HESI CRITICAL CARE EXAM
QUESTIONS WITH CORRECT ANSWERS
AND RATIONALES
A b56-year-old bfemale bclient bis breceiving bintracavitary bradiation bvia ba bradium
bimplant. bWhich
nurse bshould bbe bassigned bto bcare bfor bthis bclient?
A. bThe bnurse bwho bis bcaring bfor banother bclient breceiving bintracavitary bradiation.
B. bA bnurse bwith bMarfan's bsyndrome bwho bis bpostmenopausal.
C. bA bnurse bwith boncology bexperience bwho bmay bbe bpregnant.
D. bThe bnurse bwho bis bcaring bfor banother bclient bwho bhas bClostridium bdifficile. b-
bcorrect banswer✔✔B. bA bnurse bwith bMarfan's bsyndrome bwho bis bpostmenopausal.
RATIONALE:
A bclient breceiving bintracavity bradiation bposes ba bradiation bhazard bas blong bas bthe
bintracavity
radiation bsource bis bin bplace. bA bnurse's bability bto bcare bof bthis bclient bis bnot baffected
bby bMarfan's
syndrome b(B), bwhich bis ba bhereditary bdisorder bof bconnective btissues, bbones,
bmuscles, bligaments
and bskeletal bstructures. bThe bgoal bis bto blimit bany bone bstaff bmember's bexposure bto
bthe bcalculated
time bspan bbased bon bthe bhalf-life bof bradium, bsuch bas bthe bnumber bof bminutes bat
bthe bbedside bper bday,
so b(A) bshould bnot bbe bassigned. b(C) bshould bnot bbe bexposed bto bthe bradiation bdue
bto bthe bpossible
effect bon bthe bfetus. bA bradiation bexposure bdecreases bthe bimmune bresponse bin bthe
bclient bwho bshould
not bbe bexposed bto bthe bpotential binadvertent btransmission bof ban binfectious
borganism b(D).
1.A bclient bwho bhas bactive btuberculosis b(TB) bis badmitted bto bthe bmedical bunit. bWhat
baction bis bmost
important bfor bthe bnurse bto bimplement?
A. bFit bthe bclient bwith ba brespirator bmask.
,B. bAssign bthe bclient bto ba bnegative bair-flow broom.
C. bDon ba bclean bgown bfor bclient bcare.
D. bPlace ban bisolation bcart bin bthe bhallway b- bcorrect banswer✔✔Assign bthe bclient bto
ba bnegative bair-flow broom
RATIONALE:
Active btuberculosis brequires bimplementation bof bairborne bprecautions, bso bthe bclient
bshould bbe
assigned bto ba bnegative bpressure bair-flow broom b(D). bAlthough b(A band bC) bshould
bbe bimplemented
for bclients bin bisolation bwith bcontact bprecautions, bit bis bmost bimportant bthat bair bflow
bfrom bthe broom
is bminimized bwhen bthe bclient bhas bTB. b(B) bshould bbe bimplemented bwhen bthe
bclient bleaves bthe
isolation benvironment.
2.A bclient bis breceiving batenolol b(Tenormin) b25 bmg bPO bafter ba bmyocardial
binfarction. bThe bnurse
determines bthe bclient's bapical bpulse bis b65 bbeats bper bminute. bWhat baction bshould
bthe bnurse
implement
next?
A. bMeasure bthe bblood bpressure.
B. bReassess bthe bapical bpulse.
C. bNotify bthe bhealthcare bprovider.
D. bAdminister bthe bmedication. b- bcorrect banswer✔✔Administer bthe bmedication
RATIONALE:
Atenolol, ba bbeta-blocker, bblocks bthe bbeta breceptors bof bthe bsinoatrial bnode bto
breduce bthe bheart brate,
so bthe bmedication bshould bbe badministered b(C) bbecause bthe bclient's bapical bpulse
bis bgreater bthan b60.
(A, bB, band bD) bare bnot bindicated bat bthis btime.
3.The bnurse bis bassessing ba bclient band bidentifies ba bbruit bover bthe bthyroid. bThis
bfinding bis bconsistent
with bwhich binterpretation?
