Page 1 of 83
Critical Care Exit HESI Q & A
Metoprolol .....ANSWER.....Beta-blocker used to treat
hypertension
Second degree heart block .....ANSWER.....Telemetry pattern with
prolonged PR interval and decreased conduction time from SA
node to AV junction
Restless, intubated client .....ANSWER.....Client on mechanical
ventilation exhibiting restlessness and breath sounds on right side
only
Train derailment triage .....ANSWER.....Priority order: Middle-
aged man wandering, Woman sitting with blanket, Crying child,
Mother and father just arrived
Pneumonia with severe SOB .....ANSWER.....Client with pneumonia
admitted with pH 7.30, PaO2 60, PaCO2 62, HCO3 35;
,Page 2 of 83
Immediate communication to HCP for drowsiness and difficulty in
arousing
Burn patient with serum potassium of 4 .....ANSWER.....Patient
with burn injuries and potassium level of 4; Medication choice for
potassium not provided
Bedridden patient for 2 weeks .....ANSWER.....Patient bedridden
for 2 weeks with pH 7.37, PO2 90, PCO2 40, HCO3 25; Priority
action is turning patient side to side q2h
Assess 40-year-old with sickle cell crisis .....ANSWER.....Priority
assessment for a 40-year-old with sickle cell crisis
Major disaster triage .....ANSWER.....Priority order: Cut over eye,
Move patient to medical surgical unit, Patient with abnormal liver
levels
Carotid picture .....ANSWER.....Pointing to the neck to indicate
carotid artery
,Page 3 of 83
Wound vac effectiveness .....ANSWER.....Checking seal to ensure
no leaks in wound vac
Magnesium antidote .....ANSWER.....Calcium gluconate is the
antidote for magnesium toxicity
Trouble swallowing .....ANSWER.....Assess gag reflex or consider
thickening of fluids
Disconnected chest tube .....ANSWER.....Get new saline bottle to
stick end into until reconnecting tube
Ventricular fibrillation .....ANSWER.....Defibrillate with a shock
once; Consider calcium levels
Chest tube volume .....ANSWER.....Mark container between 100
and 150
Heart sounds audio .....ANSWER.....S1S2 heart sounds audio
Patient on benzos .....ANSWER.....Narcan is not the answer for a
patient on benzodiazepines
, Page 4 of 83
Abdominal rigidity .....ANSWER.....Low hemoglobin level is the
most concerning
Low hemoglobin level .....ANSWER.....Priority assessment for
patients with low hemoglobin levels
Patient on Heparin going for surgery .....ANSWER.....Assess
patient for bleeding before surgery
Fever of 101 .....ANSWER.....Best nursing diagnosis related to
temperature elevation
Listening and hearing silence, then kortokoff sound
.....ANSWER.....Follow through by checking blood pressure
Pancreatitis and elevated liver function
.....ANSWER.....Expectation of patient with pancreatitis and
elevated liver function who drinks alcohol daily or frequently
Dark, tarry stool .....ANSWER.....Sign of gastrointestinal bleed,
consider NSAIDs
Critical Care Exit HESI Q & A
Metoprolol .....ANSWER.....Beta-blocker used to treat
hypertension
Second degree heart block .....ANSWER.....Telemetry pattern with
prolonged PR interval and decreased conduction time from SA
node to AV junction
Restless, intubated client .....ANSWER.....Client on mechanical
ventilation exhibiting restlessness and breath sounds on right side
only
Train derailment triage .....ANSWER.....Priority order: Middle-
aged man wandering, Woman sitting with blanket, Crying child,
Mother and father just arrived
Pneumonia with severe SOB .....ANSWER.....Client with pneumonia
admitted with pH 7.30, PaO2 60, PaCO2 62, HCO3 35;
,Page 2 of 83
Immediate communication to HCP for drowsiness and difficulty in
arousing
Burn patient with serum potassium of 4 .....ANSWER.....Patient
with burn injuries and potassium level of 4; Medication choice for
potassium not provided
Bedridden patient for 2 weeks .....ANSWER.....Patient bedridden
for 2 weeks with pH 7.37, PO2 90, PCO2 40, HCO3 25; Priority
action is turning patient side to side q2h
Assess 40-year-old with sickle cell crisis .....ANSWER.....Priority
assessment for a 40-year-old with sickle cell crisis
Major disaster triage .....ANSWER.....Priority order: Cut over eye,
Move patient to medical surgical unit, Patient with abnormal liver
levels
Carotid picture .....ANSWER.....Pointing to the neck to indicate
carotid artery
,Page 3 of 83
Wound vac effectiveness .....ANSWER.....Checking seal to ensure
no leaks in wound vac
Magnesium antidote .....ANSWER.....Calcium gluconate is the
antidote for magnesium toxicity
Trouble swallowing .....ANSWER.....Assess gag reflex or consider
thickening of fluids
Disconnected chest tube .....ANSWER.....Get new saline bottle to
stick end into until reconnecting tube
Ventricular fibrillation .....ANSWER.....Defibrillate with a shock
once; Consider calcium levels
Chest tube volume .....ANSWER.....Mark container between 100
and 150
Heart sounds audio .....ANSWER.....S1S2 heart sounds audio
Patient on benzos .....ANSWER.....Narcan is not the answer for a
patient on benzodiazepines
, Page 4 of 83
Abdominal rigidity .....ANSWER.....Low hemoglobin level is the
most concerning
Low hemoglobin level .....ANSWER.....Priority assessment for
patients with low hemoglobin levels
Patient on Heparin going for surgery .....ANSWER.....Assess
patient for bleeding before surgery
Fever of 101 .....ANSWER.....Best nursing diagnosis related to
temperature elevation
Listening and hearing silence, then kortokoff sound
.....ANSWER.....Follow through by checking blood pressure
Pancreatitis and elevated liver function
.....ANSWER.....Expectation of patient with pancreatitis and
elevated liver function who drinks alcohol daily or frequently
Dark, tarry stool .....ANSWER.....Sign of gastrointestinal bleed,
consider NSAIDs
