HESI comprehensive Exam 2026
Questions and Answers
A nurse taking the vital signs of a client immediately after she has delivered a
newborn notes that the client's heart rate is 110 beats/min. What should the nurse
do first?
Recheck the heart rate in 1 hour
Offer the client oral fluids
Check the uterus and amount of lochia discharge Correct
Document the findings - Correct answer-If tachycardia is noted, the nurse should
first assess the location and firmness of the uterus and amount of lochia. Additional
assessments including blood pressure, estimated blood loss at delivery, and
hemoglobin and hematocrit determinations should be carried out. After delivery,
the normal heart rate ranges from 60 to 90 beats/min. Tachycardia may indicate
excitement, fatigue, dehydration, hypovolemia, pain, or infection. Although the
nurse would document the findings, it is most appropriate for the nurse to assess
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,the client to determine the cause of the tachycardia. Oral fluids are important if the
client is dehydrated, but further assessment of the problem is required and
dehydration would first need to be confirmed. Rechecking the heart rate in 1 hour
will delay necessary interventions.
A nurse reviews the laboratory results of a hospitalized pregnant client with a
diagnosis of sepsis who is at risk for disseminated intravascular coagulopathy
(DIC). Which laboratory finding would indicate to the nurse that DIC has
developed in the client?
Shortened prothrombin time
Increased platelet count
Positive result on d-dimer study Correct
Decreased fibrin-degradation products - Correct answer-The d-dimer study is used
to confirm the presence of fibrin split products; a positive result is indicative of
DIC. DIC is a life-threatening defect in coagulation. As plasma factors are
consumed, the circulating blood becomes deficient in clotting factors and unable to
clot. Even as anticoagulation is occurring, inappropriate coagulation is also taking
place in the microcirculation, and tiny clots form in the smallest blood vessels,
blocking blood flow to the organs and causing ischemia. Laboratory studies help
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,establish a diagnosis. The fibrinogen value and platelet count are usually
decreased, prothrombin and activated partial thromboplastin times may be
prolonged, and levels of fibrin degradation products (the most sensitive
measurement) are increased.
The nurse is assessing a client who has a history of Prinzmetal's angina. The nurse
knows that what type of medication is given to treat this condition?
Calcium channel blockers Correct
ACE inhibitors
Inotropes
Beta blockers - Correct answer-Prinzmetal's, or variant, angina is prolonged and
severe and occurs at the same time each day, most often at rest. The treatment of
choice is usually a calcium channel blocker. Calcium channel blockers relax and
dilate the vascular smooth muscle, thus relieving the coronary artery spasm in
variant angina. Inotropes, beta blockers, and angiotensin-converting enzyme
(ACE) inhibitors are not given to treat this disorder.
Ciprofloxacin hydrochloride is prescribed to a client with a urinary tract infection.
The nurse provides instruction about the medication. What does the nurse tell the
client about how best to take the medication?
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, With aluminum hydroxide
With an antacid
With milk
2 hours after meals Correct - Correct answer-Ciprofloxacin hydrochloride is an
anti-infective in the fluoroquinolone family. It may be taken without regard to
meals, but the best dosing time is 2 hours after a meal. Milk may affect absorption.
Antacids (here, aluminum hydroxide) may reduce absorption and should be
administered 2 hours apart from the ciprofloxacin hydrochloride.
Ergotamine is prescribed to a client with cluster headaches. Which occurrence does
the nurse tell the client to report to the primary health care provider if she
experiences them while taking the medication?
Fatigue and lethargy
Dizziness and fatigue
Numbness and tingling of the fingers or toes Correct
Cough - Correct answer-Ergotamine is an antimigraine medication. Prolonged
administration or an excessive dosage may produce ergotamine poisoning
(ergotism). Signs/symptoms include nausea, vomiting, weakness in the legs, pain
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
Questions and Answers
A nurse taking the vital signs of a client immediately after she has delivered a
newborn notes that the client's heart rate is 110 beats/min. What should the nurse
do first?
Recheck the heart rate in 1 hour
Offer the client oral fluids
Check the uterus and amount of lochia discharge Correct
Document the findings - Correct answer-If tachycardia is noted, the nurse should
first assess the location and firmness of the uterus and amount of lochia. Additional
assessments including blood pressure, estimated blood loss at delivery, and
hemoglobin and hematocrit determinations should be carried out. After delivery,
the normal heart rate ranges from 60 to 90 beats/min. Tachycardia may indicate
excitement, fatigue, dehydration, hypovolemia, pain, or infection. Although the
nurse would document the findings, it is most appropriate for the nurse to assess
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,the client to determine the cause of the tachycardia. Oral fluids are important if the
client is dehydrated, but further assessment of the problem is required and
dehydration would first need to be confirmed. Rechecking the heart rate in 1 hour
will delay necessary interventions.
A nurse reviews the laboratory results of a hospitalized pregnant client with a
diagnosis of sepsis who is at risk for disseminated intravascular coagulopathy
(DIC). Which laboratory finding would indicate to the nurse that DIC has
developed in the client?
Shortened prothrombin time
Increased platelet count
Positive result on d-dimer study Correct
Decreased fibrin-degradation products - Correct answer-The d-dimer study is used
to confirm the presence of fibrin split products; a positive result is indicative of
DIC. DIC is a life-threatening defect in coagulation. As plasma factors are
consumed, the circulating blood becomes deficient in clotting factors and unable to
clot. Even as anticoagulation is occurring, inappropriate coagulation is also taking
place in the microcirculation, and tiny clots form in the smallest blood vessels,
blocking blood flow to the organs and causing ischemia. Laboratory studies help
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,establish a diagnosis. The fibrinogen value and platelet count are usually
decreased, prothrombin and activated partial thromboplastin times may be
prolonged, and levels of fibrin degradation products (the most sensitive
measurement) are increased.
The nurse is assessing a client who has a history of Prinzmetal's angina. The nurse
knows that what type of medication is given to treat this condition?
Calcium channel blockers Correct
ACE inhibitors
Inotropes
Beta blockers - Correct answer-Prinzmetal's, or variant, angina is prolonged and
severe and occurs at the same time each day, most often at rest. The treatment of
choice is usually a calcium channel blocker. Calcium channel blockers relax and
dilate the vascular smooth muscle, thus relieving the coronary artery spasm in
variant angina. Inotropes, beta blockers, and angiotensin-converting enzyme
(ACE) inhibitors are not given to treat this disorder.
Ciprofloxacin hydrochloride is prescribed to a client with a urinary tract infection.
The nurse provides instruction about the medication. What does the nurse tell the
client about how best to take the medication?
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, With aluminum hydroxide
With an antacid
With milk
2 hours after meals Correct - Correct answer-Ciprofloxacin hydrochloride is an
anti-infective in the fluoroquinolone family. It may be taken without regard to
meals, but the best dosing time is 2 hours after a meal. Milk may affect absorption.
Antacids (here, aluminum hydroxide) may reduce absorption and should be
administered 2 hours apart from the ciprofloxacin hydrochloride.
Ergotamine is prescribed to a client with cluster headaches. Which occurrence does
the nurse tell the client to report to the primary health care provider if she
experiences them while taking the medication?
Fatigue and lethargy
Dizziness and fatigue
Numbness and tingling of the fingers or toes Correct
Cough - Correct answer-Ergotamine is an antimigraine medication. Prolonged
administration or an excessive dosage may produce ergotamine poisoning
(ergotism). Signs/symptoms include nausea, vomiting, weakness in the legs, pain
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
