HESI CAT Exit Exam 2026 | 200 Practice
Questions & Verified Answers |
Comprehensive HESI RN Exit Exam Study
Guide
HESI CAT Exit Exam 2026 | 200 Practice Questions & Verified Answers |
Comprehensive HESI RN Exit Exam Study Guide
• This comprehensive exam contains 200 high-yield questions mirroring actual HESI
Exit Exam content with verified answers and detailed rationales to enhance
understanding and retention.
• Study this material by reviewing each rationale thoroughly, focusing on weak
areas, and completing timed practice sections to build confidence and test-taking
speed for licensure success.
SECTION 1: MEDICAL-SURGICAL NURSING
Question 1: A client with acute myocardial infarction (AMI) reports chest pain
unrelieved by nitroglycerin. Which nursing action is the priority?
A) Administer morphine intravenously as prescribed
B) Obtain a 12-lead electrocardiogram (ECG) immediately
C) Place the client in semi-Fowler's position
D) Continue monitoring vital signs every 15 minutes
E) Notify the charge nurse of the unrelieved pain
CORRECT ANSWER: B ✓
The 12-lead ECG must be obtained immediately to determine if the client is
experiencing ongoing myocardial injury or extension of the infarction. This
diagnostic information is essential for treatment decisions. While morphine
administration is appropriate, obtaining the ECG is the priority action to guide
clinical decisions. All other actions are supportive but do not address the acute
diagnostic need.
,Question 2: A client receiving continuous heparin infusion develops heparin-
induced thrombocytopenia (HIT). Which medication should the nurse
anticipate will be prescribed to replace heparin?
A) Warfarin (Coumadin)
B) Argatroban (Acova)
C) Aspirin
D) Clopidogrel (Plavix)
E) Enoxaparin (Lovenox)
CORRECT ANSWER: B ✓
Argatroban is a direct thrombin inhibitor specifically indicated for clients with HIT
who require anticoagulation. It does not cross-react with heparin antibodies.
Warfarin is not suitable for acute anticoagulation. Enoxaparin is a low-molecular-
weight heparin and is contraindicated in HIT due to cross-reactivity. Aspirin and
clopidogrel are antiplatelet agents, not suitable replacements for anticoagulation
therapy.
Question 3: A client with sepsis has a lactate level of 4 mmol/L and is
prescribed fluid resuscitation. What is the primary goal of early fluid
administration in sepsis?
A) To decrease lactate levels and restore tissue perfusion
B) To increase blood pressure to at least 120/80 mmHg
C) To dilute bacterial endotoxins in the bloodstream
D) To promote diuresis and kidney function
E) To reduce core body temperature
CORRECT ANSWER: A ✓
The primary goal of fluid resuscitation in sepsis is to restore circulating volume and
tissue perfusion, which decreases lactate accumulation from anaerobic
,metabolism. Elevated lactate indicates tissue hypoxia. While blood pressure
management is important, the underlying goal is restoring perfusion. Diluting
endotoxins, promoting diuresis, and reducing temperature are not the primary
goals of fluid resuscitation in sepsis management.
Question 4: A client with chronic obstructive pulmonary disease (COPD) has a
respiratory rate of 28 breaths/minute and is using accessory muscles. Which
intervention is most appropriate?
A) Administer high-flow oxygen at 6 L/minute
B) Place the client in semi-Fowler's position and administer bronchodilators
C) Apply a non-rebreather mask immediately
D) Prepare for endotracheal intubation
E) Restrict fluid intake to decrease secretions
CORRECT ANSWER: B ✓
Semi-Fowler's position promotes optimal lung expansion and diaphragmatic
excursion. Bronchodilators help relieve airway obstruction and reduce the work of
breathing. This addresses the respiratory distress appropriately. High-flow oxygen
can suppress the hypoxic drive in COPD clients. A non-rebreather mask is excessive
initially. Intubation is not indicated at this stage. Fluid restriction is inappropriate
and can lead to secretion thickening.
Question 5: A client with heart failure receives furosemide 40 mg IV push. The
nurse should monitor for which priority electrolyte imbalance?
A) Hyperkalemia
B) Hypernatremia
C) Hypokalemia
D) Hypercalcemia
, E) Hypermagnesemia
CORRECT ANSWER: C ✓
Loop diuretics like furosemide cause significant potassium wasting through
increased urinary excretion. Hypokalemia is a serious complication that can lead to
cardiac arrhythmias, especially in heart failure clients. This is the priority monitoring
concern. Hyperkalemia, hypernatremia, hypercalcemia, and hypermagnesemia are
not typical consequences of loop diuretic use.
Question 6: A client with type 2 diabetes has a blood glucose of 385 mg/dL and
reports blurred vision and fatigue. Which condition should the nurse suspect?
A) Hypoglycemia
B) Hyperglycemic hyperosmolar state (HHS)
C) Diabetic ketoacidosis (DKA)
D) Somogyi phenomenon
E) Dawn phenomenon
CORRECT ANSWER: B ✓
The client presents with severe hyperglycemia (385 mg/dL), blurred vision (osmotic
effects on lens), and fatigue consistent with hyperglycemic hyperosmolar state.
Type 2 diabetics typically develop HHS rather than DKA because they retain some
insulin production. DKA occurs more commonly in type 1 diabetes with severe
metabolic acidosis. Somogyi phenomenon and dawn phenomenon involve different
glucose patterns and are not acute crises.
Question 7: A client with acute pancreatitis reports severe epigastric pain.
Which position should the nurse encourage?
