HESI CAT Exam V2 | 2026 Q&A with
Rationale (HESI CAT Exam 2026)
1. A nurse is caring for a client who is receiving intravenous furosemide for heart failure.
Which assessment finding should the nurse prioritize?
A. Weight loss of 1 kg in 24 hours
B. A blood pressure of 118/72 mmHg
C. A serum potassium level of 3.2 mEq/L
D. Urine output of 50 mL/hr
Correct Answer: C
Rationale: Furosemide is a loop diuretic that causes significant loss of potassium through
the kidneys. A potassium level of 3.2 mEq/L indicates hypokalemia, which can lead to life-
threatening cardiac arrhythmias. The nurse must prioritize this finding to prevent further
complications.
2. A client with type 1 diabetes mellitus is found unconscious and clammy. What should be
the nurse’s first action?
A. Administer 15 grams of oral carbohydrates
B. Administer glucagon intramuscularly
C. Check the client’s blood glucose level
,D. Call the healthcare provider immediately
Correct Answer: B
Rationale: An unconscious client cannot safely swallow oral carbohydrates due to the risk
of aspiration. In an emergency where the client is unresponsive and hypoglycemia is
suspected, glucagon should be administered to raise blood glucose rapidly. Monitoring the
blood glucose is important, but taking immediate action to restore consciousness in a
symptomatic patient is the priority.
3. The nurse is assessing a client 4 hours after a thyroidectomy. Which finding is most
concerning?
A. The client reports a sore throat when speaking.
B. The client has a small amount of serosanguinous drainage on the dressing.
C. The client is experiencing muscle tremors and tingling in the fingers.
D. The client’s voice sounds slightly hoarse.
Correct Answer: C
Rationale: Muscle tremors and tingling (paresthesia) are signs of hypocalcemia, which can
occur if the parathyroid glands are accidentally damaged or removed during a
thyroidectomy. This can lead to tetany and airway obstruction if not treated with calcium
gluconate. While hoarseness and a sore throat are expected, they do not take priority over
potential tetany.
,4. Which of the following interventions should the nurse include in the plan of care for a
client with MRSA? Select all that apply.
A. Perform hand hygiene before and after client contact.
B. Wear a mask when entering the client’s room.
C. Place the client in a private room.
D. Wear a gown and gloves for all direct care.
E. Use dedicated equipment such as a blood pressure cuff for this client.
F. Keep the door to the room closed at all times.
Correct Answer: ACDE
Rationale: MRSA requires contact precautions to prevent the spread of the organism. This
includes hand hygiene, a private room, and the use of gowns and gloves for contact.
Dedicated equipment should stay in the room to avoid cross-contamination; however, a
mask and keeping the door closed are required for airborne or droplet precautions, not
standard contact precautions.
5. A client is prescribed Lithium for bipolar disorder. Which instruction is most important for
the nurse to provide?
A. Maintain a consistent intake of dietary sodium.
B. Decrease fluid intake to 1 liter per day.
C. Take the medication only when feeling manic.
, D. Avoid all exercise to prevent sweating.
Correct Answer: A
Rationale: Lithium is a salt, and its excretion is closely tied to sodium levels in the body. If
sodium intake decreases or is lost through sweating, the kidneys retain lithium, leading to
toxicity. Clients must maintain consistent sodium and fluid intake to keep lithium levels
within a therapeutic range.
6. A nurse is evaluating a client’s understanding of nitroglycerin sublingual tablets for angina.
Which statement indicates the need for further teaching?
A. I can take up to 5 tablets in a 15-minute period.
B. I will call 911 if the pain is not relieved after the first dose.
C. I will store the tablets in the original dark glass bottle.
D. I should sit down before taking the medication because it may cause dizziness.
Correct Answer: A
Rationale: The standard protocol for sublingual nitroglycerin is to take one tablet every 5
minutes for a maximum of 3 doses. Taking 5 tablets is incorrect and dangerous as it can
cause severe hypotension. The other statements regarding storage, calling 911, and sitting
down are correct safety measures.
7. A child with suspected bacterial meningitis is being admitted. Which action should the
nurse take first?
