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Registered Nurse (RN)
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HESI®
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HESI®-RN Comprehensive Review
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Communication

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HESI®-RN Comprehensive Review | Registered Nurse (RN) School Study Aid

Communication
58 Picmonics to Learn | 1 hr 45 mins
Care for the Hard of Hearing
Assessment
Normal: 0-15 dB
Rinne's Test
Weber's Test
Tinnitus
Difficulty Following Conversations
Nursing Considerations
Face Patient/Speak Clearly
Rephrase Misunderstood Statements
Repeat Statements Back
Hearing Aids
Sign Language
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2 mins
Care for the Visually Impaired
Assessment
Decreased Visual Acuity
Snellen Chart
Status of Corrective Lenses
Nursing Considerations
Sighted-Guide Technique
Communication
Safe Environment
Medications
Clock Technique for Food
Activities of Daily Living (ADL)
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1 min
Osteoarthritis
Mechanism
Articular Cartilage Destruction
Biomechanical Stress
Aging
Signs and Symptoms
Asymmetric
Pain Decreases with Rest
Morning Stiffness Under 30 Minutes
Crepitus
DIP and PIP Joints
Treatment
Lifestyle Changes
Acetaminophen or NSAIDs
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2 mins
Osteoporosis Assessment
Highest Risk
Postmenopausal Women
Long Term Corticosteroids
Assessment
Kyphosis
Dowager's Hump
Loss of Height
Back Pain
Pathologic Fractures
Spinal Compression Fracture
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1 min
Osteoporosis Interventions
Increased Calcium Intake
Vitamin D Supplements
Bisphosphonates
Raloxifene
Denosumab
Calcitonin
Teriparatide
Bone Densitometry (DEXA) Scan
Weight Bearing Exercises
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2 mins
Immobility
Assessment
Mobility Continuum
Complications
Cardiovascular
Respiratory
Musculoskeletal
Integumentary
Gastrointestinal
Urinary
Considerations
Turn, Cough, Deep Breathe (TCDB)
Range of Motion (ROM)
Skin Care
Fluids
Balanced Diet
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2 mins
ROM Assessment
Types of ROM
Active ROM (AROM)
Active Assisted ROM (AAROM)
Passive ROM (PROM)
Upper Extremity
Neck Flexion, Extension and Rotation
Shoulder Flexion, Extension and Rotation
Elbow Flexion and Extension
Fingers and Wrist Flexion and Extension
Lower Extremity
Hip and Knee Flexion
Hip Abduction and Rotation
Ankle Rotation
Toe Flexion and Extension
Lumbar Rotation and Spine Inspection
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4 mins
Strength Assessment
Inspection
Assess Patient Appearance for Abnormalities
Observe ROM of Upper and Lower Extremities
Assess Motor Power
Hand Grips
Dorsiflexion and Plantarflexion
Hip and Knee Flexion Against Resistance
Manual Muscle Test (MMT) Grading System
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2 mins
Age-Related Dizziness
Presbystasis
Pathophysiology
Visual Decline
Somatosensory Dysfunction
Vestibular Dysfunction
Muscular Atrophy
Signs and Symptoms
Increased Loss of Balance
Vertigo
Treatment
Vestibular Rehabilitation
Strength Training
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3 mins
Stable Angina
Assessment
Chest Pain with Exertion
Relieved within 15 Minutes
ST Depression
Interventions
Nitroglycerin
Up to 3 Doses q 5 Minutes
Rest
Antiplatelet Medication
CABG
Angioplasty
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2 mins
Unstable Angina
Assessment
Chest Pain with Rest or Exertion
Limits ADLs
> 15 Minutes
Less Likely Relieved by Nitroglycerin
ST Depression
Fatigue
Considerations
Acute Coronary Syndrome (ACS) Treatment
Emergency Treatment
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2 mins
Airway, Breathing, Circulation (ABC's)
Airway Assessment
Changed Sound of Voice
"See-saw" Respirations
Stridor
Breathing Assessment
Normal Respiratory Rate: 12–20 Breaths/Min
Use of Accessory Muscles in Respiration
Cyanosis
Circulation Assessment
Color of Hands and Digits
Normal Capillary Refill Time (CRT): 2 Seconds
Decreased LOC
Considerations
Initial ‘Look, Listen and Feel” Assessment
Emergency Treatment
Prioritization in Exam Questions
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5 mins
