HESI comprehensive HESI RN Practice Exam C0MBINATION EXAMINATION 2025 – 2026
WITH QUESTIONS WITH CORRECT ANSWERS VERIFIED 100% GRADED A+
HESI comprehensive
A nurse taking the vital signs of a client immediately after she has delivered a
newborn notes that the client's heart rate is 110 beats/min. What should the
nurse do first?
Recheck the heart rate in 1 hour
Offer the client oral fluids
Check the uterus and amount of lochia discharge Correct
Document the findings
If tachycardia is noted, the nurse should first assess the location and firmness of the
uterus and amount of lochia. Additional assessments including blood pressure,
estimated blood loss at delivery, and hemoglobin and hematocrit determinations
should be carried out. After delivery, the normal heart rate ranges from 60 to 90
beats/min. Tachycardia may indicate excitement, fatigue, dehydration, hypovolemia,
pain, or infection. Although the nurse would document the findings, it is most
appropriate for the nurse to assess the client to determine the cause of the
tachycardia. Oral fluids are important if the client is dehydrated, but further
assessment of the problem is required and dehydration would first need to be
confirmed. Rechecking the heart rate in 1 hour will delay necessary interventions.
A nurse reviews the laboratory results of a hospitalized pregnant client with a
diagnosis of sepsis who is at risk for disseminated intravascular coagulopathy
(DIC). Which laboratory finding would indicate to the nurse that DIC has
developed in the client?
Shortened prothrombin time
Increased platelet count
Positive result on d-dimer study Correct
Decreased fibrin-degradation products
The d-dimer study is used to confirm the presence of fibrin split products; a positive
result is indicative of DIC. DIC is a life-threatening defect in coagulation. As plasma
factors are consumed, the circulating blood becomes deficient in clotting factors and
unable to clot. Even as anticoagulation is occurring, inappropriate coagulation is also
taking place in the microcirculation, and tiny clots form in the smallest blood vessels,
blocking blood flow to the organs and causing ischemia. Laboratory studies help
establish a diagnosis. The fibrinogen value and platelet count are usually decreased,
prothrombin and activated partial thromboplastin times may be prolonged, and levels
of fibrin degradation products (the most sensitive measurement) are increased.
The nurse is assessing a client who has a history of Prinzmetal's angina. The
nurse knows that what type of medication is given to treat this condition?
Calcium channel blockers Correct
ACE inhibitors
,Inotropes
Beta blockers
Prinzmetal's, or variant, angina is prolonged and severe and occurs at the same time
each day, most often at rest. The treatment of choice is usually a calcium channel
blocker. Calcium channel blockers relax and dilate the vascular smooth muscle, thus
relieving the coronary artery spasm in variant angina. Inotropes, beta blockers, and
angiotensin-converting enzyme (ACE) inhibitors are not given to treat this disorder.
Ciprofloxacin hydrochloride is prescribed to a client with a urinary tract
infection. The nurse provides instruction about the medication. What does the
nurse tell the client about how best to take the medication?
With aluminum hydroxide
With an antacid
With milk
2 hours after meals Correct
Ciprofloxacin hydrochloride is an anti-infective in the fluoroquinolone family. It may
be taken without regard to meals, but the best dosing time is 2 hours after a meal.
Milk may affect absorption. Antacids (here, aluminum hydroxide) may reduce
absorption and should be administered 2 hours apart from the ciprofloxacin
hydrochloride.
Ergotamine is prescribed to a client with cluster headaches. Which occurrence
does the nurse tell the client to report to the primary health care provider if she
experiences them while taking the medication?
Fatigue and lethargy
Dizziness and fatigue
Numbness and tingling of the fingers or toes Correct
Cough
Ergotamine is an antimigraine medication. Prolonged administration or an excessive
dosage may produce ergotamine poisoning (ergotism). Signs/symptoms include
nausea, vomiting, weakness in the legs, pain in the limb muscles, and numbness
and tingling of the fingers and toes. The client is instructed to report these
signs/symptoms to the primary health care provider if they occur. Cough, fatigue,
lethargy, and dizziness are side effects and not adverse effects of the medication.