A. bHypothyroidism.
B. bThyroid bcyst.
C. bThyroid bcancer.
D. bHyperthyroidism b- bcorrect banswer✔✔Hyperthyroidism
Rationale:Hyperthyroidism b(D) bis ban benlargement bof bthe bthyroid bgland, boften
breferred bto bas ba bgoiter, band ba
bruit bmay bbe bauscultated bover bthe bgoiter bdue bto ban bincrease bin bglandular
bvascularity bwhich
increases bas bthe bthyroid bgland bbecomes bhyperactive. bA bbruit bis bnot bcommon bwith
b(A, bB, band bC).
,A b6-year-old bchild bis balert bbut bquiet bwhen bbrought bto bthe bemergency bcenter bwith
bperiorbital becchymosis band becchymosis bbehind bthe bears. bThe bnurse bsuspects
bpotential bchild babuse band bcontinues bto bassess bthe bchild bfor badditional
bmanifestations bof ba bbasilar bskull bfracture. bWhat
assessment bfinding bwould bbe bconsistent bwith ba bbasilar bskull bfracture?
A. bHematemesis band babdominal bdistention.
B. bAsymmetry bof bthe bface band beye bmovements.
C. bRhinorrhoea bor botorrhoea bwith bHalo bsign.
D. bAbnormal bposition band bmovement bof bthe barm. b- bcorrect banswer✔✔Rhinorrhoea
bor botorrhoea bwith bHalo bsign.
RATIONALE:
Raccoon beyes b(periorbital becchymosis) band bBattle's bsign b(ecchymosis bbehind bthe
bear bover bthe
mastoid bprocess) bare bboth bsigns bof ba bbasilar bskull bfracture, bso bthe bnurse bshould
bassess bfor bpossible
meningeal btears bthat bmanifest bas ba bHalo bsign bwith bCSF bleakage bfrom bthe bears
bor bnose b(D). b(A) bis
consistent bwith borbital bfractures. b(B) boccurs bwith bwrenching btraumas bof bthe
bshoulder bor barm
fractures. b(C) boccurs bwith bblunt babdominal binjuries.
The bnurse bis bassessing ba bclient bwho bcomplains bof bweight bloss, bracing bheart brate,
band bdifficulty
sleeping. bThe bnurse bdetermines bthe bclient bhas bmoist bskin bwith bfine bhair,
bprominent beyes, blid
retraction, band ba bstaring bexpression. bThese bfindings bare bconsistent bwith bwhich
bdisorder?
A. bGrave's bdisease.
B. bMultiple bsclerosis.
C. bAddison's bdisease.
D. bCushing bsyndrome. b- bcorrect banswer✔✔Grave's bdisease
RATIONALE:
This bclient bis bexhibiting bsymptoms bassociated bwith bhyperthyroidism bor bGrave's
bdisease b(A),
which bis ban bautoimmune bcondition baffecting bthe bthyroid. b(B, bC, band bD) bare bnot
bassociated bwith
these bsymptoms.
The bnurse bis bassessing ban bolder bclient band bdetermines bthat bthe bclient's bleft bupper
beyelid bdroops,
covering bmore bof bthe biris bthan bthe bright beyelid. bWhich bdescription bshould bthe
bnurse buse bto
document bthis bfinding?
A. bA bnystagmus bon bthe bleft.
B. bExophthalmos bon bthe bright.
C. bPtosis bon bthe bleft beyelid.
, D. bAstigmatism bon bthe bright. b- bcorrect banswer✔✔Ptosis bon bthe bleft beyelid
Rationale: bPtosis bis bthe bterm bto bdescribe ban beyelid bdroop bthat bcovers ba blarge
bportion bof bthe biris b(A), bwhich
may bresult bfrom boculomotor bnerve bor beyelid bmuscle bdisorder. b(B) bis bcharacterized
bby brapid,
rhythmic bmovement bof bboth beyes. b(C) bis ba bdistortion bof bthe blens bof bthe beye,
bcausing bdecreased
visual bacuity. b(D) bis ba bterm bused bto bdescribe ba bprotrusion bof bthe beyeballs bthat
boccurs bwith
hyperthyroidism.
The bnurse bis bassessing ba bchild's bweight band bheight bduring ba bclinic bvisit bprior bto
bstarting bschool.
