HESI RN COMPREHESIVE 2 LATEST VERSION 2026-2027 EXAM WITH
ACTUAL 13O QUESTION AND CORRECT DETAILED ANSWERS WITH
RATIONALES. (MOST TESTED QUESTIONS).
QUESTION
A client at 26-weeks gestation comes to the labor and delivery unit and complains,
"Something is not right." Which finding should the nurse assess further?
CORRECT ANS: B. The cervix is effacing and dilated to 2 cm.
Expert Rationale
Cervical changes such as shortening (effacement) and dilation accompanied by regular
contractions are indicative of labor, regardless of gestational age. At 26 weeks, this is a
sign of preterm labor, which requires immediate assessment and intervention to prevent
premature delivery. Estriol levels in saliva (A) increase before preterm birth, so its
absence is not a concern. The presence of fetal fibronectin in vaginal secretions (C)
between 24 and 36 weeks has a 20-40% positive predictive value for preterm labor, but
its absence is reassuring. Irregular mild contractions (D) that do not cause cervical
change are characteristic of Braxton Hicks contractions, which are false labor and not a
cause for concern. Therefore, cervical effacement and dilation are the findings that
warrant further assessment.
DIF: Cognitive Level: Analyze (Analysis) TOP: Maternity MSC: N/A
QUESTION
A client who delivered a 9 pound 2 ounce infant 3 hours ago is experiencing uterine
atony. Which action should the nurse implement first?
CORRECT ANS: A. Massage the fundus.
Expert Rationale
Uterine atony is the failure of the uterus to contract adequately after delivery, which can
lead to postpartum hemorrhage. The initial management is fundal massage (A), which
stimulates uterine contractions and helps control bleeding. If fundal massage is
unsuccessful, then bladder catheterization (B) to relieve distention, establishing venous
access (C), and preparing for surgical intervention (D) may be necessary. However,
fundal massage is the first-line, non-invasive intervention. A client who is 3 hours post-
delivery typically has IV fluids infusing, so venous access may only need to be assessed
,rather than established.
DIF: Cognitive Level: Apply (Application) TOP: Maternity MSC: N/A
QUESTION
A young adult female comes to the health clinic to confirm a positive home pregnancy
test. After determining the client's last menstrual period (LMP) as February 14, what
expected date of birth (EDB) should the nurse calculate?
CORRECT ANS: C. November 21.
Expert Rationale
Nägele's rule is the standard method for calculating the expected date of birth (EDB).
The rule is: add 7 days to the first day of the last menstrual period (LMP) and then
subtract 3 months. For an LMP of February 14, adding 7 days gives February 21.
Subtracting 3 months gives November 21. Therefore, the correct EDB is November 21.
The other options (A, B, and D) incorrectly apply Nägele's rule.
DIF: Cognitive Level: Apply (Application) TOP: Maternity MSC: N/A
QUESTION
A multigravida at 41-weeks gestation is receiving an oxytocin (Pitocin) infusion for
induction of labor. The nurse notes the fetal heart rate (FHR) drops sharply from the
baseline for 30 seconds during the peak of a contraction and then returns to the
baseline before the end of the contraction. What action should the nurse implement at
this time?
CORRECT ANS: D. Place the client on her left side.
Expert Rationale
A sharp drop in the FHR from the baseline that returns quickly to the baseline is a
variable deceleration. Variable decelerations occur when the umbilical cord is being
compressed, which can happen during contractions. The immediate nursing action is to
change the client's position (D) to relieve the cord compression. Placing the client on her
left side increases uterine blood flow and may resolve the deceleration. Discontinuing
the oxytocin infusion (A), notifying the healthcare provider (B), and administering
oxygen (C) are actions that would be implemented if the FHR patterns indicated fetal
,stress, such as late decelerations or decreased variability. However, for variable
decelerations, position change is the first-line intervention.
DIF: Cognitive Level: Apply (Application) TOP: Maternity MSC: N/A
QUESTION
Which biological practices are federally regulated for healthcare workers? (Select all that
apply.)
CORRECT ANS: A. Standard precautions. B. N-95 tuberculosis standard. C. Blood-borne
pathogen standard. E. Resource Conservation and Recovery Act (RCRA).
Expert Rationale
The Occupational Safety and Health Administration (OSHA) mandates several biological
practices for healthcare workers. Standard precautions (A) are the foundation of
infection control. The N-95 tuberculosis standard (B) requires the use of particulate
respirators when caring for clients with confirmed or suspected tuberculosis. The blood-
borne pathogen standard (C) requires annual updates for healthcare workers about
transmission, minimization of exposure, and employee rights. The Resource
Conservation and Recovery Act (RCRA) (E) is a federal law that regulates the labeling,
storage, transportation, and disposal of biological waste. The As Low as Reasonably
Allowable (ALARA) standard (F) is an occupational health concept, but it is not an OSHA
mandate. The Biological Product Exposure Limit (BPEL) (D) is not an applicable mandate.
