504 HESI REVIEW QUESTIONS AND CORRECT ANSWERS

504 HESI REVIEW QUESTIONS AND
CORRECT ANSWERS
.TheA2nurseA2isA2caringA2forA2aA2clientA2whoA2hasA2justA2hadA2implantationA2ofA2anA2autom
aticA2internalA2cardioverter-
defibrillator.A2TheA2nurseA2wouldA2assessA2whichA2itemA2basedA2onA2priority?
a.A2AnxietyA2levelA2ofA2theA2clientA2andA2family
b.A2PresenceA2ofA2aA2MedicAlertA2cardA2forA2theA2clientA2toA2carry
c.A2KnowledgeA2ofA2restrictionsA2onA2postdischargeA2physicalA2activity
d.A2ActivationA2statusA2ofA2theA2device,A2heartA2rateA2cutoff,A2andA2numberA2ofA2shocksA2it
A2isA2programmedA2toA2deliverA2-A2Ans--D


TheA2nurseA2whoA2isA2caringA2forA2theA2clientA2afterA2insertionA2ofA2anA2automaticA2interna
lA2cardioverter-
defibrillatorA2needsA2toA2assessA2deviceA2settings,A2similarA2toA2afterA2insertionA2ofA2aA2pe
rmanentA2pacemaker.A2Specifically,A2theA2nurseA2needsA2toA2knowA2whetherA2theA2device
A2isA2activated,A2theA2heartA2rateA2cutoffA2aboveA2whichA2itA2willA2fire,A2andA2theA2numberA2
ofA2shocksA2itA2isA2programmedA2toA2deliver.A2TheA2remainingA2optionsA2areA2alsoA2nursin
gA2interventionsA2butA2areA2notA2theA2priority.

AA2client'sA2electrocardiogramA2stripA2showsA2atrialA2andA2ventricularA2ratesA2ofA2110A2be
ats/
minute.A2TheA2PRA2intervalA2isA20.14A2seconds,A2theA2QRSA2complexA2measuresA20.08A2s
econds,A2andA2theA2PPA2andA2RRA2intervalsA2areA2regular.A2HowA2wouldA2theA2nurseA2cor
rectlyA2interpretA2thisA2rhythm?
a.A2SinusA2tachycardia
b.A2SinusA2bradycardia
c.A2SinusA2dysrhythmia
d.A2NormalA2sinusA2rhythmA2-A2Ans--a

SinusA2tachycardiaA2hasA2theA2characteristicsA2ofA2normalA2sinusA2rhythm,A2includingA2aA2
regularA2PPA2intervalA2andA2normal-
widthA2PRA2andA2QRSA2intervals;A2however,A2theA2rateA2isA2theA2differentiatingA2factor.A2I
nA2sinusA2tachycardia,A2theA2atrialA2andA2ventricularA2ratesA2areA2greaterA2thanA2100A2bea
ts/minute.

TheA2nurseA2isA2monitoringA2aA2clientA2withA2acuteA2pericarditisA2forA2signsA2ofA2cardiacA2t
amponade.A2WhichA2assessmentA2findingA2indicatesA2theA2presenceA2ofA2thisA2complicati
on?
a.A2FlatA2neckA2veins
b.A2AA2pulseA2rateA2ofA260A2beats/minute
c.A2MuffledA2orA2distantA2heartA2sounds
d.A2WheezingA2onA2auscultationA2ofA2theA2lungsA2-A2Ans--c

,AssessmentA2findingsA2associatedA2withA2cardiacA2tamponadeA2includeA2tachycardia,A2di
stantA2orA2muffledA2heartA2sounds,A2jugularA2veinA2distentionA2withA2clearA2lungA2sounds,A
2andA2aA2fallingA2bloodA2pressureA2accompaniedA2byA2pulsusA2paradoxusA2(aA2dropA2inA2i
nspiratoryA2bloodA2pressureA2greaterA2thanA210A2mmA2Hg).A2TheA2otherA2optionsA2areA2no
tA2signsA2ofA2cardiacA2tamponade.

