2026 HESI COMPREHENSIVE COMPASS
MOST RECENT EXAM
SECTION 1: PHARMACOLOGY & MEDICATION ADMINISTRATION
Question 1: 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 most recent potassium level
• D) Checking the client's intake-and-output record for the last 24 hours
Answer: A
Rationale: Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor used to treat
hypertension. One common side effect is postural hypotension. Therefore the nurse would check the
client's blood pressure immediately before administering each dose.
Question 2: A nurse on the evening shift checks a physician's prescriptions and notes that the dose of a
prescribed medication is higher than the normal dose. The nurse calls the physician's answering service
and is told that the physician is off for the night and will be available in the morning. The nurse should:
• A) Call the nursing supervisor
• B) Ask the answering service to contact the on-call physician
• C) Administer the medication as prescribed
1|Page SUCCESS!!!
, • D) Hold the medication until morning
Answer: B
Rationale: When a medication dose appears to be outside the normal range, the nurse must verify the
order with the prescribing provider. If the primary physician is unavailable, the on-call physician should
be contacted. The nursing supervisor cannot prescribe medications.
Question 3: Lorazepam (Ativan) is prescribed for a client experiencing acute anxiety. The nurse
administers the medication via IV push. Over how many minutes should the nurse administer this
medication?
• A) 1 minute
• B) 2-3 minutes
• C) 5 minutes
• D) 10 minutes
Answer: B
Rationale: Lorazepam should be administered IV push slowly, over 2-3 minutes, to prevent respiratory
depression and hypotension.
Question 4: A client tells the nurse that he is taking nefazodone hydrochloride (Serzone). On the basis of
this information, the nurse determines that the client most likely has a history of:
• A) Depression
• B) Diabetes mellitus
• C) Hyperthyroidism
• D) Coronary artery disease
Answer: A
Rationale: Nefazodone (Serzone) is an antidepressant used to treat depression.
2|Page SUCCESS!!!
,Question 5: Risperidone (Risperdal) is prescribed for a client hospitalized in the mental health unit for
the treatment of a psychotic disorder. The nurse should monitor the client for which adverse effect?
• A) Hypothyroidism
• B) Tardive dyskinesia
• C) Cataracts
• D) Hyperglycemia
Answer: B
Rationale: Risperidone is an atypical antipsychotic that can cause extrapyramidal symptoms, including
tardive dyskinesia (involuntary repetitive movements). This is a serious and potentially irreversible side
effect that requires monitoring.
Question 6: A client with heart failure is prescribed furosemide (Lasix). Which laboratory value should
the nurse monitor most closely?
• A) Serum sodium
• B) Serum potassium
• C) Serum calcium
• D) Serum magnesium
Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium excretion, leading to hypokalemia. Low
potassium can predispose the client to cardiac arrhythmias, especially if the client is also on digoxin.
Question 7: A client with bipolar disorder is seen in the mental health clinic for evaluation of a new
medication regimen that includes risperidone (Risperdal). The nurse notes that the client has gained 15
pounds in the past month. Which action should the nurse take?
• A) Document the weight gain and continue the current plan
• B) Instruct the client to reduce caloric intake
• C) Notify the healthcare provider of the weight gain
3|Page SUCCESS!!!
, • D) Discontinue the medication immediately
Answer: C
Rationale: Atypical antipsychotics like risperidone can cause significant weight gain, which increases the
risk of metabolic syndrome. The healthcare provider should be notified so that the medication regimen
can be evaluated.
Question 8: A client is receiving IV heparin therapy for a deep vein thrombosis. Which laboratory value
should the nurse monitor to evaluate the effectiveness of therapy?
• A) PT (Prothrombin time)
• B) INR (International Normalized Ratio)
• C) aPTT (Activated partial thromboplastin time)
• D) Platelet count
Answer: C
Rationale: Heparin therapy is monitored using aPTT. The therapeutic range is typically 1.5-2.5 times the
normal control value. PT and INR are used to monitor warfarin therapy.
Question 9: A client is prescribed warfarin (Coumadin) for atrial fibrillation. Which dietary instruction
should the nurse include in the teaching plan?
• A) Increase intake of green leafy vegetables
• B) Maintain consistent intake of vitamin K-rich foods
• C) Avoid all foods containing vitamin K
• D) Take the medication with dairy products
Answer: B
Rationale: Warfarin works by inhibiting vitamin K-dependent clotting factors. Clients should maintain a
consistent intake of vitamin K-rich foods (green leafy vegetables) to keep INR levels stable. Sudden
changes in vitamin K intake can cause significant fluctuations in INR.