COPD Overview (Chronic Obstructive Pulmonary Disease Overview)
Causes
Inhaled Toxins
Smoking
AAT Deficiency
Assessment
Emphysema
Chronic Bronchitis
Asthma
Considerations
Spirometry
Slow Progression
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2 mins
Urinary Tract Infection Symptoms
More Common in Elderly
Most Common in Females and Babies
Change in LOC
Dehydration
Fever
Urgency
Urethral Infection
Burning
Smelly Urine
Dark Cloudy Urine
Frequency of Urination
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2 mins
Urinary Tract Infection Prevention and Treatment
Prevention
Shower after Sex
Urinate after Sex
Wipe front to Back
Treatments and Considerations
I and Os with Daily Weights
Increase Water Intake
Antibiotics
Avoid Caffeine
Dr Appointment in 2 Weeks
Void every 2 - 4 hours
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2 mins
Prostate Adenocarcinoma Characteristics and Presentation
Characteristics
Most Common Cancer in Men
Screening Test if Suspicious
Prostate Specific Antigen (PSA)
Peripheral Zone
Risk Factors
African American
Advanced Age
Presentation
Usually Asymptomatic
Terminal Hematuria
Urinary Retention or Incontinence
Lower Back Pain
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2 mins
Benign Prostatic Hyperplasia (BPH) Assessment
Assessment
Men Over 50
Enlarged Prostate Gland
Urinary Retention
Weak Urine Stream
Frequency
Urgency
Nocturia
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1 min
Benign Prostatic Hyperplasia (BPH) Interventions
Interventions
Timed Voiding
Decreased Caffeine Intake
Catheterization
Medications
Finasteride (Proscar)
Tamsulosin (Flomax)
Surgical Interventions
TURP Procedure
Open Prostatectomy
Continuous Bladder Irrigation (CBI)
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2 mins
Benign Prostatic Hyperplasia (BPH) Diagnosis and Treatment
Diagnosis
Digital Rectal Exam
Urinalysis to Detect Infection or Blood
Treatment
Alpha-1 Antagonists
Tamsulosin
5 Alpha Reductase Inhibitors
Finasteride
TURP (Transurethral Resection of Prostate)
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1 min
Stress Incontinence
Symptoms
Urine Leak with Movement
Cough or Sneeze
Increased Intra-abdominal pressure
Pathophysiology
Laxity of Pelvic Floor Muscles
Urethral Sphincter Insufficiency
Treatment
Kegel Exercises
Pessaries
Alpha-adrenergic Agonists
Surgery
Associations
History of Vaginal Birth
Cystocele
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2 mins
Functional Incontinence
Symptoms
Increased Urinary Volume
Unable to Timely Urinate
Pathophysiology
Dementia
Excessive Alcohol Consumption
Immobility
Treatment
Scheduled Voiding
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1 min
Overflow Incontinence
Symptoms
Increased Residual Urine Volume
Involuntary Urine Dribble
Urinary Frequency
Pathophysiology
Nerve Lesions Cause Bladder Atony
Bladder Outlet Obstruction
Weak Detrusor Muscles
Treatment
Bethanechol
Catheterization
Sacral Neuromodulation
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2 mins
Urge Incontinence
Symptoms
Strong Urge To Void
Unable To Void Quickly Enough
Nocturia
Increased Frequency
Small Volume Voids
Pathophysiology
Increased Detrusor Muscle Activity
Treatment
Avoid Caffeine & Alcohol
Anticholinergics
Mirabegron
Botox
Sacral Neuromodulation
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2 mins
Penicillin
Mechanism of Action
Weakens Cell Wall
Indications
Gram-Positive Infections
Prophylaxis
Side Effects
Pain at IM Injection Site
Allergic Reaction
Considerations
Skin Tests
Allergy ID
Medication Education
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2 mins
Tetracyclines Overview
End in "-cycline"
Mechanism of Action
Bacteriostatic
Indications
Infectious Diseases
Acne
Periodontal Disease
Nursing Considerations
Avoid Milk, Antacids, Iron
Sunlight Protection
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1 min
Tetracycline Toxicities
Inhibition of Bone Growth in Children
Teratogen
Discoloration of Teeth
Photosensitivity
GI Distress
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2 mins
Digoxin (Lanoxin)
Mechanism of Action
Increases Inotropy
Indications
Heart Failure
Atrial Fibrillation
Side Effects
Bradycardia
Fatigue
Contraindications
Heart Block
Nursing Considerations
Heart Rate Below 60
Hypokalemia
