HESI COMPREHENSIVE EXAM 2026/ ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST UPDATE ALREADY GRADED A+
ASSURED PASS
This comprehensive 300-question study guide covers all major content areas tested
on the HESI Comprehensive Exam 2026, including medication administration,
cardiovascular and respiratory nursing, maternity and newborn care, pediatric
nursing, mental health, leadership and management, fluid and electrolyte balance,
wound care and infection control, gastrointestinal and endocrine disorders, and
community health nursing. Each question includes a correct answer and detailed
rationale to reinforce clinical judgment and critical thinking. Key topics include
pharmacology prioritization, delegation principles, NCLEX-style prioritization,
laboratory value interpretation, and patient safety. This guide serves as an essential
review tool for nursing students preparing for the HESI Comprehensive Exam and
the NCLEX-RN.
SECTION 1: MEDICATION ADMINISTRATION AND PHARMACOLOGY
(Questions 1-35)
Question 1
Enalapril maleate 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 inhibitor used to
treat hypertension. A common side effect is postural hypotension. The nurse would
check the client's blood pressure immediately before administering each dose.
,Checking peripheral pulses, potassium levels, and intake-output are not specifically
associated with this medication.
Question 2
A nurse on the evening shift checks a primary health care provider's prescriptions
and notes that the dose of a prescribed medication is higher than the normal dose.
The nurse calls the primary health care provider's answering service and is told that
the provider is off for the night and will be available in the morning. What should
the nurse do next?
A) Call the nursing supervisor
B) Ask the answering service to contact the on-call primary health care provider
C) Withhold the medication until the primary health care provider can be reached
in the morning
D) Administer the medication but consult the primary health care provider when
available
Answer: B
Rationale: The nurse has a duty to protect the client from harm. A nurse who
believes a prescription may be in error is responsible for clarifying it before
carrying it out. The nurse would not wait until morning to obtain clarification. It is
premature to call the nursing supervisor.
Question 3
NPO status is imposed 8 hours before the procedure on a client scheduled to
undergo electroconvulsive therapy at 1 p.m. On the morning of the procedure, the
nurse checks the client's record and notes that the client routinely takes an oral
antihypertensive medication each morning. What action should the nurse take?
A) Administer the antihypertensive with a small sip of water
B) Withhold the antihypertensive and administer it at bedtime
C) Administer the medication by way of the intravenous route
D) Hold the antihypertensive and resume its administration on the day after the
ECT
Answer: A
Rationale: General anesthesia is required for ECT, so NPO status is imposed for 6
to 8 hours before treatment to help prevent aspiration. Exceptions include clients
who routinely receive cardiac medications, antihypertensive agents, or histamine
,blockers, which should be administered several hours before treatment with a small
sip of water. Withholding antihypertensives could lead to rebound hypertension.
Question 4
Lorazepam 1 mg by way of intravenous injection is prescribed for a client for the
management of anxiety. The nurse prepares the medication as prescribed and
administers the medication over a period of:
A) 3 minutes
B) 10 seconds
C) 15 seconds
D) 30 seconds
Answer: A
Rationale: Lorazepam should be administered by slow IV push at a rate not
exceeding 2 mg per minute. Therefore, 1 mg should be administered over
approximately 3 minutes to prevent adverse effects such as respiratory depression
or hypotension.
Question 5
Risperidone is prescribed for a client hospitalized in the mental health unit for
treatment of a psychotic disorder. Which finding in the client's medical record
would prompt the nurse to contact the prescribing physician before administering
the medication?
A) The client has a history of cataracts
B) The client has a history of hypothyroidism
C) The client takes a prescribed antihypertensive
D) The client is allergic to acetylsalicylic acid
Answer: C
Rationale: Risperidone can cause orthostatic hypotension. Concurrent use with
antihypertensive medications may result in additive hypotensive effects, requiring
dosage adjustment. The nurse should contact the physician before administering
the medication.
Question 6
Phenelzine sulfate is prescribed for a client with depression. The nurse provides
information to the client about the adverse effects of the medication and tells the
client to contact the physician immediately if she experiences:
, A) Dry mouth
B) Restlessness
C) Feelings of depression
D) Neck stiffness or soreness
Answer: D
Rationale: Neck stiffness or soreness can be an early sign of a hypertensive crisis, a
life-threatening adverse effect associated with monoamine oxidase inhibitors like
phenelzine. Dry mouth and restlessness are common side effects. Feelings of
depression may persist initially but do not require immediate physician contact.
Question 7
A client is taking prescribed ibuprofen 200 mg orally four times daily to relieve
joint pain resulting from rheumatoid arthritis. The client tells the nurse that the
medication is causing nausea and indigestion. What should the nurse tell the client?
A) "I will contact your primary health care provider"
B) "Stop taking the medication"
C) "Take the medication with food"
D) "Take the medication twice a day instead of four times a day"
Answer: C
Rationale: Ibuprofen is a nonsteroidal anti-inflammatory medication. Side effects
include nausea and dyspepsia. If gastrointestinal distress occurs, the client should
be instructed to take the medication with milk or food. The nurse would not
instruct the client to stop the medication or adjust the dosage, as these actions are
not within the nurse's legal scope.
Question 8
Cyclobenzaprine is prescribed to a client with multiple sclerosis for the treatment
of muscle spasms. For which common side effect does the nurse monitor the
client?
