HESI Exit Exam 2024 Graded A 2024 Study Questions and Answers with Complete Solutions

What PO2 value indicates respiratory failure in adults? PO2 60 mmHg What blood value indicates hypercapnia? PCO2 45 mmHg What condition occurs when the PO2 is 60 mmHg (acute hypoxemia), the CO2 tension rises 50 mmHg (acute hypercarbia, hypercapnia) & the pH drops 7.35, or both? Acute respiratory failure What are the S/S of respiratory failure in adults? Dyspnea, SOB Tachypnea Intercostal & sternal retractions Cyanosis Tachycardia Cough that produces sputum Fatigue Fever Crackles, wheezes Chest pain (especially when trying to deep breathe) Hypotension Confusion Agitation, restlessness What are the common causes of respiratory failure in peds? CHD RDS Infection, sepsis NM diseases Trauma, burns Aspiration FVO & dehydration Anesthesia & narcotic OD Structural anomalies resulting in airway obstruction What percentage of O2 should a child in severe respiratory distress receive? 100% O2 What is shock? Widespread, serious reduction of tissue perfusion, which leads to generalized impairment of cellular function. What is the most common cause of shock? Hypovolemia What causes septic shock? Release of endotoxins from bacteria, which act on the nerves in peripheral vascular spaces, causing vascular pooling, reduced venous return, decreased CO & results in poor systemic perfusion. What is the goal of tx for hypovolemic shock? Quick restoration of CO & tissue perfusion. It's important to differentiate between hypovolemic & cardiogenic shock. How might the RN determine the existence of cardiogenic shock? H/o MI with LV failure or possible cardiomyopathy, with S/S of pulmonary edema. If a pt is in cardiogenic shock, what might result from administration of volume-expanding fluids, and what intervention can the RN expect to perform in the event of such an occurrence? Pulmonary edema -- administer meds to manage preload, contractility and/or afterload. For example, to decrease afterload, nitroprusside may be given. What are 5 assessment findings occur in most shock pt's? Tachycardia Tachypnea Hypotension Cool, clammy skin Decreased urine output Once circulating volume is restored, vasopressors may be given to increase venous return. What are the main drugs that are used? Epi & NE Dopamine Dobutamine Isoproterenol What is the established minimum renal output per hour? 30 mL/hr What are 4 measurable criteria that are the major expected outcomes of a shock crisis? MAP 80-90 mmHg PO2 50 mmHg CVP 2-6 mmHg H2O Urine output ≥ 30 mL/hr What is DIC? A coagulation disorder in which there's paradoxical thrombosis & hemorrhage. What medication is used to tx DIC? Heparin The RN assesses a pt with the admitting dx of bipolar affective disorder, mania. Which pt S/S require the RN's immediate action? a) Incessant talking & sexual innuendos b) Grandiose delusions & poor concentration c) Outlandish behaviors & inappropriate dress d) Nonstop physical activity & poor nutritional intake d) Nonstop physical activity & poor nutritional intake Rationale: Mania is a mood characterized by excitement, euphoria, hyperactivity, excessive energy, decreased need for sleep, and impaired ability to concentrate or complete a single train of thought. The client's mood is predominantly elevated, expansive, or irritable. All of the options reflect a client's possible symptoms. However, the correct option clearly presents a problem that compromises physiological integrity and needs to be addressed immediately. The RN is caring for a pt who was involuntarily hospitalized to a mental health unit & is scheduled for ECT. The RN notes that the informed consent hasn't been obtained for the procedure. Based on this information, what is the RN's best determination in care planning?