HESI LPN
CAT Exam Practice
1. The nurse is assessing a client with Addison's disease who is weak, dizzy, disoriented, and has dry oral mucous membranes, poor skin turgor, and sunken eyes. Vital signs are blood pressure 94/44, heart rate 123 beats/minute, respiration 22 breaths/minute. Which intervention should the nurse implement first?
- A. Assess extremity strength and resistance
- B. Report a sodium level of 132 mEq/L or mmol/L (SI units)
- C. Measure and record the cardiac QRS complex
- D. Check current finger stick glucose
Correct answer: D
Rationale: The client’s symptoms suggest possible adrenal crisis or hypoglycemia. Checking glucose is a priority to rule out hypoglycemia, which requires immediate intervention. The client is presenting with symptoms indicative of hypoglycemia, which can be life-threatening if not promptly addressed. Assessing extremity strength, reporting sodium levels, or measuring the cardiac QRS complex are not the most urgent actions in this scenario.
2. A client has had several episodes of clear, watery diarrhea that started yesterday. What action should the nurse implement?
- A. Administer a prescribed PRN antiemetic
- B. Assess the client for the presence of hemorrhoids
- C. Check the client’s hemoglobin level
- D. Review the client’s current list of medications
Correct answer: D
Rationale: The correct action for the nurse to implement in a client experiencing clear, watery diarrhea is to review the client's current list of medications. Certain medications can cause diarrhea as a side effect, so identifying any potential culprits is essential. Administering an antiemetic (Choice A) is not appropriate for diarrhea, as antiemetics are used to control nausea and vomiting, not diarrhea. Assessing for hemorrhoids (Choice B) is not the priority when the client is experiencing watery diarrhea; addressing the root cause is crucial. Checking the client’s hemoglobin level (Choice C) is not the immediate action needed for this situation as it does not directly address the cause of diarrhea.
3. After a sudden loss of consciousness, a female client is taken to the ED, and initial assessment indicates that her blood glucose level is critically low. Once her glucose level is stabilized, the client reports that she was recently diagnosed with anorexia nervosa and is being treated at an outpatient clinic. Which intervention is more important to include in this client’s discharge plan?
- A. Describe the importance of maintaining stable blood glucose levels.
- B. Encourage a balanced and nutritious diet.
- C. Reinforce the need to continue outpatient treatment.
- D. Educate on the risks of untreated anorexia nervosa.
Correct answer: C
Rationale: Continuing outpatient treatment is crucial for managing anorexia nervosa and preventing future complications. Reinforcing the need to continue outpatient treatment ensures ongoing support, monitoring, and therapy for the client's anorexia nervosa. Describing the importance of maintaining stable blood glucose levels (Choice A) is relevant but does not address the underlying eating disorder directly. Encouraging a balanced and nutritious diet (Choice B) is important; however, specific dietary recommendations should be tailored to the individual's condition by healthcare providers. Educating on the risks of untreated anorexia nervosa (Choice D) is informative but does not provide a direct actionable step for the client's immediate discharge plan, unlike the importance of continuing outpatient treatment.
4. During an admission assessment on an HIV positive client diagnosed with Pneumocystis carinii pneumonia (PCP), which symptoms should the nurse carefully observe the client for?
- A. Weight loss exceeding 10 percent of baseline body weight
- B. Altered mental status and tachypnea
- C. Creamy white patches in the oral cavity
- D. Normal ABGs with wet lung sounds in all lung fields
Correct answer: B
Rationale: The correct answer is B: Altered mental status and tachypnea. These symptoms are indicative of PCP and severe HIV progression. Weight loss exceeding 10 percent of baseline body weight (choice A) may be seen in HIV/AIDS but is not specific to PCP. Creamy white patches in the oral cavity (choice C) are characteristic of oral thrush, which is more commonly associated with Candida infections in HIV patients. Normal ABGs with wet lung sounds in all lung fields (choice D) would not be expected with PCP, as it typically presents with hypoxemia and diffuse bilateral infiltrates on chest imaging.
5. A 60-year-old male with type 2 diabetes mellitus tells the nurse that he is going to join a gym and start working out. Which information is most important for the nurse to obtain?
- A. Recent serum cholesterol levels
- B. Presence of calf pain during exercise
- C. Average weight gain or loss in the last year
- D. Exercise tolerance test with EKG results
Correct answer: B
Rationale: The most important information for the nurse to obtain in this scenario is the presence of calf pain during exercise. Calf pain during exercise could indicate peripheral vascular issues, such as peripheral artery disease, which is crucial to address before starting an exercise program. High cholesterol levels (choice A) may be important but are not as immediately relevant as assessing for peripheral vascular issues. Average weight gain or loss (choice C) may provide some insight into the patient's overall health status but is not as critical as assessing for potential vascular complications. An exercise tolerance test with EKG results (choice D) may be valuable in assessing cardiovascular fitness but is not as crucial as evaluating for peripheral vascular issues given the patient's symptoms.
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