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CRITICAL CARE (HESI) EXAM QUESTIONS AND ANSWERS RATED A.
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CRITICAL CARE (HESI) EXAM QUESTIONS AND ANSWERS RATED A.
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CRITICAL CARE (HESI) EXAM QUESTIONSAND ANSWERS RATED A.
A nurse whose tuberculosis (TB ) skin test result reveals an 8 mm induration
obtains a negative chest radiograph, which indicates latent tuberculosis.
The employee-health nurse should implement which intervention for this
nurse?
A. Recommend the bacille Calmette-Guérin (BCG) vaccine.
B. Administer isoniazid (INH) daily for 6 to 9 months.
C. Repeat the skin test and chest radiograph in three weeks.
D. Give combination therapy of antitubercular drugs for 6 months.
Verified Answer -B. Administer isoniazid (INH) daily for 6 to 9 months.
RATIONALE:
Latent TB infection (LTBI) occurs when an individual becomes infected with
Mycobacterium
tuberculosis but does not become acutely ill, so isoniazid (INH) drug
therapy once daily for 6 to
9 months (B) should be implemented to prevent transmission and the
development of clinical
disease. The nurse is infected and should be treated, not retested (A).
Combination therapy (C) is
the recommended treatment for active TB. Vaccination (D) is not indicated
with infection
Prior to a cardiac catheterization, which activity should the nurse have the
client practice?
,A. Remain motionless for 5 minutes.
B. Flexing hips and knees bilaterally.
C. Valsalva's maneuver and coughing.
D. Talking while walking on a treadmill
Verified Answer -C. Valsalva's maneuver and coughing.
RATIONALE:
Before the cardiac catheterization, the client should practice techniques
(e.g., Valsalva's
maneuver, coughing, deep breathing) that will be used during the procedure
(B). The client
should keep the leg straight, not (A), for the prescribed number of hours post
cardiac
catheterization to prevent bleeding from the arterial access site. (C) is not
used in this procedure.
The client may be asked to change position during the procedure, so (D) is
not necessary.
A client who is one week postoperative after an aortic valve replacement
suddenly develops severe pain in the left leg. On assessment, the nurse
determines that the client's leg is pale and
cool, and no pulses are palpable in the left leg. After notifying the
healthcare provider, which action should the nurse take?
A. Keep the client in bed in the supine position.
B. Apply firm pressure to the femoral artery.
C. Encourage the client to exercise the leg.
,D. Elevate the legs and medicate for pain.
Verified Answer -A. Keep the client in bed in the supine position.
RATIONALE:
A common postoperative complication after valve replacement is arterial
occlusion from a clot,
which requires anticoagulant therapy to prevent further enlargement of the
thrombus and reduce
the risk of embolization. Recently formed thrombi can also be effectively
treated with an
intraarterial infusion of a thrombolytic agent, followed by bed rest (C) and
periodic angiography
to monitor the dissolution of the clot. (A, B, and D) are contraindicated due
to the risk of
vascular occlusion and embolization.
The nurse is caring for a client who is one day postoperative after a left total
knee arthroplasty (TKA). Which intervention should the nurse include in the
plan of care?
A. Immobilization of the left knee to prevent dislocation.
B. Progressive leg exercises to obtain 90-degree flexion.
C. Ambulation with full weight-bearing on first postop day.
D. Bed rest for three days with the left knee extended.
Verified Answer -B. Progressive leg exercises to obtain 90-degree flexion.
RATIONALE:
Isometric quadriceps setting begins the first day after TKA surgery and
progresses to straight-leg
, raises, then gentle ROM to increase muscle strength until 90-degree knee
flexion is obtained (A).
Bed rest and immobilization is contraindicated to prevent scar tissue, which
limits mobility (C).
Active flexion exercises through the use of a continuous passive motion
(CPM) machine
postoperatively promotes joint mobility. Postoperative exercise progresses
to full weight-bearing
before discharge, but not the first postoperative day (B). Joint mobility is a
priority outcome, and
dislocation is not typical with TKA (D).
A client with chronic osteomyelitis is scheduled for surgery to treat the
infection which has not responded to three months of intravenous antibiotic
therapy. The client asks the nurse why
surgery is necessary. Which is the best response for the nurse to provide?
A. The infection has walled off into an area of infected bone creating a
barrier to antibiotics.
B. The dead bone needs to be removed to provide a blood supply for new
bone growth.
C. If the infected dead bone is not removed, it will make a path to the skin
and drain pus.
D. The infection is caused by a mutated bacteria that is resistant to most
antibiotics.
Verified Answer -A. The infection has walled off into an area of infected bone
creating a barrier to
antibiotics.
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