Ace the HESICritical Care Exam 2025 – Realistic
PracticeQuestions, Critical Thinking Scenarios, and
Detailed Rationales for Nursing Student
A female client makes routine visits to a neighborhood community health center. The
nurse notes that this client often presents with facial bruising, particularly around the
eyes. The nurse discusses prevention of domestic violence with the client even though the
client does not admit to being battered. What level of prevention has the nurse applied in
this situation? A. Health promotion.
B. Primary prevention.
C. Secondary prevention.
D. Tertiary prevention. - - correct ans- -C. Secondary prevention.
RATIONALE:
Secondary prevention (B) attempts to halt the progression of the disease process, in this
case, an escalation in the battering, by educating the client about prevention strategies.
The nurse has identified client injuries that create a suspicion of battering and domestic
violence. (A) would be activities that occur before the disease process begins, such as
providing community seminars on the risks, and signs and symptoms of domestic violence.
(C) occurs after the disease process has
started, and includes referring the client to a battered women's shelter for treatment
following unabated, chronic abuse. Health promotion can be incorporated in all levels of
prevention (D).
A primipara with a breech presentation is in the transition phase of labor. The nurse
visualizes the perineum and sees the umbilical cord extruding from the introitus. In which
position should the nurse place the client?
A. Right lateral side with both legs flexed.
B. Left supine with thighs flexed on her abdomen.
C. Semi-Fowler's with head of bed elevated 30 degrees.
,D. Supine with the foot of the bed elevated. - - correct ans- -D. Supine with the foot of the
bed elevated.
RATIONALE:
The supine position with the foot of the bed elevated (D) (Trendelenburg) is one position
used to
alleviate gravitational pressure by the fetus on the prolapsed umbilical cord, (A, B, and C)
do not alleviate pressure on the umbilical cord.
The nurse is developing a series of childbirth preparation classes for primigravida
women and their significant others. What is the priority expected outcome for these
classes?
A. Educate significant others about providing support for their partner during labor.
B. Teach and practice breathing techniques to help cope with contractions during labor.
C. Participants can identify at least three coping strategies to use during labor.
D. Introduce comfort measures that are effective techniques to use during labor and
delivery. - - correct ans- -C. Participants can identify at least three coping strategies to use
during labor.
RATIONALE:
An expected outcome is a specific, measurable change in a client's status that occurs in
response to nursing interventions. (B) meets the criteria for an expected outcome. (A, C,
and D) are nursing interventions that should lead to the expected outcome.
Clinical portfolios are being introduced into the performance appraisal process for staff
nurses employed at a hospital. What should the nurse-manager request that each staff
nurse include in the portfolio?
A. Copies of any articles the nurse has read that relate to client care on the nursing unit.
B. Evaluations by past nursing faculty and employers to document ongoing competence.
C. Letters of support from family members and friends who are healthcare professionals.
,D. A self-evaluation that identifies how the nurse has met professional objectives and goals.
- - correct ans- -D. A self-evaluation that identifies how the nurse has met professional
objectives and goals.
RATIONALE:
A clinical portfolio should include pertinent information that assists in providing a
comprehensive view of the employee's performance. A self-evaluation (D) provides an
important assessment of the nurse's strengths, weaknesses, and progress toward the
achievement of professional goals. (A) is not pertinent nor useful evaluative data regarding
current performance.
While documentation of continuing education and any certifications achieved are important
to include in a clinical portfolio, (B) is not necessary. (C) is not a significant component of a
clinical portfolio.
When engaging in planned change on the unit, what should the nurse-manager establish
first?
A. Resources needed for the change are available.
B. Staff members are aware of the need for change.
C. Goals for achieving the change are established.
D. Options for accomplishing the change are explored. - - correct ans- -B. Staff members are
aware of the need for change.
RATIONALE:
The first step in planned change involves establishing a relationship with those involved in
the change process and instilling knowledge and awareness of the need for change (D). The
nurse manager should next implement (C), and then (A and B).
A work group is to be formed to determine a care map for a new surgical intervention that is
being conducted at the hospital. Which group is likely to be most effective in developing the
new care map?
A. Multidisciplinary group. B.
Single-discipline group.
C. Nurse-manager group.
, D. Surgical staff group. - - correct ans- -A. Multidisciplinary group.
RATIONALE:In a multidisciplinary work group (B), a number of individuals from a variety of
disciplines are involved in developing the care map, but each works independently to
implement the care plan.
Single-discipline work groups (C), such as (A or D), are likely to focus on the aspects of the
care map related only to their specific discipline.
The scope of professional nursing practice is determined by rules promulgated by which
organization?
A. American Nurses Association (ANA).
B. State's Board of Nursing.
C. State Nursing Associations.
D. National Labor Relations Board (NLRB). - - correct ans- -B. State's Board of Nursing.
RATIONALE:
The state's Board of Nursing (A) is authorized to promulgate rules and regulations that
carry the weight of law. The State Legislature delegates its law-making authority to this
administrative law body. (B and C) are influential in defining and describing nursing
standards of care, but neither have the authority to pass laws that legally define the
professional scope of nursing practice.
Although (D) may rule on issues important to nursing practice, the scope of professional
nursing practice is determined by the laws, rules, and regulations promulgated by state
Boards of
Nursing.
An older client who has been bedridden for a month is admitted with a pressure ulcer on the
left trochanter area. The nurse determines that the ulcer extends into the subcutaneous
tissue. At which stage should the nurse document this finding? A. Stage 3.
