HESI Compass Exam 1

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Sample questions from HESI Compass Exam 1

This material has 75 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift in a pediatric unit, a 6-year-old with asthma has audible wheezing and an SpO2 of 91% after two albuterol treatments. Which task is appropriate for the registered nurse to delegate to an experienced unlicensed assistive personnel (UAP)?

   • A.Decide whether the child needs another nebulizer treatment.
   • B.Obtain and report the child's current vital signs and oxygen saturation.
   • C.Assess the child's response to the second albuterol treatment.
   • D.Teach the parent how to use a peak-flow meter.

   Rationale: Obtaining and reporting vital signs is a predictable task that can be delegated to a competent UAP; the RN remains responsible for interpreting the results and responding to changes. Assessing the treatment response requires nursing judgment. Teaching and deciding whether another treatment is needed also require the RN's assessment and clinical decision-making.

2. 2.In the emergency department, a 34-year-old client with a suspected ectopic pregnancy reports worsening abdominal pain and dizziness. The client is pale; HR is 124/min, BP is 86/54 mm Hg, and hemoglobin is 8.2 g/dL. Which action should the charge nurse take first?

   • A.Arrange immediate transfer to the operating room while assigning a nurse to maintain resuscitation.
   • B.Ask the client to sign the surgical consent form before notifying the provider.
   • C.Request that the next available nurse complete the client's admission history.
   • D.Place the client in the waiting area until an ultrasound confirms the diagnosis.

   Rationale: Hypotension, tachycardia, pallor, and low hemoglobin suggest hemorrhagic shock, so rapid escalation and preparation for definitive treatment are priorities while resuscitation continues. Obtaining consent is not the priority during instability and requires the provider to explain the procedure. Completing the admission history can wait, and delaying care for an ultrasound or placing the client in the waiting area is unsafe.

3. 3.Refer to the client's chart. Which actions should the nurse take now for this 11-year-old client? Select all that apply.

   • A.Prepare to administer the prescribed rescue medication and verify the dose and route.
   • B.Position the client upright and maintain prescribed oxygen while reassessing breathing.
   • C.Delegate a focused respiratory assessment to the UAP while the nurse contacts the provider.
   • D.Wait for the next scheduled assessment because the oxygen saturation remains above 90%.
   • E.Notify the rapid response team or provider of the worsening respiratory status.

   Rationale: The falling SpO2, increasing respiratory rate, and new difficulty speaking documented at 1000 indicate deterioration and require immediate escalation, upright positioning, oxygen support, and preparation to give the prescribed rescue medication safely. A focused respiratory assessment is an RN responsibility and should not be delegated to a UAP. Waiting for the next scheduled assessment is unsafe because the trend is worsening despite an SpO2 still above 90%.

4. 4.A provider prescribes digoxin for a 72-year-old client with heart failure. Before administering the morning dose, the nurse notes an apical pulse of 54/min, potassium of 3.1 mEq/L, and a digoxin level of 1.8 ng/mL (therapeutic range 0.5-2.0 ng/mL). Which action is best?

   • A.Give the dose with food and recheck the apical pulse in 1 hour.
   • B.Ask the UAP to repeat the apical pulse and administer the dose if it is above 50/min.
   • C.Hold the dose and notify the provider of the bradycardia and hypokalemia.
   • D.Administer the dose because the digoxin level is within the therapeutic range.

   Answer and rationale are in the full material.

5. 5.During a home visit, a 15-year-old who recently started insulin says, "I skip lunch insulin because I do not want my friends to know." The adolescent's glucose log shows repeated afternoon readings above 250 mg/dL, and the parent answers every question for the client. What should the nurse do first?

   • A.Recommend that the adolescent stop attending lunch with friends until glucose control improves.
   • B.Tell the parent to supervise every injection and report any missed dose to the school.
   • C.Increase the insulin dose based on the elevated afternoon readings.
   • D.Arrange a private, developmentally appropriate conversation with the adolescent about barriers and safety.

   Answer and rationale are in the full material.