HESI Trauma Care Practice Exam With Answers (129 Solved Questions)

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VERIFIEDHESI Critical Care Exam Questions with Answersand Rationales(CORRECT ANSWERS)1. A client with asthma receives a prescription for high blood pressure during a clinicvisit. Which prescription should the nurse anticipate the client to receive that is leastlikely to exacerbate asthma?A.Carteolol (Ocupress).B.Propranolol hydrochloride (Inderal).C.Pindolol (Visken).D.Metoprolol tartrate (Lopressor).CorrectThe best antihypertensive agent for clients with asthma is metoprolol (Lopressor) (C),a beta2 blocking agent which is also cardioselective and less likely to causebronchoconstriction. Pindolol (A) is a beta2 blocker that can causebronchoconstriction and increase asthmatic symptoms. Although carteolol (B) is abeta blocking agent and an effective antihypertensive agent used in managingangina, it can increase a client's risk for bronchoconstriction due to its nonselectivebeta blocker action. Propranolol (D) also blocks the beta2 receptors in the lungs,

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causing bronchoconstriction, and is not indicated in clients with asthma and otherobstructive pulmonary disorders.2. A male client who has been taking propranolol (Inderal) for 18 months tells thenurse that the healthcare provider discontinued the medication because his bloodpressure has been normal for the past three months. Which instruction should thenurse provide?A.Obtain another antihypertensive prescription to avoid withdrawal symptoms.B.Stop the medication and keep an accurate record of blood pressure.C.Report any uncomfortable symptoms after stopping the medication.D.Ask the healthcare provider about tapering the drug dose over the next week.CorrectAlthough the healthcare provider discontinued the propranolol, measures to preventrebound cardiac excitation, such as progressively reducing the dose over one to twoweeks (C), should be recommended to prevent rebound tachycardia, hypertension,and ventricular dysrhythmias. Abrupt cessation (A and B) of the beta-blocking agentmay precipitate tachycardia and rebound hypertension, so gradual weaning should berecommended. (D) is not indicated.

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3. A client who is taking clonidine (Catapres, Duraclon) reports drowsiness. Whichadditional assessment should the nurse make?A.Has the client experienced constipation recently?B.Did the client miss any doses of the medication?C.How long has the client been taking the medication?CorrectD.Does the client use any tobacco products?Drowsiness can occur in the early weeks of treatment with clonidine and withcontinued use becomes less intense, so the length of time the client has been on themedication (A) provides information to direct additional instruction. (B, C, and D) arenot relevant.4.ID: 6974873590The nurse is preparing to administer atropine, an anticholinergic, to a client who isscheduled for a cholecystectomy. The client asks the nurse to explain the reason forthe 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.CorrectD.Minimize the amount of analgesia needed postoperatively.

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Atropine may be prescribed preoperatively to increase the automaticity of thesinoatrial node and prevent a dangerous reduction in heart rate (B) during surgicalanesthesia. (A, C and D) do not address the therapeutic action of atropine useperioperatively.5.ID: 6974876286An 80-year-old client is given morphine sulphate for postoperative pain. Whichconcomitant medication should the nurse question that poses a potential developmentof urinary retention in this geriatric client?A.Antacids.B.Tricyclic antidepressants.CorrectC.Nonsteroidal antiinflammatory agents.D.Insulin.Drugs with anticholinergic properties, such as tricyclic antidepressants (C), canexacerbate urinary retention associated with opioids in the older client. Althoughtricyclic antidepressants and antihistamines with opioids can exacerbate urinaryretention, the concurrent use of (A and B) with opioids do not. Nonsteroidalantiinflammatory agents (D) can increase the risk for bleeding, but do not increaseurinary retention with opioids (D).

