HESI CAT Exam V3 | 2026 Q&A with
Rationale (HESI CAT Exam 2026)
1. A client with heart failure is receiving digoxin 0.25 mg PO daily. Which clinical finding
should the nurse identify as an early indicator of digoxin toxicity?
A. Weight gain of 2 lbs in 24 hours
B. Anorexia and nausea
C. Increasing peripheral edema
D. Tachycardia and hypertension
Correct Answer: B
Rationale: Anorexia, nausea, and vomiting are among the earliest signs of digoxin toxicity.
These gastrointestinal symptoms often precede cardiac arrhythmias and visual changes
like yellow-green halos. The nurse should immediately assess the client’s heart rate and
serum potassium levels when these symptoms occur.
2. The nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which assessment finding requires immediate notification of the healthcare
provider?
A. Pain level of 4 on a 1-10 scale after physical therapy
B. Sudden onset of shortness of breath and chest pain
C. Small amount of serosanguineous drainage on the dressing
,D. Redness and warmth at the surgical incision site
Correct Answer: B
Rationale: Sudden onset of shortness of breath and chest pain in a postoperative client
suggests a pulmonary embolism, which is a life-threatening emergency. This condition
often results from a deep vein thrombosis dislodging from the lower extremities.
Immediate intervention, such as oxygen administration and notification of the rapid
response team, is required.
3. A client is admitted to the psychiatric unit with a diagnosis of bipolar disorder, manic
phase. Which meal choice is most appropriate for this client?
A. A cheeseburger, an apple, and a carton of milk
B. Beef stew, mashed potatoes, and a dinner roll
C. Chicken noodle soup, crackers, and apple juice
D. Spaghetti with meatballs and a side salad
Correct Answer: A
Rationale: Clients in a manic phase often have high energy levels and cannot sit still long
enough to eat a full meal using utensils. ‘Finger foods’ that are high in protein and calories
allow the client to eat while moving around the unit. A cheeseburger and an apple are
portable and meet the nutritional needs of a hyperactive client.
,4. Which actions should the nurse implement for a client who is on droplet precautions?
(Select all that apply.)
A. Wear a surgical mask when within 3 feet of the client.
B. Place the client in a private room or with a cohort client.
C. Keep the door to the client’s room closed at all times.
D. Ensure the client wears a surgical mask during transport.
E. Wear an N95 respirator mask for all client care.
F. Perform hand hygiene before and after client contact.
Correct Answer: ABDF
Rationale: Droplet precautions are used for pathogens transmitted by large-particle
droplets, requiring a surgical mask and a private room. The room door does not need to
remain closed as droplets do not stay suspended in the air like airborne particles. Hand
hygiene is a fundamental practice for all isolation categories to prevent the spread of
infection.
5. A client with type 1 diabetes mellitus is found unconscious and diaphoretic. Which action
should the nurse take first?
A. Administer glucagon intramuscularly per protocol.
B. Check the client’s blood glucose level.
C. Administer 15 grams of oral glucose paste.
, D. Notify the healthcare provider immediately.
Correct Answer: A
Rationale: An unconscious client cannot safely swallow oral glucose due to the risk of
aspiration. Glucagon is the standard emergency treatment for severe hypoglycemia in an
unconscious client when intravenous access is not immediately available. Checking the
blood glucose level is important, but if the client is symptomatic and unconscious,
treatment should not be delayed.
6. The nurse is preparing to administer a tube feeding to a client with a nasogastric (NG) tube.
Which method is the most reliable for confirming the placement of the NG tube before
feeding?
A. Auscultating for a ‘whoosh’ sound while injecting air.
B. Checking the pH of the aspirated gastric contents.
C. Obtaining a chest X-ray as ordered by the provider.
D. Observing the color and consistency of the aspirate.
Correct Answer: C
Rationale: Radiographic confirmation (X-ray) is the gold standard and most reliable
method for verifying NG tube placement. While pH testing is a common bedside method, it
can be influenced by medications and is not as definitive as an X-ray. Auscultation is no
longer considered a reliable or safe method for confirming tube placement.
