HESI Care of Patients with Shock Practice Questions

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Your adult patient has sustained a blunt force, closed head injury while playing football at a family reunion. Which of the following symptoms leads you to believe the patient is suffering from an epidural hematoma?

  • A. Goose egg' noted on patient's head
  • B. The patient is unconscious when you arrive on the scene and remains that way throughout transport
  • C. The patient lost consciousness immediately following the injury, but regained consciousness quickly. He lost consciousness again just prior to calling 911.
  • D. Sudden, severe headache
Correct Answer: C

Rationale: The correct answer is C because the patient experiencing a loss of consciousness immediately following the injury, regaining consciousness quickly, and then losing consciousness again is indicative of an epidural hematoma. This pattern is known as the "lucid interval," where the initial impact causes bleeding between the skull and dura mater, leading to a temporary improvement in symptoms before the hematoma expands, causing increased intracranial pressure and loss of consciousness.

Choice A (Goose egg' noted on patient's head) is not specific to epidural hematoma and can occur in various head injuries. Choice B (The patient is unconscious when you arrive on the scene and remains that way throughout transport) is more indicative of a severe traumatic brain injury with continuous loss of consciousness rather than the characteristic pattern of an epidural hematoma. Choice D (Sudden, severe headache) is more commonly associated with subarachnoid hemorrhage or traumatic brain injury but not specifically with epidural hematoma.

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Which of the following is true of a resident who is dying?

  • A. Residents will always be able to express when they are in pain.
  • B. Residents should have their rooms brightly lit.
  • C. Residents should lie flat on their backs to ease problems with breathing.
  • D. Residents should be fed slowly to help prevent choking and aspiration.
Correct Answer: D

Rationale: The correct answer is D because residents who are dying are at a higher risk of choking and aspiration due to weakened muscles and decreased swallowing reflex. Feeding them slowly reduces the risk of choking and aspiration.

A is incorrect because not all residents can express pain effectively.
B is incorrect because bright lighting can be uncomfortable or distressing for a dying resident.
C is incorrect because lying flat on their backs can actually worsen breathing problems for a resident who is dying.

You suspect your adult trauma patient has a potential complete spinal cord transection. If so, which of the following would you expect to find?

  • A. Total loss of pain and sensation below the waist bilaterally with some loss of movement below the waist
  • B. Bradycardia associated with loss in vascular tone
  • C. Total absence of pain, sensation, and movement (paralysis) below the point of the transection (injury)
  • D. Right-sided paralysis with decreased sensation on the opposite side of the body
Correct Answer: C

Rationale: The correct answer is C. In a complete spinal cord transection, there is total absence of pain, sensation, and movement below the level of injury due to complete disruption of nerve pathways. This results in paralysis below the injury site.

A is incorrect because a complete transection would result in total loss of pain, sensation, and movement, not just some loss of movement.

B is incorrect as bradycardia and loss of vascular tone are indicative of autonomic dysreflexia, typically seen in spinal cord injuries above T6, not a complete transection.

D is incorrect as right-sided paralysis with decreased sensation on the opposite side does not align with the expected presentation of a complete spinal cord transection.

Complications of immobility for the nervous system include

  • A. Pneumonia
  • B. Depression or insomnia
  • C. Weight gain
  • D. Constipation
Correct Answer: B

Rationale: The correct answer is B, depression or insomnia. Immobility can lead to decreased neurotransmitter release, impacting mood and sleep regulation. Depression and insomnia are common consequences. Pneumonia (A) is a respiratory complication. Weight gain (C) and constipation (D) are more related to the musculoskeletal and gastrointestinal systems, respectively.

One way for a nursing assistant to make a positive first impression on a new resident is to

  • A. Place his personal items where the NA thinks they look best
  • B. Get the admission process completed as quickly as possible
  • C. Allow the resident to introduce himself to everyone in the facility
  • D. Prepare his room before his arrival so that he feels expected and welcome
Correct Answer: D

Rationale: The correct answer is D: Prepare his room before his arrival so that he feels expected and welcome. This is the best choice because it demonstrates a proactive and thoughtful approach to welcoming the new resident. By preparing the room in advance, the nursing assistant shows consideration and care for the resident's comfort and well-being. This action helps create a positive first impression by making the resident feel valued and welcomed.

Incorrect choices:
A: Placing personal items where the NA thinks they look best may not align with the resident's preferences and could make the resident feel uncomfortable.
B: Completing the admission process quickly may prioritize efficiency over the resident's emotional needs, potentially leading to a rushed and impersonal interaction.
C: Allowing the resident to introduce himself to everyone in the facility puts the burden of initiating social interactions on the resident, which may not be ideal for someone new and unfamiliar with the environment.

Which of the following conditions may cause a resident to become confused?

  • A. A resident receives the proper amount of oxygen.
  • B. A resident takes the wrong medication.
  • C. A resident eats dinner.
  • D. A resident exercises.
Correct Answer: B

Rationale: The correct answer is B because taking the wrong medication can lead to confusion due to potential side effects or drug interactions. This can affect cognitive function. A resident receiving proper oxygen (A) is necessary for overall health but unlikely to directly cause confusion. Eating dinner (C) and exercising (D) are healthy activities that are less likely to cause confusion compared to medication errors.