Comprehensive HESI Module Exam questions
and answers 2024\2025 A+ Grade
A primary health care provider prescribes a dose of morphine sulfate 2.5 mg stat to be administered
intravenously to a client in pain. The nurse preparing the medication notes that the label on the vial of
morphine sulfate solution for injection reads "4 mg/mL." How many milliliters (mL) must the nurse draw
into a syringe for administration to the client?
- correct answer 0.625 mL
Rationale: Use the medication calculation formula:
Desired amt/available x mL = mL per dose
A nurse is monitoring a hospitalized client who is being treated for preeclampsia. Which finding elicited
during the assessment indicates that the condition has not yet resolved?
Nursing Progress Notes:
1. Hyperreflexia is present.
2. Urinary protein is not detectable.
3. Urine output is 45 mL/hr.
4. Blood pressure is 128/78 mm Hg.
- correct answer 1. Hyperreflexia is present.
Rationale: In a client with preeclampsia, deep tendon reflexes may be very brisk (hyperreflexia) and
clonus (series of involuntary, rhythmic, muscular contractions and relaxations)may be present,
suggesting cerebral irritability resulting from decreased brain circulation and edema. Hypertension,
generalized edema, and proteinuria are the three classic signs of preeclampsia. Decreased urinary
output (less than 30 mL/hr) indicates poor perfusion of the kidneys and may precede acute renal failure.
Negative findings of the urinary protein assay, urine output of 45 mL/hr, and a blood pressure of 128/78
mm Hg are all signs that preeclampsia is resolving.
,A primary health care provider writes a prescription for 1000 mL of 0.9% normal saline solution to be
administered intravenously (IV) to a client over 10 hours. The drop factor for the infusion set is 15
gtt/mL. At what drip rate does the nurse set the infusion?
- correct answer 25 gtt/min
Rationale: Use the formula for calculating IV flow rates:
Total vol x Drop factor / time in min = drops in min
1000 mL x 15/600 = 25 drops
Enalapril maleate is prescribed for a hospitalized client. Which assessment does the nurse perform as a
priority before administering the medication?
1. Checking the client's intake-and-output record for the last 24 hours
2. Checking the most recent potassium level
3. Checking the client's peripheral pulses
4. Checking the client's blood pressure
- correct answer 4. Checking the client's blood pressure
Rationale: Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor used to treat
hypertension. One common side effect is postural hypotension. Therefore the nurse would check the
client's blood pressure immediately before administering each dose. Checking the client's peripheral
pulses, the results of the most recent potassium level, and the intake and output for the previous 24
hours are not specifically associated with this mediation.
A client is scheduled to undergo an upper gastrointestinal (GI) series, and the nurse provides
instructions to the client about the test. Which statement by the client indicates a need for further
instruction?
1. "I need to take a laxative after the test is completed, because the liquid that I'll have to drink for the
test can be constipating."
2. "I need to fast for 8 hours before the test."
,3. "I need to drink citrate of magnesia the night before the test and give myself a Fleet enema on the
morning of the test."
4. "The test will take about 30 minutes."
- correct answer 3. "I need to drink citrate of magnesia the night before the test and give myself a Fleet
enema on the morning of the test."
Rationale: No special preparation is necessary before a GI series, except that NPO (nothing by mouth)
status must be maintained for 8 hours before the test. An upper GI series involves visualization of the
esophagus, duodenum, and upper jejunum by means of the use of a contrast medium. It involves
swallowing a contrast medium (usually barium), which is administered in a flavored milkshake. Films are
taken at intervals during the test, which takes about 30 minutes. After an upper GI series, the client is
prescribed a laxative to hasten elimination of the barium. Barium that remains in the colon may become
hard and difficult to expel, leading to fecal impaction.
A nurse on the evening shift checks a primary health care provider's prescriptions and notes that the
dose of a prescribed medication is higher than the normal dose. The nurse calls the primary health care
provider's answering service and is told that the primary health care provider is off for the night and will
be available in the morning. What should the nurse do next?
1. Withhold the medication until the primary health care provider can be reached in the morning
2. Administer the medication but consult the primary health care provider when he becomes available
3. Ask the answering service to contact the on-call primary health care provider
4. Call the nursing supervisor
- correct answer 3. Ask the answering service to contact the on-call primary health care provider
Rationale: The nurse has a duty to protect the client from harm. A nurse who believes that a primary
health care provider's prescription may be in error is responsible for clarifying the prescription before
carrying it out. Therefore the nurse would not administer the medication; instead, the nurse would
withhold the medication until the dose can be clarified. The nurse would not wait until the next morning
to obtain clarification. It is premature to call the nursing supervisor.
