CRITICAL CARE HESI PRACTICE QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS 100% VERIFIED ALREADY PASS GRADED A+ LATEST UPDATE 2024/2024

CRITICAL CARE HESI PRACTICE QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS 100% VERIFIED ALREADY PASS GRADED A+ LATEST UPDATE 2024/2024 ANS = A The nurse is providing post-procedure care to a client who had a cardiac catheterization. The client begins to manifest signs & symptoms associated with embolization. Which action should the nurse take? a. Notify the primary healthcare provider immediately b. Apply a warm, moist compress to the incision site c. Increase the intravenous fluid rate by 20 mL/hr d. Monitor vital signs more frequently ANS = D A client reports left-sided chest pain after playing racquetball. The client is hospitalized & diagnosed with left pneumothorax. When assessing the client's left chest area, the nurse expects to identify which finding? a. Dull sound on percussion b. Vocal fremitus on palpation c. Rales with rhonchi on auscultation d. Absence of breath sounds on auscultation ANS = C A client is admitted to the hospital with partial- & full-thickness burns of the chest & face sustained while trying to extinguish a brush fire. Which is the nurse's priority concern? a. Loss of skin integrity caused by the burns b. Potential infection as a result of the burn injury c. Inadequate gas exchange caused by smoke inhalation d. Decreased fluid volume because of the depth of the burns ANS = B During the first 48 hours after a client has sustained a thermal injury, which conditions should the nurse assess for? a. Hypokalemia & hyponatremia b. Hyperkalemia & hyponatremia c. Hypokalemia & hypernatremia d. Hyperkalemia & hypernatremia ANS = C A client who had extensive pelvic surgery 24 hours ago becomes cyanotic, is gasping for breath, & reports right-sided chest pain. What should the nurse do first? a. Obtain vital signs b. Initiate a cardiac arrest code c. Administer oxygen using a face mask d. Encourage the use of an incentive spirometer ANS = C A nurse is caring for a client with severe burns. The nurse determines that this client is at risk for hypovolemic shock. Which physiologic finding supports the nurse's conclusion? a. Decreased rate of glomerular filtration b. Excessive blood loss through the burned tissues c. Plasma proteins moving out of the intravascular compartment d. Sodium retention occurring as a result of the aldosterone mechanism ANS = A The nurse is caring for a client with burns & reviews the client's laboratory results: BUN 30 mg/dL; Cr 2.4 mg/dL; serum potassium 6.3 mEq/L; pH, 7.1; PO₂ 90 mm Hg; & Hgb 7.4 g/dL. Which condition does the nurse suspect the client has based upon these findings? a. Azotemia b. Hypokalemia c. Metabolic alkalosis d. Respiratory alkalosis ANS = D A nurse is caring for a client who experienced serious burns in a fire. Which relationship between a client's burned body surface area & fluid loss should the nurse consider when evaluating fluid loss in a client with burns? a. Equal b. Unrelated c. Inversely related d. Directly proportional ANS = C A burn client is receiving the open method for wound treatment. Which information will the nurse explain to the client? a. Bathing will not be permitted b. Dressings will be changed daily c. Personal protective equipment will be worn by staff d. Room temperature will be kept below 72° F (22.2° C) ANS = A A client presents to the emergency department with weakness & dizziness. The BP is 90/60 mm Hg, pulse is 92 & weak, & body weight reflects a 3-pound loss in two days. The weather has been hot. Which condition should the nurse conclude is the priority for this client? a. Deficient fluid volume b. Impaired skin integrity c. Inadequate nutritional intake d. Decreased participation in activities ANS = B A client is admitted with severe burns. The nurse is caring for the client 36 hours after the client's admission & identifies the client's potassium level of 6.0 mEq/L. Which drink will the nurse recommend be included in the client's diet? a. Milk b. Tea c. Orange juice d. Tomato juice ANS = A A woman comes to the office of her healthcare provider reporting shortness of breath & epigastric distress that is not relieved by antacids. To which question would a woman experiencing a myocardial infarction respond differently than a man? a. "Do you have chest pain?" b. "Are you feeling anxious?" c. "Do you have any palpitations?" d. "Are you feeling short of breath?" ANS = B During a vertex vaginal birth the nurse notes meconium-stained amniotic fluid. What is the priority nursing intervention for the newborn? a. Stimulating crying b. Suctioning the airway c. Using an Ambu bag with oxygen support d. Placing the infant in the reverse Trendelenburg position ANS = C While receiving a blood transfusion, the client suddenly shouts, "I feel like someone is lowering a heavy weight on my chest. I feel like I'm going to die!" Which actions are priority? a. Administer nitroglycerin & aspirin b. Slow the rate & monitor the vital signs c. Stop the transfusion & administer normal saline through new IV tubing d. Ask the client to further describe the feeling & rate the pain ANS = D A client who was hospitalized with partial- & full-thickness burns over 30% of the total body surface area is to be discharged. The client asks the nurse, "How will my spouse be able to care for me at home?" How should the nurse interpret this statement? a. Readiness to discuss the client's deformities b. Indication of a change in family relations c. Need for more time to think about the future d. Beginning realization of implications for the future ANS = B A nurse is assessing a client with a cast to the extremity. Which assessment finding is the priority? a. Warmth b. Numbness c. Skin desquamation d. Generalized discomfort ANS = B Which color of CSF may indicate subarachnoid hemorrhage in the client? a. Hazy b. Yellow c. Brown d. Colorless ANS = C A client arrives in the emergency department with multiple crushing wounds of the chest, abdomen, & legs. Which are the priority nursing assessments? a. Level of consciousness & pupil size b. Characteristics of pain & blood pressure c. Quality of respirations & presence of pulses d. Observation of abdominal contusions & other wounds ANS = B Which color tag will be given by the triage nurse to a client assigned to class IV, during a mass casualty situation? a. Red b. Black c. Green d. Yellow ANS = A A client who sustained a burn injury involving 36% of the body surface area is receiving hydrotherapy. Which is the best nursing intervention when providing wound care? a. Use a consistent approach to care & encourage participation b. Prepare equipment while doing the procedure & explain the treatment to the client c. Rinse the burn area with 105° F (40.6° C) water to prevent loss of body temperature d. Arrange for a change of staff every 4 to 5 days & have the client select the time for the procedure to be done ANS = B Which clinical manifestation can a client experience during a fat embolism syndrome (FES)? a. Nausea