Page 1 of 166
“HESI V3 2026 EXIT EXAM ”LATEST EXAM 2026 –
2027 SOLVED QUESTIONS & ANSWERS
VERIFIED 100% GRADED A+ (LATEST VERSION)
WELL REVISED 100% GUARANTEE PASS
HESI Comprehensive Exam
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?
Document the findings
Ask the ED primary health care provider to check the client
Continue to monitor the client's cardiac status
Inform the client that PVCs are expected after an MI
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,
, Page 2 of 166
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?
Administer the antihypertensive with a small sip of water
Withhold the antihypertensive and administer it at bedtime
Administer the medication by way of the intravenous (IV) route
Hold the antihypertensive and resume its administration on the day after the
ECT
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 rebound hypertension exists. The nurse would not administer
a medication by way of a route that has not been prescribed.
A client who recently underwent coronary artery bypass graft surgery comes
to the primary health care provider's office for a follow-up visit. On
assessment, the client tells the nurse that he is feeling depressed. Which
response by the nurse is therapeutic?
, Page 3 of 166
"Tell me more about what you're feeling."
"That's a normal response after this type of surgery."
"It will take time, but I promise you, you will get over this depression."
"Every client who has this surgery feels the same way for about a month."
"Tell me more about what you're feeling."
Rationale: The therapeutic response by the nurse is, "Tell me more about what
you're feeling." When a client expresses feelings of depression, it is extremely
important for the nurse to further explore these feelings with the client. In stating,
"This is a normal response after this type of surgery" the nurse provides false
reassurance and avoids addressing the client's feelings. "It will take time, but I
promise you, you will get over the depression" is also a false reassurance, and it
does not encourage the expression of feelings. "Every client who has this surgery
feels the same way for about a month" is a generalization that avoids the client's
feelings.
A client in labor experiences spontaneous rupture of the membranes. The
nurse immediately counts the fetal heart rate (FHR) for 1 full minute and then
checks the amniotic fluid. The nurse notes that the fluid is yellow and has a
strong odor. Which action should be the nurse's priority?
Contact the primary health care provider
Document the findings
Check the fluid for protein
Continue to monitor the client and the FHR
Contact the primary health care provider
Rationale: The priority action is for the nurse to contact the primary health care
provider. The FHR is assessed for at least 1 minute when the membranes rupture.
The nurse also checks the quantity, color, and odor of the amniotic fluid. The fluid
should be clear (often with bits of vernix) and have a mild odor. Fluid with a foul or
strong odor, cloudy appearance, or yellow coloration suggests chorioamnionitis and
warrants notifying the primary health care provider. A large amount of vernix in the
fluid suggests that the fetus is preterm. Greenish, meconium-stained fluid may be
, Page 4 of 166
seen in cases of postterm gestation or placental insufficiency. Checking the fluid for
protein is not associated with the data in the question. The nurse would continue to
monitor the client and the FHR and would document the findings.
A nurse has assisted a primary health care provider in inserting a central
venous access device into a client with a diagnosis of severe malnutrition who
will be receiving parenteral nutrition (PN). After insertion of the catheter what
does the nurse immediately do?
Call the radiography department to obtain a chest x-ray
Check the client's blood glucose level to serve as a baseline measurement
Hang the prescribed bag of PN and start the infusion at the prescribed rate
Infuse normal saline solution through the catheter at a rate of 100 mL/hr to
maintain patency
Call the radiography department to obtain a chest x-ray
Rationale: The nurse should immediately make arrangements to have a chest x-ray
done. One major complication associated with central venous catheter placement is
pneumothorax, which may result from accidental puncture of the lung. After the
catheter has been placed but before it is used for infusions, its placement must be
checked with an x-ray. Hanging the prescribed bag of PN and starting the infusion at
the prescribed rate and infusing normal saline solution through the catheter at a rate
of 100 mL/hr to maintain patency are all incorrect because they could result in the
infusion of solution into a lung if a pneumothorax is present. Although the nurse may
obtain a blood glucose measurement to serve as a baseline, this action is not the
priority.
A rape victim being treated in the emergency department says to the nurse,
"I'm really worried that I've got HIV now." What is the most appropriate
response by the nurse?
"HIV is rarely an issue in rape victims."
"Every rape victim is concerned about HIV."
"You're more likely to get pregnant than to contract HIV."
"Let's talk about the information that you need to determine your risk of
contracting HIV."