The bnurse bplots bthe bchild's bweight bon bthe bgrowth bchart band bnotes bthat bthe bchild's
bweight bis bin bthe
95th bpercentile bfor bthe bchild's bheight. bWhat baction bshould bthe bnurse btake?
A. bQuestion bthe btype band bquantity bof bfoods beaten bin ba btypical bday.
B. bEncourage bgiving btwo badditional bsnacks beach bday bto bthe bchild.
C. bRecommend ba bdaily bintake bof bat bleast bfour bglasses bof bwhole bmilk.
D. bAssess bfor bsigns bof bpoor bnutrition, bsuch bas ba bpale bappearance b- bcorrect
banswer✔✔A. bQuestion bthe btype band bquantity bof bfoods beaten bin ba btypical bday.
RATIONALE:
The bchild bis boverweight bfor bheight, bso bassessment bof bthe bchild's bdaily bdiet b(C)
bshould bbe
determined. bThe bchild bdoes bnot bneed b(A bor bB), bboth bof bwhich bwill bincrease bthe
bchild's bweight.
Poor bnutrition b(D) bis bcommonly bseen bin bunderweight bchildren, bnot boverweight.
A bchild bis breceiving bmaintenance bintravenous b(IV) bfluids bat bthe brate bof b1000 bmL
bfor bthe bfirst b10
kg bof bbody bweight, bplus b50 bmL/kg bper bday bfor beach bkilogram bbetween b10 band
b20. bHow bmany
milliliters bper bhour bshould bthe bnurse bprogram bthe binfusion bpump bfor ba bchild bwho
bweighs b19.5 bkg?
(Enter bnumeric bvalue bonly. bIf brounding bis brequired, bround bto bthe bnearest bwhole
bnumber.)
A. b24
B. b61
C. b73
D. b58 b- bcorrect banswer✔✔B. b61
RATIONALE:
The bformula bfor bcalculating bdaily bfluid brequirements bis: b0 bto b10 bkg, b100 bmL/kg
bper bday; bor b10 bto
20 bkg, b1000 bmL bfor bthe bfirst b10 bkg bof bbody bweight bplus b50 bmL/kg bper bday bfor
beach bkilogram
QUESTIONS WITH CORRECT ANSWERS
AND RATIONALES
A b56-year-old bfemale bclient bis breceiving bintracavitary bradiation bvia ba bradium
bimplant. bWhich
nurse bshould bbe bassigned bto bcare bfor bthis bclient?
A. bThe bnurse bwho bis bcaring bfor banother bclient breceiving bintracavitary bradiation.
B. bA bnurse bwith bMarfan's bsyndrome bwho bis bpostmenopausal.
C. bA bnurse bwith boncology bexperience bwho bmay bbe bpregnant.
D. bThe bnurse bwho bis bcaring bfor banother bclient bwho bhas bClostridium bdifficile. b-
bcorrect banswer✔✔B. bA bnurse bwith bMarfan's bsyndrome bwho bis bpostmenopausal.
RATIONALE:
A bclient breceiving bintracavity bradiation bposes ba bradiation bhazard bas blong bas bthe
bintracavity
radiation bsource bis bin bplace. bA bnurse's bability bto bcare bof bthis bclient bis bnot baffected
bby bMarfan's
syndrome b(B), bwhich bis ba bhereditary bdisorder bof bconnective btissues, bbones,
bmuscles, bligaments
and bskeletal bstructures. bThe bgoal bis bto blimit bany bone bstaff bmember's bexposure bto
bthe bcalculated
time bspan bbased bon bthe bhalf-life bof bradium, bsuch bas bthe bnumber bof bminutes bat
bthe bbedside bper bday,
so b(A) bshould bnot bbe bassigned. b(C) bshould bnot bbe bexposed bto bthe bradiation bdue
bto bthe bpossible
effect bon bthe bfetus. bA bradiation bexposure bdecreases bthe bimmune bresponse bin bthe
bclient bwho bshould
not bbe bexposed bto bthe bpotential binadvertent btransmission bof ban binfectious
borganism b(D).
1.A bclient bwho bhas bactive btuberculosis b(TB) bis badmitted bto bthe bmedical bunit. bWhat
baction bis bmost
important bfor bthe bnurse bto bimplement?
