HESI COMPREHENSIVE EXIT EXAM 2026-
2027 ACTUAL EXAM WITH QUESTIONS AND
CORRECT ANSWERS GRADED A+
Q1. Enalapril maleate (Vasotec) is prescribed for a
hospitalized client. Which assessment does the nurse
perform as a priority before administering the medication?
A) Checking the client's blood pressure
B) Checking the client's peripheral pulses
C) Checking the client's blood glucose level
D) Checking the client's respiratory rate
• Correct Answer: A
• Rationale: Enalapril is an ACE inhibitor used to treat
hypertension and heart failure. The nurse must prioritize
checking the patient's blood pressure prior to administration
to ensure the client is not already hypotensive, which could
lead to severe adverse perfusion effects.
Q2. A client diagnosed with deep vein thrombosis (DVT) is
receiving a continuous intravenous heparin infusion. The
nurse notes the client's activated partial thromboplastin time
(aPTT) is 110 seconds. Which action should the nurse take
first?
A) Increase the infusion rate by 10%
B) Stop the heparin infusion and notify the healthcare provider
,C) Administer Vitamin K intravenously
D) Document the finding as expected and recheck in 4 hours
• Correct Answer: B
• Rationale: A normal therapeutic aPTT range for a client on
heparin is typically 1.5 to 2.5 times the normal baseline
(around 60 to 80 seconds). An aPTT of 110 seconds
indicates over-anticoagulation and a high risk for
spontaneous bleeding, requiring the nurse to stop the
infusion immediately and contact the provider.
Q3. The nurse is caring for a client with severe chronic
obstructive pulmonary disease (COPD) who is receiving
oxygen therapy. Which oxygen delivery method and flow rate
is most appropriate to prevent respiratory depression in this
client?
A) Simple face mask at 10 L/min
B) Nasal cannula at 2 L/min
C) Non-rebreather mask at 15 L/min
D) Venturi mask at 50% FiO2
• Correct Answer: B
• Rationale: Clients with chronic COPD often rely on a
hypoxic drive (low oxygen levels) rather than hypercapnia to
stimulate breathing. Administering high concentrations of
oxygen can abolish this drive, leading to respiratory
depression; therefore, low-flow oxygen via nasal cannula is
preferred to maintain an oxygen saturation between 88%
and 92%.
,Q4. A client who underwent a subtotal thyroidectomy 24
hours ago reports numbness and tingling around the mouth
and in the fingertips. Which action should the nurse take
immediately?
A) Encourage the client to ambulate to increase circulation
B) Assess the client for Trousseau's or Chvostek's sign
C) Administer a prescribed oral potassium supplement
D) Document the finding as a transient effect of general
anesthesia
• Correct Answer: B
• Rationale: Numbness and tingling around the mouth
(perioral paresthesia) and fingertips are classic early signs of
hypocalcemia, which can occur after a thyroidectomy if the
parathyroid glands are accidentally damaged or removed.
Assessing for Trousseau's or Chvostek's sign helps confirm
hypocalcemia so that emergency calcium gluconate can be
administered if needed.
Q5. The nurse is preparing to administer digoxin (Lanoxin) to
an adult client with heart failure. The client's apical pulse is
54 beats per minute. Which action should the nurse
implement?
A) Administer the medication and document the heart rate
B) Hold the medication and recheck the pulse in 2 hours
C) Hold the medication and notify the healthcare provider
D) Administer half of the prescribed dose
• Correct Answer: C
, • Rationale: Digoxin decreases the heart rate via vagal
stimulation while increasing myocardial contractility. It should
be held if the apical pulse is less than 60 beats per minute in
an adult to avoid severe bradycardia and digitalis toxicity.
Q6. A client with type 1 diabetes mellitus is found
unresponsive, diaphoretic, and tachycardic. Which action
should the nurse implement immediately?
A) Administer 10 units of regular insulin subcutaneously
B) Administer 50% dextrose (D50W) intravenously
C) Check the client's urine for ketones
D) Call the laboratory to draw a hemoglobin A1c
• Correct Answer: B
• Rationale: The clinical manifestations of unresponsiveness,
diaphoresis, and tachycardia indicate severe hypoglycemia,
which is an immediate life-threatening emergency.
Intravenous administration of D50W will rapidly elevate the
blood glucose level and restore consciousness.
Q7. The nurse is assessing a client who returned from a
cardiac catheterization via the right femoral artery 2 hours
ago. The nurse notes that the right pedal pulse is weaker
than the left pedal pulse, and the right foot is cool to the
touch. Which action is the priority?
