RESPIRATORY HESI PREP UPDATED ACTUAL
MOCK EXAM WITH ANSWER RATIONALES
2026
◉ neonatal resuscitation.
Answer: wipe baby off, put under radiant warmer, if grunting & HR
80 Initiate CPAP or neopuff if HR decreases to 60 or less initiate
compressions and 100% FiO2
-NRP: 1 rescuer 30:2
2 rescuer 15:2
◉ pulmonary edema.
Answer: IG: sudden onset with orthopnea, pink frothy secretions,
enlarged heart, ST depress, bilateral fluffy infiltrates on x ray.
DM: give hyperinflation therapy, put in fowler's position.
Thoracentesis for infiltrate and fluid. Medication: Lasix, morphine,
and digitalis.
◉ Myocardial Ischemia/infarction.
Answer: IG: chest pain and nausea, substernal squeezing pain in left
shoulder, shows elevated ST segment, ST depression T wave
inversion on EKG.
,IG: Troponin 0.78 (elevated) (> 0.1), CK shows recent MI, pedal
edema, character of chest pain, peripheral pulses, CBC, electrolytes,
ECG, if intubated evaluate CXR for tube placement, elevation in
cardiac enzymes
DM: give oxygen for hypoxemia 2L/M BP 80/40 give dopamine,
digoxin, Levophed (inotropic drug) to increase BP. Use Verapamil if
BP is high . Sublingual nitroglycerin, O2, aspirin, and morphine.
(OMAN)
ultrasound to determine if mitral valve is blocked
PVC's ---> lidocaine or amiodarone
◉ Guillian-Barre.
Answer: IG: pt. comes in with acute weakness in legs, onset of
difficulty walking, reduced lower extremity strength, recent
infection
Test: Lumbar puncture if not diagnosed. positive if increase in
protein within cerebral spinal fluid
(Tx: plasmapheresis)
,IG: ability to swallow, cough effort, sensory and motor function, level
of consciousness, and deep tendon reflexes.
--> closely monitor respiratory muscle strength
(VC,VT, MIP) VC < 1.0 intubate, MIP < -60- -70
DM: continue to monitor MIP and VC if not intubated, refer to
physical therapy for evaluation, pressure stockings
◉ Cystic Fibrosis.
Answer: IG: has elevated hemoglobin and hematocrit sweat chloride
to diagnose must be above 60(usually already diagnosed so wont
need to do), tenacious yellow-green sputum (infection), decreased
BS, coarse crackles,
IG: Spirometry, sputum culture & sensitivity for infection, 6MWT,
CXR (bronchiectasis give antibiotics- ciprofloxacin)
DM: oral ciprofloxacin (antibiotic), increase frequency of airway
clearance therapy.
hemoptysis present give epinephrine
ivacafort, cayston is medication for CF first being diagnosed
, DM: Home care management: bronchodilator, pulmozyme, HFCWO,
tobramycin, pancreatic enzymes, For C.F. adult at college give DPI
TOBI instead of Nebulizer.
◉ neonate being delivered.
Answer: pick intubation supplies if needed: size 2.5-3.5 ETT,
laryngoscope blades, bag to ventilate suction material, warmer,
drying materials (if suction material and tubes already gathered
don't pick again) wipe off and warm under radiant warmer first
-baby ends up having a pneumothorax on left, insert chest tube
otherwise suction, give surfactant, right after birth & 12 hours later
if needed. If still showing distress put on ventilator, PC/SIMV
◉ Asthma.
Answer: IG: Personal best PEF establish different zones, adherence
to medication regimen, nocturnal awakenings. Complete education
on medications and yellow zone. Add inhaled steroid (Flovent) for
persistent yellow zone.
DM: Asthma exacerbation: albuterol multiple treatments and IV
methylprednisone if no improvement with albuterol
DM: if exercise induced use albuterol 2 puffs prior to exercise.
seasonal allergies Singulair and budesonide/formoterol (Symbicort)
complete allergen testing, vacuum, wash sheets, change filters
MOCK EXAM WITH ANSWER RATIONALES
2026
◉ neonatal resuscitation.
