HESI COMPASS COMPREHENSIVE EXIT EXAM 2026/2027
150 Questions and Correct Answers | All Modules Covered | Already Graded A+ | 100% Verified
Exam Structure
The HESI Comprehensive Exit Exam is commonly structured as follows:
150 multiple-choice questions
Single-best-answer format
Scenario-based, application, and clinical judgment items covering all modules
Introduction
This HESI COMPASS Comprehensive Exit Exam format for the 2026/2027 cycle reflects the standard assessment used for evaluating
readiness for NCLEX-RN licensure. The exam emphasizes integration of core nursing knowledge, safe patient care, pharmacology,
critical thinking, evidence-based interventions, and leadership across all practice domains.
Answer Format
All correct answers are presented in bold and green, followed by clearly defined rationales explaining clinical reasoning, safety
priorities, evidence-based interventions, and module-specific content application.
Exam Questions
1.
A client with heart failure is prescribed furosemide 40 mg IV. Which of the following assessments should the
nurse prioritize before administration?
A. Blood glucose level
B. Serum potassium level
C. Urine output and blood pressure
D. Respiratory rate
Rationale: Furosemide is a loop diuretic that can cause hypotension and electrolyte imbalances. Assessing urine output and
blood pressure helps evaluate renal perfusion and risk of hypotension before administration.
2.
A 6-year-old child with asthma is prescribed albuterol via nebulizer. Which of the following side effects should the
nurse monitor for?
A. Bradycardia
B. Hypotension
C. Tachycardia
D. Sedation
Rationale: Albuterol is a beta-2 agonist that can cause tachycardia as a side effect due to its stimulant properties on the
sympathetic nervous system.
3.
A postpartum client reports severe perineal pain. Which of the following non-pharmacological interventions
should the nurse suggest first?
A. Warm sitz bath
B. Ice pack application
C. Perineal care with cool water
D. Ambulation
Rationale: Cool water perineal care reduces swelling and pain by constricting blood vessels, providing immediate relief for
postpartum perineal discomfort.
4.
A client with schizophrenia is prescribed haloperidol. Which of the following extrapyramidal side effects should
the nurse monitor for?
A. Hypertension
B. Tachycardia
, C. Akathisia
D. Diarrhea
Rationale: Haloperidol, an antipsychotic, can cause extrapyramidal symptoms such as akathisia (restlessness), which
requires monitoring and possible intervention.
5.
A client with type 2 diabetes has a blood glucose level of 450 mg/dL. Which of the following actions should the
nurse take first?
A. Administer insulin as prescribed
B. Encourage oral fluid intake
C. Assess for signs of ketoacidosis
D. Notify the healthcare provider
Rationale: A blood glucose level of 450 mg/dL is critically high and may indicate diabetic ketoacidosis (DKA). Assessing for
signs of DKA (e.g., fruity breath, Kussmaul respirations) is the priority before administering insulin or notifying the provider.
6.
A client receiving chemotherapy reports nausea. Which of the following interventions should the nurse implement
first?
A. Administer prescribed antiemetic
B. Offer small, frequent meals
C. Assess the severity and timing of nausea
D. Encourage deep breathing exercises
Rationale: Assessing the severity and timing of nausea guides the selection of appropriate interventions, such as antiemetics
or dietary modifications.
7.
A client with chronic kidney disease has a serum potassium level of 6.2 mEq/L. Which of the following medications
should the nurse anticipate administering?
A. Potassium chloride
B. Spironolactone
C. Sodium polystyrene sulfonate (Kayexalate)
D. Furosemide
Rationale: A potassium level of 6.2 mEq/L indicates hyperkalemia. Sodium polystyrene sulfonate (Kayexalate) is used to
lower serum potassium levels by exchanging sodium for potassium in the intestines.
8.
A newborn has a heart rate of 160 bpm, respiratory rate of 70 breaths/min, and is cyanotic. Which of the following
actions should the nurse take first?
A. Administer oxygen via nasal cannula
B. Notify the healthcare provider
C. Stimulate the newborn to cry
D. Assess blood glucose level
Rationale: Stimulating the newborn to cry can improve oxygenation by expanding the lungs and increasing respiratory
effort, addressing the cyanosis immediately.
9.
A client with a history of seizures is prescribed phenytoin. Which of the following laboratory values should the
nurse monitor?
A. Serum sodium
B. Serum calcium
C. Serum phenytoin level
D. Serum magnesium
Rationale: Phenytoin has a narrow therapeutic index, and monitoring serum phenytoin levels is essential to ensure efficacy
and prevent toxicity.
10.
A client with a pressure injury on the sacrum has a stage 3 wound. Which of the following dressings should the
nurse apply?
