HESI A2 – CRITICAL THINKING 250 PRACTICE QUESTIONS
AND STRATEGY REVIEW FOR 2025 ENTRANCE EXAM
SUCCESS WITH MOST TESTED QUESTIONS
THE |HESI |A2 |CRITICAL |THINKING |SECTION |ASSESSES |A |STUDENT’S |ABILITY |TO |APPLY |LOGIC,
|CLINICAL |REASONING, |AND |PRIORITIZATION |SKILLS |IN |NURSING |SCENARIOS. |THIS |PORTION |OF
|THE |EXAM |MEASURES |HOW |WELL |A |STUDENT |CAN |ANALYZE |SITUATIONS, |MAKE |ETHICAL
|DECISIONS, |AND |IDENTIFY |APPROPRIATE |COURSES |OF |ACTION |IN |PATIENT |CARE. |IT |IS |A |KEY
|COMPONENT |IN |NURSING |PROGRAM |ADMISSIONS |AND |REQUIRES |BOTH |STRATEGIC |THINKING
|AND |CLINICAL |INSIGHT.
1. The |nurse |is |working |in |the |emergency |department |(ED) |of |a |children's |medical |center.
|Which |client |should |the |nurse |assess |first?
1. The |1-month-old |infant |who |has |developed |colic |and |is |crying.
2. The |2-year-old |toddler |who |was |bitten |by |another |child |at |the |day-care |center. |3. |The |6-year-
old |school-age |child |who |was |hit |by |a |car |while |riding |a |bicycle.
4. |The |14-year-old |adolescent |whose |mother |suspects |her |child |is |sexually |active. |-
CORRECT ANSWER-Rationale
| |
Correct |- |3-The |child |hit |by |a |car |should |be |assessed |first |because |he |or |she |may |have |life-
|threatening |injuries |that |must |be |assessed |and |treated |promptly.
2. In |an |interview, |the |nurse |may |find |it |necessary |to |take |notes |to |aid |his |or |her |memory
|later. |Which |statement |is |true |regarding |note-taking?
A) Note-taking |may |impede |the |nurse's |observation |of |the |patient's |nonverbal |behaviors.
B) Note-taking |allows |the |patient |to |continue |at |his |or |her |own |pace |as |the |nurse |records
|what |is |said.
C) Note-taking |allows |the |nurse |to |shift |attention |away |from |the |patient, |resulting |in |an
|increased |comfort |level.
D) Note-taking |allows |the |nurse |to |break |eye |contact |with |the |patient, |which |may |increase |his |or
|her |level |of |comfort. |- |CORRECT |ANSWER-A) |Note-taking |may |impede |the |nurse's
|observation |of |the |patient's |nonverbal |behaviors.
Page: |31 |Some |use |of |history |forms |and |note-taking |may |be |unavoidable. |But |be |aware |that |note-
|taking |during |the |interview |has |disadvantages. |It |breaks |eye |contact |too |often, |and |it |shifts
|attention |away |from |the |patient, |which |diminishes |his |or |her |sense |of |importance. |It |also |may
|interrupt |the |patient's |narrative |flow, |and |it |impedes |the |observation |of |the |patient's |nonverbal
|behavior.
3. The |8-year-old |client |diagnosed |with |a |vaso-occlusive |sickle |cell |crisis |is |complaining |of |a
|severe |headache. |Which |intervention |should |the |nurse |implement |first?
,1. Administer |6 |L |of |oxygen |via |nasal |cannula.
2. Assess |the |client's |neurological |status.
3. Administer |a |narcotic |analgesic |by |intravenous |push |(IVP). |4. |Increase |the |client's |intravenous
(IV) |rate. |- |CORRECT |ANSWER-Rationale
|
Correct |- |2-Because |the |client |is |complaining |of |a |headache, |the |nurse |should |first |rule |out
|cerebrovascular |accident |(CVA) |by |assess- |ing |the |client's |neurological |status |and |then |determine
|whether |it |is |a |headache |that |can |be |treated |with |medication.
4. During |an |interview, |the |nurse |states, |"You |mentioned |shortness |of |breath. |Tell |me |more
|about |that." |Which |verbal |skill |is |used |with |this |statement?
