HESI RN Compass Exit Exam V1 | Update 2026 | 200 Questions with
Verified Answers and Rationales | 100% Correct
QUESTION 1
A nurse is monitoring neurological vital signs for a male client who lost consciousness after falling and
hitting his head. Which assessment finding is the earliest and most sensitive indication of altered
cerebral function?
A. Unequal pupils
B. Loss of central reflexes
C. Inability to open the eyes
D. Change in level of consciousness
Answer: D. Explanation: A change in the client's level of consciousness, as indicated by responses to
commands during the Glasgow Coma Scale (GCS), is the first and most sensitive sign of change in
cerebral function. The other options are late signs of altered cerebral function.
QUESTION 2
A nurse is planning to teach self-care measures to a female client about prevention of yeast infections.
Which instructions should the nurse provide?
A. Use a douche preparation no more than once a month
B. Increase daily intake of fiber and leafy green vegetables
C. Select nylon underwear that is loose-fitting, white, and comfortable
D. Avoid tight-fitting clothing and do not use bubble-bath or bath salts
Answer: D. Explanation: Candidiasis thrives in a warm, moist environment perpetuated by tight-fitting
clothing, underwear, or pantyhose made of non-breathable materials. Avoiding these and bubble-bath
or bath salts helps prevent yeast infections.
,QUESTION 3
A pregnant woman's metabolic demands are increased compared to the basic metabolic rate of other
clients. Compared to other clients, how much more metabolic demand does a pregnant woman have?
A. 20 to 24%
B. 15 to 20%
C. 30 to 35%
D. 10 to 15%
Answer: A. Explanation: A pregnant woman's metabolic demands are 20 to 24% more than the basic
metabolic rate. The other clients require only 15 to 20% more than the basic metabolic rate.
QUESTION 4
The nurse is caring for a client with a terminal brain tumor who is unresponsive to stimuli. The family
asks the nurse why the client's face is moist and the skin is pale. How should the nurse respond?
A. "This is a typical response as the body begins to shut down."
B. "This is a normal finding due to your loved one's medication regimen."
C. "This is a common response to the body’s reduced need for hydration."
D. "This is a sign that death will occur within the next 24 hours."
Answer: A. Explanation: As death approaches, the body undergoes various physiological changes
including decreased circulation, leading to pale, cool, and moist skin. This is a typical part of the dying
process and should be explained to the family with compassion.
QUESTION 5
The charge nurse is evaluating the time-management skills of a new graduate nurse. Which action
should the charge nurse identify that requires intervention?
,A. Checks for new orders prior to administering medications
B. Reviews the previous shift's charting before assessing clients
C. Allows the unlicensed assistive personnel (UAP) to check a new admission's oxygen saturation
D. Takes a lunch break after completing morning care for assigned clients
Answer: C. Explanation: The RN is responsible for the initial assessment and cannot delegate assessment
tasks to a UAP. Checking oxygen saturation is part of the initial nursing assessment and must be
performed by the RN.
QUESTION 6
A client with asthma receives a prescription for high blood pressure during a clinic visit. Which
prescription should the nurse anticipate the client to receive that is least likely to exacerbate asthma?
A. Pindolol
B. Carteolol
C. Metoprolol (Lopressor)
D. Propranolol
Answer: C. Explanation: Metoprolol is a cardioselective beta-blocker that is less likely to cause
bronchoconstriction. The other options are non-selective beta-blockers that can block beta2 receptors
in the lungs, causing bronchoconstriction and exacerbating asthma.
QUESTION 7
A male client who has been taking propranolol (Inderal) for 18 months tells the nurse that the
healthcare provider discontinued the medication because his blood pressure has been normal for the
past three months. Which instruction should the nurse provide?
A. "You should keep taking the medication until you see your healthcare provider again."
B. "Make an appointment to see the healthcare provider for a prescription renewal."
, C. "Plan to have the dosage tapered down over one to two weeks to prevent rebound."
D. "Abruptly stopping your medication may lead to adverse reactions but you should do what the
healthcare provider says."
Answer: C. Explanation: Measures to prevent rebound cardiac excitation, such as progressively reducing
the dose over one to two weeks, should be recommended to prevent rebound tachycardia,
hypertension, and ventricular dysrhythmias when discontinuing propranolol.
QUESTION 8
A client with hypertension has been receiving clonidine (Catapres). The client reports drowsiness. Which
additional assessment should the nurse make?
A. How long has the client been taking the medication
B. What other medications the client takes
C. Whether the client ever had this side effect before
D. The client's occupation and need for mental alertness
Answer: A. Explanation: Drowsiness can occur in the early weeks of treatment with clonidine and with
continued use becomes less intense, so the length of time the client has been on the medication
provides important assessment information.
QUESTION 9
The nurse is providing dietary teaching for a client with gout. Which food selection indicates the client
understands the teaching?
