episodes related to a third degree heart block. After
the placement of a transcutaneous pacemaker, the nurse observes several episodes
the pacemaker failure to sense. What action should the nurse take? - ANSWER-
Increase the sensitivity

A client is receiving CPR. After systole is confirmed in two leads and sending the
transcutaneous pacemaker, which IV medication should be administered? - ANSWER-
Epinephrine (adrenaline)

A client has a chest tube connected to a closed water seal drainage system with
suction. What equipment should the nurse always have available at the clients bedside?
- ANSWER-Occlusive dressing




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, Bretylium 1 mg/min via infusion is prescribed for a client and ventricular tachycardia.
The available solution is 500 mL D5W contains bretylium 1 gram. The nurse should
program the infusion time to deliver how many mL/hr? - ANSWER-30

The client is receiving an infusion of nitroglycerin 100 mg and 500 mL D5W at 6 mL/hr.
How many mcg/min of nitroglycerin is infusing? - ANSWER-20

A client arrives in the ER complaining of pain. What description of pain should prompt
the nurse to suspect it originated in the myocardium? - ANSWER-Produces chest
heaviness with left arm pain

Four days ago a chest tube was inserted into the second intercostal space of a client
who has a pneumothorax. Today the nurse notes that there is no fluctuation in the
water-seal chamber of the Pleuravac. Which intervention would be most appropriate for
the nurse to implement? - ANSWER-Assess the clients breath sounds of the affected
lung

In developing a care plan for a client that has a chest tube due to a hemothorax, the
nurse should recognize which intervention is essential? - ANSWER-Encourage the
client to breathe deeply and cough at frequent intervals

A postoperative client is admitted the ICU with an inflated pressure infuser containing
solution of heparin 2 units/mL attached to an intraarterial cannula. Which finding
indicated that the heparin infusion has achieved its therapeutic use? - ANSWER-Intra-
arterial cannula remain patent

The nurse suspects that a client with a central venous catheter in the left subclavian
vein is experiencing an embolism. What signs and symptoms are most indicative of this
condition? - ANSWER-Anxiety, confusion, lightheadedness, and loss consciousness

A female client has been in systole for 20 minutes. She is intubated, and epinephrine
(adrenaline) 1 mg and atropine sulfate 1 mg IV were administered, with no change in
rhythm. What intervention should the nurse implement? - ANSWER-Bring members of
the family to a private area to discuss the desire to continue life saving efforts

The nurse is evaluating a clients central venous pressure reading that are trending
upwards. What nursing diagnosis is supported but the pathophysiological mechanism
most likely causing this increase? - ANSWER-Impaired cardiac output

The high pressure alarm on a mechanical vent is alarming. What intervention should the
nurse implement immediately? - ANSWER-Auscultate bilaterally for breath sounds and
confirm endotracheal suctioning

A client with a history of vasovagal attacks resulting in brady-dysrhythmias. Which
instruction is the most important in the teaching plan? - ANSWER-Use stool softeners
regularly



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