Hesi

Question 1

Air precaution: PPE, diseases

Answer 1

N95, negative pressure room

Measles, chicken pox, rubeola, shingles, tuberculosis

Question 2

Contact precaution: PPE, diseases

Answer 2

Gloves and gown

MRSA, C diff, shingella, E. coli, Hep A and E, skin and wound infection, “resistance”

Question 3

Precaution for infectious diarrhea, C. diff, Rotavirus, Norovirus

Answer 3

Contact precaution (gloves and gown)

Wash hands with soap and water (no alcohol rub)

Question 4

Live vaccines

Answer 4

MMR, Varicella, Rotavirus, Intranasal influenza

Question 5

Donning steps

Answer 5

Gown, mask, goggles, gloves

Question 6

Doffing steps

Answer 6

Gloves, goggles, gown, mask

Question 7

Position after cardiac catheter

Answer 7

Leg straight for 2-6 hours
Prevent bleeding and promote circulation

Question 8

SIADH S/S, labs, treatment

Answer 8

Water retention

S/S; FVO, swelling, bloating, edema

Labs; low sodium, low HCT, high urine concentration

Treatment; fluid restriction, diuretics, 3% NS if Na < 120

Question 9

Diabetes Insipidus

Answer 9

Excessive water excretion

S/S; FVD, thirsty, polyuria, dehydration

Labs; high sodium, high HCT, diluted urine

Treatment; give fluid, desmopressin

Question 10

Addison’s disease S/S, labs, treatment

Answer 10

Not enough steroids

Addisonian crisis; severely low BP

S/S; tan brown skin, lethargic, anorexia, kidney malfunction, cardiac problems, immunocompromised, increased for infection

Labs; decreased BS, FVD, decreased Na, increased K

Treatment; give steroids, check BS

Question 11

Cushing’s disease S/S, labs, treatment

Answer 11

Too much steroids/aldosterone/cortisone

Pituitary tumor

S/S; buffalo hump, moon face, osteoporosis, wound won’t heal, extra hair growth, no periods, thin skin and bruising, immunocompromised, increased risk for infection

Labs; high BS, high Na, FVO, low K

Treatment; restrict fluid, prevent skin breakdown, check BS

Question 12

Hyperthyroidism (Grave’s Disease)

Answer 12

S/S; fast metabolism, all symptoms are high, exophthalmos, high T3 and T4, decreased TSH

Treatment; give propylthiouracil, Radioactive iodine, thyroidectomy

Question 13

Hypothyroidism S/S, treatment

Answer 13

S/S; all S/S is down, increased TSH

Treatment; get VS up, give levothyroxine at AM early

Question 14

Hyperparathyroidism S/S

Answer 14

Increased Ca, decreased phosphorus

S/S; hypercalcemia = constipation, n/v, kidney failure, weaken bones, lethargy, fatigue

Question 15

Hypoparathyroidism labs, S/S,

Answer 15

Decreased Ca, increased Phosphorus

S/S; hypocalcemia = Trousseau’s sign, Chvostek’s sign, tingling, numbness, seizures, cramps, abnormal heart beats

Question 16

DKA treatment

Answer 16

0.9 NS

Regular insulin

Add dextrose when BS between 250 - 300

Assess K

Question 17

Multiple Myeloma characteristics, risk for

Answer 17

Over production of calcium

Risk for hypercalcemia, bone fracture, high BUN and creatinine

Question 18

Ulcerative colitis diet

Answer 18

High protein and low residue

Avoid high fiber

Question 19

Polycythemia?

Answer 19

Increased RBC due to tissue hypoxia

Question 20

Bipolar manic state interventions

Answer 20

decrease stimuli, finger food, no activities that requires focus

Question 21

High pressure alarm ventilator meaning

Answer 21

Increased resistance

Question 22

Low pressure alarm ventilator meaning

Answer 22

Disconnection, need immediate attention

Question 23

ED Triag priority

Answer 23

Trauma, chest pain, respiratory destress, acute neuro

Question 24

Disaster Triag priority

Answer 24

Red > yellow > green > black

Question 25

Pneumothorax characteristics, S/S, treatment

Answer 25

Diminished/absent lung sounds on affected side Tracheal deviation to unaffected side Changes in LOC, decreased O2, increased HR, dyspnea Chest tube

