HESI mid curricular Exam (Recent exam) Fully solved & updated 2026 Most COMPLETE (2026) (Latest Update 2026) UPDATE!!

nursing process

assess

diagnose

outcome/planning

implement

evaluate

techniques of physical assessment

inspection

palpation

percussion

auscultation

start physical assessment with

general survey assess for

-appearance

-behavior

-height/weight/BMI

-nutritional status

-waist circumference which can indicate obesity

when assessing the integumentary system you are looking for

erythema - indicating fever/inflammation

cyanosis - indicating O2 loss

jaundice - ^ billiruben

pallor - low on blood

ecchymosis

petechiae

lesions

integumentary assessment

palpate for temperature, moisture, turgor, edema

and inspect

adventitious breath sounds

wheeze - high pitch indicating airway obstruction

crackles - bubbling on in/ex

stridor - harsh high pitch sound on inhale

ronchi - sonourus , coarse low pitch

friction rub

extra heart sounds

s3-normal in children

s4- normal in older adults

order to listen to heart sounds

APETM

aortic, pulmonic, erbs point, tricuspid, mitral

assessing the abdomen what order

inspect

auscultate

percussion

palpate

bowel sounds should occur

every 5-35 seconds

gurgling

if no sounds for 5 minutes = silent ileus

bruits

abnormal bowel sound auscultated during abdominal assessment sounds like a swishing noise and indicates obstruction

neurovascular assessment

6 P's

1. pain

2. pallor

3. peripheral pulses

4. paresthesia

5. paralysis

6. pressure

cranial nerve 5

trigeminal

-motor/sensation

CHEWING

cranial nerve 7

facial

SMILE

cranial nerve 9

glossopharyngeal

SWALLOWING

cranial nerve 12

tongue

STICK YOUR TONGUE OUT AT ME

when to assess VS

on admission

based on policy

with CHANGE in condition

loss of consciousness

before/after invasive procedure

before/after med admin

heat production measures the body takes

shivering

piloerection

vasoconstriction

increased metabolism

heat losing measures the body takes

sweating

vasodilation

increased respirations

jellinek curve

phase 1 - pre alcoholic - using to relieve every day stress

phase 2 - early alcoholic - blackouts/needs it, secretive about it gulps 1st drink

phase 3 - crucial phase - lost control and gets defensive

phase 4 - chronic phase -

greatest risk for seizures in alcohol withdrawal is

within 7-48 hours of last drink

CIWA-AR

monitors pt response to tx; determines need for medication, prevents seizures. use ciwa-ar every 2 hours then 4 hours

alcoholism medications that promote sobriety

- Disulfiram (antabuse) - causes severe neg. reaction to alcohol can lead to death even if only around paint fumes.

-Naltrexone (ReVia) - reduces cravings by blocking the effects of alcohol PRN or monthly inj.

-acamprosate (campral) - reduces want/craving can't be used for pt with renal failure (2 tab 3x/day)

3 groups of laxatives and their functions

1. chemical laxatives (stimulate/irritate lining of GI

2. bulk laxatives (causes feces to ^ in bulk by ^ water content)

3. lubricant (move more smoothly)

medications that cause diarrhea

antibiotics

magnesium

medications that cause constipation

opioids

antacids

iron sulfate

anticholinergics

GI bleed stool will be

black if bleed is high in GI tract

red/pink if bleed is closer to rectum

chemical stimulant laxatives

caster oil

cascara

senna

bisacodyl

-used to evacuate bowel for diagnostic procedures

bulk laxatives

magnesium citrate

lactulose

psyllium

magnesium sulfate

magnesium hydroxide

polyethylene glycol

-reduce strain by increasing fluid

lubricant laxatives

mineral oil

docusate (colase)

glycerin

-prevent straining by coating poop to ease passage and prevent water from being absorbed

sequence of bowel studies

least invasive 1st

invasive procedures last

1. fecal occult blood test (ultrasound)

