HESI Compass Exit B Exam
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Free HESI Compass Exit B Exam Questions
A female client with degenerative disc disease and chronic sciatica is describing numbness and tingling down her left leg. Which assessment should the nurse obtain first?
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Duration of sensation.
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Precipitous activity.
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Time of last analgesic.
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Gait coordination.
Explanation
Correct Answer: A. Duration of sensation.
Explanation:
Determining the duration of numbness and tingling is the priority because it helps assess whether the client is experiencing an acute neurological change that may indicate nerve compression or ischemia requiring urgent intervention. Early identification of progressive or sudden sensory loss is critical to prevent permanent damage. Once the duration and severity are established, the nurse can explore precipitating activities, evaluate pain control measures, and assess gait coordination as part of a comprehensive neurological assessment.
The healthcare provider prescribes 500 mL of 0.45% normal saline with 100 units regular insulin to infuse at 15 units/hour. The drop factor is 20 gtt/mL. The nurse should regulate the IV to deliver how many gtt/minute? (Enter numerical value only.)
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20
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25
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30
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15
Explanation
Correct Answer: B. 25
Explanation:
Concentration = 100 units ÷ 500 mL = 0.2 units/mL.
Required mL/hr = 15 units/hr ÷ 0.2 units/mL = 75 mL/hr.
gtt/min = (mL/hr × drop factor) ÷ 60 = (75 × 20) ÷ 60 = 1500 ÷ 60 = 25 gtt/min.
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.
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.
A client is admitted with the diagnosis of Wernicke's syndrome. Which assessment finding should the nurse use when developing the client's plan of care?
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Peripheral neuropathy.
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Right lower abdominal pain.
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Confusion.
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Depression.
Explanation
Correct Answer: C. Confusion.
Explanation:
Wernicke’s syndrome, also known as Wernicke’s encephalopathy, is a neurological disorder caused by thiamine (vitamin B1) deficiency, most commonly associated with chronic alcoholism or malnutrition. The classic symptoms include confusion, ataxia (unsteady gait), and nystagmus (eye movement abnormalities). Confusion indicates significant cerebral involvement and should guide nursing care focused on safety, frequent reorientation, and thiamine supplementation. Prompt treatment with parenteral thiamine can prevent irreversible complications such as Korsakoff’s psychosis and permanent cognitive decline.
Which statement by an adolescent client with acute osteomyelitis in the right leg indicates the best understanding of the prescribed activity level after discharge?
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Leg exercise should be done as much as possible to maintain muscle tone.
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I need to keep my leg as immobile as possible during healing.
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I will not be able to participate in contact sports.
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I can resume my normal activities.
Explanation
Correct Answer:
B. I need to keep my leg as immobile as possible during healing.
Explanation:
During recovery from acute osteomyelitis, immobilization of the affected limb is essential to decrease pain, swelling, and prevent the spread of infection. Keeping the leg immobile helps reduce blood flow demands to the infected bone, minimizing the risk of pathologic fracture and containing the infection until inflammation subsides and antibiotics take full effect. Immobilization can be achieved using splints, casts, or traction, depending on the severity and location of infection.
A client with rheumatoid arthritis receives a new prescription for etanercept. Prior to administration of the first dose, the nurse should review the medical record for which condition?
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Glaucoma
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Diabetes mellitus
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Osteoporosis
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Heart failure
Explanation
Correct Answer: D. Heart failure
Explanation:
Etanercept is a TNF-alpha inhibitor used to treat rheumatoid arthritis. TNF-alpha inhibitors carry a black box warning for worsening or precipitating heart failure. Before administering the first dose, the nurse should review the client’s history for heart failure or cardiac dysfunction, as these clients are at increased risk for exacerbation. Monitoring for symptoms such as dyspnea, edema, and fatigue is essential to ensure safe therapy.
An older adult male who is admitted with end-stage chronic obstructive pulmonary disease (COPD) tells the nurse that his family wants CPR to be provided if the need arises. The client provides the nurse with a living will and an advance directive that specifies do not resuscitate (DNR). Which action should the nurse implement?
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Obtain a prescription for DNR.
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Inform the family of the client’s wishes.
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Ask the client why he made this choice.
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Request clergy consultation.
Explanation
Correct Answer: A. Obtain a prescription for DNR.
Explanation:
A living will and advance directive express a client’s legally binding wishes regarding end-of-life care. However, these documents must be supported by a healthcare provider’s written prescription for a Do Not Resuscitate (DNR) order to be implemented in the clinical setting. The nurse’s responsibility is to advocate for the client’s expressed wishes by notifying the healthcare provider and requesting that a formal DNR prescription be entered into the medical record. This ensures the client’s autonomy is respected and care aligns with their legal and ethical preferences.
When assessing a recently delivered, multigravida client, the nurse finds that her vaginal bleeding is more than expected. Which factor in this client's history is related to this finding?
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She is a gravida 6, para 5.
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She received butorphanol 2 mg IV during labor.
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She is over 35 years of age.
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The second stage of labor lasted 10 minutes.
Explanation
Correct Answer: A. She is a gravida 6, para 5.
Explanation:
A multigravida client (gravida 6, para 5) is at increased risk for uterine atony, the most common cause of postpartum hemorrhage. Repeated uterine stretching from multiple pregnancies weakens uterine muscle tone, making it less effective at contracting after delivery. Poor uterine contraction allows continued bleeding from placental implantation sites. The nurse should closely monitor fundal firmness, massage the uterus as indicated, and be prepared to administer prescribed uterotonic agents such as oxytocin to control bleeding and prevent hemorrhagic shock.
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.
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