HESI COMPASS MODULE EXAM 2 FINAL
PAPER 2026 CLINICAL JUDGMENT AND
PRIORITIZATION FULL ANSWERS AND
INSIGHT
◉ A client is experiencing a change in vision. The nurse performing
an eye examination uses an ophthalmoscope to best visualize which
area?
A.Iris
B. Cornea
C. Optic disc
D. Conjunctiva
Answer: C. Optic disc
Rationale: The ophthalmoscope enlarges the examiner's view of the
eye so that the media (anterior chamber, lens, vitreous humor) and
the ocular fundus (the internal surface of the retina) can be
examined. The optic disc is located on the internal surface of the
retina. The iris, conjunctiva, and cornea can be examined without the
use of an ophthalmoscope.
◉ A nurse notes that a client's physical examination record states
that the client's eyes moved normally through the six cardinal fields
of gaze. How should the nurse interpret this data?
,A. Normal near vision
B. Normal central vision
C. Normal peripheral vision
D. Normal ocular movements
Answer: D. Normal ocular movements
Rationale: Leading the client's eyes through the six cardinal fields of
gaze will elicit any muscle weakness during movement. This test
assesses the function of the medial rectus muscle, superior rectus
muscle, superior oblique muscle, lateral rectus muscle, inferior
rectus muscle, and inferior oblique muscle. Near vision is tested
with the use of a handheld vision screener that contains various
sizes of print. Central vision is measured with the use of a Snellen
chart. Peripheral vision is measured with the confrontation test.
◉ A nurse conducting an eye examination notes that the client
exhibits rapid, involuntary oscillating movements of the eyeball
when looking at the nurse. How should the nurse document this
finding?
A. Ptosis
B. Nystagmus
C. Scleral icterus
D. Exophthalmos
Answer: B. Nystagmus
Rationale: Nystagmus is a fine oscillating movement, most notable
around the iris. The nurse checks for nystagmus when assessing a
,client for ocular muscle weakness. Mild nystagmus at extreme
lateral gaze is normal; nystagmus at any other position is not. Ptosis
is a drooping of the eyelid. Scleral icterus is a yellowing of the sclera,
extending up to the cornea, that indicates jaundice. Exophthalmos, a
noticeable protrusion of the eyeball, is a characteristic sign of
hyperthyroidism.
◉ A nurse assessing a client's eyes notes that the pupils get larger
when the client looks at an object in the distance and become
smaller when the client looks at a nearby object. How does the nurse
document this finding?
A. Myopia
B. Hyperopia
C. Photophobia
D. Accommodation
Answer: D. Accommodation
Rationale: Accommodation is adaptation of the eye for near vision.
Movement of the ciliary muscles increases the curvature of the lens.
To observe accommodation, the examiner notes convergence
(motion toward) of the axes of the eyeballs and pupillary
constriction. Myopia is nearsightedness. Hyperopia is
farsightedness. Photophobia is abnormal sensitivity to light,
especially of the eyes.
, ◉ A nurse is using an otoscope to examine the ears of a client. Which
finding indicates to the nurse that the tympanic membrane is
normal?
Answer: Rationale: The tympanic membrane is shiny and
translucent, with a pearly gray color. The appearance of a yellow
clump of material indicates the presence of a piece of cerumen in the
external meatus. An excessive amount of cerumen in the external
auditory canal appears dark and covers a large part of the canal and
tympanic membrane. A hole in the tympanic membrane indicates
perforation of the membrane.
◉ An adult client tells the clinic nurse that he is susceptible to
middle ear infections. About which risk factor related to infection of
the ears does the nurse question this client?
A. Loud music
B. Use of power tools
C. Occupational noise
D. Exposure to cigarette smoke
Answer: D. Exposure to cigarette smoke
Rationale: Otitis media (middle ear infection) is associated with
colds, allergies, sore throats, and blockage of the eustachian tubes.