Monitor for Toxicity and Visual Changes
Digibind
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2 mins
Acute Digoxin Toxicity
Clinical Symptoms
Hyperkalemia
Cholinergic (Nausea, Vomiting, Diarrhea)
Blurry Yellow Green Vision with Halo of Light
Arrhythmia
Bradycardia
EKG Changes
Prolonged PR interval
Decreased QT
Scooping on EKG
T Wave Inversion
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2 mins
Menopause Lab Findings
Decreased Estrogen
Lack of Negative Feedback
Increased FSH
Increased LH
Increased GnRH
Small Amount of Estrogen From Androgen Conversion
Increased Androgens = Hirsutism
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1 min
Menopause Symptoms
Symptoms
HAVOCS Mnemonic
Hot Flashes
Atrophy of Vagina
Osteoporosis
Coronary Artery Disease (CAD)
Sleep disturbances
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50 secs
Cognitive Abilities Assessment
Mental Status Examination (MSE)
Collecting/Organizing Objective Information
Cognitive assessment tests
Mini-Mental State Examination (MMSE)
Montreal Cognitive Assessment Test (MoCA)
Mini-Cog
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2 mins
Parkinson's Disease Assessment
Assessment
Decreased Dopamine
Older Adult
Cogwheel Rigidity
Bradykinesia
Shuffling Gait
Resting Tremor
Pill-Rolling
Mask-Like Face
Cognitive Decline
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2 mins
Parkinson's Disease Interventions
Medications
Levodopa/Carbidopa (Sinemet)
Entacapone (Comtan)
Selegiline (Eldepryl)
Amantadine (Symmetrel)
Bromocriptine (Parlodel)
Benztropine (Cogentin)
Considerations
Allow Extra Time
Ensure Patient Safety
Surgery As Last Resort
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2 mins
Delirium
Mechanism
Rapid Onset
Reversible
Assessment
Hallucinations
Decline in Cognition
Short Attention Span
Rapid Speech
Change in Activity Level
Mood Swings
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2 mins
Hypothyroidism Assessment
Assessment
Weight Gain - Edema
Lethargy
Cold Intolerance
Bradycardia
Hypertension
Brittle Nails and Dry Skin
Constipation
Goiter
Prolonged Menses
Slowed Thinking
Diagnostic Tests
Decreased Free T4
Increased TSH
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2 mins
Hypothyroidism Intervention
Medications
Levothyroxine (Synthroid)
Liothyronine (Cytomel)
Complication
Myxedema Coma
Nursing Considerations
Lifelong Replacement Hormone
Monitor Vital Signs
Fluids and Fiber
Low Calorie, Low Fat Diet
Medication Education
No Switching Brands
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2 mins
Hashimoto's Thyroiditis
Symptoms
Hypothyroidism with Bouts of Hyperthyroidism
Enlarged, Nontender Thyroid
Mechanism
Autoimmune
Anti-Thyroid Peroxidase (TPO)
Anti-Thyroglobulin
Lab Findings
Hurthle Cells
Lymphoid Follicles
Associations
HLA-DR5 and HLA-DR3
Increased Risk Of Non-Hodgkin Lymphoma
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2 mins
Diabetes Assessment
Assessment Type 1
Juvenile Onset
Absent Insulin Production
Ketosis Prone
Assessment Type 2
Adult Onset
Insulin Resistance
Obesity
Gestational Diabetes
Onset During Pregnancy
Glucose Intolerance
Complications
Retinopathy
Peripheral Vascular Disease
Nephropathy
Neuropathy
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2 mins
Diabetes Interventions
Early Diagnosis
Insulin
Oral Hypoglycemics
Glucose Monitoring
Routine Exercise
Diabetic Diet
Monitor for Complications
Insulin Therapy
Diabetic Ketoacidosis (DKA)
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2 mins
Diabetes Education
Self-Monitoring (Blood Glucose)
SubQ Injection Technique
Lifestyle Changes
Symptoms of Hyperglycemia and Hypoglycemia
Sick Day Care
Foot Care
Exercise Therapy
Medication
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1 min
Central Diabetes Insipidus
Characteristics
ADH Deficiency
Increased Serum and Urine Osmolality
Etiologies
Mental Illness
Brain Injuries
Treatment
Desmopressin
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1 min
5 A's of Alzheimer's Disease
Agnosia
Anomia
Aphasia
Apraxia
Amnesia
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1 min
Alzheimer's Disease Assessment (Early Symptoms)
Risk Factors
Advanced Age
Early Signs and Symptoms
Poor Judgment and Decision-Making
Difficulty Having a Conversation
Inability to Manage a Budget
Losing Track of the Date or Season
