HESI CAT Exam V1 | 2026 Q&A with
Rationale (HESI CAT Exam 2026)
1. A client with congestive heart failure is prescribed digoxin. Which assessment finding
should the nurse identify as a primary indicator of digoxin toxicity?
A. Visual disturbances such as yellow-green halos
B. Increased urinary output
C. Restlessness and agitation
D. Tachycardia and hypertension
Correct Answer: A
Rationale: Digoxin toxicity commonly manifests with gastrointestinal distress and
neurological symptoms. Visual disturbances, particularly seeing yellow-green halos or
blurred vision, are classic signs of toxic levels. The nurse should also monitor for
bradycardia and check the apical pulse for one full minute prior to administration.
2. The nurse is caring for a client who is being treated for hypokalemia. Which clinical
manifestations should the nurse expect to observe? (Select all that apply)
A. Muscle weakness
B. Cardiac dysrhythmias
C. Hyperactive bowel sounds
,D. Abdominal distention
E. Prominent U waves on ECG
F. Hyperreflexia
Correct Answer: ABDE
Rationale: Hypokalemia affects neuromuscular and cardiac function due to the role of
potassium in cell membrane potential. Common signs include muscle weakness, cardiac
dysrhythmias, and decreased gastrointestinal motility leading to abdominal distention. The
presence of U waves on an electrocardiogram is a specific diagnostic indicator for low
potassium levels.
3. A client is admitted to the psychiatric unit with a diagnosis of paranoid schizophrenia.
Which intervention is most important for the nurse to implement when the client is
experiencing auditory hallucinations?
A. Leave the client alone to allow for privacy
B. Tell the client that the voices are not real
C. Ask the client what the voices are telling them to do
D. Agree with the client about the presence of the voices
Correct Answer: C
Rationale: Safety is the priority when a client is experiencing hallucinations. The nurse
must assess the content of the hallucinations to determine if they are command
,hallucinations that may lead to self-harm or violence. Acknowledging the client’s
experience without validating the hallucination helps build trust while maintaining a focus
on safety.
4. The nurse is monitoring a client following a thyroidectomy. Which assessment finding is
most important for the nurse to report to the healthcare provider immediately?
A. Tingling in the fingers and toes
B. Hoarseness when speaking
C. Pain at the incision site
D. Sore throat when swallowing
Correct Answer: A
Rationale: Tingling in the extremities, known as paresthesia, may indicate hypocalcemia
resulting from accidental damage to the parathyroid glands during surgery. Hypocalcemia
can progress to tetany and airway obstruction if left untreated. While hoarseness is
common, it should be monitored, but signs of neuromuscular irritability require immediate
intervention.
5. A nurse is teaching a client with Type 1 Diabetes Mellitus about the signs of hypoglycemia.
Which symptoms should the nurse include in the teaching? (Select all that apply)
A. Excessive thirst
B. Shakiness
C. Diaphoresis
, D. Fruity breath odor
E. Confusion
F. Increased appetite
Correct Answer: BCEF
Rationale: Hypoglycemia triggers the sympathetic nervous system, leading to symptoms
such as shakiness, sweating, and palpitations. Mental status changes like confusion occur
because the brain requires a constant supply of glucose to function. Excessive thirst and
fruity breath are typically associated with hyperglycemia and diabetic ketoacidosis rather
than low blood sugar.
6. A client with a history of COPD is receiving oxygen therapy via nasal cannula at 2 L/min.
Which oxygen saturation (SpO2) range is considered an acceptable goal for this client?
A. 88% to 92%
B. 92% to 94%
C. 95% to 100%
D. 80% to 85%
Correct Answer: A
Rationale: Clients with COPD often rely on a hypoxic drive to breathe due to chronic
carbon dioxide retention. Aiming for an SpO2 of 88% to 92% prevents the suppression of
Rationale (HESI CAT Exam 2026)
1. A client with congestive heart failure is prescribed digoxin. Which assessment finding
should the nurse identify as a primary indicator of digoxin toxicity?
A. Visual disturbances such as yellow-green halos
B. Increased urinary output
C. Restlessness and agitation
D. Tachycardia and hypertension
Correct Answer: A
Rationale: Digoxin toxicity commonly manifests with gastrointestinal distress and
neurological symptoms. Visual disturbances, particularly seeing yellow-green halos or
blurred vision, are classic signs of toxic levels. The nurse should also monitor for
bradycardia and check the apical pulse for one full minute prior to administration.
2. The nurse is caring for a client who is being treated for hypokalemia. Which clinical
manifestations should the nurse expect to observe? (Select all that apply)
A. Muscle weakness
B. Cardiac dysrhythmias
C. Hyperactive bowel sounds
,D. Abdominal distention
E. Prominent U waves on ECG
F. Hyperreflexia
Correct Answer: ABDE
Rationale: Hypokalemia affects neuromuscular and cardiac function due to the role of
potassium in cell membrane potential. Common signs include muscle weakness, cardiac
dysrhythmias, and decreased gastrointestinal motility leading to abdominal distention. The
presence of U waves on an electrocardiogram is a specific diagnostic indicator for low
potassium levels.
3. A client is admitted to the psychiatric unit with a diagnosis of paranoid schizophrenia.
Which intervention is most important for the nurse to implement when the client is
experiencing auditory hallucinations?
A. Leave the client alone to allow for privacy
B. Tell the client that the voices are not real
C. Ask the client what the voices are telling them to do
D. Agree with the client about the presence of the voices
Correct Answer: C
Rationale: Safety is the priority when a client is experiencing hallucinations. The nurse
must assess the content of the hallucinations to determine if they are command
,hallucinations that may lead to self-harm or violence. Acknowledging the client’s
experience without validating the hallucination helps build trust while maintaining a focus
on safety.
4. The nurse is monitoring a client following a thyroidectomy. Which assessment finding is
most important for the nurse to report to the healthcare provider immediately?
A. Tingling in the fingers and toes
B. Hoarseness when speaking
C. Pain at the incision site
D. Sore throat when swallowing
Correct Answer: A
Rationale: Tingling in the extremities, known as paresthesia, may indicate hypocalcemia
resulting from accidental damage to the parathyroid glands during surgery. Hypocalcemia
can progress to tetany and airway obstruction if left untreated. While hoarseness is
common, it should be monitored, but signs of neuromuscular irritability require immediate
intervention.
5. A nurse is teaching a client with Type 1 Diabetes Mellitus about the signs of hypoglycemia.
Which symptoms should the nurse include in the teaching? (Select all that apply)
A. Excessive thirst
B. Shakiness
C. Diaphoresis
, D. Fruity breath odor
E. Confusion
F. Increased appetite
Correct Answer: BCEF
Rationale: Hypoglycemia triggers the sympathetic nervous system, leading to symptoms
such as shakiness, sweating, and palpitations. Mental status changes like confusion occur
because the brain requires a constant supply of glucose to function. Excessive thirst and
fruity breath are typically associated with hyperglycemia and diabetic ketoacidosis rather
than low blood sugar.
6. A client with a history of COPD is receiving oxygen therapy via nasal cannula at 2 L/min.
Which oxygen saturation (SpO2) range is considered an acceptable goal for this client?
A. 88% to 92%
B. 92% to 94%
C. 95% to 100%
D. 80% to 85%
Correct Answer: A
Rationale: Clients with COPD often rely on a hypoxic drive to breathe due to chronic
carbon dioxide retention. Aiming for an SpO2 of 88% to 92% prevents the suppression of
