HESI CAT Exam (2026/2027) | COMPREHENSIVE QUESTIONS AND
CORRECT ANSWERS | SCORE 100%
HESI Computerized Adaptive Testing (CAT) Comprehensive Assessment | Core Domains:
Comprehensive Nursing Knowledge, Clinical Judgment, Medical-Surgical Nursing, Pediatric Nursing,
Maternity Nursing, Psychiatric Nursing, Pharmacology, Fundamentals of Nursing, and Health
Promotion | NCLEX-RN® Predictor Focus | Computerized Adaptive Testing Format
Exam Structure
The HESI CAT Exam for the 2026/2027 academic cycle is a variable-length, computer-adaptive
examination consisting of approximately 75–150 questions.
Introduction
This HESI CAT Exam preparation guide for the 2026/2027 academic year reflects the adaptive,
comprehensive nature of the HESI exit predictor exam. The content is structured to assess a broad
spectrum of nursing knowledge, clinical reasoning, and readiness for the NCLEX-RN® examination
through an adaptive questioning algorithm that adjusts difficulty based on performance.
Answer Format
All correct answers and nursing interventions must be presented in bold and green, followed by
detailed rationales that explain the clinical judgment, evidence-based practice, and nursing knowledge
required to master adaptive-style questioning and achieve a high predictor score.
1. A nurse is caring for a client 24 hours post-op after a right total hip arthroplasty
(posterior approach). Which action is most important to prevent dislocation?
A) Encourage crossing legs while sitting
B) Instruct to flex hip to 90° when sitting
C) Place an abduction pillow between the legs
D) Assist with log-rolling to the right side
C) Place an abduction pillow between the legs
Rationale: After a posterior hip replacement, the hip is most vulnerable to dislocation with internal
rotation, adduction, and flexion >90°. An abduction pillow maintains hip alignment and prevents
adduction. Crossing legs, excessive flexion, and rolling toward the operative side increase dislocation
risk. This reflects CAT’s focus on high-stakes safety knowledge.
,2. A client with type 1 diabetes has a blood glucose of 52 mg/dL and is alert but diaphoretic.
What is the nurse’s priority action?
A) Administer 15 g of fast-acting carbohydrate
B) Give 1 mg glucagon IM
C) Administer insulin
D) Encourage rest
A) Administer 15 g of fast-acting carbohydrate
Rationale: For a conscious hypoglycemic client, the priority is 15 g of simple carbohydrate (e.g., 4 oz
juice, glucose tablets). Glucagon is reserved for unconscious clients. Insulin would worsen
hypoglycemia. CAT exams test immediate, life-saving interventions in common scenarios.
3. A newborn is 1 hour old. The nurse notes acrocyanosis. What is the appropriate action?
A) Administer oxygen
B) Place under warmer
C) Document as a normal finding
D) Notify the provider
C) Document as a normal finding
Rationale: Acrocyanosis (bluish hands and feet) is normal in the first 24–48 hours due to immature
peripheral circulation. Central cyanosis (lips, trunk) is abnormal. CAT integrates foundational
knowledge across the lifespan—here, distinguishing normal newborn findings from emergencies.
4. A client with heart failure is prescribed furosemide 40 mg IV and enalapril 10 mg PO.
Which finding indicates the medications are effective?
, A) Weight gain of 1 kg in 24 hours
B) Increased bilateral crackles
C) Decreased peripheral edema
D) Jugular vein distention
C) Decreased peripheral edema
Rationale: Furosemide (diuretic) and enalapril (ACE inhibitor) reduce fluid overload. Decreased
edema, weight loss, and improved exercise tolerance indicate effectiveness. Weight gain, crackles, and
JVD suggest worsening heart failure. CAT assesses outcome evaluation—key to clinical judgment.
5. A client with schizophrenia says, “The FBI is watching me through the TV.” This is an
example of:
A) Hallucination
B) Delusion
C) Obsession
D) Compulsion
B) Delusion
Rationale: A delusion is a fixed false belief not based in reality (e.g., paranoia, grandiosity). A
hallucination is a false sensory perception (e.g., hearing voices). CAT tests core psychiatric concepts
essential for safe care across settings.
6. A nurse is preparing to administer digoxin. The apical pulse is 58 bpm. What should the
nurse do?
A) Administer the dose
, B) Hold the dose and notify the provider
C) Recheck in 30 minutes
D) Administer half the dose
B) Hold the dose and notify the provider
Rationale: Digoxin can cause bradycardia and life-threatening dysrhythmias. The dose should be held
if the apical pulse is <60 bpm (or per facility policy). The provider must be notified. CAT emphasizes
medication safety—a high-yield predictor of NCLEX success.
7. A pregnant client at 32 weeks’ gestation reports headache, blurred vision, and epigastric
pain. BP is 168/102 mm Hg. The nurse should suspect:
A) Gestational diabetes
B) Preeclampsia
C) Placenta previa
D) Hyperemesis gravidarum
B) Preeclampsia
Rationale: Preeclampsia is characterized by new-onset hypertension (≥140/90) after 20 weeks with
proteinuria and/or end-organ dysfunction (headache, visual changes, epigastric pain, elevated liver
enzymes). Immediate intervention includes seizure prophylaxis (magnesium sulfate) and blood pressure
control. CAT prioritizes obstetric emergencies.
