HESI RN COMPREHENSIVE
PREDICTOR EXAM 200 Practice
Questions with .
1. The nurse is caring for four patients. Which patient should the nurse assess
FIRST?
A. A 56-year-old with COPD who has a pulse oximetry of 91% on 2L nasal cannula.
B. A 72-year-old post-operative day 1 who is complaining of incisional pain (7/10).
C. A 45-year-old with heart failure who has new-onset confusion and crackles in
all lung fields.
D. A 30-year-old with pneumonia who has a temperature of 101.2°F and is
diaphoretic.
Answer: C. Rationale: New-onset confusion in a heart failure patient indicates
cerebral hypoxia and worsening pulmonary edema. This is an airway/breathing
issue that takes priority over pain, stable vital signs (91% is acceptable for COPD),
or fever.
2. The RN is making assignments for an LPN and an unlicensed assistive
personnel (UAP). Which task should the RN delegate to the LPN?
A. Administer a tube feeding via gastrostomy tube to a stable patient.
B. Assist a patient with a bed bath and oral care.
C. Obtain a sterile urine culture from a patient with a Foley catheter.
D. Perform passive range-of-motion exercises on a hemiplegic patient.
Answer: A. Rationale: LPNs can administer enteral feedings (tube feedings) to
stable patients. Obtaining sterile specimens (C) is an RN or specialized task; bed
baths (B) and ROM (D) are within the UAP scope.
3. The nurse receives a handoff report. Which patient should the nurse see
immediately?
A. Patient with appendicitis who has a WBC of 14,000/mm³.
,B. Patient with diabetic ketoacidosis (DKA) whose serum potassium is 3.0 mEq/L.
C. Patient with pancreatitis who is complaining of severe epigastric pain radiating
to the back.
D. Patient with a fractured femur who has a capillary refill of 4 seconds in the
affected toe.
Answer: D. Rationale: A capillary refill of 4 seconds in a fractured limb indicates
compromised circulation (compartment syndrome or vascular injury). This is a
neurovascular emergency. The potassium in B is low, but not immediately limb-
threatening.
4. Which patient can the RN assign to the UAP?
A. A patient requiring a sterile dressing change to a stage 4 pressure ulcer.
B. A patient with a nasogastric (NG) tube that needs irrigating.
C. A patient who requires a 12-lead EKG and vital signs monitoring.
D. A patient who is 2 hours post-cardiac catheterization with a sandbag over the
groin.
Answer: C. Rationale: UAPs are trained to perform 12-lead EKGs and obtain vital
signs. Sterile dressings (A), NG irrigations (B), and post-cath
sandbag/neurovascular checks (D) are assessments or sterile procedures that
require RN or LPN licensure.
5. The nurse is caring for a client with a chest tube. What is the priority
intervention if the chest tube becomes disconnected from the drainage system?
A. Clamp the chest tube immediately.
B. Place the end of the tube in sterile water.
C. Reconnect the tube to a new drainage system.
D. Notify the healthcare provider stat.
Answer: B. Rationale: If the tube is disconnected, placing the end in sterile water
creates a water seal, preventing air from entering the pleural space. Clamping (A)
can cause tension pneumothorax.
6. A client is experiencing ventricular tachycardia (VT) with a pulse. What is the
nurse's priority action?
A. Immediate defibrillation at 200 J.
B. Administer IV adenosine.
C. Assess the client's level of consciousness and blood pressure.
, D. Prepare for transcutaneous pacing.
Answer: C. Rationale: If the patient has a pulse with VT, the patient is
hemodynamically stable (for now). You must assess LOC and BP to determine
stability. Unstable VT requires synchronized cardioversion; pulseless VT requires
defibrillation (A).
7. The nurse is preparing to hang a new bag of IV fluid. The patient has an
existing IV of D5W. The new bag is D5 ½ NS with 20 mEq KCl. Prior to hanging
this bag, what is the most important nursing action?
A. Flush the IV line with normal saline.
B. Assess the patient's urine output.
C. Change the primary tubing.
D. Assess the IV site for infiltration.
Answer: B. Rationale: Potassium (KCl) should NEVER be given to a patient with
renal failure or low urine output (<30 mL/hr). You must verify adequate renal
function/urine output before hanging K+.
8. The nurse is discharging a patient on warfarin. Which statement by the
patient indicates a need for further teaching?
A. "I will use a soft-bristled toothbrush."
B. "I will take my warfarin at the same time every day."
C. "I will increase my intake of green leafy vegetables to stay healthy."
D. "I need to report any black, tarry stools to my doctor."
Answer: C. Rationale: Green leafy vegetables are high in Vitamin K, which
reverses the effects of warfarin. Patients should maintain a consistent intake, not
increase it.
9. A client with major depressive disorder is started on phenelzine (Nardil), an
MAOI. Which food item on the lunch tray should the nurse remove?
A. Broiled chicken breast.
B. Mashed potatoes.
C. Aged cheddar cheese.
D. Steamed broccoli.
Answer: C. Rationale: Aged cheese contains tyramine. MAOIs inhibit the
breakdown of tyramine, leading to a hypertensive crisis.