Misplacing Things
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1 min
Alzheimer's Disease Assessment (Late Symptoms)
Late Signs and Symptoms
Memory Impairment
Wandering Behavior
Confabulation
Perseveration
Lack of Abstract Thinking
Severe Cognitive Decline
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1 min
Alzheimer's Disease Interventions
Diagnostic Tests
PET Scan and CT
Mini-Mental State Examination
Interventions
Drug Therapy
Safe Environment
Moderate Exercise
Behavioral Modification
Assistance with Functional Independence
Assistance and Support for Caregiver
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2 mins
Depression Assessment
Physical Changes
Anergia
Self Neglect
Decreased Libido
Vegetative Signs
Mood
Sad Affect
Worthlessness
Guilt
Anger and Irritability
Cognitive
Ineffective Problem Solving
Slowed Thinking
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1 min
Donepezil
Indications
Alzheimer's Disease
Mechanism of Action
Acetylcholinesterase Inhibitor
Increased Acetylcholine
Side Effects
Nausea and Vomiting
Dizziness
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52 secs
Memantine
Indications
Alzheimer's Disease
Mechanism of Action
NMDA Receptor Antagonist
Prevents Excitotoxicity
Side Effects
Confusion
Hallucinations
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1 min
Metabolic Syndrome
Assessment
Dyslipidemia
Central Obesity
Insulin Resistance
Hypertension
Increased C-Reactive Protein (CRP)
Increased Fibrinogen
Considerations
Increased Risk Cardiovascular Disease
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1 min
Child and Elder Physical Abuse Assessment
Physical Abuse
Inconsistent Injuries
Delay in Treatment
Various Stages of Healing
Child Abuse
Symmetrical Burns
Sexually Transmitted Infection
Bloody/Torn Undergarments
Shaken Baby Syndrome
Elder Abuse
Poor Hygiene
Overmedication
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2 mins
Herpes Zoster (Shingles)
Cause/Mechanism
Varicella-Zoster Virus
Assessment
Linear, Unilateral Rash Along a Dermatome
Pruritus
Postherpetic Neuralgia
Interventions
Acyclovir
Analgesics
Gabapentin
Considerations
Contagious Vesicles
Shingrix
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3 mins
Cataract
Mechanism
Age-related
Assessment
No Pain
Cloudy Opaque Lens
Decreased Visual Acuity
Occurs Gradually
Treatment
Surgery
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1 min
Primary Open-Angle Glaucoma (POAG - Chronic)
Mechanism
Flow of Aqueous Humor Slowed
Signs and Symptoms
Slow Onset
No Pain
Tunnel Vision
IOP 22-32mm Hg
Considerations
Drug Therapy
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1 min
Primary Angle-Closure Glaucoma (PACG - Acute)
Mechanism
Rapid Increase in IOP
Signs and Symptoms
Rapid Onset
Pain
Blurred Vision
Halos Around Lights
Nausea and Vomiting
IOP over 30 mm Hg
Considerations
Drug Therapy
Surgery
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1 min
Age-Related Macular Degeneration (AMD)
Mechanism
Dry (nonexudative)
Wet (exudative)
Signs and Symptoms
Scotomas
Blurred, Darkened Vision
Loss of Central Vision
Distortion of Vision
Considerations
Drug Therapy
Surgery
Low-vision Assistive Devices
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2 mins
Traumatic Brain Injury Assessment
Assessment
Change in LOC
Personality Changes
Amnesia
Increased Intracranial Pressure
Diplopia
Posturing
Location of Injury
Basilar Skull Fracture
Halo or Ring Sign
Considerations
Intracranial Bleeding
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2 mins
Pressure Ulcers
Risk Factors
Prolonged Immobilization
Neurologic Disease
Decreased Level of Consciousness
Classification
Stage 1: Intact Skin with Non-blanchable Erythema
Stage 2: Partial Thickness Skin Loss
Stage 3: Full-thickness Skin Loss without Fascial Involvement
Stage 4: Full-thickness Skin Loss with Fascial Involvement
Management
Wound Care
Surgery
Considerations
Septicemia
Osteomyelitis
Prevention
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3 mins
Graves' Disease Characteristics
Women 20-40 years old
Pathophysiology
Anti-TSH Receptor Antibodies
Symptoms
Ophthalmopathy
Exophthalmos
Hyperthyroidism
Goiter
Pretibial Myxedema
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1 min

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