HESI Pathophysiology Exam 2 Study Guides

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Sample questions from HESI Pathophysiology Exam 2 Study Guides

This material has 20 questions with answers and rationales. Here are the first 5.

1. 1.A client receiving intravenous fluid for dehydration develops new crackles, an oxygen saturation of 88%, and increased work of breathing. Which action should the nurse take first?

   • A.Document the findings and reassess after the current fluid bag is complete.
   • B.Pause the infusion, raise the head of the bed, and assess oxygenation while obtaining urgent help.
   • C.Increase the infusion because dehydration remains the admitting diagnosis.
   • D.Encourage oral fluids to replace the remaining deficit.

   Rationale: B is correct because the new respiratory findings suggest fluid-related pulmonary congestion and require immediate respiratory support and reassessment of fluid delivery. A could worsen pulmonary edema. C delays care despite acute hypoxemia. D does not address the respiratory threat and could increase fluid burden.

2. 2.A client with chronic hyponatremia is receiving prescribed therapy. The serum sodium rises from 116 to 127 mEq/L in 12 hours. What is the nurse's priority?

   • A.Continue the current rate because the sodium remains below normal.
   • B.Prepare routine discharge teaching about dietary sodium.
   • C.Encourage unrestricted water intake without contacting the prescriber.
   • D.Notify the treating clinician immediately and obtain direction to prevent further excessive correction.

   Rationale: C is correct because an 11 mEq/L increase in 12 hours exceeds common conservative correction limits for chronic hyponatremia and creates osmotic demyelination risk. A ignores the rate of change. B attempts an uncontrolled correction without a treatment plan. D is inappropriate while a significant treatment-related danger is present.

3. 3.A client with acute kidney injury has a potassium level of 6.8 mEq/L and widening QRS complexes. Intravenous calcium gluconate is prescribed. Which explanation best describes its immediate purpose?

   • A.It stabilizes myocardial electrical activity.
   • B.It shifts potassium into cells by increasing insulin secretion.
   • C.It removes potassium through the gastrointestinal tract.
   • D.It increases glomerular filtration enough to eliminate potassium.

   Rationale: A is correct because intravenous calcium reduces the immediate cardiac membrane effects of hyperkalemia. B describes an elimination approach associated with potassium binders, not calcium. C does not describe calcium's role; insulin is separately used to shift potassium. D is incorrect because calcium does not reliably restore filtration or eliminate the potassium load.

4. 4.A postoperative client who received an opioid is difficult to arouse and has a respiratory rate of 7/min. Arterial values are pH 7.28, PaCO2 58 mm Hg, and bicarbonate 26 mEq/L. Which interpretation is most accurate?

   • A.Metabolic alkalosis caused by gastric suction.
   • B.Respiratory alkalosis caused by anxiety.
   • C.Respiratory acidosis caused by inadequate ventilation.
   • D.Metabolic acidosis caused by bicarbonate loss.

   Answer and rationale are in the full material.

5. 5.An older adult being treated for a urinary infection becomes confused. Blood pressure is 84/46 mm Hg, respiratory rate is 28/min, and urine output has fallen. Which action is most appropriate?

   • A.Wait for a fever before considering sepsis.
   • B.Activate the urgent response process and initiate assessment and treatment for possible septic shock.
   • C.Apply restraints to prevent removal of the intravenous catheter.
   • D.Offer oral fluids and reassess at the next scheduled vital-sign check.

   Answer and rationale are in the full material.