A nurse working the evening shift is helping clients get ready for sleep. A
female client diagnosed with mania is hyperactive and pacing the hallway.
What is the most appropriate action the nurse can take?
Tell the client that other clients are trying to sleep and that she is being
disruptive
Take the client to the bathroom and provide her with a warm bath Correct
Stay with the client and observe her behavior
Tell the client that it is time for sleep and that she needs to go to her room
At bedtime, the nurse should take the client to the bathroom and provide warm
baths, soothing music, and medication when indicated. For the client with mania, the
nurse needs to promote relaxation, rest, and sleep and to minimize manic behavior.
The nurse should encourage frequent rest periods during the day and keep the client
in areas of low stimulation. The client should not consume products containing
caffeine. Staying with the client and observing her behavior, telling the client that it is
time to go to sleep and to go to her room, and telling the client that other clients are
trying to sleep and that she is being disruptive do not address the client's needs and
are not measures that will help the client relax and sleep.
,A client diagnosed with type 1 diabetes mellitus has just been told that she is 6
weeks pregnant. The nurse provides information to the client about dietary
and insulin needs. What comment by the client suggests an understanding of
the information?
"I know I will have to increase my insulin during this time period."
"My insulin needs should decrease during the first trimester." Correct
"Needs for insulin will not change during the first 3 months of pregnancy."
"I will have to double up on the insulin dose during this time span."
Insulin needs generally decrease during the first trimester of pregnancy because the
secretion of placental hormones antagonistic to insulin remains low. An increase in
insulin need, lack of change in insulin need, and doubling of insulin need are all
incorrect.
A nurse develops a list of home care instructions for a client who is wearing a
halo fixation device after sustaining a cervical fracture. Which instructions
should the nurse include? Select all that apply.
Do not drive, because full range of vision is impaired with the device. Correct
Avoid sexual activity while the vest is in place.
Apply powder under the vest to prevent irritation.
Wear snug clothing to prevent the device from shifting.
Use caution when leaning forward or backward. Correct
Use a straw to drink. Correct
Straws are used to drink, and meat and other foods are cut into small pieces to
facilitate swallowing. The weight of the halo device alters balance; therefore the
client should use caution when leaning forward or backward. The client is also told
not to drive, because full range of vision is impaired with the device. A halo fixation
(stabilization) device is used to prevent the head and neck from moving after a neck
injury. The halo fixation device is not removed. Sexual activity does not have to be
avoided; the client is instructed to use a position of comfort. Powders and lotions are
used sparingly or not at all to prevent buildup of moisture and subsequent skin
breakdown. The client is instructed to wear loose clothing with a large neck. The halo
fixation device should not shift; if it does, the primary health care provider must be
notified. The client is taught to sleep with the head supported with a small pillow to
prevent unnecessary pressure and discomfort.
Empyema develops in a client with an infected pleural effusion, and the nurse
prepares the client for thoracentesis. The nurse is assisting the primary health
care provider with the procedure. What characteristics of the fluid removed
during thoracentesis should the nurse expect to note?
Clear and yellow
Thick and opaque Correct
Clear, with a foul odor
White and odorless
Empyema is the accumulation of pus in the pleural space. Empyema fluid is thick,
opaque, exudative, and intensely foul-smelling. Clear and yellow, white and
odorless, and clear and foul-smelling are incorrect descriptions of the fluid that
occurs in this disorder.
A client who was involved in a high-speed motor vehicle crash is brought to
the emergency department. Which finding indicates to the nurse that the client
has sustained a flail chest?
Asymmetrical chest movement Correct
Increased breath sounds on auscultation
, Deep respirations, 18 breaths/min
Complaints of mild chest discomfort
The nurse specifically notes paradoxical breathing (asymmetrical chest movement);
oscillation of the mediastinum; increasing dyspnea; rapid, shallow respirations;
accessory muscle breathing; restlessness; decreased breath sounds on
auscultation; cyanosis; and anxiety related to difficulty breathing. The client will also
complain of severe chest pain. Flail chest is a thoracic injury resulting in paradoxical
motion of the chest-wall segment. This causes the mediastinal structures to swing
back and forth with respiration.