PREDICTOR EXAM 200 Practice
Questions with .
1. The nurse is caring for four patients. Which patient should the nurse assess
FIRST?
A. A 56-year-old with COPD who has a pulse oximetry of 91% on 2L nasal cannula.
B. A 72-year-old post-operative day 1 who is complaining of incisional pain (7/10).
C. A 45-year-old with heart failure who has new-onset confusion and crackles in
all lung fields.
D. A 30-year-old with pneumonia who has a temperature of 101.2°F and is
diaphoretic.
Answer: C. Rationale: New-onset confusion in a heart failure patient indicates
cerebral hypoxia and worsening pulmonary edema. This is an airway/breathing
issue that takes priority over pain, stable vital signs (91% is acceptable for COPD),
or fever.
2. The RN is making assignments for an LPN and an unlicensed assistive
personnel (UAP). Which task should the RN delegate to the LPN?
A. Administer a tube feeding via gastrostomy tube to a stable patient.
B. Assist a patient with a bed bath and oral care.
C. Obtain a sterile urine culture from a patient with a Foley catheter.
D. Perform passive range-of-motion exercises on a hemiplegic patient.
Answer: A. Rationale: LPNs can administer enteral feedings (tube feedings) to
stable patients. Obtaining sterile specimens (C) is an RN or specialized task; bed
baths (B) and ROM (D) are within the UAP scope.
3. The nurse receives a handoff report. Which patient should the nurse see
immediately?
A. Patient with appendicitis who has a WBC of 14,000/mm³.
,B. Patient with diabetic ketoacidosis (DKA) whose serum potassium is 3.0 mEq/L.
C. Patient with pancreatitis who is complaining of severe epigastric pain radiating
to the back.
D. Patient with a fractured femur who has a capillary refill of 4 seconds in the
affected toe.
Answer: D. Rationale: A capillary refill of 4 seconds in a fractured limb indicates
compromised circulation (compartment syndrome or vascular injury). This is a
neurovascular emergency. The potassium in B is low, but not immediately limb-
threatening.
4. Which patient can the RN assign to the UAP?
A. A patient requiring a sterile dressing change to a stage 4 pressure ulcer.
B. A patient with a nasogastric (NG) tube that needs irrigating.
C. A patient who requires a 12-lead EKG and vital signs monitoring.
D. A patient who is 2 hours post-cardiac catheterization with a sandbag over the
groin.
Answer: C. Rationale: UAPs are trained to perform 12-lead EKGs and obtain vital
signs. Sterile dressings (A), NG irrigations (B), and post-cath
sandbag/neurovascular checks (D) are assessments or sterile procedures that
require RN or LPN licensure.
5. The nurse is caring for a client with a chest tube. What is the priority
intervention if the chest tube becomes disconnected from the drainage system?
A. Clamp the chest tube immediately.
B. Place the end of the tube in sterile water.
C. Reconnect the tube to a new drainage system.
D. Notify the healthcare provider stat.
Answer: B. Rationale: If the tube is disconnected, placing the end in sterile water
creates a water seal, preventing air from entering the pleural space. Clamping (A)
can cause tension pneumothorax.
6. A client is experiencing ventricular tachycardia (VT) with a pulse. What is the
nurse's priority action?
A. Immediate defibrillation at 200 J.
B. Administer IV adenosine.
C. Assess the client's level of consciousness and blood pressure.
, D. Prepare for transcutaneous pacing.
Answer: C. Rationale: If the patient has a pulse with VT, the patient is
hemodynamically stable (for now). You must assess LOC and BP to determine
stability. Unstable VT requires synchronized cardioversion; pulseless VT requires
defibrillation (A).
7. The nurse is preparing to hang a new bag of IV fluid. The patient has an
existing IV of D5W. The new bag is D5 ½ NS with 20 mEq KCl. Prior to hanging
this bag, what is the most important nursing action?
A. Flush the IV line with normal saline.
B. Assess the patient's urine output.
C. Change the primary tubing.
D. Assess the IV site for infiltration.
Answer: B. Rationale: Potassium (KCl) should NEVER be given to a patient with
renal failure or low urine output (<30 mL/hr). You must verify adequate renal
function/urine output before hanging K+.
8. The nurse is discharging a patient on warfarin. Which statement by the
patient indicates a need for further teaching?
A. "I will use a soft-bristled toothbrush."
B. "I will take my warfarin at the same time every day."
C. "I will increase my intake of green leafy vegetables to stay healthy."
D. "I need to report any black, tarry stools to my doctor."
Answer: C. Rationale: Green leafy vegetables are high in Vitamin K, which
reverses the effects of warfarin. Patients should maintain a consistent intake, not
increase it.
9. A client with major depressive disorder is started on phenelzine (Nardil), an
MAOI. Which food item on the lunch tray should the nurse remove?
A. Broiled chicken breast.
B. Mashed potatoes.
C. Aged cheddar cheese.
D. Steamed broccoli.
Answer: C. Rationale: Aged cheese contains tyramine. MAOIs inhibit the
breakdown of tyramine, leading to a hypertensive crisis.
