NGU HESI RN Compass Exit Exam 2026 –
Verified Questions, Rationales & Pass-Fast
Study Pack
Question 1
A client is to receive mannitol IV for increased intracranial pressure.
Which outcome may result from the use of mannitol?
A. Hypervolemia
B. Hyperglycemia
C. Hyponatremia
D. Oliguria
Correct Answer: A. Hypervolemia
Rationale:
Mannitol is an osmotic diuretic that draws fluid from brain tissue into
the vascular space, temporarily increasing circulating blood volume.
This fluid shift may cause transient hypervolemia and increased cardiac
workload. Monitoring for signs of fluid overload such as crackles and
elevated blood pressure is essential. This effect is expected early in
therapy before diuresis occurs.
Question 2
A 27-year-old client with cerebral palsy and a tracheostomy presents
with thick green mucus and cough. Which finding should the nurse
prioritize?
A. Thick green mucus
,B. Lung sounds
C. Tracheostomy state
D. Fraction of inspired oxygen
Correct Answer: B. Lung sounds
Rationale:
Lung sounds provide direct assessment of ventilation and gas exchange.
Diminished or abnormal sounds may indicate pneumonia, airway
obstruction, or respiratory compromise requiring immediate
intervention. While mucus and tracheostomy care are important,
assessment of breathing effectiveness takes priority. Early detection of
impaired ventilation prevents respiratory failure.
CONTINUED GENERATED EXAM QUESTIONS
Question 3
A client with heart failure is receiving furosemide IV. Which assessment
finding indicates the medication is effective?
A. Decreased urine output
B. Weight gain
C. Reduced crackles in lungs
D. Bradycardia
Correct Answer: C. Reduced crackles in lungs
Rationale:
Furosemide removes excess fluid from the body, decreasing pulmonary
congestion. Reduction in lung crackles indicates improved fluid balance
in the lungs. Weight loss and increased urine output also occur, but lung
improvement reflects resolution of respiratory fluid overload. This
finding confirms therapeutic effectiveness.
Question 4
, A nurse is caring for a client receiving heparin infusion. Which lab value
requires immediate reporting?
A. Hemoglobin 14 g/dL
B. Platelets 90,000/mm³
C. Sodium 138 mEq/L
D. Potassium 4.0 mEq/L
Correct Answer: B. Platelets 90,000/mm³
Rationale:
A low platelet count in a client receiving heparin suggests heparin-
induced thrombocytopenia (HIT). HIT increases risk of clot formation
despite low platelets. Immediate discontinuation of heparin is required.
Early recognition prevents life-threatening complications.
Question 5
Which intervention best prevents aspiration in a client receiving enteral
tube feeding?
A. Placing client flat during feeding
B. Checking gastric residuals
C. Flushing tube with air
D. Administering feeds rapidly
Correct Answer: B. Checking gastric residuals
Rationale:
Checking residual volume ensures the stomach is emptying
appropriately before adding more feeding. High residuals increase
aspiration risk. Maintaining head-of-bed elevation and slow feeding also
help, but residual checks provide direct safety monitoring. This
intervention prevents regurgitation and aspiration pneumonia.
Verified Questions, Rationales & Pass-Fast
Study Pack
Question 1
A client is to receive mannitol IV for increased intracranial pressure.
Which outcome may result from the use of mannitol?
A. Hypervolemia
B. Hyperglycemia
C. Hyponatremia
D. Oliguria
Correct Answer: A. Hypervolemia
Rationale:
Mannitol is an osmotic diuretic that draws fluid from brain tissue into
the vascular space, temporarily increasing circulating blood volume.
This fluid shift may cause transient hypervolemia and increased cardiac
workload. Monitoring for signs of fluid overload such as crackles and
elevated blood pressure is essential. This effect is expected early in
therapy before diuresis occurs.
Question 2
A 27-year-old client with cerebral palsy and a tracheostomy presents
with thick green mucus and cough. Which finding should the nurse
prioritize?
A. Thick green mucus
,B. Lung sounds
C. Tracheostomy state
D. Fraction of inspired oxygen
Correct Answer: B. Lung sounds
Rationale:
Lung sounds provide direct assessment of ventilation and gas exchange.
Diminished or abnormal sounds may indicate pneumonia, airway
obstruction, or respiratory compromise requiring immediate
intervention. While mucus and tracheostomy care are important,
assessment of breathing effectiveness takes priority. Early detection of
impaired ventilation prevents respiratory failure.
CONTINUED GENERATED EXAM QUESTIONS
Question 3
A client with heart failure is receiving furosemide IV. Which assessment
finding indicates the medication is effective?
A. Decreased urine output
B. Weight gain
C. Reduced crackles in lungs
D. Bradycardia
Correct Answer: C. Reduced crackles in lungs
Rationale:
Furosemide removes excess fluid from the body, decreasing pulmonary
congestion. Reduction in lung crackles indicates improved fluid balance
in the lungs. Weight loss and increased urine output also occur, but lung
improvement reflects resolution of respiratory fluid overload. This
finding confirms therapeutic effectiveness.
Question 4
, A nurse is caring for a client receiving heparin infusion. Which lab value
requires immediate reporting?
A. Hemoglobin 14 g/dL
B. Platelets 90,000/mm³
C. Sodium 138 mEq/L
D. Potassium 4.0 mEq/L
Correct Answer: B. Platelets 90,000/mm³
Rationale:
A low platelet count in a client receiving heparin suggests heparin-
induced thrombocytopenia (HIT). HIT increases risk of clot formation
despite low platelets. Immediate discontinuation of heparin is required.
Early recognition prevents life-threatening complications.
Question 5
Which intervention best prevents aspiration in a client receiving enteral
tube feeding?
A. Placing client flat during feeding
B. Checking gastric residuals
C. Flushing tube with air
D. Administering feeds rapidly
Correct Answer: B. Checking gastric residuals
Rationale:
Checking residual volume ensures the stomach is emptying
appropriately before adding more feeding. High residuals increase
aspiration risk. Maintaining head-of-bed elevation and slow feeding also
help, but residual checks provide direct safety monitoring. This
intervention prevents regurgitation and aspiration pneumonia.