“HESI V3 2026 EXIT EXAM ”LATEST EXAM 2026 –
2027 SOLVED QUESTIONS & ANSWERS
VERIFIED 100% GRADED A+ (LATEST VERSION)
WELL REVISED 100% GUARANTEE PASS
HESI Comprehensive Exam
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?
Document the findings
Ask the ED primary health care provider to check the client
Continue to monitor the client's cardiac status
Inform the client that PVCs are expected after an MI
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,
, Page 2 of 166
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?
Administer the antihypertensive with a small sip of water
Withhold the antihypertensive and administer it at bedtime
Administer the medication by way of the intravenous (IV) route
Hold the antihypertensive and resume its administration on the day after the
ECT
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 rebound hypertension exists. The nurse would not administer
a medication by way of a route that has not been prescribed.
A client who recently underwent coronary artery bypass graft surgery comes
to the primary health care provider's office for a follow-up visit. On
assessment, the client tells the nurse that he is feeling depressed. Which
response by the nurse is therapeutic?
, Page 3 of 166
"Tell me more about what you're feeling."
"That's a normal response after this type of surgery."
"It will take time, but I promise you, you will get over this depression."
"Every client who has this surgery feels the same way for about a month."
"Tell me more about what you're feeling."
Rationale: The therapeutic response by the nurse is, "Tell me more about what
you're feeling." When a client expresses feelings of depression, it is extremely
important for the nurse to further explore these feelings with the client. In stating,
"This is a normal response after this type of surgery" the nurse provides false
reassurance and avoids addressing the client's feelings. "It will take time, but I
promise you, you will get over the depression" is also a false reassurance, and it
does not encourage the expression of feelings. "Every client who has this surgery
feels the same way for about a month" is a generalization that avoids the client's
feelings.
A client in labor experiences spontaneous rupture of the membranes. The
nurse immediately counts the fetal heart rate (FHR) for 1 full minute and then
checks the amniotic fluid. The nurse notes that the fluid is yellow and has a
strong odor. Which action should be the nurse's priority?
Contact the primary health care provider
Document the findings
Check the fluid for protein
Continue to monitor the client and the FHR
Contact the primary health care provider
Rationale: The priority action is for the nurse to contact the primary health care
provider. The FHR is assessed for at least 1 minute when the membranes rupture.
The nurse also checks the quantity, color, and odor of the amniotic fluid. The fluid
should be clear (often with bits of vernix) and have a mild odor. Fluid with a foul or
strong odor, cloudy appearance, or yellow coloration suggests chorioamnionitis and
warrants notifying the primary health care provider. A large amount of vernix in the
fluid suggests that the fetus is preterm. Greenish, meconium-stained fluid may be
, Page 4 of 166
seen in cases of postterm gestation or placental insufficiency. Checking the fluid for
protein is not associated with the data in the question. The nurse would continue to
monitor the client and the FHR and would document the findings.
A nurse has assisted a primary health care provider in inserting a central
venous access device into a client with a diagnosis of severe malnutrition who
will be receiving parenteral nutrition (PN). After insertion of the catheter what
does the nurse immediately do?
Call the radiography department to obtain a chest x-ray
Check the client's blood glucose level to serve as a baseline measurement
Hang the prescribed bag of PN and start the infusion at the prescribed rate
Infuse normal saline solution through the catheter at a rate of 100 mL/hr to
maintain patency
Call the radiography department to obtain a chest x-ray
Rationale: The nurse should immediately make arrangements to have a chest x-ray
done. One major complication associated with central venous catheter placement is
pneumothorax, which may result from accidental puncture of the lung. After the
catheter has been placed but before it is used for infusions, its placement must be
checked with an x-ray. Hanging the prescribed bag of PN and starting the infusion at
the prescribed rate and infusing normal saline solution through the catheter at a rate
of 100 mL/hr to maintain patency are all incorrect because they could result in the
infusion of solution into a lung if a pneumothorax is present. Although the nurse may
obtain a blood glucose measurement to serve as a baseline, this action is not the
priority.
A rape victim being treated in the emergency department says to the nurse,
"I'm really worried that I've got HIV now." What is the most appropriate
response by the nurse?
"HIV is rarely an issue in rape victims."
"Every rape victim is concerned about HIV."
"You're more likely to get pregnant than to contract HIV."
"Let's talk about the information that you need to determine your risk of
contracting HIV."
