,HESI CAT Exit Exam | Comprehensive Nursing (2026)
Q&A
1. An adult client who is 2 days post-operative following abdominal surgery has a nasogastric
(NG) tube attached to low intermittent suction. Which assessment finding should the nurse
report to the healthcare provider immediately?
A) NG tube output of 400 mL in the past 8 hours
B) Complaints of a dry mouth and sore throat
C) Abdominal distention with absent bowel sounds
D) Intermittent bubbling in the suction control chamber
Correct Answer: Abdominal distention with absent bowel sounds
Rationale: Abdominal distention with absent bowel sounds indicates a potential paralytic
ileus or bowel obstruction, which are serious complications requiring immediate
intervention. The other findings are expected: 400 mL output is normal for NG suction, dry
mouth and sore throat are common, and intermittent bubbling indicates proper suction
function.
2. The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who
has a prescription for 2 L/min of oxygen via nasal cannula. Which assessment finding
indicates that the oxygen therapy is effective?
A) Respiratory rate of 28 breaths per minute
B) Oxygen saturation of 92% on pulse oximetry
C) Use of accessory muscles to breathe
D) PaCO2 level of 58 mm Hg on arterial blood gas
Correct Answer: Oxygen saturation of 92% on pulse oximetry
,Rationale: An oxygen saturation of 92% indicates adequate oxygenation for a client with
COPD, who often has a lower baseline SpO2 target (88-92%) due to hypoxic drive. A
respiratory rate of 28, use of accessory muscles, and elevated PaCO2 suggest respiratory
distress or failure, not effectiveness.
3. Which of the following clinical manifestations is the earliest sign of increased intracranial
pressure (ICP) in a client with a traumatic brain injury?
A) Pupillary dilation
B) Decorticate posturing
C) Decreased level of consciousness
D) Cushing's triad
Correct Answer: Decreased level of consciousness
Rationale: A change in level of consciousness (LOC) is the earliest and most sensitive
indicator of increased ICP. Pupillary changes, abnormal posturing, and Cushing's triad
(bradycardia, hypertension, irregular respirations) are late signs of impending herniation.
4. The nurse is preparing to administer a blood transfusion to a client. Which action is most
important to prevent a transfusion reaction?
A) Verify the client's blood type and crossmatch with the unit
B) Administer diphenhydramine 30 minutes before the transfusion
C) Infuse the blood over 4 hours
D) Obtain a baseline set of vital signs
Correct Answer: Verify the client's blood type and crossmatch with the unit
Rationale: Verification of blood type and crossmatch with the unit is the most critical safety
step to prevent ABO incompatibility, which can cause a life-threatening hemolytic reaction.
The other actions are appropriate but secondary to ensuring blood compatibility.
, 5. A client with heart failure is prescribed furosemide 40 mg IV push. Which laboratory value
should the nurse monitor closely after administering this medication?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Correct Answer: Serum potassium
Rationale: Furosemide is a loop diuretic that promotes excretion of potassium, leading to
hypokalemia. Hypokalemia can precipitate digoxin toxicity and cardiac arrhythmias in clients
with heart failure. Sodium, calcium, and magnesium are also affected but potassium is the
priority.
6. The nurse is assessing a newborn who is 6 hours old. Which finding should be reported to
the healthcare provider immediately?
A) Heart rate of 140 beats per minute
B) Respiratory rate of 60 breaths per minute
C) Blood glucose of 40 mg/dL
D) Axillary temperature of 97.8°F (36.6°C)
Correct Answer: Blood glucose of 40 mg/dL
Rationale: A blood glucose of 40 mg/dL is below the normal range for a newborn (typically
>45 mg/dL) and indicates hypoglycemia, which can lead to neurological damage if untreated.
Heart rate 140, respiratory rate 60, and temperature 97.8°F are within normal limits.
7. A client with major depressive disorder is prescribed phenelzine, a monoamine oxidase
inhibitor (MAOI). Which dietary instruction should the nurse include in the teaching plan?
A) "Avoid foods high in tyramine, such as aged cheese and cured meats."
