HESI Compass B

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Sample questions from HESI Compass B

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 68-year-old client arrives in the emergency department with sudden facial droop and right-sided weakness that began 45 minutes ago. Blood glucose is 112 mg/dL, blood pressure is 178/96 mm Hg, and oxygen saturation is 96% on room air. Which action should the nurse take first?

   • A.Activate the stroke response and prepare the client for immediate brain imaging
   • B.Administer aspirin with a sip of water
   • C.Lower the blood pressure to below 140/90 mm Hg
   • D.Perform a complete neurologic assessment before notifying the provider

   Rationale: Rapid stroke-team activation and noncontrast brain imaging are priorities because treatment decisions depend on identifying hemorrhage and time of onset. Aspirin is unsafe before hemorrhage is excluded, and this blood pressure does not by itself require immediate reduction before thrombolytic eligibility is assessed. A full assessment is important, but delaying the stroke response can forfeit time-sensitive treatment.

2. 2.A 74-year-old client on a medical unit suddenly becomes confused and restless. The client has pneumonia, a temperature of 39.2 C (102.6 F), heart rate 128/min, blood pressure 82/46 mm Hg, and lactate 4.1 mmol/L. Which action is the priority?

   • A.Obtain blood cultures and begin prescribed broad-spectrum antibiotics and fluid resuscitation promptly
   • B.Give acetaminophen and reassess the temperature in 1 hour
   • C.Restrict oral and intravenous fluids until the cause of confusion is known
   • D.Request a nonurgent consultation for evaluation of delirium

   Rationale: The findings suggest septic shock, so rapid cultures, antibiotics, and hemodynamic resuscitation are time-critical. Acetaminophen may reduce fever but does not address shock, while restricting fluids can worsen tissue hypoperfusion. A nonurgent delirium consultation delays emergency treatment.

3. 3.A 56-year-old client with type 1 diabetes is admitted with vomiting and abdominal pain. The client is drowsy, has deep rapid respirations, glucose 512 mg/dL, potassium 5.6 mEq/L, and arterial pH 7.18. Which prescribed intervention should the nurse implement first?

   • A.Begin the prescribed isotonic intravenous fluid bolus
   • B.Administer intravenous regular insulin
   • C.Give potassium chloride intravenously
   • D.Administer sodium bicarbonate

   Rationale: Initial isotonic fluid replacement restores circulating volume and supports perfusion in diabetic ketoacidosis. Insulin is essential but is generally started after initial fluid resuscitation and assessment of potassium; potassium is not given when the level is elevated. Bicarbonate is not routinely indicated at this pH and can cause harm.

4. 4.A 29-year-old client with asthma arrives at urgent care with severe wheezing, accessory muscle use, and oxygen saturation of 89% on room air. The client can speak only two or three words at a time. Which action should the nurse take first?

   • A.Administer the prescribed inhaled short-acting bronchodilator and supplemental oxygen
   • B.Obtain a peak expiratory flow measurement before treatment
   • C.Teach the client pursed-lip breathing
   • D.Collect a sputum specimen for culture

   Answer and rationale are in the full material.

5. 5.A 63-year-old client with chronic kidney disease has a potassium level of 6.7 mEq/L and new peaked T waves on the electrocardiogram. The client is alert and has a blood pressure of 138/82 mm Hg. Which action is the priority?

   • A.Place the client on continuous cardiac monitoring and notify the provider immediately
   • B.Encourage the client to eat a high-fiber snack
   • C.Administer the scheduled oral potassium supplement
   • D.Repeat the potassium level with the next routine laboratory draw

   Answer and rationale are in the full material.