HESI COMPREHENSIVE EXAM
QUESTIONS AND DETAILED ANSWERS.
EXPERT VERIFIED FOR GUARANTEED
PASS.
A nurse taking the vital signs of a client immediately after she has delivered a newborn notes
that the client's heart rate is 110 beats/min. What should the nurse do first?
Recheck the heart rate in 1 hour
Offer the client oral fluids
Check the uterus and amount of lochia discharge Correct
Document the findings - ANS If tachycardia is noted, the nurse should first assess the
location and firmness of the uterus and amount of lochia. Additional assessments including
blood pressure, estimated blood loss at delivery, and hemoglobin and hematocrit
determinations should be carried out. After delivery, the normal heart rate ranges from 60 to
90 beats/min. Tachycardia may indicate excitement, fatigue, dehydration, hypovolemia, pain,
or infection. Although the nurse would document the findings, it is most appropriate for the
nurse to assess the client to determine the cause of the tachycardia. Oral fluids are important if
the client is dehydrated, but further assessment of the problem is required and dehydration
would first need to be confirmed. Rechecking the heart rate in 1 hour will delay necessary
interventions.
A nurse reviews the laboratory results of a hospitalized pregnant client with a diagnosis of
sepsis who is at risk for disseminated intravascular coagulopathy (DIC). Which laboratory
finding would indicate to the nurse that DIC has developed in the client?
Shortened prothrombin time
Increased platelet count
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,Positive result on d-dimer study Correct
Decreased fibrin-degradation products - ANS The d-dimer study is used to confirm the
presence of fibrin split products; a positive result is indicative of DIC. DIC is a life-threatening
defect in coagulation. As plasma factors are consumed, the circulating blood becomes deficient
in clotting factors and unable to clot. Even as anticoagulation is occurring, inappropriate
coagulation is also taking place in the microcirculation, and tiny clots form in the smallest blood
vessels, blocking blood flow to the organs and causing ischemia. Laboratory studies help
establish a diagnosis. The fibrinogen value and platelet count are usually decreased,
prothrombin and activated partial thromboplastin times may be prolonged, and levels of fibrin
degradation products (the most sensitive measurement) are increased.
The nurse is assessing a client who has a history of Prinzmetal's angina. The nurse knows that
what type of medication is given to treat this condition?
Calcium channel blockers Correct
ACE inhibitors
Inotropes
Beta blockers - ANS Prinzmetal's, or variant, angina is prolonged and severe and occurs at
the same time each day, most often at rest. The treatment of choice is usually a calcium
channel blocker. Calcium channel blockers relax and dilate the vascular smooth muscle, thus
relieving the coronary artery spasm in variant angina. Inotropes, beta blockers, and
angiotensin-converting enzyme (ACE) inhibitors are not given to treat this disorder.
Ciprofloxacin hydrochloride is prescribed to a client with a urinary tract infection. The nurse
provides instruction about the medication. What does the nurse tell the client about how best
to take the medication?
With aluminum hydroxide
With an antacid
With milk
2 hours after meals Correct - ANS Ciprofloxacin hydrochloride is an anti-infective in the
fluoroquinolone family. It may be taken without regard to meals, but the best dosing time is 2
hours after a meal. Milk may affect absorption. Antacids (here, aluminum hydroxide) may
reduce absorption and should be administered 2 hours apart from the ciprofloxacin
hydrochloride.
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,Ergotamine is prescribed to a client with cluster headaches. Which occurrence does the nurse
tell the client to report to the primary health care provider if she experiences them while taking
the medication?
Fatigue and lethargy
Dizziness and fatigue
Numbness and tingling of the fingers or toes Correct
Cough - ANS Ergotamine is an antimigraine medication. Prolonged administration or an
excessive dosage may produce ergotamine poisoning (ergotism). Signs/symptoms include
nausea, vomiting, weakness in the legs, pain in the limb muscles, and numbness and tingling of
the fingers and toes. The client is instructed to report these signs/symptoms to the primary
health care provider if they occur. Cough, fatigue, lethargy, and dizziness are side effects and
not adverse effects of the medication.
A nurse working the evening shift is helping clients get ready for sleep. A female client
diagnosed with mania is hyperactive and pacing the hallway. What is the most appropriate
action the nurse can take?
Tell the client that other clients are trying to sleep and that she is being disruptive
Take the client to the bathroom and provide her with a warm bath Correct
Stay with the client and observe her behavior
Tell the client that it is time for sleep and that she needs to go to her room - ANS At bedtime,
the nurse should take the client to the bathroom and provide warm baths, soothing music, and
medication when indicated. For the client with mania, the nurse needs to promote relaxation,
rest, and sleep and to minimize manic behavior. The nurse should encourage frequent rest
periods during the day and keep the client in areas of low stimulation. The client should not
consume products containing caffeine. Staying with the client and observing her behavior,
telling the client that it is time to go to sleep and to go to her room, and telling the client that
other clients are trying to sleep and that she is being disruptive do not address the client's
needs and are not measures that will help the client relax and sleep.
