HESI Critical Care RN Exit Exam Actual
Exam Questions And Answers Practice
Questions with Solutions Newest |
Already Graded A+
**1. A client with heart failure is prescribed furosemide (Lasix) 40 mg
IV. Which laboratory value should the nurse assess FIRST?**
A) Sodium level
B) Potassium level
C) Creatinine level
D) Magnesium level
**Answer: B) Potassium level**
**Rationale:** Furosemide is a loop diuretic that causes significant
potassium wasting. Hypokalemia can lead to life-threatening
dysrhythmias, especially in clients taking digoxin. This is the priority
assessment before administration .
**2. A client is receiving a continuous heparin infusion for a DVT. The
aPTT result is 120 seconds (Therapeutic range is 60-100). What action
should the nurse take?**
A) Increase the infusion rate.
B) Decrease the infusion rate and notify the HCP.
,C) Discontinue the infusion immediately.
D) Administer Protamine sulfate.
**Answer: B) Decrease the infusion rate and notify the HCP.**
**Rationale:** An aPTT above the therapeutic range indicates the
client is over-anticoagulated and at high risk for bleeding. The nurse
should reduce the rate per protocol and notify the provider. Protamine
sulfate is reserved for severe bleeding or critical overdose .
**3. A nurse is preparing to administer Digoxin to a client with heart
failure. Which finding warrants withholding the medication?**
A) Heart rate of 56 bpm.
B) Blood pressure of 138/88.
C) Respiratory rate of 18.
D) Serum potassium of 4.0.
**Answer: A) Heart rate of 56 bpm.**
**Rationale:** Digoxin slows the heart rate. The general rule is to hold
the medication if the adult apical pulse is below 60 bpm and notify the
provider, as administering it could worsen the bradycardia .
**4. A patient on a ventilator suddenly develops high peak airway
pressures. What is the first action?**
A) Notify the provider.
B) Suction the airway.
C) Increase the tidal volume.
, D) Administer sedation.
**Answer: B) Suction the airway.**
**Rationale:** A sudden rise in peak airway pressure is often caused by
an obstruction in the airway, such as mucous plugging or the patient
biting the tube. Suctioning is the immediate, least invasive intervention
to try and resolve this .
**5. A client with septic shock has a MAP of 58 mmHg despite
adequate fluid resuscitation. Which vasopressor should the nurse
anticipate administering first?**
A) Dopamine
B) Vasopressin
C) Norepinephrine
D) Phenylephrine
**Answer: C) Norepinephrine**
**Rationale:** Current guidelines (Surviving Sepsis Campaign)
recommend norepinephrine as the first-line vasopressor in septic shock
to achieve a MAP ≥65 mmHg. It increases systemic vascular resistance
without significantly increasing heart rate as much as dopamine .
**6. A client is rescued from a house fire. The client weighs 60 kg and is
burned over 35% of the body. Using the Parkland formula, how much
Lactated Ringer's should the nurse expect to infuse in the first 8
hours?**
A) 2100 mL
Exam Questions And Answers Practice
Questions with Solutions Newest |
Already Graded A+
**1. A client with heart failure is prescribed furosemide (Lasix) 40 mg
IV. Which laboratory value should the nurse assess FIRST?**
A) Sodium level
B) Potassium level
C) Creatinine level
D) Magnesium level
**Answer: B) Potassium level**
**Rationale:** Furosemide is a loop diuretic that causes significant
potassium wasting. Hypokalemia can lead to life-threatening
dysrhythmias, especially in clients taking digoxin. This is the priority
assessment before administration .
**2. A client is receiving a continuous heparin infusion for a DVT. The
aPTT result is 120 seconds (Therapeutic range is 60-100). What action
should the nurse take?**
A) Increase the infusion rate.
B) Decrease the infusion rate and notify the HCP.
,C) Discontinue the infusion immediately.
D) Administer Protamine sulfate.
**Answer: B) Decrease the infusion rate and notify the HCP.**
**Rationale:** An aPTT above the therapeutic range indicates the
client is over-anticoagulated and at high risk for bleeding. The nurse
should reduce the rate per protocol and notify the provider. Protamine
sulfate is reserved for severe bleeding or critical overdose .
**3. A nurse is preparing to administer Digoxin to a client with heart
failure. Which finding warrants withholding the medication?**
A) Heart rate of 56 bpm.
B) Blood pressure of 138/88.
C) Respiratory rate of 18.
D) Serum potassium of 4.0.
**Answer: A) Heart rate of 56 bpm.**
**Rationale:** Digoxin slows the heart rate. The general rule is to hold
the medication if the adult apical pulse is below 60 bpm and notify the
provider, as administering it could worsen the bradycardia .
**4. A patient on a ventilator suddenly develops high peak airway
pressures. What is the first action?**
A) Notify the provider.
B) Suction the airway.
C) Increase the tidal volume.
, D) Administer sedation.
**Answer: B) Suction the airway.**
**Rationale:** A sudden rise in peak airway pressure is often caused by
an obstruction in the airway, such as mucous plugging or the patient
biting the tube. Suctioning is the immediate, least invasive intervention
to try and resolve this .
**5. A client with septic shock has a MAP of 58 mmHg despite
adequate fluid resuscitation. Which vasopressor should the nurse
anticipate administering first?**
A) Dopamine
B) Vasopressin
C) Norepinephrine
D) Phenylephrine
**Answer: C) Norepinephrine**
**Rationale:** Current guidelines (Surviving Sepsis Campaign)
recommend norepinephrine as the first-line vasopressor in septic shock
to achieve a MAP ≥65 mmHg. It increases systemic vascular resistance
without significantly increasing heart rate as much as dopamine .
**6. A client is rescued from a house fire. The client weighs 60 kg and is
burned over 35% of the body. Using the Parkland formula, how much
Lactated Ringer's should the nurse expect to infuse in the first 8
hours?**
A) 2100 mL
