HESI COMPREHENSIVE EXAM
QUESTIONS WITH CORRECT
ANSWERS GRADED A+ FOR 2026
ASSURED EXCEL!!
Enalaprilfmaleatefisfprescribedfforfafhospitalizedfclient.fWhichfassessmentfdoesfthefnursefperformf
asfafpriorityfbeforefadministeringfthefmedication?
Checkingfthefclient'sfbloodfpressuref
Checkingfthefclient'sfperipheralfpulses
Checkingfthefmostfrecentfpotassiumflevel
Checkingfthefclient'sfintake-and-outputfrecordfforftheflastf24fhoursf-ffCORRECTfANSWERS-
Checkingfthefclient'sfbloodfpressuref
Rationale:fEnalaprilfmaleatefisfanfangiotensin-
convertingfenzymef(ACE)finhibitorfusedftoftreatfhypertension.fOnefcommonfsidefeffectfisfposturalfh
ypotension.fThereforefthefnursefwouldfcheckfthefclient'sfbloodfpressurefimmediatelyfbeforefadmi
nisteringfeachfdose.fCheckingfthefclient'sfperipheralfpulses,fthefresultsfoffthefmostfrecentfpotassiu
mflevel,fandfthefintakefandfoutputfforfthefpreviousf24fhoursfarefnotfspecificallyfassociatedfwithfthisf
mediation.
Afclientfisfscheduledftofundergofanfupperfgastrointestinalf(GI)fseries,fandfthefnursefprovidesfinstruc
tionsftofthefclientfaboutftheftest.fWhichfstatementfbyfthefclientfindicatesfafneedfforffurtherfinstructi
on?
"Theftestfwillftakefaboutf30fminutes."
"Ifneedftoffastfforf8fhoursfbeforeftheftest."
"IfneedftofdrinkfcitratefoffmagnesiafthefnightfbeforeftheftestfandfgivefmyselffafFleetfenemafonfthefm
orningfofftheftest."f
,"Ifneedftoftakefaflaxativefafterftheftestfisfcompleted,fbecausefthefliquidfthatfI'llfhaveftofdrinkfforftheft
estfcanfbefconstipating."f-ffCORRECTfANSWERS-
"IfneedftofdrinkfcitratefoffmagnesiafthefnightfbeforeftheftestfandfgivefmyselffafFleetfenemafonfthefm
orningfofftheftest."f
Rationale:fNofspecialfpreparationfisfnecessaryfbeforefafGIfseries,fexceptfthatfNPOf(nothingfbyfmout
h)fstatusfmustfbefmaintainedfforf8fhoursfbeforeftheftest.fAnfupperfGIfseriesfinvolvesfvisualizationfoff
thefesophagus,fduodenum,fandfupperfjejunumfbyfmeansfoffthefusefoffafcontrastfmedium.fItfinvolve
sfswallowingfafcontrastfmediumf(usuallyfbarium),fwhichfisfadministeredfinfafflavoredfmilkshake.fFil
msfareftakenfatfintervalsfduringftheftest,fwhichftakesfaboutf30fminutes.fAfterfanfupperfGIfseries,fthef
clientfisfprescribedfaflaxativeftofhastenfeliminationfoffthefbarium.fBariumfthatfremainsfinfthefcolonf
mayfbecomefhardfandfdifficultftofexpel,fleadingftoffecalfimpaction.
Afnursefonfthefeveningfshiftfchecksfafprimaryfhealthfcarefprovider'sfprescriptionsfandfnotesfthatfth
efdosefoffafprescribedfmedicationfisfhigherfthanfthefnormalfdose.fThefnursefcallsfthefprimaryfhealth
fcarefprovider'sfansweringfservicefandfisftoldfthatfthefprimaryfhealthfcarefproviderfisfofffforfthefnigh
tfandfwillfbefavailablefinfthefmorning.fWhatfshouldfthefnursefdofnext?
Callfthefnursingfsupervisor
Askfthefansweringfserviceftofcontactfthefon-callfprimaryfhealthfcarefproviderf
Withholdfthefmedicationfuntilfthefprimaryfhealthfcarefproviderfcanfbefreachedfinfthefmorning
Administerfthefmedicationfbutfconsultfthefprimaryfhealthfcarefproviderfwhenfhefbecomesfavailabl
ef-ffCORRECTfANSWERS-Askfthefansweringfserviceftofcontactfthefon-
callfprimaryfhealthfcarefproviderf
Rationale:fThefnursefhasfafdutyftofprotectfthefclientffromfharm.fAfnursefwhofbelievesfthatfafprimary
fhealthfcarefprovider'sfprescriptionfmayfbefinferrorfisfresponsiblefforfclarifyingfthefprescriptionfbefo
refcarryingfitfout.fThereforefthefnursefwouldfnotfadministerfthefmedication;finstead,fthefnursefwou
ldfwithholdfthefmedicationfuntilfthefdosefcanfbefclarified.fThefnursefwouldfnotfwaitfuntilfthefnextfm
orningftofobtainfclarification.fItfisfprematureftofcallfthefnursingfsupervisor.
