NURS 310 HESI NEWEST 2026 ACTUAL EXAM TEST
BANK COMPLETE 250 REAL EXAM QUESTIONS WITH
CORRECT ANSWERS & RATIONALES VERIFIED
ANSWERS - GRADED A+ (LATEST UPDATE)
NURS 310 HESI Exam 2026-2027 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% Verified
Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive test bank contains 250 verified questions from the NURS 310 HESI exam,
covering all major content areas. Each question includes correct answers and detailed rationales to
reinforce learning. Designed for the 2026/2027 academic year, this resource ensures students are fully
prepared to achieve a top score. Updated to reflect the latest HESI guidelines and nursing standards.
Key Features:
250 real exam questions with verified answers and rationales
Covers all NURS 310 HESI content areas including pharmacology, med-surg, and maternal-newborn
Detailed rationales for correct and incorrect answers to enhance critical thinking
Updated for 2026/2027 with latest clinical guidelines and HESI blueprint
Organized by content area with question range and weight distribution
Graded A+ standard with 100% verified solutions
Updates for 2026:
- Updated to reflect 2026/2027 HESI exam blueprint changes
- Incorporated latest evidence-based practice guidelines
- Added new questions on emerging topics like COVID-19 and telehealth
- Revised rationales for clarity and depth of explanation
- Enhanced distractor analysis to address common student errors
Abstract:
This test bank provides a rigorous preparation tool for the NURS 310 HESI exam, featuring 250 authentic
questions that mirror the actual exam format and difficulty. Each question is accompanied by a correct answer and
a comprehensive rationale that explains both the correct choice and why the distractors are incorrect. The content
is organized into key nursing domains: pharmacology, medical-surgical nursing, maternal-newborn care, pediatric
nursing, psychiatric-mental health, and leadership/management. The rationales are designed to promote deep
understanding and clinical reasoning, aligning with the latest NCLEX and HESI standards. This resource is
essential for students aiming for a Grade A+ and a thorough mastery of nursing concepts. The test bank has been
meticulously updated for the 2026/2027 academic year, incorporating recent guideline changes and emerging
healthcare trends. By engaging with these questions, students can identify knowledge gaps, reinforce learning, and
build confidence for exam day.
Keywords:
NURS 310, HESI exam, test bank, nursing questions, rationales, 2026-2027, graded A+, exam preparation
Answer Format:
Each question includes the correct answer (letter and text) followed by a detailed rationale explaining the clinical
reasoning. Incorrect options are also analyzed with explanations of why they are wrong, helping students
understand common pitfalls and reinforce correct knowledge.
Compliance Checklist:
Aligned with HESI exam blueprint for 2026/2027
Page 1
, All answers verified by subject matter experts
Rationales cite current evidence-based practice
Questions reflect real exam difficulty and format
Updated for latest nursing standards and guidelines
Suitable for self-assessment and group study
Content Area Overview:
Content Area Questions Key Topics Weight
Pharmacology 1-50 Drug classifications, side effects, nursing 20%
considerations, dosage calculations
Medical-Surgical Nursing 51-120 Cardiovascular, respiratory, gastrointestinal, 28%
renal, endocrine disorders
Maternal-Newborn Care 121-160 Antepartum, intrapartum, postpartum, 16%
newborn assessment and care
Pediatric Nursing 161-200 Growth and development, common 16%
childhood illnesses, immunizations,
family-centered care
Psychiatric-Mental Health 201-230 Therapeutic communication, mood 12%
disorders, anxiety, psychosis, substance
abuse
Leadership & Management 231-250 Delegation, prioritization, ethical/legal 8%
issues, quality improvement
Page 2
,Q1. A patient with a history of chronic obstructive pulmonary disease (COPD) presents with acute
dyspnea and oxygen saturation of 85% on room air. Arterial blood gas results show pH 7.30, PaCO2
55 mm Hg, PaO2 58 mm Hg, HCO3- 26 mEq/L. Which intervention should the nurse initiate first?
A. Administer oxygen via non-rebreather mask at 15 L/min
B. Initiate noninvasive positive pressure ventilation (NIPPV)
C. Administer albuterol nebulizer treatment
D. Position the patient in high Fowler's and encourage pursed-lip breathing
Correct Answer: B. Initiate noninvasive positive pressure ventilation (NIPPV)
Rationale: The ABG shows acute-on-chronic respiratory acidosis (pH acidotic, PaCO2 elevated, HCO3-
normal). NIPPV is the first-line intervention for hypercapnic respiratory failure to improve ventilation
without intubation. High-flow oxygen can worsen hypercapnia by reducing hypoxic drive. While
bronchodilators and positioning are important, they are not the priority when PaCO2 is critically high.
