CRITICAL CARE HESI EXIT EXAM 2 PRACTICE
QUESTIONS AND RATIONALE GUIDE 2026
◉ When caring for a client on a vent, which finding provides the
greatest indication that the client has an open airway? Answer:
Bilateral breath sounds can be auscultated
◉ The nurse performs a prescribed a neurological check at the
beginning of the shift on a client who was admitted with a
subarachnoid brain attack (Stroke). The client's GCS is 9. What
information is most important for the nurse to determine? Answer:
The client's previous GCS score
◉ An adult female with a history of type 1 diabetes has been
vomiting for the past 48 hours and is admitted to the ICU with DKA.
Which assessment finding warrants immediate intervention by the
nurse? Answer: Excessive thirst
◉ A client admitted to the ICU after a colon resection with the
formation of the loop colostomy. The nurse determines that the
clients abdominal dressing is clean and dry. Vital signs are: HR: 130,
temperature: 100, BP: 88/65, and urine output of 10 mL/hr. What
interventions should the nurse implement? Answer: Give a 500 mL
IV fluid bolus challenge
, ◉ A client is admitted with syncopal episodes related to a third
degree heart block. After the placement of a transcutaneous
pacemaker, the nurse observes several episodes the pacemaker
failure to sense. What action should the nurse take? Answer:
Increase the sensitivity
◉ A client is receiving CPR. After systole is confirmed in two leads
and sending the transcutaneous pacemaker, which IV medication
should be administered? Answer: Epinephrine (adrenaline)
◉ A client has a chest tube connected to a closed water seal drainage
system with suction. What equipment should the nurse always have
available at the clients bedside? Answer: Occlusive dressing
◉ Bretylium 1 mg/min via infusion is prescribed for a client and
ventricular tachycardia. The available solution is 500 mL D5W
contains bretylium 1 gram. The nurse should program the infusion
time to deliver how many mL/hr? Answer: 30
◉ The client is receiving an infusion of nitroglycerin 100 mg and 500
mL D5W at 6 mL/hr. How many mcg/min of nitroglycerin is
infusing? Answer: 20
◉ A client arrives in the ER complaining of pain. What description of
pain should prompt the nurse to suspect it originated in the
myocardium? Answer: Produces chest heaviness with left arm pain
QUESTIONS AND RATIONALE GUIDE 2026
◉ When caring for a client on a vent, which finding provides the
greatest indication that the client has an open airway? Answer:
Bilateral breath sounds can be auscultated
◉ The nurse performs a prescribed a neurological check at the
beginning of the shift on a client who was admitted with a
subarachnoid brain attack (Stroke). The client's GCS is 9. What
information is most important for the nurse to determine? Answer:
The client's previous GCS score
◉ An adult female with a history of type 1 diabetes has been
vomiting for the past 48 hours and is admitted to the ICU with DKA.
Which assessment finding warrants immediate intervention by the
nurse? Answer: Excessive thirst
◉ A client admitted to the ICU after a colon resection with the
formation of the loop colostomy. The nurse determines that the
clients abdominal dressing is clean and dry. Vital signs are: HR: 130,
temperature: 100, BP: 88/65, and urine output of 10 mL/hr. What
interventions should the nurse implement? Answer: Give a 500 mL
IV fluid bolus challenge
, ◉ A client is admitted with syncopal episodes related to a third
degree heart block. After the placement of a transcutaneous
pacemaker, the nurse observes several episodes the pacemaker
failure to sense. What action should the nurse take? Answer:
Increase the sensitivity
◉ A client is receiving CPR. After systole is confirmed in two leads
and sending the transcutaneous pacemaker, which IV medication
should be administered? Answer: Epinephrine (adrenaline)
◉ A client has a chest tube connected to a closed water seal drainage
system with suction. What equipment should the nurse always have
available at the clients bedside? Answer: Occlusive dressing
◉ Bretylium 1 mg/min via infusion is prescribed for a client and
ventricular tachycardia. The available solution is 500 mL D5W
contains bretylium 1 gram. The nurse should program the infusion
time to deliver how many mL/hr? Answer: 30
◉ The client is receiving an infusion of nitroglycerin 100 mg and 500
mL D5W at 6 mL/hr. How many mcg/min of nitroglycerin is
infusing? Answer: 20
◉ A client arrives in the ER complaining of pain. What description of
pain should prompt the nurse to suspect it originated in the
myocardium? Answer: Produces chest heaviness with left arm pain
