HESI COMPASS MODULE 1 PRACTICE
EXAM QUESTIONS AND ACTUAL
ANSWERS.
A nurse is performing an ophthalmoscopic examination of an older client. Which age-related
change would the nurse expect to note while viewing the retina?
A. Clear fundus
B. Red BVs
C. Yellow-orange optic disc
D. Yellow spots near the macula - Answer D. Yellow spots near the macula
Rationale: Age-related changes of the retina include narrowed and straightened blood vessels,
opaque gray arteries, and gray or yellow spots of hyaline degeneration, called drusen, near the
macula. Red blood vessels, a clear fundus, and a yellow-orange optic disc are all normal
findings, not age-related changes.
Select all: Which findings are normal age-related physiological changes?
A. Increased HR
B. Diminished visual acuity
C. Decline in long-term memory
D. Increased susceptibility to UTIs
E. Increased incidence of awakening after onset of sleep - Answer B, D
Rationale: Anatomic changes in the eye affect the older individual's visual ability acuity,
sometimes leading to problems in carrying out activities of daily living. Light adaptation is
diminished and visual fields reduced. The heart rate slows and the heart valves thicken. Age-
related changes that affect the urinary tract increase an older client's susceptibility to urinary
tract infections. Short-term memory may decline with age, but long-term memory is usually
maintained. Sleep pattern changes are common with increasing age. Older persons generally
experience an increased incidence of awakening after sleep onset.
Which action should the nurse implement first to treat the dehydration?
,D. Starting an intravenous (IV) line and administer IV fluids - Answer A
Rationale: Oral hydration is the first approach to the treatment of dehydration if the client is
able to ingest fluids. Sport drinks, though high in sugar, are often recommended over tap water
because they are easily absorbed by the stomach, are generally palatable to clients, and will
more quickly correct the dehydration. Pedialyte and other commercial fluid and electrolyte
solutions are also available. The administration of IV fluids is a last-resort approach. There is no
reason to maintain Mrs. Valenti on NPO status; in fact, this could worsen the dehydration.
After 2 days Mrs. Valenti is feeling better, and the discharge planner begins arranging for her to
be sent back to the residential home. The nurse gives report to the nurse at the home, and Mrs.
Valenti arrives there late in the afternoon. Which measures should the nurse at the residential
home implement to prevent recurrence of dehydration? Select all that apply.
A. Assess urine output
B. Offering fluids with meals only
C. Offering fluids other than water, such as coffee and iced tea
D. Monitoring her pulse and respiratory rates, and blood pressure
E. Find out what fluids she prefers besides water and offer those - Answer A, D, E
Rationale: Measures to help prevent dehydration in older adults include monitoring pulse rate
and respiration for increases and the blood pressure for a decrease, all of which may indicate
dehydration. In addition, urine output should be monitored, because decreased urine output
may indicate dehydration. Fluids should be offered every hour, including with the evening snack,
and the nurse should find out what fluids are preferred and offer those, with the exception of
drinks containing caffeine (e.g., coffee and iced tea), which acts as a diuretic.
The nurse is assessing Mrs. Valenti's nutritional status. Which statements by Mrs. Valenti
indicate a risk for malnutrition? Select all that apply.
A. "Sometimes I have to make myself eat."
B. "My weight stays about the same each week."
C. "Food just doesn't taste the same as it used to."
D. "I have to wear my dentures to chew my food."
E. "Sometimes I have trouble swallowing my food." - Answer A, C, E
,A nurse provides information to a female client about the use of a diaphragm. Which statement
by the client indicates a need for further information?
A. "I need to use spermicidal cream with the diaphragm."
B. "I shouldn't leave the diaphragm in for more than 24 hours."
C. "I have to insert the diaphragm immediately before intercourse."
D. "The diaphragm should stay in place for at least 6 hours after intercourse." - Answer C
Rationale: When in place over the cervical os, the diaphragm blocks access of sperm to the
cervix. Because the device does not fit tightly enough to completely block penetration of sperm,
however, it must be filled with spermicidal jelly or cream before insertion. (Spermicide must be
reapplied with repeated intercourse.) It may be inserted as long as 6 hours before intercourse.
The diaphragm must remain in place for at least 6 hours after intercourse, but, because of the
risk of toxic shock syndrome, it should not be left in place for more than 24 hours.
A client discussing family planning methods with the nurse tells the nurse that she uses the
calendar method because her menstrual periods are regular. Which information about the
reliability of this method should the nurse provide to the client?
