HESI CAT

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Sample questions from HESI CAT

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

1. 1.At change of shift on a medical-surgical unit, the nurse receives report on four clients. Which client should the nurse assess first?

   • A.A 73-year-old client with diabetes whose glucose is 62 mg/dL and who is awake, follows commands, and can swallow
   • B.A 39-year-old client receiving a heparin infusion whose aPTT is 78 seconds with no bleeding and a target range of 60 to 80 seconds
   • C.A 54-year-old client 6 hours after thyroidectomy who reports new throat tightness and has an audible high-pitched sound on inspiration
   • D.A 68-year-old client with heart failure who gained 1 kg in 24 hours and has an SpO2 of 93% on the usual 2 L/min nasal cannula

   Rationale: New throat tightness and inspiratory stridor after thyroidectomy suggest rapidly developing airway obstruction from swelling or a hematoma, so this client needs immediate assessment and intervention. The heart failure client has a concerning weight gain but is oxygenating on the baseline support; the awake client with hypoglycemia can receive prompt oral glucose after the airway threat is addressed. The heparin result is within the stated target range and there is no bleeding. Prioritize an emerging threat to airway over stable, treatable, or expected findings.

2. 2.During a home visit, a community health nurse finds a 7-month-old infant with a temperature of 38.1 C, a respiratory rate of 42/min, and mild nasal congestion. The caregiver reports difficulty obtaining the prescribed antibiotic and asks the nurse to give the infant leftover medication from an older sibling. Which action should the nurse take?

   • A.Calculate a dose of the sibling's antibiotic based on the infant's current weight and give it with the caregiver's consent
   • B.Advise the caregiver to wait 48 hours because a mild fever and congestion are expected in infants
   • C.Ask the caregiver to bring the infant to the clinic only if the temperature reaches 40 C
   • D.Assess the infant's hydration and respiratory effort, then contact the prescriber and social services to address treatment access

   Rationale: The nurse should assess the infant's current condition and promptly coordinate with the prescriber and appropriate community resources so the prescribed treatment can be obtained safely. A sibling's medication may be the wrong drug, concentration, or duration, and the nurse should not independently calculate and administer it. Waiting without assessment risks missing deterioration, while a temperature threshold of 40 C is not an appropriate sole trigger for follow-up. Safe care includes addressing barriers to treatment without substituting an unprescribed medication.

3. 3.Refer to the client's chart. A 44-year-old client is receiving an unfractionated heparin infusion for a pulmonary embolism. Which actions should the nurse take based on the chart? Select all that apply.

   • A.Administer the next scheduled warfarin dose without consulting the prescriber
   • B.Verify the infusion rate and follow the facility's heparin protocol while obtaining instructions
   • C.Assess the client for additional bleeding, including neurologic changes and occult blood
   • D.Pause the heparin infusion and notify the prescriber about the new bleeding findings and markedly prolonged aPTT
   • E.Ask the assistive personnel to repeat the aPTT and decide whether the infusion should be restarted
   • F.Document the findings and reassess at the next routine vital-sign check without changing the infusion

   Rationale: The aPTT has risen from 68 seconds to 112 seconds, above the stated therapeutic range, and the new gingival bleeding and bruising require prompt action: pause the infusion according to protocol, assess for further bleeding, and contact the prescriber. Assistive personnel may not interpret results or make infusion decisions, and a warfarin dose should not be given without review of the active bleeding and anticoagulation plan. Simply documenting and waiting would delay response to a potentially serious adverse effect. For high-alert anticoagulants, verify the infusion and use the established protocol while escalating abnormal findings.

4. 4.In a school-based clinic, a 9-year-old child with asthma has audible wheezing, speaks in short phrases, and has an SpO2 of 91% after running during recess. The school nurse is managing another child with a minor ankle sprain. Which action is appropriate to delegate to the unlicensed assistive personnel?

   • A.Assess the child's breath sounds and decide whether the prescribed rescue inhaler is effective
   • B.Stay with the child and immediately report any worsening breathing while the nurse assesses the child
   • C.Teach the child how to use a spacer and identify signs that require emergency care
   • D.Administer the child's prescribed rescue inhaler and document the response

   Answer and rationale are in the full material.

5. 5.The provider prescribes magnesium sulfate for a 31-year-old client at 32 weeks of pregnancy with severe preeclampsia. Before starting the infusion, the nurse notes a respiratory rate of 10/min, patellar reflexes of 1+, and urine output of 20 mL/hr over the last 2 hours. What is the nurse's best action?

   • A.Hold the infusion and notify the provider of the respiratory rate, reflexes, and low urine output
   • B.Begin the prescribed loading dose and reassess the reflexes in 30 minutes
   • C.Administer the prescribed antihypertensive first and start magnesium sulfate after the blood pressure decreases
   • D.Ask the client to increase oral fluids, then begin the infusion when urine output improves

   Answer and rationale are in the full material.