QUESTIONS AND CORRECT DETAILED ANSWERS

HESI Milestone 2 (ACTUAL 2024 EXAM)

QUESTIONS AND CORRECT DETAILED ANSWERS

AGRADE

RATED

The cardiac output is determined by the volume of the circulating blood, the pumping action of the heart, and the tone of the vascular bed. Early decreases in fluid volume are compensated for by an increase in the pulse rate. Although the blood pressure will decrease, it is not the earliest indicator. Edema and crackles in the lungs indicate an increase in fluid volume.A nursing student who is researching a medication at the nurses' station asks the registered nurse (RN) what the function of an alpha-adrenergic receptor is, and where the receptors are primarily found. The RN educates the nursing student. Which statement by the nursing student indicates that teaching has been effective?

• "The peripheral arteries and veins; when stimulated they cause vasoconstriction."
• "Arterial and bronchial walls; when stimulated they cause vasodilation and

bronchodilation."

• "The heart; when stimulated it causes an increase in heart rate, atrioventricular node

conduction, and contractility." 1 / 3

• "Several tissues; when stimulated they cause contraction of smooth muscle, inhibition

of lipolysis, and promotion of platelet aggregation." - ANSWER✔✔"The peripheral arteries and veins; when stimulated they cause vasoconstriction."

Found in the peripheral arteries and veins, alpha-adrenergic receptors cause a powerful vasoconstriction when stimulated. The remaining options are incorrect statements.The client who has begun an exercise program asks the nurse why the heart "feels like it's pounding" when exercising vigorously. The nurse provides education to the client about increased cardiac response based on which physiological concept?

• Pulse rate is not a reflection of cardiac response.
• Cardiac index is the mechanism that allows blood to flow better.
• Cardiac output is the body's attempt to meet metabolic demands.
• Stroke volume is an artificial number used to determine the adequacy of cardiac

output. - ANSWER✔✔Cardiac output is the body's attempt to meet metabolic demands.

The client's symptoms are the direct result of the body's attempt to meet the metabolic demands generated during exercise. An adequate cardiac output is needed to maintain perfusion to the vital organs of the body. With exercise, these demands increase, and the heart must beat faster (increased heart rate) and harder (increased stroke volume) to meet them. Cardiac index is an artificial number used to determine the adequacy of the cardiac output for a given individual. It is calculated by adjusting the cardiac output for body surface area.The nurse is listening to a cardiologist explain the results of a cardiac catheterization to a client and family. The cardiologist tells the client that a blockage is present in the large 2 / 3

blood vessel that supplies the anterior wall of the left ventricle. The nurse determines that the blockage is located in which area?

• Circumflex coronary artery
• Right coronary artery (RCA)
• Posterior descending coronary artery (PDA)
• Left anterior descending coronary artery (LAD) - ANSWER✔✔Left anterior

descending coronary artery (LAD)

The LAD bifurcates from the left main coronary artery to supply the anterior wall of the left ventricle and a few other structures. The circumflex coronary artery bifurcates from the left coronary artery and supplies the left atrium and the lateral wall of the left ventricle. The RCA supplies the right side of the heart, including the right atrium and right ventricle. The PDA supplies the posterior wall of the heart.The new registered nurse (RN) is reviewing cardiac rhythms with a mentor. Which statement by the new RN indicates that teaching about ventricular fibrillation has been effective?

• "Ventricular fibrillation appears as irregular beats within a rhythm."
• "Ventricular fibrillation does not have P waves or QRS complexes."
• "Ventricular fibrillation is a regular pattern of wide QRS complexes."
• "Ventricular fibrillation has recognizable P waves, QRS complexes, and T waves." -

ANSWER✔✔"Ventricular fibrillation does not have P waves or QRS complexes."

• / 3