HESI Compass Exit B Exam
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Free HESI Compass Exit B Exam Questions
After diagnosis and initial treatment of a pre-school age child with cystic fibrosis, the nurse provides home care instructions to the parents. Which statement by the child's parents indicates understanding of the home care treatment to promote pulmonary function?
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"Chest physiotherapy should be performed twice a day before a meal."
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"Administer a cough suppressant every 8 hours."
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"Energy should be conserved by scheduling minimally strenuous activities."
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"Maintain supplemental oxygen at 4 to 6 L/minute."
Explanation
Correct Answer: A. "Chest physiotherapy should be performed twice a day before a meal."
Explanation:
For children with cystic fibrosis (CF), chest physiotherapy (CPT) helps loosen and mobilize thick mucus, improving airway clearance and gas exchange. Performing CPT before meals or at least one hour after eating prevents vomiting during percussion and postural drainage. It is typically done two to four times daily depending on the child’s condition. Cough suppressants (B) inhibit mucus clearance, limited activity (C) reduces pulmonary function, and routine high-flow oxygen (D) is not recommended except for acute respiratory distress.
The healthcare provider prescribes oxytocin synthetic 10 units/L via IV drip to augment a client's labor because she is experiencing a prolonged active phase. Because the client is receiving oxytocin, the nurse should closely monitor for which complication?
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Fetal tachycardia.
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Hemorrhage.
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Uterine tetany.
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Uterine hypostimulation.
Explanation
Correct Answer: C. Uterine tetany.
Explanation:
Oxytocin (Pitocin) stimulates uterine contractions and is commonly used to induce or augment labor. However, excessive dosing or sensitivity to the drug can cause uterine hyperstimulation (tetany)—a state of excessively frequent or sustained contractions without adequate relaxation between them. This condition compromises uteroplacental blood flow, leading to fetal hypoxia, bradycardia, or distress, and can cause uterine rupture or placental abruption in severe cases.
The nurse must continuously monitor uterine contraction frequency, duration, and intensity as well as fetal heart rate patterns. If uterine tetany occurs, the nurse should stop the oxytocin infusion immediately, reposition the client to the left side, provide oxygen via face mask, and notify the healthcare provider.
While oxytocin administration can indirectly contribute to fetal heart changes (A), the primary complication to monitor for is uterine hyperstimulation (tetany). Hemorrhage (B) and hypostimulation (D) are opposite or unrelated effects.
A client is discharged to a long-term care facility with an indwelling urinary catheter. Which nursing action should be included in the plan of care to reduce the client's risk for infection related to the catheter?
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Secure the drainage bag at bladder level during transport.
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Flush the catheter daily with sterile saline.
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Administer a PRN antipyretic if a fever develops.
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Encourage increased intake of oral fluids.
Explanation
Correct Answer:
D. Encourage increased intake of oral fluids.
Explanation:
Encouraging increased oral fluid intake helps reduce the risk of catheter-associated urinary tract infection (CAUTI) by promoting continuous urine flow, which flushes bacteria and sediment from the bladder and catheter tubing. Adequate hydration prevents urinary stasis, a key factor in bacterial growth, and helps maintain normal renal function. The nurse should also ensure that the urine drainage bag remains below bladder level, tubing is not kinked, and strict aseptic technique is followed during catheter care.
The nurse is preparing to administer enoxaparin 30 mg subcutaneously using a prefilled syringe containing 30 mg in 0.3 mL. Which action should the nurse implement?
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Hold the skin fold throughout the injection.
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Insert the needle at a 90-degree angle.
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Retain the air bubble in the syringe barrel.
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Massage the area after injection.
Explanation
Correct Answer: C. Retain the air bubble in the syringe barrel.
Explanation:
The nurse should retain the air bubble when administering enoxaparin because it ensures that the entire medication dose is delivered and helps seal the drug in the subcutaneous tissue, minimizing bruising or irritation at the injection site. Expelling the air could result in medication loss and skin irritation. Enoxaparin is always given in the anterolateral or posterolateral abdomen, with the skin gently pinched—not massaged—to prevent tissue damage and bleeding.
Which intervention should the nurse include in a long-term plan of care for a client with chronic obstructive pulmonary disease (COPD)?
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Limit fluid intake to reduce secretions.
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Reduce risk factors for infection.
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Use diaphragmatic breathing to achieve better exhalation.
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Administer high flow oxygen during sleep.
Explanation
Correct Answer: B. Reduce risk factors for infection.
Explanation:
For clients with chronic obstructive pulmonary disease (COPD), a major long-term goal of care is to reduce the risk of respiratory infections, which can trigger exacerbations, worsen gas exchange, and lead to hospitalization. The nurse should emphasize infection prevention strategies such as obtaining annual influenza and pneumococcal vaccinations, practicing frequent hand hygiene, avoiding crowded or polluted environments, and maintaining adequate hydration and nutrition to strengthen immune function. Preventing infection helps maintain lung function and improve quality of life.
