lOMoAR cPSD| 19500986
lOMoAR cPSD| 19500986
HESI RN CRITICAL CARE LATEST UPDATE 2022-2023 EXAM LATEST /
CRITICAL CARE HESI EXIT EXAM REAL EXAM QUESTIONS WITH
RATIONALES
New Question Set
1. 1.ID: 20123067301
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.
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.
Awarded 0.0 points out of 1.0 possible points.
2. 2.ID: 20123066699
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?
, lOMoAR cPSD| 19500986
(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.
Criteria that indicates a client is tolerating weaning off ventilator support are
respirations greater than 8 breaths/minute, but less than 35 breaths/minute;
oxygen saturation above 90%; heart rate that does not increase more than
20% from baseline heart rate; most of the work of breathing is performed by
the client; and no signs of accessory muscles are used for breathing.
Awarded 0.0 points out of 0.99 possible points.
3. 3.ID: 20123066697
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.
A "super昀椀cial partial-thickness" burn involves destruction of the epidermis
layer and some of the dermis layer. The total body surface area (%TBSA) is
easily calculated by using the "rule of nines" method. In this case,
involvement of one arm is calculated as 9% TBSA and one-half of a leg is 9%
TBSA for a combined total of 18% TBSA. A total leg involvement is
calculated as 18% TBSA.
Awarded 1.0 points out of 1.0 possible points.
4. 4.ID: 20123066695
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 electrolytes
levels. Correct
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
, lOMoAR cPSD| 19500986
functioning. This is done by maintaining normal blood pressures, 昀氀uid levels,
electrolytes levels, serum glucose levels, and normothermia. Mechanical
ventilation is provided to maintain adequate oxygenation and normal acid-
base balance. If needed, pharmaceutical support is provided for the
treatment of anemia, coagulopathy, thrombocytopenia, and diabetes
insipidus. Physiological changes occur to bodily functions as the result of
decreased perfusion within the brain.
Awarded 1.0 points out of 1.0 possible points.
5. 5.ID: 20123066691
A client is admitted to the intensive care unit with hematemesis related to
esophageal varices. Which assessment 昀椀nding should the nurse identify that
is the result of an estimated blood loss at 35% of total blood volume?
A. Absent bowel sounds. Correct
B. Coma.
C. Anuria.
D. Abdominal pain.
Massive blood loss redirects a signi昀椀cant amount of blood 昀氀ow to vital
organs. A client who has lost 30% to 40% of the total blood volume will
exhibit absent bowel sounds, lethargy, and increased serum potassium.
Awarded 1.0 points out of 1.0 possible points.
6. 6.ID: 20123066689
The nurse is planning care for a client admitted to the intensive care unit
with acute infected necrotizing pancreatitis. Which diagnostic procedure
should the nurse prepare the client to expect the healthcare provider to
prescribe?
A. Contrast-enhanced computed tomography (CT). Correct
B. Endoscopic retrograde cholangiopancreatography
(ERCP).
C. Abdominal radiography.
D. Abdominal ultrasound.
Contrast-enhanced computed tomography (CT) is the imaging modality of
choice to evaluate peripancreatic necrosis.
Awarded 0.0 points out of 1.0 possible points.
7. 7.ID: 20123066686
The nurse is caring for a client admitted to the surgical intensive care unit
(ICU) after undergoing gastrointestinal surgery. Which intervention should
the nurse include in the plan of care to minimize the risk for vomiting?
A. Maintain patency of nasogastric tube to low intermittent
suction. Correct
lOMoAR cPSD| 19500986
HESI RN CRITICAL CARE LATEST UPDATE 2022-2023 EXAM LATEST /
CRITICAL CARE HESI EXIT EXAM REAL EXAM QUESTIONS WITH
RATIONALES
New Question Set
1. 1.ID: 20123067301
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.
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.
Awarded 0.0 points out of 1.0 possible points.
2. 2.ID: 20123066699
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?
, lOMoAR cPSD| 19500986
(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.
Criteria that indicates a client is tolerating weaning off ventilator support are
respirations greater than 8 breaths/minute, but less than 35 breaths/minute;
oxygen saturation above 90%; heart rate that does not increase more than
20% from baseline heart rate; most of the work of breathing is performed by
the client; and no signs of accessory muscles are used for breathing.
Awarded 0.0 points out of 0.99 possible points.
3. 3.ID: 20123066697
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.
A "super昀椀cial partial-thickness" burn involves destruction of the epidermis
layer and some of the dermis layer. The total body surface area (%TBSA) is
easily calculated by using the "rule of nines" method. In this case,
involvement of one arm is calculated as 9% TBSA and one-half of a leg is 9%
TBSA for a combined total of 18% TBSA. A total leg involvement is
calculated as 18% TBSA.
Awarded 1.0 points out of 1.0 possible points.
4. 4.ID: 20123066695
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 electrolytes
levels. Correct
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
, lOMoAR cPSD| 19500986
functioning. This is done by maintaining normal blood pressures, 昀氀uid levels,
electrolytes levels, serum glucose levels, and normothermia. Mechanical
ventilation is provided to maintain adequate oxygenation and normal acid-
base balance. If needed, pharmaceutical support is provided for the
treatment of anemia, coagulopathy, thrombocytopenia, and diabetes
insipidus. Physiological changes occur to bodily functions as the result of
decreased perfusion within the brain.
Awarded 1.0 points out of 1.0 possible points.
5. 5.ID: 20123066691
A client is admitted to the intensive care unit with hematemesis related to
esophageal varices. Which assessment 昀椀nding should the nurse identify that
is the result of an estimated blood loss at 35% of total blood volume?
A. Absent bowel sounds. Correct
B. Coma.
C. Anuria.
D. Abdominal pain.
Massive blood loss redirects a signi昀椀cant amount of blood 昀氀ow to vital
organs. A client who has lost 30% to 40% of the total blood volume will
exhibit absent bowel sounds, lethargy, and increased serum potassium.
Awarded 1.0 points out of 1.0 possible points.
6. 6.ID: 20123066689
The nurse is planning care for a client admitted to the intensive care unit
with acute infected necrotizing pancreatitis. Which diagnostic procedure
should the nurse prepare the client to expect the healthcare provider to
prescribe?
A. Contrast-enhanced computed tomography (CT). Correct
B. Endoscopic retrograde cholangiopancreatography
(ERCP).
C. Abdominal radiography.
D. Abdominal ultrasound.
Contrast-enhanced computed tomography (CT) is the imaging modality of
choice to evaluate peripancreatic necrosis.
Awarded 0.0 points out of 1.0 possible points.
7. 7.ID: 20123066686
The nurse is caring for a client admitted to the surgical intensive care unit
(ICU) after undergoing gastrointestinal surgery. Which intervention should
the nurse include in the plan of care to minimize the risk for vomiting?
A. Maintain patency of nasogastric tube to low intermittent
suction. Correct
