HESI Mid Curricular Exam Study Guide with All Predictor Terms and Answers Wit Rationales New Updated Version guaranteed a+
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Module
HESI Mid
Institution
HESI Mid
HESI Mid Curricular Exam Study Guide with All
Predictor Terms and Answers Wit Rationales New
Updated Version guaranteed a+
Which statement made by one of the nurses indicates that the teaching has been effective?
1-"Chest pain is caused by tissue hypoxia in the myocardium."
2-"Chest pain is ...
HESI Mid Curricular Exam Study Guide with All
Predictor Terms and Answers Wit Rationales New
Updated Version guaranteed a+
Which statement made by one of the nurses indicates that the teaching has been effective?
1-"Chest pain is caused by tissue hypoxia in the myocardium."
2-"Chest pain is caused by tissue hypoxia in the vessels of the heart."
3-"Chest pain is caused by tissue hypoxia in the parietal pericardium."
4-"Chest pain is caused by tissue hypoxia in the visceral pericardium." - Correct Answer-1-
"Chest pain is caused by tissue hypoxia in the myocardium."
Rationale:The myocardial layer of the heart is damaged when a client experiences an MI. This is
the middle layer that contains the striated muscle fibers responsible for the contractile force of
the heart. In an MI, an obstruction causes an interruption in blood flow and ensuing hypoxia;
this affects the myocardial layer. The endocardium is the thin inner layer of cardiac tissue. The
parietal pericardium and visceral pericardium are outer layers that protect the heart from injury
and infection.
The nurse educator is lecturing new registered nurses (RNs) about serum calcium levels. Which
statement by one of the new RNs indicates that teaching has been effective?
1-"Calcium has no effect on the risk for stroke."
2-"Low calcium levels can lead to cardiac arrest."
3-"Low calcium levels cause high blood pressure."
4-"Calcium has no effect on urinary stone formation." - Correct Answer-2-"Low calcium levels
can lead to cardiac arrest."
Rationale:The normal calcium level is 9 to 10.5 mg/dL (2.25 to 2.75 mmol/L). A low calcium
level could lead to severe ventricular dysrhythmias, prolonged QT interval, and ultimately
cardiac arrest. Calcium is needed by the heart for contraction. Calcium ions move across cell
membranes into cardiac cells during depolarization and move back during repolarization.
Depolarization is responsible for cardiac contraction. Option 1 is unrelated to calcium levels. A
low calcium level is unrelated to hypertension. Elevated calcium levels can lead to urinary stone
formation. The nurse would take action and contact the health care provider when a calcium
level is abnormal.
The nurse is reinforcing instructions to a hospitalized client with heart block about the
fundamental concepts regarding the cardiac rhythm. The nurse plans to explain to the client
that the normal site in the heart responsible for initiating electrical impulses is which site?
1-Bundle of His
2-Purkinje fibers
3-Sinoatrial (SA) node
Rationale:The SA node is responsible for initiating electrical impulses that are conducted
through the heart. The impulse leaves the SA node and travels down through internodal and
interatrial pathways to the AV node. From there, impulses travel through the bundle of His to
the right and left bundle branches and then to the Purkinje fibers. This group of specialized
cardiac cells is referred to as the cardiac conduction system. The ability of this specialized tissue
to generate its own impulses is called automaticity.
Following a lecture on coronary artery disease, a nursing instructor asks a nursing student to
describe the structure and function of the coronary arteries. Which response by the student
indicates a need for further teaching on the anatomy and physiology of the heart?
1-"The coronary arteries branch from the aorta."
2-"The coronary arteries supply the heart muscle with blood."
3-"The left coronary artery provides blood for the left atrium and the left ventricle."
4-"The left coronary artery supplies the right atrium and right ventricle with blood." - Correct
Answer-4-"The left coronary artery supplies the right atrium and right ventricle with blood."
Rationale:The left coronary artery divides into the anterior descending artery and the
circumflex artery, providing blood for the left atrium and left ventricle. The right coronary
artery supplies the right atrium and right ventricle. Options 1, 2, and 3 are correct.
The new registered nurse (RN) is orienting on the cardiac unit. Which statement by the new RN
indicates an understanding of an early indication of fluid volume deficit due to blood loss?
1-"Pulse rate will increase."
2-"Blood pressure will decrease."
