ADULT HEALTH 3 HESI CRITICAL
CARE 2 (2026/2027) UPDATE|EXAM
QUESTIONS WITH MULTIPLE
CHOICES |VERIFIED & REVISED
ANSWERS (NEW)!!!
Amclientmwithmtypem2mdiabetesmmellitusmismrecoveringmfrommcoronarymangiographyminmthemintensi
vemcaremunitm(ICU).mWhatmfindingmwouldmbemofmthemmostmconcernmtomthemnurse?
A.maPTTmism2mtimesmthemnormalmreferenceminterval.
B.mGraftmdonormsitemismslightlymredmandmswollen.
C.mSerummcreatininemincreasedm1/4mfrommbaseline.
D.mPaO2mism80mmHg.m-mCORRECTmANSWERmThemCORRECTmANSWERmismC.
Am25%mincreaseminmserummcreatininemfollowingmcardiacmangiographym(alsomknownmasmcardiacmcat
heterization)mismamsignmofmcontrastminducedmnephropathym(CIN)mandm(potential)macutemkidneymfail
ure.mThemnursemshouldmreportmthismfindingmtomthemhealthmcaremprovidermimmediately.mNotemthatm
themclientmhasmdiabetes,mwhichmincreasesmthemriskmofmthemdevelopmentmofmCINm(ChoicemC).mChoic
emAmismincorrectmbecausemanmaPTTmofm1.5mtom2.5mtimesmthemnormalmreferencemintervalmismrecomm
endedmformheparinmanticoagulationmthatmthemclientmwillmbemreceivingmpost-
operatively.mChoicemBmmaymbemanmearlymsignmofmtissueminfectionmandmshouldmbemmonitoredmcaref
ully.mHowever,msomemdegreemofmrednessmandmswellingmismtombemexpected.mChoicemDmismincorrectm
becausemamPaO2mofm80mmHgmismwithinmthemnormalmrange.
Whenmcaringmformamclientmwithmidiopathicmmyocarditis,mwhatmismamprioritymnursingmintervention?
A.mReducingmcongestionmwithmdiureticsmandmACEminhibitors.
B.mAntibioticmadministrationmtomeliminatemcausativemagent.
C.mMaintainingmadequatemfluidmintakemformhydration.
D.mReducingmfevermwithmacetaminophen.m-mCORRECTmANSWERmA.m
,Myocarditismismanminflammatorymdiseasemofmthemmyocardiummandmmaymprogressmtomheartmfailure
.mFiftympercentmofmthemcasesmaremidiopathicm(nomcausativemagentmcanmbemdetected).mManagement
mismaimedmatmreducingmcongestionm(withmdiuretics,mACEminhibitorsmandmvasodilators),mimprovingmc
ardiacmhemodynamicsmandmsupportivemcare.mChoicemBmismincorrectmbecausemantibioticmtreatment
mismnotmusefulmunlessmambacterialminfectionmismdemonstrated.mMostmcasesmofmmyocarditismaremidio
pathic,mvirusminducedm(CoxsackiemAmandmB)mormcausedmbymamdirectmcytotoxicmeffectmofmcertainmdr
ugs.mChoicemCmismincorrectmbecausemfluidmintakemshouldmbemregulatedmtompreventmfluidmvolumemo
verload.mChoicemDmismincorrectmbecausemfevermmanagementmismnotmamprioritymformthismclient.
Themnursemisminstructingmamclientmwithmamnewlymimplantedmcardiovertermdefibrillatorm(ICD).mWhat
mstatementmindicatesmthatmteachingmhasmbeenmeffective?
A."Imshouldmcontinuemtakingmmymanti-arrhythmicmdrugs."
B."ImshouldmavoidmusingmthemmicrowavemormwatchingmTV."
C.m"Imshouldmdocumentmeverymshockmandmtakemthemlistmwithmmemonmmymnextmcardiologymvisit."
D.m"ImmaymfeelmitmwhenmmymICDmfires,mbutmitmwon'tmhurt."m-
mCORRECTmANSWERmA."Imshouldmcontinuemtakingmmymanti-arrhythmicmdrugs."
