Wow, I just took the CT exam, and I'm surprised that the questions (5 years after the original post) seem almost the same. I took the "muffins" (a box of chocolates on my exam) from a patients son, and shared them with the staff because it was a nice gesture, and to refuse seemed offensive. Regarding the question in the pharmacy (while off-duty), I chose to refuse to offer medical advice because I'm not a doctor. I also got the question about the patient defecating on themselves in the bed (chose to clean the patient first, and use towels underneath him until I could find clean sheets).
Honestly, there is no magical way to approach the questions. I just really tried to imagine myself in the situation, and decide what action I would take. For example, if I need to change bed linens for a patient, and the floor was out of linens, I would take them off of an unused bed. If I was in the middle of changing a dressing for a home health patient, and another patient called, I'd silence the call until I was done; however, if I was at dinner with friends, and I was on-call, I'd leave the table to take a call. If a patient just got a cast on their lower leg, and it became very painful, the first thing I'd check is their their toes to make sure there is adequate circulation. Really, all you need to do is think about what you'd do as a professional, and perhaps also think what you'd like a nurse to do for you if you were the patient. However, for the question about the guy who wanted to meet the nurse for coffee to discuss the physician, I chose to "explain professional boundries"--not everything the patient wants is acceptable :-). Overall, I scored 940, not the highest, but good enough. Good luck to all future HESI testers!