HESI Comprehensive Exam 2026/2027: 200
Actual Exam Questions & Verified Answers –
Complete Review Already Graded A+
1. A client with heart failure has crackles in bilateral lung bases, jugular vein
distention, and an S3 gallop. Which medication should the nurse prepare to
administer first?
A) Metoprolol
B) Furosemide IV
C) Digoxin
D) Spironolactone
Answer B: Furosemide IV
Rationale: IV furosemide rapidly reduces preload and pulmonary congestion.
Beta-blockers are not for acute decompensation.
2. The nurse is caring for a client with a new tracheostomy. Which finding
requires immediate action?
A) Small amount of serous drainage at the stoma site
B) Difficulty passing a suction catheter and decreased breath sounds
C) Temperature 37.8°C (100°F)
D) Oxygen saturation 94% on room air
Answer B: Difficulty passing a suction catheter and decreased breath sounds
,Rationale: Inability to pass catheter and diminished breath sounds suggest tube
obstruction; suction or replace tube immediately.
3. A client with bipolar disorder in a manic episode has not slept for 3 days
and is pacing rapidly. Which nursing intervention is most appropriate?
A) Administer a sedative IM
B) Provide a quiet, low-stimulation environment and offer high-calorie finger foods
C) Place the client in seclusion
D) Allow the client to continue pacing without intervention
Answer B: Provide a quiet, low-stimulation environment and offer high-
calorie finger foods
Rationale: Reduce stimuli to decrease agitation; offer portable snacks and fluids
to maintain nutrition.
4. A child with a history of asthma has a peak flow reading of 50% of
personal best. The child is speaking in short phrases and has retractions.
Which action should the nurse take first?
A) Administer an oral corticosteroid
B) Administer a rescue bronchodilator (albuterol) via nebulizer
C) Call 911
D) Apply oxygen at 2 L/min via nasal cannula
Answer B: Administer a rescue bronchodilator (albuterol) via nebulizer
,Rationale: Peak flow 50-80% (yellow zone) indicates moderate exacerbation; treat
with bronchodilator first.
5. The charge nurse is making assignments. Which client is most appropriate
to assign to an LPN?
A) Client with a new tracheostomy requiring frequent suctioning
B) Client with a urinary tract infection on oral antibiotics
C) Client with a chest tube on water seal
D) Client receiving IV dopamine for septic shock
Answer B: Client with a urinary tract infection on oral antibiotics
Rationale: Stable client on oral meds is within LPN scope. Tracheostomy, chest
tube, and vasopressors require RN.
6. A client with chronic kidney disease (CKD) has a potassium level of 6.8
mEq/L. Which ECG change does the nurse expect?
A) Prominent U waves
B) Peaked T waves
C) Prolonged PR interval
D) ST depression
Answer B: Peaked T waves
Rationale: Hyperkalemia causes peaked T waves, then wide QRS, and eventually
sine wave. Prominent U waves are hypokalemia.
, 7. A postpartum client who delivered 2 hours ago has a boggy fundus
displaced to the right and heavy lochia with clots. What is the priority
nursing action?
A) Administer methylergonovine IM
B) Assist the client to void
C) Perform fundal massage
D) Increase the oxytocin infusion rate
Answer B: Assist the client to void
Rationale: A displaced boggy fundus often indicates a distended bladder;
emptying the bladder allows the uterus to contract.
8. A client with major depressive disorder is started on phenelzine (MAOI).
Which food should the nurse instruct the client to avoid?
A) Broiled chicken
B) Aged cheddar cheese
C) Fresh apples
D) White rice
Answer B: Aged cheddar cheese
Rationale: MAOIs require a low-tyramine diet; aged cheese, cured meats, and
fermented foods cause hypertensive crisis.
Actual Exam Questions & Verified Answers –
Complete Review Already Graded A+
1. A client with heart failure has crackles in bilateral lung bases, jugular vein
distention, and an S3 gallop. Which medication should the nurse prepare to
administer first?
A) Metoprolol
B) Furosemide IV
C) Digoxin
D) Spironolactone
Answer B: Furosemide IV
Rationale: IV furosemide rapidly reduces preload and pulmonary congestion.
Beta-blockers are not for acute decompensation.
2. The nurse is caring for a client with a new tracheostomy. Which finding
requires immediate action?
A) Small amount of serous drainage at the stoma site
B) Difficulty passing a suction catheter and decreased breath sounds
C) Temperature 37.8°C (100°F)
D) Oxygen saturation 94% on room air
Answer B: Difficulty passing a suction catheter and decreased breath sounds
,Rationale: Inability to pass catheter and diminished breath sounds suggest tube
obstruction; suction or replace tube immediately.
3. A client with bipolar disorder in a manic episode has not slept for 3 days
and is pacing rapidly. Which nursing intervention is most appropriate?
A) Administer a sedative IM
B) Provide a quiet, low-stimulation environment and offer high-calorie finger foods
C) Place the client in seclusion
D) Allow the client to continue pacing without intervention
Answer B: Provide a quiet, low-stimulation environment and offer high-
calorie finger foods
Rationale: Reduce stimuli to decrease agitation; offer portable snacks and fluids
to maintain nutrition.
4. A child with a history of asthma has a peak flow reading of 50% of
personal best. The child is speaking in short phrases and has retractions.
Which action should the nurse take first?
A) Administer an oral corticosteroid
B) Administer a rescue bronchodilator (albuterol) via nebulizer
C) Call 911
D) Apply oxygen at 2 L/min via nasal cannula
Answer B: Administer a rescue bronchodilator (albuterol) via nebulizer
,Rationale: Peak flow 50-80% (yellow zone) indicates moderate exacerbation; treat
with bronchodilator first.
5. The charge nurse is making assignments. Which client is most appropriate
to assign to an LPN?
A) Client with a new tracheostomy requiring frequent suctioning
B) Client with a urinary tract infection on oral antibiotics
C) Client with a chest tube on water seal
D) Client receiving IV dopamine for septic shock
Answer B: Client with a urinary tract infection on oral antibiotics
Rationale: Stable client on oral meds is within LPN scope. Tracheostomy, chest
tube, and vasopressors require RN.
6. A client with chronic kidney disease (CKD) has a potassium level of 6.8
mEq/L. Which ECG change does the nurse expect?
A) Prominent U waves
B) Peaked T waves
C) Prolonged PR interval
D) ST depression
Answer B: Peaked T waves
Rationale: Hyperkalemia causes peaked T waves, then wide QRS, and eventually
sine wave. Prominent U waves are hypokalemia.
, 7. A postpartum client who delivered 2 hours ago has a boggy fundus
displaced to the right and heavy lochia with clots. What is the priority
nursing action?
A) Administer methylergonovine IM
B) Assist the client to void
C) Perform fundal massage
D) Increase the oxytocin infusion rate
Answer B: Assist the client to void
Rationale: A displaced boggy fundus often indicates a distended bladder;
emptying the bladder allows the uterus to contract.
8. A client with major depressive disorder is started on phenelzine (MAOI).
Which food should the nurse instruct the client to avoid?
A) Broiled chicken
B) Aged cheddar cheese
C) Fresh apples
D) White rice
Answer B: Aged cheddar cheese
Rationale: MAOIs require a low-tyramine diet; aged cheese, cured meats, and
fermented foods cause hypertensive crisis.
