,HESI RN Comprehensive Predictor Exit 2026-2027 with NGN
1. A nurse is assessing a client who is 24 hours post-operative
following an abdominal hysterectomy. Which finding is the
priority to report to the healthcare provider?
A. Temperature of 99.8°F (37.7°C)
B. Serosanguineous drainage on the dressing
C. Urine output of 30 mL in the past 2 hours
D. Pain rated 5 on a 0–10 scale
Correct Answer: C
Rationale: Urine output of 30 mL in 2 hours (15 mL/hr) is below the
minimum of 30 mL/hr, indicating possible hypovolemia or renal impairment.
Low-grade fever (A) and serosanguineous drainage (B) are expected post-
operatively. Pain of 5/10 (D) requires intervention but is not the priority.
2. A client with chronic kidney disease has a potassium level of 6.8
mEq/L. Which intervention should the nurse implement first?
A. Administer oral sodium polystyrene sulfonate
B. Place the client on a cardiac monitor
C. Prepare for hemodialysis
D. Administer IV calcium gluconate
Correct Answer: B
Rationale: Hyperkalemia (K > 6.5) can cause life-threatening cardiac
arrhythmias. The priority is continuous cardiac monitoring to detect ECG
changes (peaked T waves, widened QRS). Calcium gluconate (D) stabilizes the
,myocardium but is given after monitoring is established. Sodium polystyrene
(A) and dialysis (C) lower potassium but are not the first action.
3. A client with a history of alcohol use disorder is admitted with
acute pancreatitis. Which assessment finding indicates a life-
threatening complication?
A. Epigastric pain radiating to the back
B. Nausea and vomiting
C. Cullen's sign (periumbilical bruising)
D. Hypoactive bowel sounds
Correct Answer: C
Rationale: Cullen's sign indicates retroperitoneal bleeding and hemorrhagic
pancreatitis, a life-threatening complication. Pain radiating to the back (A),
nausea/vomiting (B), and hypoactive bowel sounds (D) are expected findings
in pancreatitis but not immediately life-threatening.
4. A nurse is providing discharge teaching to a client prescribed
warfarin. Which over-the-counter medication should the client
avoid?
A. Acetaminophen
B. Ibuprofen
C. Diphenhydramine
D. Loratadine
Correct Answer: B
Rationale: Ibuprofen (NSAID) increases bleeding risk when taken with
warfarin due to platelet inhibition and GI irritation. Acetaminophen (A) is
, safer but should be used in limited doses. Diphenhydramine (C) and
loratadine (D) are antihistamines with minimal interaction.
5. A client with a new tracheostomy has a pulse oximetry reading
of 89%. What is the nurse's priority action?
A. Suction the tracheostomy
B. Increase the oxygen flow rate
C. Assess the tracheostomy tube for patency
D. Notify the healthcare provider
Correct Answer: C
Rationale: The first action is to assess patency (mucous plug, displacement, or
cuff issues). Suctioning (A) may be needed but follows assessment. Increasing
oxygen (B) and notifying the provider (D) are secondary to ensuring a patent
airway.
6. A client with a myocardial infarction is prescribed clopidogrel.
The nurse should monitor for which adverse effect?
A. Hypertension
B. Bleeding
C. Tachycardia
D. Hyperglycemia
Correct Answer: B
Rationale: Clopidogrel is an antiplatelet agent that increases bleeding risk.
Hypertension (A), tachycardia (C), and hyperglycemia (D) are not typical
adverse effects.
1. A nurse is assessing a client who is 24 hours post-operative
following an abdominal hysterectomy. Which finding is the
priority to report to the healthcare provider?
A. Temperature of 99.8°F (37.7°C)
B. Serosanguineous drainage on the dressing
C. Urine output of 30 mL in the past 2 hours
D. Pain rated 5 on a 0–10 scale
Correct Answer: C
Rationale: Urine output of 30 mL in 2 hours (15 mL/hr) is below the
minimum of 30 mL/hr, indicating possible hypovolemia or renal impairment.
Low-grade fever (A) and serosanguineous drainage (B) are expected post-
operatively. Pain of 5/10 (D) requires intervention but is not the priority.
2. A client with chronic kidney disease has a potassium level of 6.8
mEq/L. Which intervention should the nurse implement first?
A. Administer oral sodium polystyrene sulfonate
B. Place the client on a cardiac monitor
C. Prepare for hemodialysis
D. Administer IV calcium gluconate
Correct Answer: B
Rationale: Hyperkalemia (K > 6.5) can cause life-threatening cardiac
arrhythmias. The priority is continuous cardiac monitoring to detect ECG
changes (peaked T waves, widened QRS). Calcium gluconate (D) stabilizes the
,myocardium but is given after monitoring is established. Sodium polystyrene
(A) and dialysis (C) lower potassium but are not the first action.
3. A client with a history of alcohol use disorder is admitted with
acute pancreatitis. Which assessment finding indicates a life-
threatening complication?
A. Epigastric pain radiating to the back
B. Nausea and vomiting
C. Cullen's sign (periumbilical bruising)
D. Hypoactive bowel sounds
Correct Answer: C
Rationale: Cullen's sign indicates retroperitoneal bleeding and hemorrhagic
pancreatitis, a life-threatening complication. Pain radiating to the back (A),
nausea/vomiting (B), and hypoactive bowel sounds (D) are expected findings
in pancreatitis but not immediately life-threatening.
4. A nurse is providing discharge teaching to a client prescribed
warfarin. Which over-the-counter medication should the client
avoid?
A. Acetaminophen
B. Ibuprofen
C. Diphenhydramine
D. Loratadine
Correct Answer: B
Rationale: Ibuprofen (NSAID) increases bleeding risk when taken with
warfarin due to platelet inhibition and GI irritation. Acetaminophen (A) is
, safer but should be used in limited doses. Diphenhydramine (C) and
loratadine (D) are antihistamines with minimal interaction.
5. A client with a new tracheostomy has a pulse oximetry reading
of 89%. What is the nurse's priority action?
A. Suction the tracheostomy
B. Increase the oxygen flow rate
C. Assess the tracheostomy tube for patency
D. Notify the healthcare provider
Correct Answer: C
Rationale: The first action is to assess patency (mucous plug, displacement, or
cuff issues). Suctioning (A) may be needed but follows assessment. Increasing
oxygen (B) and notifying the provider (D) are secondary to ensuring a patent
airway.
6. A client with a myocardial infarction is prescribed clopidogrel.
The nurse should monitor for which adverse effect?
A. Hypertension
B. Bleeding
C. Tachycardia
D. Hyperglycemia
Correct Answer: B
Rationale: Clopidogrel is an antiplatelet agent that increases bleeding risk.
Hypertension (A), tachycardia (C), and hyperglycemia (D) are not typical
adverse effects.