A client diagnosed with type 1 diabetes mellitus has just been told that she is 6 weeks pregnant.
The nurse provides information to the client about dietary and insulin needs. What comment by
the client suggests an understanding of the information?
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, "I know I will have to increase my insulin during this time period."
"My insulin needs should decrease during the first trimester." Correct
"Needs for insulin will not change during the first 3 months of pregnancy."
"I will have to double up on the insulin dose during this time span." - ANS Insulin needs
generally decrease during the first trimester of pregnancy because the secretion of placental
hormones antagonistic to insulin remains low. An increase in insulin need, lack of change in
insulin need, and doubling of insulin need are all incorrect.
A nurse develops a list of home care instructions for a client who is wearing a halo fixation
device after sustaining a cervical fracture. Which instructions should the nurse include? Select
all that apply.
Do not drive, because full range of vision is impaired with the device. Correct
Avoid sexual activity while the vest is in place.
Apply powder under the vest to prevent irritation.
Wear snug clothing to prevent the device from shifting.
Use caution when leaning forward or backward. Correct
Use a straw to drink. Correct - ANS Straws are used to drink, and meat and other foods are
cut into small pieces to facilitate swallowing. The weight of the halo device alters balance;
therefore the client should use caution when leaning forward or backward. The client is also
told not to drive, because full range of vision is impaired with the device. A halo fixation
(stabilization) device is used to prevent the head and neck from moving after a neck injury. The
halo fixation device is not removed. Sexual activity does not have to be avoided; the client is
instructed to use a position of comfort. Powders and lotions are used sparingly or not at all to
prevent buildup of moisture and subsequent skin breakdown. The client is instructed to wear
loose clothing with a large neck. The halo fixation device should not shift; if it does, the primary
health care provider must be notified. The client is taught to sleep with the head supported
with a small pillow to prevent unnecessary pressure and discomfort.
Empyema develops in a client with an infected pleural effusion, and the nurse prepares the
client for thoracentesis. The nurse is assisting the primary health care provider with the
procedure. What characteristics of the fluid removed during thoracentesis should the nurse
expect to note?
Clear and yellow
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
QUESTIONS AND DETAILED ANSWERS.
EXPERT VERIFIED FOR GUARANTEED
PASS.
A nurse taking the vital signs of a client immediately after she has delivered a newborn notes
that the client's heart rate is 110 beats/min. What should the nurse do first?
Recheck the heart rate in 1 hour
Offer the client oral fluids
Check the uterus and amount of lochia discharge Correct
Document the findings - ANS If tachycardia is noted, the nurse should first assess the
location and firmness of the uterus and amount of lochia. Additional assessments including
blood pressure, estimated blood loss at delivery, and hemoglobin and hematocrit
determinations should be carried out. After delivery, the normal heart rate ranges from 60 to
90 beats/min. Tachycardia may indicate excitement, fatigue, dehydration, hypovolemia, pain,
or infection. Although the nurse would document the findings, it is most appropriate for the
nurse to assess the client to determine the cause of the tachycardia. Oral fluids are important if
the client is dehydrated, but further assessment of the problem is required and dehydration
would first need to be confirmed. Rechecking the heart rate in 1 hour will delay necessary
interventions.
A nurse reviews the laboratory results of a hospitalized pregnant client with a diagnosis of
sepsis who is at risk for disseminated intravascular coagulopathy (DIC). Which laboratory
finding would indicate to the nurse that DIC has developed in the client?
Shortened prothrombin time
Increased platelet count
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,Positive result on d-dimer study Correct
Decreased fibrin-degradation products - ANS The d-dimer study is used to confirm the
presence of fibrin split products; a positive result is indicative of DIC. DIC is a life-threatening
defect in coagulation. As plasma factors are consumed, the circulating blood becomes deficient
in clotting factors and unable to clot. Even as anticoagulation is occurring, inappropriate
coagulation is also taking place in the microcirculation, and tiny clots form in the smallest blood
vessels, blocking blood flow to the organs and causing ischemia. Laboratory studies help
establish a diagnosis. The fibrinogen value and platelet count are usually decreased,
prothrombin and activated partial thromboplastin times may be prolonged, and levels of fibrin
degradation products (the most sensitive measurement) are increased.
The nurse is assessing a client who has a history of Prinzmetal's angina. The nurse knows that
what type of medication is given to treat this condition?
