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HESI CRITICAL CARE EXAM 202 5 |
HESI CRITICAL CARE EXAM
LATEST UPDATE 2025
QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES A
GRADED
- A client with asthma receives a prescription for high blood pressure during a clinic visit. Which prescription should the nurse anticipate the client to receive that is least likely to exacerbate asthma? A. Carteolol (Ocupress). B. Propranolol hydrochloride (Inderal). C. Pindolol (Visken). Incorrect D. Metoprolol tartrate (Lopressor). Correct The best antihypertensive agent for clients with asthma is metoprolol (Lopressor) (C), a beta blocking agent which is also cardioselective and less likely to cause bronchoconstriction. Pindolol (A) is a beta2 blocker that can cause bronchoconstriction and increase asthmatic symptoms. Although carteolol (B) is a beta blocking agent and an effective antihypertensive agent used in managing angina, it can increase a client's risk for bronchoconstriction due to its nonselective beta blocker action. Propranolol (D) also blocks the beta2 receptors in the lungs, causing bronchoconstriction, and is not indicated in clients with asthma and other obstructive pulmonary disorders.
- A male client who has been taking propranolol (Inderal) for 18 months tells the nurse that the healthcare provider discontinued the medication because his blood pressure has been normal for
a cholecystectomy. The client asks the nurse to explain the reason for the prescribed medication. What response is best for the nurse to provide? A. Provide a more rapid induction of anesthesia. B. Induce relaxation before induction of anesthesia. C. Decrease the risk of bradycardia during surgery. Correct D. Minimize the amount of analgesia needed postoperatively. Atropine may be prescribed preoperatively to increase the automaticity of the sinoatrial node and prevent a dangerous reduction in heart rate (B) during surgical anesthesia. (A, C and D) do not address the therapeutic action of atropine use perioperatively.
- ID: 6974876286 An 80-year-old client is given morphine sulphate for postoperative pain. Which concomitant medication should the nurse question that poses a potential development of urinary retention in this geriatric client? A. Antacids. B. Tricyclic antidepressants. Correct C. Nonsteroidal antiinflammatory agents. D. Insulin. Drugs with anticholinergic properties, such as tricyclic antidepressants (C), can exacerbate urinary retention associated with opioids in the older client. Although tricyclic antidepressants and antihistamines with opioids can exacerbate urinary retention, the concurrent use of (A and B) with opioids do not. Nonsteroidal antiinflammatory agents (D) can increase the risk for bleeding, but do not increase urinary retention with opioids (D).
- ID: 6974873559
A client with osteoarthritis is given a new prescription for a nonsteroidal antiinflammatory drug (NSAID). The client asks the nurse, "How is this medication different from the acetaminophen I have been taking?" Which information about the therapeutic action of NSAIDs should the nurse provide? A. Are less expensive. B. Provide antiinflammatory response. Correct C. Increase hepatotoxic side effects. D. Cause gastrointestinal bleeding. Nonsteroidal antiinflammatory drugs (NSAIDs) have antiinflammatory properties (B), which relieves pain associated with osteoarthritis and differs from acetaminophen, a non-narcotic analgesic and antipyretic. (A) does not teach the client about the medication's actions. Although NSAIDs are irritating to the gastrointestinal (GI) system and can cause GI bleeding (C), instructions to take with food in the stomach to manage this as an expected side effect should be included, but this does not answer the client's question. Acetaminophen is potentially hepatotoxic (D) , not NSAIDs.
- ID: 6974876262 A client with cancer has a history of alcohol abuse and is taking acetaminophen (Tylenol) for pain. Which organ function is most important for the nurse to monitor? A. Cardiorespiratory. B. Liver. Correct C. Sensory. D. Kidney.
