HESI Compass Exit B Exam
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Free HESI Compass Exit B Exam Questions
The nurse is caring for a client who has been admitted with recurring migraine headaches. To assess the quality of the client's pain experienced from the migraine headache, which approach should the nurse use?
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Ask the client to describe the pain.
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Provide a numeric pain scale.
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Identify effective pain relief measures.
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Observe body language and movement.
Explanation
Correct Answer: A. Ask the client to describe the pain.
Explanation:
Assessing the quality of pain involves having the client describe the characteristics of the pain in their own words—such as whether it is throbbing, sharp, dull, or burning. This subjective data helps the nurse understand the sensory experience and tailor interventions appropriately. While numeric pain scales (B) measure pain intensity, and observing behavior (D) provides clues about discomfort, the client’s verbal description is the most accurate and direct way to assess the quality of migraine pain.
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.
A client is admitted for type 2 diabetes mellitus (DM) and chronic kidney disease (CKD). When the nurse evaluates diet teaching, which breakfast selection by the client indicates effective learning?
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Scrambled eggs, bacon, one slice of whole wheat toast with butter and jam.
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Banana pancakes with maple syrup, sausage links, half grapefruit, and low-fat milk.
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Oatmeal with butter, artificial sweetener, and strawberries, and 6 ounces coffee.
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Orange juice, yogurt with berries, cold cereal with milk, bran muffin with margarine.
Explanation
Correct Answer:
C. Oatmeal with butter, artificial sweetener, and strawberries, and 6 ounces coffee.
Explanation:
Clients with type 2 diabetes mellitus and chronic kidney disease require meals that help control blood glucose and reduce kidney workload by limiting sodium, phosphorus, and potassium.
Oatmeal with butter, artificial sweetener, and strawberries provides complex carbohydrates and fiber that support steady blood glucose control. Using artificial sweetener avoids excess sugar intake, and strawberries offer vitamins with relatively low potassium compared to other fruits. The small portion of coffee without added sugar is acceptable in moderation.
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.
One hundred victims of a train derailment are brought to the Emergency Department of a small rural hospital. An older client with extensive crushing injuries to the lower extremities and pelvis has a blood pressure of 42/28, a thready pulse of 120 beats/minute, and a respiratory rate of 10 breaths/minute with periods of apnea. Using the disaster triage system, which action should the nurse take?
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Transport to radiology department.
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Obtain the crash cart and defibrillator.
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Initiate a large bore IV infusion.
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Assign a black triage color.
Explanation
Correct Answer: D. Assign a black triage color.
Explanation:
In mass casualty and disaster triage, victims are categorized based on the likelihood of survival and urgency of care. A black tag is assigned to individuals who are expected to die or whose injuries are so severe that survival is unlikely even with treatment. This client’s findings—extensive crush injuries, severe hypotension (42/28 mm Hg), thready pulse, and respiratory depression with apnea—indicate irreversible shock and impending death. Providing extensive interventions would divert resources from victims with a higher chance of survival.
The nurse is reviewing a pregnant client's prenatal immunization history. Which immunization should the nurse instruct the client to receive after pregnancy?
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Meningitis B.
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Measles, mumps, rubella.
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Diphtheria, pertussis, tetanus.
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Influenza vaccine.
Explanation
Correct Answer: B. Measles, mumps, rubella.
Explanation:
The MMR vaccine is a live attenuated vaccine and is contraindicated during pregnancy because of the potential risk to the developing fetus. However, it is safe and recommended postpartum to protect the mother against rubella, which can cause congenital rubella syndrome in future pregnancies. The nurse should ensure the vaccine is administered before discharge and advise avoiding pregnancy for at least one month after receiving it. Vaccines like Tdap and influenza can be safely administered during pregnancy.
A primigravida at 36 weeks’ gestation, who is Rh negative, experienced abdominal trauma in a motor vehicle collision. Which assessment finding is most important for the nurse to report to the healthcare provider?
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Fetal heart rate of 162 beats/minute.
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Mild contractions every 10 minutes.
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Trace of protein in the urine.
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Positive fetal hemoglobin testing.
Explanation
Correct Answer: D. Positive fetal hemoglobin testing.
Explanation:
A positive fetal hemoglobin test (Kleihauer-Betke test) indicates fetomaternal hemorrhage, where fetal blood cells have entered the maternal circulation. For an Rh-negative mother, this is a critical finding because exposure to Rh-positive fetal blood can trigger maternal antibody formation (isoimmunization), threatening this and future pregnancies through hemolytic disease of the newborn (erythroblastosis fetalis).
This result must be immediately reported so that the healthcare provider can prescribe Rho(D) immune globulin (RhoGAM) within 72 hours to prevent sensitization.
A slightly elevated fetal heart rate (A) may reflect maternal stress or fetal activity and is not immediately dangerous. Mild contractions (B) after trauma may be transient but require continued observation. A trace of protein in the urine (C) is a minor finding, not directly linked to the risk of isoimmunization. The priority is preventing Rh sensitization, making the positive fetal hemoglobin test the most urgent finding to report.
An adolescent with autism spectrum disorder (ASD) comes to the clinic for the first time. Which intervention(s) should the nurse implement? (Select all that apply.)
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Consider having the teen's caregiver wait in the clinic reception area.
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Encourage the adolescent to handle the physical exam instruments.
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Allow time for talking before beginning the physical assessment.
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Familiarize the adolescent with the clinic setting and healthcare staff.
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Make every effort to establish eye contact with the adolescent.
Explanation
Correct Answers:
B. Encourage the adolescent to handle the physical exam instruments.
C. Allow time for talking before beginning the physical assessment.
D. Familiarize the adolescent with the clinic setting and healthcare staff.
Explanation:
B. Encourage the adolescent to handle the physical exam instruments
Allowing the adolescent to touch or handle examination tools helps reduce fear and anxiety by increasing familiarity and predictability. This approach supports comfort and cooperation, as individuals with ASD often struggle with new sensory experiences and unexpected stimuli.
C. Allow time for talking before beginning the physical assessment
Giving the adolescent extra time to process and respond builds trust and reduces stress. Clients with ASD often need more time to adjust to new interactions and may find sudden transitions overwhelming. Establishing rapport first promotes a smoother examination process.
D. Familiarize the adolescent with the clinic setting and healthcare staff
Introducing the environment and personnel before care activities helps ease sensory and social discomfort common in ASD. Predictability and structure help the adolescent feel secure and decrease the likelihood of behavioral distress during the visit.
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.
A client reports that they drank a liter of a solution to cleanse the intestines for a colonoscopy but vomited a cup of it immediately. How many mL of fluid intake should the nurse document? (Enter numeric value only. If rounding is required, round to the nearest whole number.)
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760 mL
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850 mL
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900 mL
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950 mL
Explanation
Correct Answer:
A. 760 mL
Explanation:
1 liter = 1000 mL
1 cup = 240 mL
Since the client vomited one cup (240 mL) immediately after drinking, that amount should be subtracted from the total consumed.
1000 mL – 240 mL = 760 mL
Therefore, the nurse should document 760 mL as the client’s fluid intake.
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