lOMoAR cPSD| 19500986
HESI CRITICAL CARE 2022/2023 VERSION A AND
B/ CRITICAL CARE HESI EXIT EXAM 2022/2023
QUESTIONS AND CORRECT
ANSWERS|EXPERT FEEDBACK
lOMoAR cPSD| 19500986
VERSION A
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. Incorrect
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? (Select all that apply.)
1
, lOMoAR cPSD| 19500986
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
2
, 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). Incorrect 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
B. Provide a soft, bland diet with oral liquids, such as diluted juices.
3
HESI CRITICAL CARE 2022/2023 VERSION A AND
B/ CRITICAL CARE HESI EXIT EXAM 2022/2023
QUESTIONS AND CORRECT
ANSWERS|EXPERT FEEDBACK
lOMoAR cPSD| 19500986
VERSION A
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. Incorrect
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? (Select all that apply.)
1
, lOMoAR cPSD| 19500986
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
2
, 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). Incorrect 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
B. Provide a soft, bland diet with oral liquids, such as diluted juices.
3
