HESI Compass Exit B

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Sample questions from HESI Compass Exit B

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

1. 1.At 0730 on a medical-surgical unit, a 68-year-old client with pneumonia has a temperature of 38.2 C, HR 104/min, RR 26/min, BP 126/74 mm Hg, and SpO2 91% on 2 L/min oxygen. At the same time, a stable client requests help ordering breakfast and another is ready for discharge. Which action should the RN take first?

   • A.Complete the stable client's discharge paperwork.
   • B.Ask the charge nurse to assess the client with pneumonia.
   • C.Ask the nursing assistant to help the client order breakfast.
   • D.Assess the client with pneumonia and address the oxygenation concern.

   Rationale: The increased respiratory rate and low oxygen saturation despite supplemental oxygen require prompt RN assessment. Breakfast assistance and routine discharge paperwork can be delayed, and the RN should not delegate the initial assessment of an unstable client. Prioritize airway and breathing concerns before routine tasks.

2. 2.At 0800 on a telemetry unit, a 72-year-old client admitted with gastrointestinal bleeding reports sudden weakness. The chart shows hemoglobin falling from 9.1 to 7.2 g/dL, HR rising from 88 to 122/min, and BP falling from 118/72 to 92/58 mm Hg. Refer to the client's chart. Which action should the nurse take first?

   • A.Ask the client to walk to the bathroom to assess exertional tolerance.
   • B.Document the trend and continue routine hourly rounds.
   • C.Notify the rapid response team and remain with the client.
   • D.Give the scheduled oral iron and recheck hemoglobin tomorrow.

   Rationale: The falling hemoglobin, tachycardia, hypotension, and new weakness indicate possible worsening blood loss and hemodynamic instability. The nurse should summon urgent assistance and remain with the client while supporting immediate assessment. Walking, routine oral iron, or documentation without escalation would delay treatment.

3. 3.At change of shift on a surgical unit, a 64-year-old client returns from surgery with a new prescription for IV opioid analgesia. The client is difficult to arouse, RR 8/min, and SpO2 89% on 2 L/min. Which action is the priority?

   • A.Document the findings and wait for the next scheduled vital signs.
   • B.Hold the opioid and stimulate the client while calling for immediate assistance.
   • C.Administer the prescribed opioid and reassess pain in 30 minutes.
   • D.Ask the nursing assistant to increase oxygen and return in an hour.

   Rationale: Difficult arousal, bradypnea, and hypoxemia suggest opioid-related respiratory depression. Withhold the opioid, stimulate the client, support airway and breathing, and obtain urgent assistance according to protocol. Administering the dose or delaying reassessment could worsen respiratory compromise.

4. 4.On a medical-surgical unit, a 61-year-old client with chronic kidney disease has a potassium level of 6.4 mEq/L (reference range 3.5-5.0 mEq/L) and peaked T waves on the monitor. Which action should the nurse take first?

   • A.Notify the provider immediately and maintain cardiac monitoring.
   • B.Offer a potassium-rich snack to improve nutritional status.
   • C.Recheck the potassium level with the next morning laboratory draw.
   • D.Encourage ambulation to reduce the potassium level.

   Answer and rationale are in the full material.

5. 5.At 0900 on a pediatric unit, a 6-month-old admitted with bronchiolitis has worsening retractions and poor feeding. The chart shows RR increasing from 42 to 62/min and SpO2 falling from 95% to 89% on room air. Refer to the client's chart. Which action is the priority?

   • A.Place the infant flat and allow the infant to rest undisturbed.
   • B.Provide oxygen as prescribed and promptly escalate the respiratory deterioration.
   • C.Document the findings and reassess at the next routine observation.
   • D.Offer a full bottle to prevent dehydration before reassessing breathing.

   Answer and rationale are in the full material.