RNSG 2231 HESI EXTRA CREDIT MODULE 9 EXAM
QUESTIONS AND ANSWERS RATED A+
1. Questions
1. 1.ID: 9477047208
A nurse is caring for a client who has lost a significant
amount of blood as a result of complications during a
surgical procedure. Which parameter does the nurse
recognize as the earliest indication of new decreases in
fluid volume?
A. Pulse rate Correct
B. Blood pressure
C. Pulmonary artery systolic pressure
D. Pulmonary artery end-diastolic pressure
Rationale: Cardiac output is determined by the volume of the circulating blood,
the pumping action of the heart, and the tone of the vascular bed. Early
decreases in fluid volume are compensated for by an increase in the pulse
rate. Remember that pulse rate multiplied by stroke volume equals cardiac
output. An increase in pulse is often sufficient with small amounts of volume
, depletion to maintain the blood pressure. Pulmonary artery systolic pressure
and pulmonary artery end-diastolic pressure, measurements obtained with the
use of a pulmonary artery catheter, provide information about the pressures in
the pulmonary artery and in the left ventricle at the end of diastole.
Test-Taking Strategy: Note the strategic word “earliest.” Pulmonary artery
systolic pressure and pulmonary artery end-diastolic pressure can be
eliminated first, because these measurements are obtained with the use of a
pulmonary artery catheter. To select from the remaining options, focus on the
strategic word, which will direct you to the correct option. Review the
physiology of the cardiovascular system and the means of compensation
inherent in that system.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Assessment
Content Area: Adult Health/Cardiovascular
Giddens Concepts: Clinical Judgment, Fluid and Electrolyte Balance
HESI Concepts: Clinical Decision Making/Clinical Judgment, Fluid and
Electroytes
Reference: Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L.
(2014). Medical-surgical nursing: Assessment and management of clinical
problems (9th ed., p. 292). St. Louis: Mosby.
Awarded 1.0 points out of 1.0 possible points.
2. 2.ID: 9477054249
,A nurse is reviewing the results of serum laboratory
studies of a client with suspected hepatitis. Which
increased parameter is interpreted by the nurse as the
most specific indicator of this disease?
A. Hemoglobin
B. Serum bilirubin Correct
, Blood urea nitrogen (BUN)
C. Erythrocyte sedimentation rate (ESR)
Rationale: Laboratory indicators of hepatitis include increased liver enzymes,
serum bilirubin level, and ESR. However, ESR is a nonspecific test that
indicates the presence of inflammation somewhere in the body. An increased
BUN may indicate renal dysfunction. The hemoglobin level is unrelated to this
diagnosis.
Test-Taking Strategy: Note the strategic word, most. Focusing on the client’s
diagnosis and recalling that the liver is the organ involved in this disease
process will direct you to the correct option. Review the expected findings in
hepatitis.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Assessment
Content Area: Adult Health/Gastrointestinal
Giddens Concepts: Cellular Regulation, Evidence
HESI Concepts:Cellular Regulation, Evidence Based Practice/Evidence
Reference: Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L.
(2014). Medical-surgical nursing: Assessment and management of clinical
problems (9th ed., pp. 1010-1011). St. Louis: Mosby.
Awarded 1.0 points out of 1.0 possible points.
3. 3.ID: 9477051455
A client who has just undergone surgery suddenly
experiences chest pain, dyspnea, and tachypnea. The
nurse suspects that the client has a pulmonary embolism
and immediately sets about to take which action?
A. Preparing the client for a perfusion scan
B. Attaching the client to a cardiac monitor
C. Administering oxygen by way of nasal cannula
QUESTIONS AND ANSWERS RATED A+
1. Questions
1. 1.ID: 9477047208
A nurse is caring for a client who has lost a significant
amount of blood as a result of complications during a
surgical procedure. Which parameter does the nurse
recognize as the earliest indication of new decreases in
fluid volume?
A. Pulse rate Correct
B. Blood pressure
C. Pulmonary artery systolic pressure
D. Pulmonary artery end-diastolic pressure
Rationale: Cardiac output is determined by the volume of the circulating blood,
the pumping action of the heart, and the tone of the vascular bed. Early
decreases in fluid volume are compensated for by an increase in the pulse
rate. Remember that pulse rate multiplied by stroke volume equals cardiac
output. An increase in pulse is often sufficient with small amounts of volume
, depletion to maintain the blood pressure. Pulmonary artery systolic pressure
and pulmonary artery end-diastolic pressure, measurements obtained with the
use of a pulmonary artery catheter, provide information about the pressures in
the pulmonary artery and in the left ventricle at the end of diastole.
Test-Taking Strategy: Note the strategic word “earliest.” Pulmonary artery
systolic pressure and pulmonary artery end-diastolic pressure can be
eliminated first, because these measurements are obtained with the use of a
pulmonary artery catheter. To select from the remaining options, focus on the
strategic word, which will direct you to the correct option. Review the
physiology of the cardiovascular system and the means of compensation
inherent in that system.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Assessment
Content Area: Adult Health/Cardiovascular
Giddens Concepts: Clinical Judgment, Fluid and Electrolyte Balance
HESI Concepts: Clinical Decision Making/Clinical Judgment, Fluid and
Electroytes
Reference: Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L.
(2014). Medical-surgical nursing: Assessment and management of clinical
problems (9th ed., p. 292). St. Louis: Mosby.
Awarded 1.0 points out of 1.0 possible points.
2. 2.ID: 9477054249
,A nurse is reviewing the results of serum laboratory
studies of a client with suspected hepatitis. Which
increased parameter is interpreted by the nurse as the
most specific indicator of this disease?
A. Hemoglobin
B. Serum bilirubin Correct
, Blood urea nitrogen (BUN)
C. Erythrocyte sedimentation rate (ESR)
Rationale: Laboratory indicators of hepatitis include increased liver enzymes,
serum bilirubin level, and ESR. However, ESR is a nonspecific test that
indicates the presence of inflammation somewhere in the body. An increased
BUN may indicate renal dysfunction. The hemoglobin level is unrelated to this
diagnosis.
Test-Taking Strategy: Note the strategic word, most. Focusing on the client’s
diagnosis and recalling that the liver is the organ involved in this disease
process will direct you to the correct option. Review the expected findings in
hepatitis.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Assessment
Content Area: Adult Health/Gastrointestinal
Giddens Concepts: Cellular Regulation, Evidence
HESI Concepts:Cellular Regulation, Evidence Based Practice/Evidence
Reference: Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L.
(2014). Medical-surgical nursing: Assessment and management of clinical
problems (9th ed., pp. 1010-1011). St. Louis: Mosby.
Awarded 1.0 points out of 1.0 possible points.
3. 3.ID: 9477051455
A client who has just undergone surgery suddenly
experiences chest pain, dyspnea, and tachypnea. The
nurse suspects that the client has a pulmonary embolism
and immediately sets about to take which action?
A. Preparing the client for a perfusion scan
B. Attaching the client to a cardiac monitor
C. Administering oxygen by way of nasal cannula