2. barium studies

3. endoscopic examinations

types of enemas

oil - lubricate stool and intestinal mucosa

carminative - help expel gas

medicated - provide meds absorbed through rectum

anthelmintic - destroys parasites

osmosis

movement of WATER from lesser particles to greater particles

osmotic pressure

pressure generated by water moving accross membrane

diffusion

movement of particles from HIGH concentration to LOW concentration

active transport

requires ENERGY to move solutes from LESSER concentration to HIGHER solute concentration

filtration

passage of FLUID from HIGHER to LOWER PRESSURE

colloid osmotic pressure

PULLS fluid back into the veins using ALBUMIN

hydrostatic pressure

PUSHES fluid OUT of the capillaries into the interstitial fluid

albumin

is a water magnet that is made in the liver and hangs out in the veins to pull fluid back in to the veins

fluid volume deficit

loss of equal parts water and sodium

fluid volume excess

too much water and sodium equally

average osmolality in 1 kg or L of soln

300

hypotonic solutions

give if someone has high sodium concentration

hypertonic

used for brain swelling as causes cells to shrink bc forces water out of the cells

ADH

works on WATER by telling kidneys to retain water

aldosterone

works on SODIUM by telling kidneys to reabsorb sodium water follows sodium

renin-angiotensin-aldosterone system (RAAS)

Who is Florence Nightingale?

Founder of modern nursing. Established first secular nursing school in the world.

NAme 3 things that happened for nurses in the 20th century

Education standards & programs developed

Legislation (1910-1922)

Development of nursing research

What act in what year amended to require a grade 12 education for nurses?

Registered Nurses Act 1940

First degree program in Alberta was in the _____'s

1960's

When was the beginning of a push to get a Baccalaureate Entry to Practice?

1980's

Nurses #self-regulating since?

Early 1990's

CARNA purpose

protection of the public

Health Professions Act (HPA) is instituted to promote...

flexibility in the scope & roles of professional practice so the health system operates w/ maximum effectiveness

Health Professions Act outlines... (3)

-Outlines registration process & requirements

-Outlines continuing competence program requirements

-Outlines professional conduct complaints, investigations, & hearings

-Outlines registration process & requirements

-Outlines continuing competence program requirements

-Outlines professional conduct complaints, investigations, & hearings

This is...

Health Professions Act

Canadian Nurses Associations 7 primary values include:

-Providing safe, compassionate, competent & ethical care

-Promoting health & well-being

-Promoting & respecting informed decision-making

-Preserving dignity

-Maintaining privacy & confidentiality

-Promoting justice

-Being accountable

CNA current objectives include: (5)

-To promote & enhance the role of registered nurses to strengthen nursing & the Canadian health system

-To shape & advocate for health public policy provincially/territoriality, nationally, internationally

-To advance nursing leadership for nursing & for health

-To broadly engage nurses in advancing nursing & health

-To advocate for public-funded health system & nursing self-regulation

What is the international council of nurses? (ICN)

Federation of more than 130 national nursing associations

List 4 of the ICN's Code of Ethics

Nurses & people

Nurses and practice

Nurses and profession

Nurses and co-workers

The primary factors that shape the health of Canadians are...

the living conditions they experience

the 12 determinants of health are

-Income & income distribution

-Education

-Unemployment & job security

-Employment & working conditions

-Early childhood development

-Food insecurity

-Housing

-Social exclusion

-Social safety network

-Health service

-Aboriginal status

-Gender

-Race

-Disability

List the 5 health promotion strategies

1. build public health policy

2. create supportive environments

3. strengthen community action

4. develop personal skills

5. reorient health services

5 components of Canadian health act?

1. public administration

2. comprehensiveness

3. universality

4. portability

5. accessibility

List the 5 principles of primary health care

1. accessibility

2. active public participation

3. health promotion

4. use of appropriate technology & innovation

5. intersectoral cooperation & collaboration

define mornbidity

measures of disease frequency. (such as prevalence and incidence)

Define prevalence

the total # of people suffering from a specific disease at a certain point in time

3 components of epidemiology

Agent, host and environment.

Erickson's theory on aging is

integrity vs despair

Integrity vs despair is who's theory concerning older adults

Erickson

Ericksons theory of older adults includes the developmental tasks of: (6)

1. adjusting to decreasing health & physical strength

2. Adjusting to retirement

3. Adjusting to death of a spouse

4.Accepting one's self as an aging person

5. Finding ways to maintain quality of life

6. Redefining relationships w/ adult children

What are two competing ideas about aging?