A. Transparent film dressing
B. Hydrocolloid dressing
, C. Foam dressing
D. Gauze dressing
Rationale: A foam dressing is appropriate for a stage 3 pressure injury as it absorbs exudate, maintains a moist environment,
and protects the wound from contamination.
11.
A client with COPD is receiving oxygen at 2 L/min via nasal cannula. The nurse notes the client's oxygen saturation
is 88%. Which of the following actions should the nurse take?
A. Increase oxygen flow rate to 4 L/min
B. Assess the client's respiratory rate and effort
C. Notify the healthcare provider
D. Encourage deep breathing exercises
Rationale: An oxygen saturation of 88% in a client with COPD may indicate worsening respiratory status. The nurse should
notify the healthcare provider for further evaluation and possible intervention.
12.
A client with major depressive disorder is prescribed fluoxetine. Which of the following statements by the client
indicates understanding of the teaching?
A. "I will stop taking the medication if I feel better."
B. "I can drink alcohol while taking this medication."
C. "It may take several weeks for the medication to work."
D. "I should take this medication only when I feel depressed."
Rationale: Fluoxetine, an SSRI, typically takes 4-6 weeks to reach full therapeutic effect. This statement indicates the client
understands the expected timeline for improvement.
13.
A client with a fractured femur is immobilized with skeletal traction. Which of the following assessments should
the nurse prioritize?
A. Pain level
B. Skin integrity
C. Neurovascular status
D. Bowel sounds
Rationale: Neurovascular status (e.g., pulses, sensation, movement) must be assessed frequently in clients with skeletal
traction to detect complications such as compartment syndrome or nerve damage.
14.
A client with hypertension is prescribed lisinopril. Which of the following should the nurse include in the
teaching?
A. "Take the medication with food to prevent stomach upset."
B. "Avoid potassium-rich foods."
C. "Report any signs of swelling in the face or throat."
D. "Increase fluid intake to 3 liters per day."
Rationale: Lisinopril, an ACE inhibitor, can cause angioedema. Clients should be instructed to report signs of swelling in the
face or throat immediately.
15.
A client with a colostomy reports liquid stool. Which of the following dietary modifications should the nurse
suggest?
A. Increase fiber intake
B. Drink more water
C. Consume foods high in pectin
D. Avoid all dairy products
Rationale: Foods high in pectin, such as applesauce and bananas, can help thicken stool consistency in clients with liquid
ostomy output.
16.
A client with pneumonia has thick, tenacious secretions. Which of the following interventions should the nurse
implement?
A. Administer a prescribed antitussive
B. Encourage bed rest
150 Questions and Correct Answers | All Modules Covered | Already Graded A+ | 100% Verified
Exam Structure
The HESI Comprehensive Exit Exam is commonly structured as follows:
150 multiple-choice questions
Single-best-answer format
Scenario-based, application, and clinical judgment items covering all modules
Introduction
This HESI COMPASS Comprehensive Exit Exam format for the 2026/2027 cycle reflects the standard assessment used for evaluating
readiness for NCLEX-RN licensure. The exam emphasizes integration of core nursing knowledge, safe patient care, pharmacology,
critical thinking, evidence-based interventions, and leadership across all practice domains.
Answer Format
All correct answers are presented in bold and green, followed by clearly defined rationales explaining clinical reasoning, safety
priorities, evidence-based interventions, and module-specific content application.
Exam Questions
1.
A client with heart failure is prescribed furosemide 40 mg IV. Which of the following assessments should the
nurse prioritize before administration?
A. Blood glucose level
B. Serum potassium level
C. Urine output and blood pressure
D. Respiratory rate
Rationale: Furosemide is a loop diuretic that can cause hypotension and electrolyte imbalances. Assessing urine output and
blood pressure helps evaluate renal perfusion and risk of hypotension before administration.
2.
A 6-year-old child with asthma is prescribed albuterol via nebulizer. Which of the following side effects should the
nurse monitor for?
A. Bradycardia
B. Hypotension
C. Tachycardia
D. Sedation
Rationale: Albuterol is a beta-2 agonist that can cause tachycardia as a side effect due to its stimulant properties on the
sympathetic nervous system.
3.
A postpartum client reports severe perineal pain. Which of the following non-pharmacological interventions
should the nurse suggest first?
A. Warm sitz bath
B. Ice pack application
C. Perineal care with cool water
D. Ambulation
Rationale: Cool water perineal care reduces swelling and pain by constricting blood vessels, providing immediate relief for
postpartum perineal discomfort.
4.
A client with schizophrenia is prescribed haloperidol. Which of the following extrapyramidal side effects should
the nurse monitor for?
A. Hypertension
B. Tachycardia
, C. Akathisia
D. Diarrhea
Rationale: Haloperidol, an antipsychotic, can cause extrapyramidal symptoms such as akathisia (restlessness), which
requires monitoring and possible intervention.
5.
