Fundamentals HESI (no meds)

Question 1

What is acute cellulitis?

Answer 1

skin infection of the DERMIS and HYPODERMIS

Question 2

What characteristics are associated with psoriasis?

Answer 2

silvery-white scales

Question 3

How is Shingles diagnosed?

Answer 3

lesion culture

Question 4

What will the nurse find on a hand with frostbite?

Answer 4

white/blue skin that is INSENSITIVE TO TOUCH

Question 5

What is the most reliable assessment for cardiac output and tissue perfusion?

Answer 5

urine output

Question 6

Describe the Rule of Nines?

Answer 6

used to estimated burn percentage

4. 5% anterior head (face)
5. 5% posterior head

18% anterior torso
18% posterior torso

4. 5% anterior arm
5. 5% posterior arm

9% anterior leg
9% posterior leg

1% perineum

Question 7

What is the expected adult urine output?

Answer 7

30-50 mL/hour

Question 8

By which route should a burn victim recieve their pain medication?

Answer 8

IV (they should be NPO since the digestive system will be effed)

Question 9

Who is NOT allowed to care for a client with herpes zoster?

Answer 9

• a nurse who never had chickenpox

- a nurse who never received the varicella-zoster vaccine

Question 10

Where are the legs if they are in a “dependent” position?

Answer 10

dangling off the bed - the venous blood flow is now “dependent” on the heart’s workload rather than passive flow

Question 11

What position should a patient with a grafted burn on the right knee be in?

Answer 11

the affected leg should be immobilized for 3-7 days b/c the graft crosses a joint

Question 12

What is the “normal” level of carbon monoxide in the body?

Answer 12

1% - 10%

Question 13

Most common sites of cancer metastasis?

Answer 13

lungs
liver
brain
bones

Question 14

Where do multiple myeloma cells proliferate?

Answer 14

the bones

Question 15

What is a Billroth procedure?

Answer 15

a partial gastrectomy

Question 16

What organ does a Whipple procedure involve? What levels should be monitored?

Answer 16

pancreas

blood glucose

Question 17

What needs to be monitored after a TURP procedure?

Answer 17

transurethral resection of the prostate

hyponatremia

Question 18

What is a normal platelet count?

Answer 18

150,000 - 450,000

Question 19

What is the priority complication for a patient with multiple myelomas? Tx?

Answer 19

HYPERcalcemia

tx with hydration

Question 20

How long can one healthcare provider stay in a patient’s room if the patient has an internal radiation implant?

Answer 20

30 minutes

• NO pregnant women
• NO person younger than 16

Question 21

A post-operative client is being switched from NPO to a clear liquid diet on the basis that _________.

Answer 21

peristalsis has resumed (check bowel sounds)

Question 22

What is a hallmark sign of LATE ovarian cancer?

Answer 22

abdominal distention

Question 23

A nurse notes bloody drainage from the nasogastric tube of a client immediately following a gastrectomy, what is the nurse’s most appropriate action?

Answer 23

continue to monitor

bleeding is normal for the first 24 hours following this surgery

Question 24

When should a urinary stoma bag be changed?

Answer 24

when it is 1/3 full

Question 25

What is an early sign of superior vena cava syndrome - an oncological emergency?

Answer 25

face edema

Question 26

When should a breast self-exam be conducted?

Answer 26

monthly - 7 days after the onset of menstruation

Question 27

What electrolyte imbalance and hallmark symptom is associated with hyperparathyroidism?

Answer 27

HYPERcalcemia Polyuria

Question 28

What is a pheochromocytoma?

Answer 28

an adrenal tumor causes the oversecretion of catecholamines (HTN, H/A)

Question 29

Murphey's sign is indicative of:

Answer 29

cholecystitis

Question 30

What are two signs indicative of pancreatitis?

Answer 30

Cullen's - discoloration of the abdomen and umbilical area Turner's - blue discoloration of the flanks

Question 31

What indicates the patency of a cardiac fistula/graft?

Answer 31

a thrill a bruit notify HCP is a thrill/bruit is ABSENT

Question 32

Where does bladder pain radiate to?

Answer 32

the shoulder

Question 33

Which test differentiates between a myasthenic crisis and a cholinergic crisis? What should you have during the test?

Answer 33

Tensilon Test - have atropine available if strength improves - myasthenic - give more meds if more weakness - cholinergic - give antidote (atropine)

Question 34

What is autonomic dysreflexia? What causes it?

Answer 34

catecholamine release in response to bowel, bladder or skin irritation (sitting on a needle, distended bladder) occurs in spinal injuries above T6 - patient can't feel anything below the waist and the body is screaming for help

Question 35

What is the limbic system responsible for?

Answer 35

feelings and emotions "feeling in limbo"

Question 36

Allergies to which foods may put a patient at risk for latex allergy?

Answer 36

``` banana avocado pineapple grapes hazelnuts ```

Question 37

How should a nurse take a documented spiritual history?

Answer 37

FICA Faith Importance Community Address in care - as a nurse

Question 38

What is Digoxin used to treat?

Answer 38

A-fib

Question 39

Side effects of TB drugs; Rifampin, INH, ETM

Answer 39

Rifampin - reduces effectiveness of BC, stains secretions orange (no contacts) INH - increases phenytoin levels ETM - check vision before starting therapy

Question 40

What is not used after a part of the lung is removed?

Answer 40

a chest tube - they want the remaining space to fill with fluid so the other organs do not shift

Question 41

What is the priority nursing action for a chest tube that falls out?

Answer 41

tape the hole on three sides with gauze

Question 42

What does the nurse do if a chest tube becomes disconnected?

Answer 42

do NOT clamp! place the end in sterile water until a new tube can be connected

Question 43

What electrolyte imbalance is common after a thyroidectomy?

Answer 43

hypocalcemia