A. It is unreliable
B. It is extremely reliable if menstrual periods are regular.
C. If it has prevented pregnancy so far, it is a reliable method.
D. It is very reliable if the basal body temperature method is also used. - Answer A
Rationale: The calendar method is based on the fact that ovulation occurs approximately 14
days before the onset of menses. It is unreliable because many factors, such as illness or stress,
can affect the time of ovulation. In the basal body temperature method, the woman charts her
temperature each morning before getting out of bed. The basal body temperature may
decrease slightly before ovulation and then increase slightly with ovulation. This method, which
is not reliable because errors are frequent, is often used along with other methods. Therefore
the other options are incorrect.
The nurse provides information to Marilyn about follow-up care while taking the oral
contraceptives. Which instruction should the nurse provide to Marilyn?
, C. She will need to have a yearly pelvic and breast examination, Papanicolaou (Pap) smear, and
blood pressure measurement.
D. She will need to have a pelvic and breast examination and Pap smear every 2 years, but her
blood pressure should be checked every 6 months. - Answer C
Rationale: A woman who takes oral contraceptives should have a yearly pelvic and breast
examination, Pap smear, and blood pressure measurement. Cardiovascular tests and liver
function studies are not necessary.
After a year, Marilyn calls the nurse to report that she may be pregnant. She says, "I missed 2
days of pills, so we've been using the rhythm method. Do I still take today's pill?" Which
responses by the nurse are appropriate? Select all that apply.
A. "Can you stop by the office this afternoon for a pregnancy test?"
B. "Keep taking the birth control until your pregnancy is confirmed."
C. "The rhythm method is quite accurate. You probably are not pregnant."
D. "Wait a week, and if you still think you're pregnant stop the birth control pill."
E. "Do not take the birth control until you are tested in the office for pregnancy." - Answer A
Rationale: Pregnancy, or possible pregnancy, is a contraindication to the use of oral
contraceptives. The client should be told to stop taking the contraceptive until pregnancy is
confirmed or ruled out. The rhythm method, though commonly used, is not always effective,
because ovulation is often irregular. The nurse cannot determine whether the client is pregnant
with just a telephone conversation. A pregnancy test should be performed as soon as possible.
A client attending prenatal birthing class asks the nurse how long it takes for an egg to implant
in the uterus once it has been fertilized. Which response should the nurse give?
A. 4 days
B. 10 days
C. 14 days
D. 21 days - Answer B
Rationale: Fertilization occurs when one spermatozoon enters the ovum and the two nuclei
containing the parents' chromosomes merge. Once the ovum is fertilized, implantation
EXAM QUESTIONS AND ACTUAL
ANSWERS.
A nurse is performing an ophthalmoscopic examination of an older client. Which age-related
change would the nurse expect to note while viewing the retina?
A. Clear fundus
B. Red BVs
C. Yellow-orange optic disc
D. Yellow spots near the macula - Answer D. Yellow spots near the macula
Rationale: Age-related changes of the retina include narrowed and straightened blood vessels,
opaque gray arteries, and gray or yellow spots of hyaline degeneration, called drusen, near the
macula. Red blood vessels, a clear fundus, and a yellow-orange optic disc are all normal
findings, not age-related changes.
Select all: Which findings are normal age-related physiological changes?
A. Increased HR
B. Diminished visual acuity
C. Decline in long-term memory
D. Increased susceptibility to UTIs
E. Increased incidence of awakening after onset of sleep - Answer B, D
Rationale: Anatomic changes in the eye affect the older individual's visual ability acuity,
sometimes leading to problems in carrying out activities of daily living. Light adaptation is
diminished and visual fields reduced. The heart rate slows and the heart valves thicken. Age-
related changes that affect the urinary tract increase an older client's susceptibility to urinary
tract infections. Short-term memory may decline with age, but long-term memory is usually
maintained. Sleep pattern changes are common with increasing age. Older persons generally
experience an increased incidence of awakening after sleep onset.
Which action should the nurse implement first to treat the dehydration?
,D. Starting an intravenous (IV) line and administer IV fluids - Answer A
Rationale: Oral hydration is the first approach to the treatment of dehydration if the client is
able to ingest fluids. Sport drinks, though high in sugar, are often recommended over tap water
because they are easily absorbed by the stomach, are generally palatable to clients, and will
more quickly correct the dehydration. Pedialyte and other commercial fluid and electrolyte
solutions are also available. The administration of IV fluids is a last-resort approach. There is no
reason to maintain Mrs. Valenti on NPO status; in fact, this could worsen the dehydration.
After 2 days Mrs. Valenti is feeling better, and the discharge planner begins arranging for her to
be sent back to the residential home. The nurse gives report to the nurse at the home, and Mrs.
Valenti arrives there late in the afternoon. Which measures should the nurse at the residential
home implement to prevent recurrence of dehydration? Select all that apply.