,Anfemergencyfdepartmentf(ED)fnursefisfmonitoringfafclientfwithfsuspectedfacutefmyocardialfinfarc
tionf(MI)fwhofisfawaitingftransferftofthefcoronaryfintensivefcarefunit.fThefnursefnotesfthefsuddenfo
nsetfoffprematurefventricularfcontractionsf(PVCs)fonfthefmonitor,fchecksfthefclient'sfcarotidfpulse,f
andfdeterminesfthatfthefPVCsfarefnotfperfusing.fWhatfisfthefnurse'sfmostfappropriatefaction?
Documentftheffindings
AskfthefEDfprimaryfhealthfcarefproviderftofcheckfthefclientf
Continueftofmonitorfthefclient'sfcardiacfstatus
InformfthefclientfthatfPVCsfarefexpectedfafterfanfMIf-ffCORRECTfANSWERS-
AskfthefEDfprimaryfhealthfcarefproviderftofcheckfthefclientf
Rationale:fThefmostfappropriatefactionfbyfthefnursefwouldfbeftofaskfthefEDfhealthfcarefproviderftof
checkfthefclient.fPVCsfarefafresultfoffincreasedfirritabilityfoffventricularfcells.fPeripheralfpulsesfmayf
befabsentforfdiminishedfwithfthefPVCsfthemselvesfbecausefthefdecreasedfstrokefvolumefoffthefpre
maturefbeatsfmayfinfturnfdecreasefperipheralfperfusion.fBecausefotherfrhythmsfalsofcausefwidene
dfQRSfcomplexes,fitfisfessentialfthatfthefnursefdeterminefwhetherfthefprematurefbeatsfarefresultin
gfinfperfusionfoffthefextremities.fThisfisfdonefbyfpalpatingfthefcarotid,fbrachial,forffemoralfarteryfwh
ilefobservingfthefmonitorfforfwidenedfcomplexesforfbyfauscultatingfforfapicalfheartfsounds.fInfthefsi
tuationfoffacutefMI,fPVCsfmayfbefconsideredfwarningfdysrhythmias,fpossiblyfheraldingfthefonsetfoff
ventricularftachycardiaforfventricularffibrillation.fTherefore,fthefnursefwouldfnotftellfthefclientfthatf
thefPVCsfarefexpected.fAlthoughfthefnursefwillfcontinueftofmonitorfthefclientfandfdocumentftheffin
dings,fthesefarefnotfthefmostfappropriatefactionsfoffthosefprovided.
NPOfstatusfisfimposedf8fhoursfbeforefthefprocedurefonfafclientfscheduledftofundergofelectroconvul
siveftherapyf(ECT)fatf1fp.m.fOnfthefmorningfoffthefprocedure,fthefnursefchecksfthefclient'sfrecordfa
ndfnotesfthatfthefclientfroutinelyftakesfanforalfantihypertensivefmedicationfeachfmorning.fWhatfac
tionfshouldfthefnurseftake?
Administerfthefantihypertensivefwithfafsmallfsipfoffwaterf
Withholdfthefantihypertensivefandfadministerfitfatfbedtime
Administerfthefmedicationfbyfwayfoffthefintravenousf(IV)froute
, HoldfthefantihypertensivefandfresumefitsfadministrationfonfthefdayfafterfthefECTf-
ffCORRECTfANSWERS-Administerfthefantihypertensivefwithfafsmallfsipfoffwaterf
Rationale:fThefnursefshouldfadministerfthefantihypertensivefwithfafsmallfsipfoffwater.fGeneralfanes
thesiafisfrequiredfforfECT,fsofNPOfstatusfisfimposedfforf6ftof8fhoursfbeforeftreatmentftofhelpfprevent
faspiration.fExceptionsfincludefclientsfwhofroutinelyfreceivefcardiacfmedications,fantihypertensivef
agents,forfhistaminef(H2)fblockers,fwhichfshouldfbefadministeredfseveralfhoursfbeforeftreatmentfw
ithfafsmallfsipfoffwater.fWithholdingfthefantihypertensivefandfadministeringfitfatfbedtimefandfwithh
oldingfthefantihypertensivefandfresumingfadministrationfonfthefdayfafterfthefECTfarefincorrectfacti
ons,fbecausefantihypertensivesfmustfbefadministeredfonftime;fotherwise,fthefriskfforfreboundfhyp
ertensionfexists.fThefnursefwouldfnotfadministerfafmedicationfbyfwayfoffafroutefthatfhasfnotfbeenfp
rescribed.
