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HESI Mid Curricular V2 exams with complete questions and correct

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HESI Mid Curricular V2 exams with
complete questions and correct
answers
A patient presents with fatigue, weight gain, constipation, and cold intolerance. Which of the following
thyroid disorders is the patient most likely experiencing?

A. Hyperthyroidism

B. Hypothyroidism

C. Thyroid cancer

D. Thyroiditis - Correct Answer: B. Hypothyroidism



Symptoms of hypothyroidism include "fatigue and insomnia," "weight gain is very common,"
"constipation and cold intolerance are common," which align with the patient's presenting symptoms.



Hypothyroidism

Risk factors - not enough iodine, thyroidectomy, antithyroid meds

Assessment - ↓ T3 & T4, ↑ TSH, depression/fatigue, cold intolerance, dry/brittle skin, hair loss, ↓
appetite, weight gain, myxedema (puffiness/edema of eyes), constipation, ↓ BP & HR

Meds - levothyroxine (Synthroid)

Myxedema coma



A patient with hyperthyroidism reports experiencing excessive sweating and heat intolerance. Which of
the following is the most likely underlying cause of these symptoms?

A. Toxic multinodular goiter

B. Graves' disease or thyrotoxicosis

C. Impaired heat-loss mechanisms in the hypothalamus

D. Hereditary condition of uncontrolled heat production - Correct Answer: B. Graves' disease or
thyrotoxicosis

,Symptoms of Graves' disease or thyrotoxicosis, the most common type of hyperthyroidism, include
excessive perspiration (hyperhidrosis), heat intolerance, nervousness, irritability.



Hyperthyroidism

Risk factors - too much iodine, toxic nodular goiter (DO NOT PALPATE), thyroid replacement meds

Assessment - lots of energy, enlarged thyroid gland, weight loss, ↑ appetite, diarrhea, heat intolerance,
tachycardia, ↑ BP, diaphoresis, nervousness, insomnia, T3 & T4 ↑, TSH ↓, exophthalmos (encourage
lubricant eye drops)

Meds - iodine (Lugol's solution), beta-blockers (↓ HR & BP), antithyroid meds: methimazole,
propylthiouracil (PTU)

Treatment - radioactive iodine therapy, thyroidectomy

Thyroid storm S&S - fever, tachycardia, agitation, HTN



A patient has been prescribed eye drops following eye surgery. Which of the following instructions
should the nurse provide regarding proper administration of the eye drops?

A. Tilt the head back and instill the drops directly into the eye B. Wait 5 to 10 minutes between
instillation of different eye drop medications

C. Use the same bottle of eye drops for both eyes

D. Discard any remaining eye drops after the prescribed course is completed - Correct Answer: B. Wait 5
to 10 minutes between instillation of different eye drop medications



When more than one drop is prescribed, teach the patient to wait 5 to 10 minutes between drug
instillations to prevent one drug from diluting another drug.



Also do not touch the tip of the dropper to your eye, administer drops in conjunctival sac (NOT in the
lacrimal duct - can cause systemic absorption), DO NOT RUB EYE



A patient with a pulmonary embolism (PE) presents with cyanosis and hypotension. Which of the
following is the most likely cause of these symptoms?

A. Decreased tissue perfusion

B. Increased pulmonary blood flow

C. Improved gas exchange

, D. Right ventricular hypertrophy - Correct Answer: A. Decreased tissue perfusion



Cardiac symptoms related to decreased tissue perfusion include cyanosis hypotension. Systemic
hypotension results from acute pulmonary hypertension and reduced forward blood flow.



Implement O2 therapy, monitor O2 sat, severe hypoxemia may require mechanical ventilation

Administer anticoagulants as ordered to improve tissue perfusion - monitor for bleeding

Document increasing dyspnea, dysrhythmias, distended neck veins, edema

Ambulate as tolerated, elevate legs when in bed/chair

Instruct patient on wearing knee/thigh high compression stockings long-term to prevent venous
insufficiency and reduce swelling



Select all medications that may be ordered preoperatively for a patient undergoing surgery. (Select all
that apply)

A. Benzodiazepines

B. Opioids

C. Antiemetics

D. Antihypertensives

E. Anticholinergics - Correct Answer: A. Benzodiazepines

B. Opioids

C. Antiemetics

E. Anticholinergics



The anesthesia provider or surgeon may order preanesthetic drugs ("on-call medications," "preops") to
reduce patient anxiety, the amount of general anesthesia required, respiratory tract secretions, and the
risk of nausea, vomiting, and possible aspiration. Typically, the nurse administers preoperative
medications before a patient leaves for the OR. Preoperative drugs such as benzodiazepines, opioids,
antiemetics, and anticholinergics usually cause dry mouth, drowsiness, and dizziness but do not induce
sleep.



Which of the following medications may cause concern during a preoperative assessment? (Select all
that apply)

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