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Examen

HESI STUDY LATEST UPDATED FINAL EXAM WITH COMPLETE DETAILED QUESTIONS AND CORRECT VERIFIED ANSWERS ALREADY A+ GRADED

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HESI STUDY LATEST UPDATED FINAL EXAM WITH COMPLETE DETAILED QUESTIONS AND CORRECT VERIFIED ANSWERS ALREADY A+ GRADED

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HESI STUDY LATEST UPDATED 2024-2025 FINAL EXAM WITH
COMPLETE DETAILED QUESTIONS AND CORRECT VERIFIED
ANSWERS ALREADY A+ GRADED

When a family member of a client with cardiogenic shock asks the nurse for more information about the
condition, how would the nurse describe cardiogenic shock?



An irreversible phenomenon



A failure of the circulatory pump



Usually a fleeting reaction to tissue injury



Generally caused by decreased blood volume - ANSWER-A failure of the circulatory pump



The nurse will anticipate the need to administer which type of medication when a client with
cardiogenic shock has an increased pulmonary artery wedge pressure reading of 30 mm Hg?



Vasopressor



Loop diuretic



Antidysrhythmic



Beta-adrenergic blocker - ANSWER-loop diuretic



Increased pulmonary artery wedge pressure indicates increased left ventricular preload; the nurse will
anticipate the need to decrease preload by administration of a loop diuretic. A vasopressor would not
decrease ventricular preload and vasopressors are not usually used in cardiogenic shock because they

,increase cardiac workload and oxygen demand. There is no indication that the client has a dysrhythmia
and antidysrhythmic treatment is not indicated. A beta-adrenergic blocker would decrease cardiac
output and likely increase left ventricular preload.



When the nurse is caring for a client who has cardiogenic shock, which clinical manifestations will be
expected? Select all that apply. One, some, or all responses may be correct.



Rapid pulse



Deep respirations



Warm, flushed skin



Increased blood pressure



Decreased urinary output - ANSWER-rapid pulse, decreased urinary output



The heart rate increases (tachycardia) to meet the body's oxygen demands and circulate blood to vital
organs; the pulse is weak and thready because of peripheral vasoconstriction. The urinary output
decreases because increased catecholamines and activation of the renin-angiotensin-aldosterone
system increase fluid reabsorption in the kidneys. The respirations are rapid and shallow, not deep. The
skin is cold and clammy because of vasoconstriction caused by the shunting of blood to vital organs. The
blood pressure is decreased, not increased, because of continued hypoperfusion and multiorgan failure.



After a myocardial infarction, a client asks the nurse, "What's the chance of me having another heart
attack if I watch my diet and stress levels carefully?" What is the most appropriate initial response by
the nurse?



Identifying the concerns and helping the client explore feelings



Telling the client that it is important to be especially careful with diet and stress

, Suggesting that the client discuss the feelings of vulnerability with the primary health care provider



Understanding that the client is frightened and suggesting a talk with the psychiatric nurse - ANSWER-
Identifying the concerns and helping the client explore feelings



Which information about a client who is being discharged 3 days after having an ST segment elevation
myocardial infarction (STEMI) and coronary artery stent placement indicates that a home health referral
may be needed at discharge?



ST segments have not yet returned to baseline.



Troponin T and Troponin I levels are still elevated.



Client reports frequently forgetting to take medications.



Pulse increases from 65 beats/minute to 75 beats/minute with exercise. - ANSWER-Client reports
frequently forgetting to take medications.



When the pulse rate for a client with a recent myocardial infarction increases from 70 beats/minute to
135 beats/minute while climbing the stairs, which instruction would the cardiac rehabilitation nurse give
to the client?



"Continue climbing."



"Stand still and rest."



"Walk down the stairs."



"Climb but at a slower rate." - ANSWER-"Stand still and rest."
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