AlthoughmICDsmaremverymeffectiveminmterminatingmarrhythmias,mtheymdomnotmpreventmthemmfromm
occurring.mAnti-
arrhythmicmdrugsmaremalmostmalwaysmcontinuedmtomreducemthemamountmofmarrhythmiasmthatmthe
mpatientmismexperiencing.mChoicemBmismincorrectmbecausemhouseholdmappliancesmsuchmasmmicrowa
vesmandmTVsmcanmbemusedmsafely.mHowever,mprolongedmexposuremshouldmbemavoided.mThemclientm
shouldmbeminstructedmtomavoidmstrongmelectromagneticmfieldsm(e.g.,mMRI,mlargemgenerators).mChoi
cemCmismincorrectmbecausemthemcardiologistmmustmbemcontactedmdirectlymaftermamshockmoccurs.mDo
cumentingmshocksmtomdiscussmthemmatmthemnextmcardiologymvisitmwillmcompromisemthemclient'smsa
fety.mChoicemDmismincorrectmbecausemmostmpatientsmagreemthatmreceivingmamshockmfrommthemICDmi
smpainful.mThemnursemshouldmbemstraightforwardmaboutmthismtompreparemthemclientmformthemevent.
Themnursemobservesmthatmamclientmwithmamconcussionmfollowingmamcarmincidentmismconstantlymblo
wingmhismnose.mWhatmismthembestmnextmactionmformthemnursemtomtake?
A.mInstructmthemclientmtomstopmblowingmasmthismactivitymmaymincreasemintracranialmpressuremandm
worsenmthemconcussion.
,B.mOffermthemclientmamnasalmdecongestant.
C.mMeasuremthemclient'smtemperaturemandmassessmlungmsounds.
D.mLookmformsignsmofmbruisingmaroundmthemclient'smeyes.m-mCORRECTmANSWERmD.
Rhinorrheam(drainagemofmclearmfluidmfrommthemnosemandmnasalmpassages)mfollowingmamheadminjur
ymmaymbemamsignmofmcerebrospinalmfluidm(CSF)mleakmfrommambasilarmskullmfracture.mAmbasilarmskullmf
racturemismamtraumaticmbreakminmonemormseveralmofmthembonesmthatmmakemupmthembasemofmthemsku
llm(ethmoid,msphenoid,moccipital,mfrontal,mtemporalmbone).mComplicationsmfrommbasilarmskullmfrac
turesmincludemCSFmfluidmleakagem(whichmcanmpresentmasmrhinorrheamormotorrhea),mmeningitis,mcra
nialmnerveminjury,mandminmseriousmcases,mdeath.mClientsmwithmtraumaticminjuriesmtomthemhead,msuc
hmasmamconcussion,mshouldmbemassessedmformbasilarmskullmfractures.mClinicalmmanifestationsmofmthi
smconditionmmaymincludemraccoonmeyesm(bruisingmaroundmthemeyes),mandmCSFmleakagemfrommears/
nose.ChoicemDm"lookmformsignsmofmbruisingmaroundmthemclient'smeyes"mwouldmbemthembestmactionm
bymthemnursemtomfurthermassessmformsignsmofmambasilarmskullmfracturemandmpreventmfurthermcompli
cations.mWhilemthismismanmeasymfirstmassessment,mthemnursemshouldmbemawaremthatmraccoonmeyesm
canmbemsubtlemormabsentmandmamnegativemfindingmshouldmnotmbemusedmtomrulemoutmthempresencem
ofmamspinalmfluidmleak.mAftermassessmentmofmthemface,mthemnursemshouldmalsomcollectmthemnasalmfl
uidmformamhalomtestm(CSFmseparatesmfrommbloodmwhenmitmismplacedmonmfiltermpapermandmproducesm
amclinicallymdetectablemhalo),mandmfinally,mamCTmscanmshouldmbemcompletedmtomconfirmmthemdiagn
osis.Althoughmincreasedmintracranialmpressuremcanmbemammajormcomplicationmofmamtraumaticmbrai
nminjurymasmidentifiedminmChoicemA,mitmismimportantmtomconsidermallmassessmentmfindings.mThismch
oicemdoesmnotmindicatemthatmthemnursemacknowledgesmthatmthemclient'smrunnymnosemcouldmbemamC
SFmleakmsecondarymtomambasilarmskullmfracture.mNotemthatmifmCSFmismleakingmfrommthemnose,mintrac
ranialmhypotensionmmaymoccurminmwhichmpressureminmthembrai
Atmthemstartmofmamnewmshiftmthemnursemreceivesmlaboratorymresultsmformamclientmwhomrecentlymarri
vedminmthememergencymdepartment:mNa+m152mmEQ/L,mKm4.8mmEq/L,mHCO3-
m20mmmol/L,muream84mg/dl,mcreatininem1.9mg/dl,mserummglucosem680mmg/dL,mserummosmolality
m334mOSM/kg,murinemnegativemformketones.mABGs:mnormal.mWBCmcountm18,000/uL,mCRPm120mg
/L,mESRm70mm/h.mWhatmshouldmthemnursemexpectmwhenmassessingmthismclient?
