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HESI Comprehensive Exam 3 2026 – 300+ Questions on Med-Surg, Pediatrics, OB, Psych & Leadership with Correct Answers

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This comprehensive HESI Exam 3 (2026) review document contains more than 300 exam-style questions with correct answers covering medical-surgical nursing, psychiatric nursing, pediatrics, obstetrics, pharmacology, leadership, delegation, and professional practice. The content spans high-yield topics including heart failure assessment (JVD evaluation), hepatic encephalopathy and elevated ammonia, GERD and Nissen fundoplication complications, GI hemorrhage recognition (rigid abdomen, bright red NG drainage), cirrhosis and ascites management, cholelithiasis, Addison’s disease, CKD and peritoneal dialysis advocacy, fluid volume excess, diabetic ketoacidosis, and myasthenia gravis. Maternal-newborn and pediatric concepts are thoroughly addressed, including fetal heart rate decelerations (late and variable), Rh incompatibility, premature infant airway management, hydrocephalus and VP shunt care, postpartum infection indicators, labor arrest patterns, pediatric tracheostomy care, child abuse reporting, and developmental expectations such as social smiling and Erikson stages. Psychiatric and mental health content includes bipolar disorder, schizophrenia, suicide risk assessment, oppositional defiant disorder, eating disorders, Alzheimer’s care strategies, alcohol withdrawal management, therapeutic communication phases, spiritual distress, and crisis intervention priorities. Pharmacology and clinical procedures are extensively reviewed, including insulin types, nitroglycerin side effects, risperidone adverse effects, disulfiram reactions, atropine ophthalmic effects, opioid-induced respiratory acidosis, timolol contraindications, IM injection landmarks, sterile technique breaks, nasogastric tube placement verification, suctioning limits, and medication preparation from ampules. Leadership and management principles such as delegation to UAP, shared governance, CQI benchmarking, documentation standards, informatics, informed consent, advocacy, malpractice liability, and mass casualty prioritization are also integrated throughout the exam material. This resource is particularly relevant for: Nursing students preparing for the HESI comprehensive exit exam NCLEX-RN preparation courses Senior-level medical-surgical nursing students Maternal-newborn and pediatric nursing courses Psychiatric-mental health nursing coursework Nursing leadership and management review ADN and BSN final comprehensive exams The structured question-and-answer format supports clinical judgment development, prioritization skills, delegation decisions, and high-level exam readiness across multiple nursing specialties. Keywords: HESI comprehensive exam, NCLEX preparation, medical surgical nursing, psychiatric nursing, pediatric nursing, obstetric nursing, heart failure assessment, hepatic encephalopathy, Nissen fundoplication complications, GI bleeding priority, fetal heart rate decelerations, Rh incompatibility, hydrocephalus VP shunt, postpartum infection signs, insulin regular IV use, risperidone side effects, opioid respiratory acidosis, delegation to UAP, sterile technique break, nasogastric tube placement, fluid volume excess, diabetic ketoacidosis, myasthenia gravis, Addison disease, shared governance, quality improvement nursing, informed consent advocacy

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HESI Comprehensive Exam 3
2026 Exam Questions and
Correct Answers | New Update


A 38-year-old female client is admitted to the mental health unit after a

recent manic episode of spending large amounts of money on new

furniture, making excessive long-distance phone calls, and not sleeping for

three days. During the admission process, the client is wearing a green

bathing suit. What intervention should the nurse implement? - 🧠 ANSWER

✔✔Assess the client's needs for food, liquids, and rest.

,During a group therapy session, a client with hypomania threatens to strike

another client. What intervention is best for the nurse to implement? - 🧠

ANSWER ✔✔Firmly inform the client that acting out anger is not

acceptable.

A client who is a laboratory technician and has a history of allergic rhinitis,

asthma, and multiple food allergies is scheduled for surgery. Which action

should the nurse implement? - 🧠 ANSWER ✔✔Document a possible Type I

latex allergy.

In reviewing the medical record, the nurse notes that a client's last eye

examination revealed an IOP of 28 mmHg. What information should the

nurse ask the client? - 🧠 ANSWER ✔✔Use of prescribed eye drops since

last exam by ophthalmologist.

Which action should the nurse implement to assess for JVD in a client with

HF? - 🧠 ANSWER ✔✔Observe the vertical distention of the veins as the

client is gradually elevated to an upright position.

The nurse identifies a client's laboratory results and identifies an elevated

serum ammonia level. Which pathophysiological process contributes to this

, finding? - 🧠 ANSWER ✔✔Failure of the liver to convert ammonia absorbed

from the bowel to urea.

A client with GERD is unconscious and unresponsive to stimuli. The nurse

places the client in a side-lying position. The nurse should monitor for the

risk of which complication? - 🧠 ANSWER ✔✔Aspiration pneumonia.


A client returns to the unit after abdominal Nissen fundoplication for

treatment of GERD. After 4 hours, the nurse determines the client has no

drainage from the NGT and has absent bowel sounds. What action should

the nurse implement? - 🧠 ANSWER ✔✔Irrigate the NGT with normal saline.


A male client who is admitted with a bleeding peptic ulcer develops sudden,

severe upper abdominal pain. The client becomes diaphoretic and draws

his knees over his abdomen. Which finding should the nurse report to the

healthcare provider? - 🧠 ANSWER ✔✔A rigid, boardlike abdomen.


A client returns to the postoperative unit after a gastroduodenostomy

(Billroth I) for treatment of a perforated ulcer. The healthcare provider's

prescriptions include morphine with a patient-controlled analgesia (PCA),

nasogastric tube (NGT) to low intermittent nasogastric suction, and IV fluids

and antibiotics. The client complains of increasing abdominal pain 12 hours



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