HESI CASE STUDY: ADVANCED CARDIAC LIFE SUPPORT
(ACLS): SEPSIS - GRADED A+
CORE DOMAINS
Geriatric Surgical Risk Assessment
Preoperative Nursing Interventions
Postoperative Respiratory Management
Sepsis Recognition and Early Intervention
Cardiac Arrest and ACLS Protocol
End-of-Life Care and Therapeutic Communication
INTRODUCTION
This comprehensive case study analysis provides a detailed,
evidence-based solution for the HESI Advanced Cardiac Life Support
(ACLS): Sepsis case study. It follows a 68-year-old client through the
perioperative period, sepsis recognition, cardiac arrest, and end-of-
life care. Each question is answered with a complete rationale
grounded in current clinical practice guidelines, including the
Surviving Sepsis Campaign and American Heart Association ACLS
protocols. This resource is designed to support nursing students in
developing critical thinking and clinical judgment skills for high-
acuity patient scenarios.
SECTION ONE: PREOPERATIVE ASSESSMENT AND SURGICAL RISK
(QUESTIONS 1–5)
1. The nurse is aware that the older adult client is at an increased risk
for surgical complications due to normal physiological functions and
comorbidities. Which risk factors place the older adult client at
increased risk for surgical complications?
A. Increased glomerular filtration rate
B. Enhanced elasticity of the arterial walls
C. Decreased respiratory muscle strength
D. Increased cardiac output
, C. Decreased respiratory muscle strength
RATIONALE: A decrease in respiratory muscle strength
predisposes the older client to postoperative respiratory
complications, including atelectasis and pneumonia. This decline
makes it harder for the patient to cough effectively or take deep
breaths after surgery. Increased glomerular filtration rate, enhanced
arterial elasticity, and increased cardiac output are not age-related
changes; in fact, GFR, arterial elasticity, and cardiac output all decline
with age.
2. Upon completing the client's assessment, the nurse determines
that the client has which surgical risk factors? (Select all that apply.)
A. Metoprolol
B. Poor appetite
C. Diabetes Mellitus
D. Albumin 3.0 g/dL
E. Marital status
A, B, C, D. Metoprolol, Poor appetite, Diabetes Mellitus, Albumin
3.0 g/dL
RATIONALE:
• Metoprolol: Beta-blockers can increase the risk of bradycardia
when used with anesthetics.
• Poor appetite: Places the client at risk for surgical complications
due to inadequate nutrition.
• Diabetes Mellitus: Increases the risk of fluctuating blood sugar
levels and delayed healing.
• Albumin 3.0 g/dL: A low albumin level indicates malnutrition,
which severely impairs wound healing and increases infection
risk.
• Marital status: Is not a surgical risk factor.
(ACLS): SEPSIS - GRADED A+
CORE DOMAINS
Geriatric Surgical Risk Assessment
Preoperative Nursing Interventions
Postoperative Respiratory Management
Sepsis Recognition and Early Intervention
Cardiac Arrest and ACLS Protocol
End-of-Life Care and Therapeutic Communication
INTRODUCTION
This comprehensive case study analysis provides a detailed,
evidence-based solution for the HESI Advanced Cardiac Life Support
(ACLS): Sepsis case study. It follows a 68-year-old client through the
perioperative period, sepsis recognition, cardiac arrest, and end-of-
life care. Each question is answered with a complete rationale
grounded in current clinical practice guidelines, including the
Surviving Sepsis Campaign and American Heart Association ACLS
protocols. This resource is designed to support nursing students in
developing critical thinking and clinical judgment skills for high-
acuity patient scenarios.
SECTION ONE: PREOPERATIVE ASSESSMENT AND SURGICAL RISK
(QUESTIONS 1–5)
1. The nurse is aware that the older adult client is at an increased risk
for surgical complications due to normal physiological functions and
comorbidities. Which risk factors place the older adult client at
increased risk for surgical complications?
A. Increased glomerular filtration rate
B. Enhanced elasticity of the arterial walls
C. Decreased respiratory muscle strength
D. Increased cardiac output
, C. Decreased respiratory muscle strength
RATIONALE: A decrease in respiratory muscle strength
predisposes the older client to postoperative respiratory
complications, including atelectasis and pneumonia. This decline
makes it harder for the patient to cough effectively or take deep
breaths after surgery. Increased glomerular filtration rate, enhanced
arterial elasticity, and increased cardiac output are not age-related
changes; in fact, GFR, arterial elasticity, and cardiac output all decline
with age.
2. Upon completing the client's assessment, the nurse determines
that the client has which surgical risk factors? (Select all that apply.)
A. Metoprolol
B. Poor appetite
C. Diabetes Mellitus
D. Albumin 3.0 g/dL
E. Marital status
A, B, C, D. Metoprolol, Poor appetite, Diabetes Mellitus, Albumin
3.0 g/dL
RATIONALE:
• Metoprolol: Beta-blockers can increase the risk of bradycardia
when used with anesthetics.
• Poor appetite: Places the client at risk for surgical complications
due to inadequate nutrition.
• Diabetes Mellitus: Increases the risk of fluctuating blood sugar
levels and delayed healing.
• Albumin 3.0 g/dL: A low albumin level indicates malnutrition,
which severely impairs wound healing and increases infection
risk.
• Marital status: Is not a surgical risk factor.
