HESI EXIT CRITICAL
CARE EXAMINATION
STUDY GUIDE 2022
Nurse plans to administer a dose of metoprolol at 0900 to a client with HTN. At 0800 nurse notes
telemetry pattern shows second degree heart block with Ventricular rate of 50. Action
Hold scheduled dose and notify HCP of telemetry pattern
Nurse is reviewing client ECG and determines PR interval prolonged. Indicates
Increased conduction time from the SA node to the AV junction
When assessing a restless, intubated client on mechanical ventilation, nurse auscultates breath sounds on
right side only. Action
Reposition the depth of the ET tube
Nurse called to a train derailment likely caused by terrorist bomb. Triage in order
Middle-aged man wandering around
Woman sitting on ground with blanket
Crying child held by another passenger
Mother and father just arrived on scene
Client with pneumonia admitted with severe SOB, ABGs pH 7.30, PaO2 60, PaCO2 62, HCO3 35.
Which needs immediate communication to HCP
Drowsiness and diff in arousing
Assess a 78 year old with L sided HF. Symptoms
Dyspnea, cough, fatigue
Caring for a burn patient with serum potassium of 4. Question which medication
Potassium
Patient admitted with deep 2nd degree burns of thighs, chest and arms covering 40% BSA. Fluid shift after
burn so nurse expects
Decreased cardiac output
Patient bedridden for 2 wks with following lab values: pH 7.37, PO2 90, PCO2 40, HCO3 25,
hypoalbuminemia and hypocalcemia. Priority action
Turn patient side to side q2h
Which age group should nurse assess first
40 year old with sickle cell crisis
There has been a major disaster. Triage nurse should give which patient priority
Cut over eye
Move which patient to medical surgical unit
Patient with ABNL liver levels
One open bed in ICU but reserved for patient coming from PACU with respiratory problems, what to do
Take patient to ICU and arrange for respiratory patient to stay in PACU
, HESI EXIT CRITICAL
CARE EXAMINATION
STUDY GUIDE 2022
Carotid picture
Point to neck
Someone with wound vac how to make sure it is effective
Check seal to make sure no leaks
Magnesium antidote
Calcium gluconate
Patient having trouble swallowing when wife gives drink of water
Assess gag reflex OR may have been thickening answer-there were two alike
Chest tube becomes disconnected
Get new saline bottle to stick end into until reconnect tube
Patient in ventricular fibrillation
Defib shock once
Know calcium levels….there was a question with calcium 5.0 and the answer was
patient with hyperthyroidism taking inderal (propanalol)
Chest tube volume 125
Mark container between 100 and 150
Heart sounds audio
S1S2
Patient on benzos
Answer is not narcan
???
Abdominal rigidity
4 patients-which one more concern
Low Hgb level
4 patients with conditions of concern-priority
Make sure patient has units of blood available
Patient on Heparin going for surgery in a.m.,-priority
Assess patient for bleeds
Patient with fever of 101-best nursing Dx
r/t temperature elevation
Listening and hearing silence, then kortokoff sound what to do
follow through by checking BP
Patient with pancreatitis and elevated liver function-what expect of patient
, HESI EXIT CRITICAL
CARE EXAMINATION
STUDY GUIDE 2022
patient drinks alcohol daily or lots/wk (alcohol related answer for sure)
CARE EXAMINATION
STUDY GUIDE 2022
Nurse plans to administer a dose of metoprolol at 0900 to a client with HTN. At 0800 nurse notes
telemetry pattern shows second degree heart block with Ventricular rate of 50. Action
Hold scheduled dose and notify HCP of telemetry pattern
Nurse is reviewing client ECG and determines PR interval prolonged. Indicates
Increased conduction time from the SA node to the AV junction
When assessing a restless, intubated client on mechanical ventilation, nurse auscultates breath sounds on
right side only. Action
Reposition the depth of the ET tube
Nurse called to a train derailment likely caused by terrorist bomb. Triage in order
Middle-aged man wandering around
Woman sitting on ground with blanket
Crying child held by another passenger
Mother and father just arrived on scene
Client with pneumonia admitted with severe SOB, ABGs pH 7.30, PaO2 60, PaCO2 62, HCO3 35.
Which needs immediate communication to HCP
Drowsiness and diff in arousing
Assess a 78 year old with L sided HF. Symptoms
Dyspnea, cough, fatigue
Caring for a burn patient with serum potassium of 4. Question which medication
Potassium
Patient admitted with deep 2nd degree burns of thighs, chest and arms covering 40% BSA. Fluid shift after
burn so nurse expects
Decreased cardiac output
Patient bedridden for 2 wks with following lab values: pH 7.37, PO2 90, PCO2 40, HCO3 25,
hypoalbuminemia and hypocalcemia. Priority action
Turn patient side to side q2h
Which age group should nurse assess first
40 year old with sickle cell crisis
There has been a major disaster. Triage nurse should give which patient priority
Cut over eye
Move which patient to medical surgical unit
Patient with ABNL liver levels
One open bed in ICU but reserved for patient coming from PACU with respiratory problems, what to do
Take patient to ICU and arrange for respiratory patient to stay in PACU
, HESI EXIT CRITICAL
CARE EXAMINATION
STUDY GUIDE 2022
Carotid picture
Point to neck
Someone with wound vac how to make sure it is effective
Check seal to make sure no leaks
Magnesium antidote
Calcium gluconate
Patient having trouble swallowing when wife gives drink of water
Assess gag reflex OR may have been thickening answer-there were two alike
Chest tube becomes disconnected
Get new saline bottle to stick end into until reconnect tube
Patient in ventricular fibrillation
Defib shock once
Know calcium levels….there was a question with calcium 5.0 and the answer was
patient with hyperthyroidism taking inderal (propanalol)
Chest tube volume 125
Mark container between 100 and 150
Heart sounds audio
S1S2
Patient on benzos
Answer is not narcan
???
Abdominal rigidity
4 patients-which one more concern
Low Hgb level
4 patients with conditions of concern-priority
Make sure patient has units of blood available
Patient on Heparin going for surgery in a.m.,-priority
Assess patient for bleeds
Patient with fever of 101-best nursing Dx
r/t temperature elevation
Listening and hearing silence, then kortokoff sound what to do
follow through by checking BP
Patient with pancreatitis and elevated liver function-what expect of patient
, HESI EXIT CRITICAL
CARE EXAMINATION
STUDY GUIDE 2022
patient drinks alcohol daily or lots/wk (alcohol related answer for sure)
