HESI Compass Exit B Exam

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Free HESI Compass Exit B Exam Questions

1.

The nurse administers ophthalmic timolol to a client with glaucoma. The client routinely takes carvedilol, spironolactone, and ibuprofen daily. Which medication(s) should the nurse withhold? (Select all that apply.)

  • Any antianxiety medications

  • Over-the-counter oral antipyretics

  • Nonsteroidal antiinflammatory drugs

  • Other beta-adrenergic blocker agents

  • Oral and subcutaneous anticoagulants

Explanation

Correct Answers: C. Nonsteroidal antiinflammatory drugs

D. Other beta-adrenergic blocker agents


Explanation:

C. Nonsteroidal antiinflammatory drugs

NSAIDs, such as ibuprofen, can reduce the effectiveness of antihypertensive and diuretic medications like spironolactone and may worsen renal function, particularly in older adults or clients receiving multiple cardiovascular agents. The nurse should withhold NSAIDs and notify the provider to prevent possible drug interactions and kidney injury.

D. Other beta-adrenergic blocker agents

Timolol is a topical beta-adrenergic blocker. Concurrent use with other systemic beta-blockers such as carvedilol can result in additive cardiovascular effects, including bradycardia, hypotension, and heart block. The nurse should withhold additional beta-blocker doses and notify the healthcare provider for further evaluation before administering both medications together.


2.

A resident of a long-term care facility is being admitted to a medical unit. The client has a fractured humerus and methicillin-resistant Staphylococcus aureus (MRSA). Which room should the charge nurse assign this client?

  • A private isolation room with a vented negative airflow system.

  • A semi-private room with another client who also has MRSA.

  • A private room, and institute protective environment measures.

  • A semi-private room with a client who has hepatitis B (HBV).

Explanation

Correct Answer:

B. A semi-private room with another client who also has MRSA.

Explanation:

Clients infected or colonized with MRSA require contact precautions to prevent cross-contamination. The best room assignment for this client is with another client who has MRSA, as they share the same infection and therefore do not pose an additional infection risk to each other. This allows for effective use of resources while maintaining proper infection control practices such as gown and glove use, dedicated equipment, and frequent hand hygiene.


3.

The nurse is teaching a client with coronary artery disease about a newly prescribed medication, atorvastatin. The client plans to take the medication in the morning with breakfast. What food choices are best for the nurse to recommend that the client should include with the meal? Select all that apply.

  • Low-fat yogurt.

  • Oatmeal.

  • Whole banana.

  • Sliced grapefruit.

  • Whole milk.

Explanation

Correct Answers: A. Low-fat yogurt, B. Oatmeal, C. Whole banana.

Explanation:

A. Low-fat yogurt

Low-fat yogurt is a good breakfast option for clients with coronary artery disease because it provides protein and calcium with minimal saturated fat. Reducing saturated fat intake helps lower LDL cholesterol levels, which supports the lipid-lowering effects of atorvastatin. It also provides a balanced source of nutrients without interfering with the medication’s metabolism.

B. Oatmeal

Oatmeal is rich in soluble fiber, which binds to cholesterol in the digestive tract and helps reduce LDL (“bad”) cholesterol levels. Eating oatmeal regularly complements atorvastatin therapy by promoting heart health and improving lipid control. It also helps maintain steady blood glucose levels and provides a low-fat energy source suitable for cardiac diets.

C. Whole banana

A whole banana is an excellent source of potassium, which helps regulate blood pressure and supports cardiovascular health. It contains natural sugars and fiber, providing energy without excessive fat or cholesterol. Bananas also do not interact with atorvastatin metabolism, making them a safe and heart-healthy choice with breakfast.


4.

A client has reported sexual assault. After placing the samples in sealed containers, which action is most important for the nurse to implement?

  • Assist the client with toileting, hygiene, and dressing with clean clothes.

  • Document the characteristics of the various sites of sample collection.

  • Maintain possession of the evidence collection kit at all times until submitted to law enforcement.

  • Provide discharge instruction for prophylactic antibiotic, pregnancy, and HIV prevention medication.

Explanation

Correct Answer:

C. Maintain possession of the evidence collection kit at all times until submitted to law enforcement.

Explanation:

After collecting forensic evidence in a sexual assault case, the most important nursing action is to maintain the chain of custody. The nurse must ensure the evidence collection kit remains in their possession at all times until it is formally handed over to law enforcement with proper documentation. Any break in this chain can render the evidence inadmissible in court. Maintaining integrity of evidence is crucial for protecting the client’s legal rights and ensuring justice.


5.

The charge nurse in an extended care facility is organizing unit activities for the day. Which action may be safely delegated to the practical nurse (PN)?

  • Evaluate client teaching through return demonstration.

  • Establish blood pressure parameters for client monitoring.

  • Evaluate a staff member providing wound care.

  • Measure the client's body weight each morning.

Explanation

Correct Answer: D. Measure the client's body weight each morning.

Explanation:

The practical nurse (PN) may safely be delegated routine, stable-care tasks such as measuring and recording daily body weight. This activity does not require clinical judgment or independent decision-making. Tasks involving assessment, evaluation, or establishing parameters (as in options A, B, and C) fall within the scope of the registered nurse (RN), who is responsible for interpreting data, making clinical decisions, and supervising care quality. The PN’s role focuses on implementing nursing care under RN direction.