A. One chronic and one acute illness. Correct B. Two acute illnesses. C. One acute and one infectious illness. Incorrect D. Two chronic illnesses. The plan of care should include goals that are specific for chronic and acute illnesses. Adult- onset diabetes is a life-long chronic disease, whereas influenza is an acute illness with a short term duration (C). (A, B, and D) do not include the correct duration categories for this situation.
- ID: 6974877914 Following an emergency Cesarean delivery, the nurse encourages the new mother to breastfeed her newborn. The client asks why she should breastfeed now. Which information should the nurse provide? A. Stimulate contraction of the uterus. Correct B. Initiate the lactation process. C. Facilitate maternal-infant bonding. D. Prevent neonatal hypoglycemia. When the infant suckles at the breast, oxytocin is released by the posterior pituitary to stimulates the "letdown" reflex, which causes the release of colostrum, and contracts the uterus (C) to prevent uterine hemorrhage. (A and B) do not support the client's need in the immediate period after the emergency delivery. Although maternal-newborn bonding (D) is facilitated by early breastfeeding, the priority is uterine contraction stimulation.
- ID: 6974875104
Which intervention should the nurse include in the plan of care for a female client with severe postpartum depression who is admitted to the inpatient psychiatric unit? A. Restrict visitors who irritate the client. B. Full rooming-in for the infant and mother. C. Supervised and guided visits with infant. Correct D. Daily visits with her significant other. Structured visits (C) provide an opportunity for the mother and infant to bond and should be facilitated and encouraged according to the client's pace of progress. (A) is unrealistic and may not be safe for the baby or the client. (B) is an unrealistic expectation. Although daily visits may provide support, the significant other may not be able to be there every day (D) based on other family responsibilities.
- ID: 6974873535 A 16-year-old male client is admitted to the hospital after falling off a bike and sustaining a fractured bone. The healthcare provider explains the surgery needed to immobilize the fracture. Which action should be implemented to obtain a valid informed consent? A. Obtain the permission of the custodial parent for the surgery. Correct B. Notify the non-custodial parent to also sign a consent form. C. Instruct the client sign the consent before giving medications. D. Obtain the signature of the client’s stepfather for the surgery. Incorrect The client is a minor and cannot legally sign his own consent unless he is an emancipated minor, so the consent should be obtained from the guardian for this client, which is the custodial parent (B). (A) is not a legal option. A stepparent is not a legal guardian for a minor unless the child has
Short-term goals should be realistic and attainable and should have a timeline of 7 to 10 days before discharge. (A) meets those criteria. (B) is nurse-oriented. (C) may be beyond the capabilities of a confused client. (D) is a long-term goal.
- ID: 6974873569 A male client is angry and is leaving the hospital against medical advice (AMA). The client demands to take his chart with him and states the chart is "his" and he doesn' t want any more contact with the hospital. How should the nurse respond? A. This hospital does not need to keep it if you are leaving and not returning here. B. Because you are leaving against medical advice, you may not have your chart. C. The information in your chart is confidential and cannot leave this facility legally. D. The chart is the property of the hospital but I will see that a copy is made for you. Correct The chart is the property of the facility, but the client has a legal right to the information in it, even if he is leaving AMA, so a copy of the record (D) should be provided. The client does not lose his legal rights to his medical record if he leaves AMA (A). The medical record is confidential, but the hospital protects the client's privacy by not allowing unauthorized access to the record, so the hospital may provide the client with a copy (B). The hospital must maintain records of the care provided and should not release the original record (C).
- ID: 6974877906
The nurse manager is assisting a nurse with improving organizational skills and time management. Which nursing activity is the priority in pre-planning a schedule for selected nursing activities in the daily assignment? A. Tracheostomy tube suctioning. Incorrect B. Medication administration. Correct C. Colostomy care instruction. D. Client personal hygiene. In developing organizational skills, medication administration is based on a prescribed schedule that is time-sensitive in the delivery of nursing care and should be the priority in scheduling nursing activities in a daily assignment. Although suctioning a client's tracheostomy takes precedence in providing care, the client's PRN need is less amenable to a preselected schedule. (B and C) can be scheduled around time-sensitive delivery of care.