Question 26

Intussusception stool characteristics

Answer 26

Currant jelly and olive shape

Question 27

Hirschsprung disease

Answer 27

Ribbon like stool Fail to pass meconium within 24 hours No stool first 24 - 48 hours

Question 28

DKA S/S

Answer 28

Hyperglycemia, dehydration, tachy, hypotension, polyuria, thirsty, lethargy, nausea, vomiting, metabolic acidosis, sweet/fruity breath, Kussmaul respiration (deep and rapid),

Question 29

Hypocalcemia S/S, EKG

Answer 29

Tetany (muscle spasm), Chvostek's sign (facial), Trousseau's sign (wrist), prolonged QT

Question 30

Hepatic Encephalopathy S/S, treatment

Answer 30

Asterixis (flapping tremor) Lactulose (help excrete ammonia)

Question 31

GBS S/S, treatment

Answer 31

Respiratory acidosis IV immunoglobulins, plasmapheresis

Question 32

Myasthenia Gravis cause, treatment

Answer 32

Not enough acetylcholine (muscle weakness = respiratory paralysis) Pyridostigmine, neostigmine

Question 33

V tach treatment

Answer 33

With pulse = stable V tach (amiodarone or synchronized cardioversion) No pulse = unstable V tach (CPR, defibrillator, epinephrine)

Question 34

Kawasaki disease S/S

Answer 34

Less than 5 years old Strawberry tongue

Question 35

Preeclampsia complication, treatment

Answer 35

HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) Bed rest and magnesium sulfate

Question 36

Warfarin antidote

Answer 36

Vit K

Question 37

Heparin antidote

Answer 37

Protamine sulfate

Question 38

Benzodiazepine antidote

Answer 38

Flumazenil

Question 39

Morphine antidote

Answer 39

Naloxone

Question 40

Acetaminophen antidote

Answer 40

N-Acetylcysteine

Question 41

Bradycardia treatment, causes

Answer 41

Atropine (only if patient has symptoms pale, cool, clammy) Vagal maneuver, CCB and Beta blockers

Question 42

V Fib EKG, treatment, causes

Answer 42

Squiggly line Defibrillation (not synchronized) before CPR and drugs Drugs; LAP (lidocaine, amiodarone, procainamide) Untreated V tach, post MI

Question 43

V Tach EKG, treatment, causes

Answer 43

WWWWW (tombstone pattern) Early Defib (apply pads>call out clear>shock) No pulse = Defib With pulse = Cardioversion Post MI, hypoxia, low K, low magnesium

Question 44

A Fib EKG, treatment, causes

Answer 44

No P wave, uneven QRS Cardioversion (after TTE clot check) Digoxin (check apical pulse 60 sec., toxicity max 2.0, potassium lower than 3.5) Anticoagulants Valvular disease, heart failure, pulmonary hypertension, COPD, after heart surgery

Question 45

A Flutter EKG, treatment, causes

Answer 45

Saw tooth pattern Cardioversion (after TTE clot check) Digoxin (check apical pulse 60 sec., toxicity max 2.0, potassium lower than 3.5) Anticoagulants Valvular disease, heart failure, pulmonary hypertension, COPD, after heart surgery

Question 46

Supraventricular Tach EKG, caused, treatment

Answer 46

NNNNNNN Super fast pattern Simulants, strenuous exercise, hypoxia, heart disease Vagal maneuver Adenosine (rapid push with flush NS, expect heart rate to stop) Cardioversion

Question 47

Torsades de Pointes EKG, causes, treatment

Answer 47

Tornado patterns Post MI, hypoxia, low magnesium Magnesium sulfate

Question 48

Asystole EKG, treatment

Answer 48

Flat line (dead) Epinephrine, atropine, CPR No Defib needed

Question 49

P wave =

Answer 49

Atrial rhythm

Question 50

QRS wave =

Answer 50

Ventricular rhythm

Question 51

Lack QRS complexes =

Answer 51

Asystole

Question 52

Wide QRS complexes =

Answer 52

V Tach

Question 53

Chaotic or unorganized waves =

Answer 53

Fibrillation

Question 54

Chaotic and no P waves =

Answer 54

A Fib

Question 55

Chaotic and no QRS complexes =

Answer 55

V Fib

Question 56

Bizarre rhythm with QRS complexes =

Answer 56

V Tach