Answer: wipe baby off, put under radiant warmer, if grunting & HR
80 Initiate CPAP or neopuff if HR decreases to 60 or less initiate
compressions and 100% FiO2
-NRP: 1 rescuer 30:2
2 rescuer 15:2
◉ pulmonary edema.
Answer: IG: sudden onset with orthopnea, pink frothy secretions,
enlarged heart, ST depress, bilateral fluffy infiltrates on x ray.
DM: give hyperinflation therapy, put in fowler's position.
Thoracentesis for infiltrate and fluid. Medication: Lasix, morphine,
and digitalis.
◉ Myocardial Ischemia/infarction.
Answer: IG: chest pain and nausea, substernal squeezing pain in left
shoulder, shows elevated ST segment, ST depression T wave
inversion on EKG.
,IG: Troponin 0.78 (elevated) (> 0.1), CK shows recent MI, pedal
edema, character of chest pain, peripheral pulses, CBC, electrolytes,
ECG, if intubated evaluate CXR for tube placement, elevation in
cardiac enzymes
DM: give oxygen for hypoxemia 2L/M BP 80/40 give dopamine,
digoxin, Levophed (inotropic drug) to increase BP. Use Verapamil if
BP is high . Sublingual nitroglycerin, O2, aspirin, and morphine.
(OMAN)
ultrasound to determine if mitral valve is blocked
PVC's ---> lidocaine or amiodarone
◉ Guillian-Barre.
Answer: IG: pt. comes in with acute weakness in legs, onset of
difficulty walking, reduced lower extremity strength, recent
infection
Test: Lumbar puncture if not diagnosed. positive if increase in
protein within cerebral spinal fluid
(Tx: plasmapheresis)
,IG: ability to swallow, cough effort, sensory and motor function, level
of consciousness, and deep tendon reflexes.
--> closely monitor respiratory muscle strength
(VC,VT, MIP) VC < 1.0 intubate, MIP < -60- -70
DM: continue to monitor MIP and VC if not intubated, refer to
physical therapy for evaluation, pressure stockings
◉ Cystic Fibrosis.
Answer: IG: has elevated hemoglobin and hematocrit sweat chloride
to diagnose must be above 60(usually already diagnosed so wont
need to do), tenacious yellow-green sputum (infection), decreased
BS, coarse crackles,
IG: Spirometry, sputum culture & sensitivity for infection, 6MWT,
CXR (bronchiectasis give antibiotics- ciprofloxacin)
DM: oral ciprofloxacin (antibiotic), increase frequency of airway
clearance therapy.
hemoptysis present give epinephrine
ivacafort, cayston is medication for CF first being diagnosed
, DM: Home care management: bronchodilator, pulmozyme, HFCWO,
tobramycin, pancreatic enzymes, For C.F. adult at college give DPI
TOBI instead of Nebulizer.
◉ neonate being delivered.
Answer: pick intubation supplies if needed: size 2.5-3.5 ETT,
laryngoscope blades, bag to ventilate suction material, warmer,
drying materials (if suction material and tubes already gathered
don't pick again) wipe off and warm under radiant warmer first
-baby ends up having a pneumothorax on left, insert chest tube
otherwise suction, give surfactant, right after birth & 12 hours later
if needed. If still showing distress put on ventilator, PC/SIMV
◉ Asthma.
Answer: IG: Personal best PEF establish different zones, adherence
to medication regimen, nocturnal awakenings. Complete education
on medications and yellow zone. Add inhaled steroid (Flovent) for
persistent yellow zone.
DM: Asthma exacerbation: albuterol multiple treatments and IV
methylprednisone if no improvement with albuterol
DM: if exercise induced use albuterol 2 puffs prior to exercise.
seasonal allergies Singulair and budesonide/formoterol (Symbicort)
complete allergen testing, vacuum, wash sheets, change filters