- ID: 6974876220 What nursing delivery of care provides the nurse to plan and direct care of a group of clients over a 24-hour period? A. Case management. B. Team nursing. Incorrect C. Primary nursing. Correct D. Functional nursing. Primary nursing (B) is a model of delivery of care where a nurse is accountable for planning care for clients around the clock. Functional nursing (D) is a care delivery model that provides client care by assignment of functions or tasks. Team nursing (A) is a care delivery model where
C. Drinks 240 mL of fluid five times during the shift. Correct D. Voids at least 1000 mL between 7 am and 3 pm. The nurse should evaluate the client's outcome by observing the client's performance of each expected behavior, so drinking 240 mL of fluid five or six times during the shift (D) indicates a fluid intake of 1200 to 1440 mL, which meets the objective of at least 1000 mL during the designated period. (A) uses the term "adequate," which is not quantified. (B) is not the objective, which establishes an intake of at least 1000 mL. (C) is not an evaluation of the specific fluid intake.
- ID: 6974873553 The nurse plans a teaching session with a client but postpones the planned session based on which nursing problem? A. Knowledge deficit regarding impending surgery. B. Ineffective management of treatment regimen. C. Activity intolerance related to postoperative pain. Correct D. Noncompliance with prescribed exercise plan. Pain, fatigue, or anxiety can interfere with the ability to pay attention and participate in learning, so the nursing diagnosis in (A) indicates a need to postpone teaching. (B, C, and D) indicate a need for instruction.
- ID: 6974875106 A client who has active tuberculosis (TB) is admitted to the medical unit. What action is most important for the nurse to implement?
A. Fit the client with a respirator mask. B. Assign the client to a negative air-flow room. Correct C. Don a clean gown for client care. D. Place an isolation cart in the hallway. Active tuberculosis requires implementation of airborne precautions, so the client should be assigned to a negative pressure air-flow room (D). Although (A and C) should be implemented for clients in isolation with contact precautions, it is most important that air flow from the room is minimized when the client has TB. (B) should be implemented when the client leaves the isolation environment.
- ID: 6974873585 A client is receiving atenolol (Tenormin) 25 mg PO after a myocardial infarction. The nurse determines the client's apical pulse is 65 beats per minute. What action should the nurse implement next? A. Measure the blood pressure. B. Reassess the apical pulse. C. Notify the healthcare provider. D. Administer the medication. Correct Atenolol, a beta-blocker, blocks the beta receptors of the sinoatrial node to reduce the heart rate, so the medication should be administered (C) because the client's apical pulse is greater than 60. (A, B, and D) are not indicated at this time.
- ID: 6974875175
consistent with orbital fractures. (B) occurs with wrenching traumas of the shoulder or arm fractures. (C) occurs with blunt abdominal injuries.
- ID: 6974873555 The nurse is assessing a client who complains of weight loss, racing heart rate, and difficulty sleeping. The nurse determines the client has moist skin with fine hair, prominent eyes, lid retraction, and a staring expression. These findings are consistent with which disorder? A. Grave's disease. Correct B. Multiple sclerosis. C. Addison's disease. D. Cushing syndrome. This client is exhibiting symptoms associated with hyperthyroidism or Grave's disease (A), which is an autoimmune condition affecting the thyroid. (B, C, and D) are not associated with these symptoms.
- ID: 6974875146 The nurse is assessing an older client and determines that the client's left upper eyelid droops, covering more of the iris than the right eyelid. Which description should the nurse use to document this finding? A. A nystagmus on the left. B. Exophthalmos on the right. C. Ptosis on the left eyelid. Correct D. Astigmatism on the right.
