HESI CAT Newest Exam Preparation With Complete
Questions And Correct Answers With Rationales
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QUESTION 1
A client with chronic obstructive pulmonary disease (COPD) is
prescribed oxygen therapy at 2 liters per minute via nasal cannula.
Which assessment finding indicates that the oxygen therapy is
effective?
A) Respiratory rate of 28 breaths per minute
B) Pulse oximetry reading of 92%
C) Use of accessory muscles during respiration
D) Arterial carbon dioxide partial pressure of 55 mmHg
Answer: B
Explanation: In COPD management, the goal of oxygen therapy is to
maintain adequate oxygenation while avoiding suppression of the
hypoxic respiratory drive. A pulse oximetry reading of 92% indicates
that oxygenation is within the target range for most patients with
COPD, suggesting that the therapy is effective. A respiratory rate of 28
is tachypneic and suggests ongoing respiratory distress. Use of
accessory muscles is a sign of increased work of breathing and
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ineffective oxygenation. An arterial carbon dioxide partial pressure of
55 mmHg is elevated and may indicate carbon dioxide retention, which
is a concern in COPD but does not directly reflect the effectiveness of
oxygen therapy in terms of oxygenation.
QUESTION 2
The nurse is caring for a client who has just undergone a total hip
arthroplasty. Which postoperative intervention is most important to
prevent dislocation of the new prosthesis?
A) Maintaining the hip in adduction
B) Keeping the knees together at all times
C) Placing a pillow between the legs when turning
D) Encouraging the client to cross the legs while sitting
Answer: C
Explanation: After total hip arthroplasty, the primary concern is to
prevent dislocation of the prosthesis. Placing a pillow between the legs
when turning or positioning the client maintains the hip in abduction
and prevents adduction, which is a position that can cause dislocation.
Adduction and crossing the legs are strictly contraindicated because
they increase the risk of prosthesis displacement. Keeping the knees
together is essentially adduction and should be avoided.
QUESTION 3
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A client with diabetic ketoacidosis (DKA) is receiving an intravenous
infusion of regular insulin. Which laboratory value requires the most
immediate intervention?
A) Serum potassium of 3.2 mEq/L
B) Serum glucose of 350 mg/dL
C) Serum bicarbonate of 18 mEq/L
D) Arterial pH of 7.28
Answer: A
Explanation: In DKA, insulin therapy drives potassium back into the cells,
which can precipitate severe hypokalemia. A serum potassium of 3.2
mEq/L is critically low and can lead to life-threatening cardiac
dysrhythmias. While a glucose of 350 mg/dL, bicarbonate of 18 mEq/L,
and a pH of 7.28 are all abnormal findings consistent with DKA, the
potassium level poses the most immediate and potentially fatal risk. The
nurse should anticipate potassium replacement and continuous cardiac
monitoring.
QUESTION 4
The nurse is assessing a client with suspected meningitis. Which finding
is characteristic of Kernig's sign?
A) Pain and resistance with neck flexion
B) Flexion of the hips and knees when the neck is flexed
C) Inability to extend the leg when the hip is flexed at a 90-degree angle
D) Brudzinski's sign is the correct term for this assessment
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Answer: C
Explanation: Kernig's sign is a classic meningeal sign. It is elicited by
flexing the client's hip to 90 degrees and then attempting to extend the
knee. Pain and resistance to knee extension constitute a positive
Kernig's sign and indicate meningeal irritation. Option A describes
nuchal rigidity, which is assessed by passive neck flexion. Option B
describes Brudzinski's sign, where flexion of the neck causes involuntary
flexion of the hips and knees.
QUESTION 5
A client with heart failure is prescribed furosemide. Which laboratory
finding should the nurse monitor most closely?
A) Serum sodium of 140 mEq/L
B) Serum potassium of 3.0 mEq/L
C) Serum chloride of 100 mEq/L
D) Serum magnesium of 2.0 mEq/L
Answer: B
Explanation: Furosemide is a loop diuretic that inhibits sodium and
chloride reabsorption in the ascending loop of Henle, leading to
increased excretion of water, sodium, chloride, and potassium.
Hypokalemia, defined as a serum potassium less than 3.5 mEq/L, is a
common and significant adverse effect. A potassium of 3.0 mEq/L is
dangerously low and can cause cardiac dysrhythmias, muscle weakness,