TheA2nurseA2inA2theA2medicalA2unitA2isA2reviewingA2theA2laboratoryA2testA2resultsA2forA2aA2
clientA2whoA2hasA2beenA2transferredA2fromA2theA2intensiveA2careA2unitA2(ICU).A2TheA2nurs
eA2notesA2thatA2aA2cardiacA2troponinA2TA2assayA2wasA2performedA2whileA2theA2clientA2was
A2inA2theA2ICU.A2TheA2nurseA2determinesA2thatA2thisA2testA2wasA2performedA2toA2assistA2in
A2diagnosingA2whichA2condition?
a.A2HeartA2failure
b.A2AtrialA2fibrillation
c.A2MyocardialA2infarction
d.A2VentricularA2tachycardiaA2-A2Ans--c

CardiacA2troponinA2TA2orA2cardiacA2troponinA2IA2haveA2beenA2foundA2toA2beA2proteinA2mar
kersA2inA2theA2detectionA2ofA2myocardialA2infarction,A2andA2assayA2forA2theseA2proteinsA2is
A2usedA2inA2someA2institutionsA2toA2aidA2inA2theA2diagnosisA2ofA2aA2myocardialA2infarction.A
2TheA2testA2isA2notA2usedA2toA2diagnoseA2heartA2failure,A2atrialA2fibrillation,A2orA2ventricular
A2tachycardia.


TheA2nurseA2isA2caringA2forA2aA2clientA2withA2aA2diagnosisA2ofA2myocardialA2infarctionA2(MI
)A2andA2isA2assistingA2theA2clientA2inA2completingA2theA2dietA2menu.A2WhichA2beverageA2w
ouldA2theA2nurseA2instructA2theA2clientA2toA2selectA2fromA2theA2menu?
a.A2Tea
b.A2Cola
c.A2Coffee
d.A2AppleA2juiceA2-A2Ans--d

AA2clientA2withA2aA2diagnosisA2ofA2MIA2shouldA2notA2consumeA2caffeinatedA2beverages.A2
CaffeinatedA2productsA2canA2produceA2aA2vasoconstrictiveA2effect,A2leadingA2toA2furtherA2
cardiacA2ischemia.A2Coffee,A2tea,A2andA2colaA2allA2containA2caffeineA2andA2needA2toA2beA2
avoidedA2inA2theA2clientA2withA2MI.A2AppleA2juiceA2doesA2notA2containA2caffeine.

AA2clientA2withA2noA2historyA2ofA2heartA2diseaseA2hasA2experiencedA2acuteA2myocardialA2i
nfarctionA2andA2hasA2beenA2givenA2thrombolyticA2therapyA2withA2tissueA2plasminogenA2act
ivator.A2WhatA2assessmentA2findingA2wouldA2theA2nurseA2identifyA2asA2anA2indicatorA2thatA
2theA2clientA2isA2experiencingA2complicationsA2ofA2thisA2therapy?
a.A2TarryA2stools
b.A2NauseaA2andA2vomiting
c.A2Orange-coloredA2urine
d.A2DecreasedA2urineA2outputA2-A2Ans--a

ThrombolyticA2agentsA2areA2usedA2toA2dissolveA2existingA2thrombi,A2andA2theA2nurseA2wo
uldA2monitorA2theA2clientA2forA2obviousA2orA2occultA2signsA2ofA2bleeding.A2ThisA2includesA2

,assessmentA2forA2obviousA2bleedingA2withinA2theA2gastrointestinalA2(GI)A2tract,A2urinaryA2
system,A2andA2skin.A2ItA2alsoA2includesA2HematestA2testingA2ofA2secretionsA2forA2occultA2bl
ood.A2TheA2correctA2optionA2isA2theA2onlyA2oneA2thatA2indicatesA2theA2presenceA2ofA2blood
.

