NURS 310 HESI NEWEST 2026 ACTUAL
EXAM TEST BANK| HESI NURS310 EXAM
REVIEW WITH COMPLETE 300 REAL
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ (MOST
RECENT!!)
1. A nurse is caring for a client with heart failure who reports sudden onset of
dyspnea and coughing up pink, frothy sputum. Which action should the nurse take
FIRST?
A) Auscultate lung sounds
B) Place the client in high-Fowler's position
C) Notify the healthcare provider
D) Administer IV furosemide
Correct Answer: B
Rationale: High-Fowler's position uses gravity to reduce venous return and decrease
pulmonary congestion, which is the immediate priority before further assessment or
medication. Airway/breathing always comes first.
2. A client with chronic obstructive pulmonary disease (COPD) has an arterial
blood gas (ABG) showing pH 7.31, PaCO2 58 mmHg, and HCO3 30 mEq/L. The
nurse interprets this as:
A) Metabolic acidosis
B) Respiratory acidosis with partial compensation
C) Respiratory alkalosis
D) Metabolic alkalosis
,Correct Answer: B
Rationale: Low pH indicates acidosis. High PaCO2 (>45) indicates respiratory cause.
Elevated HCO3 (>26) shows the kidneys are trying to compensate, but since pH is still
abnormal, it's only partial compensation.
3. A postoperative client has an indwelling urinary catheter. Which finding
requires immediate intervention?
A) Urine output of 40 mL/hr
B) Dark yellow, clear urine
C) No urine output for 4 hours
D) Mild suprapubic discomfort
Correct Answer: C
Rationale: No urine output for 4 hours (less than 30 mL/hr) indicates possible
obstruction or acute kidney injury. The nurse must assess for kinks, sediment, or bladder
distention immediately.
4. The nurse is preparing to administer digoxin to a client with atrial fibrillation.
Which assessment finding should cause the nurse to hold the medication?
A) Apical pulse of 58 bpm
B) Serum potassium of 3.8 mEq/L
C) Blood pressure of 130/85 mmHg
D) Respiratory rate of 18 breaths/min
Correct Answer: A
Rationale: Digoxin is held if the apical pulse is <60 bpm (or <50 in some protocols) due
to risk of severe bradycardia and heart block. Normal potassium is 3.5–5.0, so 3.8 is safe.
5. A client with cirrhosis develops ascites and is prescribed spironolactone. The
nurse understands the primary action of this medication is to:
A) Block aldosterone to promote sodium and water excretion while sparing potassium
B) Increase osmotic pressure in the renal tubules
,C) Inhibit carbonic anhydrase in the proximal tubule
D) Block ADH receptors in the collecting duct
Correct Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic that antagonizes aldosterone,
reducing sodium and water retention common in liver disease, while preventing
hypokalemia.
6. The nurse is delegating vital sign measurement to an unlicensed assistive
personnel (UAP). Which client should the nurse NOT delegate to the UAP?
A) Stable postoperative day 3 client
B) Client with pneumonia on room air
C) Client on a continuous IV heparin infusion
D) Client with hypertension controlled on lisinopril
Correct Answer: C
Rationale: A client on an IV heparin infusion requires a nurse's assessment for bleeding
signs and titration monitoring. Vital signs on stable clients are appropriate to delegate
to UAP.
7. A client is 24 hours post-thyroidectomy. Which finding indicates a life-
threatening complication?
A) Hoarseness and mild sore throat
B) Serum calcium of 7.2 mg/dL and positive Chvostek's sign
C) Pain rated 4/10 at incision site
D) Drainage of 20 mL serosanguineous fluid
Correct Answer: B
Rationale: Hypocalcemia (normal 8.5–10.5) due to accidental parathyroid removal
causes laryngeal stridor and tetany. Chvostek's sign (facial twitching) is an early warning
of impending airway compromise.
, 8. The nurse is caring for a client with acute pancreatitis. Which laboratory value is
most specific to this condition?
A) Elevated ALT
B) Elevated serum amylase and lipase
C) Elevated BUN and creatinine
D) Decreased serum albumin
Correct Answer: B
Rationale: Amylase and lipase rise sharply in acute pancreatitis due to enzyme leakage
into the bloodstream. Lipase is more specific because it stays elevated longer.
9. A client with type 1 diabetes mellitus reports sweating, tremors, and confusion.
The nurse checks the blood glucose and it is 52 mg/dL. What is the PRIORITY
intervention?
A) Administer 50% dextrose IV push
B) Give 15 grams of oral fast-acting carbohydrate (e.g., 4 oz orange juice)
C) Recheck blood glucose in 15 minutes
D) Call the healthcare provider
Correct Answer: B
Rationale: The client is conscious and able to swallow (confusion is not
unconsciousness). The standard "Rule of 15" is to give 15g oral glucose first, recheck in
15 min, and repeat if needed. IV dextrose is for unconscious patients.
10. A nurse receives shift report on four clients. Which client should be assessed
FIRST?
A) Client with pneumonia and new onset of confusion
B) Client with chronic kidney disease and potassium of 5.1 mEq/L
C) Client with hip fracture complaining of pain 6/10
D) Client with a urinary tract infection and temperature of 100.5°F
Correct Answer: A
Rationale: New confusion in a pneumonia client suggests hypoxemia or sepsis (acute
deterioration). This is a priority airway/neurological change. The other findings are
abnormal but stable.
