Advanced Med surg Hesi exam with |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
correct answers |||\\\
HH 1 - correct answer✔✔ARDS is an unexpected, catastrophic pulmonary complication
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
occuring in a person with no previous pulmonary problems. Clients are critically ill and are
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
managed in an intensive care unit. The mortality rate is high
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
HH 2 - correct answer✔✔Interventions to prevent complications of clients on mechanical
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
ventilation with ARDS |||\\\ |||\\\
-elevate the high of the bed at least 30 degrees
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Assist with daily awakening
|||\\\ |||\\\ |||\\\
-Implement a comprehensive oral hygiene plan |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Implement a comprehensive mobilization program |||\\\ |||\\\ |||\\\ |||\\\
HH 3 - correct answer✔✔Suction only when secretions are present
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
HH 4 - correct answer✔✔Before drawing a sample for ABGs from the radial artery, perform
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
the Allen test to assess collateral circulation. Make the clients hand blanch by obliterating both
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
the radial and the ulnar pulses. Then release the pressure over the ulnar artery only. If flow
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
through the ulnar artery is good, flushing will be seen immediately. The allen test is then
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
positive and the radial artery can be used for puncture.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
HH 5 - correct answer✔✔Cardinal signs of Acute Respiratory Failure in children are
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
restlessness, tachypnea, tachycardia, and diaphoresis |||\\\ |||\\\ |||\\\ |||\\\
HH 6 - correct answer✔✔Pco2 >45 or Po2 <60 on 50% 02 signifies respiratory failure
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
,-A child in severe distress should be on 100% 02
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What Po2 values indicate respiratory failure in adults? - correct answer✔✔Po2 below 60
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What blood value indicates hypercapnia? - correct answer✔✔Pco2 above 45
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Identify the condition that exists when the Po2 is less than 50 and Fio2 is greater than 60% -
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
correct answer✔✔Hypoxemia |||\\\ |||\\\
List three symptoms of respiratory failure in adults? - correct answer✔✔Dyspnea/tachypnea
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Intercostal and sternal retractions |||\\\ |||\\\ |||\\\
cyanosis
List four common causes of respiratory - correct answer✔✔Congenital heart disease
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Infection or sepsis |||\\\ |||\\\
Respiratory distress syndrome |||\\\ |||\\\
Aspiration
Fluid overload or dehydration
|||\\\ |||\\\ |||\\\
What percentage of 02 should a child in severe respiratory distress receive? - correct
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
answer✔✔100%
HH 7 - correct answer✔✔Early signs of shock are agitation and restlessness resulting from
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
cerebral hypoxia |||\\\
HH 8 - correct answer✔✔Severe shock leads to widespread cellular injury and impairs the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
integrity of the capillary membranes. Fluid and osmotic proteins seep into the extravascular
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
spaces, further reducing cardiac output. |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
, A vicious circle of decreased perfusion to all cellular level activities ensues. All organs are
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
damaged and if perfusion problems persist the damage can be permanent. |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
HH 9 - correct answer✔✔All types of shock can lead to systemic inflammatory response
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
syndrome (SIRS) and results in multiple organ dysfunction syndrome (MODS) |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
HH 10 - correct answer✔✔If cardiogenic shock exists in the presence of pulmonary edema,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
position the client to reduce venous return (high fowlers) to decrease further venous return to
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
the left ventricle |||\\\ |||\\\
HH 11 - correct answer✔✔All vasopressor and vasodilator drugs are potent and dangerous
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
and require that the client be titrated
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
You are caring for a women who was in a severe MVA several days earlier. She has several
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
fractures and internal injuries. The exploratory laparotomy was sucessful in controlling the |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
bleeding. However today you find that this client is bleeding from her incision site, is short of |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
breath, and has a weak thready pulse, cold, clammy skin, and hematuria. |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What do you think is wrong with the client and what would you expect to do about it? - correct
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
answer✔✔These are typical signs of DIC crisis. Expect to administer IV heparin to block the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
formation of thrombin. However, the client described is already past the coagulation phase and |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
into the hemorrhagic phase. Her care would include administration of clotting factors, along
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
with palliative treatment of the symptoms as they arise.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Poor prognosis |||\\\
Define shock - correct answer✔✔Widespread, serious reduction of tissue perfusion, which
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
leads to generalized impairment of cellular function |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What is the most common cause of shock? - correct answer✔✔hypovolemia