A) Reflection
B) Facilitation
C) Direct |question
D) Open-ended |question |- |CORRECT |ANSWER-D) |Open-ended |question
Page: |32 |The |open-ended |question |asks |for |narrative |information. |It |states |the |topic |to |be
|discussed |but |only |in |general |terms. |The |nurse |should |use |it |to |begin |the |interview, |to |introduce
|a |new |section |of |questions, |and |whenever |the |person |introduces |a |new |topic.
5. The |6-year-old |client |who |has |undergone |abdominal |surgery |is |attempting |to |make |a |pinwheel
|spin |by |blowing |on |it |with |the |nurse's |assistance. |The |child |starts |crying |because |the |pinwheel
|won't |spin. |Which |action |should |the |nurse |implement |first?
1. Praise |the |child |for |the |attempt |to |make |the |pinwheel |spin.
2. Notify |the |respiratory |therapist |to |implement |incentive |spirometry. |3. |Encourage |the |child |to
|turn |from |side |to |side |and |cough.
4. |Demonstrate |how |to |make |the |pinwheel |spin |by |blowing |on |it. |- |CORRECT |ANSWER-
Rationale
Correct |-1. |The |nurse |should |always |praise |the |child |for |attempts |at |cooperation |even |if |the |child
|did |not |accomplish |what |the |nurse |asked.
6. A |nurse |is |taking |complete |health |histories |on |all |of |the |patients |attending |a |wellness
|workshop. |On |the |history |form, |one |of |the |written |questions |asks, |"You |don't |smoke, |drink, |or
|take |drugs, |do |you?" |This |question |is |an |example |of:
A) talking |too |much.
B) using |confrontation.
,C) using |biased |or |leading |questions.
D) using |blunt |language |to |deal |with |distasteful |topics. |- |CORRECT |ANSWER-C) |using |biased
|or |leading |questions.
Page: |36 |This |is |an |example |of |using |leading |or |biased |questions. |Asking, |"You |don't |smoke, |do
|you?" |implies |that |one |answer |is |"better" |than |another. |If |the |person |wants |to |please |someone,
|he |or |she |is |either |forced |to |answer |in |a |way |corresponding |to |their |implied |values |or |is |made
|to |feel |guilty |when |admitting |the |other |answer.
6. The |nurse |is |caring |for |clients |on |the |pediatric |medical |unit. |Which |client |should |the |nurse
|assess |first?
1. The |child |diagnosed |with |type |1 |diabetes |who |has |a |blood |glucose
level |of |180 |mg/dL.
|
2. The |child |diagnosed |with |pneumonia |who |is |coughing |and |has |a |temperature
of |100°F.
|
3. The |child |diagnosed |with |gastroenteritis |who |has |a |potassium |(K+)
level |of |3.9 |mEq/L.
|
4. The |child |diagnosed |with |cystic |fibrosis |who |has |a |pulse |oximeter |reading |of |90%. |-
CORRECT ANSWER-Rationale
| |
Correct |- |4. |A |pulse |oximeter |reading |of |less |than |93% |is |significant |and |indicates |hypoxia, |which
|is |life |threatening; |therefore, |this |child |should |be |assessed |first.
7. During |an |interview, |a |parent |of |a |hospitalized |child |is |sitting |in |an |open |position. |As |the
|interviewer |begins |to |discuss |his |son's |treatment, |however, |he |suddenly |crosses |his |arms |against
|his |chest |and |crosses |his |legs. |This |would |suggest |that |the |parent |is:
A) just |changing |positions.
B) more |comfortable |in |this |position.
C) tired |and |needs |a |break |from |the |interview.
D) uncomfortable |talking |about |his |son's |treatment. |- |CORRECT |ANSWER-D)
|uncomfortable |talking |about |his |son's |treatment.
Page: |37 |Note |the |person's |position. |An |open |position |with |the |extension |of |large |muscle |groups
|shows |relaxation, |physical |comfort, |and |a |willingness |to |share |information. |A |closed |position |with
, the |arms |and |legs |crossed |tends |to |look |defensive |and |anxious. |Note |any |change |in |posture. |If |a
|person |in |a |relaxed |position |suddenly |tenses, |it |suggests |possible |discomfort |with |the |new |topic.
8. The |nurse |has |received |the |a.m. |shift |report |for |clients |on |a |pediatric |unit. |Which
|medication |should |the |nurse |administer |first?