A.mFruity,macetonembreath.
B.mDrymmucusmmembranes.
C.mPupilsmnarrowmandmirresponsivemtomlight.
, D.mDistendedmneckmveins.m-mCORRECTmANSWERmB.mDrymmucusmmembranes.
Basedmonmthemlaboratorymresultsmthemnursemshouldmsuspectmhyperosmoticmhyperglycemicmnonke
toticmsyndromem(HHNS).mCriteriamformthismhealthmproblemmincludesmamserummglucosemlevelm>m600
mg/dL,mamserummosmolalitym>m300mOSM/kg,mdehydration,mandmabsencemofmketones.mHHNSmismam
complicationmofmdiabetes,musuallymfollowingmanminfection.mSeveremdehydrationmandmhighmglucose
mlevelsminmthemabsencemofmketonesmaremthemhallmarkmofmthismcondition.mUponmphysicalmexaminati
onmthemnursemshouldmexpectmtomfindmdrymmucusmmembranesm(asmwellmasmtachycardia,mhypotensi
onmand,minmsomemcases,malteredmmentalmstatus).mChoicemAmismincorrectmbecausemamfruitymacetone
mbreathmismanmindicationmofmdiabeticmketoacidosism(DKA)mduemtomketonemexcretion.mAsmHHNSmdoe
smnotmproducemketones,mthemsmellmofmthemclient'smbreathmwillmbemnormal.mChoicemCmismincorrectm
becausemnarrowmpupilsmirresponsivemtomlightmaremamsignmofmseverelymincreasedmintracranialmpress
ure.mTheremismnomreasonmtomsuspectmthemclientmhasmthismhealthmproblem.mChoicemDmismincorrectmb
ecausemthemclientmismlikelymtombemhypotensive.mDistendedmneckmveinsmaremammanifestationmofmrig
ht-sidedmheartmfailure.
ThememergencymroommnursemisminformedmbymthemEmergencymMedicalmServicesm(EMS)mthatmamclie
ntmwithmanmacutemanteriormmyocardialminfarctionmandmSTmelevationm(STEMI)monmECGmwillmbemtreat
edmwithmpercutaneousmcoronaryminterventionm(PCI)mimmediatelymuponmarrival.mWhatmshouldmthe
mnursemdomtombestmassistmthismclient?
A.mAdministermt-PAm(alteplase).
B.mAdministermepinephrine.
c
D.mWithholdmmorphinemsulfate.m-mCORRECTmANSWERmC.mAdministermaspirinmandmclopidogrel.
Aspirinmandmantiplateletmtherapymwithmclopidogrelmreducesmmortalityminmclientsmwithmmyocardial
minfarctionm(MI)mandmshouldmbemadministeredmtomallmclientsmwithmanmacutemmyocardialminfarction
mregardlessmofmreperfusionmtherapy.mThemnursemshouldmadministermbothmdrugsmbeforemPCImtreat
mentmisminitiated.mChoicemAmismincorrectmbecausemfibrinolyticmtherapymismthemalternativemtomPCIma
ndmshouldmbeminitiatedmonlymifmPCImismnotmavailablemormismcontraindicated.mChoicemBmismincorrectm
becausemthemclientmismnotminmcardiacmarrest.mEpinephrinemwillmincreasemthemclient'smheartmrateman
dmbloodmpressure,mtherebymincreasingmoxygenmdemand.mAsmthemcardiacmtissuemismalreadymischemi
c,mthismsituationmshouldmbemavoided.mChoicemDmismincorrectmbecausemadequatempainmmanagemen
CARE 2 (2026/2027) UPDATE|EXAM
QUESTIONS WITH MULTIPLE
CHOICES |VERIFIED & REVISED
ANSWERS (NEW)!!!
