HESI RN EXIT EXAM 2
COMPREHENSIVE
STUDY GUIDE
SECTION 1: GASTROINTESTINAL & HEPATIC
QUESTION 1
Client with acute pancreatitis admitted. Which assessment has highest priority?
ANSWER
D. Intensity of pain
RATIONALE / EXPLANATION
Hallmark sign of pancreatitis is severe abdominal pain due to autodigestion of pancreas by
amylase and lipase.
QUESTION 2
Ascites related to liver failure - which pathophysiological mechanisms? (Select all)
ANSWER
B. Fluid shifts due to decreased serum protein
C. Increased hydrostatic pressure in portal circulation
D. Increased aldosterone levels increase sodium/water retention
RATIONALE / EXPLANATION
Liver failure: decreased albumin → fluid shifts; portal hypertension → fluid into abdomen;
aldosterone not inactivated → retention.
QUESTION 3
Clinical finding in cardiac cirrhosis?
ANSWER
C. Peripheral edema
RATIONALE / EXPLANATION
Page 1 of 28
,Cardiac cirrhosis is associated with severe right-sided HF - peripheral edema is the most defining
characteristic.
QUESTION 4
Client had abdominal surgery yesterday. Wound edges close together, no redness, slight
bright red oozing. Action?
ANSWER
A. Record these findings in the client's record
RATIONALE / EXPLANATION
These are NORMAL findings for one day postoperative - wound healing by primary intention.
Page 2 of 28
, SECTION 2: CARDIOVASCULAR & EMERGENCY
QUESTION 5
Heart failure client's lower extremities swell when sitting at computer all day. Best response?
ANSWER
C. Get up and walk around frequently during the day
RATIONALE / EXPLANATION
Walking stimulates circulation, venous return, and reduces swelling from gravitational blood
pooling.
QUESTION 6
50-year-old with cocaine ingestion has VT converting to VF. Priority action?
ANSWER
B. Defibrillate at 200 joules
RATIONALE / EXPLANATION
Rapid defibrillation is critical to re-establish cardiac output and preserve vital organ function.
QUESTION 7
EKG waveform analysis - what indicates disturbance in ventricular electrical conduction?
ANSWER
QRS interval of 0.14 seconds
RATIONALE / EXPLANATION
Normal QRS is 0.04-0.12 seconds. Prolonged QRS (>0.12) indicates ventricular electrical
anomaly.
QUESTION 8
Calculate MAP for BP 152/90 mm Hg:
ANSWER
Page 3 of 28
COMPREHENSIVE
STUDY GUIDE
SECTION 1: GASTROINTESTINAL & HEPATIC
QUESTION 1
Client with acute pancreatitis admitted. Which assessment has highest priority?
ANSWER
D. Intensity of pain
RATIONALE / EXPLANATION
Hallmark sign of pancreatitis is severe abdominal pain due to autodigestion of pancreas by
amylase and lipase.
QUESTION 2
Ascites related to liver failure - which pathophysiological mechanisms? (Select all)
ANSWER
B. Fluid shifts due to decreased serum protein
C. Increased hydrostatic pressure in portal circulation
D. Increased aldosterone levels increase sodium/water retention
RATIONALE / EXPLANATION
Liver failure: decreased albumin → fluid shifts; portal hypertension → fluid into abdomen;
aldosterone not inactivated → retention.
QUESTION 3
Clinical finding in cardiac cirrhosis?
ANSWER
C. Peripheral edema
RATIONALE / EXPLANATION
Page 1 of 28
,Cardiac cirrhosis is associated with severe right-sided HF - peripheral edema is the most defining
characteristic.
QUESTION 4
Client had abdominal surgery yesterday. Wound edges close together, no redness, slight
bright red oozing. Action?
ANSWER
A. Record these findings in the client's record
RATIONALE / EXPLANATION
These are NORMAL findings for one day postoperative - wound healing by primary intention.
Page 2 of 28
, SECTION 2: CARDIOVASCULAR & EMERGENCY
QUESTION 5
Heart failure client's lower extremities swell when sitting at computer all day. Best response?
ANSWER
C. Get up and walk around frequently during the day
RATIONALE / EXPLANATION
Walking stimulates circulation, venous return, and reduces swelling from gravitational blood
pooling.
QUESTION 6
50-year-old with cocaine ingestion has VT converting to VF. Priority action?
ANSWER
B. Defibrillate at 200 joules
RATIONALE / EXPLANATION
Rapid defibrillation is critical to re-establish cardiac output and preserve vital organ function.
QUESTION 7
EKG waveform analysis - what indicates disturbance in ventricular electrical conduction?
ANSWER
QRS interval of 0.14 seconds
RATIONALE / EXPLANATION
Normal QRS is 0.04-0.12 seconds. Prolonged QRS (>0.12) indicates ventricular electrical
anomaly.
QUESTION 8
Calculate MAP for BP 152/90 mm Hg:
ANSWER
Page 3 of 28
