HESI Compass Exit B Exam
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Free HESI Compass Exit B Exam Questions
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.
The nurse finds a fire in the bathroom of an empty client room and immediately reports the location. After reporting the fire, which action should the nurse take next?
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Evacuate the clients in the rooms closest to the fire.
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Obtain the fire extinguisher located on the unit.
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Shut the doors to the bathroom and the empty room.
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Close the doors to all of the client rooms on the unit.
Explanation
Correct Answer: C. Shut the doors to the bathroom and the empty room.
Explanation:
According to the RACE protocol (Rescue, Alarm, Contain, Extinguish/Evacuate), after reporting or activating the alarm, the next priority action is to contain the fire by closing doors to the affected area. In this case, the nurse should shut the doors to the bathroom and the empty room where the fire originated to prevent the spread of smoke and flames. Containment protects other clients and buys time for safe evacuation if needed.
The nurse assumes care of a postoperative adult client with type 2 diabetes mellitus and learns that the client has a current blood glucose level of 750 mg/dL (42 mmol/L). When assessing the client, which is the priority?
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Observe wound drainage characteristics.
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Assess for signs of fluid volume deficit.
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Determine when the client last ate.
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Measure the level of acute pain.
Explanation
Correct Answer: B. Assess for signs of fluid volume deficit.
Explanation:
A blood glucose level of 750 mg/dL indicates a hyperosmolar hyperglycemic state (HHS), a life-threatening emergency characterized by severe dehydration, hyperosmolarity, and high blood glucose without significant ketosis. The nurse’s priority is to assess for fluid volume deficit—including poor skin turgor, dry mucous membranes, tachycardia, and hypotension—because dehydration and electrolyte imbalance can rapidly lead to shock and organ failure. Fluid resuscitation is the cornerstone of HHS management. Other assessments are important but not as immediately life-saving.
The nurse is caring for a client who is immobile and developed a stage IV pressure injury on the sacrum. The nurse identifies eschar in the wound bed. Which intervention is most important for the nurse to implement?
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Place a foam surface on top of the mattress.
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Raise the head of the bed only to 30 degrees.
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Perform passive range of motion exercises.
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Increase the daily intake of vitamin C.
Explanation
Correct Answer: B. Raise the head of the bed only to 30 degrees.
Explanation:
For clients with sacral pressure injuries, maintaining the head of the bed at 30 degrees or lower is crucial to minimize shear and friction forces that can worsen tissue damage and impede wound healing. This position reduces pressure on the sacrum and promotes circulation. While pressure-relieving surfaces, nutrition, and range of motion are all supportive, positioning is the most immediate and essential intervention to prevent further injury and facilitate healing of a stage IV pressure ulcer with eschar.
In preparing to administer an intravenous medication, the nurse notes that the drug is listed in the drug reference guide as being incompatible with the currently infusing intravenous solution of Ringer's Lactate. What action should the nurse take?
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Administer the scheduled dose slowly and observe the client for any signs of a reaction.
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Flush the line with a compatible solution before and after administering the medication.
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Hold the scheduled dose of medication and notify the healthcare provider of the identified incompatibility.
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Discontinue the intravenous solution and use the IV only for medication administration.
Explanation
Correct Answer:
B. Flush the line with a compatible solution before and after administering the medication.
Explanation:
When a prescribed IV medication is incompatible with the primary infusing solution, the nurse should stop the current infusion and flush the IV line with a compatible solution, such as normal saline, both before and after administering the medication. This procedure prevents drug-solution interaction, precipitate formation, and potential vein irritation or embolism. Once the medication is safely administered, the primary IV solution can be resumed.
The nurse is assigned to care for two critical care clients. One client was admitted yesterday with pneumonia, is being mechanically ventilated and has an elevated temperature. The other client had a thoracotomy two days ago and is now complaining of incisional pain. Which intervention should the nurse implement first?
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Assess level of consciousness and vital signs for both clients.
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Administer pain medication to the client with incisional discomfort.
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Complete a head-to-toe physical assessment for the client with pneumonia.
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Review the plan of care and the medications for both clients.
Explanation
Correct Answer: A. Assess level of consciousness and vital signs for both clients.
Explanation:
The nurse should first assess the level of consciousness and vital signs for both clients to determine their immediate stability and identify potential life-threatening changes. The ventilated client with pneumonia and fever is at risk for hypoxia, sepsis, or respiratory distress, while the postoperative client could develop complications such as bleeding or hypovolemia. Collecting this data first allows the nurse to prioritize care and respond quickly to emergent conditions before addressing comfort measures or reviewing care plans.
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.
The nurse is wearing personal protective equipment (PPE) while caring for a client. When exiting the client's room, which PPE should be removed first?
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Gloves.
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Gown.
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Mask.
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Eyewear.
Explanation
Correct Answer:
A. Gloves.
Explanation:
Gloves should be removed first when exiting a client’s room because they are most likely to be contaminated with infectious material. Removing them first helps prevent the spread of pathogens to other PPE or environmental surfaces. Gloves are carefully peeled off inside out, and hand hygiene should be performed immediately after removal or after removing all PPE, depending on facility policy.
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.
A client with eczema is experiencing severe pruritus. Which PRN prescription(s) should the nurse administer? Select all that apply.
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Transdermal analgesic.
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Topical alcohol rub.
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Topical corticosteroid.
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Oral antihistamine.
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Topical scabicide.
Explanation
Correct Answers:
C. Topical corticosteroid.
D. Oral antihistamine.
C: Topical corticosteroid.
Topical corticosteroids reduce inflammation, redness, and itching associated with eczema by suppressing the local immune response. They help soothe irritated skin and decrease the urge to scratch, which prevents secondary infections. The nurse should apply corticosteroids thinly to affected areas as prescribed, avoiding overuse to prevent skin thinning.
D: Oral antihistamine.
Oral antihistamines relieve pruritus (itching) by blocking histamine release, especially beneficial at night when itching disrupts sleep. They provide systemic relief without worsening inflammation. Sedating antihistamines may also promote rest. These medications, combined with moisturizers and trigger avoidance, are key in managing eczema symptoms.
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