HESI CAT EXAMINATION FINAL PAPER 2026
FULL SOLUTION VIEW AHEAD GRADED A+
◉The nurse finds a client with schizophrenia lying under a bench in
the hall. The client says, "God told me to lie here." What is the best
response by the nurse?
1
"I didn't hear anyone talking; come with me to your room."
2
"What you heard was in your head; it was your imagination."
3
"Come to the dayroom and watch television; you'll feel better."
4
"God wouldn't tell you to lie there in the hall. God wants you to
behave reasonably.". Answer: 1
The nurse is focusing on reality and trying to distract and refocus
the client's attention. "What you heard was in your head; it was your
imagination" is too blunt and belittling; this approach rarely is
effective. "Come to the dayroom and watch television; you'll feel
better" is false reassurance; the nurse does not know that the client
will feel better. "God wouldn't tell you to lie in the hall; God wants
you to behave reasonably" may be interpreted as belittling or an
,attempt to convince the client that the behavior is irrational, which
is usually ineffective.
◉A nurse is obtaining a health history from a client who is known to
be verbally abusive. The client tells the nurse, "You're ugly, and
you're probably stupid, too. Why am I stuck with you as my nurse?"
What is the best response by the nurse?
1
"It doesn't matter what you think, because I know I'm a capable
nurse."
2
"Tell me more about why my caring for you today is so upsetting to
you."
3
"If you like, I will arrange to switch assignments so you can have
another nurse."
4
"You are talking inappropriately, so I'm going to leave and will come
back when you stop being verbally abusive.". Answer: 4
The response "You are talking inappropriately, so I'm going to leave
and will come back when you stop being verbally abusive" provides
specific realistic feedback without rejecting the client. The reply "It
doesn't matter what you think, because I know I'm a capable nurse"
is defensive and insulting to the client. The reply "Tell me more
about why my caring for you today is so upsetting to you" will most
,likely encourage more inappropriate communication. The client's
behavior is the issue, and switching assignments does not address
this. The client may view a change of nurse as rejection.
◉A nurse anticipates that most clients with phobias will use which
defense mechanisms?
1
Dissociation and denial
2
Introjection and sublimation
3
Projection and displacement
4
Substitution and reaction formation. Answer: 3
Clients with phobias cope with anxiety by placing it on specific
persons, objects, or situations through displacement, projection, or
both. The person with a phobia recognizes and admits the
exaggerated fear as a real part of the self and does not deny it.
Neither introjection, whereby a person internalizes and
incorporates the traits of another, nor sublimation, whereby socially
acceptable behavior is substituted for unacceptable instincts, is
related to phobic activity. A less valued object is not substituted for
one more highly valued (substitution), nor are the expressed
feelings opposite of the experienced feelings of fear (reaction
formation).
, ◉A depressed client cries when the family does not visit. What is the
most therapeutic response by the nurse?
1
"It's difficult to realize that no one cares about you."
2
"Your family didn't visit, and now you're feeling rejected."
3
"It's terrible to have such negative thoughts about yourself."
4
"Your family members work—that's why they don't visit you.".
Answer: 2
The statement "Your family didn't visit, and now you're feeling
rejected" accurately reflects the client's emotions and may
encourage exploration of feelings. The nurse does not know that no
one cares about the client, and the statement may increase the
client's unhappiness. The client is upset about the lack of visitors;
discussing negative self-thoughts changes the subject. The defensive
statement "Your family members work—that's why they don't visit
you" may worsen the client's self-derogatory feelings.
◉A nurse is caring for a client with the diagnosis of bulimia nervosa.
What does the nurse understand to be the function of food for
individuals with bulimia?
1
FULL SOLUTION VIEW AHEAD GRADED A+
◉The nurse finds a client with schizophrenia lying under a bench in
the hall. The client says, "God told me to lie here." What is the best
response by the nurse?
1
"I didn't hear anyone talking; come with me to your room."
2
"What you heard was in your head; it was your imagination."
3
"Come to the dayroom and watch television; you'll feel better."
4
"God wouldn't tell you to lie there in the hall. God wants you to
behave reasonably.". Answer: 1
The nurse is focusing on reality and trying to distract and refocus
the client's attention. "What you heard was in your head; it was your
imagination" is too blunt and belittling; this approach rarely is
effective. "Come to the dayroom and watch television; you'll feel
better" is false reassurance; the nurse does not know that the client
will feel better. "God wouldn't tell you to lie in the hall; God wants
you to behave reasonably" may be interpreted as belittling or an
,attempt to convince the client that the behavior is irrational, which
is usually ineffective.
◉A nurse is obtaining a health history from a client who is known to
be verbally abusive. The client tells the nurse, "You're ugly, and
you're probably stupid, too. Why am I stuck with you as my nurse?"
What is the best response by the nurse?
1
"It doesn't matter what you think, because I know I'm a capable
nurse."
2
"Tell me more about why my caring for you today is so upsetting to
you."
3
"If you like, I will arrange to switch assignments so you can have
another nurse."
4
"You are talking inappropriately, so I'm going to leave and will come
back when you stop being verbally abusive.". Answer: 4
The response "You are talking inappropriately, so I'm going to leave
and will come back when you stop being verbally abusive" provides
specific realistic feedback without rejecting the client. The reply "It
doesn't matter what you think, because I know I'm a capable nurse"
is defensive and insulting to the client. The reply "Tell me more
about why my caring for you today is so upsetting to you" will most
,likely encourage more inappropriate communication. The client's
behavior is the issue, and switching assignments does not address
this. The client may view a change of nurse as rejection.
◉A nurse anticipates that most clients with phobias will use which
defense mechanisms?
1
Dissociation and denial
2
Introjection and sublimation
3
Projection and displacement
4
Substitution and reaction formation. Answer: 3
Clients with phobias cope with anxiety by placing it on specific
persons, objects, or situations through displacement, projection, or
both. The person with a phobia recognizes and admits the
exaggerated fear as a real part of the self and does not deny it.
Neither introjection, whereby a person internalizes and
incorporates the traits of another, nor sublimation, whereby socially
acceptable behavior is substituted for unacceptable instincts, is
related to phobic activity. A less valued object is not substituted for
one more highly valued (substitution), nor are the expressed
feelings opposite of the experienced feelings of fear (reaction
formation).
, ◉A depressed client cries when the family does not visit. What is the
most therapeutic response by the nurse?
1
"It's difficult to realize that no one cares about you."
2
"Your family didn't visit, and now you're feeling rejected."
3
"It's terrible to have such negative thoughts about yourself."
4
"Your family members work—that's why they don't visit you.".
Answer: 2
The statement "Your family didn't visit, and now you're feeling
rejected" accurately reflects the client's emotions and may
encourage exploration of feelings. The nurse does not know that no
one cares about the client, and the statement may increase the
client's unhappiness. The client is upset about the lack of visitors;
discussing negative self-thoughts changes the subject. The defensive
statement "Your family members work—that's why they don't visit
you" may worsen the client's self-derogatory feelings.
◉A nurse is caring for a client with the diagnosis of bulimia nervosa.
What does the nurse understand to be the function of food for
individuals with bulimia?
1