1. The |third |dose |of |the |aminoglycoside |antibiotic |to |the |child |diagnosed
with |methicillin-resistant |Staphylococcus |aureus |(MRSA).
|
2. The |IVP |steroid |methylprednisolone |(Solu-Medrol) |to |the |child |diagnosed
with |asthma.
|
3. The |sliding |scale |insulin |to |the |child |diagnosed |with |type |1 |diabetes |mellitus.
4. The |stimulant |methylphenidate |(Ritalin) |to |a |child |diagnosed |with
attention |deficit-hyperactivity |disorder |(ADHD). |- |CORRECT |ANSWER-
|
Rationale
Correct |- |3-Sliding |scale |insulin |is |ordered |ac, |which |is |before |meals; |therefore, |this |medication
|must |be |administered |first |after |receiving |the |a.m. |shift |report.
4-Routine |medications |have |a |1-hour |leeway |before |and |after |the |scheduled |time; |therefore, |this
|medication |does |not |have |to |be |adminis- |tered |first.
9. The |nurse |is |interviewing |a |patient |who |has |a |hearing |impairment. |What |techniques |would
|be |most |beneficial |in |communicating |with |this |patient?
A) Determine |the |communication |method |he |prefers.
B) Avoid |using |facial |and |hand |gestures |because |most |hearing-impaired |people |find |this |degrading.
C) Request |a |sign |language |interpreter |before |meeting |with |him |to |help |facilitate
|the |communication.
D) Speak |loudly |and |with |exaggerated |facial |movement |when |talking |with |him |because |this
|helps |with |lip |reading. |- |CORRECT |ANSWER-A) |Determine |the |communication |method |he
|prefers.
Pages: |40-41 |The |nurse |should |ask |the |deaf |person |the |preferred |way |to |communicate—by
|signing, |lip |reading, |or |writing. |If |the |person |prefers |lip |reading, |then |the |nurse |should |be |sure |to
|face |him |or |her |squarely |and |have |good |lighting |on |the |nurse's |face. |The |nurse |should |not
|exaggerate |lip |movements |because |this |distorts |words. |Similarly, |shouting |distorts |the |reception
|of |a |hearing |aid |the |person |may |wear. |The |nurse |should |speak |slowly |and |should |supplement |his
|or |her |voice |with |appropriate |hand |gestures |or |pantomime.
AND STRATEGY REVIEW FOR 2025 ENTRANCE EXAM
SUCCESS WITH MOST TESTED QUESTIONS
THE |HESI |A2 |CRITICAL |THINKING |SECTION |ASSESSES |A |STUDENT’S |ABILITY |TO |APPLY |LOGIC,
|CLINICAL |REASONING, |AND |PRIORITIZATION |SKILLS |IN |NURSING |SCENARIOS. |THIS |PORTION |OF
|THE |EXAM |MEASURES |HOW |WELL |A |STUDENT |CAN |ANALYZE |SITUATIONS, |MAKE |ETHICAL
|DECISIONS, |AND |IDENTIFY |APPROPRIATE |COURSES |OF |ACTION |IN |PATIENT |CARE. |IT |IS |A |KEY
|COMPONENT |IN |NURSING |PROGRAM |ADMISSIONS |AND |REQUIRES |BOTH |STRATEGIC |THINKING
|AND |CLINICAL |INSIGHT.
1. The |nurse |is |working |in |the |emergency |department |(ED) |of |a |children's |medical |center.
|Which |client |should |the |nurse |assess |first?
1. The |1-month-old |infant |who |has |developed |colic |and |is |crying.
2. The |2-year-old |toddler |who |was |bitten |by |another |child |at |the |day-care |center. |3. |The |6-year-
old |school-age |child |who |was |hit |by |a |car |while |riding |a |bicycle.
4. |The |14-year-old |adolescent |whose |mother |suspects |her |child |is |sexually |active. |-
CORRECT ANSWER-Rationale
| |
Correct |- |3-The |child |hit |by |a |car |should |be |assessed |first |because |he |or |she |may |have |life-
|threatening |injuries |that |must |be |assessed |and |treated |promptly.
2. In |an |interview, |the |nurse |may |find |it |necessary |to |take |notes |to |aid |his |or |her |memory
|later. |Which |statement |is |true |regarding |note-taking?
A) Note-taking |may |impede |the |nurse's |observation |of |the |patient's |nonverbal |behaviors.
B) Note-taking |allows |the |patient |to |continue |at |his |or |her |own |pace |as |the |nurse |records
|what |is |said.
