OB HESI Exit Exam V4 EXAM GUIDE OB HESI Exit Exam V4 EXAM GUIDE

OB HESI Exit Exam V4 EXAM GUIDE HESI Exit Exam V4 STUDY G HESI Exit Exam V4 STUDY GUIDE Alternate Format/Visual/Audio Questions Q) Audio lung sounds…listen to recording A) Fine/Coarse crackles Q) Visual Picture of an ear/inside canal…questions asks what contracture does an otoscope tool allow you to view…I think it’s the tympanic membrane…but you have to click on the hot spot…so look it up to make sure!!! Q) Visual picture of finger nail ridges…look up which one indicates cyanosis. The question asks just that which one indicates cyanosis. It is not the one with the deep ridges…I missed this one. Q) Visual/Chart listing symptoms of a patient…look up s/s of disseminated intravascular coagulation…I think that’s the answer! Q) Visual/Sequence put in order…Question asks you to put in order the correct way to obtain a baby’s vitals signs…Hint respiratory is always first so you can get an accurate account before you upset baby…Least invasive first !!! Look up how to assess/vitals on an infant! Q) Image of a chest tube drainage collection chamber…you have to mark the level of fluid (850) …easy just click between 800 and 900 ml markings on chamber!!! Q) Select all that apply…How to assess for pain in an infant…what shows they are in pain??? It lists respirations..crying etc…know which ones can be used as pain indicators in an infant!!! Look Up General Questions/What I Remember Q) About GERD and how you know the medication a proton pump inhibitor is working/providing therapeutic action A) Pt has a decrease in heartburn/burning sensation… Q) About pancreatitis A) Has to do with alcohol consumption…can’t remember exact wording! Q) About Hepatitis C and which person has the risk of getting it A)…Look up how it’s contracted and the different routes…question lists daycare workers etc as options. Q) On TORCH and what it tests for….it’s used for infants to screen for ????? Look UP and you will get it right…options list different tests…you need to know what it’s used for!!! Q) On disseminated intravascular coagulation….wants to know labs that confirm diagnosis or would show you had it…look up DIC and lab values associated with it!!!! Q) On being short staffed…how would the charge nurse assign nurses, UAPs, and herself… the question states 10 pts on unit with 4 new being admitted…look up staffing/assignments. Q) States that the emergency generator goes out in the unit…What does the nurse instruct the UAP to do first …I think the answer is have all the patients stay in their rooms…Look up disaster management/power/electrical outage plan /Interventions. Q) About a kid biting another kid …what does the nurse do first? I think the answer was thoroughly wash the bite with mild soap and water…look up first aid (bites). Q’s) 3 to 5 on child abuse reporting and procedure…look this up!!!! Q) On the correct way to administer liquid iron to an infant…I believe the answer is use the dropper/syringe …look up iron administration in infants!!! Q) On the correct way to calculate BMI…answer using height and weight (easy one)!! Q) On using alcohol based sanitizer…what does the nurse do next after applying it…I think the answer is interlace fingers together and rub!!! Look up correct procedure. Q) what is Zofran/Odansteron (spelling) do or used for…..answer decreases nausea ! Q) About UAP getting ready to shower a pt who reports he is dizzy, confused…what does the nurse instruct the UAP to do…I think the answer was give pt a bed bath! Q) Pt w/ Alzheimer’s is in bed and UAP leaves pt to get clean sheets because he was incontinent…The nurse observes the (options/answers) which does the nurse do FIRST… Answer raise side rails that were left down!!! Q) How to assess skin blanching…think the answer is gently apply pressure and let go… LOOK UP skin blanching/assessment. Q) About penicillin and an adverse reaction a patient had to it…what do you teach the pt??? I believe the answer was avoid cephalosporin because the cross sensitivity between penicillin…look up! Pt’s allergic to penicillin are usually allergic to cephalosporins too. Q) On delirium tremens …look up Q) About a patient catheter being left on bed and becoming infection…question asks what was the infections RESOVOIUR of entry…LOOK UP portals of infection/entry ways. Q) On SED stockings (correct way to use on a one day post op surgical patient and what the nurse should document in the chart about it)…look up SED use. Q) On what type of restraint to use w/ a pt who is angry and throwing things …options list 3 types of chemical/medicine restraints and 1 physical restraint…look up restraint indications/procedures!!!! I think it’s the physical one! Q) About removing ammonia from body…I believe lactulose is the correct answer…look up its uses. Q) About