Afclientfwhofrecentlyfunderwentfcoronaryfarteryfbypassfgraftfsurgeryfcomesftofthefprimaryfhealthf
carefprovider'sfofficefforfaffollow-
upfvisit.fOnfassessment,fthefclientftellsfthefnursefthatfhefisffeelingfdepressed.fWhichfresponsefbyfth
efnursefisftherapeutic?
"Tellfmefmorefaboutfwhatfyou'reffeeling."f
"That'sfafnormalfresponsefafterfthisftypefoffsurgery."
"Itfwillftakeftime,fbutfIfpromisefyou,fyoufwillfgetfoverfthisfdepression."
"Everyfclientfwhofhasfthisfsurgeryffeelsfthefsamefwayfforfaboutfafmonth."f-ffCORRECTfANSWERS-
"Tellfmefmorefaboutfwhatfyou'reffeeling."f
Rationale:fTheftherapeuticfresponsefbyfthefnursefis,f"Tellfmefmorefaboutfwhatfyou'reffeeling."fWhe
nfafclientfexpressesffeelingsfoffdepression,fitfisfextremelyfimportantfforfthefnurseftoffurtherfexploref
theseffeelingsfwithfthefclient.fInfstating,f"Thisfisfafnormalfresponsefafterfthisftypefoffsurgery"fthefnu
rsefprovidesffalsefreassurancefandfavoidsfaddressingfthefclient'sffeelings.f"Itfwillftakeftime,fbutfIfpro
misefyou,fyoufwillfgetfoverfthefdepression"fisfalsofaffalsefreassurance,fandfitfdoesfnotfencouragefthe
fexpressionfofffeelings.f"Everyfclientfwhofhasfthisfsurgeryffeelsfthefsamefwayfforfaboutfafmonth"fisfaf
generalizationfthatfavoidsfthefclient'sffeelings.
QUESTIONS WITH CORRECT
ANSWERS GRADED A+ FOR 2026
ASSURED EXCEL!!
Enalaprilfmaleatefisfprescribedfforfafhospitalizedfclient.fWhichfassessmentfdoesfthefnursefperformf
asfafpriorityfbeforefadministeringfthefmedication?
Checkingfthefclient'sfbloodfpressuref
Checkingfthefclient'sfperipheralfpulses
Checkingfthefmostfrecentfpotassiumflevel
Checkingfthefclient'sfintake-and-outputfrecordfforftheflastf24fhoursf-ffCORRECTfANSWERS-
Checkingfthefclient'sfbloodfpressuref
Rationale:fEnalaprilfmaleatefisfanfangiotensin-
convertingfenzymef(ACE)finhibitorfusedftoftreatfhypertension.fOnefcommonfsidefeffectfisfposturalfh
ypotension.fThereforefthefnursefwouldfcheckfthefclient'sfbloodfpressurefimmediatelyfbeforefadmi
nisteringfeachfdose.fCheckingfthefclient'sfperipheralfpulses,fthefresultsfoffthefmostfrecentfpotassiu
mflevel,fandfthefintakefandfoutputfforfthefpreviousf24fhoursfarefnotfspecificallyfassociatedfwithfthisf
mediation.
Afclientfisfscheduledftofundergofanfupperfgastrointestinalf(GI)fseries,fandfthefnursefprovidesfinstruc
tionsftofthefclientfaboutftheftest.fWhichfstatementfbyfthefclientfindicatesfafneedfforffurtherfinstructi
on?
"Theftestfwillftakefaboutf30fminutes."
"Ifneedftoffastfforf8fhoursfbeforeftheftest."
