HESI COMPASS COMPREHENSIVE EXIT EXAM 2026 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) who is receiving oxygen at
2 L/min via nasal cannula. The patient becomes increasingly confused and lethargic. What is the nurse's priority
action?
A. Increase the oxygen flow rate to 4 L/min
B. Assess the patient's oxygen saturation and respiratory rate
C. Notify the healthcare provider immediately
D. Decrease the oxygen flow rate to 1 L/min
🟢 Correct Answer:
C. Notify the healthcare provider immediately
🔴 RATIONALE:
Confusion and lethargy in a COPD patient receiving oxygen may indicate carbon dioxide narcosis, a life-
threatening condition caused by the loss of hypoxic drive. The nurse should notify the healthcare provider
immediately and prepare to support ventilation. While assessing and decreasing oxygen may be appropriate,
notifying the provider is the priority.
,Question 2
A patient with heart failure is receiving intravenous furosemide. Which assessment finding indicates the desired
therapeutic effect has been achieved?
A. Increased peripheral edema
B. Decreased urine output
C. Increased urine output and decreased shortness of breath
D. Elevated blood pressure and tachycardia
🟢 Correct Answer:
C. Increased urine output and decreased shortness of breath
🔴 RATIONALE:
Furosemide is a loop diuretic used to reduce fluid volume overload. The desired therapeutic effects include
increased urine output, decreased edema, and relief of shortness of breath. Increased edema or decreased urine
output indicates the medication is not effective.
Question 3
The nurse is caring for a patient with acute kidney injury who has a serum potassium level of 6.8 mEq/L. Which
intervention should the nurse implement first?
A. Administer oral sodium polystyrene sulfonate
B. Prepare the patient for emergent hemodialysis
C. Administer intravenous calcium gluconate
D. Administer intravenous insulin and dextrose
,🟢 Correct Answer:
C. Administer intravenous calcium gluconate
🔴 RATIONALE:
Hyperkalemia of 6.8 mEq/L is a life-threatening emergency due to the risk of cardiac arrhythmias. The first
priority is to stabilize the cardiac membrane by administering IV calcium gluconate. While insulin and dextrose,
sodium polystyrene, and hemodialysis are all treatments for hyperkalemia, cardiac membrane stabilization is the
immediate priority.
Question 4
A patient with a spinal cord injury at T5 is experiencing a severe headache, profuse diaphoresis, and a blood
pressure of 220/120 mmHg. What is the nurse's priority action?
A. Administer a prescribed antihypertensive medication
B. Place the patient in a supine position
C. Assess for a distended bladder or fecal impaction
D. Notify the healthcare provider
🟢 Correct Answer:
C. Assess for a distended bladder or fecal impaction
🔴 RATIONALE:
The patient is experiencing autonomic dysreflexia, a medical emergency triggered by a noxious stimulus below
the level of injury. The most common triggers are a distended bladder or fecal impaction. The nurse should
, immediately assess for and remove the triggering stimulus. Sitting the patient upright is also important to help
lower blood pressure.
Question 5
The nurse is preparing to administer a blood transfusion to a patient. Which IV solution should be used to
prime the blood administration tubing?
A. 5% dextrose in water
B. 0.9% normal saline
C. Lactated Ringer's solution
D. 0.45% normal saline
🟢 Correct Answer:
B. 0.9% normal saline
🔴 RATIONALE:
Only 0.9% normal saline should be used to prime blood administration tubing. Dextrose solutions can cause
hemolysis of red blood cells, and lactated Ringer's contains calcium, which can cause clotting in the tubing.
Normal saline maintains isotonicity and is compatible with blood products.
Question 6
A patient with cirrhosis of the liver is exhibiting signs of hepatic encephalopathy. Which medication should the
nurse anticipate administering?
VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) who is receiving oxygen at
2 L/min via nasal cannula. The patient becomes increasingly confused and lethargic. What is the nurse's priority
action?
A. Increase the oxygen flow rate to 4 L/min
B. Assess the patient's oxygen saturation and respiratory rate
C. Notify the healthcare provider immediately
D. Decrease the oxygen flow rate to 1 L/min
🟢 Correct Answer:
C. Notify the healthcare provider immediately
🔴 RATIONALE:
Confusion and lethargy in a COPD patient receiving oxygen may indicate carbon dioxide narcosis, a life-
threatening condition caused by the loss of hypoxic drive. The nurse should notify the healthcare provider
immediately and prepare to support ventilation. While assessing and decreasing oxygen may be appropriate,
notifying the provider is the priority.
,Question 2
A patient with heart failure is receiving intravenous furosemide. Which assessment finding indicates the desired
therapeutic effect has been achieved?
A. Increased peripheral edema
B. Decreased urine output
C. Increased urine output and decreased shortness of breath
D. Elevated blood pressure and tachycardia
🟢 Correct Answer:
C. Increased urine output and decreased shortness of breath
🔴 RATIONALE:
Furosemide is a loop diuretic used to reduce fluid volume overload. The desired therapeutic effects include
increased urine output, decreased edema, and relief of shortness of breath. Increased edema or decreased urine
output indicates the medication is not effective.
Question 3
The nurse is caring for a patient with acute kidney injury who has a serum potassium level of 6.8 mEq/L. Which
intervention should the nurse implement first?
A. Administer oral sodium polystyrene sulfonate
B. Prepare the patient for emergent hemodialysis
C. Administer intravenous calcium gluconate
D. Administer intravenous insulin and dextrose
,🟢 Correct Answer:
C. Administer intravenous calcium gluconate
🔴 RATIONALE:
Hyperkalemia of 6.8 mEq/L is a life-threatening emergency due to the risk of cardiac arrhythmias. The first
priority is to stabilize the cardiac membrane by administering IV calcium gluconate. While insulin and dextrose,
sodium polystyrene, and hemodialysis are all treatments for hyperkalemia, cardiac membrane stabilization is the
immediate priority.
Question 4
A patient with a spinal cord injury at T5 is experiencing a severe headache, profuse diaphoresis, and a blood
pressure of 220/120 mmHg. What is the nurse's priority action?
A. Administer a prescribed antihypertensive medication
B. Place the patient in a supine position
C. Assess for a distended bladder or fecal impaction
D. Notify the healthcare provider
🟢 Correct Answer:
C. Assess for a distended bladder or fecal impaction
🔴 RATIONALE:
The patient is experiencing autonomic dysreflexia, a medical emergency triggered by a noxious stimulus below
the level of injury. The most common triggers are a distended bladder or fecal impaction. The nurse should
, immediately assess for and remove the triggering stimulus. Sitting the patient upright is also important to help
lower blood pressure.
Question 5
The nurse is preparing to administer a blood transfusion to a patient. Which IV solution should be used to
prime the blood administration tubing?
A. 5% dextrose in water
B. 0.9% normal saline
C. Lactated Ringer's solution
D. 0.45% normal saline
🟢 Correct Answer:
B. 0.9% normal saline
🔴 RATIONALE:
Only 0.9% normal saline should be used to prime blood administration tubing. Dextrose solutions can cause
hemolysis of red blood cells, and lactated Ringer's contains calcium, which can cause clotting in the tubing.
Normal saline maintains isotonicity and is compatible with blood products.
Question 6
A patient with cirrhosis of the liver is exhibiting signs of hepatic encephalopathy. Which medication should the
nurse anticipate administering?
