HESI COMPASS COMPREHENSIVE EXIT EXAM 2026 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
The nurse is caring for a patient with acute kidney injury (AKI) who has a serum potassium level of 6.8 mEq/L.
Which intervention should the nurse implement first?
A. Administer oral sodium polystyrene sulfonate
B. Prepare the patient for emergent hemodialysis
C. Administer intravenous calcium gluconate
D. Administer intravenous insulin and dextrose
🟢 Correct Answer:
C. Administer intravenous calcium gluconate
🔴 RATIONALE:
Hyperkalemia of 6.8 mEq/L is a life-threatening emergency due to the risk of cardiac arrhythmias. The first
priority is to stabilize the cardiac membrane by administering IV calcium gluconate. While insulin and dextrose,
sodium polystyrene, and hemodialysis are all treatments for hyperkalemia, cardiac membrane stabilization is the
immediate priority.
Question 2
A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 3 L/min via nasal cannula.
,The nurse notes the patient's respiratory rate has dropped to 8 breaths/min. What is the nurse's priority action?
A. Increase the oxygen flow rate to 4 L/min
B. Assess the patient's oxygen saturation level
C. Decrease the oxygen flow rate to 1-2 L/min
D. Notify the healthcare provider immediately
🟢 Correct Answer:
D. Notify the healthcare provider immediately
🔴 RATIONALE:
A sudden drop in respiratory rate in a COPD patient receiving supplemental oxygen may indicate respiratory
depression due to loss of hypoxic drive. This is a medical emergency. While decreasing the oxygen flow rate
may be appropriate, the nurse must notify the provider immediately and prepare to support ventilation.
Question 3
The nurse is providing care to a patient with heart failure who is receiving intravenous furosemide. Which
assessment finding indicates the medication is having the desired therapeutic effect?
A. Decreased blood pressure
B. Increased urine output
C. Decreased heart rate
D. Increased peripheral edema
🟢 Correct Answer:
B. Increased urine output
,🔴 RATIONALE:
Furosemide is a loop diuretic used to reduce fluid volume overload. The desired therapeutic effect is increased
urine output, which leads to decreased edema, reduced shortness of breath, and improved oxygenation. While
decreased blood pressure and heart rate may occur, increased urine output is the most direct indicator of
effectiveness.
Question 4
The nurse is caring for a patient with a chest tube following a pneumothorax. Which finding indicates the chest
tube is functioning correctly?
A. Continuous bubbling in the water seal chamber
B. Tidaling in the water seal chamber with respiration
C. No drainage in the collection chamber
D. Bubbling in the suction control chamber
🟢 Correct Answer:
B. Tidaling in the water seal chamber with respiration
🔴 RATIONALE:
Tidaling (fluctuations) in the water seal chamber is an expected finding that indicates the chest tube is patent
and functioning correctly. Continuous bubbling in the water seal chamber indicates an air leak. Suction control
chamber bubbling is related to the suction setting.
, Question 5
A patient with diabetes mellitus is admitted with diabetic ketoacidosis (DKA). Which laboratory finding is most
consistent with this diagnosis?
A. Serum glucose 180 mg/dL
B. Arterial pH 7.25
C. Serum bicarbonate 22 mEq/L
D. Serum potassium 3.0 mEq/L
🟢 Correct Answer:
B. Arterial pH 7.25
🔴 RATIONALE:
DKA is characterized by metabolic acidosis with an arterial pH below 7.30, serum glucose often exceeding 250
mg/dL, and low serum bicarbonate (less than 15 mEq/L). A pH of 7.25 indicates acidosis. A serum glucose of 180
mg/dL is not high enough for DKA.
Question 6
A patient is prescribed warfarin (Coumadin) for atrial fibrillation. The nurse notes the patient's INR is 1.8. What is
the nurse's priority action?
