HESI – Critical Care Adult Health III
Access The Exact Questions for HESI – Critical Care Adult Health III
💯 100% Pass Rate guaranteed
🗓️ Unlock for 1 Month
Rated 4.8/5 from over 1000+ reviews
- Unlimited Exact Practice Test Questions
- Trusted By 200 Million Students and Professors
What’s Included:
- Unlock Actual Exam Questions and Answers for HESI – Critical Care Adult Health III on monthly basis
- Well-structured questions covering all topics, accompanied by organized images.
- Learn from mistakes with detailed answer explanations.
- Easy To understand explanations for all students.
Free HESI – Critical Care Adult Health III Questions
During insertion of a pulmonary artery catheter, which action is most important for the nurse to implement?
-
Don sterile gloves and hand instruments to the healthcare provider.
-
Assess the insertion site for hemorrhage.
-
Keep the family informed about the client’s condition.
-
Monitor the client for dysrhythmias.
Explanation
Correct Answer:
D. Monitor the client for dysrhythmias.
Explanation:
During pulmonary artery (PA) catheter insertion, the catheter passes through the right atrium and right ventricle before entering the pulmonary artery. As it moves through the heart chambers, it can irritate the myocardium and cause ventricular dysrhythmias, such as premature ventricular contractions (PVCs) or even ventricular tachycardia. Continuous ECG monitoring is essential to detect and respond immediately to these potentially life-threatening rhythm disturbances.
At the start of a new shift, the nurse receives laboratory results for a client who recently arrived in the emergency department:
Na⁺ 152 mEq/L, K⁺ 4.8 mEq/L, HCO₃⁻ 20 mmol/L, urea 84 mg/dL, creatinine 1.9 mg/dL, serum glucose 680 mg/dL, serum osmolality 334 mOsm/kg, urine negative for ketones. ABGs: normal. WBC count 18,000/µL, CRP 120 mg/L, ESR 70 mm/h.
What should the nurse expect when assessing this client?
-
Fruity, acetone breath.
-
Dry mucous membranes.
-
Pupils narrow and irresponsive to light.
-
Distended neck veins.
Explanation
Correct Answer:
B. Dry mucous membranes.
Explanation:
This client’s findings are consistent with Hyperosmolar Hyperglycemic State (HHS), a serious complication of type 2 diabetes mellitus.
Key indicators:
Severe hyperglycemia (glucose 680 mg/dL)
High serum osmolality (334 mOsm/kg)
Absence of ketones in urine and normal ABG values (no acidosis)
Elevated sodium, urea, and creatinine, indicating severe dehydration
Inflammatory markers (WBC, CRP, ESR) elevated due to stress or infection trigger.
Because of the severe dehydration caused by osmotic diuresis, the nurse should expect to find dry mucous membranes, poor skin turgor, tachycardia, and hypotension.
A client with a gunshot wound is brought to the emergency department (ED) with a bullet entry at the spinal level of C8 and T1. The client is able to move the upper arms. To further assess the client’s spinal nerve function, which action should the nurse implement?
-
Apply resistance while the client lifts the legs.
-
Check the urinary bladder for distention.
-
Ask the client to grasp an object or form a fist.
-
Determine patellar tendon reflex response.
Explanation
Correct Answer:
C. Ask the client to grasp an object or form a fist.
Explanation:
The C8 and T1 spinal nerves control fine motor movement and strength of the hands and fingers. By asking the client to grasp an object or form a fist, the nurse assesses motor function of these specific spinal levels. The ability (or inability) to flex the fingers and maintain grip strength provides critical information about the extent of neurological impairment below the level of injury.
The nurse is assessing a client and identifies a bruit over the thyroid. This finding is consistent with which interpretation?
-
Hypothyroidism
-
Thyroid cyst.
-
Thyroid cancer.
-
Hyperthyroidism
Explanation
Correct Answer:
D. Hyperthyroidism.
Explanation:
A thyroid bruit is a whooshing sound heard over the thyroid gland during auscultation, caused by increased blood flow through the gland. This finding is most commonly associated with hyperthyroidism, particularly Graves’ disease, where the thyroid becomes hypervascular due to overactivity.
In contrast, hypothyroidism results in a sluggish metabolism and does not increase glandular blood flow. Thyroid cysts and thyroid cancer typically present as nodules or masses but do not cause a bruit. Therefore, the presence of a thyroid bruit indicates increased thyroid activity and vascularity, consistent with hyperthyroidism.
The nurse observes that a client being treated for septic shock secondary to erysipelas has developed numerous small red dots on the extremities. What should the nurse do first to assist this client?
-
Immediately notify the healthcare provider that the client is allergic to the IV antibiotic.
-
Inspect the IV injection site and oral mucosa.
-
Elevate the client's legs to improve venous return.
-
Obtain an order for a lumbar puncture.
Explanation
Correct Answer:
B. Inspect the IV injection site and oral mucosa.
Explanation:
The appearance of numerous small red dots (petechiae) in a client with septic shock may indicate disseminated intravascular coagulation (DIC), a life-threatening complication where widespread microclotting leads to bleeding under the skin and mucous membranes. The nurse should first assess the extent of bleeding by inspecting the IV sites and oral mucosa for further petechiae or oozing, then promptly notify the healthcare provider.