Risk factors include youth (otitis media is usually a childhood
disease), congenital abnormalities, immune deficiencies, exposure to
cigarette smoke, family history of otitis media, recent upper
respiratory infections, and allergies. Loud music, the use of power
tools, and occupational noise can all cause hearing loss. Hearing loss
PAPER 2026 CLINICAL JUDGMENT AND
PRIORITIZATION FULL ANSWERS AND
INSIGHT
◉ A client is experiencing a change in vision. The nurse performing
an eye examination uses an ophthalmoscope to best visualize which
area?
A.Iris
B. Cornea
C. Optic disc
D. Conjunctiva
Answer: C. Optic disc
Rationale: The ophthalmoscope enlarges the examiner's view of the
eye so that the media (anterior chamber, lens, vitreous humor) and
the ocular fundus (the internal surface of the retina) can be
examined. The optic disc is located on the internal surface of the
retina. The iris, conjunctiva, and cornea can be examined without the
use of an ophthalmoscope.
◉ A nurse notes that a client's physical examination record states
that the client's eyes moved normally through the six cardinal fields
of gaze. How should the nurse interpret this data?
,A. Normal near vision
B. Normal central vision
C. Normal peripheral vision
D. Normal ocular movements
Answer: D. Normal ocular movements
Rationale: Leading the client's eyes through the six cardinal fields of
gaze will elicit any muscle weakness during movement. This test
assesses the function of the medial rectus muscle, superior rectus
muscle, superior oblique muscle, lateral rectus muscle, inferior
rectus muscle, and inferior oblique muscle. Near vision is tested
with the use of a handheld vision screener that contains various
sizes of print. Central vision is measured with the use of a Snellen
chart. Peripheral vision is measured with the confrontation test.
◉ A nurse conducting an eye examination notes that the client
exhibits rapid, involuntary oscillating movements of the eyeball
when looking at the nurse. How should the nurse document this
finding?
A. Ptosis
B. Nystagmus
C. Scleral icterus
D. Exophthalmos
Answer: B. Nystagmus
Rationale: Nystagmus is a fine oscillating movement, most notable
around the iris. The nurse checks for nystagmus when assessing a
,client for ocular muscle weakness. Mild nystagmus at extreme
lateral gaze is normal; nystagmus at any other position is not. Ptosis
is a drooping of the eyelid. Scleral icterus is a yellowing of the sclera,
extending up to the cornea, that indicates jaundice. Exophthalmos, a
noticeable protrusion of the eyeball, is a characteristic sign of
hyperthyroidism.
◉ A nurse assessing a client's eyes notes that the pupils get larger
when the client looks at an object in the distance and become
smaller when the client looks at a nearby object. How does the nurse
document this finding?
A. Myopia
B. Hyperopia
C. Photophobia
D. Accommodation
Answer: D. Accommodation
Rationale: Accommodation is adaptation of the eye for near vision.
Movement of the ciliary muscles increases the curvature of the lens.
To observe accommodation, the examiner notes convergence
(motion toward) of the axes of the eyeballs and pupillary
constriction. Myopia is nearsightedness. Hyperopia is
farsightedness. Photophobia is abnormal sensitivity to light,
especially of the eyes.
, ◉ A nurse is using an otoscope to examine the ears of a client. Which
finding indicates to the nurse that the tympanic membrane is
normal?
Answer: Rationale: The tympanic membrane is shiny and
translucent, with a pearly gray color. The appearance of a yellow
clump of material indicates the presence of a piece of cerumen in the
external meatus. An excessive amount of cerumen in the external
auditory canal appears dark and covers a large part of the canal and
tympanic membrane. A hole in the tympanic membrane indicates
perforation of the membrane.
◉ An adult client tells the clinic nurse that he is susceptible to
middle ear infections. About which risk factor related to infection of
the ears does the nurse question this client?
A. Loud music
B. Use of power tools
C. Occupational noise
D. Exposure to cigarette smoke
Answer: D. Exposure to cigarette smoke
Rationale: Otitis media (middle ear infection) is associated with
colds, allergies, sore throats, and blockage of the eustachian tubes.
Risk factors include youth (otitis media is usually a childhood
disease), congenital abnormalities, immune deficiencies, exposure to
cigarette smoke, family history of otitis media, recent upper
respiratory infections, and allergies. Loud music, the use of power
tools, and occupational noise can all cause hearing loss. Hearing loss
