NCLEX HESI EXIT CRITICAL
THINKING 2025 STUDY
MANUAL & PREPARATION
GUIDE || NEW EDITION
Description (100 words)
This study manual provides a comprehensive set of critical-thinking practice questions designed
to reflect the style and difficulty of the 2025 NCLEX and HESI Exit examinations. The guide
emphasizes clinical judgment, prioritization, delegation, patient safety, and application-level
reasoning rather than simple recall. Each question mirrors real-world nursing scenarios that
require analyzing data, recognizing cues, and making safe decisions. The goal is to prepare
students for high-acuity clinical situations, strengthen problem-solving skills, and improve
readiness for adaptive testing formats. The manual follows the updated Next Generation NCLEX
(NGN) framework and incorporates evidence-based nursing practices.
5 KEYWORDS
1. Critical Thinking
2. Prioritization
3. Delegation
4. NCLEX/HESI
5. Clinical Judgment
NCLEX–HESI EXIT CRITICAL THINKING QUESTIONS (1–25)
(Correct answer marked with )
,1. The nurse receives four morning shift clients. Which client should the nurse assess FIRST?
A. A post-op client requesting pain medication
B. A COPD client with O₂ saturation of 88% on 2 L/min
C. A client with a fever of 100.8°F (38.2°C)
D. A diabetic client asking for breakfast
Answer: B
2. The nurse is caring for a client with pneumonia who suddenly becomes restless and
confused. What is the priority action?
A. Notify the provider
B. Assess oxygen saturation
C. Reorient the client
D. Obtain a temperature
3. Which task is appropriate to delegate to an experienced UAP?
A. Teaching incentive spirometer
B. Assessing lung sounds
C. Ambulating a stable post-op client
D. Evaluating drainage from a JP drain
4. A nurse notes a potassium level of 6.2 mEq/L. What action is PRIORITY?
A. Notify dietary services
B. Place the client on a heart monitor
C. Hold oral fluids
D. Administer a laxative
5. A nurse enters the room and finds a client on the floor. What is the FIRST action?
A. Call for help
B. Assess the client for injury
C. Notify the provider
D. File an incident report
,6. Which client should the nurse assign to an LPN?
A. New-onset chest pain
B. Post-op day 2 needing wound care
C. Acute stroke with dysphagia
D. Unstable diabetic with glucose 455 mg/dL
7. The nurse is teaching a client about a new antihypertensive. What indicates understanding?
A. “I will stop taking it if I feel dizzy.”
B. “I should change positions slowly.”
C. “I can double the dose if I miss one.”
D. “I will avoid taking it at bedtime.”
8. Which client condition requires contact precautions?
A. Measles
B. Influenza
C. C. difficile
D. Tuberculosis
9. A nurse preparing to administer digoxin notes an apical pulse of 54 bpm. What action is
correct?
A. Give the medication
B. Hold the medication and notify provider
C. Document the finding only
D. Give half the dose
10. The nurse is reviewing discharge instructions for a heart failure client. Which statement
needs correction?
A. “I will weigh myself daily.”
B. “I will limit sodium intake.”
, C. “I should notify my doctor if I gain 3 lbs in 2 days.”
D. “I can drink as much fluid as I want.”
11. Which finding indicates fluid overload?
A. Dry mucous membranes
B. Bounding pulses
C. Weight loss
D. Hypotension
12. A client receiving a blood transfusion reports itching. What is the nurse’s FIRST action?
A. Call the provider
B. Stop the transfusion
C. Restart at a slower rate
D. Assess the IV site
13. Which action prevents ventilator-associated pneumonia (VAP)?
A. Suctioning every hour
B. Keeping HOB at 30–45°
C. Encouraging daily ambulation
D. Increasing ventilator settings
14. A postoperative client has 150 mL of drainage in 1 hour from a hemovac. What should the
nurse do?
