HESI A2 Critical Thinking – Nursing Entrance Exam Critical Thinking Practice
& Review (2025-2026)
Section 1: Problem Solving (Questions 1-5)
Question 1
A home health nurse arrives at a patient's house for a scheduled wound dressing
change. The patient, who lives alone, informs the nurse that their caregiver (adult child)
quit unexpectedly two days ago and they have been unable to get groceries or
medications. The wound appears slightly more inflamed than at the last visit. What is
the best response?
A. Complete the wound care quickly and advise the patient to call their doctor about the
inflammation
B. Perform the dressing change, assess the wound thoroughly, and contact the case
manager to arrange immediate support services
C. Skip the wound care and focus on helping the patient order groceries first
D. Tell the patient they need to find a new caregiver before the next scheduled visit
Explainer:
Correct Answer: B
Why it's Best: This response demonstrates comprehensive problem-solving by
addressing the immediate clinical need (wound assessment and care) while
recognizing the broader situational factors contributing to potential complications.
Contacting the case manager activates the interdisciplinary team to address social
determinants of health (food insecurity, medication access) that directly impact wound
healing. This approach treats the patient holistically rather than as a single problem.
Analysis of Other Options:
, ● A: Addresses the wound but misses the root cause (inability to obtain
supplies/medications) and fails to connect the patient with resources
● C: Prioritizes groceries over an emerging clinical issue; neglects professional
responsibility to assess the changing wound condition
● D: Places burden on the vulnerable patient and delays addressing immediate
health and safety needs
Question 2
During a busy shift, a nurse discovers that the unit's automated medication dispensing
system is malfunctioning and not recording withdrawals properly. The pharmacy is
aware and working on a fix, but it's been two hours. The nurse needs to administer
several scheduled medications. What is the best action?
A. Document the system issue and administer medications using the override function
with a witness
B. Hold all medications until the system is fully operational to ensure accurate
documentation
C. Call the pharmacy again to demand an immediate fix before administering any
medications
D. Remove medications using the override function without a witness since the
pharmacy already knows about the problem
Explainer:
Correct Answer: A
Why it's Best: This solution balances patient safety (timely medication administration)
with risk mitigation (using override appropriately with witness verification). It
acknowledges the system problem while ensuring patients receive necessary
treatments. Documenting the issue creates an audit trail and demonstrates professional
accountability. The witness requirement provides a safety check during the temporary
workaround.
Analysis of Other Options:
, ● B: Prioritizes documentation accuracy over patient care; withholding scheduled
medications could cause harm
● C: Ineffective problem-solving that delays patient care; pharmacy is already
aware and working on the issue
● D: Compromises safety protocols; bypassing the witness requirement increases
risk of medication errors without accountability
Question 3
A nurse on a medical-surgical unit notices that a post-operative patient has been
pressing the call light frequently for minor requests (adjusting pillows, turning lights
on/off, asking for water). The nurse is also responsible for a newly admitted patient with
complex needs and is feeling stretched thin. What is the best approach?
A. Ask the charge nurse to reassign one of the patients to balance the workload more
evenly
B. Set boundaries with the post-op patient by explaining that call lights should be
reserved for urgent needs only
C. Delegate appropriate tasks to the nursing assistant and cluster care for the post-op
patient while ensuring the new admission receives priority attention
D. Focus primarily on the new admission since the post-op patient is stable and their
requests are not medically necessary
Explainer:
Correct Answer: C
Why it's Best: This response demonstrates creative problem-solving through effective
delegation and care coordination. It addresses the underlying issue (frequent call light
use) by proactively meeting needs through clustering, while ensuring both patients
receive appropriate attention. Delegating non-clinical tasks to the nursing assistant
optimizes team resources. This approach maintains therapeutic relationships with both
patients without compromising care quality.
Analysis of Other Options:
& Review (2025-2026)
Section 1: Problem Solving (Questions 1-5)
Question 1
A home health nurse arrives at a patient's house for a scheduled wound dressing
change. The patient, who lives alone, informs the nurse that their caregiver (adult child)
quit unexpectedly two days ago and they have been unable to get groceries or
medications. The wound appears slightly more inflamed than at the last visit. What is
the best response?
A. Complete the wound care quickly and advise the patient to call their doctor about the
inflammation
B. Perform the dressing change, assess the wound thoroughly, and contact the case
manager to arrange immediate support services
C. Skip the wound care and focus on helping the patient order groceries first
D. Tell the patient they need to find a new caregiver before the next scheduled visit
Explainer:
Correct Answer: B
Why it's Best: This response demonstrates comprehensive problem-solving by
addressing the immediate clinical need (wound assessment and care) while
recognizing the broader situational factors contributing to potential complications.
Contacting the case manager activates the interdisciplinary team to address social
determinants of health (food insecurity, medication access) that directly impact wound
healing. This approach treats the patient holistically rather than as a single problem.
Analysis of Other Options:
, ● A: Addresses the wound but misses the root cause (inability to obtain
supplies/medications) and fails to connect the patient with resources
● C: Prioritizes groceries over an emerging clinical issue; neglects professional
responsibility to assess the changing wound condition
● D: Places burden on the vulnerable patient and delays addressing immediate
health and safety needs
Question 2
During a busy shift, a nurse discovers that the unit's automated medication dispensing
system is malfunctioning and not recording withdrawals properly. The pharmacy is
aware and working on a fix, but it's been two hours. The nurse needs to administer
several scheduled medications. What is the best action?
A. Document the system issue and administer medications using the override function
with a witness
B. Hold all medications until the system is fully operational to ensure accurate
documentation
C. Call the pharmacy again to demand an immediate fix before administering any
medications
D. Remove medications using the override function without a witness since the
pharmacy already knows about the problem
Explainer:
Correct Answer: A
Why it's Best: This solution balances patient safety (timely medication administration)
with risk mitigation (using override appropriately with witness verification). It
acknowledges the system problem while ensuring patients receive necessary
treatments. Documenting the issue creates an audit trail and demonstrates professional
accountability. The witness requirement provides a safety check during the temporary
workaround.
Analysis of Other Options:
, ● B: Prioritizes documentation accuracy over patient care; withholding scheduled
medications could cause harm
● C: Ineffective problem-solving that delays patient care; pharmacy is already
aware and working on the issue
● D: Compromises safety protocols; bypassing the witness requirement increases
risk of medication errors without accountability
Question 3
A nurse on a medical-surgical unit notices that a post-operative patient has been
pressing the call light frequently for minor requests (adjusting pillows, turning lights
on/off, asking for water). The nurse is also responsible for a newly admitted patient with
complex needs and is feeling stretched thin. What is the best approach?
A. Ask the charge nurse to reassign one of the patients to balance the workload more
evenly
B. Set boundaries with the post-op patient by explaining that call lights should be
reserved for urgent needs only
C. Delegate appropriate tasks to the nursing assistant and cluster care for the post-op
patient while ensuring the new admission receives priority attention
D. Focus primarily on the new admission since the post-op patient is stable and their
requests are not medically necessary
Explainer:
Correct Answer: C
Why it's Best: This response demonstrates creative problem-solving through effective
delegation and care coordination. It addresses the underlying issue (frequent call light
use) by proactively meeting needs through clustering, while ensuring both patients
receive appropriate attention. Delegating non-clinical tasks to the nursing assistant
optimizes team resources. This approach maintains therapeutic relationships with both
patients without compromising care quality.
Analysis of Other Options:
