HESI Compass Comprehensive Exit Exam 2025/2026 — 500 Practice Questions with Verified
Answers & Detailed Rationales
Table of Contents
1. Exam Overview
2. Domain 1: Management of Care (Questions 1–85)
3. Domain 2: Safety and Infection Control (Questions 86–155)
4. Domain 3: Health Promotion and Maintenance (Questions 156–220)
5. Domain 4: Psychosocial Integrity (Questions 221–280)
6. Domain 5: Basic Care and Comfort (Questions 281–340)
7. Domain 6: Pharmacological and Parenteral Therapies (Questions 341–400)
8. Domain 7: Reduction of Risk Potential (Questions 401–450)
9. Domain 8: Physiological Adaptation (Questions 451–500)
10. Answer Key Summary
Exam Overview
The HESI Compass Comprehensive Exit Exam is a comprehensive, computer-adaptive
assessment designed to evaluate nursing students' readiness for the NCLEX-RN licensure
examination. It is an integral component of the HESI Compass NCLEX review course, which
builds student NCLEX readiness through individualized learning pathways, content review
modules, and HESI Assessment readiness indicators.
Exam Format
| Feature | Details |
|---------|---------|
,| Exam Name | HESI RN Compass Exit Exam |
| Versions | Multiple (V1, V2, V3, etc.) |
| Format | Next Generation NCLEX (NGN) style questions; computer-adaptive |
| Question Count | Typically 150–160 questions per version (includes unscored pilot items) |
| Time Limit | Approximately 3–4 hours |
| Passing Score | 850 scaled score (readiness threshold); 900 for strong readiness indicator |
| Question Types | Multiple-choice, Select All That Apply (SATA), prioritization, ordered
response, NGN-style case-based items |
Core Domains and Blueprint Alignment
The exam is aligned with the NCLEX-RN Test Plan across all eight Client Need categories and
nine sub-domains. The core domains and their approximate weightings are:
| Domain | Approx. Weight | Questions |
|--------|----------------|-----------|
| Management of Care | 17–23% | 85 |
| Safety and Infection Control | 9–15% | 70 |
| Health Promotion and Maintenance | 6–12% | 65 |
| Psychosocial Integrity | 6–12% | 60 |
| Basic Care and Comfort | 6–12% | 60 |
| Pharmacological and Parenteral Therapies | 12–18% | 60 |
| Reduction of Risk Potential | 9–15% | 50 |
| Physiological Adaptation | 11–17% | 50 |
| TOTAL | 100% | 500 |
Content Coverage
The exam comprehensively covers all major nursing content areas:
,- Medical-Surgical Nursing: Cardiovascular, respiratory, endocrine, renal, gastrointestinal,
neurological, musculoskeletal, and hematologic/oncologic disorders
- Pharmacology: Medication administration, side effects, interactions, and high-alert
medications
- Maternal-Newborn Nursing: Antepartum, intrapartum, postpartum, and newborn care
- Pediatric Nursing: Growth and development, common pediatric disorders, and family-
centered care
- Mental Health Nursing: Therapeutic communication, psychiatric disorders, and
psychopharmacology
- Fundamentals of Nursing: Basic care, safety, infection control, and documentation
- Leadership and Management: Delegation, prioritization, advocacy, and legal/ethical issues
Cognitive Blueprint
| Cognitive Level | Percentage |
|-----------------|------------|
| Recall | 30% |
| Application | 50% |
| Analysis | 20% |
Item Style
| Style | Percentage |
|-------|------------|
| Scenario-based | 75–80% |
| Direct recall | 20–25% |
, DOMAIN 1: MANAGEMENT OF CARE
Questions 1–85
1. The charge nurse is making client assignments for the night shift. Which client should be
assigned to the licensed practical nurse (LPN) under the supervision of the registered nurse
(RN)?
A) A client who is 12 hours postoperative following a subtotal thyroidectomy and requires
assessment for signs of hypocalcemia
B) A client admitted with heart failure exacerbation who has crackles bilaterally and needs a
furosemide IV push
C) A client with a stage III pressure injury requiring wound irrigation, debridement, and
evaluation of healing progress
D) A client who is 2 days post-appendectomy with an abdominal incision that needs vital
signs monitoring and a dressing change
Correct Answer: D) A client who is 2 days post-appendectomy with an abdominal incision
that needs vital signs monitoring and a dressing change
Rationale: The RN is responsible for assessment, evaluation, and complex interventions. The
LPN can perform stable, routine tasks such as vital signs monitoring and dressing changes on
a stable postoperative client. Options A, B, and C require RN-level assessment or
intervention (IV push medication, wound evaluation, and assessment for hypocalcemia).
---
2. A nurse is caring for four clients. Which client should the nurse assess FIRST?
A) A client who is 1 day postoperative and reports pain at a level of 6/10
B) A client with COPD who has an oxygen saturation of 88% on room air
Answers & Detailed Rationales
Table of Contents
1. Exam Overview
2. Domain 1: Management of Care (Questions 1–85)
3. Domain 2: Safety and Infection Control (Questions 86–155)
4. Domain 3: Health Promotion and Maintenance (Questions 156–220)
5. Domain 4: Psychosocial Integrity (Questions 221–280)
6. Domain 5: Basic Care and Comfort (Questions 281–340)
7. Domain 6: Pharmacological and Parenteral Therapies (Questions 341–400)
8. Domain 7: Reduction of Risk Potential (Questions 401–450)
9. Domain 8: Physiological Adaptation (Questions 451–500)
10. Answer Key Summary
Exam Overview
The HESI Compass Comprehensive Exit Exam is a comprehensive, computer-adaptive
assessment designed to evaluate nursing students' readiness for the NCLEX-RN licensure
examination. It is an integral component of the HESI Compass NCLEX review course, which
builds student NCLEX readiness through individualized learning pathways, content review
modules, and HESI Assessment readiness indicators.
Exam Format
| Feature | Details |
|---------|---------|
,| Exam Name | HESI RN Compass Exit Exam |
| Versions | Multiple (V1, V2, V3, etc.) |
| Format | Next Generation NCLEX (NGN) style questions; computer-adaptive |
| Question Count | Typically 150–160 questions per version (includes unscored pilot items) |
| Time Limit | Approximately 3–4 hours |
| Passing Score | 850 scaled score (readiness threshold); 900 for strong readiness indicator |
| Question Types | Multiple-choice, Select All That Apply (SATA), prioritization, ordered
response, NGN-style case-based items |
Core Domains and Blueprint Alignment
The exam is aligned with the NCLEX-RN Test Plan across all eight Client Need categories and
nine sub-domains. The core domains and their approximate weightings are:
| Domain | Approx. Weight | Questions |
|--------|----------------|-----------|
| Management of Care | 17–23% | 85 |
| Safety and Infection Control | 9–15% | 70 |
| Health Promotion and Maintenance | 6–12% | 65 |
| Psychosocial Integrity | 6–12% | 60 |
| Basic Care and Comfort | 6–12% | 60 |
| Pharmacological and Parenteral Therapies | 12–18% | 60 |
| Reduction of Risk Potential | 9–15% | 50 |
| Physiological Adaptation | 11–17% | 50 |
| TOTAL | 100% | 500 |
Content Coverage
The exam comprehensively covers all major nursing content areas:
,- Medical-Surgical Nursing: Cardiovascular, respiratory, endocrine, renal, gastrointestinal,
neurological, musculoskeletal, and hematologic/oncologic disorders
- Pharmacology: Medication administration, side effects, interactions, and high-alert
medications
- Maternal-Newborn Nursing: Antepartum, intrapartum, postpartum, and newborn care
- Pediatric Nursing: Growth and development, common pediatric disorders, and family-
centered care
- Mental Health Nursing: Therapeutic communication, psychiatric disorders, and
psychopharmacology
- Fundamentals of Nursing: Basic care, safety, infection control, and documentation
- Leadership and Management: Delegation, prioritization, advocacy, and legal/ethical issues
Cognitive Blueprint
| Cognitive Level | Percentage |
|-----------------|------------|
| Recall | 30% |
| Application | 50% |
| Analysis | 20% |
Item Style
| Style | Percentage |
|-------|------------|
| Scenario-based | 75–80% |
| Direct recall | 20–25% |
, DOMAIN 1: MANAGEMENT OF CARE
Questions 1–85
1. The charge nurse is making client assignments for the night shift. Which client should be
assigned to the licensed practical nurse (LPN) under the supervision of the registered nurse
(RN)?
A) A client who is 12 hours postoperative following a subtotal thyroidectomy and requires
assessment for signs of hypocalcemia
B) A client admitted with heart failure exacerbation who has crackles bilaterally and needs a
furosemide IV push
C) A client with a stage III pressure injury requiring wound irrigation, debridement, and
evaluation of healing progress
D) A client who is 2 days post-appendectomy with an abdominal incision that needs vital
signs monitoring and a dressing change
Correct Answer: D) A client who is 2 days post-appendectomy with an abdominal incision
that needs vital signs monitoring and a dressing change
Rationale: The RN is responsible for assessment, evaluation, and complex interventions. The
LPN can perform stable, routine tasks such as vital signs monitoring and dressing changes on
a stable postoperative client. Options A, B, and C require RN-level assessment or
intervention (IV push medication, wound evaluation, and assessment for hypocalcemia).
---
2. A nurse is caring for four clients. Which client should the nurse assess FIRST?
A) A client who is 1 day postoperative and reports pain at a level of 6/10
B) A client with COPD who has an oxygen saturation of 88% on room air
