HESI LPN
CAT Exam Practice
1. A client with leukemia who is receiving myelosuppressive chemotherapy has a platelet count of 25,000/mm3. Which intervention is most important for the nurse to include in this client’s plan of care?
- A. Monitor for signs of activity intolerance
- B. Require visitors to wear respiratory masks
- C. Assess urine and stool for occult blood
- D. Obtain client’s temperature q4 hours
Correct answer: C
Rationale: The correct answer is to assess urine and stool for occult blood. With a low platelet count, there is an increased risk of bleeding. Monitoring for occult blood is essential to detect any signs of internal bleeding. Choices A, B, and D are not the priority interventions in this situation. While monitoring for signs of activity intolerance, requiring visitors to wear respiratory masks, and obtaining the client's temperature are important aspects of care, they are not as critical as assessing for occult blood in a client with a low platelet count.
2. The nurse asks a female client with borderline personality disorder, 'How do you feel about your children not coming to visit this weekend?' The client looks out the window and replies, 'I really don't care.' Which response is best for the nurse to provide?
- A. I noticed you were looking out the window when discussing your feelings.
- B. I think you're lying and it bothers you that your children aren't coming.
- C. I think you should discuss your children not coming in the group meeting.
- D. Why do you think your children didn't want to come visit you this weekend?
Correct answer: A
Rationale: Acknowledging the client's non-verbal behavior, such as looking out the window, demonstrates active listening and provides the client with an opportunity to explore their feelings further. Choice B is incorrect as it accuses the client of lying without any evidence, which can damage the therapeutic relationship. Choice C is inappropriate as it dismisses the client's feelings and suggests a group discussion without addressing the client's emotions directly. Choice D is also incorrect as it focuses on the children's actions rather than the client's feelings, missing an opportunity for therapeutic communication.
3. A 22-year-old male client is admitted to the emergency center following a suicide attempt. His records reveal that this is his third suicide attempt in the past two years. He is conscious, but does not respond to verbal commands for treatment. Which assessment finding should prompt the nurse to prepare the client for gastric lavage?
- A. He ingested the drug 3 hours prior to admission to the emergency center.
- B. The family reports that he took an entire bottle of acetaminophen (Tylenol).
- C. He is unresponsive to instructions and is unable to cooperate with emetic therapy.
- D. Those with repeated suicide attempts desire punishment to relieve their guilt.
Correct answer: C
Rationale: The correct answer is C because the client's unresponsiveness to instructions and inability to cooperate with emetic therapy would make it challenging to implement such therapy effectively. In such cases, gastric lavage may be necessary to remove the ingested substance. Choices A and B are important considerations in treatment planning but do not directly indicate the need for gastric lavage. Choice D is incorrect as medical treatments should never be used as punitive measures but rather for therapeutic purposes.
4. How should the healthcare provider assist parents of a SIDS infant in coping?
- A. Encourage seeking grief counseling
- B. Remain detached
- C. Alleviate feelings of guilt and blame
- D. Discuss the parents' mistakes
Correct answer: C
Rationale: Assisting parents of a SIDS infant in coping involves alleviating feelings of guilt and blame, providing emotional support, and offering appropriate counseling. It is crucial to address the parents' emotional well-being and help them cope with the loss. Choice A is not the best answer as it focuses solely on grief counseling, while the primary concern is addressing feelings of guilt and blame. Choice B is inappropriate as remaining detached does not provide the necessary emotional support these parents need. Choice D is incorrect as discussing the parents' mistakes can intensify their feelings of guilt and blame, rather than helping them cope effectively.
5. While performing an inspection of a client's fingernails, the PN observes a suspected abnormality of the nail's shape and character. Which finding should the PN document?
- A. Clubbed nails
- B. Splinter hemorrhages
- C. Longitudinal ridges
- D. Koilonychia or spoon nails
Correct answer: A
Rationale: The correct answer is A: Clubbed nails. Clubbed nails are a significant finding often associated with chronic hypoxia or lung disease. The presence of clubbed nails should be documented for further evaluation. Splinter hemorrhages (Choice B) are tiny areas of bleeding under the nails and are associated with conditions like endocarditis. Longitudinal ridges (Choice C) are common and often a normal finding in older adults. Koilonychia or spoon nails (Choice D) refer to nails that are concave or scooped out, often seen in conditions like iron deficiency anemia or hemochromatosis. These conditions are not typically associated with chronic hypoxia or lung disease, making them less likely findings in this situation.