Amclientmwithmtypem2mdiabetesmmellitusmismrecoveringmfrommcoronarymangiographyminmthemintensi
vemcaremunitm(ICU).mWhatmfindingmwouldmbemofmthemmostmconcernmtomthemnurse?
A.maPTTmism2mtimesmthemnormalmreferenceminterval.
B.mGraftmdonormsitemismslightlymredmandmswollen.
C.mSerummcreatininemincreasedm1/4mfrommbaseline.
D.mPaO2mism80mmHg.m-mCORRECTmANSWERmThemCORRECTmANSWERmismC.
Am25%mincreaseminmserummcreatininemfollowingmcardiacmangiographym(alsomknownmasmcardiacmcat
heterization)mismamsignmofmcontrastminducedmnephropathym(CIN)mandm(potential)macutemkidneymfail
ure.mThemnursemshouldmreportmthismfindingmtomthemhealthmcaremprovidermimmediately.mNotemthatm
themclientmhasmdiabetes,mwhichmincreasesmthemriskmofmthemdevelopmentmofmCINm(ChoicemC).mChoic
emAmismincorrectmbecausemanmaPTTmofm1.5mtom2.5mtimesmthemnormalmreferencemintervalmismrecomm
endedmformheparinmanticoagulationmthatmthemclientmwillmbemreceivingmpost-
operatively.mChoicemBmmaymbemanmearlymsignmofmtissueminfectionmandmshouldmbemmonitoredmcaref
ully.mHowever,msomemdegreemofmrednessmandmswellingmismtombemexpected.mChoicemDmismincorrectm
becausemamPaO2mofm80mmHgmismwithinmthemnormalmrange.
Whenmcaringmformamclientmwithmidiopathicmmyocarditis,mwhatmismamprioritymnursingmintervention?
A.mReducingmcongestionmwithmdiureticsmandmACEminhibitors.
B.mAntibioticmadministrationmtomeliminatemcausativemagent.
C.mMaintainingmadequatemfluidmintakemformhydration.
D.mReducingmfevermwithmacetaminophen.m-mCORRECTmANSWERmA.m
,Myocarditismismanminflammatorymdiseasemofmthemmyocardiummandmmaymprogressmtomheartmfailure
.mFiftympercentmofmthemcasesmaremidiopathicm(nomcausativemagentmcanmbemdetected).mManagement
mismaimedmatmreducingmcongestionm(withmdiuretics,mACEminhibitorsmandmvasodilators),mimprovingmc
ardiacmhemodynamicsmandmsupportivemcare.mChoicemBmismincorrectmbecausemantibioticmtreatment
mismnotmusefulmunlessmambacterialminfectionmismdemonstrated.mMostmcasesmofmmyocarditismaremidio
pathic,mvirusminducedm(CoxsackiemAmandmB)mormcausedmbymamdirectmcytotoxicmeffectmofmcertainmdr
ugs.mChoicemCmismincorrectmbecausemfluidmintakemshouldmbemregulatedmtompreventmfluidmvolumemo
verload.mChoicemDmismincorrectmbecausemfevermmanagementmismnotmamprioritymformthismclient.
Themnursemisminstructingmamclientmwithmamnewlymimplantedmcardiovertermdefibrillatorm(ICD).mWhat
mstatementmindicatesmthatmteachingmhasmbeenmeffective?
A."Imshouldmcontinuemtakingmmymanti-arrhythmicmdrugs."
B."ImshouldmavoidmusingmthemmicrowavemormwatchingmTV."
C.m"Imshouldmdocumentmeverymshockmandmtakemthemlistmwithmmemonmmymnextmcardiologymvisit."
D.m"ImmaymfeelmitmwhenmmymICDmfires,mbutmitmwon'tmhurt."m-
mCORRECTmANSWERmA."Imshouldmcontinuemtakingmmymanti-arrhythmicmdrugs."
