CAT Exam Practice Test

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An adult suffered burns to the face and chest resulting from a grease fire. On admission, the client was intubated, and a 2-liter bolus of normal saline was administered IV. Currently, the normal saline is infusing at 250 ml/hour. The client's heart rate is 120 beats/minute, blood pressure is 90/50 mmHg, respirations are 12 breaths/minute over the ventilated 12 breaths for a total of 24 breaths/minute, and the central venous pressure (CVP) is 4 mm H2O. Which intervention should the nurse implement?

  • A. Increase the rate of normal saline infusion
  • B. Infuse an additional bolus of normal saline
  • C. Lower the head of the bed to a recumbent position
  • D. Bring a tracheostomy tray to the bedside
Correct Answer: B

Rationale: The correct intervention is to infuse an additional bolus of normal saline. The client's presentation with a heart rate of 120 beats/minute, hypotensive blood pressure of 90/50 mmHg, and low CVP of 4 mm H2O indicates hypovolemic shock. Administering more normal saline can help in restoring intravascular volume and improving perfusion. Increasing the rate of normal saline infusion (Choice A) is not the best choice as it may lead to fluid overload. Lowering the head of the bed to a recumbent position (Choice C) could worsen hypotension by reducing venous return. Bringing a tracheostomy tray to the bedside (Choice D) is not a priority at this time as the client is already intubated, and the immediate concern is addressing the hypovolemia.

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A nurse who works in the nursery is attending the vaginal delivery of a term infant. What action should the nurse complete before leaving the delivery room?

  • A. Obtain the infant's vital signs.
  • B. Observe the infant latching onto the breast.
  • C. Administer a vitamin K injection.
  • D. Place the ID bands on the infant and mother.
Correct Answer: D

Rationale: Placing ID bands on the infant and mother is crucial to ensure correct identification and prevent mix-ups. This step is essential for maintaining proper identification of the newborn and the mother, facilitating safe care delivery. Before leaving the delivery room, ensuring proper identification is a priority to prevent any errors. Obtaining the infant's vital signs may be important but does not take precedence over ensuring correct identification. Observing the infant latching onto the breast is crucial for breastfeeding initiation but can be done after proper identification. Administering a vitamin K injection is also important but should not delay the immediate identification process.

A client with eczema is experiencing severe pruritus. Which PRN prescription should the nurse administer?

  • A. Topical corticosteroid
  • B. Topical scabicide
  • C. Topical alcohol rub
  • D. Transdermal analgesic
Correct Answer: A

Rationale: The correct answer is A: Topical corticosteroid. Topical corticosteroids are commonly used to manage itching in eczema by reducing inflammation and suppressing the immune response. In this case, for severe pruritus in eczema, a topical corticosteroid would be appropriate. Choice B, Topical scabicide, is used to treat scabies, not eczema. Choice C, Topical alcohol rub, is not typically used to manage pruritus in eczema. Choice D, Transdermal analgesic, is more for pain relief and not specifically targeted at managing itching associated with eczema.

Which client is at the greatest risk for developing delirium?

  • A. An adult client who cannot sleep due to constant pain
  • B. An older client who attempted suicide 1 month ago
  • C. A young adult who takes antipsychotic medications twice a day
  • D. A middle-aged woman who uses a tank for supplemental oxygen
Correct Answer: B

Rationale: The correct answer is B because older adults are at higher risk for delirium, especially following a recent suicide attempt, which can be a significant stressor. Choice A is less likely to develop delirium solely due to difficulty sleeping; delirium is more complex and multifactorial. Choice C, a young adult taking antipsychotic medications, may be at risk for other conditions but not necessarily delirium. Choice D, a middle-aged woman using supplemental oxygen, is not directly linked to an increased risk of delirium compared to the older client who recently attempted suicide.

While changing a client's chest tube dressing, the nurse notes a crackling sensation when gentle pressure is applied to the skin at the insertion site. What is the best action for the nurse to take?

  • A. Apply a pressure dressing around the chest tube insertion site
  • B. Assess the client for allergies to topical cleaning agents
  • C. Measure the area of swelling and crackling
  • D. Administer an oral antihistamine per PRN protocol
Correct Answer: A

Rationale: A crackling sensation indicates subcutaneous emphysema, caused by air trapped under the skin. Applying a pressure dressing around the chest tube insertion site can help manage the issue by preventing further air leakage into the tissues. Choice B is incorrect because the crackling sensation is not related to allergies. Choice C is incorrect as measuring the area does not address the underlying cause. Choice D is incorrect as administering an oral antihistamine is not indicated for subcutaneous emphysema.

The nurse is teaching a class on child care to new parents. Which instruction should be included about the prevention of rotavirus infection in infants who are starting to eat foods?

  • A. Keep house pets away from the food preparation area
  • B. Avoid feeding infants fresh fruits
  • C. Use only lactose-free formulas
  • D. Wash hands before any food preparation
Correct Answer: D

Rationale: The correct answer is D: Wash hands before any food preparation. Rotavirus is a highly contagious virus that can be prevented by maintaining proper hygiene. Washing hands before handling food can help prevent the spread of infections, including rotavirus. Choices A, B, and C are incorrect because while they are good practices for general hygiene and infant care, they are not specifically targeted at preventing rotavirus infection.

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