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6.ID: 6974873559A client with osteoarthritis is given a new prescription for a nonsteroidalantiinflammatory drug (NSAID). The client asks the nurse, "How is this medicationdifferent from the acetaminophen I have been taking?" Which information about thetherapeutic action of NSAIDs should the nurse provide?A.Are less expensive.B.Provide antiinflammatory response.CorrectC.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, anon-narcotic analgesic and antipyretic. (A) does not teach the client about themedication's actions. Although NSAIDs are irritating to the gastrointestinal (GI) systemand can cause GI bleeding (C), instructions to take with food in the stomach tomanage this as an expected side effect should be included, but this does not answerthe client's question. Acetaminophen is potentially hepatotoxic (D), not NSAIDs.7.ID: 6974876262

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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.CorrectC.Sensory.D.Kidney.Acetaminophen and alcohol are both metabolized in the liver. This places the client atrisk for hepatotoxicity, so monitoring liver (A) function is the most importantassessment because the combination of acetaminophen and alcohol, even inmoderate amounts, can cause potentially fatal liver damage. Other non-narcoticanalgesics, such as n onsteroidal anti-inflammatory drugs (NSAIDs), are more likelyto promote adverse renal effects (B). Acetaminophen does not place the client at riskfor toxic reactions related to (C or D).8.ID: 6974875110The nurse obtains a heart rate of 92 and a blood pressure of 110/76 prior toadministering a scheduled dose of verapamil (Calan) for a client with atrial flutter.Which action should the nurse implement?A.Give intravenous (IV) calcium gluconate.

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B.Withhold the drug and notify the healthcare provider.C.Administer the dose as prescribed.CorrectD.Recheck the vital signs in 30 minutes and then administer the dose.Verapamil slows sinoatrial (SA) nodal automaticity, delays atrioventricular (AV) nodalconduction, which slows the ventricular rate, and is used to treat atrial flutter, so (A)should be implemented, based on the client's heart rate and blood pressure. (B andC) are not indicated. (D) delays the administration of the scheduled dose.9.ID: 6974873583A client is admitted to the hospital with a diagnosis of Type 2 diabetes mellitus andinfluenza. Which categories of illness should the nurse develop goals for the client'splan of care?A.One chronic and one acute illness.CorrectB.Two acute illnesses.C.One acute and one infectious illness.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

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illness with a short term duration (C). (A, B, and D) do not include the correct durationcategories for this situation.10.ID: 6974877914Following an emergency Cesarean delivery, the nurse encourages the new mother tobreastfeed her newborn. The client asks why she should breastfeed now. Whichinformation should the nurse provide?A.Stimulate contraction of the uterus.CorrectB.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 tostimulates the "letdown" reflex, which causes the release of colostrum, and contractsthe uterus (C) to prevent uterine hemorrhage. (A and B) do not support the client'sneed in the immediate period after the emergency delivery. Although maternal-newborn bonding (D) is facilitated by early breastfeeding, the priority is uterinecontraction stimulation.11.ID: 6974875104

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Which intervention should the nurse include in the plan of care for a female client withsevere 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.CorrectD.Daily visits with her significant other.Structured visits (C) provide an opportunity for the mother and infant to bond andshould be facilitated and encouraged according to the client's pace of progress. (A) isunrealistic and may not be safe for the baby or the client. (B) is an unrealisticexpectation. Although daily visits may provide support, the significant other may notbe able to be there every day (D) based on other family responsibilities.12.ID: 6974873535A 16-year-old male client is admitted to the hospital after falling off a bike andsustaining a fractured bone. The healthcare provider explains the surgery needed toimmobilize the fracture. Which action should be implemented to obtain a validinformed consent?A.Obtain the permission of the custodial parent for the surgery.CorrectB.Notify the non-custodial parent to also sign a consent form.

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C.Instruct the client sign the consent before giving medications.D.Obtain the signature of the client’s stepfather for the surgery.The client is a minor and cannot legally sign his own consent unless he is anemancipated minor, so the consent should be obtained from the guardian for thisclient, which is the custodial parent (B). (A) is not a legal option. A stepparent is not alegal guardian for a minor unless the child has been adopted by the stepparent (C).The non-custodial parent does not need to co-sign this form (D).13.ID: 6974876258During a client assessment, the client says, "I can't walk very well." Which actionshould the nurse implement first?A.Predict the likelihood of the outcome.B.Consider alternatives.C.Choose the most successful approach.D.Identify the problem.CorrectThe sequential steps in problem-solving are to first identify the problem (B), thenconsider alternatives (C), consider outcomes of the alternatives (D), predict thelikelihood of the outcomes occurring, and choose the alternative with the best chanceof success (A).