a Peripheral PICC line ,,,, pt develops fever,,,,what/where do you assess the PICC line at…look up where peripheral PICCs are inserted and how to assess them! Q) About what to teach parents about the cause of their child’s acute asthma attack…look up why it happens/pathophysiology…what triggers it!!!! Q) About a MAXAIR inhaler in kids…look up different types of inhalers and what they do… can’t remember exact name but it starts with an M…think it was MAXAIR??? Q) On condolyta (spelling) warts HPV… whats the most important thing to teach a female diagnosed with it…I think the answer is use protection…the options list get a vaccine etc… look up treatment/precautions etc and age limits on the vaccine…question list her age and I think she is too old to get vaccine. Q) On a 7yr olds normal growth/weight…list growth measurements over last year is it normal or not???? Look up normal development for a 7 year old…height, weight etc… Q) On normal weight gain for a 6 month old…question gives weight now how they gain weight…doubled by birth etc…look up Q) This one stumped me…on Photo chemotherapy and atopic dermatitis…pt is 3 months post photo therapy but developed dermatitis and was recently prescribed a med??? For it… he is going on vacation what should you teach/tell…(wait/wear sunscreen/stay out of uv light etc…look up photo chemotherapy and dermatitis interventions and precautions after treatment!!!! Q) On what lunch to give a pt on a low sodium diet…Look up low sodium diets …options list food choices. Q) On post cataract surgery discharge …what should the nurse ensure??? I think they have to have someone with them after surgery for 24 hrs…look up patient teaching/interventions post-op!!! Q) On skeletal traction…priority intervention/assessment…answer monitor pin sites for infection!!!! Q) On what assessment/tool is the most accurate measure of hydration status in patients/geriatrics??? LOOK UP Q) On Celestone maternity drug…look up ! Q) On a mother getting a laceration during labor…what to prevent assess for…look up laceration interventions/care. Q) On what to assess/do when a woman comes into the ER screaming she is in labor…what do you do…I chose get vitals but not sure if that was right…other option I remember was assess fetal heart rate. Look up Q) Kid has a tonsillectomy , when you get home what do you report to the DR. immediately…I think its excessive swallowing which may be a sign of hemorrhage… look up to be sure!! Q) Steps to take after a nurse pokes herself with an IV needle that was in a patient with HIV…Question wants to know what you would do after you clean it…look up reporting/infection control procedure. I think the answer is report it to the ??? health nurse/manager… Q) About giving a immunizations for a 2 month old and where to give the injection…there are a lot and it’s in the book…look up what shots they get at that age and where to give them. I think the site is the Vasteras lateralis …and maybe the FLU in the deltoid..Cant remember look up! Q) On what type of diet for a kid with cystic fibrosis…answer = high fat and protein! Q) Asks correct position to put a child in who has a nosebleed/epistaxsis…look up…sitting up, head back etc…not sure I guessed! Q) Bus accident w/ kids who needs to be triaged/helped first…remember ABC’s…look up triage priority and I think it’s the kid with the respiratory issue… Q) Asks what to do if you walk in a patients room and they are having sex??? Options I remember are …shut door/leave..tell to stop etc… I think its shut door and leave…look up! Q) Asks you to put in sequence the steps for a pt who is in respiratory distress…Options are.. Notify Dr…Get crash cart..Call rapid Response (1st)…notify family /or something like that… look up order for emergency response Q) About a pt who calls in and reports flushing of the skin…he took cialis and has stable angina…look up interactions and adverse effects…time of duration of meds/nitro for angina. Q) on borderline personality disorder and dichotomous thinking…questions asks how the nurse should respond to this pt who thinks this ^^^^ way…look up. Q) On patient dying and family wants to view body…what do you do??? Options include… escort to room…tell them where the room is…only allow immediate family …cant remember the last one…look up policy on this…I guessed escort them to room and allow to view body. Q) Asks what to monitor in an adolescent who was just prescribed Zoloft…my answer was s/s of suicide/depression…look up effects! Q) Asks how a father should respond …when his wife dies and their preschool age child says…I’ll be good, when mommy comes back…It lists statements the father can make…look up preschool development /death/parent teaching these…These topics came from a study guide Carol gave me that list/covers every topic that could