An emergency department (ED) nurse is monitoring a client with suspected acute myocardial infarction
(MI) who is awaiting transfer to the coronary intensive care unit. The nurse notes the sudden onset of
premature ventricular contractions (PVCs) on the monitor, checks the client's carotid pulse, and
determines that the PVCs are not perfusing. What is the nurse's most appropriate action?
, 1. Inform the client that PVCs are expected after an MI
2. Ask the ED primary health care provider to check the client
3. Document the findings
4. Continue to monitor the client's cardiac status
- correct answer 2. Ask the ED primary health care provider to check the client
Rationale: The most appropriate action by the nurse would be to ask the ED health care provider to
check the client. PVCs are a result of increased irritability of ventricular cells. Peripheral pulses may be
absent or diminished with the PVCs themselves because the decreased stroke volume of the premature
beats may in turn decrease peripheral perfusion. Because other rhythms also cause widened QRS
complexes, it is essential that the nurse determine whether the premature beats are resulting in
perfusion of the extremities. This is done by palpating the carotid, brachial, or femoral artery while
observing the monitor for widened complexes or by auscultating for apical heart sounds. In the situation
of acute MI, PVCs may be considered warning dysrhythmias, possibly heralding the onset of ventricular
tachycardia or ventricular fibrillation. Therefore, the nurse would not tell the client that the PVCs are
expected. Although the nurse will continue to monitor the client and document the findings, these are
not the most appropriate actions of those provided.
NPO status is imposed 8 hours before the procedure on a client scheduled to undergo electroconvulsive
therapy (ECT) at 1 p.m. On the morning of the procedure, the nurse checks the client's record and notes
that the client routinely takes an oral antihypertensive medication each morning. What action should
the nurse take?
Withhold the antihypertensive and administer it at bedtime
Administer the antihypertensive with a small sip of water
Administer the medication by way of the intravenous (IV) route
Hold the antihypertensive and resume its administration on the day after the ECT
- correct answer Administer the antihypertensive with a small sip of water
Rationale: The nurse should administer the antihypertensive with a small sip of water. General
anesthesia is required for ECT, so NPO status is imposed for 6 to 8 hours before treatment to help
prevent aspiration. Exceptions include clients who routinely receive cardiac medications,
antihypertensive agents, or histamine (H2) blockers, which should be administered several hours before
treatment with a small sip of water. Withholding the antihypertensive and administering it at bedtime
and withholding the antihypertensive and resuming administration on the day after the ECT are
incorrect actions, because antihypertensives must be administered on time; otherwise, the risk for
and answers 2024\2025 A+ Grade
A primary health care provider prescribes a dose of morphine sulfate 2.5 mg stat to be administered
intravenously to a client in pain. The nurse preparing the medication notes that the label on the vial of
morphine sulfate solution for injection reads "4 mg/mL." How many milliliters (mL) must the nurse draw
into a syringe for administration to the client?
- correct answer 0.625 mL
Rationale: Use the medication calculation formula:
Desired amt/available x mL = mL per dose
A nurse is monitoring a hospitalized client who is being treated for preeclampsia. Which finding elicited
during the assessment indicates that the condition has not yet resolved?
Nursing Progress Notes:
1. Hyperreflexia is present.
2. Urinary protein is not detectable.
3. Urine output is 45 mL/hr.
4. Blood pressure is 128/78 mm Hg.
- correct answer 1. Hyperreflexia is present.
Rationale: In a client with preeclampsia, deep tendon reflexes may be very brisk (hyperreflexia) and
clonus (series of involuntary, rhythmic, muscular contractions and relaxations)may be present,
suggesting cerebral irritability resulting from decreased brain circulation and edema. Hypertension,
generalized edema, and proteinuria are the three classic signs of preeclampsia. Decreased urinary
output (less than 30 mL/hr) indicates poor perfusion of the kidneys and may precede acute renal failure.
Negative findings of the urinary protein assay, urine output of 45 mL/hr, and a blood pressure of 128/78
mm Hg are all signs that preeclampsia is resolving.
,A primary health care provider writes a prescription for 1000 mL of 0.9% normal saline solution to be
administered intravenously (IV) to a client over 10 hours. The drop factor for the infusion set is 15
gtt/mL. At what drip rate does the nurse set the infusion?
- correct answer 25 gtt/min
Rationale: Use the formula for calculating IV flow rates:
Total vol x Drop factor / time in min = drops in min
1000 mL x 15/600 = 25 drops
Enalapril maleate is prescribed for a hospitalized client. Which assessment does the nurse perform as a
priority before administering the medication?
1. Checking the client's intake-and-output record for the last 24 hours
2. Checking the most recent potassium level
3. Checking the client's peripheral pulses
4. Checking the client's blood pressure
- correct answer 4. Checking the client's blood pressure
Rationale: Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor used to treat
hypertension. One common side effect is postural hypotension. Therefore the nurse would check the
client's blood pressure immediately before administering each dose. Checking the client's peripheral
pulses, the results of the most recent potassium level, and the intake and output for the previous 24
hours are not specifically associated with this mediation.