DIF: Cognitive Level: Remember (Knowledge) TOP: Community Health MSC: N/A
QUESTION
Which contextual factors are considered external environmental influences in the
framework for occupational health programs and services? (Select all that apply.)
CORRECT ANS: A. Economics. C. Technology. F. Legislation/regulation.
Expert Rationale
External environmental influences affect occupational health programs. Economics (A)
affects the health of the company and workforce productivity. Technology (C) adds to an
industry's capacity to develop and implement new or improved work processes.
Legislation and regulation (F) in the workplace, such as the blood-borne pathogen
, standard, affect the workforce in terms of requirements, administration, and control
strategies. The workforce (B) is an internal factor, as occupational safety programs are
built around the workforce to strive for maximum internal productivity. Interventions (D)
are internal environmental influences of an occupational health and safety program.
Socio-economic status (E) is a demographic variable commonly used in epidemiology.
DIF: Cognitive Level: Understand (Comprehension) TOP: Community Health MSC: N/A
QUESTION
A client with terminal pancreatic cancer is receiving hospice care at home and reports
increasing shortness of breath and associated anxiety. Which prescription should the
nurse implement first?
CORRECT ANS: C. Morphine sulfate (Roxanol) 5 to 10 mg SL as needed.
Expert Rationale
Comfort and pain management using an effective analgesic-sedative such as morphine
(C) is the most important standard of care therapy in hospice home care. Morphine
reduces anxiety, dyspnea, and pain, enhancing the quality of life for a client with a life
expectancy of less than six months. Adjunct therapy that promotes a sense of well-
being, including prednisone (A), and providing adequate oxygenation (B and D) work to
supplement morphine in easing a client's discomfort. However, morphine is the first-line
treatment for dyspnea and anxiety in terminal illness.
DIF: Cognitive Level: Apply (Application) TOP: Community Health MSC: N/A
QUESTION
During the initial home visit, the nurse performs a family assessment. Which component
is most important for the nurse to consider?
CORRECT ANS: C. An exploration of the group relationships, structure, functions, and
roles.
Expert Rationale
Understanding an individual requires determining the family members' relationships,
functions, and roles (C) with one another in the group structure. This provides
clarification about decision-making and responsibilities. While the legal definition of
ACTUAL 13O QUESTION AND CORRECT DETAILED ANSWERS WITH
RATIONALES. (MOST TESTED QUESTIONS).
QUESTION
A client at 26-weeks gestation comes to the labor and delivery unit and complains,
"Something is not right." Which finding should the nurse assess further?
CORRECT ANS: B. The cervix is effacing and dilated to 2 cm.
Expert Rationale
Cervical changes such as shortening (effacement) and dilation accompanied by regular
contractions are indicative of labor, regardless of gestational age. At 26 weeks, this is a
sign of preterm labor, which requires immediate assessment and intervention to prevent
premature delivery. Estriol levels in saliva (A) increase before preterm birth, so its
absence is not a concern. The presence of fetal fibronectin in vaginal secretions (C)
between 24 and 36 weeks has a 20-40% positive predictive value for preterm labor, but
its absence is reassuring. Irregular mild contractions (D) that do not cause cervical
change are characteristic of Braxton Hicks contractions, which are false labor and not a
cause for concern. Therefore, cervical effacement and dilation are the findings that
warrant further assessment.
DIF: Cognitive Level: Analyze (Analysis) TOP: Maternity MSC: N/A
QUESTION
A client who delivered a 9 pound 2 ounce infant 3 hours ago is experiencing uterine
atony. Which action should the nurse implement first?
CORRECT ANS: A. Massage the fundus.
Expert Rationale
Uterine atony is the failure of the uterus to contract adequately after delivery, which can
lead to postpartum hemorrhage. The initial management is fundal massage (A), which
stimulates uterine contractions and helps control bleeding. If fundal massage is
unsuccessful, then bladder catheterization (B) to relieve distention, establishing venous
access (C), and preparing for surgical intervention (D) may be necessary. However,
fundal massage is the first-line, non-invasive intervention. A client who is 3 hours post-
delivery typically has IV fluids infusing, so venous access may only need to be assessed
,rather than established.
DIF: Cognitive Level: Apply (Application) TOP: Maternity MSC: N/A
QUESTION
A young adult female comes to the health clinic to confirm a positive home pregnancy
test. After determining the client's last menstrual period (LMP) as February 14, what
expected date of birth (EDB) should the nurse calculate?
CORRECT ANS: C. November 21.
Expert Rationale
Nägele's rule is the standard method for calculating the expected date of birth (EDB).