A nurse is preparing a pregnant client in the third trimester for an
amniocentesis. What does the nurse tell the client is the reason amniocentesis
is often performed during the third trimester?
To establish an accurate age for the fetus
To assess the degree of fetal lung maturity Correct
To discover genetic characteristics
To know the sex of the fetus
Amniocentesis is the aspiration of fluid from the amniotic sac for examination.
Common indications for amniocentesis during the third trimester include assessment
of fetal lung maturity and evaluation of fetal condition when the woman has Rh
isoimmunization. A common purpose of amniocentesis in the second trimester is to
examine fetal cells in the amniotic fluid to identify chromosomal abnormalities. Other
methods of genetic analysis, such as those for metabolic defects in the fetus, may be
performed on the cells as well. The sex and age of the fetus are not determined with
the use of amniocentesis.
A nurse is caring for a client with sarcoidosis. The client is upset because he
has missed work and worried about how he will care financially for his wife
and three small children. On the basis of the client's concern, which problem
does the nurse identify?
Powerlessness
Disruption of thought processes
Anxiety Correct
Inability to maintain health
Anxiety is a vague, uneasy feeling of apprehension. Some related factors include a
threat or perceived threat to physical or emotional integrity or self-concept, changes
in function in one's role, and threats to or changes in socioeconomic status. The
client experiencing powerlessness expresses feelings of having no control over a
situation or outcome. Disruption of thought processes involves disturbance of
cognitive abilities or thought. Inability to maintain health is being incapable of seeking
out help needed to maintain health.
A nurse is caring for a client with open-angle glaucoma. The nurse knows that
what agents are used to treat this condition?
Myotic agents Correct
Anticholinergic agents
Mydriatric agents
Cycloplegic agents
Miotic agents are used to treat glaucoma. Mydriatic medications dilate the pupil and
can cause an increase in intraocular pressure in the eye. Besides mydriatic agents,
cycloplegic and anticholinergic agents are contraindicated in clients with glaucoma.
A client with acute gouty arthritis is being started on medication therapy with
indomethacin. The nurse provides medication instructions to the client. How
WITH QUESTIONS WITH CORRECT ANSWERS VERIFIED 100% GRADED A+
HESI comprehensive
A nurse taking the vital signs of a client immediately after she has delivered a
newborn notes that the client's heart rate is 110 beats/min. What should the
nurse do first?
Recheck the heart rate in 1 hour
Offer the client oral fluids
Check the uterus and amount of lochia discharge Correct
Document the findings
If tachycardia is noted, the nurse should first assess the location and firmness of the
uterus and amount of lochia. Additional assessments including blood pressure,
estimated blood loss at delivery, and hemoglobin and hematocrit determinations
should be carried out. After delivery, the normal heart rate ranges from 60 to 90
beats/min. Tachycardia may indicate excitement, fatigue, dehydration, hypovolemia,
pain, or infection. Although the nurse would document the findings, it is most
appropriate for the nurse to assess the client to determine the cause of the
tachycardia. Oral fluids are important if the client is dehydrated, but further
assessment of the problem is required and dehydration would first need to be
confirmed. Rechecking the heart rate in 1 hour will delay necessary interventions.
A nurse reviews the laboratory results of a hospitalized pregnant client with a
diagnosis of sepsis who is at risk for disseminated intravascular coagulopathy
(DIC). Which laboratory finding would indicate to the nurse that DIC has
developed in the client?
Shortened prothrombin time
Increased platelet count
Positive result on d-dimer study Correct
Decreased fibrin-degradation products
The d-dimer study is used to confirm the presence of fibrin split products; a positive
result is indicative of DIC. DIC is a life-threatening defect in coagulation. As plasma
factors are consumed, the circulating blood becomes deficient in clotting factors and
unable to clot. Even as anticoagulation is occurring, inappropriate coagulation is also
taking place in the microcirculation, and tiny clots form in the smallest blood vessels,
blocking blood flow to the organs and causing ischemia. Laboratory studies help
establish a diagnosis. The fibrinogen value and platelet count are usually decreased,
prothrombin and activated partial thromboplastin times may be prolonged, and levels
of fibrin degradation products (the most sensitive measurement) are increased.
