CRITICAL CARE HESI PRACTICE QUESTIONS WITH ANSWERS 2023/24
a - CORRECT ANSWERS The nurse is providing post procedure care to a
client who had a cardiac
... [Show More] catheterization. The client begins to manifest signs and
symptoms associated with embolization. Which action should the nurse take?
a. Notify the primary healthcare provider immediately
b. Apply a warm, moist compress to the incision site
c. Increase the intravenous fluid rate by 20 mL/hr
d. Monitor vital signs more frequently
b - CORRECT ANSWERS A nurse observes a window washer falling 25 feet
(7.6 m) to the ground. The nurse rushes to the scene and determines that the
person is in cardiopulmonary arrest. What should the nurse do first?
a. Feel for a pulse
b. Begin chest compressions
c. Leave to call for assistance
d. Perform the abdominal thrust maneuver
d - CORRECT ANSWERS A client reports left-sided chest pain after playing
racquetball. The client is hospitalized and diagnosed with left pneumothorax.
When assessing the client's left chest area, the nurse expects to identify which
finding?
a. Dull sound on percussion
b. Vocal fremitus on palpation
c. Rales with rhonchi on auscultation
d. Absence of breath sounds on auscultation
c - CORRECT ANSWERS A client is admitted to the hospital with partial- and
full-thickness burns of the chest and face sustained while trying to extinguish a
brush fire. Which is the nurse's priority concern?
a. Loss of skin integrity caused by the burns
b. Potential infection as a result of the burn injury
c. Inadequate gas exchange caused by smoke inhalation
d. Decreased fluid volume because of the depth of the burns
b - CORRECT ANSWERS During the first 48 hours after a client has sustained
a thermal injury, which conditions should the nurse assess for?
a. Hypokalemia and hyponatremia
b. Hyperkalemia and hyponatremia
c. Hypokalemia and hypernatremia
d. Hyperkalemia and hypernatremia
a - CORRECT ANSWERS A nurse is assessing a client's ECG reading. The
client's atrial and ventricular heart rates are equal at 88 beats per min. The PR
interval is 0.14 seconds, and the QRS width is 0.10 seconds. Rhythm is regular
with normal P waves and QRS complexes. How will the nurse interpret this
rhythm?
a. Normal sinus rhythm
b. Sinus tachycardia
c. Sinus bradycardia
d. Sinus arrhythmia
b - CORRECT ANSWERS The nurse is caring for a client with a diagnosis of
necrotizing fasciitis. Which is the priority concern of the nurse when caring for
this client?
a. Fluid volume
b. Skin integrity
c. Physical mobility
d. Urinary elimination
c - CORRECT ANSWERS A client who had extensive pelvic surgery 24 hours
ago becomes cyanotic, is gasping for breath, and reports right-sided chest pain.
What should the nurse do first?
a. Obtain vital signs
b. Initiate a cardiac arrest code
c. Administer oxygen using a face mask
d. Encourage the use of an incentive spirometer
c - CORRECT ANSWERS A nurse is caring for a client with severe burns. The
nurse determines that this client is at risk for hypovolemic shock. Which
physiologic finding supports the nurse's conclusion?
a. Decreased rate of glomerular filtration
b. Excessive blood loss through the burned tissues
c. Plasma proteins moving out of the intravascular compartment
d. Sodium retention occurring as a result of the aldosterone mechanism
a - CORRECT ANSWERS The nurse is caring for a client with burns and
reviews the client's laboratory results: blood urea nitrogen (BUN), 30 mg/dL
(10.2 mmol/L); creatinine, 2.4 mg/dL (184 mcmol/L); serum potassium, 6.3
mEq/L (6.3 mmol/L); pH, 7.1; Po 2, 90 mm Hg; and hemoglobin (Hgb), 7.4
g/dL (74 mmol/L). Which condition does the nurse suspect the client has based
upon these findings?
a. Azotemia
b. Hypokalemia
c. Metabolic alkalosis
d. Respiratory alkalosis
d - CORRECT ANSWERS A nurse is caring for a client who experienced
serious burns in a fire. Which relationship between a client's burned body
surface area and fluid loss should the nurse consider when evaluating fluid loss
in a client with burns?
a. Equal
b. Unrelated
c. Inversely related
d. Directly proportional
c - CORRECT ANSWERS A burn client is receiving the open method for
wound treatment. Which information will the nurse explain to the client?
a. Bathing will not be permitted.
b. Dressings will be changed daily.
c. Personal protective equipment will be worn by staff.
d. Room temperature will be kept below 72° F (22.2° C).
a - CORRECT ANSWERS A client presents to the emergency department with
weakness and dizziness. The blood pressure is 90/60 mm Hg, pulse is 92 and
weak, and body weight reflects a 3-pound (1.4 kilogram) loss in two days. The
weather has been hot. Which condition should the nurse conclude is the priority
for this client?