The rule is: add 7 days to the first day of the last menstrual period (LMP) and then
subtract 3 months. For an LMP of February 14, adding 7 days gives February 21.
Subtracting 3 months gives November 21. Therefore, the correct EDB is November 21.
The other options (A, B, and D) incorrectly apply Nägele's rule.
DIF: Cognitive Level: Apply (Application) TOP: Maternity MSC: N/A
QUESTION
A multigravida at 41-weeks gestation is receiving an oxytocin (Pitocin) infusion for
induction of labor. The nurse notes the fetal heart rate (FHR) drops sharply from the
baseline for 30 seconds during the peak of a contraction and then returns to the
baseline before the end of the contraction. What action should the nurse implement at
this time?
CORRECT ANS: D. Place the client on her left side.
Expert Rationale
A sharp drop in the FHR from the baseline that returns quickly to the baseline is a
variable deceleration. Variable decelerations occur when the umbilical cord is being
compressed, which can happen during contractions. The immediate nursing action is to
change the client's position (D) to relieve the cord compression. Placing the client on her
left side increases uterine blood flow and may resolve the deceleration. Discontinuing
the oxytocin infusion (A), notifying the healthcare provider (B), and administering
oxygen (C) are actions that would be implemented if the FHR patterns indicated fetal
,stress, such as late decelerations or decreased variability. However, for variable
decelerations, position change is the first-line intervention.
DIF: Cognitive Level: Apply (Application) TOP: Maternity MSC: N/A
QUESTION
Which biological practices are federally regulated for healthcare workers? (Select all that
apply.)
CORRECT ANS: A. Standard precautions. B. N-95 tuberculosis standard. C. Blood-borne
pathogen standard. E. Resource Conservation and Recovery Act (RCRA).
Expert Rationale
The Occupational Safety and Health Administration (OSHA) mandates several biological
practices for healthcare workers. Standard precautions (A) are the foundation of
infection control. The N-95 tuberculosis standard (B) requires the use of particulate
respirators when caring for clients with confirmed or suspected tuberculosis. The blood-
borne pathogen standard (C) requires annual updates for healthcare workers about
transmission, minimization of exposure, and employee rights. The Resource
Conservation and Recovery Act (RCRA) (E) is a federal law that regulates the labeling,
storage, transportation, and disposal of biological waste. The As Low as Reasonably
Allowable (ALARA) standard (F) is an occupational health concept, but it is not an OSHA
mandate. The Biological Product Exposure Limit (BPEL) (D) is not an applicable mandate.
DIF: Cognitive Level: Remember (Knowledge) TOP: Community Health MSC: N/A
QUESTION
Which contextual factors are considered external environmental influences in the
framework for occupational health programs and services? (Select all that apply.)
CORRECT ANS: A. Economics. C. Technology. F. Legislation/regulation.
Expert Rationale
External environmental influences affect occupational health programs. Economics (A)
affects the health of the company and workforce productivity. Technology (C) adds to an
industry's capacity to develop and implement new or improved work processes.
Legislation and regulation (F) in the workplace, such as the blood-borne pathogen
, standard, affect the workforce in terms of requirements, administration, and control
strategies. The workforce (B) is an internal factor, as occupational safety programs are
built around the workforce to strive for maximum internal productivity. Interventions (D)
are internal environmental influences of an occupational health and safety program.
Socio-economic status (E) is a demographic variable commonly used in epidemiology.
DIF: Cognitive Level: Understand (Comprehension) TOP: Community Health MSC: N/A
QUESTION
A client with terminal pancreatic cancer is receiving hospice care at home and reports
increasing shortness of breath and associated anxiety. Which prescription should the
nurse implement first?
CORRECT ANS: C. Morphine sulfate (Roxanol) 5 to 10 mg SL as needed.
Expert Rationale
Comfort and pain management using an effective analgesic-sedative such as morphine
(C) is the most important standard of care therapy in hospice home care. Morphine
reduces anxiety, dyspnea, and pain, enhancing the quality of life for a client with a life
expectancy of less than six months. Adjunct therapy that promotes a sense of well-
being, including prednisone (A), and providing adequate oxygenation (B and D) work to
supplement morphine in easing a client's discomfort. However, morphine is the first-line
treatment for dyspnea and anxiety in terminal illness.
DIF: Cognitive Level: Apply (Application) TOP: Community Health MSC: N/A
QUESTION
During the initial home visit, the nurse performs a family assessment. Which component
is most important for the nurse to consider?
CORRECT ANS: C. An exploration of the group relationships, structure, functions, and
roles.
Expert Rationale
Understanding an individual requires determining the family members' relationships,
functions, and roles (C) with one another in the group structure. This provides
clarification about decision-making and responsibilities. While the legal definition of