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
correct answers |||\\\
HH 1 - correct answer✔✔ARDS is an unexpected, catastrophic pulmonary complication
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
occuring in a person with no previous pulmonary problems. Clients are critically ill and are
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
managed in an intensive care unit. The mortality rate is high
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
HH 2 - correct answer✔✔Interventions to prevent complications of clients on mechanical
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
ventilation with ARDS |||\\\ |||\\\
-elevate the high of the bed at least 30 degrees
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Assist with daily awakening
|||\\\ |||\\\ |||\\\
-Implement a comprehensive oral hygiene plan |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Implement a comprehensive mobilization program |||\\\ |||\\\ |||\\\ |||\\\
HH 3 - correct answer✔✔Suction only when secretions are present
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
HH 4 - correct answer✔✔Before drawing a sample for ABGs from the radial artery, perform
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
the Allen test to assess collateral circulation. Make the clients hand blanch by obliterating both
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
the radial and the ulnar pulses. Then release the pressure over the ulnar artery only. If flow
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
through the ulnar artery is good, flushing will be seen immediately. The allen test is then
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
positive and the radial artery can be used for puncture.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
HH 5 - correct answer✔✔Cardinal signs of Acute Respiratory Failure in children are
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
restlessness, tachypnea, tachycardia, and diaphoresis |||\\\ |||\\\ |||\\\ |||\\\
HH 6 - correct answer✔✔Pco2 >45 or Po2 <60 on 50% 02 signifies respiratory failure
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
,-A child in severe distress should be on 100% 02
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What Po2 values indicate respiratory failure in adults? - correct answer✔✔Po2 below 60
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What blood value indicates hypercapnia? - correct answer✔✔Pco2 above 45
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Identify the condition that exists when the Po2 is less than 50 and Fio2 is greater than 60% -
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
correct answer✔✔Hypoxemia |||\\\ |||\\\
List three symptoms of respiratory failure in adults? - correct answer✔✔Dyspnea/tachypnea
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Intercostal and sternal retractions |||\\\ |||\\\ |||\\\
cyanosis
List four common causes of respiratory - correct answer✔✔Congenital heart disease
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Infection or sepsis |||\\\ |||\\\
Respiratory distress syndrome |||\\\ |||\\\
Aspiration
Fluid overload or dehydration
|||\\\ |||\\\ |||\\\
What percentage of 02 should a child in severe respiratory distress receive? - correct
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
answer✔✔100%
HH 7 - correct answer✔✔Early signs of shock are agitation and restlessness resulting from
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
cerebral hypoxia |||\\\
HH 8 - correct answer✔✔Severe shock leads to widespread cellular injury and impairs the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
integrity of the capillary membranes. Fluid and osmotic proteins seep into the extravascular
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
spaces, further reducing cardiac output. |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
, A vicious circle of decreased perfusion to all cellular level activities ensues. All organs are
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
damaged and if perfusion problems persist the damage can be permanent. |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
HH 9 - correct answer✔✔All types of shock can lead to systemic inflammatory response
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
syndrome (SIRS) and results in multiple organ dysfunction syndrome (MODS) |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
HH 10 - correct answer✔✔If cardiogenic shock exists in the presence of pulmonary edema,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
position the client to reduce venous return (high fowlers) to decrease further venous return to
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
the left ventricle |||\\\ |||\\\
HH 11 - correct answer✔✔All vasopressor and vasodilator drugs are potent and dangerous
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
and require that the client be titrated
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
You are caring for a women who was in a severe MVA several days earlier. She has several
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
fractures and internal injuries. The exploratory laparotomy was sucessful in controlling the |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
bleeding. However today you find that this client is bleeding from her incision site, is short of |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
breath, and has a weak thready pulse, cold, clammy skin, and hematuria. |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What do you think is wrong with the client and what would you expect to do about it? - correct
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
answer✔✔These are typical signs of DIC crisis. Expect to administer IV heparin to block the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
formation of thrombin. However, the client described is already past the coagulation phase and |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
into the hemorrhagic phase. Her care would include administration of clotting factors, along
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
with palliative treatment of the symptoms as they arise.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Poor prognosis |||\\\
Define shock - correct answer✔✔Widespread, serious reduction of tissue perfusion, which
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
leads to generalized impairment of cellular function |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What is the most common cause of shock? - correct answer✔✔hypovolemia
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