C) Note-taking |allows |the |nurse |to |shift |attention |away |from |the |patient, |resulting |in |an
|increased |comfort |level.
D) Note-taking |allows |the |nurse |to |break |eye |contact |with |the |patient, |which |may |increase |his |or
|her |level |of |comfort. |- |CORRECT |ANSWER-A) |Note-taking |may |impede |the |nurse's
|observation |of |the |patient's |nonverbal |behaviors.
Page: |31 |Some |use |of |history |forms |and |note-taking |may |be |unavoidable. |But |be |aware |that |note-
|taking |during |the |interview |has |disadvantages. |It |breaks |eye |contact |too |often, |and |it |shifts
|attention |away |from |the |patient, |which |diminishes |his |or |her |sense |of |importance. |It |also |may
|interrupt |the |patient's |narrative |flow, |and |it |impedes |the |observation |of |the |patient's |nonverbal
|behavior.
3. The |8-year-old |client |diagnosed |with |a |vaso-occlusive |sickle |cell |crisis |is |complaining |of |a
|severe |headache. |Which |intervention |should |the |nurse |implement |first?
,1. Administer |6 |L |of |oxygen |via |nasal |cannula.
2. Assess |the |client's |neurological |status.
3. Administer |a |narcotic |analgesic |by |intravenous |push |(IVP). |4. |Increase |the |client's |intravenous
(IV) |rate. |- |CORRECT |ANSWER-Rationale
|
Correct |- |2-Because |the |client |is |complaining |of |a |headache, |the |nurse |should |first |rule |out
|cerebrovascular |accident |(CVA) |by |assess- |ing |the |client's |neurological |status |and |then |determine
|whether |it |is |a |headache |that |can |be |treated |with |medication.
4. During |an |interview, |the |nurse |states, |"You |mentioned |shortness |of |breath. |Tell |me |more
|about |that." |Which |verbal |skill |is |used |with |this |statement?
A) Reflection
B) Facilitation
C) Direct |question
D) Open-ended |question |- |CORRECT |ANSWER-D) |Open-ended |question
Page: |32 |The |open-ended |question |asks |for |narrative |information. |It |states |the |topic |to |be
|discussed |but |only |in |general |terms. |The |nurse |should |use |it |to |begin |the |interview, |to |introduce
|a |new |section |of |questions, |and |whenever |the |person |introduces |a |new |topic.
5. The |6-year-old |client |who |has |undergone |abdominal |surgery |is |attempting |to |make |a |pinwheel
|spin |by |blowing |on |it |with |the |nurse's |assistance. |The |child |starts |crying |because |the |pinwheel
|won't |spin. |Which |action |should |the |nurse |implement |first?
1. Praise |the |child |for |the |attempt |to |make |the |pinwheel |spin.
2. Notify |the |respiratory |therapist |to |implement |incentive |spirometry. |3. |Encourage |the |child |to
|turn |from |side |to |side |and |cough.
4. |Demonstrate |how |to |make |the |pinwheel |spin |by |blowing |on |it. |- |CORRECT |ANSWER-
Rationale
Correct |-1. |The |nurse |should |always |praise |the |child |for |attempts |at |cooperation |even |if |the |child
|did |not |accomplish |what |the |nurse |asked.
6. A |nurse |is |taking |complete |health |histories |on |all |of |the |patients |attending |a |wellness
|workshop. |On |the |history |form, |one |of |the |written |questions |asks, |"You |don't |smoke, |drink, |or
|take |drugs, |do |you?" |This |question |is |an |example |of:
A) talking |too |much.
B) using |confrontation.
,C) using |biased |or |leading |questions.
D) using |blunt |language |to |deal |with |distasteful |topics. |- |CORRECT |ANSWER-C) |using |biased
|or |leading |questions.
Page: |36 |This |is |an |example |of |using |leading |or |biased |questions. |Asking, |"You |don't |smoke, |do
|you?" |implies |that |one |answer |is |"better" |than |another. |If |the |person |wants |to |please |someone,
|he |or |she |is |either |forced |to |answer |in |a |way |corresponding |to |their |implied |values |or |is |made
|to |feel |guilty |when |admitting |the |other |answer.
6. The |nurse |is |caring |for |clients |on |the |pediatric |medical |unit. |Which |client |should |the |nurse
|assess |first?