A) Supine with legs extended
B) Prone position
Questions & Verified Answers |
Comprehensive HESI RN Exit Exam Study
Guide
HESI CAT Exit Exam 2026 | 200 Practice Questions & Verified Answers |
Comprehensive HESI RN Exit Exam Study Guide
• This comprehensive exam contains 200 high-yield questions mirroring actual HESI
Exit Exam content with verified answers and detailed rationales to enhance
understanding and retention.
• Study this material by reviewing each rationale thoroughly, focusing on weak
areas, and completing timed practice sections to build confidence and test-taking
speed for licensure success.
SECTION 1: MEDICAL-SURGICAL NURSING
Question 1: A client with acute myocardial infarction (AMI) reports chest pain
unrelieved by nitroglycerin. Which nursing action is the priority?
A) Administer morphine intravenously as prescribed
B) Obtain a 12-lead electrocardiogram (ECG) immediately
C) Place the client in semi-Fowler's position
D) Continue monitoring vital signs every 15 minutes
E) Notify the charge nurse of the unrelieved pain
CORRECT ANSWER: B ✓
The 12-lead ECG must be obtained immediately to determine if the client is
experiencing ongoing myocardial injury or extension of the infarction. This
diagnostic information is essential for treatment decisions. While morphine
administration is appropriate, obtaining the ECG is the priority action to guide
clinical decisions. All other actions are supportive but do not address the acute
diagnostic need.
,Question 2: A client receiving continuous heparin infusion develops heparin-
induced thrombocytopenia (HIT). Which medication should the nurse
anticipate will be prescribed to replace heparin?
A) Warfarin (Coumadin)
B) Argatroban (Acova)
C) Aspirin
D) Clopidogrel (Plavix)
E) Enoxaparin (Lovenox)
CORRECT ANSWER: B ✓
Argatroban is a direct thrombin inhibitor specifically indicated for clients with HIT
who require anticoagulation. It does not cross-react with heparin antibodies.
Warfarin is not suitable for acute anticoagulation. Enoxaparin is a low-molecular-
weight heparin and is contraindicated in HIT due to cross-reactivity. Aspirin and
clopidogrel are antiplatelet agents, not suitable replacements for anticoagulation
therapy.
Question 3: A client with sepsis has a lactate level of 4 mmol/L and is
prescribed fluid resuscitation. What is the primary goal of early fluid
administration in sepsis?
A) To decrease lactate levels and restore tissue perfusion
B) To increase blood pressure to at least 120/80 mmHg
C) To dilute bacterial endotoxins in the bloodstream
D) To promote diuresis and kidney function
E) To reduce core body temperature
CORRECT ANSWER: A ✓
The primary goal of fluid resuscitation in sepsis is to restore circulating volume and
tissue perfusion, which decreases lactate accumulation from anaerobic
,metabolism. Elevated lactate indicates tissue hypoxia. While blood pressure
management is important, the underlying goal is restoring perfusion. Diluting
endotoxins, promoting diuresis, and reducing temperature are not the primary
goals of fluid resuscitation in sepsis management.
Question 4: A client with chronic obstructive pulmonary disease (COPD) has a
respiratory rate of 28 breaths/minute and is using accessory muscles. Which
intervention is most appropriate?
A) Administer high-flow oxygen at 6 L/minute
B) Place the client in semi-Fowler's position and administer bronchodilators
C) Apply a non-rebreather mask immediately
D) Prepare for endotracheal intubation
E) Restrict fluid intake to decrease secretions
CORRECT ANSWER: B ✓
Semi-Fowler's position promotes optimal lung expansion and diaphragmatic
excursion. Bronchodilators help relieve airway obstruction and reduce the work of
breathing. This addresses the respiratory distress appropriately. High-flow oxygen
can suppress the hypoxic drive in COPD clients. A non-rebreather mask is excessive
initially. Intubation is not indicated at this stage. Fluid restriction is inappropriate
and can lead to secretion thickening.
Question 5: A client with heart failure receives furosemide 40 mg IV push. The
nurse should monitor for which priority electrolyte imbalance?
A) Hyperkalemia
B) Hypernatremia
C) Hypokalemia
D) Hypercalcemia
, E) Hypermagnesemia
CORRECT ANSWER: C ✓
Loop diuretics like furosemide cause significant potassium wasting through
increased urinary excretion. Hypokalemia is a serious complication that can lead to
cardiac arrhythmias, especially in heart failure clients. This is the priority monitoring
concern. Hyperkalemia, hypernatremia, hypercalcemia, and hypermagnesemia are
not typical consequences of loop diuretic use.
Question 6: A client with type 2 diabetes has a blood glucose of 385 mg/dL and
reports blurred vision and fatigue. Which condition should the nurse suspect?
A) Hypoglycemia
B) Hyperglycemic hyperosmolar state (HHS)
C) Diabetic ketoacidosis (DKA)
D) Somogyi phenomenon
E) Dawn phenomenon
CORRECT ANSWER: B ✓
The client presents with severe hyperglycemia (385 mg/dL), blurred vision (osmotic
effects on lens), and fatigue consistent with hyperglycemic hyperosmolar state.
Type 2 diabetics typically develop HHS rather than DKA because they retain some
insulin production. DKA occurs more commonly in type 1 diabetes with severe
metabolic acidosis. Somogyi phenomenon and dawn phenomenon involve different
glucose patterns and are not acute crises.
Question 7: A client with acute pancreatitis reports severe epigastric pain.
Which position should the nurse encourage?
A) Supine with legs extended
B) Prone position
