lOMoARcPSD|26582732
Hesi Rn Exit
Study Guide 2025
Section 9 – Core Test-Taking Frameworks (Abcs • Maslow’s • Nursing
Process)
Abcs Priority
• Airway → Choking, Stridor, Trach Obstruction: Establish/Maintain Airway First (Suction,
Reposition, Oral Airway, Prepare To Intubate).
• Breathing → Assess Work Of Breathing, Apply Oxygen, Position High-Fowler’s, Prepare For
Ventilation If Needed.
• Circulation → Control Bleeding, Start Large-Bore Ivs, Give Fluids/Blood, Treat Arrhythmias
Per Acls.
Hesi Rationale: When Two Answers Seem Correct, Pick The One That Maintains
Airway/Oxygenation First.
Maslow’s Hierarchy (Use When All Physiological Needs Are Stable)
• Physiological (Abcs, Fluids, Electrolytes, Pain, Elimination, Nutrition) → Always First.
• Safety/Security (Falls, Infection, Abuse, Suicide Risk).
• Love/Belonging → Esteem → Self-Actualization.
Hesi Rationale: Physiological Trumps Psychosocial Unless There Is An Imminent Safety Risk.
Nursing Process – Adpie
• Assess → Gather Data (Vitals, Labs, Focused Assessment).
• Diagnose → Identify Priority Problems (Actual > Risk).
• Plan → Measurable Outcomes (E.G., Spo₂ ≥ 95%).
• Implement → Abcs First; Delegate Stable Tasks Only.
• Evaluate → Reassess Outcomes; Document Response.
Hesi Rationale: If You Haven’t Assessed Yet, Choose An Assessment Answer Unless An
Immediate Life-Threat Exists (Then Implement An Abc Action).
Stable Vs Unstable (Delegation Filter)
• Stable (Delegate): Chronic, Expected Findings, Predictable Outcomes, Post-Op >24 H.
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• Unstable (Rn Only): New Admit, New Onset, Change In Status, Fresh Post-Op <24 H,
Abnormal Trending Vitals.
Hesi Keywords
• First → Assessment Or Abc.
• Best/Most Important → Action That Impacts Survival/Safety Most.
• Next → The Step After Assessment Or Initial Stabilization.
Section 1 – Cardiac & Shock
Heart Failure (Left Vs Right)
• Left Hf → Pulmonary Congestion: Dyspnea, Orthopnea, Crackles, Pink Frothy Sputum.
• Right Hf → Systemic Congestion: Edema, Jvd, Hepatomegaly, Ascites.
• Interventions: High-Fowler’s, O₂, Loop Diuretics, Acei/Arb, Beta-Blocker, Na⁺/Fluid
Restriction, Daily Weights.
Hesi Rationale: Position For Oxygenation Before Meds (Abcs). Left = Lungs; Right = Rest Of Body.
Myocardial Infarction (Mi)
• Assessment: Crushing Chest Pain >20 Min, Radiates; Diaphoresis; Anxiety.
• Enzymes: Troponin Rises First/Specific; Ck-Mb Rises 4–6 H; Myoglobin Earliest But
Nonspecific.
• Priority: Mona-B (Morphine, O₂, Nitro, Aspirin, Beta-Blocker), 12-Lead Ecg, Iv Access.
Hesi Rationale: Apply O₂ If Hypoxemic (Abcs). Recognize Unstable Angina/Mi As Priority.
Dysrhythmias – What To Do First
• A-Fib: Control Rate (Ccb/Bb), Anticoagulate To Prevent Stroke.
• V-Tach W/ Pulse: Amiodarone; If Unstable → Synchronized Cardioversion.
• Pulseless V-Tach/V-Fib: Defibrillate → Cpr → Epi. Asystole: Cpr + Epinephrine; Do Not
Defibrillate.
Hesi Rationale: Determine Pulse First; That Drives Shock Vs Cpr Decision.
Hypertensive Crisis
• S/S: Severe Ha, Vision Changes, Neuro Deficits; Bp ≥180/120.
• Tx: Iv Nicardipine, Nitroprusside, Labetalol; Reduce Bp Gradually (≈25% In First Hour).