Why Wrong:
A - High-flow oxygen may suppress hypoxic drive and worsen hypercapnia in COPD patients with
chronic CO2 retention.
C - Albuterol addresses bronchospasm but does not correct acute hypercapnic respiratory failure.
D - Pursed-lip breathing aids exhalation but is insufficient for severe acute respiratory acidosis.
Reference: Ignatavicius, D.D., & Workman, M.L. (2026). Medical-Surgical Nursing: Concepts for
Interprofessional Collaborative Care, 10th Ed., Ch. 29.
Q2. A patient receiving IV heparin for deep vein thrombosis develops a platelet count drop from
250,000/mm³ to 110,000/mm³ over three days. The nurse suspects heparin-induced
thrombocytopenia (HIT). Which action is most appropriate?
A. Continue heparin and monitor platelet count daily
B. Discontinue heparin immediately and start argatroban
C. Administer protamine sulfate to reverse heparin
D. Administer low-molecular-weight heparin (LMWH) as a substitute
Correct Answer: B. Discontinue heparin immediately and start argatroban
Rationale: HIT is a life-threatening immune reaction to heparin causing thrombocytopenia and
paradoxical thrombosis. Immediate cessation of all heparin products is essential, and a non-heparin
anticoagulant like argatroban (direct thrombin inhibitor) should be started. Protamine sulfate reverses
heparin but does not treat HIT. LMWH is contraindicated due to cross-reactivity.
Why Wrong:
A - Continuing heparin in HIT increases risk of thrombosis and further platelet destruction.
C - Protamine neutralizes heparin but does not address the immune-mediated HIT and does not
provide ongoing anticoagulation.
D - LMWH has high cross-reactivity with HIT antibodies and can worsen the condition.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 34.
Page 3
, Q3. A patient with heart failure (HF) with reduced ejection fraction (HFrEF) is started on
sacubitril/valsartan. Which laboratory value requires close monitoring during the first month of
therapy?
A. Serum potassium and serum creatinine
B. Serum sodium and hemoglobin
C. Serum calcium and magnesium
D. Serum glucose and glycosylated hemoglobin
Correct Answer: A. Serum potassium and serum creatinine
Rationale: Sacubitril/valsartan is an angiotensin receptor-neprilysin inhibitor (ARNI) that can cause
hyperkalemia and acute kidney injury due to its effects on the renin-angiotensin-aldosterone system.
Serum potassium and creatinine should be monitored regularly. Hypokalemia is less common; sodium,
hemoglobin, and glucose are not primary concerns with this drug.
Why Wrong:
B - Sodium and hemoglobin are not the most critical values; ARNIs rarely cause significant
hyponatremia or anemia.
C - Calcium and magnesium are not typically affected by sacubitril/valsartan.
D - Glucose and HbA1c are unrelated to ARNI therapy; these are relevant for diabetes management.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 26.
Q4. A patient with septic shock is receiving norepinephrine infusion at 15 mcg/min. The nurse notes
the patient's blood pressure remains 80/50 mm Hg, heart rate 120 bpm, and urine output 15
mL/hour. Which intervention should the nurse anticipate next?
A. Increase norepinephrine to 20 mcg/min
B. Add a second vasopressor such as vasopressin
C. Administer a fluid bolus of 500 mL normal saline
D. Start dobutamine to improve cardiac output
Correct Answer: B. Add a second vasopressor such as vasopressin
Rationale: In septic shock, if a patient remains hypotensive on moderate doses of norepinephrine (e.g.,
>10-15 mcg/min), the next step per Surviving Sepsis Campaign guidelines is to add a second vasopressor,
typically vasopressin, to achieve target MAP. Increasing norepinephrine dose further may cause excessive
vasoconstriction and adverse effects. Fluid resuscitation should have been optimized earlier; if ongoing,
reassessment is needed. Dobutamine is considered if there is evidence of myocardial dysfunction.
Why Wrong:
A - Higher doses of norepinephrine increase risk of arrhythmias and peripheral ischemia; adding a
second agent is preferred.
C - The patient's urine output suggests hypoperfusion, but if fluid status is adequate, additional fluids
may not help and could cause volume overload.
D - Dobutamine is not first-line for hypotension; it is used for low cardiac output with adequate
perfusion pressure.
Reference: Rhodes, A., et al. (2025). Surviving Sepsis Campaign: International Guidelines for
Management of Sepsis and Septic Shock. Critical Care Medicine, 53(1).
