HESI: CAT Exam with complete solutions
At a routine prenatal visit, a client at 24-weeks gestation complains of nasal stuffiness and occasional nosebleeds. Which hormone is responsible for these changes?
A. Human chorionic gonadotropin.
B. Progesterone.
C. Relaxin.
D. Estrogen. - Answer- A client who has localized eczematous eruptions on b oth hands is diagnosed as having
contact dermatitis. What instruction should the nurse include in this client's discharge teaching plan?
A. Wear latex gloves whenever outdoors.
B. Apply an oil-based ointment to the affected areas.
C. Take prescribed antihistamine near bedtime.
D. Soak hands in warm soapy water three times a day. - Answer- While transcribing a new prescription, the nurse notes that the prescribed dosage is much lower than the recommended dosage listed in the drug reference guide. Which client data supports the dosage reduction?
A. Decreased serum creatinine
B. Increased serum protein.
C. Increased liver enzymes.
D. Prolonged prothrombin time. - Answer- The nurse assigns an unlicensed assistive personnel (UAP) to take the vital signs of a client who is positive for Human Immunodeficiency Virus (HIV). What protective apparel should the nurse counsel the UAP to wear when carrying out this assignment?
A. None.
B. Gown, gloves, mask.
C. Gloves and mask.
D. Gloves only. - Answer- A client with Guillain-Barre syndrome requires a tracheostomy and mechanical ventilation due to the progression of the disease. What nursing intervention is most helpful in aiding this clinet to communicate with the staff and family?
A. Speak slowly and disntinctly while in direct view of the client.
B. Teach the client to point to a letter board word chart to communicate needs.
C. Provide the client with a pencil and tablet of paper.
D. With the client, develop a system of eye blinks to communicate "yes" or "no." - Answer- A client with peptic ulcer disease (PUD) is admitted to the emergency room complaining
of sudden severe upper abdominal pain. Assessment indicates an extremely tender and
rigid abdomen, B/P of 90/60 mmHg, and pulse of 110 beat/minute. The emergency department nurse should anticipate implementation of which intervention?
A. Preparing the client for emergency abdominal surgery.
B. Infusing the proton pump inhibitor Protonix intravenously.
C. Administering an iced saline lavage.
D. Inserting a nasogastric tube to decompress the bowel. - Answer- Which finding should the nurse expect a client to exhibit who is newly diagnosed with fibromyalgia?
A. Recent joint trauma.
B. Disruption in sleep patterns.
C. Unexplained weight gain.
D. Itching and rash. - Answer- A male client with diabetes mellitus reports that he has had trouble following his diet, and the result of his fasting blood glucose test is 90 mg/dl. What action should the nurse
implement first?
A. Obtain a urine specimen from the client to test for ketonuria.
B. Assure the client that his diabetes control is within normal limits.
C. Schedule the client to attend classes about diet management.
D. Review the findings of his glycosylated hemoglobin test. - Answer- A multipara postpartum client complain intense cramping while breastfeeding. What instruction should the nurse provide to the client?
A. Change the infant's position during the next feeding.
B. Void and completely empty bladder before each feeding.
C. Take a prescribed analgesic an hour prior to breastfeeding.
D. Drink two glasses of water 30 minutes prior to breastfeeding. - Answer- A nurse is preparing to teach the parents of a child who had a surgical repair of myelomeningocele how to change an occlusive dressing on the child's back. Which statement by the parents indicates that they understand this procedure?
A. "We should rapidly remove the tape from the edges of the dressing when changing it."
B. "The dressing should be wetted periodically to keep the skin incision moist."
C. "The dressing will help dry the sutures for ease of removal."
D. " The purpose of the dressing is to protect the incision from fecal contamination." - Answer- While the nurse is preparing to administer a high volume saline enema to a male client, the client appears anxious and states that he is not able to turn on his right side without help because of a recent stroke. What action should the nurse take first?
A. Reassure the client that he can remain in any position of comfort during the enema.
B. Assess the client's ability to independently turn to his left side. C. Instruct the client that the procedure will only last about ten minutes.
