HESI RN CAT PRACTICE 2026 Computer
Adaptive Exam Prep & Review | Pass on First
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Rationales Latest Update 2026 | Instant
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Content Areas Covered:
• Medical-Surgical Nursing (30 questions)
• Pharmacology (10 questions)
• Maternity & Newborn (10 questions)
• Pediatric Nursing (10 questions)
• Mental Health Nursing (10 questions)
• Leadership & Delegation (5 questions)
• Nutrition & Metabolism (5 questions)
• Critical Care & Emergency (5 questions)
• Gerontological Nursing (5 questions)
• Infection Control (3 questions)
• Fluid & Electrolytes (2 questions)
• Legal & Ethical (5 questions)
• Patient Education (5 questions)
• Oncology Nursing (5 questions)
• Respiratory Nursing (5 questions)
• Renal & Urinary Nursing (5 questions)
MEDICAL-SURGICAL NURSING
Q1. A nurse is caring for a patient with heart failure. Which finding requires
immediate action?
A) Bilateral +1 pedal edema
B) Crackles in lung bases
C) Weight gain of 2 lbs in 24 hours
D) Shortness of breath while talking
,Correct Answer: D
Rationale: Shortness of breath while talking indicates significant respiratory
compromise and possible acute decompensated heart failure. Airway, breathing,
circulation (ABCs) take priority. Crackles may be chronic, weight gain is slower,
and +1 edema is not immediately life-threatening.
Q2. A patient on warfarin has an INR of 5.5 and is actively bleeding. Which
medication should the nurse anticipate administering?
A) Vitamin K
B) Protamine sulfate
C) Aspirin
D) Enoxaparin
Correct Answer: A
Rationale: Vitamin K reverses warfarin's anticoagulant effect in active bleeding.
Protamine sulfate reverses heparin. Aspirin worsens bleeding. Enoxaparin is an
anticoagulant and would be contraindicated.
Q3. A postpartum patient reports a firm fundus and heavy bleeding with large
clots. What should the nurse do first?
A) Administer oxytocin IV
B) Massage the fundus
C) Call the provider
D) Measure blood pressure
Correct Answer: B
Rationale: Fundal massage should be performed first to expel clots and improve
uterine tone. Oxytocin may be given after if massage fails. Blood pressure is
secondary. Calling the provider can be done simultaneously but massage is
immediate priority.
Q4. A patient with COPD has an SpO₂ of 86% on 2 L oxygen. The oxygen is
increased to 4 L. Later, the patient becomes lethargic. What is the most likely
cause?
A) Hyperoxia
B) CO₂ narcosis
C) Pneumothorax
D) Atelectasis
,Correct Answer: B
Rationale: COPD patients often have chronic hypercapnia and rely on hypoxic
drive. High-flow oxygen can reduce the respiratory drive, leading to CO₂ narcosis,
drowsiness, and eventual respiratory failure.
Q5. Which task can be delegated to an unlicensed assistive personnel (UAP)?
A) Assess a post-operative incision
B) Ambulate a patient with a walker
C) Teach insulin injection technique
D) Evaluate a patient's pain level
Correct Answer: B
Rationale: Ambulating a stable patient with a walker is within the UAP's scope of
practice. Assessment, teaching, and pain evaluation are nursing responsibilities that
cannot be delegated.
Q6. A patient with a chest tube to water seal drainage has continuous bubbling in
the water seal chamber. What is the most appropriate action?
A) Document as normal finding
B) Clamp the chest tube immediately
C) Assess for an air leak
D) Increase suction pressure
Correct Answer: C
Rationale: Continuous bubbling in the water seal chamber indicates an air leak.
The nurse should assess the system for loose connections or cracks. Clamping a
chest tube without an order is dangerous. Intermittent bubbling is normal with
exhalation/coughing.
Q7. A patient is receiving total parenteral nutrition (TPN) via a central line. Which
complication requires immediate intervention?
