"Ultimate HESI A2 Critical Thinking
Practice Test 2025: 70 Most
Frequently Tested Exam Questions
with ABCD Otions, Detailed
Rationales, and NGN Clinical
Judgment Scenarios for Nursing
Success"
The HESI A2 Critical Thinking Exam focuses heavily on clinical
decision-making and ethical principles in real-life patient care scenarios.
The questions are often scenario-based, testing your ability to apply
nursing judgment using principles like:
• Priority setting (ABC, Maslow)
• Ethical principles (autonomy, beneficence, nonmaleficence,
justice)
• Delegation
• Patient safety
• Cultural competence
• Communication and advocacy
,1. A nurse enters the room and finds the client unresponsive with no
pulse. What is the nurse’s priority action?
A. Call the family
B. Begin chest compressions
C. Notify the healthcare provider
D. Check for advance directives
✅ Answer: B
Rationale: Start CPR immediately unless there is a DNR.
2. A 4-year-old child is crying during a dressing change. What
should the nurse do first?
A. Restrain the child
B. Continue without delay
C. Explain the procedure in simple terms
D. Ask the parents to leave
✅ Answer: C
Rationale: Use age-appropriate communication to reduce fear.
3. A patient with cancer chooses to stop chemotherapy. What action
demonstrates the nurse’s understanding of ethical practice?
A. Report the patient to the physician
B. Attempt to persuade the patient
C. Support the patient’s decision
D. Tell the family to intervene
✅ Answer: C
Rationale: Respecting autonomy is a key ethical principle.
4. The nurse sees an unlicensed assistive personnel (UAP) feeding a
patient with dysphagia lying flat. What should the nurse do first?
A. Document the observation
, B. Tell the UAP to continue
C. Raise the head of the bed
D. Report the UAP to the supervisor
✅ Answer: C
Rationale: Immediate action prevents aspiration (patient safety).
5. A client with heart failure is receiving diuretics. Which
assessment should the nurse report first?
A. Fatigue
B. Weak pulse
C. Muscle cramps
D. Irregular heartbeat
✅ Answer: D
Rationale: Irregular heartbeat suggests dangerous electrolyte
imbalance.
6. Which patient should the nurse assess first?
A. Post-op client reporting pain
B. COPD client with O2 sat of 88%
C. Client who needs blood sugar check
D. Client waiting to ambulate
✅ Answer: B
Rationale: Airway/breathing takes priority over pain or mobility.
7. A nurse is caring for a client with a feeding tube and notices the
feeding has not been absorbed. What should the nurse do first?
A. Document the finding
B. Hold the feeding
C. Notify the provider
Practice Test 2025: 70 Most
Frequently Tested Exam Questions
with ABCD Otions, Detailed
Rationales, and NGN Clinical
Judgment Scenarios for Nursing
Success"
The HESI A2 Critical Thinking Exam focuses heavily on clinical
decision-making and ethical principles in real-life patient care scenarios.
The questions are often scenario-based, testing your ability to apply
nursing judgment using principles like:
• Priority setting (ABC, Maslow)
• Ethical principles (autonomy, beneficence, nonmaleficence,
justice)
• Delegation
• Patient safety
• Cultural competence
• Communication and advocacy
,1. A nurse enters the room and finds the client unresponsive with no
pulse. What is the nurse’s priority action?
A. Call the family
B. Begin chest compressions
C. Notify the healthcare provider
D. Check for advance directives
✅ Answer: B
Rationale: Start CPR immediately unless there is a DNR.
2. A 4-year-old child is crying during a dressing change. What
should the nurse do first?
A. Restrain the child
B. Continue without delay
C. Explain the procedure in simple terms
D. Ask the parents to leave
✅ Answer: C
Rationale: Use age-appropriate communication to reduce fear.
3. A patient with cancer chooses to stop chemotherapy. What action
demonstrates the nurse’s understanding of ethical practice?
A. Report the patient to the physician
B. Attempt to persuade the patient
C. Support the patient’s decision
D. Tell the family to intervene
✅ Answer: C
Rationale: Respecting autonomy is a key ethical principle.
4. The nurse sees an unlicensed assistive personnel (UAP) feeding a
patient with dysphagia lying flat. What should the nurse do first?
A. Document the observation
, B. Tell the UAP to continue
C. Raise the head of the bed
D. Report the UAP to the supervisor
✅ Answer: C
Rationale: Immediate action prevents aspiration (patient safety).
5. A client with heart failure is receiving diuretics. Which
assessment should the nurse report first?
A. Fatigue
B. Weak pulse
C. Muscle cramps
D. Irregular heartbeat
✅ Answer: D
Rationale: Irregular heartbeat suggests dangerous electrolyte
imbalance.
6. Which patient should the nurse assess first?
A. Post-op client reporting pain
B. COPD client with O2 sat of 88%
C. Client who needs blood sugar check
D. Client waiting to ambulate
✅ Answer: B
Rationale: Airway/breathing takes priority over pain or mobility.
7. A nurse is caring for a client with a feeding tube and notices the
feeding has not been absorbed. What should the nurse do first?
A. Document the finding
B. Hold the feeding
C. Notify the provider