A. Obtain a sputum culture.
Rationale (HESI CAT Exam 2026)
1. A nurse is caring for a client who is receiving intravenous furosemide for heart failure.
Which assessment finding should the nurse prioritize?
A. Weight loss of 1 kg in 24 hours
B. A blood pressure of 118/72 mmHg
C. A serum potassium level of 3.2 mEq/L
D. Urine output of 50 mL/hr
Correct Answer: C
Rationale: Furosemide is a loop diuretic that causes significant loss of potassium through
the kidneys. A potassium level of 3.2 mEq/L indicates hypokalemia, which can lead to life-
threatening cardiac arrhythmias. The nurse must prioritize this finding to prevent further
complications.
2. A client with type 1 diabetes mellitus is found unconscious and clammy. What should be
the nurse’s first action?
A. Administer 15 grams of oral carbohydrates
B. Administer glucagon intramuscularly
C. Check the client’s blood glucose level
,D. Call the healthcare provider immediately
Correct Answer: B
Rationale: An unconscious client cannot safely swallow oral carbohydrates due to the risk
of aspiration. In an emergency where the client is unresponsive and hypoglycemia is
suspected, glucagon should be administered to raise blood glucose rapidly. Monitoring the
blood glucose is important, but taking immediate action to restore consciousness in a
symptomatic patient is the priority.
3. The nurse is assessing a client 4 hours after a thyroidectomy. Which finding is most
concerning?
A. The client reports a sore throat when speaking.
B. The client has a small amount of serosanguinous drainage on the dressing.
C. The client is experiencing muscle tremors and tingling in the fingers.
D. The client’s voice sounds slightly hoarse.
Correct Answer: C
Rationale: Muscle tremors and tingling (paresthesia) are signs of hypocalcemia, which can
occur if the parathyroid glands are accidentally damaged or removed during a
thyroidectomy. This can lead to tetany and airway obstruction if not treated with calcium
gluconate. While hoarseness and a sore throat are expected, they do not take priority over
potential tetany.
,4. Which of the following interventions should the nurse include in the plan of care for a
client with MRSA? Select all that apply.
A. Perform hand hygiene before and after client contact.
B. Wear a mask when entering the client’s room.
C. Place the client in a private room.
D. Wear a gown and gloves for all direct care.
E. Use dedicated equipment such as a blood pressure cuff for this client.
F. Keep the door to the room closed at all times.
Correct Answer: ACDE
Rationale: MRSA requires contact precautions to prevent the spread of the organism. This
includes hand hygiene, a private room, and the use of gowns and gloves for contact.
Dedicated equipment should stay in the room to avoid cross-contamination; however, a
mask and keeping the door closed are required for airborne or droplet precautions, not
standard contact precautions.
5. A client is prescribed Lithium for bipolar disorder. Which instruction is most important for
the nurse to provide?
A. Maintain a consistent intake of dietary sodium.
B. Decrease fluid intake to 1 liter per day.
C. Take the medication only when feeling manic.
, D. Avoid all exercise to prevent sweating.
Correct Answer: A
Rationale: Lithium is a salt, and its excretion is closely tied to sodium levels in the body. If
sodium intake decreases or is lost through sweating, the kidneys retain lithium, leading to
toxicity. Clients must maintain consistent sodium and fluid intake to keep lithium levels
within a therapeutic range.
6. A nurse is evaluating a client’s understanding of nitroglycerin sublingual tablets for angina.
Which statement indicates the need for further teaching?
A. I can take up to 5 tablets in a 15-minute period.
B. I will call 911 if the pain is not relieved after the first dose.
C. I will store the tablets in the original dark glass bottle.
D. I should sit down before taking the medication because it may cause dizziness.
Correct Answer: A
Rationale: The standard protocol for sublingual nitroglycerin is to take one tablet every 5
minutes for a maximum of 3 doses. Taking 5 tablets is incorrect and dangerous as it can
cause severe hypotension. The other statements regarding storage, calling 911, and sitting
down are correct safety measures.
7. A child with suspected bacterial meningitis is being admitted. Which action should the
nurse take first?
A. Obtain a sputum culture.
