HESI Compass Exit B Exam
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Free HESI Compass Exit B Exam Questions
The healthcare provider prescribes 1 liter of lactated Ringer’s to infuse in 8 hours. The IV administration set delivers 15 gtt/mL. How many mL/hour should the nurse program the infusion pump? (Enter numeric value only. If rounding is required, round to the nearest whole number.)
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100
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125
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150
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175
Explanation
Correct Answer: B. 125
Explanation:
1 liter = 1000 mL.
Infusion time = 8 hours.
1000 mL ÷ 8 hr = 125 mL/hr.
The infusion pump should therefore be programmed to deliver 125 mL per hour to complete the infusion over 8 hours.
(Note: The drop factor applies only to manual IV flow rate calculations, not pump settings.)
The nurse working on a medical unit is assigned to care for four clients. Which client should the nurse assess first?
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A client who has a pressure ulcer and now has a temperature of 102.3° F.
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A client who had a stroke and now has right-sided weakness.
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An elderly client who is requesting medication for constipation.
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A client who is quadriplegic and is complaining of a severe headache.
Explanation
Correct Answer: D. A client who is quadriplegic and is complaining of a severe headache.
Explanation:
A severe headache in a client with quadriplegia (especially resulting from a spinal cord injury above T6) is a hallmark sign of autonomic dysreflexia, a life-threatening medical emergency. This condition is triggered by a noxious stimulus—often bladder distention, fecal impaction, or skin irritation—that causes sudden, uncontrolled hypertension, bradycardia, and severe headache. Immediate nursing action is required to sit the client upright, loosen restrictive clothing, and identify and remove the triggering cause (such as emptying the bladder). If untreated, autonomic dysreflexia can lead to stroke, seizures, or death.
A male infant is admitted to the pediatric unit with pertussis and is exhibiting a "whooping-like cough." The mother brings the infant to the nurses' station to seek assistance. Which intervention should the nurse implement first?
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Ask the mother if the cool mist humidifier at the bedside is functioning and releasing mist.
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Give the infant an oral dose of a prescribed antitussive and analgesic/antipyretic.
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Cover the infant's mouth and assist the mother to take the infant back to the room.
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Explain the need to maintain droplet precautions to prevent spread to others on the unit.
Explanation
Correct Answer: C. Cover the infant's mouth and assist the mother to take the infant back to the room.
Explanation:
Pertussis (whooping cough) is a highly contagious respiratory infection transmitted by droplets. The nurse’s priority is to prevent exposure to others by immediately covering the infant’s mouth and returning the child to the assigned isolation room. Once the infant is safely contained, droplet precautions can be reinforced, including the use of masks and hand hygiene. Supportive care—such as humidified air, hydration, and prescribed medications—should follow after infection control measures are ensured.
An older female client who resides at an assisted living facility comes for an annual gynecological visit at the clinic and states she has a burning sensation when urinating. Assessment findings include: blood pressure 128/88 mm Hg, urine negative for bacteria, and ecchymotic areas on both forearms. She reports being sexually active and drinks beer once or twice a month. During this clinic visit, which intervention(s) should the nurse implement? Select all that apply.
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Ask the client if someone brought her to the clinic.
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Review list of daily medications for aspirin or other anticoagulants.
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Question her if she previously or currently uses any illicit drugs.
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Inquire if she is being emotionally or physically abused.
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Determine number of sexual partners she has had recently.
Explanation
Correct Answers:
B. Review list of daily medications for aspirin or other anticoagulants.
D. Inquire if she is being emotionally or physically abused.
E. Determine number of sexual partners she has had recently.
B: Review list of daily medications for aspirin or other anticoagulants.
Ecchymotic areas (bruising) on the forearms may be related to anticoagulant or antiplatelet medication use, such as aspirin or warfarin. Reviewing the medication list helps identify potential causes of bruising and assess the client’s bleeding risk, which is especially important before performing gynecologic procedures or obtaining specimens.
D: Inquire if she is being emotionally or physically abused.
Unexplained bruising, particularly on the forearms, may be a red flag for elder abuse. The nurse should sensitively and privately question the client about possible emotional or physical abuse, following mandatory reporting laws. Early recognition and intervention protect the client’s safety and promote appropriate support services.
E: Determine number of sexual partners she has had recently.
The client’s report of burning during urination despite a negative urinalysis may indicate a sexually transmitted infection (STI). Assessing her sexual history, including number of partners and protection use, helps guide appropriate screening, diagnosis, and education for STI prevention and sexual health.
An adult female client with chronic kidney disease (CKD) asks the nurse if she can continue taking her over-the-counter medications. Which medication provides the greatest threat to this client?
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Cough syrup containing codeine.