A. bFit bthe bclient bwith ba brespirator bmask.
,B. bAssign bthe bclient bto ba bnegative bair-flow broom.
C. bDon ba bclean bgown bfor bclient bcare.
D. bPlace ban bisolation bcart bin bthe bhallway b- bcorrect banswer✔✔Assign bthe bclient bto
ba bnegative bair-flow broom
RATIONALE:
Active btuberculosis brequires bimplementation bof bairborne bprecautions, bso bthe bclient
bshould bbe
assigned bto ba bnegative bpressure bair-flow broom b(D). bAlthough b(A band bC) bshould
bbe bimplemented
for bclients bin bisolation bwith bcontact bprecautions, bit bis bmost bimportant bthat bair bflow
bfrom bthe broom
is bminimized bwhen bthe bclient bhas bTB. b(B) bshould bbe bimplemented bwhen bthe
bclient bleaves bthe
isolation benvironment.
2.A bclient bis breceiving batenolol b(Tenormin) b25 bmg bPO bafter ba bmyocardial
binfarction. bThe bnurse
determines bthe bclient's bapical bpulse bis b65 bbeats bper bminute. bWhat baction bshould
bthe bnurse
implement
next?
A. bMeasure bthe bblood bpressure.
B. bReassess bthe bapical bpulse.
C. bNotify bthe bhealthcare bprovider.
D. bAdminister bthe bmedication. b- bcorrect banswer✔✔Administer bthe bmedication
RATIONALE:
Atenolol, ba bbeta-blocker, bblocks bthe bbeta breceptors bof bthe bsinoatrial bnode bto
breduce bthe bheart brate,
so bthe bmedication bshould bbe badministered b(C) bbecause bthe bclient's bapical bpulse
bis bgreater bthan b60.
(A, bB, band bD) bare bnot bindicated bat bthis btime.
3.The bnurse bis bassessing ba bclient band bidentifies ba bbruit bover bthe bthyroid. bThis
bfinding bis bconsistent
with bwhich binterpretation?
A. bHypothyroidism.
B. bThyroid bcyst.
C. bThyroid bcancer.
D. bHyperthyroidism b- bcorrect banswer✔✔Hyperthyroidism
Rationale:Hyperthyroidism b(D) bis ban benlargement bof bthe bthyroid bgland, boften
breferred bto bas ba bgoiter, band ba
bruit bmay bbe bauscultated bover bthe bgoiter bdue bto ban bincrease bin bglandular
bvascularity bwhich
increases bas bthe bthyroid bgland bbecomes bhyperactive. bA bbruit bis bnot bcommon bwith
b(A, bB, band bC).
,A b6-year-old bchild bis balert bbut bquiet bwhen bbrought bto bthe bemergency bcenter bwith
bperiorbital becchymosis band becchymosis bbehind bthe bears. bThe bnurse bsuspects
bpotential bchild babuse band bcontinues bto bassess bthe bchild bfor badditional
bmanifestations bof ba bbasilar bskull bfracture. bWhat
assessment bfinding bwould bbe bconsistent bwith ba bbasilar bskull bfracture?
A. bHematemesis band babdominal bdistention.
B. bAsymmetry bof bthe bface band beye bmovements.
C. bRhinorrhoea bor botorrhoea bwith bHalo bsign.
D. bAbnormal bposition band bmovement bof bthe barm. b- bcorrect banswer✔✔Rhinorrhoea
bor botorrhoea bwith bHalo bsign.
RATIONALE:
Raccoon beyes b(periorbital becchymosis) band bBattle's bsign b(ecchymosis bbehind bthe
bear bover bthe
mastoid bprocess) bare bboth bsigns bof ba bbasilar bskull bfracture, bso bthe bnurse bshould
bassess bfor bpossible
meningeal btears bthat bmanifest bas ba bHalo bsign bwith bCSF bleakage bfrom bthe bears
bor bnose b(D). b(A) bis
consistent bwith borbital bfractures. b(B) boccurs bwith bwrenching btraumas bof bthe
bshoulder bor barm
fractures. b(C) boccurs bwith bblunt babdominal binjuries.