8. A client receiving vancomycin IV complains of flushing, itching, and hypotension. The
nurse suspects:
A) Anaphylaxis
B) Red man syndrome
CORRECT ANSWERS | SCORE 100%
HESI Computerized Adaptive Testing (CAT) Comprehensive Assessment | Core Domains:
Comprehensive Nursing Knowledge, Clinical Judgment, Medical-Surgical Nursing, Pediatric Nursing,
Maternity Nursing, Psychiatric Nursing, Pharmacology, Fundamentals of Nursing, and Health
Promotion | NCLEX-RN® Predictor Focus | Computerized Adaptive Testing Format
Exam Structure
The HESI CAT Exam for the 2026/2027 academic cycle is a variable-length, computer-adaptive
examination consisting of approximately 75–150 questions.
Introduction
This HESI CAT Exam preparation guide for the 2026/2027 academic year reflects the adaptive,
comprehensive nature of the HESI exit predictor exam. The content is structured to assess a broad
spectrum of nursing knowledge, clinical reasoning, and readiness for the NCLEX-RN® examination
through an adaptive questioning algorithm that adjusts difficulty based on performance.
Answer Format
All correct answers and nursing interventions must be presented in bold and green, followed by
detailed rationales that explain the clinical judgment, evidence-based practice, and nursing knowledge
required to master adaptive-style questioning and achieve a high predictor score.
1. A nurse is caring for a client 24 hours post-op after a right total hip arthroplasty
(posterior approach). Which action is most important to prevent dislocation?
A) Encourage crossing legs while sitting
B) Instruct to flex hip to 90° when sitting
C) Place an abduction pillow between the legs
D) Assist with log-rolling to the right side
C) Place an abduction pillow between the legs
Rationale: After a posterior hip replacement, the hip is most vulnerable to dislocation with internal
rotation, adduction, and flexion >90°. An abduction pillow maintains hip alignment and prevents
adduction. Crossing legs, excessive flexion, and rolling toward the operative side increase dislocation
risk. This reflects CAT’s focus on high-stakes safety knowledge.
,2. A client with type 1 diabetes has a blood glucose of 52 mg/dL and is alert but diaphoretic.
What is the nurse’s priority action?
A) Administer 15 g of fast-acting carbohydrate
B) Give 1 mg glucagon IM
C) Administer insulin
D) Encourage rest
A) Administer 15 g of fast-acting carbohydrate
Rationale: For a conscious hypoglycemic client, the priority is 15 g of simple carbohydrate (e.g., 4 oz
juice, glucose tablets). Glucagon is reserved for unconscious clients. Insulin would worsen
hypoglycemia. CAT exams test immediate, life-saving interventions in common scenarios.
3. A newborn is 1 hour old. The nurse notes acrocyanosis. What is the appropriate action?
A) Administer oxygen
B) Place under warmer
C) Document as a normal finding
D) Notify the provider
C) Document as a normal finding
Rationale: Acrocyanosis (bluish hands and feet) is normal in the first 24–48 hours due to immature
peripheral circulation. Central cyanosis (lips, trunk) is abnormal. CAT integrates foundational
knowledge across the lifespan—here, distinguishing normal newborn findings from emergencies.
4. A client with heart failure is prescribed furosemide 40 mg IV and enalapril 10 mg PO.
Which finding indicates the medications are effective?
, A) Weight gain of 1 kg in 24 hours
B) Increased bilateral crackles
C) Decreased peripheral edema
D) Jugular vein distention
C) Decreased peripheral edema
Rationale: Furosemide (diuretic) and enalapril (ACE inhibitor) reduce fluid overload. Decreased
edema, weight loss, and improved exercise tolerance indicate effectiveness. Weight gain, crackles, and
JVD suggest worsening heart failure. CAT assesses outcome evaluation—key to clinical judgment.
5. A client with schizophrenia says, “The FBI is watching me through the TV.” This is an
example of:
A) Hallucination
B) Delusion
C) Obsession
D) Compulsion
B) Delusion
Rationale: A delusion is a fixed false belief not based in reality (e.g., paranoia, grandiosity). A
hallucination is a false sensory perception (e.g., hearing voices). CAT tests core psychiatric concepts
essential for safe care across settings.
6. A nurse is preparing to administer digoxin. The apical pulse is 58 bpm. What should the
nurse do?
A) Administer the dose
, B) Hold the dose and notify the provider
C) Recheck in 30 minutes
D) Administer half the dose
B) Hold the dose and notify the provider
Rationale: Digoxin can cause bradycardia and life-threatening dysrhythmias. The dose should be held
if the apical pulse is <60 bpm (or per facility policy). The provider must be notified. CAT emphasizes
medication safety—a high-yield predictor of NCLEX success.
7. A pregnant client at 32 weeks’ gestation reports headache, blurred vision, and epigastric
pain. BP is 168/102 mm Hg. The nurse should suspect:
A) Gestational diabetes
B) Preeclampsia
C) Placenta previa
D) Hyperemesis gravidarum
B) Preeclampsia
Rationale: Preeclampsia is characterized by new-onset hypertension (≥140/90) after 20 weeks with
proteinuria and/or end-organ dysfunction (headache, visual changes, epigastric pain, elevated liver
enzymes). Immediate intervention includes seizure prophylaxis (magnesium sulfate) and blood pressure
control. CAT prioritizes obstetric emergencies.
8. A client receiving vancomycin IV complains of flushing, itching, and hypotension. The
nurse suspects:
A) Anaphylaxis
B) Red man syndrome
