HESI COMPASS EXIT EXAM 2026
ULTIMATE STUDY GUIDE VERIFIED
Q&AS WITH RATIONALES
Master the 2026 HESI Compass Comprehensive Exit Exam with
this premium, high-yield study guide featuring realistic multiple-
choice practice questions. Every question includes italicized
correct answers and detailed rationales in bold italics, designed
specifically to mirror the latest NCLEX-style formatting and
testing modules. Boost your academic performance, guarantee
your exam success, and secure top grades with this
comprehensive nursing review bundle.
1. A client with a history of heart failure is
admitted with a serum potassium level of 2.9
mEq/L. Which medication should the nurse
withhold until consulting the healthcare
provider?
A. Furosemide
B. Spironolactone
C. Digoxin
D. Enalapril
Answer: C. Digoxin
Rationale: Hypokalemia (<3.5 mEq/L)
significantly increases the risk of digoxin
, toxicity because potassium and digoxin compete
for the same binding sites on the ATPase pump.
Withholding the medication protects the client
from dangerous cardiac dysrhythmias.
2. The nurse notes standard intermittent
decelerations on the fetal monitor of a laboring
client. What is the priority nursing action?
A. Administer oxygen via nasal cannula.
B. Change the maternal position.
C. Prepare for immediate vaginal delivery.
D. Increase the intravenous oxytocin rate.
Answer: B. Change the maternal position.
Rationale: Variable decelerations are typically
caused by umbilical cord compression.
Relieving this compression by turning the client
to a lateral or knee-chest position is the
primary intervention to restore fetal
oxygenation.
3. An adult client is admitted with a blood glucose
level of 580 mg/dL, altered mental status, and
positive serum ketones. Which intravenous fluid
order should the nurse anticipate initiating first?
, A. 5% Dextrose in 0.45% Normal Saline
B. 0.9% Sodium Chloride
C. 5% Dextrose in Water
D. Lactated Ringer's
Answer: B. 0.9% Sodium Chloride
Rationale: In diabetic ketoacidosis (DKA), severe
dehydration from osmotic diuresis requires
immediate intravascular volume expansion.
Isotonic normal saline (0.9% NaCl) is the initial
fluid of choice before adding dextrose.
4. A client post-thyroidectomy develops tingling
around the mouth and muscle twitching. Which
medication should the nurse prepare to
administer?
A. Potassium chloride
B. Magnesium sulfate
C. Calcium gluconate
D. Sodium bicarbonate
Answer: C. Calcium gluconate
Rationale: Tingling around the mouth and
muscle twitching indicate hypocalcemia, a
, common complication of thyroidectomy if the
parathyroid glands are accidentally damaged or
removed. Intravenous calcium gluconate is the
antidote.
5. Which laboratory value should the nurse
monitor closely for a client receiving a
continuous intravenous heparin infusion for a
deep vein thrombosis?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
D. Platelet count only
Answer: B. Activated partial thromboplastin
time (aPTT)
Rationale: The aPTT is used to monitor the
therapeutic effectiveness of unfractionated
heparin infusions. PT and INR are utilized to
monitor oral warfarin therapy.
6. A nurse is caring for a client with a chest tube
attached to a water-seal drainage system. The
nurse notes continuous bubbling in the water-
ULTIMATE STUDY GUIDE VERIFIED
Q&AS WITH RATIONALES
Master the 2026 HESI Compass Comprehensive Exit Exam with
this premium, high-yield study guide featuring realistic multiple-
choice practice questions. Every question includes italicized
correct answers and detailed rationales in bold italics, designed
specifically to mirror the latest NCLEX-style formatting and
testing modules. Boost your academic performance, guarantee
your exam success, and secure top grades with this
comprehensive nursing review bundle.
1. A client with a history of heart failure is
admitted with a serum potassium level of 2.9
mEq/L. Which medication should the nurse
withhold until consulting the healthcare
provider?
A. Furosemide
B. Spironolactone
C. Digoxin
D. Enalapril
Answer: C. Digoxin
Rationale: Hypokalemia (<3.5 mEq/L)
significantly increases the risk of digoxin
, toxicity because potassium and digoxin compete
for the same binding sites on the ATPase pump.
Withholding the medication protects the client
from dangerous cardiac dysrhythmias.
2. The nurse notes standard intermittent
decelerations on the fetal monitor of a laboring
client. What is the priority nursing action?
A. Administer oxygen via nasal cannula.
B. Change the maternal position.
C. Prepare for immediate vaginal delivery.
D. Increase the intravenous oxytocin rate.
Answer: B. Change the maternal position.
Rationale: Variable decelerations are typically
caused by umbilical cord compression.
Relieving this compression by turning the client
to a lateral or knee-chest position is the
primary intervention to restore fetal
oxygenation.
3. An adult client is admitted with a blood glucose
level of 580 mg/dL, altered mental status, and
positive serum ketones. Which intravenous fluid
order should the nurse anticipate initiating first?
, A. 5% Dextrose in 0.45% Normal Saline
B. 0.9% Sodium Chloride
C. 5% Dextrose in Water
D. Lactated Ringer's
Answer: B. 0.9% Sodium Chloride
Rationale: In diabetic ketoacidosis (DKA), severe
dehydration from osmotic diuresis requires
immediate intravascular volume expansion.
Isotonic normal saline (0.9% NaCl) is the initial
fluid of choice before adding dextrose.
4. A client post-thyroidectomy develops tingling
around the mouth and muscle twitching. Which
medication should the nurse prepare to
administer?
A. Potassium chloride
B. Magnesium sulfate
C. Calcium gluconate
D. Sodium bicarbonate
Answer: C. Calcium gluconate
Rationale: Tingling around the mouth and
muscle twitching indicate hypocalcemia, a
, common complication of thyroidectomy if the
parathyroid glands are accidentally damaged or
removed. Intravenous calcium gluconate is the
antidote.
5. Which laboratory value should the nurse
monitor closely for a client receiving a
continuous intravenous heparin infusion for a
deep vein thrombosis?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
D. Platelet count only
Answer: B. Activated partial thromboplastin
time (aPTT)
Rationale: The aPTT is used to monitor the
therapeutic effectiveness of unfractionated
heparin infusions. PT and INR are utilized to
monitor oral warfarin therapy.
6. A nurse is caring for a client with a chest tube
attached to a water-seal drainage system. The
nurse notes continuous bubbling in the water-