A client with type 2 diabetes has a blood glucose level of 450 mg/dL. Which of the following actions should the
nurse take first?
A. Administer insulin as prescribed
B. Encourage oral fluid intake
C. Assess for signs of ketoacidosis
D. Notify the healthcare provider
Rationale: A blood glucose level of 450 mg/dL is critically high and may indicate diabetic ketoacidosis (DKA). Assessing for
signs of DKA (e.g., fruity breath, Kussmaul respirations) is the priority before administering insulin or notifying the provider.
6.
A client receiving chemotherapy reports nausea. Which of the following interventions should the nurse implement
first?
A. Administer prescribed antiemetic
B. Offer small, frequent meals
C. Assess the severity and timing of nausea
D. Encourage deep breathing exercises
Rationale: Assessing the severity and timing of nausea guides the selection of appropriate interventions, such as antiemetics
or dietary modifications.
7.
A client with chronic kidney disease has a serum potassium level of 6.2 mEq/L. Which of the following medications
should the nurse anticipate administering?
A. Potassium chloride
B. Spironolactone
C. Sodium polystyrene sulfonate (Kayexalate)
D. Furosemide
Rationale: A potassium level of 6.2 mEq/L indicates hyperkalemia. Sodium polystyrene sulfonate (Kayexalate) is used to
lower serum potassium levels by exchanging sodium for potassium in the intestines.
8.
A newborn has a heart rate of 160 bpm, respiratory rate of 70 breaths/min, and is cyanotic. Which of the following
actions should the nurse take first?
A. Administer oxygen via nasal cannula
B. Notify the healthcare provider
C. Stimulate the newborn to cry
D. Assess blood glucose level
Rationale: Stimulating the newborn to cry can improve oxygenation by expanding the lungs and increasing respiratory
effort, addressing the cyanosis immediately.
9.
A client with a history of seizures is prescribed phenytoin. Which of the following laboratory values should the
nurse monitor?
A. Serum sodium
B. Serum calcium
C. Serum phenytoin level
D. Serum magnesium
Rationale: Phenytoin has a narrow therapeutic index, and monitoring serum phenytoin levels is essential to ensure efficacy
and prevent toxicity.
10.
A client with a pressure injury on the sacrum has a stage 3 wound. Which of the following dressings should the
nurse apply?
A. Transparent film dressing
B. Hydrocolloid dressing
, C. Foam dressing
D. Gauze dressing
Rationale: A foam dressing is appropriate for a stage 3 pressure injury as it absorbs exudate, maintains a moist environment,
and protects the wound from contamination.
11.
A client with COPD is receiving oxygen at 2 L/min via nasal cannula. The nurse notes the client's oxygen saturation
is 88%. Which of the following actions should the nurse take?
A. Increase oxygen flow rate to 4 L/min
B. Assess the client's respiratory rate and effort
C. Notify the healthcare provider
D. Encourage deep breathing exercises
Rationale: An oxygen saturation of 88% in a client with COPD may indicate worsening respiratory status. The nurse should
notify the healthcare provider for further evaluation and possible intervention.
12.
A client with major depressive disorder is prescribed fluoxetine. Which of the following statements by the client
indicates understanding of the teaching?
A. "I will stop taking the medication if I feel better."
B. "I can drink alcohol while taking this medication."
C. "It may take several weeks for the medication to work."
D. "I should take this medication only when I feel depressed."
Rationale: Fluoxetine, an SSRI, typically takes 4-6 weeks to reach full therapeutic effect. This statement indicates the client
understands the expected timeline for improvement.
13.
A client with a fractured femur is immobilized with skeletal traction. Which of the following assessments should
the nurse prioritize?
A. Pain level
B. Skin integrity
C. Neurovascular status
D. Bowel sounds
Rationale: Neurovascular status (e.g., pulses, sensation, movement) must be assessed frequently in clients with skeletal
traction to detect complications such as compartment syndrome or nerve damage.
14.
A client with hypertension is prescribed lisinopril. Which of the following should the nurse include in the
teaching?
A. "Take the medication with food to prevent stomach upset."
B. "Avoid potassium-rich foods."
C. "Report any signs of swelling in the face or throat."
D. "Increase fluid intake to 3 liters per day."
Rationale: Lisinopril, an ACE inhibitor, can cause angioedema. Clients should be instructed to report signs of swelling in the
face or throat immediately.
15.
A client with a colostomy reports liquid stool. Which of the following dietary modifications should the nurse
suggest?
A. Increase fiber intake
B. Drink more water
C. Consume foods high in pectin
D. Avoid all dairy products
Rationale: Foods high in pectin, such as applesauce and bananas, can help thicken stool consistency in clients with liquid
ostomy output.
16.
A client with pneumonia has thick, tenacious secretions. Which of the following interventions should the nurse
implement?
A. Administer a prescribed antitussive
B. Encourage bed rest
