HESI Exit Exam Critical Thinking & Clinical Judgment Practice Questions – 80 Questions with Answers & Rationales

HESI Exit Exam
Critical Thinking and Clinical Judgment
Practice Questions (Set 3)

80 NCLEX-Style Case-Based Questions with Answers

Perfect for Nursing Students Preparing for HESI and NCLEX Exams




Designed for Stuvia Study Resources

Updated May 2025

, HESI Exit Exam Critical Thinking and Clinical Judgment Practice (Set 3)


Instructions
This document contains 80 HESI Exit Exam-style case-based multiple-choice questions
focused on Critical Thinking and Clinical Judgment. Each question presents a patient
scenario and asks what the nurse should do next, with four answer options (A–D). Select
the best answer, and use the provided correct answer for self-assessment.

Question Set 1 Question Set 1
Question 1: A client with a history of angina reports chest pain radiating to the jaw.
The pain started 10 minutes ago. What should the nurse do next?
A. Administer sublingual nitroglycerin as prescribed.
B. Encourage deep breathing exercises.
C. Obtain a chest X-ray.
D. Document the pain intensity.
Correct Answer: A (Nitroglycerin relieves angina pain.)
Question 2: A postoperative client reports sudden calf pain and warmth. The leg is
swollen compared to the other. What should the nurse do next?
A. Apply a warm compress.
B. Notify the healthcare provider.
C. Encourage leg exercises.
D. Administer analgesics.
Correct Answer: B (Symptoms suggest deep vein thrombosis.)
Question 3: A client with chronic renal failure reports nausea and has a blood urea
nitrogen (BUN) of 80 mg/dL. What should the nurse do next?
A. Encourage a high-protein diet.
B. Assess fluid status and vital signs.
C. Administer a diuretic.
D. Document the findings.
Correct Answer: B (Assessment evaluates uremia severity.)
Question 4: A client with a history of peptic ulcer disease reports severe epigastric pain
and vomiting blood. What should the nurse do next?
A. Administer an antacid.
B. Notify the healthcare provider.
C. Encourage oral fluids.
D. Apply a cold compress.


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, HESI Exit Exam Critical Thinking and Clinical Judgment Practice (Set 3)


Correct Answer: B (Hematemesis indicates gastrointestinal bleeding.)

Question Set 2 Question Set 2
Question 1: A client with a new colostomy reports a burning sensation around the stoma.
The skin is erythematous. What should the nurse do next?
A. Apply a larger appliance.
B. Assess the stoma and peristomal skin.
C. Restrict oral intake.
D. Change the appliance without assessment.
Correct Answer: B (Assessment identifies skin irritation causes.)
Question 2: A client with a history of heart failure reports waking up at night gasping
for air. What should the nurse do next?
A. Encourage increased fluid intake.
B. Assess for paroxysmal nocturnal dyspnea.
C. Administer a bronchodilator.
D. Restrict all activity.
Correct Answer: B (Assessment confirms heart failure exacerbation.)
Question 3: A client with a spinal cord injury reports a sudden onset of sweating and a
blood pressure of 190/100 mmHg. What should the nurse do next?
A. Administer an antihypertensive.
B. Check for bladder or bowel impaction.
C. Encourage relaxation techniques.
D. Document the blood pressure.
Correct Answer: B (Autonomic dysreflexia requires identifying the trigger.)
Question 4: A client with a history of COPD reports increased dyspnea and a productive
cough with yellow sputum. What should the nurse do next?
A. Encourage pursed-lip breathing.
B. Notify the healthcare provider.
C. Restrict oxygen therapy.
D. Administer a cough suppressant.
Correct Answer: B (Yellow sputum suggests infection.)




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