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Birth control pills.
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Cold medications containing
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Magnesium hydroxide.
Explanation
Correct Answer: D. Magnesium hydroxide.
Explanation:
Clients with chronic kidney disease (CKD) have impaired renal excretion, making them highly susceptible to magnesium toxicity when using medications such as magnesium hydroxide (Milk of Magnesia). The kidneys are responsible for filtering excess magnesium, and when renal function is compromised, magnesium can accumulate in the bloodstream, leading to bradycardia, hypotension, respiratory depression, and cardiac arrest. Therefore, magnesium-containing products—including some laxatives and antacids—must be avoided or used only under medical supervision.
An adult client with a diagnosis of bipolar disorder arrives in an elated state on admission to the psychiatric unit. Which is the best room assignment the nurse can make for this client?
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A room that contains very little furniture.
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A room that has at least two other clients assigned to it.
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A bright colored room located near the recreation room.
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A quiet room away from the nurse's station.
Explanation
Correct Answer:
A. A room that contains very little furniture.
Explanation:
A client experiencing mania (elated state) due to bipolar disorder often demonstrates hyperactivity, impulsivity, and poor judgment, which can lead to accidental injury or destruction of property. The best room assignment is one that contains minimal furniture and simple surroundings, reducing the risk of harm to the client and others while limiting external stimulation. This environment supports safety and helps decrease sensory overload, which can worsen manic symptoms.
A child is admitted to the hospital with diarrhea and vomiting. Potassium chloride is prescribed for inclusion with rehydration IV fluids. Prior to administering the potassium, the nurse should ensure that which condition exists?
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The client has had no cardiac arrhythmias in the last 24 hours.
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The oxygen saturation level per pulse oximeter is greater than 95%.
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The client has stopped vomiting before the potassium is added to the IV fluids.
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The client is able to void, assuring kidney function is present.
Explanation
Correct Answer: D. The client is able to void, assuring kidney function is present.
Explanation:
Before administering potassium chloride (KCl), the nurse must verify that the client has adequate renal function, confirmed by the ability to void urine. The kidneys are responsible for excreting excess potassium, and if renal function is impaired, potassium can accumulate rapidly, leading to hyperkalemia—a potentially fatal condition causing cardiac arrhythmias or arrest. For this reason, the nurse should never add or administer potassium to IV fluids unless urine output is established, typically at least 1 mL/kg/hr in children.
The absence of arrhythmias (A) does not guarantee safe potassium administration, oxygen saturation (B) is unrelated, and stopping vomiting (C) does not reflect renal clearance capability. Therefore, confirming urine output before potassium administration is the most critical safety measure to prevent life-threatening complications.
The nurse is preparing to administer an IM dose of vitamin B1 (Thiamine) to a male client experiencing acute alcohol withdrawal and peripheral neuritis. The client belligerently states, "What do you think you're doing?" How should the nurse respond?
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"This shot will help relieve the pain in your feet."
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"I cannot give you this medication until you calm down."
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"You will feel calmer and less jittery after this shot."
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"Would you prefer to learn to administer your own shot?"
Explanation
Correct Answer: A. "This shot will help relieve the pain in your feet."
Explanation:
Clients undergoing acute alcohol withdrawal often experience irritability, confusion, and peripheral neuritis due to thiamine (vitamin B1) deficiency. The most therapeutic nursing response is to provide simple, honest, and concrete information about the purpose of the medication. Stating that the injection will help relieve foot pain caused by peripheral nerve inflammation addresses the client’s concern directly and reduces anxiety through reassurance and clarity.
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.
A client at the healthcare clinic reports a new onset of pyrosis and dyspepsia to the nurse. Which nursing action has the highest priority?
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Recommend the use of antacids to control symptoms.
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Provide reassurance that these are common symptoms of reflux disease.
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Instruct the client about the symptoms of reflux disease.
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Schedule an appointment for a physical examination.
Explanation
Correct Answer: D. Schedule an appointment for a physical examination.
Explanation:
Pyrosis (heartburn) and dyspepsia (indigestion) are classic symptoms of gastroesophageal reflux disease (GERD) but may also indicate more serious conditions such as peptic ulcer disease, hiatal hernia, or even esophageal cancer. Because these symptoms are of new onset, the nurse’s highest priority is to schedule a comprehensive physical examination with a healthcare provider to establish a diagnosis and identify underlying causes before recommending any self-treatment.
While antacids (A) may provide temporary relief, they could mask worsening disease and delay appropriate care. Offering reassurance (B) or premature teaching (C) without evaluation is unsafe because it assumes a benign cause. Therefore, the priority action is to ensure timely medical assessment for accurate diagnosis and management.
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