A) Elevate the right leg on two pillows
B) Apply a warm compress to the right groin site
C) Notify the healthcare provider immediately
D) Instruct the client to perform vigorous ankle pumps
2027 ACTUAL EXAM WITH QUESTIONS AND
CORRECT ANSWERS GRADED A+
Q1. Enalapril maleate (Vasotec) is prescribed for a
hospitalized client. Which assessment does the nurse
perform as a priority before administering the medication?
A) Checking the client's blood pressure
B) Checking the client's peripheral pulses
C) Checking the client's blood glucose level
D) Checking the client's respiratory rate
• Correct Answer: A
• Rationale: Enalapril is an ACE inhibitor used to treat
hypertension and heart failure. The nurse must prioritize
checking the patient's blood pressure prior to administration
to ensure the client is not already hypotensive, which could
lead to severe adverse perfusion effects.
Q2. A client diagnosed with deep vein thrombosis (DVT) is
receiving a continuous intravenous heparin infusion. The
nurse notes the client's activated partial thromboplastin time
(aPTT) is 110 seconds. Which action should the nurse take
first?
A) Increase the infusion rate by 10%
B) Stop the heparin infusion and notify the healthcare provider
,C) Administer Vitamin K intravenously
D) Document the finding as expected and recheck in 4 hours
• Correct Answer: B
• Rationale: A normal therapeutic aPTT range for a client on
heparin is typically 1.5 to 2.5 times the normal baseline
(around 60 to 80 seconds). An aPTT of 110 seconds
indicates over-anticoagulation and a high risk for
spontaneous bleeding, requiring the nurse to stop the
infusion immediately and contact the provider.
Q3. The nurse is caring for a client with severe chronic
obstructive pulmonary disease (COPD) who is receiving
oxygen therapy. Which oxygen delivery method and flow rate
is most appropriate to prevent respiratory depression in this
client?
A) Simple face mask at 10 L/min
B) Nasal cannula at 2 L/min
C) Non-rebreather mask at 15 L/min
D) Venturi mask at 50% FiO2
• Correct Answer: B
• Rationale: Clients with chronic COPD often rely on a
hypoxic drive (low oxygen levels) rather than hypercapnia to
stimulate breathing. Administering high concentrations of
oxygen can abolish this drive, leading to respiratory
depression; therefore, low-flow oxygen via nasal cannula is
preferred to maintain an oxygen saturation between 88%
and 92%.
,Q4. A client who underwent a subtotal thyroidectomy 24
hours ago reports numbness and tingling around the mouth
and in the fingertips. Which action should the nurse take
immediately?
A) Encourage the client to ambulate to increase circulation
B) Assess the client for Trousseau's or Chvostek's sign
C) Administer a prescribed oral potassium supplement
D) Document the finding as a transient effect of general
anesthesia
• Correct Answer: B
• Rationale: Numbness and tingling around the mouth
(perioral paresthesia) and fingertips are classic early signs of
hypocalcemia, which can occur after a thyroidectomy if the
parathyroid glands are accidentally damaged or removed.
Assessing for Trousseau's or Chvostek's sign helps confirm
hypocalcemia so that emergency calcium gluconate can be
administered if needed.
Q5. The nurse is preparing to administer digoxin (Lanoxin) to
an adult client with heart failure. The client's apical pulse is
54 beats per minute. Which action should the nurse
implement?
A) Administer the medication and document the heart rate
B) Hold the medication and recheck the pulse in 2 hours
C) Hold the medication and notify the healthcare provider
D) Administer half of the prescribed dose
• Correct Answer: C
, • Rationale: Digoxin decreases the heart rate via vagal
stimulation while increasing myocardial contractility. It should
be held if the apical pulse is less than 60 beats per minute in
an adult to avoid severe bradycardia and digitalis toxicity.
Q6. A client with type 1 diabetes mellitus is found
unresponsive, diaphoretic, and tachycardic. Which action
should the nurse implement immediately?
A) Administer 10 units of regular insulin subcutaneously
B) Administer 50% dextrose (D50W) intravenously
C) Check the client's urine for ketones
D) Call the laboratory to draw a hemoglobin A1c
• Correct Answer: B
• Rationale: The clinical manifestations of unresponsiveness,
diaphoresis, and tachycardia indicate severe hypoglycemia,
which is an immediate life-threatening emergency.
Intravenous administration of D50W will rapidly elevate the
blood glucose level and restore consciousness.
Q7. The nurse is assessing a client who returned from a
cardiac catheterization via the right femoral artery 2 hours
ago. The nurse notes that the right pedal pulse is weaker
than the left pedal pulse, and the right foot is cool to the
touch. Which action is the priority?
A) Elevate the right leg on two pillows
B) Apply a warm compress to the right groin site
C) Notify the healthcare provider immediately
D) Instruct the client to perform vigorous ankle pumps
