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HESI A2 V1- CRITICAL THINKING ACTUAL
EXAM TOP TIER QUESTIONS AND ANSWERS
The Patient: An older confused male.
The Situation: At 3 am the patient, who thinks he is in the bathroom, defecates in
the bed. The bed needs to be changed. However, there are no bed sheets on the
nursing unit.
The Question: What action should the nurse take first? - ANSWER Ask a nursing
assistant to go to another unit and borrow linen.
The Patient: A 25-year-old female hospitalized for anorexia.
The Situation: The charge nurse denies the patient permission to pass dinner
trays.
The Question: What is the most important reason for the nurse to deny this
anorexic patient permission to pass the dinner trays? - ANSWER Treatment
protocol for anorexics mandates that they avoid preoccupation with food.
The Patient: A 75-year-old male who had a heart attack four years ago.
The Situation: The patient tells the nurse, "Even though I stopped smoking 10
years ago, I have a terrible cough."
The Question: What action should the nurse take first? - ANSWER Auscultate all
lung fields.
The Patient: A 70-year-old man dying of prostate cancer.
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The Situation: Nurse "A," who is charge of a medical unit, notices that a dying
patient continues to moan in pain after receiving intravenous injections of
morphine whenever Nurse "B" may be diluting the patient's dose and taking the
morphine to feed an addiction.
The Question: What should Nurse "A" do in this situation? - ANSWER Notify the
shift supervisor and unit director of the circumstances before taking action.
The Patient: A 29-year-old male.
The Situation: A lower leg cast was applied yesterday to a fractured leg. Today the
patient tells the nurse that he is in "terrible pain."
The Question: Which action is most important for the nurse to take? - ANSWER
Check the patient's those for adequate circulation.
The Patient: A 54-year-old male who weighs 275 pounds. He is 5'10' tall and has
many family members who have died of heart disease.
The Situation: He comes to the clinic stating that he has had several episodes of
"chest pain" in the last week.
The Question: What is the most important action for the nurse to take? - ANSWER
Ask the patient to describe the chest pain.
The Patient: A 7-year-old child.
The Situation: A nurse arrives with an injection containing preoperative sedation
that must be given to the child now. The child asks the nurse if the shot will hurt.
The Question: What response should the nurse offer to this child? - ANSWER
"Yes, but it won't last very long and soon you will be sleepy."
HESI A2 V1- CRITICAL THINKING ACTUAL
EXAM TOP TIER QUESTIONS AND ANSWERS
The Patient: An older confused male.
The Situation: At 3 am the patient, who thinks he is in the bathroom, defecates in
the bed. The bed needs to be changed. However, there are no bed sheets on the
nursing unit.
The Question: What action should the nurse take first? - ANSWER Ask a nursing
assistant to go to another unit and borrow linen.
The Patient: A 25-year-old female hospitalized for anorexia.
The Situation: The charge nurse denies the patient permission to pass dinner
trays.
The Question: What is the most important reason for the nurse to deny this
anorexic patient permission to pass the dinner trays? - ANSWER Treatment
protocol for anorexics mandates that they avoid preoccupation with food.
The Patient: A 75-year-old male who had a heart attack four years ago.
The Situation: The patient tells the nurse, "Even though I stopped smoking 10
years ago, I have a terrible cough."
The Question: What action should the nurse take first? - ANSWER Auscultate all
lung fields.
The Patient: A 70-year-old man dying of prostate cancer.
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The Situation: Nurse "A," who is charge of a medical unit, notices that a dying
patient continues to moan in pain after receiving intravenous injections of
morphine whenever Nurse "B" may be diluting the patient's dose and taking the
morphine to feed an addiction.
The Question: What should Nurse "A" do in this situation? - ANSWER Notify the
shift supervisor and unit director of the circumstances before taking action.
The Patient: A 29-year-old male.
The Situation: A lower leg cast was applied yesterday to a fractured leg. Today the
patient tells the nurse that he is in "terrible pain."
The Question: Which action is most important for the nurse to take? - ANSWER
Check the patient's those for adequate circulation.
The Patient: A 54-year-old male who weighs 275 pounds. He is 5'10' tall and has
many family members who have died of heart disease.
The Situation: He comes to the clinic stating that he has had several episodes of
"chest pain" in the last week.
The Question: What is the most important action for the nurse to take? - ANSWER
Ask the patient to describe the chest pain.
The Patient: A 7-year-old child.
The Situation: A nurse arrives with an injection containing preoperative sedation
that must be given to the child now. The child asks the nurse if the shot will hurt.
The Question: What response should the nurse offer to this child? - ANSWER
"Yes, but it won't last very long and soon you will be sleepy."