A. Administer the next dose of warfarin as prescribed
B. Hold the next dose and notify the healthcare provider
C. Administer vitamin K intramuscularly
D. Increase the dose of warfarin per protocol
VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
The nurse is caring for a patient with acute kidney injury (AKI) who has a serum potassium level of 6.8 mEq/L.
Which intervention should the nurse implement first?
A. Administer oral sodium polystyrene sulfonate
B. Prepare the patient for emergent hemodialysis
C. Administer intravenous calcium gluconate
D. Administer intravenous insulin and dextrose
🟢 Correct Answer:
C. Administer intravenous calcium gluconate
🔴 RATIONALE:
Hyperkalemia of 6.8 mEq/L is a life-threatening emergency due to the risk of cardiac arrhythmias. The first
priority is to stabilize the cardiac membrane by administering IV calcium gluconate. While insulin and dextrose,
sodium polystyrene, and hemodialysis are all treatments for hyperkalemia, cardiac membrane stabilization is the
immediate priority.
Question 2
A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 3 L/min via nasal cannula.
,The nurse notes the patient's respiratory rate has dropped to 8 breaths/min. What is the nurse's priority action?
A. Increase the oxygen flow rate to 4 L/min
B. Assess the patient's oxygen saturation level
C. Decrease the oxygen flow rate to 1-2 L/min
D. Notify the healthcare provider immediately
🟢 Correct Answer:
D. Notify the healthcare provider immediately
🔴 RATIONALE:
A sudden drop in respiratory rate in a COPD patient receiving supplemental oxygen may indicate respiratory
depression due to loss of hypoxic drive. This is a medical emergency. While decreasing the oxygen flow rate
may be appropriate, the nurse must notify the provider immediately and prepare to support ventilation.
Question 3
The nurse is providing care to a patient with heart failure who is receiving intravenous furosemide. Which
assessment finding indicates the medication is having the desired therapeutic effect?
A. Decreased blood pressure
B. Increased urine output
C. Decreased heart rate
D. Increased peripheral edema
🟢 Correct Answer:
B. Increased urine output
,🔴 RATIONALE:
Furosemide is a loop diuretic used to reduce fluid volume overload. The desired therapeutic effect is increased
urine output, which leads to decreased edema, reduced shortness of breath, and improved oxygenation. While
decreased blood pressure and heart rate may occur, increased urine output is the most direct indicator of
effectiveness.
Question 4
The nurse is caring for a patient with a chest tube following a pneumothorax. Which finding indicates the chest
tube is functioning correctly?
A. Continuous bubbling in the water seal chamber
B. Tidaling in the water seal chamber with respiration
C. No drainage in the collection chamber
D. Bubbling in the suction control chamber
🟢 Correct Answer:
B. Tidaling in the water seal chamber with respiration
🔴 RATIONALE:
Tidaling (fluctuations) in the water seal chamber is an expected finding that indicates the chest tube is patent
and functioning correctly. Continuous bubbling in the water seal chamber indicates an air leak. Suction control
chamber bubbling is related to the suction setting.
, Question 5
A patient with diabetes mellitus is admitted with diabetic ketoacidosis (DKA). Which laboratory finding is most
consistent with this diagnosis?
A. Serum glucose 180 mg/dL
B. Arterial pH 7.25
C. Serum bicarbonate 22 mEq/L
D. Serum potassium 3.0 mEq/L
🟢 Correct Answer:
B. Arterial pH 7.25
🔴 RATIONALE:
DKA is characterized by metabolic acidosis with an arterial pH below 7.30, serum glucose often exceeding 250
mg/dL, and low serum bicarbonate (less than 15 mEq/L). A pH of 7.25 indicates acidosis. A serum glucose of 180
mg/dL is not high enough for DKA.
Question 6
A patient is prescribed warfarin (Coumadin) for atrial fibrillation. The nurse notes the patient's INR is 1.8. What is
the nurse's priority action?
A. Administer the next dose of warfarin as prescribed
B. Hold the next dose and notify the healthcare provider
C. Administer vitamin K intramuscularly
D. Increase the dose of warfarin per protocol