4|Page SUCCESS!!!
MOST RECENT EXAM
SECTION 1: PHARMACOLOGY & MEDICATION ADMINISTRATION
Question 1: 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 most recent potassium level
• D) Checking the client's intake-and-output record for the last 24 hours
Answer: A
Rationale: Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor used to treat
hypertension. One common side effect is postural hypotension. Therefore the nurse would check the
client's blood pressure immediately before administering each dose.
Question 2: A nurse on the evening shift checks a physician's prescriptions and notes that the dose of a
prescribed medication is higher than the normal dose. The nurse calls the physician's answering service
and is told that the physician is off for the night and will be available in the morning. The nurse should:
• A) Call the nursing supervisor
• B) Ask the answering service to contact the on-call physician
• C) Administer the medication as prescribed
1|Page SUCCESS!!!
, • D) Hold the medication until morning
Answer: B
Rationale: When a medication dose appears to be outside the normal range, the nurse must verify the
order with the prescribing provider. If the primary physician is unavailable, the on-call physician should
be contacted. The nursing supervisor cannot prescribe medications.
Question 3: Lorazepam (Ativan) is prescribed for a client experiencing acute anxiety. The nurse
administers the medication via IV push. Over how many minutes should the nurse administer this
medication?
• A) 1 minute
• B) 2-3 minutes
• C) 5 minutes
• D) 10 minutes
Answer: B
Rationale: Lorazepam should be administered IV push slowly, over 2-3 minutes, to prevent respiratory
depression and hypotension.
Question 4: A client tells the nurse that he is taking nefazodone hydrochloride (Serzone). On the basis of
this information, the nurse determines that the client most likely has a history of:
• A) Depression
• B) Diabetes mellitus
• C) Hyperthyroidism
• D) Coronary artery disease
Answer: A
Rationale: Nefazodone (Serzone) is an antidepressant used to treat depression.
2|Page SUCCESS!!!
,Question 5: Risperidone (Risperdal) is prescribed for a client hospitalized in the mental health unit for
the treatment of a psychotic disorder. The nurse should monitor the client for which adverse effect?
• A) Hypothyroidism
• B) Tardive dyskinesia
• C) Cataracts
• D) Hyperglycemia
Answer: B
Rationale: Risperidone is an atypical antipsychotic that can cause extrapyramidal symptoms, including
tardive dyskinesia (involuntary repetitive movements). This is a serious and potentially irreversible side
effect that requires monitoring.
Question 6: A client with heart failure is prescribed furosemide (Lasix). Which laboratory value should
the nurse monitor most closely?
• A) Serum sodium
• B) Serum potassium
• C) Serum calcium
• D) Serum magnesium
Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium excretion, leading to hypokalemia. Low
potassium can predispose the client to cardiac arrhythmias, especially if the client is also on digoxin.
Question 7: A client with bipolar disorder is seen in the mental health clinic for evaluation of a new
medication regimen that includes risperidone (Risperdal). The nurse notes that the client has gained 15
pounds in the past month. Which action should the nurse take?
• A) Document the weight gain and continue the current plan
• B) Instruct the client to reduce caloric intake
• C) Notify the healthcare provider of the weight gain
3|Page SUCCESS!!!
, • D) Discontinue the medication immediately
Answer: C
Rationale: Atypical antipsychotics like risperidone can cause significant weight gain, which increases the
risk of metabolic syndrome. The healthcare provider should be notified so that the medication regimen
can be evaluated.
Question 8: A client is receiving IV heparin therapy for a deep vein thrombosis. Which laboratory value
should the nurse monitor to evaluate the effectiveness of therapy?
• A) PT (Prothrombin time)
• B) INR (International Normalized Ratio)
• C) aPTT (Activated partial thromboplastin time)
• D) Platelet count
Answer: C
Rationale: Heparin therapy is monitored using aPTT. The therapeutic range is typically 1.5-2.5 times the
normal control value. PT and INR are used to monitor warfarin therapy.
Question 9: A client is prescribed warfarin (Coumadin) for atrial fibrillation. Which dietary instruction
should the nurse include in the teaching plan?
• A) Increase intake of green leafy vegetables
• B) Maintain consistent intake of vitamin K-rich foods
• C) Avoid all foods containing vitamin K
• D) Take the medication with dairy products
Answer: B
Rationale: Warfarin works by inhibiting vitamin K-dependent clotting factors. Clients should maintain a
consistent intake of vitamin K-rich foods (green leafy vegetables) to keep INR levels stable. Sudden
changes in vitamin K intake can cause significant fluctuations in INR.
4|Page SUCCESS!!!