The nurse is assessing a client who has a history of Prinzmetal's angina. The
nurse knows that what type of medication is given to treat this condition?
Calcium channel blockers Correct
ACE inhibitors
,Inotropes
Beta blockers
Prinzmetal's, or variant, angina is prolonged and severe and occurs at the same time
each day, most often at rest. The treatment of choice is usually a calcium channel
blocker. Calcium channel blockers relax and dilate the vascular smooth muscle, thus
relieving the coronary artery spasm in variant angina. Inotropes, beta blockers, and
angiotensin-converting enzyme (ACE) inhibitors are not given to treat this disorder.
Ciprofloxacin hydrochloride is prescribed to a client with a urinary tract
infection. The nurse provides instruction about the medication. What does the
nurse tell the client about how best to take the medication?
With aluminum hydroxide
With an antacid
With milk
2 hours after meals Correct
Ciprofloxacin hydrochloride is an anti-infective in the fluoroquinolone family. It may
be taken without regard to meals, but the best dosing time is 2 hours after a meal.
Milk may affect absorption. Antacids (here, aluminum hydroxide) may reduce
absorption and should be administered 2 hours apart from the ciprofloxacin
hydrochloride.
Ergotamine is prescribed to a client with cluster headaches. Which occurrence
does the nurse tell the client to report to the primary health care provider if she
experiences them while taking the medication?
Fatigue and lethargy
Dizziness and fatigue
Numbness and tingling of the fingers or toes Correct
Cough
Ergotamine is an antimigraine medication. Prolonged administration or an excessive
dosage may produce ergotamine poisoning (ergotism). Signs/symptoms include
nausea, vomiting, weakness in the legs, pain in the limb muscles, and numbness
and tingling of the fingers and toes. The client is instructed to report these
signs/symptoms to the primary health care provider if they occur. Cough, fatigue,
lethargy, and dizziness are side effects and not adverse effects of the medication.
A nurse working the evening shift is helping clients get ready for sleep. A
female client diagnosed with mania is hyperactive and pacing the hallway.
What is the most appropriate action the nurse can take?
Tell the client that other clients are trying to sleep and that she is being
disruptive
Take the client to the bathroom and provide her with a warm bath Correct
Stay with the client and observe her behavior
Tell the client that it is time for sleep and that she needs to go to her room
At bedtime, the nurse should take the client to the bathroom and provide warm
baths, soothing music, and medication when indicated. For the client with mania, the
nurse needs to promote relaxation, rest, and sleep and to minimize manic behavior.
The nurse should encourage frequent rest periods during the day and keep the client
in areas of low stimulation. The client should not consume products containing
caffeine. Staying with the client and observing her behavior, telling the client that it is
time to go to sleep and to go to her room, and telling the client that other clients are
trying to sleep and that she is being disruptive do not address the client's needs and
are not measures that will help the client relax and sleep.
,A client diagnosed with type 1 diabetes mellitus has just been told that she is 6
weeks pregnant. The nurse provides information to the client about dietary
and insulin needs. What comment by the client suggests an understanding of
the information?
"I know I will have to increase my insulin during this time period."
"My insulin needs should decrease during the first trimester." Correct
"Needs for insulin will not change during the first 3 months of pregnancy."
"I will have to double up on the insulin dose during this time span."
Insulin needs generally decrease during the first trimester of pregnancy because the
secretion of placental hormones antagonistic to insulin remains low. An increase in
insulin need, lack of change in insulin need, and doubling of insulin need are all
incorrect.
A nurse develops a list of home care instructions for a client who is wearing a
halo fixation device after sustaining a cervical fracture. Which instructions
should the nurse include? Select all that apply.
Do not drive, because full range of vision is impaired with the device. Correct
Avoid sexual activity while the vest is in place.
Apply powder under the vest to prevent irritation.
Wear snug clothing to prevent the device from shifting.