EXAM TEST BANK| HESI NURS310 EXAM
REVIEW WITH COMPLETE 300 REAL
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ (MOST
RECENT!!)
1. A nurse is caring for a client with heart failure who reports sudden onset of
dyspnea and coughing up pink, frothy sputum. Which action should the nurse take
FIRST?
A) Auscultate lung sounds
B) Place the client in high-Fowler's position
C) Notify the healthcare provider
D) Administer IV furosemide
Correct Answer: B
Rationale: High-Fowler's position uses gravity to reduce venous return and decrease
pulmonary congestion, which is the immediate priority before further assessment or
medication. Airway/breathing always comes first.
2. A client with chronic obstructive pulmonary disease (COPD) has an arterial
blood gas (ABG) showing pH 7.31, PaCO2 58 mmHg, and HCO3 30 mEq/L. The
nurse interprets this as:
A) Metabolic acidosis
B) Respiratory acidosis with partial compensation
C) Respiratory alkalosis
D) Metabolic alkalosis
,Correct Answer: B
Rationale: Low pH indicates acidosis. High PaCO2 (>45) indicates respiratory cause.
Elevated HCO3 (>26) shows the kidneys are trying to compensate, but since pH is still
abnormal, it's only partial compensation.
3. A postoperative client has an indwelling urinary catheter. Which finding
requires immediate intervention?
A) Urine output of 40 mL/hr
B) Dark yellow, clear urine
C) No urine output for 4 hours
D) Mild suprapubic discomfort
Correct Answer: C
Rationale: No urine output for 4 hours (less than 30 mL/hr) indicates possible
obstruction or acute kidney injury. The nurse must assess for kinks, sediment, or bladder
distention immediately.
4. The nurse is preparing to administer digoxin to a client with atrial fibrillation.
Which assessment finding should cause the nurse to hold the medication?
A) Apical pulse of 58 bpm
B) Serum potassium of 3.8 mEq/L
C) Blood pressure of 130/85 mmHg
D) Respiratory rate of 18 breaths/min
Correct Answer: A
Rationale: Digoxin is held if the apical pulse is <60 bpm (or <50 in some protocols) due
to risk of severe bradycardia and heart block. Normal potassium is 3.5–5.0, so 3.8 is safe.
5. A client with cirrhosis develops ascites and is prescribed spironolactone. The
nurse understands the primary action of this medication is to:
A) Block aldosterone to promote sodium and water excretion while sparing potassium
B) Increase osmotic pressure in the renal tubules
,C) Inhibit carbonic anhydrase in the proximal tubule
D) Block ADH receptors in the collecting duct
Correct Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic that antagonizes aldosterone,
reducing sodium and water retention common in liver disease, while preventing
hypokalemia.
6. The nurse is delegating vital sign measurement to an unlicensed assistive
personnel (UAP). Which client should the nurse NOT delegate to the UAP?
A) Stable postoperative day 3 client
B) Client with pneumonia on room air
C) Client on a continuous IV heparin infusion
D) Client with hypertension controlled on lisinopril
Correct Answer: C
Rationale: A client on an IV heparin infusion requires a nurse's assessment for bleeding
signs and titration monitoring. Vital signs on stable clients are appropriate to delegate
to UAP.
7. A client is 24 hours post-thyroidectomy. Which finding indicates a life-
threatening complication?
A) Hoarseness and mild sore throat
B) Serum calcium of 7.2 mg/dL and positive Chvostek's sign
C) Pain rated 4/10 at incision site
D) Drainage of 20 mL serosanguineous fluid
Correct Answer: B
Rationale: Hypocalcemia (normal 8.5–10.5) due to accidental parathyroid removal
causes laryngeal stridor and tetany. Chvostek's sign (facial twitching) is an early warning
of impending airway compromise.
, 8. The nurse is caring for a client with acute pancreatitis. Which laboratory value is
most specific to this condition?
A) Elevated ALT
B) Elevated serum amylase and lipase
C) Elevated BUN and creatinine
D) Decreased serum albumin
Correct Answer: B
Rationale: Amylase and lipase rise sharply in acute pancreatitis due to enzyme leakage
into the bloodstream. Lipase is more specific because it stays elevated longer.
9. A client with type 1 diabetes mellitus reports sweating, tremors, and confusion.
The nurse checks the blood glucose and it is 52 mg/dL. What is the PRIORITY
intervention?
A) Administer 50% dextrose IV push
B) Give 15 grams of oral fast-acting carbohydrate (e.g., 4 oz orange juice)
C) Recheck blood glucose in 15 minutes
D) Call the healthcare provider
Correct Answer: B
Rationale: The client is conscious and able to swallow (confusion is not
unconsciousness). The standard "Rule of 15" is to give 15g oral glucose first, recheck in
15 min, and repeat if needed. IV dextrose is for unconscious patients.
10. A nurse receives shift report on four clients. Which client should be assessed
FIRST?
A) Client with pneumonia and new onset of confusion
B) Client with chronic kidney disease and potassium of 5.1 mEq/L
C) Client with hip fracture complaining of pain 6/10
D) Client with a urinary tract infection and temperature of 100.5°F
Correct Answer: A
Rationale: New confusion in a pneumonia client suggests hypoxemia or sepsis (acute
deterioration). This is a priority airway/neurological change. The other findings are
abnormal but stable.
