HESI LPN
CAT Exam Practice Test
1. A college student brings a dorm roommate to the campus clinic because the roommate has been talking to someone who is not present. The client tells the nurse that her voices are saying, “Kill, Kill.†What question should the nurse ask the client next?
- A. When did these voices begin?
- B. Are you planning to obey the voices?
- C. Have you taken any hallucinogens?
- D. Do you believe the voices are real?
Correct answer: B
Rationale: Assessing whether the client has a plan to act on the voices is critical for evaluating the risk of harm. Asking if the client is planning to obey the voices helps determine the immediate safety concerns. While understanding when the voices began could provide insight into the situation, assessing the intent to act on them is more urgent. Asking about hallucinogen use may be relevant but does not address the immediate safety issue. Inquiring about the client's belief in the reality of the voices is important but does not address the immediate risk of harm.
2. An older male client is admitted to the mental health unit with a sudden onset of global disorientation and is continuously conversing with his mother, who died 50 years ago. The nurse reviews the multiple prescriptions the client is currently taking and assesses his urine specimen, which is cloudy, dark yellow, and has a foul odor. These findings suggest that this client is experiencing which condition?
- A. Psychotic episode
- B. Dementia
- C. Delirium
- D. Depression
Correct answer: C
Rationale: The correct answer is C, delirium. The sudden onset of global disorientation along with cloudy, dark yellow urine with a foul odor are indicative of delirium. Delirium is an acute condition characterized by a fluctuating disturbance in awareness and cognition. In this case, the symptoms are suggestive of an underlying physiological cause, such as infection or medication side effects. Choice A, psychotic episode, is less likely as the symptoms are more in line with delirium than a primary psychotic disorder. Choice B, dementia, is a chronic and progressive condition, not typically presenting with sudden onset disorientation. Choice D, depression, does not align with the acute cognitive changes and urine abnormalities described in the scenario.
3. A male client with hypertension, who received new antihypertensive prescriptions at his last visit returns to the clinic two weeks later to evaluate his blood pressure (BP). His BP is 158/106 mmHg and he admits that he has not been taking the prescribed medication because the drugs make him feel bad. In explaining the need for hypertension control, the nurse should stress that an elevated BP places the client at risk for which pathophysiological condition?
- A. Stroke secondary to hemorrhage
- B. Acute kidney injury due to glomerular damage
- C. Heart block due to myocardial damage
- D. Blindness secondary to cataracts
Correct answer: A
Rationale: The correct answer is A: Stroke secondary to hemorrhage. Hypertension increases the risk of stroke due to the stress and damage it causes to blood vessels, which can lead to hemorrhage. Choice B is incorrect because acute kidney injury is more commonly associated with chronic uncontrolled hypertension, not acute elevations. Choice C is incorrect as heart block is not a direct consequence of hypertension. Choice D is incorrect as hypertension does not directly cause cataracts leading to blindness.
4. The nurse receives change of shift report on a group of clients for the upcoming shift. A client with which condition requires the most immediate attention by the nurse?
- A. Gunshot wound three hours ago with dark drainage of 2 cm on the dressing
- B. Mastectomy 2 days ago with 50 ml bloody drainage in the Jackson-Pratt drain
- C. Collapsed lung after a fall 8 hours ago with 100 ml blood in the chest tube collection container
- D. Abdominal-perineal resection 2 days ago with no drainage on dressing and fever and chills
Correct answer: C
Rationale: A collapsed lung with significant blood accumulation requires immediate attention to prevent respiratory compromise. Option A may also require attention, but the immediate threat to airway and breathing in option C takes precedence over the others. Option B has expected drainage after a mastectomy, and option D's fever and chills, while concerning, do not pose an immediate life-threatening risk as in option C.
5. 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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