3-"Edema will be present in the legs."
4-"Crackles in the lungs will be present." - Correct Answer-1-"Pulse rate will increase."
Rationale:The cardiac output is determined by the volume of the circulating blood, the pumping
action of the heart, and the tone of the vascular bed. Early decreases in fluid volume are
compensated for by an increase in the pulse rate. Although the blood pressure will decrease, it
is not the earliest indicator. Edema and crackles in the lungs indicate an increase in fluid
volume.
A young adult client, admitted to the emergency department following a motor vehicle collision
is receiving transfusion of 4 units of packed red blood cells (PRBC). The client's pretransfusion
hematocrit is 17% (0.17 volume). How many hematocrit value should the nurse expect the
client to have after all of the PRBCs have been transfused
Reference Range:
Hematocrit (42% to 52% (0.4Lto 0.52 volume fraction)]
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,A 9% (0.09 volume fraction).
B 39% (0.39 volume fraction).
C 19% (0.19 volume traction)
D 29% (0.29 volume fraction).
D 29% (0.29 volume fraction).
A female client on a psychiatric unit is sweating profusely while she vigorously does push- ups
and then runs the length of the corridor several times before crashing into furniture in the
sitting room. Picking herself up, she begins to toss chairs aside, looking for a red one to sit in.
When another client objects to the disturbance, the client shouts, "I am the boss here. I do
what I want." Which nursing problem best supports these observations?
• A Disturbed personal identity related to grandiosity.
• B Risk for activity intolerance related to hyperactivity.
• C Risk for other related violence related to disruptive behavior.
• D Deficient diversional activity related to excess energy level.
• C Risk for other related violence related to disruptive behavior.
We have an expert-written solution to this problem!
The antitubular drug isoniazid is prescribed for a client with active tuberculosis. To evaluate the
effectiveness of this medication, which outcome can the nurse expect this client to exhibit?
A Decreased appetite and weight loss.
B A positive sputum smear and culture.
C Decreased cough and sputum.
D Vertigo and tinnitus.
C Decreased cough and sputum.
5 The nurse performs a routine assessment on a 12-hour-old infant. Which finding requires the
nurse to intervene?
• A Crying for more than 10 minutes.
• B Acrocyanosis with hands and feet cool to touch.
• C Respiratory rate of 73 breaths/minute.
• D No voiding or stooling since birth.
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, • C Respiratory rate of 73 breaths/minute.
→ infant is hyperventilating; should be 30-60 breaths/min
A client with acquired immunodeficiency syndrome (AIDS) has impaired gas exchange from a
respiratory infection. Which assessment finding warrants immediate intervention by the nurse?
• A Diminished lung sounds.
• B Generalized weakness.
• C Elevated temperature.
• D Pain when swallowing.
• A Diminished lung sounds.
A client who is terminally ill has an advance directive that stipulates no resuscitative measures
are to be taken. The client's death is imminent and the family is in the client's room. The client is
currently exhibiting Cheyne-Stokes respirations and has a blood pressure of 60/30 mm Hg.
Which is the priority nursing action?
• A Allow privacy for the family and client to express their feelings to one another.
• B. Elevate the head of the client's bed and apply oxygen using a face mask.
• C Apply an automatic blood pressure cuff and take readings every 15 minutes.
• D Teach the client's family how to use an oral suction device to clear the airway.
• A Allow privacy for the family and client to express their feelings to one another.
A client with cirrhosis has ascites and reports feeling short of breath. The client is in a Semi-
Fowler's position with arms posit Which action should the nurse implement?
A Reposition the client in a side-lying position and support his abdomen with pillows.
B Raise the head of the bed to a Fowler's position and support his arms with a pillow.
C Place the client in a shock position and monitor his vital signs at frequent intervals.
D. Elevate the client's feet on a pillow while keeping the head of the bed elevated.
B Raise the head of the bed to a Fowler's position and support his arms with a pillow.
A school-aged child is admitted with status asthmaticus. The child is receiving oxygen at 4
liters/minute per nasal cannula, but remains dyspneic and is extremely anxious. Which
intervention should the nurse implement?
• A Administer an as needed (PRN) anxiolytic.
• B Orient the child to the hospital unit.
• C Talk to child while holding the child's hand.
D Encourage intake of oral fluids.
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