HESI EXIT EXAM 2024 LATEST UPDATE QUESTIONS AND VERIFIED CORRECT ANSWERS WITH COMPLETE SOLUTIONS AND GRADED A++ BY EXPERTS ALREADY PASSED!!

HESI EXIT EXAM 2024 LATEST UPDATE QUESTIONS AND VERIFIED CORRECT ANSWERS WITH COMPLETE SOLUTIONS AND GRADED A++ BY EXPERTS ALREADY PASSED!! What PO2 value indicates respiratory failure in adults? PO2 60 mmHg What blood value indicates hypercapnia? PCO2 45 mmHg What condition occurs when the PO2 is 60 mmHg (acute hypoxemia), the CO2 tension rises 50 mmHg (acute hypercarbia, hypercapnia) & the pH drops 7.35, or both? Acute respiratory failure What are the S/S of respiratory failure in adults? Dyspnea, SOB Tachypnea Intercostal & sternal retractions Cyanosis Tachycardia Cough that produces sputum Fatigue Fever Crackles, wheezes Chest pain (especially when trying to deep breathe) Hypotension Confusion Agitation, restlessness What are the common causes of respiratory failure in peds? CHD RDS Infection, sepsis NM diseases Trauma, burns Aspiration FVO & dehydration Anesthesia & narcotic OD Structural anomalies resulting in airway obstruction What percentage of O2 should a child in severe respiratory distress receive? 100% O2 What is shock? Widespread, serious reduction of tissue perfusion, which leads to generalized impairment of cellular function. What is the most common cause of shock? Hypovolemia What causes septic shock? Release of endotoxins from bacteria, which act on the nerves in peripheral vascular spaces, causing vascular pooling, reduced venous return, decreased CO & results in poor systemic perfusion. What is the goal of tx for hypovolemic shock? Quick restoration of CO & tissue perfusion. It's important to differentiate between hypovolemic & cardiogenic shock. How might the RN determine the existence of cardiogenic shock? H/o MI with LV failure or possible cardiomyopathy, with S/S of pulmonary edema. If a pt is in cardiogenic shock, what might result from administration of volume-expanding fluids, and what intervention can the RN expect to perform in the event of such an occurrence? Pulmonary edema -- administer meds to manage preload, contractility and/or afterload. For example, to decrease afterload, nitroprusside may be given. What are 5 assessment findings occur in most shock pt's? Tachycardia Tachypnea Hypotension Cool, clammy skin Decreased urine output Once circulating volume is restored, vasopressors may be given to increase venous return. What are the main drugs that are used? Epi & NE Dopamine Dobutamine Isoproterenol What is the established minimum renal output per hour? 30 mL/hr What are 4 measurable criteria that are the major expected outcomes of a shock crisis? MAP 80-90 mmHg PO2 50 mmHg CVP 2-6 mmHg H2O Urine output ≥ 30 mL/hr What is DIC? A coagulation disorder in which there's paradoxical thrombosis & hemorrhage. What medication is used to tx DIC? Heparin The RN assesses a pt with the admitting dx of bipolar affective disorder, mania. Which pt S/S require the RN's immediate action? a) Incessant talking & sexual innuendos b) Grandiose delusions & poor concentration c) Outlandish behaviors & inappropriate dress d) Nonstop physical activity & poor nutritional intake d) Nonstop physical activity & poor nutritional intake Rationale: Mania is a mood characterized by excitement, euphoria, hyperactivity, excessive energy, decreased need for sleep, and impaired ability to concentrate or complete a single train of thought. The client's mood is predominantly elevated, expansive, or irritable. All of the options reflect a client's possible symptoms. However, the correct option clearly presents a problem that compromises physiological integrity and needs to be addressed immediately. The RN is caring for a pt who was involuntarily hospitalized to a mental health unit & is scheduled for ECT. The RN notes that the informed consent hasn't been obtained for the procedure. Based on this information, what is the RN's best determination in care planning? a) The informed consent doesn't need to be obtained. b) The informed consent would be obtained from the family. c) The informed consent needs to be obtained from the pt. d) The PCP will provide informed consent. c) The informed consent needs to be obtained from the pt. Rationale: Clients who are admitted involuntarily to a mental health unit do not lose their right to informed consent. Clients must be considered legally competent until they have been declared incompetent through a legal proceeding. The best determination for the nurse to make is to obtain the informed consent from the client. A pt presents to the ED with UGI bleeding & in moderate distress. In care planning, what is the priority RN action for this pt? a) VS assessment b) Abdominal examination c) Inserting NG tube d) Thorough investigation of precipitating events a) VS assessment Rationale: The priority nursing action is to assess the vital signs. This would provide information about the amount of blood loss that has occurred and provide a baseline by which to monitor the progress of treatment. The client may be unable to provide subjective data until the immediate physical needs are met. Although an abdominal examination and an assessment of the precipitating events may be necessary, these actions are not the priority. Insertion of a nasogastric tube is not the priority and will require a primary health care provider's prescription; in addition, the vital signs would be checked before performing this procedure. The RN is caring for a pt with anorexia nervosa. Which behavior is characteristic of this disorder & reflects anxiety mgmt? a) Engaging in immoral acts b) Always reinforcing self-approval c) Observing rigid rules & regulations d) Having the need to always make the right decision c) Observing rigid rules & regulations Rationale: Clients with anorexia nervosa have the desire to please others. Their need to be correct or perfect interferes with rational decision-making processes. These clients are moralistic. Rules and rituals help these clients manage their anxiety. The RN provides instructions to a malnourished pregnant pt regarding Fe2+ supplementation. Which pt statement indicates an understanding of the instructions? a) "Iron supplements will give me diarrhea." b) "Meat doesn't provide iron & should be avoided." c) "The iron is best absorbed if taken on an empty stomach."