TheA2nurseA2hasA2justA2completedA2educationA2onA2myocardialA2infarctionA2(MI)A2toA2aA2gr
oupA2ofA2newA2nurses.A2WhichA2statementA2madeA2byA2oneA2ofA2theA2nursesA2indicatesA2t
hatA2theA2teachingA2hasA2beenA2effective?
a.A2"ChestA2painA2isA2causedA2byA2tissueA2hypoxiaA2inA2theA2myocardium."
b.A2"ChestA2painA2isA2causedA2byA2tissueA2hypoxiaA2inA2theA2vesselsA2ofA2theA2heart."
c.A2"ChestA2painA2isA2causedA2byA2tissueA2hypoxiaA2inA2theA2parietalA2pericardium."
d.A2"ChestA2painA2isA2causedA2byA2tissueA2hypoxiaA2inA2theA2visceralA2pericardium."A2-
A2Ans--a


TheA2myocardialA2layerA2ofA2theA2heartA2isA2damagedA2whenA2aA2clientA2experiencesA2anA
2MI.A2ThisA2isA2theA2middleA2layerA2thatA2containsA2theA2striatedA2muscleA2fibersA2responsi
bleA2forA2theA2contractileA2forceA2ofA2theA2heart.A2InA2anA2MI,A2anA2obstructionA2causesA2a
nA2interruptionA2inA2bloodA2flowA2andA2ensuingA2hypoxia;A2thisA2affectsA2theA2myocardialA2l
ayer.A2TheA2endocardiumA2isA2theA2thinA2innerA2layerA2ofA2cardiacA2tissue.A2TheA2parietalA
2pericardiumA2andA2visceralA2pericardiumA2areA2outerA2layersA2thatA2protectA2theA2heartA2f
romA2injuryA2andA2infection.

TheA2registeredA2nurseA2(RN)A2isA2educatingA2aA2newA2nurseA2onA2mitralA2stenosis.A2Whi
chA2statementA2byA2theA2newA2nurseA2indicatesA2thatA2theA2teachingA2hasA2beenA2effectiv
e?
a.A2"LeftA2ventricleA2toA2aortaA2narrowingA2willA2impedeA2flowA2ofA2blood."
b.A2"LeftA2atriumA2toA2leftA2ventricleA2narrowingA2willA2impedeA2flowA2ofA2blood."
c.A2"RightA2atriumA2toA2rightA2ventricleA2narrowingA2willA2impedeA2flowA2ofA2blood."
d.A2"RightA2ventricleA2toA2pulmonaryA2arteryA2narrowingA2willA2impedeA2flowA2ofA2blood."A2-
A2Ans--b


TheA2mitralA2valveA2separatesA2theA2leftA2atriumA2fromA2theA2leftA2ventricle.A2TheA2remaini
ngA2optionsA2describeA2impededA2flowA2dueA2toA2aortic,A2tricuspid,A2andA2pulmonicA2steno
sis,A2respectively.

TheA2registeredA2nurseA2(RN)A2isA2educatingA2aA2newA2nurseA2aboutA2aorticA2regurgitatio
n.A2WhichA2statementA2byA2theA2newA2nurseA2indicatesA2thatA2theA2teachingA2hasA2beenA2
effective?
a.A2"FailureA2ofA2theA2aorticA2valveA2toA2closeA2completelyA2allowsA2bloodA2toA2flowA2retrog
radeA2throughA2theA2aortaA2toA2theA2leftA2ventricle."
b.A2"FailureA2ofA2theA2aorticA2valveA2toA2closeA2completelyA2allowsA2bloodA2toA2flowA2retrog
radeA2throughA2theA2leftA2ventricleA2toA2theA2leftA2atrium."
c.A2"FailureA2ofA2theA2aorticA2valveA2toA2closeA2completelyA2allowsA2bloodA2toA2flowA2retrog
radeA2throughA2theA2rightA2ventricleA2toA2theA2rightA2atrium."
d.A2"FailureA2ofA2theA2aorticA2valveA2toA2closeA2completelyA2allowsA2bloodA2toA2flowA2retrog
radeA2throughA2theA2pulmonaryA2arteryA2toA2theA2rightA2ventricle."A2-A2Ans--a

, TheA2aorticA2valveA2separatesA2theA2aortaA2fromA2theA2leftA2ventricle.A2TheA2statementsA2i
nA2theA2remainingA2optionsA2areA2inaccurate.