1. Active aging "use it or lose it'

2. Disengagement

T/F: people 65 and older have a 4-6 times higher suicide rate?

True. Particularly older men

T/F: some cognitive decline is inevitable as people age?

False. Incidence does not increase over age of 80

T/F: alcohol abuse is uncommon in the elderly

Incidence of 4% in this age group and rising

Define dementia

A gradual & progressive decline in mental processing ability that affects short-term memory, communication, language, judgement, reasoning, and abstract thinking

Mini-mental state examination includes (5)

1. orientation (max10)

2. registration (max3)

3. Attention & calculation (max 5)

4. Recall (max 3)

5. Language (max 9)

What is the geriatric depression scale

Interview scored out of 30 items (or 15). Dichotomous scale (yes/no).

Delirium is

characterized by an acute & fluctuating onset of confusion, disturbances in attention, disorganized thinking and/or decline in LOC. (a medical emergency)

Explain the confusion assessment method

The diagnosis of delurium by CAM requires the presence of features 1 & 2 and either 3 or 4.

Feature 1: acute onset or fluctuating course

feature 2: inattention

feature 3: disorganized thinking

feature 4: altered LOC

List some causes of delirium (5)

1. medications

2. infectious process

3. dehydration & electrolyte imbalance

4. metabolic imbalances

5. hypoxia

What are the 4 types of nursing diagnosis's

1. actual diagnosis

2. risk diagnosis

3. health promotion diagnosis

4. wellness diagnosis

NANDA are...

internationally approved nursing diagnosis

Implementation

Any treatment based on clinical judgement & knowledge to enhance patient outcomes

MCGILL stands for

M: Moyra Allen & McGill University

C: Client is family=family is client

G: Guiding questions

I: Intrinsic qualities

L: Let go of traditional roles

L: leave power w/ the family

define negative duty

do not harm the other

define positive duty

help the other

define health equity

just treatment of individuals in their own social context

Culture

shared patterns of learned values and behaviours that shape the way one interprets experiences and enacts social behavior. It distinguishes members of one group from another. Visible and invisible components

Human rights and health

The right to a standard of living adequate for the health & well-being of him/her & his/her family, and the right to security in the event of unemployment, sickness, diability, widowhood, old age, or other lack of livelihood in circumstances beyond his/her control

Global citizenship

Agranulocytosis/Neutropenia/agranulocytosis/leukopenia

acute decrease in the number of WBC in peripheral blood

Causes: treatment with antibiotics, bone marrow transplant, chemo, radiation.

--> can lead to:

-respiratory infection

-ulceration of the mouth

-high fever

-UTI

Anaphylactic reaction

respiratory distress/arrest

sx:

-hives/rash

-difficulty breathing

-dilated pupils

-diaphoresis

-"panic" feeling

-^HR

-respiratory arrest

TX:

--admin epinepherine subcut.

--massage site to ^ absorption rate

--repeat dose q15-20min

--notify MD

cytotoxic reaction

allergic reaction where cell death occurs

sx:

-decreased WBC, hematocrit, platelets

-elevated liver enzymes

-decreased renal function

TX:

--notify MD to D/C drug

--rest until allergic response is over

serum sickness

allergic reaction where tissue damage occurs up to 1 week after exposure to a drug.

sx:

-itchy rash

-high fever

-swollen lymph nodes

-swollen joints

-edema of face/limbs

TX:

--notify MD to D/C drug

--comfort measures

delayed allergic reaction

allergic reaction w/

sx:

rash

hives

swollen joints

TX:

--Notify MD to D/C drug

--provide skin care

--comfort measures

--antihistamines/topical corticosteroids

blood dyscrasia

bone marrow suppression caused by meds;

sx:

fever/chills/weakness

sore throat

back pain

dark urine

decreased H&H

low platelets

low WBC

TX:

--monitor labs

--protective isolation (prevent infection) (neutropenic precautions)

--bleeding precautions

--rest

Hypoglycemia

BG<70

-cold/clammy

-fatigue

-increased HR/BP

-confusion

-severe=seizure/coma

caused by:

--too much insulin

--excessive physical activity

--insufficient food

TX:

assess BG

give snack 15 g carb

severe=glucagon then snack

can also give D50W IV 25-50mL

monitor BG