Stable Vs Unstable Angina
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Hesi Rn Exit
Study Guide 2025
Section 9 – Core Test-Taking Frameworks (Abcs • Maslow’s • Nursing
Process)
Abcs Priority
• Airway → Choking, Stridor, Trach Obstruction: Establish/Maintain Airway First (Suction,
Reposition, Oral Airway, Prepare To Intubate).
• Breathing → Assess Work Of Breathing, Apply Oxygen, Position High-Fowler’s, Prepare For
Ventilation If Needed.
• Circulation → Control Bleeding, Start Large-Bore Ivs, Give Fluids/Blood, Treat Arrhythmias
Per Acls.
Hesi Rationale: When Two Answers Seem Correct, Pick The One That Maintains
Airway/Oxygenation First.
Maslow’s Hierarchy (Use When All Physiological Needs Are Stable)
• Physiological (Abcs, Fluids, Electrolytes, Pain, Elimination, Nutrition) → Always First.
• Safety/Security (Falls, Infection, Abuse, Suicide Risk).
• Love/Belonging → Esteem → Self-Actualization.
Hesi Rationale: Physiological Trumps Psychosocial Unless There Is An Imminent Safety Risk.
Nursing Process – Adpie
• Assess → Gather Data (Vitals, Labs, Focused Assessment).
• Diagnose → Identify Priority Problems (Actual > Risk).
• Plan → Measurable Outcomes (E.G., Spo₂ ≥ 95%).
• Implement → Abcs First; Delegate Stable Tasks Only.
• Evaluate → Reassess Outcomes; Document Response.
Hesi Rationale: If You Haven’t Assessed Yet, Choose An Assessment Answer Unless An
Immediate Life-Threat Exists (Then Implement An Abc Action).
Stable Vs Unstable (Delegation Filter)
• Stable (Delegate): Chronic, Expected Findings, Predictable Outcomes, Post-Op >24 H.
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• Unstable (Rn Only): New Admit, New Onset, Change In Status, Fresh Post-Op <24 H,
Abnormal Trending Vitals.
Hesi Keywords
• First → Assessment Or Abc.
• Best/Most Important → Action That Impacts Survival/Safety Most.
• Next → The Step After Assessment Or Initial Stabilization.
Section 1 – Cardiac & Shock
Heart Failure (Left Vs Right)
• Left Hf → Pulmonary Congestion: Dyspnea, Orthopnea, Crackles, Pink Frothy Sputum.
• Right Hf → Systemic Congestion: Edema, Jvd, Hepatomegaly, Ascites.
• Interventions: High-Fowler’s, O₂, Loop Diuretics, Acei/Arb, Beta-Blocker, Na⁺/Fluid
Restriction, Daily Weights.
Hesi Rationale: Position For Oxygenation Before Meds (Abcs). Left = Lungs; Right = Rest Of Body.
Myocardial Infarction (Mi)
• Assessment: Crushing Chest Pain >20 Min, Radiates; Diaphoresis; Anxiety.
• Enzymes: Troponin Rises First/Specific; Ck-Mb Rises 4–6 H; Myoglobin Earliest But
Nonspecific.
• Priority: Mona-B (Morphine, O₂, Nitro, Aspirin, Beta-Blocker), 12-Lead Ecg, Iv Access.
Hesi Rationale: Apply O₂ If Hypoxemic (Abcs). Recognize Unstable Angina/Mi As Priority.
Dysrhythmias – What To Do First
• A-Fib: Control Rate (Ccb/Bb), Anticoagulate To Prevent Stroke.
• V-Tach W/ Pulse: Amiodarone; If Unstable → Synchronized Cardioversion.
• Pulseless V-Tach/V-Fib: Defibrillate → Cpr → Epi. Asystole: Cpr + Epinephrine; Do Not
Defibrillate.
Hesi Rationale: Determine Pulse First; That Drives Shock Vs Cpr Decision.
Hypertensive Crisis
• S/S: Severe Ha, Vision Changes, Neuro Deficits; Bp ≥180/120.
• Tx: Iv Nicardipine, Nitroprusside, Labetalol; Reduce Bp Gradually (≈25% In First Hour).
Stable Vs Unstable Angina
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