A client is scheduled to undergo an upper gastrointestinal (GI) series, and the nurse provides
instructions to the client about the test. Which statement by the client indicates a need for further
instruction?
1. "I need to take a laxative after the test is completed, because the liquid that I'll have to drink for the
test can be constipating."
2. "I need to fast for 8 hours before the test."
,3. "I need to drink citrate of magnesia the night before the test and give myself a Fleet enema on the
morning of the test."
4. "The test will take about 30 minutes."
- correct answer 3. "I need to drink citrate of magnesia the night before the test and give myself a Fleet
enema on the morning of the test."
Rationale: No special preparation is necessary before a GI series, except that NPO (nothing by mouth)
status must be maintained for 8 hours before the test. An upper GI series involves visualization of the
esophagus, duodenum, and upper jejunum by means of the use of a contrast medium. It involves
swallowing a contrast medium (usually barium), which is administered in a flavored milkshake. Films are
taken at intervals during the test, which takes about 30 minutes. After an upper GI series, the client is
prescribed a laxative to hasten elimination of the barium. Barium that remains in the colon may become
hard and difficult to expel, leading to fecal impaction.
A nurse on the evening shift checks a primary health care provider's prescriptions and notes that the
dose of a prescribed medication is higher than the normal dose. The nurse calls the primary health care
provider's answering service and is told that the primary health care provider is off for the night and will
be available in the morning. What should the nurse do next?
1. Withhold the medication until the primary health care provider can be reached in the morning
2. Administer the medication but consult the primary health care provider when he becomes available
3. Ask the answering service to contact the on-call primary health care provider
4. Call the nursing supervisor
- correct answer 3. Ask the answering service to contact the on-call primary health care provider
Rationale: The nurse has a duty to protect the client from harm. A nurse who believes that a primary
health care provider's prescription may be in error is responsible for clarifying the prescription before
carrying it out. Therefore the nurse would not administer the medication; instead, the nurse would
withhold the medication until the dose can be clarified. The nurse would not wait until the next morning
to obtain clarification. It is premature to call the nursing supervisor.
An emergency department (ED) nurse is monitoring a client with suspected acute myocardial infarction
(MI) who is awaiting transfer to the coronary intensive care unit. The nurse notes the sudden onset of
premature ventricular contractions (PVCs) on the monitor, checks the client's carotid pulse, and
determines that the PVCs are not perfusing. What is the nurse's most appropriate action?
, 1. Inform the client that PVCs are expected after an MI
2. Ask the ED primary health care provider to check the client
3. Document the findings
4. Continue to monitor the client's cardiac status
- correct answer 2. Ask the ED primary health care provider to check the client
Rationale: The most appropriate action by the nurse would be to ask the ED health care provider to
check the client. PVCs are a result of increased irritability of ventricular cells. Peripheral pulses may be
absent or diminished with the PVCs themselves because the decreased stroke volume of the premature
beats may in turn decrease peripheral perfusion. Because other rhythms also cause widened QRS
complexes, it is essential that the nurse determine whether the premature beats are resulting in
perfusion of the extremities. This is done by palpating the carotid, brachial, or femoral artery while
observing the monitor for widened complexes or by auscultating for apical heart sounds. In the situation
of acute MI, PVCs may be considered warning dysrhythmias, possibly heralding the onset of ventricular
tachycardia or ventricular fibrillation. Therefore, the nurse would not tell the client that the PVCs are
expected. Although the nurse will continue to monitor the client and document the findings, these are
not the most appropriate actions of those provided.
NPO status is imposed 8 hours before the procedure on a client scheduled to undergo electroconvulsive
therapy (ECT) at 1 p.m. On the morning of the procedure, the nurse checks the client's record and notes
that the client routinely takes an oral antihypertensive medication each morning. What action should
the nurse take?
Withhold the antihypertensive and administer it at bedtime
Administer the antihypertensive with a small sip of water
Administer the medication by way of the intravenous (IV) route
Hold the antihypertensive and resume its administration on the day after the ECT
- correct answer Administer the antihypertensive with a small sip of water
Rationale: The nurse should administer the antihypertensive with a small sip of water. General
anesthesia is required for ECT, so NPO status is imposed for 6 to 8 hours before treatment to help
prevent aspiration. Exceptions include clients who routinely receive cardiac medications,
antihypertensive agents, or histamine (H2) blockers, which should be administered several hours before
treatment with a small sip of water. Withholding the antihypertensive and administering it at bedtime
and withholding the antihypertensive and resuming administration on the day after the ECT are
incorrect actions, because antihypertensives must be administered on time; otherwise, the risk for
