HESI COMPASS COMPREHENSIVE EXIT
EXAM 1 QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2025
1. A client with chronic kidney disease is experiencing hyperkalemia.
Which intervention is the highest priority?
A. Administer sodium polystyrene sulfonate
B. Place the client on a cardiac monitor
C. Provide a potassium-restricted diet
D. Monitor urine output
Hyperkalemia can cause life-threatening cardiac arrhythmias. Continuous
cardiac monitoring is essential to detect ECG changes early.
2. A nurse is caring for a client who is on a heparin infusion. What lab
value should the nurse monitor?
,A. INR
B. Hemoglobin
C. aPTT
D. Platelets
aPTT is the best indicator of heparin's anticoagulant effect and is used to
guide therapy.
3. A postpartum client is experiencing uterine atony. What is the nurse’s
first action?
A. Notify the provider
B. Start a blood transfusion
C. Massage the fundus
D. Assess the perineum
Uterine massage helps stimulate uterine contractions and control bleeding,
making it the first action.
4. Which finding indicates an adverse effect of enalapril?
A. Constipation
B. Insomnia
C. Hypokalemia
D. Persistent cough
ACE inhibitors like enalapril often cause a dry, persistent cough due to
bradykinin accumulation.
, 5. A nurse assesses a client with heart failure. Which finding requires
immediate attention?
A. Weight gain of 2 pounds
B. Bilateral crackles in the lungs
C. Mild shortness of breath on exertion
D. Fatigue
Crackles indicate pulmonary edema, a serious complication requiring
immediate intervention.
6. A client with diabetes is prescribed metformin. Which condition
requires the nurse to withhold the drug?
A. Scheduled CT scan with contrast
B. Chronic pain
C. Asthma
D. Mild hypertension
Contrast dyes can impair renal function. Metformin should be held 24–48
hours before and after contrast administration.
7. What dietary recommendation is best for a client with Meniere’s
disease?
A. High-protein diet
B. High-sodium diet
C. Low-sodium diet
D. Low-fat diet
, A low-sodium diet helps reduce inner ear fluid pressure and minimizes
vertigo symptoms.
8. Which task is appropriate to delegate to an unlicensed assistive
personnel (UAP)?
A. Assess pain level
B. Administer oral medications
C. Teach incentive spirometry
D. Assist with ambulation
Ambulation assistance is within the UAP scope; assessments and teaching
are not.
9. A client with COPD is receiving oxygen at 5 L/min. Which assessment
requires immediate action?
A. O2 sat of 90%
B. Decreased level of consciousness
C. Productive cough
D. Barrel-shaped chest
A decreased LOC in a COPD client receiving high-flow oxygen may indicate
CO2 retention.
10. Which client behavior indicates understanding of how to
prevent dumping syndrome?
A. Drinking fluids with meals
B. Eating small, frequent meals
EXAM 1 QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2025
1. A client with chronic kidney disease is experiencing hyperkalemia.
Which intervention is the highest priority?
A. Administer sodium polystyrene sulfonate
B. Place the client on a cardiac monitor
C. Provide a potassium-restricted diet
D. Monitor urine output
Hyperkalemia can cause life-threatening cardiac arrhythmias. Continuous
cardiac monitoring is essential to detect ECG changes early.
2. A nurse is caring for a client who is on a heparin infusion. What lab
value should the nurse monitor?
,A. INR
B. Hemoglobin
C. aPTT
D. Platelets
aPTT is the best indicator of heparin's anticoagulant effect and is used to
guide therapy.
3. A postpartum client is experiencing uterine atony. What is the nurse’s
first action?
A. Notify the provider
B. Start a blood transfusion
C. Massage the fundus
D. Assess the perineum
Uterine massage helps stimulate uterine contractions and control bleeding,
making it the first action.
4. Which finding indicates an adverse effect of enalapril?
A. Constipation
B. Insomnia
C. Hypokalemia
D. Persistent cough
ACE inhibitors like enalapril often cause a dry, persistent cough due to
bradykinin accumulation.
, 5. A nurse assesses a client with heart failure. Which finding requires
immediate attention?
A. Weight gain of 2 pounds
B. Bilateral crackles in the lungs
C. Mild shortness of breath on exertion
D. Fatigue
Crackles indicate pulmonary edema, a serious complication requiring
immediate intervention.
6. A client with diabetes is prescribed metformin. Which condition
requires the nurse to withhold the drug?
A. Scheduled CT scan with contrast
B. Chronic pain
C. Asthma
D. Mild hypertension
Contrast dyes can impair renal function. Metformin should be held 24–48
hours before and after contrast administration.
7. What dietary recommendation is best for a client with Meniere’s
disease?
A. High-protein diet
B. High-sodium diet
C. Low-sodium diet
D. Low-fat diet
, A low-sodium diet helps reduce inner ear fluid pressure and minimizes
vertigo symptoms.
8. Which task is appropriate to delegate to an unlicensed assistive
personnel (UAP)?
A. Assess pain level
B. Administer oral medications
C. Teach incentive spirometry
D. Assist with ambulation
Ambulation assistance is within the UAP scope; assessments and teaching
are not.
9. A client with COPD is receiving oxygen at 5 L/min. Which assessment
requires immediate action?
A. O2 sat of 90%
B. Decreased level of consciousness
C. Productive cough
D. Barrel-shaped chest
A decreased LOC in a COPD client receiving high-flow oxygen may indicate
CO2 retention.
10. Which client behavior indicates understanding of how to
prevent dumping syndrome?
A. Drinking fluids with meals
B. Eating small, frequent meals
