Comprehensive HESI
Review Exit exam
2000 questions and
100% correct
answers
,Comprehensive HESI Review Exit exam 2000 questions and 100% correct answers
Acute Respiratory Distress Syndrome (ARDS) - correct answer The exchange of oxygen for
carbon dioxide in the lungs is inadequate for oxygen consumption and carbon dioxide
production within the body's cells
Characteristics of ARDS - correct answer Hypoxemia that persists even when 100% oxygen is
given; decreased pulmonary compliance; dyspnea; non-cardiac associated bilateral pulmonary
edema; dense pulmonary infiltrates on X-ray
ARDS - correct answer No abnormal breath sounds are present in this disorder on auscultation
because the edema occurs first in the interstitial spaces and not the airways.
ARDS - correct answer Unexpected, catastrophic pulmonary complication occurring in a person
with no pervious pulmonary problems.
ARDS - correct answer Common laboratory finding is a lowered pO2; not responsive to high
concentrations of oxygen and often need intubation and mechanical ventilation with PEEP
PEEP Positive end-expiratory pressure - correct answer The instillation and maintenance of
small amounts of air into the alveolar sacs to prevent then from collapsing each time the client
exhales; amount of pressure can be set and is usually around 5-10cm of water
Nursing Assessment of ARDS - correct answer Dyspnea, hyperpnea; intercostals retractions;
cyanosis, pallor; hypoxemia; diffuse pulmonary infiltrates seen on chest radiograph as "white-
out" appearance; verbalized anxiety, restlessness
Hypoxemia - correct answer PO2 < 50mmHg with FiO2 >60%
Common causes of respiratory failure - correct answer COPD; pneumonia; tuberculosis;
contusion; aspiration; inhaled toxins' emboli; drug OD; fluid overload; DIC; shock
Suction - correct answer When providing care to a patient with ARDS, only do this when
secretions are present
7.35-7.45 - correct answer PH normal value
35-45 mmH - correct answer PCO2 normal value
22-26 mEq - correct answer HCO3 normal value
80-100mm - correct answer PO2 normal value
95-100% - correct answer O2 normal value
Allen Test - correct answer Perform this test before drawing an ABG from the radial artery
,Comprehensive HESI Review Exit exam 2000 questions and 100% correct answers
Common cause of respiratory failure in children - correct answer Congenital heart disease;
respiratory distress syndrome; infection, sepsis; neuromuscular diseases; trauma and burns;
aspiration; fluid overload and dehydration; anesthesia and narcotic OD
Nursing assessment of child in respiratory failure - correct answer Kid just "looks bad;" very
slow or very rapid RR, dyspnea, apnea, gasping; tachycardia; cyanosis, pallor, or mottled color;
irritability and lethargy; retractions, nasal flaring, poor air movement; hypoxemia, hypercapnia,
respiratory acidosis
Respiratory Failure - correct answer PCO2 > 45 or PO2 < 60 on 50% O2; a child in severe distress
should be on 100% O2
Shock - correct answer Widespread, serious reduction of tissue perfusion which, if prolonged,
leads to generalized impairment of cellular functioning
System Hypotension - correct answer Marked reduction in either cardiac output or peripheral
vasomotor tone, without a compensatory elevation in the other results in this
Early signs of shock - correct answer Agitation and restlessness that results from cerebral
hypoxia
Hypovolemic Shock - correct answer Related to external or internal blood or fluid loss
Cardiogenic Shock - correct answer Related to ischemia or impairment in tissue perfusion
resulting from MI, serious arrhythmia, or HF; all cause decrease CO
Vasogenic Shock - correct answer Related to allergens, spinal cord injury, or peripheral
neuropathies, all resulting in venous pooling and decreased blood return to the heart, which
decreases cardiac output over time
Septic Shock - correct answer Related to endotoxins released by bacteria, which cause vascular
pooling, diminished venous return, and reduced CO
High fowler position with legs down - correct answer Position to reduce venous return in order
to decrease further venous return to the left ventricle
Medical treatment for shock - correct answer Rapid infusion of volume-expanding fluids such as
whole blood, plasma, plasma substitutes; isotonic, electrolyte IV solutions; CVP artery
catheters; CVP measurements, urine output, HR, clinical and mental state; immediate
attendtion to improvement of perfusion; administration of drugs is withheld until circulating
volume has been restores; O2 administration
Pulmonary edema - correct answer If shock is cardiogenic in nature, the infusion of volume-
expanding fluids may result in this
, Comprehensive HESI Review Exit exam 2000 questions and 100% correct answers
Cardiac Function - correct answer When treating a patient with shock, the restoration of what
should take priority
Increase Cardiac Contractility - correct answer Administration of cardiotonic drugs such as
digitalis does what?
Dopamine and digitalis - correct answer Increases the contractility
Dopamine (Dopram) and norepinephrine (Levophed) - correct answer Vaso-constricting agents
that may be used in cardiogenic shock
Nursing Assessment of patient in shock - correct answer Tachycardia, tachypnea, decrease in
BP (systolic <80mmHg) ; mental status changes; cool, clammy skin; diaphoresis, paleness; urine
output decreases; CVP <4cm of H2O; urine SG >1.020
Hypovolemia - correct answer Urine SG >1.020 indicates?
Early shock mental status changes - correct answer Restless, hyper-alert
Late shock mental status changes - correct answer Decreased alertness, lethargy, coma
Patient in shock - correct answer Maintain a urine output of at least 30ml/hr and notify health
care provider if it drops below this
CVP - correct answer Administer prescribed fluids until designated ?? is reached in patients
with shock
CVP - correct answer When a patient is in shock, this number is usually elevated to 16-19 cm of
H2O as compensation for decreased cardiac output
Patient in shock - correct answer Place this patient in Trendelenburg position (feet up 45
degrees, head flat
IM or Subcutaneous route - correct answer Do not administer medications via these routes to a
patient in shock until perfusion improves to the muscles and subcutaneous tissues
Vasopressors or adrenergic stimulants - correct answer When administering these medications
to a patient in shock, they must be administered via a volume-controlled pump; monitor BP q 5-
15 min; watch IV site carefully for extravasation and tissue damage; ask about the target mean
systolic BP
Vasopressors or adrenergic stimulants used in shock patients - correct answer Epinephrine
(Bronkaid). Dopamine (Dopram), Dobutamine (Dobutrex), norepinephrine (Levophed),
isoproterenol (Isuprel)
