HESI RN COMPASS EXIT V1
LATEST UPDATED 2026-2027
REAL FINAL EXAM WITH 100
COMPLETE PRACTICE
QUESTIONS AND 100%
VERIFIED ANSWERS WITH
CERTIFIED RATIONALES
MOST RECENT!!! A+ GRADE
GUARANTEE
1. A client with heart failure has a new prescription for carvedilol. Which assessment
finding would indicate the client is having an adverse effect to this medication?
a) Heart rate 62 bpm
b) Blood pressure 88/50 mm Hg
c) Respiratory rate 18/min
d) Pedal edema +1
Explanation: Carvedilol is a beta-blocker; hypotension (systolic <90) is an adverse
effect requiring dose adjustment or discontinuation.
2. A nurse is caring for a client with a chest tube following a thoracotomy. Which
finding requires immediate intervention?
, a) Continuous bubbling in the suction control chamber
b) Sudden cessation of tidaling with new respiratory distress
c) 150 mL of serosanguineous drainage in the past 8 hours
d) Pain at insertion site rated 4/10
Explanation: Cessation of tidaling plus distress indicates possible tube occlusion or
tension pneumothorax.
3. A client with diabetes mellitus type 1 has a blood glucose of 45 mg/dL and is
unconscious. What is the priority nursing action?
a) Give 15 g of oral glucose paste
b) Administer glucagon 1 mg IM
c) Recheck blood glucose in 15 minutes
d) Give regular insulin IV push
Explanation: Unconscious client cannot swallow; glucagon raises blood glucose
rapidly and is given IM or subcutaneously.
4. A nurse is preparing to administer a blood transfusion. Which IV solution is
compatible with packed red blood cells?
a) 5% Dextrose in water
b) Lactated Ringer’s
c) 0.9% Sodium chloride
d) 0.45% Sodium chloride
Explanation: Only normal saline (0.9% NaCl) is compatible; dextrose causes
hemolysis; Lactated Ringer’s contains calcium which can clot blood.
5. A client with a history of opioid abuse is prescribed naloxone. The nurse
understands that naloxone:
a) Potentiates opioid effects
b) Reverses opioid-induced respiratory depression
c) Treats opioid withdrawal symptoms
d) Is a long-acting opioid agonist
Explanation: Naloxone is an opioid antagonist that rapidly reverses respiratory
depression; duration is short (30-60 minutes).
, 6. A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 86% on room air. The nurse should:
a) Apply a non-rebreather mask at 15 L/min
b) Initiate nasal cannula at 2 L/min
c) Encourage pursed-lip breathing only
d) Document as normal for COPD
*Explanation: Oxygen titrated to 88-92% in COPD; 2 L/min nasal cannula is safe;
high oxygen may depress respiratory drive.*
7. A nurse is assessing a client’s IV site. Which finding indicates phlebitis?
a) Edema and coolness around the site
b) Redness, warmth, and a palpable cord along the vein
c) Blanching and pain during infusion
d) Clear drainage at the insertion site
Explanation: Phlebitis signs include erythema, warmth, tenderness, and palpable
venous cord; infiltration causes coolness and edema.
8. A client is receiving a continuous heparin infusion. The aPTT is 110 seconds
(control 30 seconds). What should the nurse do first?
a) Increase the infusion rate
b) Stop the infusion and notify the provider
c) Continue the infusion, recheck in 4 hours
d) Administer vitamin K
*Explanation: aPTT >100 seconds indicates overdose/bleeding risk; stop infusion;
protamine sulfate may be ordered.*
9. A nurse is providing discharge teaching to a client with a new prescription for
warfarin. Which statement indicates understanding?
a) “I will take ibuprofen if I have a headache.”
b) “I will eat the same amount of green leafy vegetables each week.”
c) “I will stop taking warfarin if I see bruising.”
d) “I will use a straight razor to shave.”
LATEST UPDATED 2026-2027
REAL FINAL EXAM WITH 100
COMPLETE PRACTICE
QUESTIONS AND 100%
VERIFIED ANSWERS WITH
CERTIFIED RATIONALES
MOST RECENT!!! A+ GRADE
GUARANTEE
1. A client with heart failure has a new prescription for carvedilol. Which assessment
finding would indicate the client is having an adverse effect to this medication?
a) Heart rate 62 bpm
b) Blood pressure 88/50 mm Hg
c) Respiratory rate 18/min
d) Pedal edema +1
Explanation: Carvedilol is a beta-blocker; hypotension (systolic <90) is an adverse
effect requiring dose adjustment or discontinuation.
2. A nurse is caring for a client with a chest tube following a thoracotomy. Which
finding requires immediate intervention?
, a) Continuous bubbling in the suction control chamber
b) Sudden cessation of tidaling with new respiratory distress
c) 150 mL of serosanguineous drainage in the past 8 hours
d) Pain at insertion site rated 4/10
Explanation: Cessation of tidaling plus distress indicates possible tube occlusion or
tension pneumothorax.
3. A client with diabetes mellitus type 1 has a blood glucose of 45 mg/dL and is
unconscious. What is the priority nursing action?
a) Give 15 g of oral glucose paste
b) Administer glucagon 1 mg IM
c) Recheck blood glucose in 15 minutes
d) Give regular insulin IV push
Explanation: Unconscious client cannot swallow; glucagon raises blood glucose
rapidly and is given IM or subcutaneously.
4. A nurse is preparing to administer a blood transfusion. Which IV solution is
compatible with packed red blood cells?
a) 5% Dextrose in water
b) Lactated Ringer’s
c) 0.9% Sodium chloride
d) 0.45% Sodium chloride
Explanation: Only normal saline (0.9% NaCl) is compatible; dextrose causes
hemolysis; Lactated Ringer’s contains calcium which can clot blood.
5. A client with a history of opioid abuse is prescribed naloxone. The nurse
understands that naloxone:
a) Potentiates opioid effects
b) Reverses opioid-induced respiratory depression
c) Treats opioid withdrawal symptoms
d) Is a long-acting opioid agonist
Explanation: Naloxone is an opioid antagonist that rapidly reverses respiratory
depression; duration is short (30-60 minutes).
, 6. A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 86% on room air. The nurse should:
a) Apply a non-rebreather mask at 15 L/min
b) Initiate nasal cannula at 2 L/min
c) Encourage pursed-lip breathing only
d) Document as normal for COPD
*Explanation: Oxygen titrated to 88-92% in COPD; 2 L/min nasal cannula is safe;
high oxygen may depress respiratory drive.*
7. A nurse is assessing a client’s IV site. Which finding indicates phlebitis?
a) Edema and coolness around the site
b) Redness, warmth, and a palpable cord along the vein
c) Blanching and pain during infusion
d) Clear drainage at the insertion site
Explanation: Phlebitis signs include erythema, warmth, tenderness, and palpable
venous cord; infiltration causes coolness and edema.
8. A client is receiving a continuous heparin infusion. The aPTT is 110 seconds
(control 30 seconds). What should the nurse do first?
a) Increase the infusion rate
b) Stop the infusion and notify the provider
c) Continue the infusion, recheck in 4 hours
d) Administer vitamin K
*Explanation: aPTT >100 seconds indicates overdose/bleeding risk; stop infusion;
protamine sulfate may be ordered.*
9. A nurse is providing discharge teaching to a client with a new prescription for
warfarin. Which statement indicates understanding?
a) “I will take ibuprofen if I have a headache.”
b) “I will eat the same amount of green leafy vegetables each week.”
c) “I will stop taking warfarin if I see bruising.”
d) “I will use a straight razor to shave.”