A) Diarrhea
B) Drowsiness
C) Abdominal pain
D) Increased salivation
Answer: B
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST UPDATE ALREADY GRADED A+
ASSURED PASS
This comprehensive 300-question study guide covers all major content areas tested
on the HESI Comprehensive Exam 2026, including medication administration,
cardiovascular and respiratory nursing, maternity and newborn care, pediatric
nursing, mental health, leadership and management, fluid and electrolyte balance,
wound care and infection control, gastrointestinal and endocrine disorders, and
community health nursing. Each question includes a correct answer and detailed
rationale to reinforce clinical judgment and critical thinking. Key topics include
pharmacology prioritization, delegation principles, NCLEX-style prioritization,
laboratory value interpretation, and patient safety. This guide serves as an essential
review tool for nursing students preparing for the HESI Comprehensive Exam and
the NCLEX-RN.
SECTION 1: MEDICATION ADMINISTRATION AND PHARMACOLOGY
(Questions 1-35)
Question 1
Enalapril maleate 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 inhibitor used to
treat hypertension. A common side effect is postural hypotension. The nurse would
check the client's blood pressure immediately before administering each dose.
,Checking peripheral pulses, potassium levels, and intake-output are not specifically
associated with this medication.
Question 2
A nurse on the evening shift checks a primary health care provider's prescriptions
and notes that the dose of a prescribed medication is higher than the normal dose.
The nurse calls the primary health care provider's answering service and is told that
the provider is off for the night and will be available in the morning. What should
the nurse do next?
A) Call the nursing supervisor
B) Ask the answering service to contact the on-call primary health care provider
C) Withhold the medication until the primary health care provider can be reached
in the morning
D) Administer the medication but consult the primary health care provider when
available
Answer: B
Rationale: The nurse has a duty to protect the client from harm. A nurse who
believes a prescription may be in error is responsible for clarifying it before
carrying it out. The nurse would not wait until morning to obtain clarification. It is
premature to call the nursing supervisor.
Question 3
NPO status is imposed 8 hours before the procedure on a client scheduled to
undergo electroconvulsive therapy at 1 p.m. On the morning of the procedure, the
nurse checks the client's record and notes that the client routinely takes an oral
antihypertensive medication each morning. What action should the nurse take?
A) Administer the antihypertensive with a small sip of water
B) Withhold the antihypertensive and administer it at bedtime
C) Administer the medication by way of the intravenous route
D) Hold the antihypertensive and resume its administration on the day after the
ECT
Answer: A
Rationale: General anesthesia is required for ECT, so NPO status is imposed for 6
to 8 hours before treatment to help prevent aspiration. Exceptions include clients
who routinely receive cardiac medications, antihypertensive agents, or histamine
,blockers, which should be administered several hours before treatment with a small
sip of water. Withholding antihypertensives could lead to rebound hypertension.
Question 4
Lorazepam 1 mg by way of intravenous injection is prescribed for a client for the
management of anxiety. The nurse prepares the medication as prescribed and
administers the medication over a period of:
A) 3 minutes
B) 10 seconds
C) 15 seconds
D) 30 seconds
Answer: A
Rationale: Lorazepam should be administered by slow IV push at a rate not
exceeding 2 mg per minute. Therefore, 1 mg should be administered over
approximately 3 minutes to prevent adverse effects such as respiratory depression
or hypotension.
Question 5
Risperidone is prescribed for a client hospitalized in the mental health unit for
treatment of a psychotic disorder. Which finding in the client's medical record
would prompt the nurse to contact the prescribing physician before administering
the medication?
A) The client has a history of cataracts
B) The client has a history of hypothyroidism
C) The client takes a prescribed antihypertensive
D) The client is allergic to acetylsalicylic acid
Answer: C
Rationale: Risperidone can cause orthostatic hypotension. Concurrent use with
antihypertensive medications may result in additive hypotensive effects, requiring
dosage adjustment. The nurse should contact the physician before administering
the medication.
Question 6
Phenelzine sulfate is prescribed for a client with depression. The nurse provides
information to the client about the adverse effects of the medication and tells the
client to contact the physician immediately if she experiences:
, A) Dry mouth
B) Restlessness
C) Feelings of depression
D) Neck stiffness or soreness
Answer: D
Rationale: Neck stiffness or soreness can be an early sign of a hypertensive crisis, a
life-threatening adverse effect associated with monoamine oxidase inhibitors like
phenelzine. Dry mouth and restlessness are common side effects. Feelings of
depression may persist initially but do not require immediate physician contact.
Question 7
A client is taking prescribed ibuprofen 200 mg orally four times daily to relieve
joint pain resulting from rheumatoid arthritis. The client tells the nurse that the
medication is causing nausea and indigestion. What should the nurse tell the client?
A) "I will contact your primary health care provider"
B) "Stop taking the medication"
C) "Take the medication with food"
D) "Take the medication twice a day instead of four times a day"
Answer: C
Rationale: Ibuprofen is a nonsteroidal anti-inflammatory medication. Side effects
include nausea and dyspepsia. If gastrointestinal distress occurs, the client should
be instructed to take the medication with milk or food. The nurse would not
instruct the client to stop the medication or adjust the dosage, as these actions are
not within the nurse's legal scope.
Question 8
Cyclobenzaprine is prescribed to a client with multiple sclerosis for the treatment
of muscle spasms. For which common side effect does the nurse monitor the
client?
A) Diarrhea
B) Drowsiness
C) Abdominal pain
D) Increased salivation
Answer: B
