HESI Critical Care Comprehensive Exam Questions and Answers with Rationales Latest 2022 – 2023 ADDED POSSIBLE QUESTIONS 

2022 HESI Critical Care Exam Comprehensive

1.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.

C. Don a clean gown for client care.

D. Place an isolation cart in the hallway.

RATIONALE:

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.

2.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.

RATIONALE:

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.

3.The nurse is assessing a client and identifies a bruit over the thyroid. This finding is consistent

with which interpretation?

A. Hypothyroidism.

B. Thyroid cyst.

C. Thyroid cancer.

D. Hyperthyroidism.

RATIONALE:

Hyperthyroidism (D) is an enlargement of the thyroid gland, often referred to as a goiter, and a

bruit may be auscultated over the goiter due to an increase in glandular vascularity which

increases as the thyroid gland becomes hyperactive. A bruit is not common with (A, B, and C).

4.A 6-year-old child is alert but quiet when brought to the emergency center with periorbital

ecchymosis and ecchymosis behind the ears. The nurse suspects potential child abuse and

continues to assess the child for additional manifestations of a basilar skull fracture. What

assessment finding would be consistent with a basilar skull fracture?

A. Hematemesis and abdominal distention.

PRIMEXAM

B. Asymmetry of the face and eye movements.

C. Rhinorrhoea or otorrhoea with Halo sign.

D. Abnormal position and movement of the arm.

RATIONALE:

Raccoon eyes (periorbital ecchymosis) and Battle's sign (ecchymosis behind the ear over the

mastoid process) are both signs of a basilar skull fracture, so the nurse should assess for possible

meningeal tears that manifest as a Halo sign with CSF leakage from the ears or nose (D). (A) is

consistent with orbital fractures. (B) occurs with wrenching traumas of the shoulder or arm

fractures. (C) occurs with blunt abdominal injuries.

5.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.

B. Multiple sclerosis.

C. Addison's disease.

D. Cushing syndrome.

RATIONALE:

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.

6.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.

D. Astigmatism on the right.