The bnurse bis bassessing ba bclient bwho bcomplains bof bweight bloss, bracing bheart brate,
band bdifficulty
sleeping. bThe bnurse bdetermines bthe bclient bhas bmoist bskin bwith bfine bhair,
bprominent beyes, blid
retraction, band ba bstaring bexpression. bThese bfindings bare bconsistent bwith bwhich
bdisorder?
A. bGrave's bdisease.
B. bMultiple bsclerosis.
C. bAddison's bdisease.
D. bCushing bsyndrome. b- bcorrect banswer✔✔Grave's bdisease
RATIONALE:
This bclient bis bexhibiting bsymptoms bassociated bwith bhyperthyroidism bor bGrave's
bdisease b(A),
which bis ban bautoimmune bcondition baffecting bthe bthyroid. b(B, bC, band bD) bare bnot
bassociated bwith
these bsymptoms.
The bnurse bis bassessing ban bolder bclient band bdetermines bthat bthe bclient's bleft bupper
beyelid bdroops,
covering bmore bof bthe biris bthan bthe bright beyelid. bWhich bdescription bshould bthe
bnurse buse bto
document bthis bfinding?
A. bA bnystagmus bon bthe bleft.
B. bExophthalmos bon bthe bright.
C. bPtosis bon bthe bleft beyelid.
, D. bAstigmatism bon bthe bright. b- bcorrect banswer✔✔Ptosis bon bthe bleft beyelid
Rationale: bPtosis bis bthe bterm bto bdescribe ban beyelid bdroop bthat bcovers ba blarge
bportion bof bthe biris b(A), bwhich
may bresult bfrom boculomotor bnerve bor beyelid bmuscle bdisorder. b(B) bis bcharacterized
bby brapid,
rhythmic bmovement bof bboth beyes. b(C) bis ba bdistortion bof bthe blens bof bthe beye,
bcausing bdecreased
visual bacuity. b(D) bis ba bterm bused bto bdescribe ba bprotrusion bof bthe beyeballs bthat
boccurs bwith
hyperthyroidism.
The bnurse bis bassessing ba bchild's bweight band bheight bduring ba bclinic bvisit bprior bto
bstarting bschool.
The bnurse bplots bthe bchild's bweight bon bthe bgrowth bchart band bnotes bthat bthe bchild's
bweight bis bin bthe
95th bpercentile bfor bthe bchild's bheight. bWhat baction bshould bthe bnurse btake?
A. bQuestion bthe btype band bquantity bof bfoods beaten bin ba btypical bday.
B. bEncourage bgiving btwo badditional bsnacks beach bday bto bthe bchild.
C. bRecommend ba bdaily bintake bof bat bleast bfour bglasses bof bwhole bmilk.
D. bAssess bfor bsigns bof bpoor bnutrition, bsuch bas ba bpale bappearance b- bcorrect
banswer✔✔A. bQuestion bthe btype band bquantity bof bfoods beaten bin ba btypical bday.
RATIONALE:
The bchild bis boverweight bfor bheight, bso bassessment bof bthe bchild's bdaily bdiet b(C)
bshould bbe
determined. bThe bchild bdoes bnot bneed b(A bor bB), bboth bof bwhich bwill bincrease bthe
bchild's bweight.
Poor bnutrition b(D) bis bcommonly bseen bin bunderweight bchildren, bnot boverweight.
A bchild bis breceiving bmaintenance bintravenous b(IV) bfluids bat bthe brate bof b1000 bmL
bfor bthe bfirst b10
kg bof bbody bweight, bplus b50 bmL/kg bper bday bfor beach bkilogram bbetween b10 band
b20. bHow bmany
milliliters bper bhour bshould bthe bnurse bprogram bthe binfusion bpump bfor ba bchild bwho
bweighs b19.5 bkg?
(Enter bnumeric bvalue bonly. bIf brounding bis brequired, bround bto bthe bnearest bwhole
bnumber.)
A. b24
B. b61
C. b73
D. b58 b- bcorrect banswer✔✔B. b61
RATIONALE:
The bformula bfor bcalculating bdaily bfluid brequirements bis: b0 bto b10 bkg, b100 bmL/kg
bper bday; bor b10 bto
20 bkg, b1000 bmL bfor bthe bfirst b10 bkg bof bbody bweight bplus b50 bmL/kg bper bday bfor
beach bkilogram
