HESI CAT Exam

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A group of nurses implemented a pilot study to evaluate a proposed evidence-based change to providing client care. Evaluation indicates successful outcomes, and the nurses want to integrate the change throughout the facility. Which action should be taken? (Select all that apply)

  • A. Invite data review by the quality improvement department
  • B. Submit a sentinel event report to the research committee
  • C. Propose clinical practice guidelines to the nursing committee
  • D. Arrange in-service training through the educational department
Correct Answer: A

Rationale: Inviting data review by the quality improvement department is crucial to ensure the quality and efficacy of the proposed evidence-based change. This step allows for a comprehensive analysis of the data collected during the pilot study. Proposing clinical practice guidelines to the nursing committee is also essential for integrating the successful change into routine practice. In-service training through the educational department will help educate staff and ensure they are proficient in implementing the new practices. Submitting a sentinel event report to the research committee is not necessary in this scenario as the outcomes were successful, and there were no adverse events that would warrant such a report. Choices B, C, and D are not as relevant in this context compared to inviting data review by the quality improvement department, which is a crucial step in ensuring the success of the proposed change.

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The nurse is admitting a client from the post-anesthesia unit to the postoperative surgical care unit. Which intervention should the nurse implement first?

  • A. Advance to clear liquids as tolerated
  • B. Straight catheterization if unable to void
  • C. Administer Cefazolin 1 gram IVPQ q6 hours
  • D. Obtain a complete blood cell count (CBC) in the morning
Correct Answer: B

Rationale: The correct answer is to perform straight catheterization if the client is unable to void. This action is essential to prevent urinary retention and its potential complications following anesthesia. Option A, advancing to clear liquids, is not the priority upon admission as the focus should be on urinary function first. Option C involves administering an antibiotic, which is important but not the immediate priority. Option D, obtaining a CBC, can be done later and is not as crucial as ensuring proper urinary function postoperatively.

The nurse is demonstrating wound care to a client following abdominal surgery. In what order should the nurse teach the technique?

  • A. Remove old dressing using clean gloves. Discard gloves with old dressing
  • B. Moisten sterile gauze with normal saline. Clean wound from least contaminated area to most contaminated area
  • C. Apply sterile gauze dressing to wound area
  • D. Secure dressing with tape
Correct Answer: A

Rationale: The correct order ensures proper aseptic technique and wound care to prevent infection. The first step is to remove the old dressing using clean gloves to prevent contamination. Discarding the gloves with the old dressing helps maintain cleanliness. Choices B, C, and D are incorrect because cleaning the wound, applying a new dressing, and securing it should come after removing the old dressing to maintain asepsis and prevent infection.

When assessing a mildly obese 35-year-old female client, the nurse is unable to locate the gallbladder when palpating below the liver margin at the lateral border of the rectus abdominal muscle. What is the most likely explanation for the failure to locate the gallbladder by palpation?

  • A. The client is too obese.
  • B. Palpating in the wrong location.
  • C. The gallbladder is normal.
  • D. Deeper palpation technique is needed.
Correct Answer: A

Rationale: The correct answer is A. Obesity can make it difficult to palpate the gallbladder due to increased abdominal tissue, making it challenging to locate specific structures. Choice B is incorrect because the nurse is palpating in the correct location below the liver margin at the lateral border of the rectus abdominal muscle, where the gallbladder is typically located. Choice C is incorrect as the inability to palpate the gallbladder does not necessarily indicate abnormality; it may be due to anatomical variations or technical challenges. Choice D is incorrect as the issue lies more with the difficulty posed by excess adipose tissue rather than the need for deeper palpation techniques.

The parents of a 6-year-old recently diagnosed with asthma should be taught that the symptom of acute episodes of asthma is due to which physiological response?

  • A. Inflammation of the mucous membrane & bronchospasm
  • B. Increased mucus production and bronchoconstriction
  • C. Allergic reactions and hyperventilation
  • D. Airway narrowing and decreased lung capacity
Correct Answer: A

Rationale: The correct answer is A: Inflammation of the mucous membrane & bronchospasm. Acute asthma episodes are primarily caused by inflammation of the airways and bronchospasm, which lead to airway obstruction. Increased mucus production and bronchoconstriction (Choice B) are part of the physiological responses in asthma but do not directly cause acute episodes. Allergic reactions and hyperventilation (Choice C) are related to asthma triggers and responses but are not the direct causes of acute episodes. Airway narrowing and decreased lung capacity (Choice D) are consequences of inflammation and bronchospasm but do not explain the physiological response leading to acute asthma episodes.

Following the evacuation of a subdural hematoma, an older adult develops an infection. The client is transferred to the neuro intensive care unit with a temperature of 101.8 F (39.3 C) axillary, pulse of 180 beats/minute, and a blood pressure of 90/60 mmHg. What is the priority intervention to include in this client's plan of care?

  • A. Confusion
  • B. Check neuro vital signs every 4 hours.
  • C. Maintain intravenous access.
  • D. Keep the suture line clean and dry.
Correct Answer: C

Rationale: The priority intervention for the client in this scenario is to maintain intravenous (IV) access. Given the client's condition with infection, elevated temperature, tachycardia, and hypotension, it is crucial to ensure IV access for administering antibiotics, fluids, and other medications promptly. This can help manage the infection, stabilize hemodynamics, and support the client's hydration and medication needs. Checking neuro vital signs, although important, is secondary to addressing the immediate need for IV access. Keeping the suture line clean and dry is important for wound care but not the priority when dealing with a systemic infection and hemodynamic instability.

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