A. Continue monitoring
B. Notify the surgeon
C. Empty the drain
D. Increase IV fluids
15. Which medication should the nurse question in a client with asthma?
THINKING 2025 STUDY
MANUAL & PREPARATION
GUIDE || NEW EDITION
Description (100 words)
This study manual provides a comprehensive set of critical-thinking practice questions designed
to reflect the style and difficulty of the 2025 NCLEX and HESI Exit examinations. The guide
emphasizes clinical judgment, prioritization, delegation, patient safety, and application-level
reasoning rather than simple recall. Each question mirrors real-world nursing scenarios that
require analyzing data, recognizing cues, and making safe decisions. The goal is to prepare
students for high-acuity clinical situations, strengthen problem-solving skills, and improve
readiness for adaptive testing formats. The manual follows the updated Next Generation NCLEX
(NGN) framework and incorporates evidence-based nursing practices.
5 KEYWORDS
1. Critical Thinking
2. Prioritization
3. Delegation
4. NCLEX/HESI
5. Clinical Judgment
NCLEX–HESI EXIT CRITICAL THINKING QUESTIONS (1–25)
(Correct answer marked with )
,1. The nurse receives four morning shift clients. Which client should the nurse assess FIRST?
A. A post-op client requesting pain medication
B. A COPD client with O₂ saturation of 88% on 2 L/min
C. A client with a fever of 100.8°F (38.2°C)
D. A diabetic client asking for breakfast
Answer: B
2. The nurse is caring for a client with pneumonia who suddenly becomes restless and
confused. What is the priority action?
A. Notify the provider
B. Assess oxygen saturation
C. Reorient the client
D. Obtain a temperature
3. Which task is appropriate to delegate to an experienced UAP?
A. Teaching incentive spirometer
B. Assessing lung sounds
C. Ambulating a stable post-op client
D. Evaluating drainage from a JP drain
4. A nurse notes a potassium level of 6.2 mEq/L. What action is PRIORITY?
A. Notify dietary services
B. Place the client on a heart monitor
C. Hold oral fluids
D. Administer a laxative
5. A nurse enters the room and finds a client on the floor. What is the FIRST action?
A. Call for help
B. Assess the client for injury
C. Notify the provider
D. File an incident report
,6. Which client should the nurse assign to an LPN?
A. New-onset chest pain
B. Post-op day 2 needing wound care
C. Acute stroke with dysphagia
D. Unstable diabetic with glucose 455 mg/dL
7. The nurse is teaching a client about a new antihypertensive. What indicates understanding?
A. “I will stop taking it if I feel dizzy.”
B. “I should change positions slowly.”
C. “I can double the dose if I miss one.”
D. “I will avoid taking it at bedtime.”
8. Which client condition requires contact precautions?
A. Measles
B. Influenza
C. C. difficile
D. Tuberculosis
9. A nurse preparing to administer digoxin notes an apical pulse of 54 bpm. What action is
correct?
A. Give the medication
B. Hold the medication and notify provider
C. Document the finding only
D. Give half the dose
10. The nurse is reviewing discharge instructions for a heart failure client. Which statement
needs correction?
A. “I will weigh myself daily.”
B. “I will limit sodium intake.”
, C. “I should notify my doctor if I gain 3 lbs in 2 days.”
D. “I can drink as much fluid as I want.”
11. Which finding indicates fluid overload?
A. Dry mucous membranes
B. Bounding pulses
C. Weight loss
D. Hypotension
12. A client receiving a blood transfusion reports itching. What is the nurse’s FIRST action?
A. Call the provider
B. Stop the transfusion
C. Restart at a slower rate
D. Assess the IV site
13. Which action prevents ventilator-associated pneumonia (VAP)?
A. Suctioning every hour
B. Keeping HOB at 30–45°
C. Encouraging daily ambulation
D. Increasing ventilator settings
14. A postoperative client has 150 mL of drainage in 1 hour from a hemovac. What should the
nurse do?
A. Continue monitoring
B. Notify the surgeon
C. Empty the drain
D. Increase IV fluids
15. Which medication should the nurse question in a client with asthma?
