HESI RN Compass Comprehensive Exit Exam Test
Bank | Complete Study Guide with Actual Exam
Questions, Verified Correct Answers and Detailed
Rationales (100% Verified Correct Solutions) |
Latest Update 2026/2027 - Already Graded A+
Question 1
Enalapril maleate (Vasotec) is prescribed for a hospitalized client. Which assessment does
the nurse perform as a priority before administering the medication?
A. Checking the client's blood pressure
B. Checking the client's peripheral pulses
C. Checking the most recent potassium level
D. Checking the client's intake-and-output record for the last 24 hours
Answer: A
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 peripheral pulses (B), potassium level (C), and intake/output (D) are not
specifically associated with this medication.
Question 2
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?
A. "The test will take about 30 minutes."
B. "I need to fast for 8 hours before the test."
C. "I need to drink citrate of magnesia the night before the test and give myself a Fleet
enema on the morning of the test."
D. "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."
Answer: C
Rationale: An upper GI series involves visualization of the esophagus, duodenum, and
upper jejunum using a contrast medium (usually barium). No special preparation is
necessary except NPO status for 8 hours before the test. Citrate of magnesia and Fleet
enema (C) are preparations for a lower GI series, not an upper GI series. After the test, the
client should take a laxative to hasten elimination of barium (D) to prevent fecal impaction.
1
,Question 3
A nurse on the evening shift checks a physician's prescriptions and notes that the dose of a
prescribed medication is higher than the normal dose. The nurse calls the physician's
answering service and is told that the physician is off for the night and will be available in
the morning. The nurse should:
A. Call the nursing supervisor
B. Ask the answering service to contact the on-call physician
C. Withhold the medication until the physician can be reached in the morning
D. Administer the medication but consult the physician when he becomes available
Answer: B
Rationale: When a medication dose appears higher than normal, the nurse should clarify
the prescription with the physician. If the physician is unavailable, the nurse should ask the
answering service to contact the on-call physician. Withholding the medication (C) or
administering it (D) without clarification could harm the client. Calling the nursing
supervisor (A) is not the first action.
Question 4
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 resulting in perfusion.
The appropriate action by the nurse is:
A. Documenting the findings
B. Asking the ED physician to check the client
C. Continuing to monitor the client's cardiac status
D. Informing the client that PVCs are expected after an MI
Answer: B
Rationale: PVCs after an MI can indicate ventricular irritability and may progress to life-
threatening arrhythmias. The nurse should ask the ED physician to check the client.
Documenting (A) or continuing to monitor (C) without notifying the physician is
inappropriate. Informing the client that PVCs are expected (D) is incorrect and dismissive.
Question 5
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. The nurse should:
A. Administer the antihypertensive with a small sip of water
B. Withhold the antihypertensive and administer it at bedtime
C. Administer the medication by way of the intravenous (IV) route
2
,D. Hold the antihypertensive and resume its administration on the day after the ECT
Answer: A
Rationale: The client should receive the antihypertensive with a small sip of water to
maintain blood pressure control. Withholding the medication (B, D) could lead to
hypertension. IV administration (C) is not appropriate for an oral medication.
Question 6
A client who recently underwent coronary artery bypass graft surgery comes to the
physician'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?
A. "Tell me more about what you're feeling."
B. "That's a normal response after this type of surgery."
C. "It will take time, but, I promise you, you will get over this depression."
D. "Every client who has this surgery feels the same way for about a month."
Answer: A
Rationale: "Tell me more about what you're feeling" is a therapeutic response that
encourages the client to express feelings. Options B, C, and D are dismissive and do not
encourage further communication.
Question 7
A client in labor experiences spontaneous rupture of the membranes. The nurse
immediately counts the fetal heart rate (FHR) for 1 full minute and then checks the
amniotic fluid. The nurse notes that the fluid is yellow and has a strong odor. Which of the
following actions should be the nurse's priority?
A. Contacting the physician
B. Documenting the findings
C. Checking the fluid for protein
D. Continuing to monitor the client and the FHR
Answer: A
Rationale: Yellow amniotic fluid with a strong odor may indicate infection or meconium
staining. The nurse should contact the physician immediately. Documenting (B) is
important but not the priority. Checking for protein (C) is not appropriate. Continuing to
monitor (D) without notifying the physician delays necessary intervention.