A. Baked chicken
B. Scrambled eggs
C. Liver and onions
D. Beef tenderloin
Verified Answers and Rationales | 100% Correct
QUESTION 1
A nurse is monitoring neurological vital signs for a male client who lost consciousness after falling and
hitting his head. Which assessment finding is the earliest and most sensitive indication of altered
cerebral function?
A. Unequal pupils
B. Loss of central reflexes
C. Inability to open the eyes
D. Change in level of consciousness
Answer: D. Explanation: A change in the client's level of consciousness, as indicated by responses to
commands during the Glasgow Coma Scale (GCS), is the first and most sensitive sign of change in
cerebral function. The other options are late signs of altered cerebral function.
QUESTION 2
A nurse is planning to teach self-care measures to a female client about prevention of yeast infections.
Which instructions should the nurse provide?
A. Use a douche preparation no more than once a month
B. Increase daily intake of fiber and leafy green vegetables
C. Select nylon underwear that is loose-fitting, white, and comfortable
D. Avoid tight-fitting clothing and do not use bubble-bath or bath salts
Answer: D. Explanation: Candidiasis thrives in a warm, moist environment perpetuated by tight-fitting
clothing, underwear, or pantyhose made of non-breathable materials. Avoiding these and bubble-bath
or bath salts helps prevent yeast infections.
,QUESTION 3
A pregnant woman's metabolic demands are increased compared to the basic metabolic rate of other
clients. Compared to other clients, how much more metabolic demand does a pregnant woman have?
A. 20 to 24%
B. 15 to 20%
C. 30 to 35%
D. 10 to 15%
Answer: A. Explanation: A pregnant woman's metabolic demands are 20 to 24% more than the basic
metabolic rate. The other clients require only 15 to 20% more than the basic metabolic rate.
QUESTION 4
The nurse is caring for a client with a terminal brain tumor who is unresponsive to stimuli. The family
asks the nurse why the client's face is moist and the skin is pale. How should the nurse respond?
A. "This is a typical response as the body begins to shut down."
B. "This is a normal finding due to your loved one's medication regimen."
C. "This is a common response to the body’s reduced need for hydration."
D. "This is a sign that death will occur within the next 24 hours."
Answer: A. Explanation: As death approaches, the body undergoes various physiological changes
including decreased circulation, leading to pale, cool, and moist skin. This is a typical part of the dying
process and should be explained to the family with compassion.
QUESTION 5
The charge nurse is evaluating the time-management skills of a new graduate nurse. Which action
should the charge nurse identify that requires intervention?
,A. Checks for new orders prior to administering medications
B. Reviews the previous shift's charting before assessing clients
C. Allows the unlicensed assistive personnel (UAP) to check a new admission's oxygen saturation
D. Takes a lunch break after completing morning care for assigned clients
Answer: C. Explanation: The RN is responsible for the initial assessment and cannot delegate assessment
tasks to a UAP. Checking oxygen saturation is part of the initial nursing assessment and must be
performed by the RN.
QUESTION 6
A client with asthma receives a prescription for high blood pressure during a clinic visit. Which
prescription should the nurse anticipate the client to receive that is least likely to exacerbate asthma?
A. Pindolol
B. Carteolol
C. Metoprolol (Lopressor)
D. Propranolol
Answer: C. Explanation: Metoprolol is a cardioselective beta-blocker that is less likely to cause
bronchoconstriction. The other options are non-selective beta-blockers that can block beta2 receptors
in the lungs, causing bronchoconstriction and exacerbating asthma.
QUESTION 7
A male client who has been taking propranolol (Inderal) for 18 months tells the nurse that the
healthcare provider discontinued the medication because his blood pressure has been normal for the
past three months. Which instruction should the nurse provide?
A. "You should keep taking the medication until you see your healthcare provider again."
B. "Make an appointment to see the healthcare provider for a prescription renewal."
, C. "Plan to have the dosage tapered down over one to two weeks to prevent rebound."
D. "Abruptly stopping your medication may lead to adverse reactions but you should do what the
healthcare provider says."
Answer: C. Explanation: Measures to prevent rebound cardiac excitation, such as progressively reducing
the dose over one to two weeks, should be recommended to prevent rebound tachycardia,
hypertension, and ventricular dysrhythmias when discontinuing propranolol.
QUESTION 8
A client with hypertension has been receiving clonidine (Catapres). The client reports drowsiness. Which
additional assessment should the nurse make?
A. How long has the client been taking the medication
B. What other medications the client takes
C. Whether the client ever had this side effect before
D. The client's occupation and need for mental alertness
Answer: A. Explanation: Drowsiness can occur in the early weeks of treatment with clonidine and with
continued use becomes less intense, so the length of time the client has been on the medication
provides important assessment information.
QUESTION 9
The nurse is providing dietary teaching for a client with gout. Which food selection indicates the client
understands the teaching?
A. Baked chicken
B. Scrambled eggs
C. Liver and onions
D. Beef tenderloin