1. The |child |diagnosed |with |type |1 |diabetes |who |has |a |blood |glucose
level |of |180 |mg/dL.
|
2. The |child |diagnosed |with |pneumonia |who |is |coughing |and |has |a |temperature
of |100°F.
|
3. The |child |diagnosed |with |gastroenteritis |who |has |a |potassium |(K+)
level |of |3.9 |mEq/L.
|
4. The |child |diagnosed |with |cystic |fibrosis |who |has |a |pulse |oximeter |reading |of |90%. |-
CORRECT ANSWER-Rationale
| |
Correct |- |4. |A |pulse |oximeter |reading |of |less |than |93% |is |significant |and |indicates |hypoxia, |which
|is |life |threatening; |therefore, |this |child |should |be |assessed |first.
7. During |an |interview, |a |parent |of |a |hospitalized |child |is |sitting |in |an |open |position. |As |the
|interviewer |begins |to |discuss |his |son's |treatment, |however, |he |suddenly |crosses |his |arms |against
|his |chest |and |crosses |his |legs. |This |would |suggest |that |the |parent |is:
A) just |changing |positions.
B) more |comfortable |in |this |position.
C) tired |and |needs |a |break |from |the |interview.
D) uncomfortable |talking |about |his |son's |treatment. |- |CORRECT |ANSWER-D)
|uncomfortable |talking |about |his |son's |treatment.
Page: |37 |Note |the |person's |position. |An |open |position |with |the |extension |of |large |muscle |groups
|shows |relaxation, |physical |comfort, |and |a |willingness |to |share |information. |A |closed |position |with
, the |arms |and |legs |crossed |tends |to |look |defensive |and |anxious. |Note |any |change |in |posture. |If |a
|person |in |a |relaxed |position |suddenly |tenses, |it |suggests |possible |discomfort |with |the |new |topic.
8. The |nurse |has |received |the |a.m. |shift |report |for |clients |on |a |pediatric |unit. |Which
|medication |should |the |nurse |administer |first?
1. The |third |dose |of |the |aminoglycoside |antibiotic |to |the |child |diagnosed
with |methicillin-resistant |Staphylococcus |aureus |(MRSA).
|
2. The |IVP |steroid |methylprednisolone |(Solu-Medrol) |to |the |child |diagnosed
with |asthma.
|
3. The |sliding |scale |insulin |to |the |child |diagnosed |with |type |1 |diabetes |mellitus.
4. The |stimulant |methylphenidate |(Ritalin) |to |a |child |diagnosed |with
attention |deficit-hyperactivity |disorder |(ADHD). |- |CORRECT |ANSWER-
|
Rationale
Correct |- |3-Sliding |scale |insulin |is |ordered |ac, |which |is |before |meals; |therefore, |this |medication
|must |be |administered |first |after |receiving |the |a.m. |shift |report.
4-Routine |medications |have |a |1-hour |leeway |before |and |after |the |scheduled |time; |therefore, |this
|medication |does |not |have |to |be |adminis- |tered |first.
9. The |nurse |is |interviewing |a |patient |who |has |a |hearing |impairment. |What |techniques |would
|be |most |beneficial |in |communicating |with |this |patient?
A) Determine |the |communication |method |he |prefers.
B) Avoid |using |facial |and |hand |gestures |because |most |hearing-impaired |people |find |this |degrading.
C) Request |a |sign |language |interpreter |before |meeting |with |him |to |help |facilitate
|the |communication.
D) Speak |loudly |and |with |exaggerated |facial |movement |when |talking |with |him |because |this
|helps |with |lip |reading. |- |CORRECT |ANSWER-A) |Determine |the |communication |method |he
|prefers.
Pages: |40-41 |The |nurse |should |ask |the |deaf |person |the |preferred |way |to |communicate—by
|signing, |lip |reading, |or |writing. |If |the |person |prefers |lip |reading, |then |the |nurse |should |be |sure |to
|face |him |or |her |squarely |and |have |good |lighting |on |the |nurse's |face. |The |nurse |should |not
|exaggerate |lip |movements |because |this |distorts |words. |Similarly, |shouting |distorts |the |reception
|of |a |hearing |aid |the |person |may |wear. |The |nurse |should |speak |slowly |and |should |supplement |his
|or |her |voice |with |appropriate |hand |gestures |or |pantomime.
