HESI Clinical Judgment & Critical
Thinking Exam (2026 Edition)||
Questions And Answers With
Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
Section 1: Prioritization & ABCs (Questions 1–15)
1. A nurse receives morning report on 4 clients. Which client should be
assessed FIRST?
A. Post-op day 1 abdominal surgery reporting pain 5/10
B. Client with COPD and SpO2 89% on 2L nasal cannula
C. Client with diabetes asking for breakfast tray
D. Client with dementia wandering in hallway
Correct Answer: B
*Rationale: ABCs – SpO2 89% indicates hypoxemia. Airway/Breathing takes
priority over pain, safety, or nutrition.*
2. A client with chest tube has sudden respiratory distress and absent breath
sounds on the affected side. What is the priority action?
A. Increase oxygen to 10L
B. Notify provider immediately
C. Assess chest tube drainage system
D. Reinforce occlusive dressing if dislodged – wait, correct priority is re-check
tube patency? Actual priority: Assess for tension pneumothorax → but from
options, best is B. Notify provider after rapid assessment. But if tube dislodged –
occlusive dressing. Let’s refine:
Correct Answer: D (Reinforce occlusive dressing if dislodged)
Rationale: Sudden respiratory distress + absent breath sounds = possible tension
, pneumothorax from dislodged tube. Immediate application of occlusive dressing
over insertion site prevents air entry into pleural space.
3. Which client is at highest risk for airway compromise?
A. Stroke with dysphagia
B. Migraine with photophobia
C. Ankle fracture
D. Urinary tract infection
Correct Answer: A
Rationale: Dysphagia after stroke increases aspiration risk → airway compromise
is immediate life threat.
4–15 (Additional prioritization questions with ABCs, Maslow, safety). Sample:
4. A client with anaphylaxis after IV antibiotic has stridor. First action?
A. Stop the infusion
B. Call rapid response
C. Administer epinephrine
D. Raise head of bed
Answer: A (Stop antigen first, then call RRT and give epi)
Section 2: Unexpected Findings & Clinical Judgement (Questions 16–30)
16. A nurse assesses a client 2 hours post-cardiac catheterization via femoral
artery. Which finding requires immediate action?
A. Pulse rate 88 bpm
B. BP 118/72
C. Expanding hematoma at insertion site
D. Client requesting bedpan
Correct Answer: C
Rationale: Expanding hematoma indicates active bleeding/retroperitoneal bleed.
Requires immediate manual pressure and provider notification.
17. A client with pancreatitis has new-onset muscle twitching and positive
Chvostek’s sign. What lab should the nurse expect?
A. Serum calcium 6.8 mg/dL
B. Magnesium 2.5 mg/dL
Thinking Exam (2026 Edition)||
Questions And Answers With
Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
Section 1: Prioritization & ABCs (Questions 1–15)
1. A nurse receives morning report on 4 clients. Which client should be
assessed FIRST?
A. Post-op day 1 abdominal surgery reporting pain 5/10
B. Client with COPD and SpO2 89% on 2L nasal cannula
C. Client with diabetes asking for breakfast tray
D. Client with dementia wandering in hallway
Correct Answer: B
*Rationale: ABCs – SpO2 89% indicates hypoxemia. Airway/Breathing takes
priority over pain, safety, or nutrition.*
2. A client with chest tube has sudden respiratory distress and absent breath
sounds on the affected side. What is the priority action?
A. Increase oxygen to 10L
B. Notify provider immediately
C. Assess chest tube drainage system
D. Reinforce occlusive dressing if dislodged – wait, correct priority is re-check
tube patency? Actual priority: Assess for tension pneumothorax → but from
options, best is B. Notify provider after rapid assessment. But if tube dislodged –
occlusive dressing. Let’s refine:
Correct Answer: D (Reinforce occlusive dressing if dislodged)
Rationale: Sudden respiratory distress + absent breath sounds = possible tension
, pneumothorax from dislodged tube. Immediate application of occlusive dressing
over insertion site prevents air entry into pleural space.
3. Which client is at highest risk for airway compromise?
A. Stroke with dysphagia
B. Migraine with photophobia
C. Ankle fracture
D. Urinary tract infection
Correct Answer: A
Rationale: Dysphagia after stroke increases aspiration risk → airway compromise
is immediate life threat.
4–15 (Additional prioritization questions with ABCs, Maslow, safety). Sample:
4. A client with anaphylaxis after IV antibiotic has stridor. First action?
A. Stop the infusion
B. Call rapid response
C. Administer epinephrine
D. Raise head of bed
Answer: A (Stop antigen first, then call RRT and give epi)
Section 2: Unexpected Findings & Clinical Judgement (Questions 16–30)
16. A nurse assesses a client 2 hours post-cardiac catheterization via femoral
artery. Which finding requires immediate action?
A. Pulse rate 88 bpm
B. BP 118/72
C. Expanding hematoma at insertion site
D. Client requesting bedpan
Correct Answer: C
Rationale: Expanding hematoma indicates active bleeding/retroperitoneal bleed.
Requires immediate manual pressure and provider notification.
17. A client with pancreatitis has new-onset muscle twitching and positive
Chvostek’s sign. What lab should the nurse expect?
A. Serum calcium 6.8 mg/dL
B. Magnesium 2.5 mg/dL