Page 4
BANK COMPLETE 250 REAL EXAM QUESTIONS WITH
CORRECT ANSWERS & RATIONALES VERIFIED
ANSWERS - GRADED A+ (LATEST UPDATE)
NURS 310 HESI Exam 2026-2027 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% Verified
Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive test bank contains 250 verified questions from the NURS 310 HESI exam,
covering all major content areas. Each question includes correct answers and detailed rationales to
reinforce learning. Designed for the 2026/2027 academic year, this resource ensures students are fully
prepared to achieve a top score. Updated to reflect the latest HESI guidelines and nursing standards.
Key Features:
250 real exam questions with verified answers and rationales
Covers all NURS 310 HESI content areas including pharmacology, med-surg, and maternal-newborn
Detailed rationales for correct and incorrect answers to enhance critical thinking
Updated for 2026/2027 with latest clinical guidelines and HESI blueprint
Organized by content area with question range and weight distribution
Graded A+ standard with 100% verified solutions
Updates for 2026:
- Updated to reflect 2026/2027 HESI exam blueprint changes
- Incorporated latest evidence-based practice guidelines
- Added new questions on emerging topics like COVID-19 and telehealth
- Revised rationales for clarity and depth of explanation
- Enhanced distractor analysis to address common student errors
Abstract:
This test bank provides a rigorous preparation tool for the NURS 310 HESI exam, featuring 250 authentic
questions that mirror the actual exam format and difficulty. Each question is accompanied by a correct answer and
a comprehensive rationale that explains both the correct choice and why the distractors are incorrect. The content
is organized into key nursing domains: pharmacology, medical-surgical nursing, maternal-newborn care, pediatric
nursing, psychiatric-mental health, and leadership/management. The rationales are designed to promote deep
understanding and clinical reasoning, aligning with the latest NCLEX and HESI standards. This resource is
essential for students aiming for a Grade A+ and a thorough mastery of nursing concepts. The test bank has been
meticulously updated for the 2026/2027 academic year, incorporating recent guideline changes and emerging
healthcare trends. By engaging with these questions, students can identify knowledge gaps, reinforce learning, and
build confidence for exam day.
Keywords:
NURS 310, HESI exam, test bank, nursing questions, rationales, 2026-2027, graded A+, exam preparation
Answer Format:
Each question includes the correct answer (letter and text) followed by a detailed rationale explaining the clinical
reasoning. Incorrect options are also analyzed with explanations of why they are wrong, helping students
understand common pitfalls and reinforce correct knowledge.
Compliance Checklist:
Aligned with HESI exam blueprint for 2026/2027
Page 1
, All answers verified by subject matter experts
Rationales cite current evidence-based practice
Questions reflect real exam difficulty and format
Updated for latest nursing standards and guidelines
Suitable for self-assessment and group study
Content Area Overview:
Content Area Questions Key Topics Weight
Pharmacology 1-50 Drug classifications, side effects, nursing 20%
considerations, dosage calculations
Medical-Surgical Nursing 51-120 Cardiovascular, respiratory, gastrointestinal, 28%
renal, endocrine disorders
Maternal-Newborn Care 121-160 Antepartum, intrapartum, postpartum, 16%
newborn assessment and care
Pediatric Nursing 161-200 Growth and development, common 16%
childhood illnesses, immunizations,
family-centered care
Psychiatric-Mental Health 201-230 Therapeutic communication, mood 12%
disorders, anxiety, psychosis, substance
abuse
Leadership & Management 231-250 Delegation, prioritization, ethical/legal 8%
issues, quality improvement
Page 2
,Q1. A patient with a history of chronic obstructive pulmonary disease (COPD) presents with acute
dyspnea and oxygen saturation of 85% on room air. Arterial blood gas results show pH 7.30, PaCO2
55 mm Hg, PaO2 58 mm Hg, HCO3- 26 mEq/L. Which intervention should the nurse initiate first?
A. Administer oxygen via non-rebreather mask at 15 L/min
B. Initiate noninvasive positive pressure ventilation (NIPPV)
C. Administer albuterol nebulizer treatment
D. Position the patient in high Fowler's and encourage pursed-lip breathing
Correct Answer: B. Initiate noninvasive positive pressure ventilation (NIPPV)
Rationale: The ABG shows acute-on-chronic respiratory acidosis (pH acidotic, PaCO2 elevated, HCO3-
normal). NIPPV is the first-line intervention for hypercapnic respiratory failure to improve ventilation
without intubation. High-flow oxygen can worsen hypercapnia by reducing hypoxic drive. While
bronchodilators and positioning are important, they are not the priority when PaCO2 is critically high.