A. Assess urine output
B. Offering fluids with meals only
C. Offering fluids other than water, such as coffee and iced tea
D. Monitoring her pulse and respiratory rates, and blood pressure
E. Find out what fluids she prefers besides water and offer those - Answer A, D, E
Rationale: Measures to help prevent dehydration in older adults include monitoring pulse rate
and respiration for increases and the blood pressure for a decrease, all of which may indicate
dehydration. In addition, urine output should be monitored, because decreased urine output
may indicate dehydration. Fluids should be offered every hour, including with the evening snack,
and the nurse should find out what fluids are preferred and offer those, with the exception of
drinks containing caffeine (e.g., coffee and iced tea), which acts as a diuretic.
The nurse is assessing Mrs. Valenti's nutritional status. Which statements by Mrs. Valenti
indicate a risk for malnutrition? Select all that apply.
A. "Sometimes I have to make myself eat."
B. "My weight stays about the same each week."
C. "Food just doesn't taste the same as it used to."
D. "I have to wear my dentures to chew my food."
E. "Sometimes I have trouble swallowing my food." - Answer A, C, E
,A nurse provides information to a female client about the use of a diaphragm. Which statement
by the client indicates a need for further information?
A. "I need to use spermicidal cream with the diaphragm."
B. "I shouldn't leave the diaphragm in for more than 24 hours."
C. "I have to insert the diaphragm immediately before intercourse."
D. "The diaphragm should stay in place for at least 6 hours after intercourse." - Answer C
Rationale: When in place over the cervical os, the diaphragm blocks access of sperm to the
cervix. Because the device does not fit tightly enough to completely block penetration of sperm,
however, it must be filled with spermicidal jelly or cream before insertion. (Spermicide must be
reapplied with repeated intercourse.) It may be inserted as long as 6 hours before intercourse.
The diaphragm must remain in place for at least 6 hours after intercourse, but, because of the
risk of toxic shock syndrome, it should not be left in place for more than 24 hours.
A client discussing family planning methods with the nurse tells the nurse that she uses the
calendar method because her menstrual periods are regular. Which information about the
reliability of this method should the nurse provide to the client?
A. It is unreliable
B. It is extremely reliable if menstrual periods are regular.
C. If it has prevented pregnancy so far, it is a reliable method.
D. It is very reliable if the basal body temperature method is also used. - Answer A
Rationale: The calendar method is based on the fact that ovulation occurs approximately 14
days before the onset of menses. It is unreliable because many factors, such as illness or stress,
can affect the time of ovulation. In the basal body temperature method, the woman charts her
temperature each morning before getting out of bed. The basal body temperature may
decrease slightly before ovulation and then increase slightly with ovulation. This method, which
is not reliable because errors are frequent, is often used along with other methods. Therefore
the other options are incorrect.
The nurse provides information to Marilyn about follow-up care while taking the oral
contraceptives. Which instruction should the nurse provide to Marilyn?
, C. She will need to have a yearly pelvic and breast examination, Papanicolaou (Pap) smear, and
blood pressure measurement.
D. She will need to have a pelvic and breast examination and Pap smear every 2 years, but her
blood pressure should be checked every 6 months. - Answer C
Rationale: A woman who takes oral contraceptives should have a yearly pelvic and breast
examination, Pap smear, and blood pressure measurement. Cardiovascular tests and liver
function studies are not necessary.
After a year, Marilyn calls the nurse to report that she may be pregnant. She says, "I missed 2
days of pills, so we've been using the rhythm method. Do I still take today's pill?" Which
responses by the nurse are appropriate? Select all that apply.
A. "Can you stop by the office this afternoon for a pregnancy test?"
B. "Keep taking the birth control until your pregnancy is confirmed."
C. "The rhythm method is quite accurate. You probably are not pregnant."
D. "Wait a week, and if you still think you're pregnant stop the birth control pill."
E. "Do not take the birth control until you are tested in the office for pregnancy." - Answer A
Rationale: Pregnancy, or possible pregnancy, is a contraindication to the use of oral
contraceptives. The client should be told to stop taking the contraceptive until pregnancy is
confirmed or ruled out. The rhythm method, though commonly used, is not always effective,
because ovulation is often irregular. The nurse cannot determine whether the client is pregnant
with just a telephone conversation. A pregnancy test should be performed as soon as possible.
A client attending prenatal birthing class asks the nurse how long it takes for an egg to implant
in the uterus once it has been fertilized. Which response should the nurse give?
A. 4 days
B. 10 days
C. 14 days
D. 21 days - Answer B
Rationale: Fertilization occurs when one spermatozoon enters the ovum and the two nuclei
containing the parents' chromosomes merge. Once the ovum is fertilized, implantation