a. Deficient fluid volume
b. Impaired skin integrity
c. Inadequate nutritional intake
d. Decreased participation in activities
b - CORRECT ANSWERS A client is admitted with severe burns. The nurse is
caring for the client 36 hours after the client's admission and identifies the
client's potassium level of 6.0 mEq/L (6.0 mmol/L). Which drink will the nurse
recommend be included in the client's diet?
a. Milk
b. Tea
c. Orange juice
d. Tomato juice
a - CORRECT ANSWERS A woman comes to the office of her healthcare
provider reporting shortness of breath and epigastric distress that is not relieved
by antacids. To which question would a woman experiencing a myocardial
infarction respond differently than a man?
a. "Do you have chest pain?"
b. "Are you feeling anxious?"
c. "Do you have any palpitations?"
d. "Are you feeling short of breath?"
b - CORRECT ANSWERS During a vertex vaginal birth the nurse notes
meconium-stained amniotic fluid. What is the priority nursing intervention for
the newborn?
a. Stimulating crying
b. Suctioning the airway
c. Using an Ambu bag with oxygen support
d. Placing the infant in the reverse Trendelenburg position
c - CORRECT ANSWERS While receiving a blood transfusion, the client
suddenly shouts, "I feel like someone is lowering a heavy weight on my chest. I
feel like I'm going to die!" Which actions are priority?
a. Administer nitroglycerin and aspirin
b. Slow the rate and monitor the vital signs
c. Stop the transfusion and administer normal saline through new IV tubing
d. Ask the client to further describe the feeling and rate the pain
d - CORRECT ANSWERS A client who was hospitalized with partial- and fullthickness burns over 30% of the total body surface area is to be discharged. The
client asks the nurse, "How will my spouse be able to care for me at home?"
How should the nurse interpret this statement?
a. Readiness to discuss the client's deformities
b. Indication of a change in family relations
c. Need for more time to think about the future
d. Beginning realization of implications for the future
b - CORRECT ANSWERS A nurse is assessing a client with a cast to the
extremity. Which assessment finding is the priority?
a. Warmth
b. Numbness
c. Skin desquamation
d. Generalized discomfort
b - CORRECT ANSWERS Which color of cerebrospinal fluid (CSF) may
indicate subarachnoid hemorrhage in the client?
a. Hazy
b. Yellow
c. Brown
d. Colorless
c - CORRECT ANSWERS A client arrives in the emergency department with
multiple crushing wounds of the chest, abdomen, and legs. Which are the
priority nursing assessments?
a. Level of consciousness and pupil size
b. Characteristics of pain and blood pressure
c. Quality of respirations and presence of pulses
d. Observation of abdominal contusions and other wounds
b - CORRECT ANSWERS Which color tag will be given by the triage nurse to
a client assigned to class IV, during a mass casualty situation?
a. Red
b. Black
c. Green
d. Yellow
a - CORRECT ANSWERS A client who sustained a burn injury involving 36%
of the body surface area is receiving hydrotherapy. Which is the best nursing
intervention when providing wound care?
a. Use a consistent approach to care and encourage participation.
b. Prepare equipment while doing the procedure and explain the treatment to the
client.
c. Rinse the burn area with 105° F (40.6° C) water to prevent loss of body
temperature.
d. Arrange for a change of staff every 4 to 5 days and have the client select the
time for the procedure to be done.
b - CORRECT ANSWERS Which clinical manifestation can a client
experience during a fat embolism syndrome (FES)?
a. Nausea
b. Dyspnea
c. Orthopnea
d. Paresthesia
b - CORRECT ANSWERS A client was admitted with full-thickness burns 2
weeks ago. Since admission, the client has lost an average of 1 lb (0.5 kg) of
weight each day. Which action will the nurse most likely take based upon the
adjusted dietary plan?
a. Provide low-sodium milk.
b. Provide high-protein drinks.
c. Provide foods that are low in potassium.
d. Provide 10% more calories in the form of fats.
d - CORRECT ANSWERS A burn victim has waxy white areas interspersed
with pink and red areas on the anterior trunk and all of both arms. The nurse
calculates the percentage of total body surface area (TBSA). Which percentage
will the nurse report?
a. 20
b. 25
c. 30
d. 36
d - CORRECT ANSWERS A nurse places a client with severe burns on a
circulating air bed. Which goal is the nurse trying to achieve?
a. Increasing mobility
b. Preventing contractures
c. Limiting orthostatic hypotension
d. Preventing pressure on peripheral blood vessels
a - CORRECT ANSWERS Which noninvasive assessment and management
skills certification would the nurse be required to use for airway maintenance
and cardiopulmonary resuscitation (CPR)?
a. Basic Life Support (BLS)
b. Certified Emergency Nurse (CEN)
c. Advanced Cardiac Life Support (ACLS)
d. Pediatric Advanced Life Support (PALS)
b - CORRECT ANSWERS The nurse is caring for different clients in a mass
casualty event. Which client is assigned the lowest priority for care?
a. Client with red tag
b. Client with black tag
c. Client with green tag
d. Client with yellow tag
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