Question 8
A nurse has assisted a physician in inserting a central venous access device into a client
with a diagnosis of severe malnutrition who will be receiving parenteral nutrition (PN).
3
, After insertion of the catheter, the nurse immediately plans to:
A. Call the radiography department to obtain a chest x-ray
B. Check the client's blood glucose level to serve as a baseline measurement
C. Hang the prescribed bag of PN and start the infusion at the prescribed rate
D. Infuse normal saline solution through the catheter at a rate of 100 mL/hr to maintain
patency
Answer: A
Rationale: After central line insertion, a chest x-ray is required to confirm proper
placement and rule out pneumothorax. PN should not be started until placement is
confirmed. Infusing normal saline (D) may be done but is not the immediate priority.
Question 9
A rape victim being treated in the emergency department says to the nurse, "I'm really
worried that I've got HIV now." What is the appropriate response by the nurse?
A. "HIV is rarely an issue in rape victims."
B. "Every rape victim is concerned about HIV."
C. "You're more likely to get pregnant than to contract HIV."
D. "Let's talk about the information that you need to determine your risk of contracting
HIV."
Answer: D
Rationale: The nurse should provide information about HIV risk and testing without
dismissing the client's concerns. Options A and C minimize the client's concerns. Option B
generalizes and does not address the client's specific concern.
Question 10
A client is taking prescribed ibuprofen (Motrin), 300 mg orally four times daily, to relieve
joint pain resulting from rheumatoid arthritis. The client tells the nurse that the medication
is causing nausea and indigestion. The nurse should tell the client to:
A. Contact the physician
B. Stop taking the medication
C. Take the medication with food
D. Take the medication twice a day instead of four times
Answer: C
Rationale: Taking NSAIDs with food can reduce gastrointestinal irritation. Contacting the
physician (A) may be necessary if symptoms persist, but taking with food is the first
recommendation. Stopping the medication (B) is not appropriate without consulting the
physician. Changing the dose (D) is not appropriate.
4
Bank | Complete Study Guide with Actual Exam
Questions, Verified Correct Answers and Detailed
Rationales (100% Verified Correct Solutions) |
Latest Update 2026/2027 - Already Graded A+
Question 1
Enalapril maleate (Vasotec) is prescribed for a hospitalized client. Which assessment does
the nurse perform as a priority before administering the medication?
A. Checking the client's blood pressure
B. Checking the client's peripheral pulses
C. Checking the most recent potassium level
D. Checking the client's intake-and-output record for the last 24 hours
Answer: A
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 peripheral pulses (B), potassium level (C), and intake/output (D) are not
specifically associated with this medication.
Question 2
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?
A. "The test will take about 30 minutes."
B. "I need to fast for 8 hours before the test."
C. "I need to drink citrate of magnesia the night before the test and give myself a Fleet
enema on the morning of the test."
D. "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."
Answer: C
Rationale: An upper GI series involves visualization of the esophagus, duodenum, and
upper jejunum using a contrast medium (usually barium). No special preparation is
necessary except NPO status for 8 hours before the test. Citrate of magnesia and Fleet
enema (C) are preparations for a lower GI series, not an upper GI series. After the test, the
client should take a laxative to hasten elimination of barium (D) to prevent fecal impaction.
1
,Question 3
A nurse on the evening shift checks a physician's prescriptions and notes that the dose of a
prescribed medication is higher than the normal dose. The nurse calls the physician's
answering service and is told that the physician is off for the night and will be available in
the morning. The nurse should:
A. Call the nursing supervisor
B. Ask the answering service to contact the on-call physician
C. Withhold the medication until the physician can be reached in the morning
D. Administer the medication but consult the physician when he becomes available
Answer: B
Rationale: When a medication dose appears higher than normal, the nurse should clarify
the prescription with the physician. If the physician is unavailable, the nurse should ask the
answering service to contact the on-call physician. Withholding the medication (C) or
administering it (D) without clarification could harm the client. Calling the nursing
supervisor (A) is not the first action.
Question 4
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 resulting in perfusion.