AlthoughmICDsmaremverymeffectiveminmterminatingmarrhythmias,mtheymdomnotmpreventmthemmfromm
occurring.mAnti-
arrhythmicmdrugsmaremalmostmalwaysmcontinuedmtomreducemthemamountmofmarrhythmiasmthatmthe
mpatientmismexperiencing.mChoicemBmismincorrectmbecausemhouseholdmappliancesmsuchmasmmicrowa
vesmandmTVsmcanmbemusedmsafely.mHowever,mprolongedmexposuremshouldmbemavoided.mThemclientm
shouldmbeminstructedmtomavoidmstrongmelectromagneticmfieldsm(e.g.,mMRI,mlargemgenerators).mChoi
cemCmismincorrectmbecausemthemcardiologistmmustmbemcontactedmdirectlymaftermamshockmoccurs.mDo
cumentingmshocksmtomdiscussmthemmatmthemnextmcardiologymvisitmwillmcompromisemthemclient'smsa
fety.mChoicemDmismincorrectmbecausemmostmpatientsmagreemthatmreceivingmamshockmfrommthemICDmi
smpainful.mThemnursemshouldmbemstraightforwardmaboutmthismtompreparemthemclientmformthemevent.
Themnursemobservesmthatmamclientmwithmamconcussionmfollowingmamcarmincidentmismconstantlymblo
wingmhismnose.mWhatmismthembestmnextmactionmformthemnursemtomtake?
A.mInstructmthemclientmtomstopmblowingmasmthismactivitymmaymincreasemintracranialmpressuremandm
worsenmthemconcussion.
,B.mOffermthemclientmamnasalmdecongestant.
C.mMeasuremthemclient'smtemperaturemandmassessmlungmsounds.
D.mLookmformsignsmofmbruisingmaroundmthemclient'smeyes.m-mCORRECTmANSWERmD.
Rhinorrheam(drainagemofmclearmfluidmfrommthemnosemandmnasalmpassages)mfollowingmamheadminjur
ymmaymbemamsignmofmcerebrospinalmfluidm(CSF)mleakmfrommambasilarmskullmfracture.mAmbasilarmskullmf
racturemismamtraumaticmbreakminmonemormseveralmofmthembonesmthatmmakemupmthembasemofmthemsku
llm(ethmoid,msphenoid,moccipital,mfrontal,mtemporalmbone).mComplicationsmfrommbasilarmskullmfrac
turesmincludemCSFmfluidmleakagem(whichmcanmpresentmasmrhinorrheamormotorrhea),mmeningitis,mcra
nialmnerveminjury,mandminmseriousmcases,mdeath.mClientsmwithmtraumaticminjuriesmtomthemhead,msuc
hmasmamconcussion,mshouldmbemassessedmformbasilarmskullmfractures.mClinicalmmanifestationsmofmthi
smconditionmmaymincludemraccoonmeyesm(bruisingmaroundmthemeyes),mandmCSFmleakagemfrommears/
nose.ChoicemDm"lookmformsignsmofmbruisingmaroundmthemclient'smeyes"mwouldmbemthembestmactionm
bymthemnursemtomfurthermassessmformsignsmofmambasilarmskullmfracturemandmpreventmfurthermcompli
cations.mWhilemthismismanmeasymfirstmassessment,mthemnursemshouldmbemawaremthatmraccoonmeyesm
canmbemsubtlemormabsentmandmamnegativemfindingmshouldmnotmbemusedmtomrulemoutmthempresencem
ofmamspinalmfluidmleak.mAftermassessmentmofmthemface,mthemnursemshouldmalsomcollectmthemnasalmfl
uidmformamhalomtestm(CSFmseparatesmfrommbloodmwhenmitmismplacedmonmfiltermpapermandmproducesm
amclinicallymdetectablemhalo),mandmfinally,mamCTmscanmshouldmbemcompletedmtomconfirmmthemdiagn
osis.Althoughmincreasedmintracranialmpressuremcanmbemammajormcomplicationmofmamtraumaticmbrai
nminjurymasmidentifiedminmChoicemA,mitmismimportantmtomconsidermallmassessmentmfindings.mThismch
oicemdoesmnotmindicatemthatmthemnursemacknowledgesmthatmthemclient'smrunnymnosemcouldmbemamC
SFmleakmsecondarymtomambasilarmskullmfracture.mNotemthatmifmCSFmismleakingmfrommthemnose,mintrac
ranialmhypotensionmmaymoccurminmwhichmpressureminmthembrai
Atmthemstartmofmamnewmshiftmthemnursemreceivesmlaboratorymresultsmformamclientmwhomrecentlymarri
vedminmthememergencymdepartment:mNa+m152mmEQ/L,mKm4.8mmEq/L,mHCO3-
m20mmmol/L,muream84mg/dl,mcreatininem1.9mg/dl,mserummglucosem680mmg/dL,mserummosmolality
m334mOSM/kg,murinemnegativemformketones.mABGs:mnormal.mWBCmcountm18,000/uL,mCRPm120mg
/L,mESRm70mm/h.mWhatmshouldmthemnursemexpectmwhenmassessingmthismclient?