This is not an allergic reaction (A) since petechiae are non-pruritic and non-blanching. Leg elevation (C) does not address the underlying coagulopathy. Lumbar puncture (D) is contraindicated in bleeding disorders due to the risk of hemorrhage.
A client, who is 4 hours postoperative laparotomy, has rapidly increasing abdominal distention with elevated pulse and respiratory rates. The client's skin is cool and pale, and there is no change in the blood pressure. Which intervention should the nurse implement immediately?
-
Prepare for nasogastric tube insertion.
-
Monitor the client's recent hemoglobin levels.
-
Measure the client's abdominal girth.
-
Notify the healthcare provider of the client's status.
Explanation
Correct Answer:
D. Notify the healthcare provider of the client's status.
Explanation:
The client’s rapidly increasing abdominal distention, tachycardia, tachypnea, and cool, pale skin are early signs of internal hemorrhage or postoperative bleeding that may progress to hypovolemic shock. Even though the blood pressure has not yet changed, compensatory mechanisms (increased heart and respiratory rates) indicate emerging circulatory compromise. The nurse should immediately notify the healthcare provider for urgent evaluation and possible surgical intervention. Delaying action could result in life-threatening shock.
The nurse identifies the collaborative problem of potential electrolyte imbalance in a client with acute pancreatitis. Which assessment finding should the nurse associate with an electrolyte imbalance related to acute pancreatitis?
-
Muscle twitching and digit numbness.
-
Hyperglycemia
-
Paralytic ileus and abdominal distention.
-
Hypotension
Explanation
Correct Answer:
A. Muscle twitching and digit numbness.
Explanation:
Clients with acute pancreatitis are at high risk for hypocalcemia, which occurs when calcium binds with fatty acids during fat necrosis (saponification) in the inflamed pancreas. Muscle twitching, numbness, tingling of the digits, and positive Chvostek’s or Trousseau’s signs are hallmark symptoms of low calcium levels. These neuromuscular manifestations result from increased neuronal excitability caused by decreased calcium levels in the blood.
The nurse is caring for a client with a T4 spinal cord injury. Which assessment finding should the nurse address immediately?
-
Reflexes are absent in the lower extremities.
-
Client is incontinent for feces.
-
Client's bladder is distended.
-
Client has warm, blanching erythema on the sacral area.
Explanation
Correct Answer:
C. Client's bladder is distended.
Explanation:
In a client with a T4 spinal cord injury, a distended bladder can trigger autonomic dysreflexia, a life-threatening emergency characterized by sudden severe hypertension, headache, bradycardia, and possible stroke. The nurse must immediately relieve the bladder distention (e.g., by catheterization) to remove the stimulus.
Absent reflexes (A) and fecal incontinence (B) are expected findings in spinal cord injuries and are not emergencies. Erythema on the sacral area (D) indicates risk for pressure injury but is not immediately life-threatening compared to the danger of autonomic dysreflexia.
A young adult client is admitted to the intensive care unit (ICU) following an intentional acetaminophen overdose. The client is obtunded and mechanically ventilated. Current vital signs are a temperature of 87.8°F (31°C), a heart rate of 54 beats/minute, and a blood pressure of 60/40 mm Hg. Which intervention should the nurse implement first?
-
Rapid IV bolus of warmed normal saline.
-
Initiate a vasopressor infusion.
-
Prepare an IV dose of acetylcysteine.
-
Obtain serum acetaminophen levels.
Explanation
Correct Answer:
A. Rapid IV bolus of warmed normal saline.
Explanation:
The client’s vital signs indicate severe hypotension, bradycardia, and hypothermia, consistent with shock and decreased perfusion. The immediate priority is to restore intravascular volume to support cardiac output and organ perfusion. Administering a rapid IV bolus of warmed normal saline addresses both hypovolemia and hypothermia, which are life-threatening and must be corrected before any diagnostic or secondary treatments are initiated.
A client with ventricular tachycardia develops dyspnea, palpitations and lightheadedness. Assessment reveals tachypnea, hypotension, pallor, diaphoresis, and jugular vein distention. Which nursing diagnosis should be included in the client's plan of care?
-
Increased cardiac output.
-
Impaired gas exchange.
-
Fluid volume overload.
-
Ineffective airway clearance.
Explanation
Correct Answer:
B. Impaired gas exchange.
Explanation:
Ventricular tachycardia causes a rapid, ineffective ventricular contraction that reduces cardiac output and coronary perfusion. This leads to systemic hypoperfusion and impaired gas exchange as oxygen delivery to tissues decreases. The client’s symptoms—dyspnea, hypotension, pallor, and diaphoresis—reflect hypoxia and poor circulation. The nurse should prioritize interventions to restore effective cardiac rhythm, maintain oxygenation, and support tissue perfusion. Increased cardiac output is incorrect because output decreases during VT.
How to Order
Select Your Exam
Click on your desired exam to open its dedicated page with resources like practice questions, flashcards, and study guides.Choose what to focus on, Your selected exam is saved for quick access Once you log in.
Subscribe
Hit the Subscribe button on the platform. With your subscription, you will enjoy unlimited access to all practice questions and resources for a full 1-month period. After the month has elapsed, you can choose to resubscribe to continue benefiting from our comprehensive exam preparation tools and resources.
Pay and unlock the practice Questions
Once your payment is processed, you’ll immediately unlock access to all practice questions tailored to your selected exam for 1 month .