Use caution when leaning forward or backward. Correct
Use a straw to drink. Correct
Straws are used to drink, and meat and other foods are cut into small pieces to
facilitate swallowing. The weight of the halo device alters balance; therefore the
client should use caution when leaning forward or backward. The client is also told
not to drive, because full range of vision is impaired with the device. A halo fixation
(stabilization) device is used to prevent the head and neck from moving after a neck
injury. The halo fixation device is not removed. Sexual activity does not have to be
avoided; the client is instructed to use a position of comfort. Powders and lotions are
used sparingly or not at all to prevent buildup of moisture and subsequent skin
breakdown. The client is instructed to wear loose clothing with a large neck. The halo
fixation device should not shift; if it does, the primary health care provider must be
notified. The client is taught to sleep with the head supported with a small pillow to
prevent unnecessary pressure and discomfort.
Empyema develops in a client with an infected pleural effusion, and the nurse
prepares the client for thoracentesis. The nurse is assisting the primary health
care provider with the procedure. What characteristics of the fluid removed
during thoracentesis should the nurse expect to note?
Clear and yellow
Thick and opaque Correct
Clear, with a foul odor
White and odorless
Empyema is the accumulation of pus in the pleural space. Empyema fluid is thick,
opaque, exudative, and intensely foul-smelling. Clear and yellow, white and
odorless, and clear and foul-smelling are incorrect descriptions of the fluid that
occurs in this disorder.
A client who was involved in a high-speed motor vehicle crash is brought to
the emergency department. Which finding indicates to the nurse that the client
has sustained a flail chest?
Asymmetrical chest movement Correct
Increased breath sounds on auscultation
, Deep respirations, 18 breaths/min
Complaints of mild chest discomfort
The nurse specifically notes paradoxical breathing (asymmetrical chest movement);
oscillation of the mediastinum; increasing dyspnea; rapid, shallow respirations;
accessory muscle breathing; restlessness; decreased breath sounds on
auscultation; cyanosis; and anxiety related to difficulty breathing. The client will also
complain of severe chest pain. Flail chest is a thoracic injury resulting in paradoxical
motion of the chest-wall segment. This causes the mediastinal structures to swing
back and forth with respiration.
A nurse is preparing a pregnant client in the third trimester for an
amniocentesis. What does the nurse tell the client is the reason amniocentesis
is often performed during the third trimester?
To establish an accurate age for the fetus
To assess the degree of fetal lung maturity Correct
To discover genetic characteristics
To know the sex of the fetus
Amniocentesis is the aspiration of fluid from the amniotic sac for examination.
Common indications for amniocentesis during the third trimester include assessment
of fetal lung maturity and evaluation of fetal condition when the woman has Rh
isoimmunization. A common purpose of amniocentesis in the second trimester is to
examine fetal cells in the amniotic fluid to identify chromosomal abnormalities. Other
methods of genetic analysis, such as those for metabolic defects in the fetus, may be
performed on the cells as well. The sex and age of the fetus are not determined with
the use of amniocentesis.
A nurse is caring for a client with sarcoidosis. The client is upset because he
has missed work and worried about how he will care financially for his wife
and three small children. On the basis of the client's concern, which problem
does the nurse identify?
Powerlessness
Disruption of thought processes
Anxiety Correct
Inability to maintain health
Anxiety is a vague, uneasy feeling of apprehension. Some related factors include a
threat or perceived threat to physical or emotional integrity or self-concept, changes
in function in one's role, and threats to or changes in socioeconomic status. The
client experiencing powerlessness expresses feelings of having no control over a
situation or outcome. Disruption of thought processes involves disturbance of
cognitive abilities or thought. Inability to maintain health is being incapable of seeking
out help needed to maintain health.
A nurse is caring for a client with open-angle glaucoma. The nurse knows that
what agents are used to treat this condition?
Myotic agents Correct
Anticholinergic agents
Mydriatric agents
Cycloplegic agents
Miotic agents are used to treat glaucoma. Mydriatic medications dilate the pupil and
can cause an increase in intraocular pressure in the eye. Besides mydriatic agents,
cycloplegic and anticholinergic agents are contraindicated in clients with glaucoma.
A client with acute gouty arthritis is being started on medication therapy with
indomethacin. The nurse provides medication instructions to the client. How