Why Wrong:
A - High-flow oxygen may suppress hypoxic drive and worsen hypercapnia in COPD patients with
chronic CO2 retention.
C - Albuterol addresses bronchospasm but does not correct acute hypercapnic respiratory failure.
D - Pursed-lip breathing aids exhalation but is insufficient for severe acute respiratory acidosis.
Reference: Ignatavicius, D.D., & Workman, M.L. (2026). Medical-Surgical Nursing: Concepts for
Interprofessional Collaborative Care, 10th Ed., Ch. 29.
Q2. A patient receiving IV heparin for deep vein thrombosis develops a platelet count drop from
250,000/mm³ to 110,000/mm³ over three days. The nurse suspects heparin-induced
thrombocytopenia (HIT). Which action is most appropriate?
A. Continue heparin and monitor platelet count daily
B. Discontinue heparin immediately and start argatroban
C. Administer protamine sulfate to reverse heparin
D. Administer low-molecular-weight heparin (LMWH) as a substitute
Correct Answer: B. Discontinue heparin immediately and start argatroban
Rationale: HIT is a life-threatening immune reaction to heparin causing thrombocytopenia and
paradoxical thrombosis. Immediate cessation of all heparin products is essential, and a non-heparin
anticoagulant like argatroban (direct thrombin inhibitor) should be started. Protamine sulfate reverses
heparin but does not treat HIT. LMWH is contraindicated due to cross-reactivity.
Why Wrong:
A - Continuing heparin in HIT increases risk of thrombosis and further platelet destruction.
C - Protamine neutralizes heparin but does not address the immune-mediated HIT and does not
provide ongoing anticoagulation.
D - LMWH has high cross-reactivity with HIT antibodies and can worsen the condition.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 34.
Page 3
, Q3. A patient with heart failure (HF) with reduced ejection fraction (HFrEF) is started on
sacubitril/valsartan. Which laboratory value requires close monitoring during the first month of
therapy?
A. Serum potassium and serum creatinine
B. Serum sodium and hemoglobin
C. Serum calcium and magnesium
D. Serum glucose and glycosylated hemoglobin
Correct Answer: A. Serum potassium and serum creatinine
Rationale: Sacubitril/valsartan is an angiotensin receptor-neprilysin inhibitor (ARNI) that can cause
hyperkalemia and acute kidney injury due to its effects on the renin-angiotensin-aldosterone system.
Serum potassium and creatinine should be monitored regularly. Hypokalemia is less common; sodium,
hemoglobin, and glucose are not primary concerns with this drug.
Why Wrong:
B - Sodium and hemoglobin are not the most critical values; ARNIs rarely cause significant
hyponatremia or anemia.
C - Calcium and magnesium are not typically affected by sacubitril/valsartan.
D - Glucose and HbA1c are unrelated to ARNI therapy; these are relevant for diabetes management.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 26.
Q4. A patient with septic shock is receiving norepinephrine infusion at 15 mcg/min. The nurse notes
the patient's blood pressure remains 80/50 mm Hg, heart rate 120 bpm, and urine output 15
mL/hour. Which intervention should the nurse anticipate next?
A. Increase norepinephrine to 20 mcg/min
B. Add a second vasopressor such as vasopressin
C. Administer a fluid bolus of 500 mL normal saline
D. Start dobutamine to improve cardiac output
Correct Answer: B. Add a second vasopressor such as vasopressin
Rationale: In septic shock, if a patient remains hypotensive on moderate doses of norepinephrine (e.g.,
>10-15 mcg/min), the next step per Surviving Sepsis Campaign guidelines is to add a second vasopressor,
typically vasopressin, to achieve target MAP. Increasing norepinephrine dose further may cause excessive
vasoconstriction and adverse effects. Fluid resuscitation should have been optimized earlier; if ongoing,
reassessment is needed. Dobutamine is considered if there is evidence of myocardial dysfunction.
Why Wrong:
A - Higher doses of norepinephrine increase risk of arrhythmias and peripheral ischemia; adding a
second agent is preferred.
C - The patient's urine output suggests hypoperfusion, but if fluid status is adequate, additional fluids
may not help and could cause volume overload.
D - Dobutamine is not first-line for hypotension; it is used for low cardiac output with adequate
perfusion pressure.
Reference: Rhodes, A., et al. (2025). Surviving Sepsis Campaign: International Guidelines for
Management of Sepsis and Septic Shock. Critical Care Medicine, 53(1).
Page 4
