HESI A2 V1- Critical Thinking Questions and Answers Rated A
The Patient: A 65-year-old man.
The Situation- The family brings the patient to the emer-
Determine the patient's level of consciousness.
gency room because he just took an entire bottle of pills.
The Question: What action should the nurse take first?
The Patient: An 80-year-old male who has used continu-
ous oxygen for the past three years.
The Situation: While making a home visit, the wife tells
the nurse that her husband was doing well on 2 liters of Assess the patient's oxygen saturation by pulse oximeter.
oxygen per minute until late night when he developed
severe shortness of breath on the way to the bathroom.
The Question: What action should the nurse take first?
The Patient: A 41-year-old male.
The Situation: The patient is complaining of severe stom-
ach pain and states that he has been "vomiting all the Administer a prescribed pain medication.
time."
The Question: What should the nurse do first?
The Patient: The wife of a wealthy owner of the town's
bank.
The Situation: The patient and her husband arrive on the
unit. While orienting the patient to the hospital room, the Advise the patient to have her husband take the items
nurse notices that the patient has placed a large amount home when he leaves.
of cash and some expensive earrings in the drawer of the
bedside table.
The Question: What is the best action for the nurse to take?
The Patient: A 45-year-old female who is 5'2" tall, weighs
200 pounds, and has smoked since age 21.
The Situation: The patient comes to the clinic with a com-
A previous blood clot in the leg.
plaint of "leg pain."
The Question: It is most important for the nurse do obtain
information about which previous occurrence?
1/8
, HESI A2 V1- Critical Thinking Questions and Answers Rated A
The Patient: A 61-year-old female.
The Situation: The patient has a fever of unknown origin.
The nurse administered a fever-reducing medication 30
minutes ago. At this time there has been no decrease in Sponge the patient with cool water.
the patient's fever.
The Question: What action would be best for the nurse to
take?
The Patient: A 70-year-old male who is relatively healthy.
The Situation: A liquid medication is prescribed for this
patient. Determine if the patient is allergic to the medication.
The Question: Prior to administering the prescribed med-
ication, what intervention has the highest priority?
The Patient: A 50-year-old female.
The Situation: While the nurse is ottering the patient her
morning medications, she tells the nurse that she does Withhold the medication until the patient's prescription if
not recall ever taking a pill that was pink-colored. verified.
The Question: What should the nurse do in response to
this patient's comment?
The Patients:
1. A 63-year-old with a burn on the left lower leg who is
complaining of pain.
2. A 45-year-old with pneumonia, complaining of short-
ness of breath.
3. A 31-year-old with abdominal pain who has just vomit- The 45-year-old with pneumonia and shortness of breath
ed blood.
4. A 88-year-old who has right-sided paralysis and wants
to be helped to the bathroom immediately.
The Situation: The nurse is caring for these patients.
The Question: Who should the nurse see first?
2/8
The Patient: A 65-year-old man.
The Situation- The family brings the patient to the emer-
Determine the patient's level of consciousness.
gency room because he just took an entire bottle of pills.
The Question: What action should the nurse take first?
The Patient: An 80-year-old male who has used continu-
ous oxygen for the past three years.
The Situation: While making a home visit, the wife tells
the nurse that her husband was doing well on 2 liters of Assess the patient's oxygen saturation by pulse oximeter.
oxygen per minute until late night when he developed
severe shortness of breath on the way to the bathroom.
The Question: What action should the nurse take first?
The Patient: A 41-year-old male.
The Situation: The patient is complaining of severe stom-
ach pain and states that he has been "vomiting all the Administer a prescribed pain medication.
time."
The Question: What should the nurse do first?
The Patient: The wife of a wealthy owner of the town's
bank.
The Situation: The patient and her husband arrive on the
unit. While orienting the patient to the hospital room, the Advise the patient to have her husband take the items
nurse notices that the patient has placed a large amount home when he leaves.
of cash and some expensive earrings in the drawer of the
bedside table.
The Question: What is the best action for the nurse to take?
The Patient: A 45-year-old female who is 5'2" tall, weighs
200 pounds, and has smoked since age 21.
The Situation: The patient comes to the clinic with a com-
A previous blood clot in the leg.
plaint of "leg pain."
The Question: It is most important for the nurse do obtain
information about which previous occurrence?
1/8
, HESI A2 V1- Critical Thinking Questions and Answers Rated A
The Patient: A 61-year-old female.
The Situation: The patient has a fever of unknown origin.
The nurse administered a fever-reducing medication 30
minutes ago. At this time there has been no decrease in Sponge the patient with cool water.
the patient's fever.
The Question: What action would be best for the nurse to
take?
The Patient: A 70-year-old male who is relatively healthy.
The Situation: A liquid medication is prescribed for this
patient. Determine if the patient is allergic to the medication.
The Question: Prior to administering the prescribed med-
ication, what intervention has the highest priority?
The Patient: A 50-year-old female.
The Situation: While the nurse is ottering the patient her
morning medications, she tells the nurse that she does Withhold the medication until the patient's prescription if
not recall ever taking a pill that was pink-colored. verified.
The Question: What should the nurse do in response to
this patient's comment?
The Patients:
1. A 63-year-old with a burn on the left lower leg who is
complaining of pain.
2. A 45-year-old with pneumonia, complaining of short-
ness of breath.
3. A 31-year-old with abdominal pain who has just vomit- The 45-year-old with pneumonia and shortness of breath
ed blood.
4. A 88-year-old who has right-sided paralysis and wants
to be helped to the bathroom immediately.
The Situation: The nurse is caring for these patients.
The Question: Who should the nurse see first?
2/8
