CRITICAL CARE HESI EXAM QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS VERIFIED
The nurses calculating fluid resuscitation for young adult male who was burned
in a bloody accident at 1200 and is seen in the ER at 1400. The HCP determines
that the client has burn over 30% of his body, mainly over his arms and chest.
Using the Parkland formula for fluid resuscitation, the client is to receive 7000 mL
of fluid in 24 hours. Which goal should the nurse establish for this clients plan of
care?
By 2000, the client will have received 3500 mL of fluid
When caring for a client on a vent, which finding provides the greatest indication
that the client has an open airway?
Bilateral breath sounds can be auscultated
The nurse performs a prescribed a neurological check at the beginning of the
shift on a client who was admitted with a subarachnoid brain attack (Stroke). The
client's GCS is 9. What information is most important for the nurse to determine?
The client's previous GCS score
An adult female with a history of type 1 diabetes has been vomiting for the past
48 hours and is admitted to the ICU with DKA. Which assessment finding
warrants immediate intervention by the nurse?
Excessive thirst
A client admitted to the ICU after a colon resection with the formation of the loop
colostomy. The nurse determines that the clients abdominal dressing is clean
and dry. Vital signs are: HR: 130, temperature: 100, BP: 88/65, and urine output of
10 mL/hr. What interventions should the nurse implement?
Give a 500 mL IV fluid bolus challenge
A client is admitted with syncopal episodes related to a third degree heart block.
After the placement of a transcutaneous pacemaker, the nurse observes several
episodes the pacemaker failure to sense. What action should the nurse take?
, Increase the sensitivity
A client is receiving CPR. After systole is confirmed in two leads and sending the
transcutaneous pacemaker, which IV medication should be administered?
Epinephrine (adrenaline)
A client has a chest tube connected to a closed water seal drainage system with
suction. What equipment should the nurse always have available at the clients
bedside?
Occlusive dressing
Bretylium 1 mg/min via infusion is prescribed for a client and ventricular
tachycardia. The available solution is 500 mL D5W contains bretylium 1 gram. The
nurse should program the infusion time to deliver how many mL/hr?
30
The client is receiving an infusion of nitroglycerin 100 mg and 500 mL D5W at 6
mL/hr. How many mcg/min of nitroglycerin is infusing?
20
A client arrives in the ER complaining of pain. What description of pain should
prompt the nurse to suspect it originated in the myocardium?
Produces chest heaviness with left arm pain
Four days ago a chest tube was inserted into the second intercostal space of a
client who has a pneumothorax. Today the nurse notes that there is no
fluctuation in the water-seal chamber of the Pleuravac. Which intervention would
be most appropriate for the nurse to implement?
Assess the clients breath sounds of the affected lung
In developing a care plan for a client that has a chest tube due to a hemothorax,
the nurse should recognize which intervention is essential?
Encourage the client to breathe deeply and cough at frequent intervals
A postoperative client is admitted the ICU with an inflated pressure infuser
containing solution of heparin 2 units/mL attached to an intraarterial cannula.
Which finding indicated that the heparin infusion has achieved its therapeutic
use?
Intra-arterial cannula remain patent
COMPLETE SOLUTIONS VERIFIED
The nurses calculating fluid resuscitation for young adult male who was burned
in a bloody accident at 1200 and is seen in the ER at 1400. The HCP determines
that the client has burn over 30% of his body, mainly over his arms and chest.
Using the Parkland formula for fluid resuscitation, the client is to receive 7000 mL
of fluid in 24 hours. Which goal should the nurse establish for this clients plan of
care?
By 2000, the client will have received 3500 mL of fluid
When caring for a client on a vent, which finding provides the greatest indication
that the client has an open airway?
Bilateral breath sounds can be auscultated
The nurse performs a prescribed a neurological check at the beginning of the
shift on a client who was admitted with a subarachnoid brain attack (Stroke). The
client's GCS is 9. What information is most important for the nurse to determine?
The client's previous GCS score
An adult female with a history of type 1 diabetes has been vomiting for the past
48 hours and is admitted to the ICU with DKA. Which assessment finding
warrants immediate intervention by the nurse?
Excessive thirst
A client admitted to the ICU after a colon resection with the formation of the loop
colostomy. The nurse determines that the clients abdominal dressing is clean
and dry. Vital signs are: HR: 130, temperature: 100, BP: 88/65, and urine output of
10 mL/hr. What interventions should the nurse implement?
Give a 500 mL IV fluid bolus challenge
A client is admitted with syncopal episodes related to a third degree heart block.
After the placement of a transcutaneous pacemaker, the nurse observes several
episodes the pacemaker failure to sense. What action should the nurse take?
, Increase the sensitivity
A client is receiving CPR. After systole is confirmed in two leads and sending the
transcutaneous pacemaker, which IV medication should be administered?
Epinephrine (adrenaline)
A client has a chest tube connected to a closed water seal drainage system with
suction. What equipment should the nurse always have available at the clients
bedside?
Occlusive dressing
Bretylium 1 mg/min via infusion is prescribed for a client and ventricular
tachycardia. The available solution is 500 mL D5W contains bretylium 1 gram. The
nurse should program the infusion time to deliver how many mL/hr?
30
The client is receiving an infusion of nitroglycerin 100 mg and 500 mL D5W at 6
mL/hr. How many mcg/min of nitroglycerin is infusing?
20
A client arrives in the ER complaining of pain. What description of pain should
prompt the nurse to suspect it originated in the myocardium?
Produces chest heaviness with left arm pain
Four days ago a chest tube was inserted into the second intercostal space of a
client who has a pneumothorax. Today the nurse notes that there is no
fluctuation in the water-seal chamber of the Pleuravac. Which intervention would
be most appropriate for the nurse to implement?
Assess the clients breath sounds of the affected lung
In developing a care plan for a client that has a chest tube due to a hemothorax,
the nurse should recognize which intervention is essential?
Encourage the client to breathe deeply and cough at frequent intervals
A postoperative client is admitted the ICU with an inflated pressure infuser
containing solution of heparin 2 units/mL attached to an intraarterial cannula.
Which finding indicated that the heparin infusion has achieved its therapeutic
use?
Intra-arterial cannula remain patent
