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HESI CAT Exam Test Bank
1. The nurse is obtaining the medical histories of new clients at a community-based primary care clinic. Which individual has the highest risk for experiencing elder abuse?
- A. A 69-year-old widowed female who lives alone and volunteers at a school
- B. A 95-year-old ambulatory male who resides in a nursing home in a small town
- C. A 78-year-old female on a fixed income who lives with her relatives
- D. An 81-year-old male with diabetes who lives with his wife of 52 years
Correct answer: C
Rationale: Elder abuse risk is higher in individuals who live with relatives and are on a fixed income as these factors can contribute to vulnerability. Living with relatives may expose the individual to potential abusive situations within the family dynamics. Additionally, being on a fixed income may limit financial independence and increase dependency on others, potentially leading to financial abuse. The other options, such as living alone and volunteering, residing in a nursing home, or living with a long-term spouse, do not inherently pose the same level of risk factors for elder abuse as living with relatives on a fixed income.
2. An adult client with a broken femur is transferred to the medical-surgical unit to await surgical internal fixation after the application of an external traction device to stabilize the leg. An hour after an opioid analgesic was administered, the client reports muscle spasms and pain at the fracture site. While waiting for the client to be transported to surgery, which action should the nurse implement?
- A. Observe for signs of deep vein thrombosis.
- B. Administer a PRN dose of a muscle relaxant.
- C. Check the client’s most recent electrolyte values.
- D. Reduce the weight on the traction device.
Correct answer: B
Rationale: The correct answer is B: Administer a PRN dose of a muscle relaxant. Muscle spasms and pain might be relieved by muscle relaxants, which are appropriate before surgery. Choice A is incorrect because the client is experiencing muscle spasms, not signs of deep vein thrombosis. Choice C is not the most immediate action needed in this situation. Choice D is incorrect because reducing the weight on the traction device would not directly address the muscle spasms and pain reported by the client.
3. The charge nurse is making assignments for clients on an endocrine unit. Which client is best to assign to a new graduate nurse?
- A. A female adult with hyperthyroidism who is returning to the unit after a thyroidectomy
- B. A male adult with Cushing's syndrome who reports a headache and visual disturbances
- C. An older man with Addison's disease who is diaphoretic and has hand tremors
- D. A perimenopausal woman with Graves' disease who is nervous and has exophthalmos
Correct answer: A
Rationale: A new graduate nurse can manage the care of a stable client returning from a thyroidectomy. Choice B is not suitable for a new graduate nurse as it involves complex symptoms of Cushing's syndrome that require more experience and knowledge. Choice C presents a client with acute manifestations of Addison's disease, which may be challenging for a new graduate nurse. Choice D involves a client with Graves' disease experiencing nervousness and exophthalmos, which also require a higher level of expertise to manage effectively.
4. Which action should the school nurse take first when conducting a screening for scoliosis?
- A. Compare dorsal trunk measurements
- B. Have the individual extend arms over the head for visualization
- C. Inspect for symmetrical shoulder height
- D. Observe weight-bearing on each leg
Correct answer: C
Rationale: Inspecting for symmetrical shoulder height is a crucial initial step in screening for scoliosis. Asymmetry in shoulder height can indicate the presence of spinal curvature, which is a key indicator of scoliosis. This assessment is prioritized as it provides a visual clue to potential spinal abnormalities. Choices A, B, and D are not the first steps in scoliosis screening. Choice A involves a more detailed measurement that is not the primary visual indicator for scoliosis; choice B is not a primary indicator of scoliosis but can be used for further examination, and choice D is not directly related to identifying spinal curvature.
5. A client with myasthenia gravis (MG) is receiving immunosuppressive therapy. Review of recent laboratory test results shows that the client’s serum magnesium level has decreased below the normal range. In addition to contacting the healthcare provider, what nursing action is most important?
- A. Check the visual difficulties
- B. Note the most recent hemoglobin level
- C. Assess for hand and joint pain
- D. Observe rhythm on telemetry monitor
Correct answer: D
Rationale: The correct answer is to observe the rhythm on the telemetry monitor. Decreased magnesium levels can lead to cardiac issues, such as arrhythmias. Monitoring the heart rhythm is crucial in this situation. Checking visual difficulties (choice A) is not directly related to the potential cardiac effects of low magnesium levels. Noting the hemoglobin level (choice B) and assessing for hand and joint pain (choice C) are not the priority when dealing with low magnesium levels and possible cardiac complications.
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