HESI RN CRITICAL CARE LATEST UPDATE EXAM LATEST / CRITICAL CARE HESI EXIT EXAM REAL EXAM QUESTIONS WITH RATIONALES

HESI RN CRITICAL CARE LATEST UPDATE EXAM LATEST / CRITICAL CARE HESI EXIT EXAM REAL EXAM QUESTIONS WITH RATIONALES New Question Set 1. 1.ID: The nurse is assessing a client who is 12 hours postoperative for the removal of a benign pituitary brain tumor and has been placed in a drug induced coma with normal saline 0.9% infusing at 125 mL/hr. The client's heart rate is 90 beats/minute, blood pressure 100/60 mmHg, and the indwelling urinary catheter has drained 250 mL of pale yellow urine in the last 30 minutes into the collection bag. After reporting these 昀椀ndings to the healthcare provider, which action should the nurse implement? A. Identify the underlying cause of this condition. B. Prepare to administer desmopressin (DDAVP). Correct C. Decrease the intravenous 昀氀uids to a maintenance rate. D. Replace 昀氀uid losses with D5W every shift. Awarded 0.0 points out of 1.0 possible points. 2. 2.ID: An intubated client is in the process of being weaned off ventilator support. The client's baseline parameters are temperature 98.2 F (36.8 C), heart rate 88 beats/minute, respirations 14 breaths/minute, blood pressure 112/78 mmHg, and oxygen saturation 94%. Which assessment 昀椀ndings would indicate to the nurse that the client is tolerating the weaning procedure? Neurogenic diabetes insipidus (DI) is a condition that can occur when there is trauma to the brain such as tumors or injury to the brain in particular the pituitary or hypothalamus area. DI can also occur with cerebral edema present. The antidiuretic hormone de昀椀ciency occurs rapidly and results in polyuria, anywhere between 5- 40 liters of urine/24 hours. The client demonstrates signs and symptoms of hypovolemia. Electrolyte imbalances include hypernatremia, along with hypokalemia and hypercalcemia when it is neurogenic etiology. Clients with neurogenic DI are primarily controlled through administration of exogenous ADH preparations, of which desmopressin (DDAVP) is most commonly used. Fluid output is carefully monitored and 昀氀uids are replaced every hour. lOMoAR cPSD| Once an identi昀椀ed organ donor has been declared clinically brain dead, the primary focus of care changes from preserving life to preserving organ (Select all that apply.) A. Oxygen saturation is 91%. Correct B. Slight nasal 昀氀aring is present. C. Heart rate is 97 beats/minute. Correct D. Work of breathing is done by client. Correct E. Respiratory rate is 36 breaths/minute. Awarded 0.0 points out of 0.99 possible points. 3. 3.ID: The nurse is assessing a burn victim who suffered destruction of the epidermis and some of the dermis of the entire right arm and half the length of the right leg. How should the nurse document the burn assessment 昀椀ndings? A. Super昀椀cial, 18% TBSA. B. Super昀椀cial partial-thickness, 18% TBSA. Correct C. Deep-partial thickness, 27% TBSA. D. Full-thickness, 27% TBSA. Awarded 1.0 points out of 1.0 possible points. 4. 4.ID: The critical care nurse is providing care for a client diagnosed clinically brain dead and identi昀椀ed as an organ donor. Which are the nurse's priorities in providing care? (Select all that apply.) A. Sustaining a state of hypothermia. B. Maintaining a normal blood pressure. Correct C. Ensuring adequate oxygenation and ventilation. Correct D. Treating any coagulopathy, thrombocytopenia and anemia. Correct E. Monitoring arterial blood gases and serum electrolyte