"IfneedftofdrinkfcitratefoffmagnesiafthefnightfbeforeftheftestfandfgivefmyselffafFleetfenemafonfthefm
orningfofftheftest."f
,"Ifneedftoftakefaflaxativefafterftheftestfisfcompleted,fbecausefthefliquidfthatfI'llfhaveftofdrinkfforftheft
estfcanfbefconstipating."f-ffCORRECTfANSWERS-
"IfneedftofdrinkfcitratefoffmagnesiafthefnightfbeforeftheftestfandfgivefmyselffafFleetfenemafonfthefm
orningfofftheftest."f
Rationale:fNofspecialfpreparationfisfnecessaryfbeforefafGIfseries,fexceptfthatfNPOf(nothingfbyfmout
h)fstatusfmustfbefmaintainedfforf8fhoursfbeforeftheftest.fAnfupperfGIfseriesfinvolvesfvisualizationfoff
thefesophagus,fduodenum,fandfupperfjejunumfbyfmeansfoffthefusefoffafcontrastfmedium.fItfinvolve
sfswallowingfafcontrastfmediumf(usuallyfbarium),fwhichfisfadministeredfinfafflavoredfmilkshake.fFil
msfareftakenfatfintervalsfduringftheftest,fwhichftakesfaboutf30fminutes.fAfterfanfupperfGIfseries,fthef
clientfisfprescribedfaflaxativeftofhastenfeliminationfoffthefbarium.fBariumfthatfremainsfinfthefcolonf
mayfbecomefhardfandfdifficultftofexpel,fleadingftoffecalfimpaction.
Afnursefonfthefeveningfshiftfchecksfafprimaryfhealthfcarefprovider'sfprescriptionsfandfnotesfthatfth
efdosefoffafprescribedfmedicationfisfhigherfthanfthefnormalfdose.fThefnursefcallsfthefprimaryfhealth
fcarefprovider'sfansweringfservicefandfisftoldfthatfthefprimaryfhealthfcarefproviderfisfofffforfthefnigh
tfandfwillfbefavailablefinfthefmorning.fWhatfshouldfthefnursefdofnext?
Callfthefnursingfsupervisor
Askfthefansweringfserviceftofcontactfthefon-callfprimaryfhealthfcarefproviderf
Withholdfthefmedicationfuntilfthefprimaryfhealthfcarefproviderfcanfbefreachedfinfthefmorning
Administerfthefmedicationfbutfconsultfthefprimaryfhealthfcarefproviderfwhenfhefbecomesfavailabl
ef-ffCORRECTfANSWERS-Askfthefansweringfserviceftofcontactfthefon-
callfprimaryfhealthfcarefproviderf
Rationale:fThefnursefhasfafdutyftofprotectfthefclientffromfharm.fAfnursefwhofbelievesfthatfafprimary
fhealthfcarefprovider'sfprescriptionfmayfbefinferrorfisfresponsiblefforfclarifyingfthefprescriptionfbefo
refcarryingfitfout.fThereforefthefnursefwouldfnotfadministerfthefmedication;finstead,fthefnursefwou
ldfwithholdfthefmedicationfuntilfthefdosefcanfbefclarified.fThefnursefwouldfnotfwaitfuntilfthefnextfm
orningftofobtainfclarification.fItfisfprematureftofcallfthefnursingfsupervisor.
,Anfemergencyfdepartmentf(ED)fnursefisfmonitoringfafclientfwithfsuspectedfacutefmyocardialfinfarc
tionf(MI)fwhofisfawaitingftransferftofthefcoronaryfintensivefcarefunit.fThefnursefnotesfthefsuddenfo
nsetfoffprematurefventricularfcontractionsf(PVCs)fonfthefmonitor,fchecksfthefclient'sfcarotidfpulse,f
andfdeterminesfthatfthefPVCsfarefnotfperfusing.fWhatfisfthefnurse'sfmostfappropriatefaction?
Documentftheffindings
AskfthefEDfprimaryfhealthfcarefproviderftofcheckfthefclientf
Continueftofmonitorfthefclient'sfcardiacfstatus
InformfthefclientfthatfPVCsfarefexpectedfafterfanfMIf-ffCORRECTfANSWERS-
AskfthefEDfprimaryfhealthfcarefproviderftofcheckfthefclientf
Rationale:fThefmostfappropriatefactionfbyfthefnursefwouldfbeftofaskfthefEDfhealthfcarefproviderftof
checkfthefclient.fPVCsfarefafresultfoffincreasedfirritabilityfoffventricularfcells.fPeripheralfpulsesfmayf
befabsentforfdiminishedfwithfthefPVCsfthemselvesfbecausefthefdecreasedfstrokefvolumefoffthefpre
maturefbeatsfmayfinfturnfdecreasefperipheralfperfusion.fBecausefotherfrhythmsfalsofcausefwidene
dfQRSfcomplexes,fitfisfessentialfthatfthefnursefdeterminefwhetherfthefprematurefbeatsfarefresultin
gfinfperfusionfoffthefextremities.fThisfisfdonefbyfpalpatingfthefcarotid,fbrachial,forffemoralfarteryfwh
ilefobservingfthefmonitorfforfwidenedfcomplexesforfbyfauscultatingfforfapicalfheartfsounds.fInfthefsi
tuationfoffacutefMI,fPVCsfmayfbefconsideredfwarningfdysrhythmias,fpossiblyfheraldingfthefonsetfoff
ventricularftachycardiaforfventricularffibrillation.fTherefore,fthefnursefwouldfnotftellfthefclientfthatf
thefPVCsfarefexpected.fAlthoughfthefnursefwillfcontinueftofmonitorfthefclientfandfdocumentftheffin
dings,fthesefarefnotfthefmostfappropriatefactionsfoffthosefprovided.