Ptosis is the term to describe an eyelid droop that covers a large portion of the iris (A), which may result from oculomotor nerve or eyelid muscle disorder. (B) is characterized by rapid, rhythmic movement of both eyes. (C) is a distortion of the lens of the eye, causing decreased visual acuity. (D) is a term used to describe a protrusion of the eyeballs that occurs with hyperthyroidism.
- ID: 6974875126 The nurse is assessing a child's weight and height during a clinic visit prior to starting school. The nurse plots the child's weight on the growth chart and notes that the child's weight is in the 95th percentile for the child's height. What action should the nurse take? A. Question the type and quantity of foods eaten in a typical day. Correct B. Encourage giving two additional snacks each day to the child. C. Recommend a daily intake of at least four glasses of whole milk. D. Assess for signs of poor nutrition, such as a pale appearance. The child is overweight for height, so assessment of the child's daily diet (C) should be determined. The child does not need (A or B), both of which will increase the child's weight. Poor nutrition (D) is commonly seen in underweight children, not overweight.
- ID: 6974876202 A child is receiving maintainance intravenous (IV) fluids at the rate of 1000 mL for the first 10 kg of body weight, plus 50 mL/kg per day for each kilogram between 10 and 20. How many milliliters per hour should the nurse program the infusion pump for a child who weighs 19.5 kg? (Enter numeric value only. If rounding is required, round to the nearest whole number.)
The nurse is developing a teaching plan for an adolescent with a Milwaukee brace. Which instruction should the nurse include? A. Wear the brace over a T-shirt 23 hours per day. Correct B. Dress with the brace over regular clothing. C. Shower with the brace directly against the skin. D. Remove the brace just before going to bed. Idiopathic scoliosis is an abnormal lateral curvature of the spine in adolescent females. Early treatment uses a Milwaukee brace that places pressure against the lateral spinal curvature, under the neck, and against the iliac crest, so it should be worn for 23 hours per day over a T-shirt (D) which reduces friction and chafing of the skin. (A, B, and C) reduce the effectiveness of the brace.
- ID: 6974873594 A 9 - year-old is hospitalized for neutropenia and is placed in reverse isolation. The child asks the nurse, "Why do you have to wear a gown and mask when you are in my room?" How should the nurse respond? A. “To protect you because you can get an infection very easily.” Correct B. "Your condition could be spread to staff and other clients in the hospital.” C. “There are many forms of bacteria and germs in the hospital.” D. “After taking medication for 24 hours a gown and mask won't be needed.” Reverse isolation precaution implement measures to protect the client from exposure to microorganisms from others (B). Although microbes are prevalent in all environments, (A) does not adequately answer the child's question. Reverse isolation should be implemented until the
client's white blood cell increases (C). Neutropenia in this child does not place others (D) at risk for infection.
- ID: 6974876230 The nurse is giving discharge instructions to the parents of a newborn with a prescription for home phototherapy. Which statement by a parent indicates understanding of the phototherapy? A. “I should leave the baby under the light all of the time.” B. “I should dress the baby in light clothing when the baby is under the light.” C. “I need to change the baby’s position every four hours.” D. “I will keep the baby’s eyes covered when the baby is under the light.” Correct Neonatal jaundice is related to subcutaneous deposition of fat-soluble (indirect) bilirubin, which is converted to a water-soluble form when the skin is exposed to an ultraviolet light, so the infant's eyes should be protected (C) by closing the eyes and placing patches over them before placing the baby under the phototherapy light source. The baby's position should be changed about every two hours, not (A), so that the light reaches all areas of the body to promote conversion to a water-soluble form of bilirubin, which is excreted in the urine. The infant can be removed from the light for feedings and diaper changes, but should receive phototherapy exposure for 18 hours a day (B). The baby should be naked or dressed in only a diaper to expose as much skin as possible to the light (D).
- ID: 6974876242 A male client who had abdominal surgery has a nasogastric tube to suction, oxygen per nasal cannula, and complains of dry mouth. Which action should the nurse implement?