A.mFruity,macetonembreath.
B.mDrymmucusmmembranes.
C.mPupilsmnarrowmandmirresponsivemtomlight.
, D.mDistendedmneckmveins.m-mCORRECTmANSWERmB.mDrymmucusmmembranes.
Basedmonmthemlaboratorymresultsmthemnursemshouldmsuspectmhyperosmoticmhyperglycemicmnonke
toticmsyndromem(HHNS).mCriteriamformthismhealthmproblemmincludesmamserummglucosemlevelm>m600
mg/dL,mamserummosmolalitym>m300mOSM/kg,mdehydration,mandmabsencemofmketones.mHHNSmismam
complicationmofmdiabetes,musuallymfollowingmanminfection.mSeveremdehydrationmandmhighmglucose
mlevelsminmthemabsencemofmketonesmaremthemhallmarkmofmthismcondition.mUponmphysicalmexaminati
onmthemnursemshouldmexpectmtomfindmdrymmucusmmembranesm(asmwellmasmtachycardia,mhypotensi
onmand,minmsomemcases,malteredmmentalmstatus).mChoicemAmismincorrectmbecausemamfruitymacetone
mbreathmismanmindicationmofmdiabeticmketoacidosism(DKA)mduemtomketonemexcretion.mAsmHHNSmdoe
smnotmproducemketones,mthemsmellmofmthemclient'smbreathmwillmbemnormal.mChoicemCmismincorrectm
becausemnarrowmpupilsmirresponsivemtomlightmaremamsignmofmseverelymincreasedmintracranialmpress
ure.mTheremismnomreasonmtomsuspectmthemclientmhasmthismhealthmproblem.mChoicemDmismincorrectmb
ecausemthemclientmismlikelymtombemhypotensive.mDistendedmneckmveinsmaremammanifestationmofmrig
ht-sidedmheartmfailure.
ThememergencymroommnursemisminformedmbymthemEmergencymMedicalmServicesm(EMS)mthatmamclie
ntmwithmanmacutemanteriormmyocardialminfarctionmandmSTmelevationm(STEMI)monmECGmwillmbemtreat
edmwithmpercutaneousmcoronaryminterventionm(PCI)mimmediatelymuponmarrival.mWhatmshouldmthe
mnursemdomtombestmassistmthismclient?
A.mAdministermt-PAm(alteplase).
B.mAdministermepinephrine.
c
D.mWithholdmmorphinemsulfate.m-mCORRECTmANSWERmC.mAdministermaspirinmandmclopidogrel.
Aspirinmandmantiplateletmtherapymwithmclopidogrelmreducesmmortalityminmclientsmwithmmyocardial
minfarctionm(MI)mandmshouldmbemadministeredmtomallmclientsmwithmanmacutemmyocardialminfarction
mregardlessmofmreperfusionmtherapy.mThemnursemshouldmadministermbothmdrugsmbeforemPCImtreat
mentmisminitiated.mChoicemAmismincorrectmbecausemfibrinolyticmtherapymismthemalternativemtomPCIma
ndmshouldmbeminitiatedmonlymifmPCImismnotmavailablemormismcontraindicated.mChoicemBmismincorrectm
becausemthemclientmismnotminmcardiacmarrest.mEpinephrinemwillmincreasemthemclient'smheartmrateman
dmbloodmpressure,mtherebymincreasingmoxygenmdemand.mAsmthemcardiacmtissuemismalreadymischemi
c,mthismsituationmshouldmbemavoided.mChoicemDmismincorrectmbecausemadequatempainmmanagemen