A client with gestational diabetes, at 39-weeks gestation, is in the second stage of labor. After delivery of the fetal head, the nurse recognizes that shoulder dystocia is occurring. Which intervention should the nurse implement first?
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Lower the head of the bed and apply suprapubic pressure.
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Assist the client to sharply flex her thighs up against the abdomen.
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Prepare the client for an emergency cesarean birth.
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Encourage the client to move to a hands-and-knees position.
Explanation
Correct Answer:
A. Lower the head of the bed and apply suprapubic pressure.
Explanation:
When shoulder dystocia occurs, the first immediate nursing action is to lower the head of the bed and apply suprapubic pressure while calling for assistance. Suprapubic pressure is applied just above the pubic bone to push the fetal anterior shoulder downward and under the symphysis pubis, helping to release the trapped shoulder. This technique directly relieves the obstruction and allows delivery to proceed while preventing excessive traction on the fetal head, which could cause brachial plexus injury.
The school nurse is planning to begin an obesity screening program in a school system. It is best to begin the screening program with which group?
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Kindergarten.
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Third grade.
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High school.
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Onset of puberty.
Explanation
Correct Answer:
B. Third grade.
Explanation:
Third grade is the most appropriate time to begin an obesity screening program in a school setting. At this age, children are typically 8–9 years old, and their growth and body composition begin to stabilize following early childhood fluctuations. Screening at this stage provides a more accurate assessment of body mass index (BMI) trends and helps identify children at risk for obesity before the rapid hormonal and physical changes of puberty occur. Early identification allows for targeted education and lifestyle interventions that can be integrated at home and school to prevent long-term health complications.
Which dietary intervention(s) should the nurse include in the plan of care for a client who had bariatric surgery? Select all that apply.
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Separate fluids from meals.
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Plan meals to include rice porridge.
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Eliminate acidic food choices.
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Offer more bread and cheese.
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Provide small frequent meals.
Explanation
Correct Answers:
A. Separate fluids from meals.
E. Provide small frequent meals.
A: Separate fluids from meals.
After bariatric surgery, clients should avoid drinking fluids during meals and for about 30 minutes before and after eating. This helps prevent dumping syndrome, early satiety, and stretching of the surgical pouch. Separating fluids also promotes better digestion and nutrient absorption, ensuring the client receives adequate nutrition from smaller meal volumes.
E: Provide small frequent meals.
Clients should consume small, frequent meals (typically 6 per day) to prevent discomfort, nausea, and vomiting. The reduced gastric capacity requires portion control and slow eating to promote tolerance and prevent overfilling. This approach supports gradual digestion, adequate nutrient intake, and adaptation to the altered gastrointestinal anatomy following bariatric surgery.
An older adult recently diagnosed with type 2 diabetes mellitus (DM) suddenly becomes confused and weak, with cool, clammy skin. The client is unable to remember what to do for such symptoms and is taken to a nearby urgent care facility by a neighbor. Which nursing interventions should the nurse implement? Select all that apply.
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Check a blood sample for glucose level.
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Report any changes in blood pressure.
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Prepare to administer regular insulin.
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Observe respiratory rate and pattern.
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Palpate for bladder pain or distention.
Explanation
Correct Answers:
A. Check a blood sample for glucose level, B. Report any changes in blood pressure, D. Observe respiratory rate and pattern.
Explanation:
A. Check a blood sample for glucose level
The client’s symptoms—confusion, weakness, cool and clammy skin—indicate possible hypoglycemia, a common acute complication of diabetes. The priority is to immediately assess blood glucose to confirm hypoglycemia and guide rapid intervention. Prompt glucose testing allows for the administration of carbohydrates or IV dextrose if levels are dangerously low.
B. Report any changes in blood pressure
Hypoglycemia or its treatment may cause hemodynamic instability. Monitoring and reporting abnormal blood pressure changes helps identify potential circulatory compromise or shock, especially in older adults who may deteriorate quickly.
D. Observe respiratory rate and pattern
Respiratory changes can signal progression toward more serious metabolic disturbances such as ketoacidosis or respiratory compensation for acidosis. Careful observation ensures timely recognition of respiratory distress or altered oxygenation.
The nurse is preparing to administer an oral antibiotic to a client with unilateral weakness, ptosis, mouth drooping, and aspiration pneumonia. Which is the priority nursing assessment that should be done before administering this medication?
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Obtain and record the client's vital signs.
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Ask the client about soft food preferences.
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Determine which side of the body is weak.
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Auscultate the client's breath sounds.
Explanation
Correct Answer:
D. Auscultate the client's breath sounds.
Explanation:
The client’s symptoms — unilateral weakness, ptosis, mouth drooping, and aspiration pneumonia — indicate possible neurologic impairment affecting swallowing ability and airway protection, such as a stroke or neuromuscular disorder. Before giving an oral medication, the nurse must assess breath sounds to detect signs of aspiration, such as crackles, diminished air entry, or rhonchi, which suggest fluid or infection in the lungs. If breath sounds indicate aspiration or respiratory compromise, oral medications should be withheld, and alternative routes should be considered to prevent further aspiration and respiratory distress.
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