Calcium channel blockers Correct
ACE inhibitors
Inotropes
Beta blockers - ANS Prinzmetal's, or variant, angina is prolonged and severe and occurs at
the same time each day, most often at rest. The treatment of choice is usually a calcium
channel blocker. Calcium channel blockers relax and dilate the vascular smooth muscle, thus
relieving the coronary artery spasm in variant angina. Inotropes, beta blockers, and
angiotensin-converting enzyme (ACE) inhibitors are not given to treat this disorder.
Ciprofloxacin hydrochloride is prescribed to a client with a urinary tract infection. The nurse
provides instruction about the medication. What does the nurse tell the client about how best
to take the medication?
With aluminum hydroxide
With an antacid
With milk
2 hours after meals Correct - ANS Ciprofloxacin hydrochloride is an anti-infective in the
fluoroquinolone family. It may be taken without regard to meals, but the best dosing time is 2
hours after a meal. Milk may affect absorption. Antacids (here, aluminum hydroxide) may
reduce absorption and should be administered 2 hours apart from the ciprofloxacin
hydrochloride.
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,Ergotamine is prescribed to a client with cluster headaches. Which occurrence does the nurse
tell the client to report to the primary health care provider if she experiences them while taking
the medication?
Fatigue and lethargy
Dizziness and fatigue
Numbness and tingling of the fingers or toes Correct
Cough - ANS Ergotamine is an antimigraine medication. Prolonged administration or an
excessive dosage may produce ergotamine poisoning (ergotism). Signs/symptoms include
nausea, vomiting, weakness in the legs, pain in the limb muscles, and numbness and tingling of
the fingers and toes. The client is instructed to report these signs/symptoms to the primary
health care provider if they occur. Cough, fatigue, lethargy, and dizziness are side effects and
not adverse effects of the medication.
A nurse working the evening shift is helping clients get ready for sleep. A female client
diagnosed with mania is hyperactive and pacing the hallway. What is the most appropriate
action the nurse can take?
Tell the client that other clients are trying to sleep and that she is being disruptive
Take the client to the bathroom and provide her with a warm bath Correct
Stay with the client and observe her behavior
Tell the client that it is time for sleep and that she needs to go to her room - ANS At bedtime,
the nurse should take the client to the bathroom and provide warm baths, soothing music, and
medication when indicated. For the client with mania, the nurse needs to promote relaxation,
rest, and sleep and to minimize manic behavior. The nurse should encourage frequent rest
periods during the day and keep the client in areas of low stimulation. The client should not
consume products containing caffeine. Staying with the client and observing her behavior,
telling the client that it is time to go to sleep and to go to her room, and telling the client that
other clients are trying to sleep and that she is being disruptive do not address the client's
needs and are not measures that will help the client relax and sleep.
A client diagnosed with type 1 diabetes mellitus has just been told that she is 6 weeks pregnant.
The nurse provides information to the client about dietary and insulin needs. What comment by
the client suggests an understanding of the information?
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, "I know I will have to increase my insulin during this time period."
"My insulin needs should decrease during the first trimester." Correct
"Needs for insulin will not change during the first 3 months of pregnancy."
"I will have to double up on the insulin dose during this time span." - ANS Insulin needs
generally decrease during the first trimester of pregnancy because the secretion of placental
hormones antagonistic to insulin remains low. An increase in insulin need, lack of change in
insulin need, and doubling of insulin need are all incorrect.
A nurse develops a list of home care instructions for a client who is wearing a halo fixation
device after sustaining a cervical fracture. Which instructions should the nurse include? Select
all that apply.
Do not drive, because full range of vision is impaired with the device. Correct
Avoid sexual activity while the vest is in place.
Apply powder under the vest to prevent irritation.
Wear snug clothing to prevent the device from shifting.
Use caution when leaning forward or backward. Correct
Use a straw to drink. Correct - ANS Straws are used to drink, and meat and other foods are
cut into small pieces to facilitate swallowing. The weight of the halo device alters balance;
therefore the client should use caution when leaning forward or backward. The client is also
told not to drive, because full range of vision is impaired with the device. A halo fixation
(stabilization) device is used to prevent the head and neck from moving after a neck injury. The
halo fixation device is not removed. Sexual activity does not have to be avoided; the client is
instructed to use a position of comfort. Powders and lotions are used sparingly or not at all to
prevent buildup of moisture and subsequent skin breakdown. The client is instructed to wear
loose clothing with a large neck. The halo fixation device should not shift; if it does, the primary
health care provider must be notified. The client is taught to sleep with the head supported
with a small pillow to prevent unnecessary pressure and discomfort.
Empyema develops in a client with an infected pleural effusion, and the nurse prepares the
client for thoracentesis. The nurse is assisting the primary health care provider with the
procedure. What characteristics of the fluid removed during thoracentesis should the nurse
expect to note?
Clear and yellow
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