D. Ask a UAP to assist the client to maintain a right lateral position. - Answer- The nurse notes that a client is experiencing supraventricular tachyacardia (SVT). Which action should the nurse implement?
A. Assess the client's heart sounds and vital signs.
B. Call a code and start CPR immediately.
C. Prepare to administer adenosine, an antidysrhythmic.
D. Place a crash cart at the client's bedside. - Answer- . A client is receiving an IV infusion of regular insulin, 50 units in 100 ml of normal saline
at 4 units/ hour. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only.) - Answer- A client takes dronedarone (Multaq) 400 mg PO twice daily is admitted with chest pain and shortness of breath. The nurse should withhold the Multaq if the client manifests which finding?
A. Three premature ventricular beats/minute.
B. QTc interval less than 500 milliseconds.
C. Respiratory rate greater than 30 beats/minute.
D. Palpable radial pulse less than 50 beats/minute. - Answer- A middle-aged client with complaints of chest pain radiating into his jaw is en route to the hospital via ambulance. Oxygen was started, threee nitroglycerin sprays of 5 minute
intervals were administered, with no pain relief, and an IV was initiated. The cardiac monitor indicates normal sinus rhythm. On arrival at the Emergency Department, which intervention should the nurse implement first?
A. Prepare for defibrillation or cardioversion.
B. Inject 5,000 units heparin subcutaneously
C. Obtain a 12 lead EKG.
D. Administer a chewable aspirin 325 mg. - Answer- The nurse is planning a fall prevention program for the residents at a long-term care facility. Which intervention is most important in providing a safe environment?
A. Encourage clients to wear rubber-soled shoes.
B. Accompany residents older than 80 years during ambulation.
C. Apply a vest restraint prophylactically to confused residents.
D. Leave the hall lights on during the night. - Answer- For a client who has been receiving linezolid (Zyvox) for two weeks to treat an MRSA- infected wounds, what finding requires the most immediate action by the nurse?
A. Ecchymosis
B. Insomnia
C. Tongue discoloration
D. Vaginal discharge - Answer-
At a routine prenatal visit, a client at 24-weeks gestation complains of nasal stuffiness and occasional nosebleeds. Which hormone is responsible for these changes?
A. Human chorionic gonadotropin.
B. Progesterone.
C. Relaxin.
D. Estrogen. - Answer- A client who has localized eczematous eruptions on b oth hands is diagnosed as having
contact dermatitis. What instruction should the nurse include in this client's discharge teaching plan?
A. Wear latex gloves whenever outdoors.
B. Apply an oil-based ointment to the affected areas.
C. Take prescribed antihistamine near bedtime.
D. Soak hands in warm soapy water three times a day. - Answer- While transcribing a new prescription, the nurse notes that the prescribed dosage is much lower than the recommended dosage listed in the drug reference guide. Which client data supports the dosage reduction?
A. Decreased serum creatinine
B. Increased serum protein.
C. Increased liver enzymes.
D. Prolonged prothrombin time. - Answer- The nurse assigns an unlicensed assistive personnel (UAP) to take the vital signs of a client who is positive for Human Immunodeficiency Virus (HIV). What protective apparel should the nurse counsel the UAP to wear when carrying out this assignment?
A. None.
B. Gown, gloves, mask.
C. Gloves and mask.
D. Gloves only. - Answer- A client with Guillain-Barre syndrome requires a tracheostomy and mechanical ventilation due to the progression of the disease. What nursing intervention is most helpful in aiding this clinet to communicate with the staff and family?
A. Speak slowly and disntinctly while in direct view of the client.
B. Teach the client to point to a letter board word chart to communicate needs.
C. Provide the client with a pencil and tablet of paper.
D. With the client, develop a system of eye blinks to communicate "yes" or "no." - Answer- A client with peptic ulcer disease (PUD) is admitted to the emergency room complaining
of sudden severe upper abdominal pain. Assessment indicates an extremely tender and
rigid abdomen, B/P of 90/60 mmHg, and pulse of 110 beat/minute. The emergency department nurse should anticipate implementation of which intervention?
A. Preparing the client for emergency abdominal surgery.
B. Infusing the proton pump inhibitor Protonix intravenously.
C. Administering an iced saline lavage.
D. Inserting a nasogastric tube to decompress the bowel. - Answer- Which finding should the nurse expect a client to exhibit who is newly diagnosed with fibromyalgia?
A. Recent joint trauma.
B. Disruption in sleep patterns.
C. Unexplained weight gain.
D. Itching and rash. - Answer- A male client with diabetes mellitus reports that he has had trouble following his diet, and the result of his fasting blood glucose test is 90 mg/dl. What action should the nurse
implement first?
A. Obtain a urine specimen from the client to test for ketonuria.
B. Assure the client that his diabetes control is within normal limits.
C. Schedule the client to attend classes about diet management.
D. Review the findings of his glycosylated hemoglobin test. - Answer- A multipara postpartum client complain intense cramping while breastfeeding. What instruction should the nurse provide to the client?
A. Change the infant's position during the next feeding.
B. Void and completely empty bladder before each feeding.
C. Take a prescribed analgesic an hour prior to breastfeeding.
D. Drink two glasses of water 30 minutes prior to breastfeeding. - Answer- A nurse is preparing to teach the parents of a child who had a surgical repair of myelomeningocele how to change an occlusive dressing on the child's back. Which statement by the parents indicates that they understand this procedure?
A. "We should rapidly remove the tape from the edges of the dressing when changing it."
B. "The dressing should be wetted periodically to keep the skin incision moist."
C. "The dressing will help dry the sutures for ease of removal."
D. " The purpose of the dressing is to protect the incision from fecal contamination." - Answer- While the nurse is preparing to administer a high volume saline enema to a male client, the client appears anxious and states that he is not able to turn on his right side without help because of a recent stroke. What action should the nurse take first?
A. Reassure the client that he can remain in any position of comfort during the enema.
B. Assess the client's ability to independently turn to his left side. C. Instruct the client that the procedure will only last about ten minutes.
D. Ask a UAP to assist the client to maintain a right lateral position. - Answer- The nurse notes that a client is experiencing supraventricular tachyacardia (SVT). Which action should the nurse implement?
A. Assess the client's heart sounds and vital signs.
B. Call a code and start CPR immediately.
C. Prepare to administer adenosine, an antidysrhythmic.
D. Place a crash cart at the client's bedside. - Answer- . A client is receiving an IV infusion of regular insulin, 50 units in 100 ml of normal saline
at 4 units/ hour. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only.) - Answer- A client takes dronedarone (Multaq) 400 mg PO twice daily is admitted with chest pain and shortness of breath. The nurse should withhold the Multaq if the client manifests which finding?
A. Three premature ventricular beats/minute.
B. QTc interval less than 500 milliseconds.
C. Respiratory rate greater than 30 beats/minute.
D. Palpable radial pulse less than 50 beats/minute. - Answer- A middle-aged client with complaints of chest pain radiating into his jaw is en route to the hospital via ambulance. Oxygen was started, threee nitroglycerin sprays of 5 minute
intervals were administered, with no pain relief, and an IV was initiated. The cardiac monitor indicates normal sinus rhythm. On arrival at the Emergency Department, which intervention should the nurse implement first?
A. Prepare for defibrillation or cardioversion.
B. Inject 5,000 units heparin subcutaneously
C. Obtain a 12 lead EKG.
D. Administer a chewable aspirin 325 mg. - Answer- The nurse is planning a fall prevention program for the residents at a long-term care facility. Which intervention is most important in providing a safe environment?
A. Encourage clients to wear rubber-soled shoes.
B. Accompany residents older than 80 years during ambulation.
C. Apply a vest restraint prophylactically to confused residents.
D. Leave the hall lights on during the night. - Answer- For a client who has been receiving linezolid (Zyvox) for two weeks to treat an MRSA- infected wounds, what finding requires the most immediate action by the nurse?
A. Ecchymosis
B. Insomnia
C. Tongue discoloration
D. Vaginal discharge - Answer-