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14.ID: 6974875112The nurse identifies a client's needs and formulates the nursing problem of,"Imbalanced nutrition: less than body requirements, related to mental impairment anddecreased intake, as evidenced by increasing confusion and weight loss of more than30 pounds over the last 6 months." Which short-term goal is best for this client?A.Verbalize understanding of plan and of intention to eat meals.B.Eat 50% of six small meals each day by the end of one week.CorrectC.Meals prepared during hospitalization will be fed by the nurse.D.Demonstrate progressive weight gain toward the ideal weight.Short-term goals should be realistic and attainable and should have a timeline of 7 to10 days before discharge. (A) meets those criteria. (B) is nurse-oriented. (C) may bebeyond the capabilities of a confused client. (D) is a long-term goal.15.ID: 6974873569A male client is angry and is leaving the hospital against medical advice (AMA). Theclient demands to take his chart with him and states the chart is "his" and he doesn' twant any more contact with the hospital. How should the nurse respond?

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A.This hospital does not need to keep it if you are leaving and notreturning here.B.Because you are leaving against medical advice, you may not haveyour chart.C.The information in your chart is confidential and cannot leave thisfacility legally.D.The chart is the property of the hospital but I will see that a copy ismade for you.CorrectThe chart is the property of the facility, but the client has a legal right to theinformation in it, even if he is leaving AMA, so a copy of the record (D) should beprovided. The client does not lose his legal rights to his medical record if he leavesAMA (A). The medical record is confidential, but the hospital protects the client'sprivacy by not allowing unauthorized access to the record, so the hospital mayprovide the client with a copy (B). The hospital must maintain records of the careprovided and should not release the original record (C).16.ID: 6974877906

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The nurse manager is assisting a nurse with improving organizational skills and timemanagement. Which nursing activity is the priority in pre-planning a schedule forselected nursing activities in the daily assignment?A.Tracheostomy tube suctioning.B.Medication administration.CorrectC.Colostomy care instruction.D.Client personal hygiene.In developing organizational skills, medication administration is based on a prescribedschedule that is time-sensitive in the delivery of nursing care and should be thepriority in scheduling nursing activities in a daily assignment. Although suctioning aclient's tracheostomy takes precedence in providing care, the client's PRN need isless amenable to a preselected schedule. (B and C) can be scheduled around time-sensitive delivery of care.17.ID: 6974876220What nursing delivery of care provides the nurse to plan and direct care of a group ofclients over a 24-hour period?A.Case management.B.Team nursing.

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C.Primary nursing.CorrectD.Functional nursing.Primary nursing (B) is a model of delivery of care where a nurse is accountable forplanning care for clients around the clock. Functional nursing (D) is a care deliverymodel that provides client care by assignment of functions or tasks. Team nursing (A)is a care delivery model where assignments to a group of clients are provided by amixed-staff team. Case management (C) is the delivery of care that uses acollaborative process of assessment, planning, facilitation, and advocacy for optionsand services to meet an individual's health needs and promote quality cost-effectiveoutcomes.18.ID: 6974876280Two unlicensed assistive personnel (UAP) are arguing on the unit about whodeserves to take a break first. What is the most important basic guideline that thenurse should follow in resolving the conflict?A.Require the UAPs to reach a compromise.B.Weigh the consequences of each possible solution.C.Encourage the two to view the humor of the conflict.D.Deal with issues and not personalities.Correct

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Dealing with the issues which are concrete, not personalities (A) which includeemotional reactions, is one of seven important key behaviors in managing conflict. (B,C, and D) do not resolve the conflict when diverse opinions are expressedemotionally.19.ID: 6974873531The nurse is caring for a client who is unable to void. The plan of care establishes anobjective for the client to ingest at least 1000 mL of fluid between 7:00 am and 3:30pm. Which client response should the nurse document that indicates a successfuloutcome?A.Demonstrates adequate fluid intake and output.B.Verbalizes abdominal comfort without pressure.C.Drinks 240 mL of fluid five times during the shift.CorrectD.Voids at least 1000 mL between 7 am and 3 pm.The nurse should evaluate the client's outcome by observing the client's performanceof 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 least1000 mL during the designated period. (A) uses the term "adequate," which is not

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