NPOfstatusfisfimposedf8fhoursfbeforefthefprocedurefonfafclientfscheduledftofundergofelectroconvul
siveftherapyf(ECT)fatf1fp.m.fOnfthefmorningfoffthefprocedure,fthefnursefchecksfthefclient'sfrecordfa
ndfnotesfthatfthefclientfroutinelyftakesfanforalfantihypertensivefmedicationfeachfmorning.fWhatfac
tionfshouldfthefnurseftake?
Administerfthefantihypertensivefwithfafsmallfsipfoffwaterf
Withholdfthefantihypertensivefandfadministerfitfatfbedtime
Administerfthefmedicationfbyfwayfoffthefintravenousf(IV)froute
, HoldfthefantihypertensivefandfresumefitsfadministrationfonfthefdayfafterfthefECTf-
ffCORRECTfANSWERS-Administerfthefantihypertensivefwithfafsmallfsipfoffwaterf
Rationale:fThefnursefshouldfadministerfthefantihypertensivefwithfafsmallfsipfoffwater.fGeneralfanes
thesiafisfrequiredfforfECT,fsofNPOfstatusfisfimposedfforf6ftof8fhoursfbeforeftreatmentftofhelpfprevent
faspiration.fExceptionsfincludefclientsfwhofroutinelyfreceivefcardiacfmedications,fantihypertensivef
agents,forfhistaminef(H2)fblockers,fwhichfshouldfbefadministeredfseveralfhoursfbeforeftreatmentfw
ithfafsmallfsipfoffwater.fWithholdingfthefantihypertensivefandfadministeringfitfatfbedtimefandfwithh
oldingfthefantihypertensivefandfresumingfadministrationfonfthefdayfafterfthefECTfarefincorrectfacti
ons,fbecausefantihypertensivesfmustfbefadministeredfonftime;fotherwise,fthefriskfforfreboundfhyp
ertensionfexists.fThefnursefwouldfnotfadministerfafmedicationfbyfwayfoffafroutefthatfhasfnotfbeenfp
rescribed.
Afclientfwhofrecentlyfunderwentfcoronaryfarteryfbypassfgraftfsurgeryfcomesftofthefprimaryfhealthf
carefprovider'sfofficefforfaffollow-
upfvisit.fOnfassessment,fthefclientftellsfthefnursefthatfhefisffeelingfdepressed.fWhichfresponsefbyfth
efnursefisftherapeutic?
"Tellfmefmorefaboutfwhatfyou'reffeeling."f
"That'sfafnormalfresponsefafterfthisftypefoffsurgery."
"Itfwillftakeftime,fbutfIfpromisefyou,fyoufwillfgetfoverfthisfdepression."
"Everyfclientfwhofhasfthisfsurgeryffeelsfthefsamefwayfforfaboutfafmonth."f-ffCORRECTfANSWERS-
"Tellfmefmorefaboutfwhatfyou'reffeeling."f
Rationale:fTheftherapeuticfresponsefbyfthefnursefis,f"Tellfmefmorefaboutfwhatfyou'reffeeling."fWhe
nfafclientfexpressesffeelingsfoffdepression,fitfisfextremelyfimportantfforfthefnurseftoffurtherfexploref
theseffeelingsfwithfthefclient.fInfstating,f"Thisfisfafnormalfresponsefafterfthisftypefoffsurgery"fthefnu
rsefprovidesffalsefreassurancefandfavoidsfaddressingfthefclient'sffeelings.f"Itfwillftakeftime,fbutfIfpro
misefyou,fyoufwillfgetfoverfthefdepression"fisfalsofaffalsefreassurance,fandfitfdoesfnotfencouragefthe
fexpressionfofffeelings.f"Everyfclientfwhofhasfthisfsurgeryffeelsfthefsamefwayfforfaboutfafmonth"fisfaf
generalizationfthatfavoidsfthefclient'sffeelings.