Rationale (HESI CAT Exam 2026)
1. A client with heart failure is receiving digoxin 0.25 mg PO daily. Which clinical finding
should the nurse identify as an early indicator of digoxin toxicity?
A. Weight gain of 2 lbs in 24 hours
B. Anorexia and nausea
C. Increasing peripheral edema
D. Tachycardia and hypertension
Correct Answer: B
Rationale: Anorexia, nausea, and vomiting are among the earliest signs of digoxin toxicity.
These gastrointestinal symptoms often precede cardiac arrhythmias and visual changes
like yellow-green halos. The nurse should immediately assess the client’s heart rate and
serum potassium levels when these symptoms occur.
2. The nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which assessment finding requires immediate notification of the healthcare
provider?
A. Pain level of 4 on a 1-10 scale after physical therapy
B. Sudden onset of shortness of breath and chest pain
C. Small amount of serosanguineous drainage on the dressing
,D. Redness and warmth at the surgical incision site
Correct Answer: B
Rationale: Sudden onset of shortness of breath and chest pain in a postoperative client
suggests a pulmonary embolism, which is a life-threatening emergency. This condition
often results from a deep vein thrombosis dislodging from the lower extremities.
Immediate intervention, such as oxygen administration and notification of the rapid
response team, is required.
3. A client is admitted to the psychiatric unit with a diagnosis of bipolar disorder, manic
phase. Which meal choice is most appropriate for this client?
A. A cheeseburger, an apple, and a carton of milk
B. Beef stew, mashed potatoes, and a dinner roll
C. Chicken noodle soup, crackers, and apple juice
D. Spaghetti with meatballs and a side salad
Correct Answer: A
Rationale: Clients in a manic phase often have high energy levels and cannot sit still long
enough to eat a full meal using utensils. ‘Finger foods’ that are high in protein and calories
allow the client to eat while moving around the unit. A cheeseburger and an apple are
portable and meet the nutritional needs of a hyperactive client.
,4. Which actions should the nurse implement for a client who is on droplet precautions?
(Select all that apply.)
A. Wear a surgical mask when within 3 feet of the client.
B. Place the client in a private room or with a cohort client.
C. Keep the door to the client’s room closed at all times.
D. Ensure the client wears a surgical mask during transport.
E. Wear an N95 respirator mask for all client care.
F. Perform hand hygiene before and after client contact.
Correct Answer: ABDF
Rationale: Droplet precautions are used for pathogens transmitted by large-particle
droplets, requiring a surgical mask and a private room. The room door does not need to
remain closed as droplets do not stay suspended in the air like airborne particles. Hand
hygiene is a fundamental practice for all isolation categories to prevent the spread of
infection.
5. A client with type 1 diabetes mellitus is found unconscious and diaphoretic. Which action
should the nurse take first?
A. Administer glucagon intramuscularly per protocol.
B. Check the client’s blood glucose level.
C. Administer 15 grams of oral glucose paste.
, D. Notify the healthcare provider immediately.
Correct Answer: A
Rationale: An unconscious client cannot safely swallow oral glucose due to the risk of
aspiration. Glucagon is the standard emergency treatment for severe hypoglycemia in an
unconscious client when intravenous access is not immediately available. Checking the
blood glucose level is important, but if the client is symptomatic and unconscious,
treatment should not be delayed.
6. The nurse is preparing to administer a tube feeding to a client with a nasogastric (NG) tube.
Which method is the most reliable for confirming the placement of the NG tube before
feeding?
A. Auscultating for a ‘whoosh’ sound while injecting air.
B. Checking the pH of the aspirated gastric contents.
C. Obtaining a chest X-ray as ordered by the provider.
D. Observing the color and consistency of the aspirate.
Correct Answer: C
Rationale: Radiographic confirmation (X-ray) is the gold standard and most reliable
method for verifying NG tube placement. While pH testing is a common bedside method, it
can be influenced by medications and is not as definitive as an X-ray. Auscultation is no
longer considered a reliable or safe method for confirming tube placement.
