HESI Comprehensive Exam| 263 QUESTIONS
AND ANSWERS | 2026 UPDATE WITH
COMPLETE SOLUTION ALREADY
GRADED A+
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?
Call the nursing supervisor
Ask the answering service to contact the on-call primary health care provider
Withhold the medication until the primary health care provider can be
reached in the morning
Administer the medication but consult the primary health care provider when
he becomes available - ANSWERS-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?
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 - ANSWERS-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 providedEnalapril maleate is prescribed for a
hospitalized client. Which assessment does the nurse perform as a priority
before administering the medication?
Checking the client's blood pressure
Checking the client's peripheral pulses
Checking the most recent potassium level
,Checking the client's intake-and-output record for the last 24 hours -
ANSWERS-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?
"The test will take about 30 minutes."
"I need to fast for 8 hours before the test."
"I need to drink citrate of magnesia the night before the test and give myself
a Fleet enema on the morning of the test."
"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." - ANSWERS-"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.
, .
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 - ANSWERS-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?
"Tell me more about what you're feeling."
"That's a normal response after this type of surgery."
AND ANSWERS | 2026 UPDATE WITH
COMPLETE SOLUTION ALREADY
GRADED A+
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?
Call the nursing supervisor
Ask the answering service to contact the on-call primary health care provider
Withhold the medication until the primary health care provider can be
reached in the morning
Administer the medication but consult the primary health care provider when
he becomes available - ANSWERS-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?
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 - ANSWERS-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 providedEnalapril maleate is prescribed for a
hospitalized client. Which assessment does the nurse perform as a priority
before administering the medication?
Checking the client's blood pressure
Checking the client's peripheral pulses
Checking the most recent potassium level
,Checking the client's intake-and-output record for the last 24 hours -
ANSWERS-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?
"The test will take about 30 minutes."
"I need to fast for 8 hours before the test."
"I need to drink citrate of magnesia the night before the test and give myself
a Fleet enema on the morning of the test."
"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." - ANSWERS-"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.
, .
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 - ANSWERS-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?
"Tell me more about what you're feeling."
"That's a normal response after this type of surgery."