A) Blood glucose of 150 mg/dL
B) Temperature of 100.2°F (37.9°C)
C) Cracked tubing with air visible
D) Weight gain of 0.5 lb in 24 hours
Correct Answer: C
Rationale: A cracked TPN line with visible air poses a risk of air embolism, which
, is life-threatening. The nurse should clamp the line immediately, place patient in
left lateral Trendelenburg position, and notify provider.
Q8. A patient with diabetes is NPO for surgery. The morning blood glucose is 180
mg/dL. What should the nurse do?
A) Hold all diabetes medications
B) Administer half the usual insulin dose
C) Notify the provider for instructions
D) Give regular insulin IV push
Correct Answer: C
Rationale: The nurse should notify the provider for specific instructions regarding
insulin administration in NPO patients. Sliding scale or basal insulin may be given
with dextrose IV to prevent hypoglycemia or hyperglycemia. Never independently
adjust insulin for NPO patients.
Q9. A patient is admitted with acute pancreatitis. Which laboratory finding is most
consistent with this diagnosis?
A) Elevated serum amylase and lipase
B) Elevated alkaline phosphatase
C) Decreased serum calcium
D) Elevated blood urea nitrogen (BUN)
Correct Answer: A
Rationale: Elevated serum amylase and lipase are hallmark findings in acute
pancreatitis. Lipase is more specific and remains elevated longer. Hypocalcemia
may occur late. Alkaline phosphatase elevation suggests biliary obstruction.
Q10. A patient with a hip fracture is on bed rest. Which intervention is most
effective in preventing a deep vein thrombosis (DVT)?
A) Massage the calves twice daily
B) Apply sequential compression devices (SCDs)
C) Elevate the affected leg on pillows
D) Place a pillow under the knees
Correct Answer: B
Rationale: SCDs promote venous return and are a proven DVT prevention
measure. Massaging calves can dislodge an existing clot. Elevation alone is
insufficient. Pillow under knees can cause venous stasis.
Adaptive Exam Prep & Review | Pass on First
Try Questions with Verified Answers & Detailed
Rationales Latest Update 2026 | Instant
Download PDF
Content Areas Covered:
• Medical-Surgical Nursing (30 questions)
• Pharmacology (10 questions)
• Maternity & Newborn (10 questions)
• Pediatric Nursing (10 questions)
• Mental Health Nursing (10 questions)
• Leadership & Delegation (5 questions)
• Nutrition & Metabolism (5 questions)
• Critical Care & Emergency (5 questions)
• Gerontological Nursing (5 questions)
• Infection Control (3 questions)
• Fluid & Electrolytes (2 questions)
• Legal & Ethical (5 questions)
• Patient Education (5 questions)
• Oncology Nursing (5 questions)
• Respiratory Nursing (5 questions)
• Renal & Urinary Nursing (5 questions)
MEDICAL-SURGICAL NURSING
Q1. A nurse is caring for a patient with heart failure. Which finding requires
immediate action?
A) Bilateral +1 pedal edema
B) Crackles in lung bases
C) Weight gain of 2 lbs in 24 hours
D) Shortness of breath while talking
,Correct Answer: D
Rationale: Shortness of breath while talking indicates significant respiratory
compromise and possible acute decompensated heart failure. Airway, breathing,
circulation (ABCs) take priority. Crackles may be chronic, weight gain is slower,
and +1 edema is not immediately life-threatening.
Q2. A patient on warfarin has an INR of 5.5 and is actively bleeding. Which
medication should the nurse anticipate administering?
A) Vitamin K
B) Protamine sulfate
C) Aspirin
D) Enoxaparin
Correct Answer: A
Rationale: Vitamin K reverses warfarin's anticoagulant effect in active bleeding.
Protamine sulfate reverses heparin. Aspirin worsens bleeding. Enoxaparin is an
anticoagulant and would be contraindicated.
Q3. A postpartum patient reports a firm fundus and heavy bleeding with large
clots. What should the nurse do first?