The appropriate action by the nurse is:
A. Documenting the findings
B. Asking the ED physician to check the client
C. Continuing to monitor the client's cardiac status
D. Informing the client that PVCs are expected after an MI
Answer: B
Rationale: PVCs after an MI can indicate ventricular irritability and may progress to life-
threatening arrhythmias. The nurse should ask the ED physician to check the client.
Documenting (A) or continuing to monitor (C) without notifying the physician is
inappropriate. Informing the client that PVCs are expected (D) is incorrect and dismissive.
Question 5
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. The nurse should:
A. Administer the antihypertensive with a small sip of water
B. Withhold the antihypertensive and administer it at bedtime
C. Administer the medication by way of the intravenous (IV) route
2
,D. Hold the antihypertensive and resume its administration on the day after the ECT
Answer: A
Rationale: The client should receive the antihypertensive with a small sip of water to
maintain blood pressure control. Withholding the medication (B, D) could lead to
hypertension. IV administration (C) is not appropriate for an oral medication.
Question 6
A client who recently underwent coronary artery bypass graft surgery comes to the
physician'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?
A. "Tell me more about what you're feeling."
B. "That's a normal response after this type of surgery."
C. "It will take time, but, I promise you, you will get over this depression."
D. "Every client who has this surgery feels the same way for about a month."
Answer: A
Rationale: "Tell me more about what you're feeling" is a therapeutic response that
encourages the client to express feelings. Options B, C, and D are dismissive and do not
encourage further communication.
Question 7
A client in labor experiences spontaneous rupture of the membranes. The nurse
immediately counts the fetal heart rate (FHR) for 1 full minute and then checks the
amniotic fluid. The nurse notes that the fluid is yellow and has a strong odor. Which of the
following actions should be the nurse's priority?
A. Contacting the physician
B. Documenting the findings
C. Checking the fluid for protein
D. Continuing to monitor the client and the FHR
Answer: A
Rationale: Yellow amniotic fluid with a strong odor may indicate infection or meconium
staining. The nurse should contact the physician immediately. Documenting (B) is
important but not the priority. Checking for protein (C) is not appropriate. Continuing to
monitor (D) without notifying the physician delays necessary intervention.
Question 8
A nurse has assisted a physician in inserting a central venous access device into a client
with a diagnosis of severe malnutrition who will be receiving parenteral nutrition (PN).
3
, After insertion of the catheter, the nurse immediately plans to:
A. Call the radiography department to obtain a chest x-ray
B. Check the client's blood glucose level to serve as a baseline measurement
C. Hang the prescribed bag of PN and start the infusion at the prescribed rate
D. Infuse normal saline solution through the catheter at a rate of 100 mL/hr to maintain
patency
Answer: A
Rationale: After central line insertion, a chest x-ray is required to confirm proper
placement and rule out pneumothorax. PN should not be started until placement is
confirmed. Infusing normal saline (D) may be done but is not the immediate priority.
Question 9
A rape victim being treated in the emergency department says to the nurse, "I'm really
worried that I've got HIV now." What is the appropriate response by the nurse?
A. "HIV is rarely an issue in rape victims."
B. "Every rape victim is concerned about HIV."
C. "You're more likely to get pregnant than to contract HIV."
D. "Let's talk about the information that you need to determine your risk of contracting
HIV."
Answer: D
Rationale: The nurse should provide information about HIV risk and testing without
dismissing the client's concerns. Options A and C minimize the client's concerns. Option B
generalizes and does not address the client's specific concern.
Question 10
A client is taking prescribed ibuprofen (Motrin), 300 mg orally four times daily, to relieve
joint pain resulting from rheumatoid arthritis. The client tells the nurse that the medication
is causing nausea and indigestion. The nurse should tell the client to:
A. Contact the physician
B. Stop taking the medication
C. Take the medication with food
D. Take the medication twice a day instead of four times
Answer: C
Rationale: Taking NSAIDs with food can reduce gastrointestinal irritation. Contacting the
physician (A) may be necessary if symptoms persist, but taking with food is the first
recommendation. Stopping the medication (B) is not appropriate without consulting the
physician. Changing the dose (D) is not appropriate.
4
