CRITICAL CARE HESI EXAM LATEST QUESTIONS AND ANSWERS
WITH COMPLETE SOLUTIONS VERIFIED GRADED A+
A client recovering from a percutaneous coronary intervention (PCI) after an
acute myocardial infarction is being transferred from the PACU to the Cardiac
ICU. Which assessment finding should the PACU nurse inform the healthcare
provider of immediately?
a. onset of chest pain
b. need to apply pressure dressing
c. presence of occasional PVCs
d. absence of any urinary output during PACU stay
a. onset of chest pain
This suggests the onset of another MI and reocclusion of a vessel.
What is the preferred treatment of an acute MI within 12 hours of symptom onset?
PCI; places a stent in the affected coronary artery
How often must a PCI pressure dressing site be assessed?
q30min for 4 hours
qh thereafter
Central Venous Pressure (CVP)
the pressure of blood in the thoracic vena cava, near the right atrium of the heart;
reflects the amount of blood returning to the heart and the ability of the heart to pump
the blood into the arterial system; normal is 2-6 mmHg
Sensitivity of a pacemaker
pacing devices ability to detect what electrical activity is being generated by the patient's
heart to prevent any competition between the hearts intrinsic activity
Contrast Induced Nephropathy (CIN)
A sudden deterioration in renal function that is caused by intravascular administration of
iodinated contrast medium; typically seen with angiplasty/angiography
, Signs of tension pneumothorax
1. affected side will have decreased or absent lung sounds
2. cyanosis
3. Tracheal deviation (late sign)
4. distended neck veins
5. tachycardia, tachypnea
Pneumatic Antishock Garment
An inflatable device that covers the legs and abdomen; used to splint the lower
extremities or pelvis, or to control bleeding in the lower extremities or pelvis.
- used for intraperitoneal hemorrhage
What is the expected ABG of a pulmonary embolism?
Tachypnea and tachycardia--> respiratory alkalosis
A client is brought to the emergency department following a motor vehicle
accident. Initial assessment reveals that the client is unconscious with a blood
pressure of 165/73 mmHg, HR 50 bpm, RR 8 and irregular, temperature of 103 F.
What do you suspect is happening?
The findings reveal Cushing's Triad (hypertension with widening pulse pressure,
bradycardia and bradypnea); this indicates increased ICP
Symptoms of Right Ventricular Hypertrophy
fatigue, swelling, weakness, chest pain, SOB, dizziness
The nurse is caring for a client who is being weaned from mechanical ventilation.
Which assessment finding indicates that the client is ready to the the
endotracheal tube removed?
- pulse ox: 98% with a T piece
- evidence of reversal of the underlying cause of respiratory failure
-PEEP <8 and FiO2 <0.50
- hemodynamic stability
- ability to initiate an inspiratory effort.
A client with ARDS was endotracheally intubated and transferred to the ICU 12
hours ago. Upon assessment, the nurse notes bilateral rales and diminished
WITH COMPLETE SOLUTIONS VERIFIED GRADED A+
A client recovering from a percutaneous coronary intervention (PCI) after an
acute myocardial infarction is being transferred from the PACU to the Cardiac
ICU. Which assessment finding should the PACU nurse inform the healthcare
provider of immediately?
a. onset of chest pain
b. need to apply pressure dressing
c. presence of occasional PVCs
d. absence of any urinary output during PACU stay
a. onset of chest pain
This suggests the onset of another MI and reocclusion of a vessel.
What is the preferred treatment of an acute MI within 12 hours of symptom onset?
PCI; places a stent in the affected coronary artery
How often must a PCI pressure dressing site be assessed?
q30min for 4 hours
qh thereafter
Central Venous Pressure (CVP)
the pressure of blood in the thoracic vena cava, near the right atrium of the heart;
reflects the amount of blood returning to the heart and the ability of the heart to pump
the blood into the arterial system; normal is 2-6 mmHg
Sensitivity of a pacemaker
pacing devices ability to detect what electrical activity is being generated by the patient's
heart to prevent any competition between the hearts intrinsic activity
Contrast Induced Nephropathy (CIN)
A sudden deterioration in renal function that is caused by intravascular administration of
iodinated contrast medium; typically seen with angiplasty/angiography
, Signs of tension pneumothorax
1. affected side will have decreased or absent lung sounds
2. cyanosis
3. Tracheal deviation (late sign)
4. distended neck veins
5. tachycardia, tachypnea
Pneumatic Antishock Garment
An inflatable device that covers the legs and abdomen; used to splint the lower
extremities or pelvis, or to control bleeding in the lower extremities or pelvis.
- used for intraperitoneal hemorrhage
What is the expected ABG of a pulmonary embolism?
Tachypnea and tachycardia--> respiratory alkalosis
A client is brought to the emergency department following a motor vehicle
accident. Initial assessment reveals that the client is unconscious with a blood
pressure of 165/73 mmHg, HR 50 bpm, RR 8 and irregular, temperature of 103 F.
What do you suspect is happening?
The findings reveal Cushing's Triad (hypertension with widening pulse pressure,
bradycardia and bradypnea); this indicates increased ICP
Symptoms of Right Ventricular Hypertrophy
fatigue, swelling, weakness, chest pain, SOB, dizziness
The nurse is caring for a client who is being weaned from mechanical ventilation.
Which assessment finding indicates that the client is ready to the the
endotracheal tube removed?
- pulse ox: 98% with a T piece
- evidence of reversal of the underlying cause of respiratory failure
-PEEP <8 and FiO2 <0.50
- hemodynamic stability
- ability to initiate an inspiratory effort.
A client with ARDS was endotracheally intubated and transferred to the ICU 12
hours ago. Upon assessment, the nurse notes bilateral rales and diminished