WhichA2laboratoryA2testA2resultsA2mayA2beA2associatedA2withA2peakedA2orA2tall,A2tentedA2
TA2wavesA2onA2aA2client'sA2electrocardiogramA2(ECG)?
a.A2ChlorideA2levelA2ofA298A2mEq/LA2(98A2mmol/L)
b.A2SodiumA2levelA2ofA2135A2mEq/LA2(135A2mmol/L)
c.A2PotassiumA2levelA2ofA26.8A2mEq/LA2(6.8A2mmol/L)
d.A2MagnesiumA2levelA2ofA21.8-2.6A2mEq/LA2(0.74A2mmol/L)A2-A2Ans--c

HyperkalemiaA2canA2causeA2tall,A2peaked,A2orA2tentedA2TA2wavesA2onA2theA2ECG.A2Potas
siumA2levelsA2ofA25.0A2mEq/LA2(5.0A2mmol/
L)A2orA2greaterA2indicateA2hyperkalemia.A2OptionsA21,A22,A2andA24A2areA2normalA2levels.

AA2clientA2isA2beingA2dischargedA2fromA2theA2hospitalA2afterA2beingA2treatedA2forA2infective
A2endocarditis.A2TheA2nurseA2wouldA2provideA2theA2clientA2withA2whichA2dischargeA2instruc
tion?
a.A2TakeA2acetaminophenA2ifA2theA2chestA2painA2worsens.
b.A2TakeA2antibioticsA2untilA2theA2chestA2painA2isA2fullyA2resolved.
c.A2UseA2aA2firm-bristleA2toothbrushA2andA2flossA2vigorouslyA2toA2preventA2cavities.
d.A2NotifyA2allA2physicians'A2ofA2theA2historyA2ofA2infectiveA2endocarditisA2beforeA2anyA2inv
asiveA2procedures.A2-A2Ans--d

TheA2clientA2needsA2toA2alertA2anyA2physicianA2aboutA2theA2historyA2ofA2infectiveA2endocar
ditisA2beforeA2invasiveA2dental,A2oral,A2orA2upperA2respiratoryA2procedures.A2TheA2physici
anA2wouldA2placeA2theA2clientA2withA2aA2historyA2ofA2infectiveA2endocarditisA2onA2prophyla
cticA2antibioticsA2ifA2oneA2ofA2theseA2proceduresA2isA2needed.A2AntibioticsA2needA2toA2beA2
takenA2forA2theA2fullA2courseA2ofA2therapy.A2TheA2clientA2needsA2toA2notifyA2theA2physicianA
2ifA2chestA2painA2worsensA2orA2ifA2dyspneaA2orA2otherA2symptomsA2occur.A2TheA2clientA2w
ouldA2useA2aA2softA2toothbrushA2andA2flossA2carefullyA2toA2avoidA2anyA2traumaA2toA2theA2g
ums,A2whichA2couldA2provideA2aA2portalA2ofA2entryA2forA2bacterialA2infection.

TheA2newA2registeredA2nurseA2(RN)A2isA2reviewingA2cardiacA2rhythmsA2withA2aA2mentor.A2
WhichA2statementA2byA2theA2newA2RNA2indicatesA2thatA2teachingA2aboutA2ventricularA2fibri
llationA2hasA2beenA2effective?
a.A2"VentricularA2fibrillationA2appearsA2asA2irregularA2beatsA2withinA2aA2rhythm."
b.A2"VentricularA2fibrillationA2doesA2notA2haveA2PA2wavesA2orA2QRSA2complexes."
c.A2"VentricularA2fibrillationA2isA2aA2regularA2patternA2ofA2wideA2QRSA2complexes."
d.A2"VentricularA2fibrillationA2hasA2recognizableA2PA2waves,A2QRSA2complexes,A2andA2TA2
waves."A2-A2Ans--b

VentricularA2fibrillationA2isA2characterizedA2byA2theA2absenceA2ofA2PA2wavesA2andA2QRSA2
complexes.A2TheA2rhythmA2isA2instantlyA2recognizableA2byA2theA2presenceA2ofA2coarseA2o
rA2fineA2fibrillatoryA2wavesA2onA2theA2cardiacA2monitoringA2screen.A2PrematureA2ventricula
rA2contractionsA2(PVCs)A2appearA2asA2irregularA2beatsA2withinA2aA2rhythm.A2VentricularA2t