Q&A
1. An adult client who is 2 days post-operative following abdominal surgery has a nasogastric
(NG) tube attached to low intermittent suction. Which assessment finding should the nurse
report to the healthcare provider immediately?
A) NG tube output of 400 mL in the past 8 hours
B) Complaints of a dry mouth and sore throat
C) Abdominal distention with absent bowel sounds
D) Intermittent bubbling in the suction control chamber
Correct Answer: Abdominal distention with absent bowel sounds
Rationale: Abdominal distention with absent bowel sounds indicates a potential paralytic
ileus or bowel obstruction, which are serious complications requiring immediate
intervention. The other findings are expected: 400 mL output is normal for NG suction, dry
mouth and sore throat are common, and intermittent bubbling indicates proper suction
function.
2. The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who
has a prescription for 2 L/min of oxygen via nasal cannula. Which assessment finding
indicates that the oxygen therapy is effective?
A) Respiratory rate of 28 breaths per minute
B) Oxygen saturation of 92% on pulse oximetry
C) Use of accessory muscles to breathe
D) PaCO2 level of 58 mm Hg on arterial blood gas
Correct Answer: Oxygen saturation of 92% on pulse oximetry
,Rationale: An oxygen saturation of 92% indicates adequate oxygenation for a client with
COPD, who often has a lower baseline SpO2 target (88-92%) due to hypoxic drive. A
respiratory rate of 28, use of accessory muscles, and elevated PaCO2 suggest respiratory
distress or failure, not effectiveness.
3. Which of the following clinical manifestations is the earliest sign of increased intracranial
pressure (ICP) in a client with a traumatic brain injury?
A) Pupillary dilation
B) Decorticate posturing
C) Decreased level of consciousness
D) Cushing's triad
Correct Answer: Decreased level of consciousness
Rationale: A change in level of consciousness (LOC) is the earliest and most sensitive
indicator of increased ICP. Pupillary changes, abnormal posturing, and Cushing's triad
(bradycardia, hypertension, irregular respirations) are late signs of impending herniation.
4. The nurse is preparing to administer a blood transfusion to a client. Which action is most
important to prevent a transfusion reaction?
A) Verify the client's blood type and crossmatch with the unit
B) Administer diphenhydramine 30 minutes before the transfusion
C) Infuse the blood over 4 hours
D) Obtain a baseline set of vital signs
Correct Answer: Verify the client's blood type and crossmatch with the unit
Rationale: Verification of blood type and crossmatch with the unit is the most critical safety
step to prevent ABO incompatibility, which can cause a life-threatening hemolytic reaction.
The other actions are appropriate but secondary to ensuring blood compatibility.
, 5. A client with heart failure is prescribed furosemide 40 mg IV push. Which laboratory value
should the nurse monitor closely after administering this medication?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Correct Answer: Serum potassium
Rationale: Furosemide is a loop diuretic that promotes excretion of potassium, leading to
hypokalemia. Hypokalemia can precipitate digoxin toxicity and cardiac arrhythmias in clients
with heart failure. Sodium, calcium, and magnesium are also affected but potassium is the
priority.
6. The nurse is assessing a newborn who is 6 hours old. Which finding should be reported to
the healthcare provider immediately?
A) Heart rate of 140 beats per minute
B) Respiratory rate of 60 breaths per minute
C) Blood glucose of 40 mg/dL
D) Axillary temperature of 97.8°F (36.6°C)
Correct Answer: Blood glucose of 40 mg/dL
Rationale: A blood glucose of 40 mg/dL is below the normal range for a newborn (typically
>45 mg/dL) and indicates hypoglycemia, which can lead to neurological damage if untreated.
Heart rate 140, respiratory rate 60, and temperature 97.8°F are within normal limits.
7. A client with major depressive disorder is prescribed phenelzine, a monoamine oxidase
inhibitor (MAOI). Which dietary instruction should the nurse include in the teaching plan?
A) "Avoid foods high in tyramine, such as aged cheese and cured meats."