possibly be on any of the volume 4 HESI’s…so I narrowed it down to the topics that were on the version I took and you will too. CRITICAL CARE TOPICS • Hypothyroidism • Tertiary Prevention= screening etc • Disaster Intervention Plans • Stabilize Neck/Trauma • DIC • Chest tube tension///alarm meanings//pneumothorax • Staffing ICU • Telemetry (pts on) FUNDAMENTALS TOPICS • Assigning Float nurses/uaps • Elevated Pulse • Male catheterization • Chain of infection • Restraints • Hand Hygiene…fundamentals • IV assessment • IRON Administration MED SURG/MATERNITY/GERIATRICS TOPICS • Dilaudid and Promethazine • TUB Bath Geriatrics…check temp • TURP patient teaching/discharge information • PCD’s • Skin Assess blanching • Oral NG tube care • Dehydration S/S • Assess bleeding source • Bulk forming laxatives • Diluadid –SE • Fluid Overload S/S • Respiratory Inhalers • Hygiene self care deficit • Urine output-infant diaper weight (the math question) • Age appropriate growth 7 yr old • Weight gain 6 month old (normal) • Fluid volume deficit –veni-puncture- PEDS • Airborne Precautions • Priority vesicant administration • C-Diff precautions • Side rails client safety • Assign disaster • SBAR communication…what to report to Dr. • Establish rapport • Shower assist • Low sodium menu choice • Sterile fields • Palliative care • Delegation- gag reflex • Cataract lens implant…teaching/evaluate knowledge • Nail Rigdes…cyanosis • Geri---increasing confusion • Renal-dehydration-urine specific gravity • Clestone • TORCH SCREEN • Laceration nursing care (maternity/labor) • Newborn vital sign order • S/S air embolism • Antihypertensive side effects • Arterial peripheral disease • Chest pain report findings • Dobutamine IV • End of life (assess) what confirms death • Heart failure • Metabolic syndrome and exercise • MI s/s • Heart failure and weight gain • Hyponatremia and fluid restriction • Steroids taper off..never stop abruptly • Thyroid incision complications • Esophageal varices teaching…what can pt eat 3 days after healing…is a question on there. • GERD/Protonix…reduces heartburn • Hepatitis C how you contract it • Lactulose and cirrhosis • Liver transplant s/s to report to DR…what sign after rash do you need to immediately report!!! Discharge teaching • Zofran effectiveness • Codeine and constipation • AIDS puncture • Evaluating antibiotic therapy • Transfusion reaction…Stop ! • Chemotherapy protocols…give anti-nausea meds 30-3hrs prior • When to hold PLavix • Evisceration///skin integrity • Burns and urinary output • Traction pin sites • Pulmonary embolism first action… • Epilepsy discharge plan…what is most important to teach • Cervical cord injury • Increased ICP know 1st SIGN • PACU assessment • COPD smoking cause • CKD/hemodialysis • Renal/force fluids • STD (HPV) • Chest tube normal functioning • COPD postural drain • Cataract surgery • Antipyretic • Ears tympanic membrane…be able to recognize on picture • Ab inspection & palpation • Thyroid surgery –PTH drug • Pneumothorax –evaluate treatment • DIC Labs • Electrical burns-urine • Retroperitoneal bleeding/renal • D mellitus – foot assessment • Fracture femur risks…fat embolism! • Pancreatitis • Teaching penicillin allergy • Diabetes insipidus S/S • Bradycardia • LHR • Adolescent communication • School age activity • Routine immunizations for 2 month old • Fine and gross motor development skills • Lead poisoning • Pavlik harness…how to wear it..skin care • Adderall patient teaching/evaluation • Hydrocephalus---ICP s/s of ^ ICP irritability when being held…can be caused by shunt placement. • Pain infant • Post op…Swallowing tonsillectomy* • Cystic fibrosis diet • Nose bleed position • Asthma what causes it • Triage bus…peds • Cleft lip and restraining baby…answer put in car/seat • Advanced directives • Sex in hospital room • Operative permit…legal for RN • Delegation TURP pt what a UAP can do… • Priority..O2 low…if on vent start manual resuscitation**** • Rapid response Team • Delegation –glucometer • NGT irrigation/assignment • Living will parameters..what it means • Cushings syndrome • Tadafil/Cialis MENTAL HEALTH TOPICS • Alcohol withdrawal symptoms…tremors/delirium tremons • Borderline/dichotomous thinking • Borderline disorder…how to interact with these pts • Couple counseling (answer) husband and wife having issues with her dx • Haldol/chemical restraint • Pts (mental health) interrupting meetings etc…how to deal with them • Delirium and constant pain • Bipolar disorder/suicide • Suicide • Death/view body • Laryngectomy (anxiety/communications) how to ease their anxiety • Angry client management • Zoloft teaching • Interview /angry patient • Alzheimer’s redirection • Grief/death preschool reaction • Impulsivity in pediatric pts • Concerta in ADHD PEDS • Delusions • Depression nursing problem