B. Stage 1.
C. Stage 2.
D. Stage 4 - - correct ans- -A. Stage 3
PracticeQuestions, Critical Thinking Scenarios, and
Detailed Rationales for Nursing Student
A female client makes routine visits to a neighborhood community health center. The
nurse notes that this client often presents with facial bruising, particularly around the
eyes. The nurse discusses prevention of domestic violence with the client even though the
client does not admit to being battered. What level of prevention has the nurse applied in
this situation? A. Health promotion.
B. Primary prevention.
C. Secondary prevention.
D. Tertiary prevention. - - correct ans- -C. Secondary prevention.
RATIONALE:
Secondary prevention (B) attempts to halt the progression of the disease process, in this
case, an escalation in the battering, by educating the client about prevention strategies.
The nurse has identified client injuries that create a suspicion of battering and domestic
violence. (A) would be activities that occur before the disease process begins, such as
providing community seminars on the risks, and signs and symptoms of domestic violence.
(C) occurs after the disease process has
started, and includes referring the client to a battered women's shelter for treatment
following unabated, chronic abuse. Health promotion can be incorporated in all levels of
prevention (D).
A primipara with a breech presentation is in the transition phase of labor. The nurse
visualizes the perineum and sees the umbilical cord extruding from the introitus. In which
position should the nurse place the client?
A. Right lateral side with both legs flexed.
B. Left supine with thighs flexed on her abdomen.
C. Semi-Fowler's with head of bed elevated 30 degrees.
,D. Supine with the foot of the bed elevated. - - correct ans- -D. Supine with the foot of the
bed elevated.
RATIONALE:
The supine position with the foot of the bed elevated (D) (Trendelenburg) is one position
used to
alleviate gravitational pressure by the fetus on the prolapsed umbilical cord, (A, B, and C)
do not alleviate pressure on the umbilical cord.
The nurse is developing a series of childbirth preparation classes for primigravida
women and their significant others. What is the priority expected outcome for these
classes?
A. Educate significant others about providing support for their partner during labor.
B. Teach and practice breathing techniques to help cope with contractions during labor.
C. Participants can identify at least three coping strategies to use during labor.
D. Introduce comfort measures that are effective techniques to use during labor and
delivery. - - correct ans- -C. Participants can identify at least three coping strategies to use
during labor.
RATIONALE:
An expected outcome is a specific, measurable change in a client's status that occurs in
response to nursing interventions. (B) meets the criteria for an expected outcome. (A, C,
and D) are nursing interventions that should lead to the expected outcome.
Clinical portfolios are being introduced into the performance appraisal process for staff
nurses employed at a hospital. What should the nurse-manager request that each staff
nurse include in the portfolio?
A. Copies of any articles the nurse has read that relate to client care on the nursing unit.
B. Evaluations by past nursing faculty and employers to document ongoing competence.
C. Letters of support from family members and friends who are healthcare professionals.
,D. A self-evaluation that identifies how the nurse has met professional objectives and goals.
- - correct ans- -D. A self-evaluation that identifies how the nurse has met professional
objectives and goals.
RATIONALE:
A clinical portfolio should include pertinent information that assists in providing a
comprehensive view of the employee's performance. A self-evaluation (D) provides an
important assessment of the nurse's strengths, weaknesses, and progress toward the
achievement of professional goals. (A) is not pertinent nor useful evaluative data regarding
current performance.
While documentation of continuing education and any certifications achieved are important
to include in a clinical portfolio, (B) is not necessary. (C) is not a significant component of a
clinical portfolio.
When engaging in planned change on the unit, what should the nurse-manager establish
first?
A. Resources needed for the change are available.
B. Staff members are aware of the need for change.
C. Goals for achieving the change are established.
D. Options for accomplishing the change are explored. - - correct ans- -B. Staff members are
aware of the need for change.
RATIONALE:
The first step in planned change involves establishing a relationship with those involved in
the change process and instilling knowledge and awareness of the need for change (D). The
nurse manager should next implement (C), and then (A and B).
A work group is to be formed to determine a care map for a new surgical intervention that is
being conducted at the hospital. Which group is likely to be most effective in developing the
new care map?
A. Multidisciplinary group. B.
Single-discipline group.
C. Nurse-manager group.
, D. Surgical staff group. - - correct ans- -A. Multidisciplinary group.
RATIONALE:In a multidisciplinary work group (B), a number of individuals from a variety of
disciplines are involved in developing the care map, but each works independently to
implement the care plan.
Single-discipline work groups (C), such as (A or D), are likely to focus on the aspects of the
care map related only to their specific discipline.
The scope of professional nursing practice is determined by rules promulgated by which
organization?
A. American Nurses Association (ANA).
B. State's Board of Nursing.
C. State Nursing Associations.
D. National Labor Relations Board (NLRB). - - correct ans- -B. State's Board of Nursing.
RATIONALE:
The state's Board of Nursing (A) is authorized to promulgate rules and regulations that
carry the weight of law. The State Legislature delegates its law-making authority to this
administrative law body. (B and C) are influential in defining and describing nursing
standards of care, but neither have the authority to pass laws that legally define the
professional scope of nursing practice.
Although (D) may rule on issues important to nursing practice, the scope of professional
nursing practice is determined by the laws, rules, and regulations promulgated by state
Boards of
Nursing.
An older client who has been bedridden for a month is admitted with a pressure ulcer on the
left trochanter area. The nurse determines that the ulcer extends into the subcutaneous
tissue. At which stage should the nurse document this finding? A. Stage 3.
B. Stage 1.
C. Stage 2.
D. Stage 4 - - correct ans- -A. Stage 3