A) Administer oxytocin IV
B) Massage the fundus
C) Call the provider
D) Measure blood pressure
Correct Answer: B
Rationale: Fundal massage should be performed first to expel clots and improve
uterine tone. Oxytocin may be given after if massage fails. Blood pressure is
secondary. Calling the provider can be done simultaneously but massage is
immediate priority.
Q4. A patient with COPD has an SpO₂ of 86% on 2 L oxygen. The oxygen is
increased to 4 L. Later, the patient becomes lethargic. What is the most likely
cause?
A) Hyperoxia
B) CO₂ narcosis
C) Pneumothorax
D) Atelectasis
,Correct Answer: B
Rationale: COPD patients often have chronic hypercapnia and rely on hypoxic
drive. High-flow oxygen can reduce the respiratory drive, leading to CO₂ narcosis,
drowsiness, and eventual respiratory failure.
Q5. Which task can be delegated to an unlicensed assistive personnel (UAP)?
A) Assess a post-operative incision
B) Ambulate a patient with a walker
C) Teach insulin injection technique
D) Evaluate a patient's pain level
Correct Answer: B
Rationale: Ambulating a stable patient with a walker is within the UAP's scope of
practice. Assessment, teaching, and pain evaluation are nursing responsibilities that
cannot be delegated.
Q6. A patient with a chest tube to water seal drainage has continuous bubbling in
the water seal chamber. What is the most appropriate action?
A) Document as normal finding
B) Clamp the chest tube immediately
C) Assess for an air leak
D) Increase suction pressure
Correct Answer: C
Rationale: Continuous bubbling in the water seal chamber indicates an air leak.
The nurse should assess the system for loose connections or cracks. Clamping a
chest tube without an order is dangerous. Intermittent bubbling is normal with
exhalation/coughing.
Q7. A patient is receiving total parenteral nutrition (TPN) via a central line. Which
complication requires immediate intervention?
A) Blood glucose of 150 mg/dL
B) Temperature of 100.2°F (37.9°C)
C) Cracked tubing with air visible
D) Weight gain of 0.5 lb in 24 hours
Correct Answer: C
Rationale: A cracked TPN line with visible air poses a risk of air embolism, which
, is life-threatening. The nurse should clamp the line immediately, place patient in
left lateral Trendelenburg position, and notify provider.
Q8. A patient with diabetes is NPO for surgery. The morning blood glucose is 180
mg/dL. What should the nurse do?
A) Hold all diabetes medications
B) Administer half the usual insulin dose
C) Notify the provider for instructions
D) Give regular insulin IV push
Correct Answer: C
Rationale: The nurse should notify the provider for specific instructions regarding
insulin administration in NPO patients. Sliding scale or basal insulin may be given
with dextrose IV to prevent hypoglycemia or hyperglycemia. Never independently
adjust insulin for NPO patients.
Q9. A patient is admitted with acute pancreatitis. Which laboratory finding is most
consistent with this diagnosis?
A) Elevated serum amylase and lipase
B) Elevated alkaline phosphatase
C) Decreased serum calcium
D) Elevated blood urea nitrogen (BUN)
Correct Answer: A
Rationale: Elevated serum amylase and lipase are hallmark findings in acute
pancreatitis. Lipase is more specific and remains elevated longer. Hypocalcemia
may occur late. Alkaline phosphatase elevation suggests biliary obstruction.
Q10. A patient with a hip fracture is on bed rest. Which intervention is most
effective in preventing a deep vein thrombosis (DVT)?
A) Massage the calves twice daily
B) Apply sequential compression devices (SCDs)
C) Elevate the affected leg on pillows
D) Place a pillow under the knees
Correct Answer: B
Rationale: SCDs promote venous return and are a proven DVT prevention
measure. Massaging calves can dislodge an existing clot. Elevation alone is
insufficient. Pillow under knees can cause venous stasis.