6.

An adult male client presents to the psychiatric clinic accompanied by his mother who is concerned that her child is going to jail because he broke into a jewelry store. The nurse conducts an intake assessment and determines that the son is using marijuana daily. Which information should the nurse provide this mother?

  • Describe the consequences of enabling behaviors.

  • Refer the son to a drug treatment program immediately.

  • Tell the mother to discourage her son's marijuana use.

  • Suggest to the mother that she allow her son to go to jail.

Explanation

Correct Answer: A. Describe the consequences of enabling behaviors.

Explanation:

When a parent continually protects or rescues an adult child from the negative consequences of substance use, this is considered enabling behavior. Enabling allows the substance abuse to continue by preventing the individual from experiencing the natural results of their actions, such as legal, social, or financial consequences. The nurse’s role is to educate the mother about how her behavior—such as covering for her son or attempting to keep him out of jail—reinforces his dependency and prevents accountability. By understanding this dynamic, the mother can set appropriate boundaries that may encourage her son to seek treatment voluntarily.


7.

A client received a thrombolytic medication following a myocardial infarction. When the client has a bowel movement, which action should the nurse implement?

  • Assess for fatty yellow streaks in the client's stool.

  • Obtain a specimen for culture and sensitivity analysis.

  • Send a stool sample to the lab for a guaiac test.

  • Observe the stool for a clay-colored appearance.

Explanation

Correct Answer: C. Send a stool sample to the lab for a guaiac test.

Explanation:

Clients who receive thrombolytic therapy are at increased risk for internal bleeding, including gastrointestinal hemorrhage. A guaiac test (fecal occult blood test) detects hidden blood in the stool, allowing early identification of bleeding that might not be visible. Monitoring for GI bleeding is essential because thrombolytics break down fibrin clots systemically. If stool is positive for occult blood, the nurse should notify the healthcare provider immediately. Clay-colored stool (D) relates to biliary obstruction, while fatty or yellow stools (A) indicate steatorrhea, not bleeding.


8.

A client with Neisseria meningitidis calls the nurses station to report a severe headache and vomiting. The unlicensed assistive personnel (UAP) approaches the room to provide an emesis basin and is stopped by the nurse. Which action should the nurse take?

  • Remind the UAP to apply a fitted respirator mask before entering the client's room.

  • Assign the UAP to provide care for another client and assume full care of the client.

  • Review the need for the UAP to wear a face mask while in close contact with the client.

  • Instruct the UAP to notify the nurse of any changes in the client's emesis.

Explanation

Correct Answer: C. Review the need for the UAP to wear a face mask while in close contact with the client.

Explanation:

Clients with Neisseria meningitidis (meningococcal meningitis) require droplet precautions because the infection spreads through respiratory secretions. The UAP should wear a surgical mask when within 3 feet of the client, along with standard precautions such as gloves and hand hygiene. A fitted respirator (A) is for airborne infections like tuberculosis. Reassigning care (B) is unnecessary if precautions are followed, and monitoring emesis (D) is not a priority compared to preventing exposure to this highly contagious organism.


9.

A client who had a right total knee replacement two days ago is progressed to a soft diet. What food selection(s) should the nurse recommend to this client? Select all that apply.

  • Fried chicken and green salad.

  • Scrambled eggs and potatoes.

  • Pasta with a cream sauce.

  • Steamed rice and cooked squash.

  • Ice cream with nuts.

  • Pancakes with syrup.

Explanation

Correct Answers:

B. Scrambled eggs and potatoes, C. Pasta with a cream sauce, D. Steamed rice and cooked squash, F. Pancakes with syrup.

Explanation:

B. Scrambled eggs and potatoes

Scrambled eggs and soft-cooked potatoes are ideal for a soft diet because they are easy to chew, swallow, and digest. Eggs provide protein to support tissue repair after surgery, while potatoes supply carbohydrates for energy. Both foods are gentle on the gastrointestinal tract and appropriate for postoperative recovery.

C. Pasta with a cream sauce

Pasta is smooth and soft in texture, making it suitable for a soft diet. The cream sauce provides calories and energy needed for healing while maintaining a palatable and easily digestible meal option. This selection ensures adequate nutrition without causing discomfort or strain during chewing.

D. Steamed rice and cooked squash

Steamed rice and well-cooked vegetables like squash are mild and easy to digest, which fits the requirements of a soft diet. These foods provide carbohydrates, vitamins, and fiber for recovery without irritating the digestive system. They also help maintain energy levels while promoting gentle digestion.

F. Pancakes with syrup

Pancakes are tender and simple to chew, providing a pleasant carbohydrate source for energy. When served with syrup, they offer additional calories, which are beneficial for clients recovering from surgery. This meal is easy to tolerate and suitable for clients transitioning to regular diets.



 


10.

Which statement by an adolescent client with acute osteomyelitis in the right leg indicates the best understanding of the prescribed activity level after discharge?

  • Leg exercise should be done as much as possible to maintain muscle tone.

  • I need to keep my leg as immobile as possible during healing.

  • I will not be able to participate in contact sports.

  • 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.


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