HESI A2 Critical Thinking Exam 2026|
Actual Exam Questions and Correct
Answers
1. The nurse is working in the emergency department (ED) of a children's medical center. Which
client should the nurse assess first?
The 1-month-old infant who has developed colic and is crying.
The 2-year-old toddler who was bitten by another child at the day-care center.
The 6-year-old school-age child who was hit by a car while riding a bicycle.
The 14-year-old adolescent whose mother suspects her child is sexually active.
Correct Answer: 3
Rationale: The child hit by a car should be assessed first because he or she may have life-
threatening injuries that must be assessed and treated promptly.
2. In an interview, the nurse may find it necessary to take notes to aid his or her memory later.
Which statement is true regarding note-taking?
A) Note-taking may impede the nurse's observation of the patient's nonverbal behaviors.
B) Note-taking allows the patient to continue at his or her own pace as the nurse records what is
said.
C) Note-taking allows the nurse to shift attention away from the patient, resulting in an increased
comfort level.
D) Note-taking allows the nurse to break eye contact with the patient, which may increase his or
her level of comfort.
Correct Answer: A
Rationale: Note-taking may impede the nurse's observation of the patient's nonverbal behaviors.
Page: 31 Some use of history forms and note-taking may be unavoidable. But be aware that note-
taking during the interview has disadvantages. It breaks eye contact too often, and it shifts
,attention away from the patient, which diminishes his or her sense of importance. It also may
interrupt the patient's narrative flow, and it impedes the observation of the patient's nonverbal
behavior.
3. The 8-year-old client diagnosed with a vaso-occlusive sickle cell crisis is complaining of a
severe headache. Which intervention should the nurse implement first?
Administer 6 L of oxygen via nasal cannula.
Assess the client's neurological status.
Administer a narcotic analgesic by intravenous push (IVP).
Increase the client's intravenous (IV) rate.
Correct Answer: 2
Rationale: Because the client is complaining of a headache, the nurse should first rule out
cerebrovascular accident (CVA) by assessing the client's neurological status and then determine
whether it is a headache that can be treated with medication.
4. During an interview, the nurse states, "You mentioned shortness of breath. Tell me more about
that." Which verbal skill is used with this statement?
A) Reflection
B) Facilitation
C) Direct question
D) Open-ended question
Correct Answer: D
Rationale: The open-ended question asks for narrative information. It states the topic to be
discussed but only in general terms. The nurse should use it to begin the interview, to introduce a
new section of questions, and whenever the person introduces a new topic.
Page: 32
5. The 6-year-old client who has undergone abdominal surgery is attempting to make a pinwheel
spin by blowing on it with the nurse's assistance. The child starts crying because the pinwheel
won't spin. Which action should the nurse implement first?
,Praise the child for the attempt to make the pinwheel spin.
Notify the respiratory therapist to implement incentive spirometry.
Encourage the child to turn from side to side and cough.
Demonstrate how to make the pinwheel spin by blowing on it.
Correct Answer: 1
Rationale: The nurse should always praise the child for attempts at cooperation even if the child
did not accomplish what the nurse asked.
6. A nurse is taking complete health histories on all of the patients attending a wellness
workshop. On the history form, one of the written questions asks, "You don't smoke, drink, or
take drugs, do you?" This question is an example of:
A) talking too much.
B) using confrontation.
C) using biased or leading questions.
D) using blunt language to deal with distasteful topics.
Correct Answer: C
Rationale: This is an example of using leading or biased questions. Asking, "You don't smoke,
do you?" implies that one answer is "better" than another. If the person wants to please someone,
he or she is either forced to answer in a way corresponding to their implied values or is made to
feel guilty when admitting the other answer.
Page: 36
7. The nurse is caring for clients on the pediatric medical unit. Which client should the nurse
assess first?
The child diagnosed with type 1 diabetes who has a blood glucose level of 180 mg/dL.
The child diagnosed with pneumonia who is coughing and has a temperature of 100°F.
The child diagnosed with gastroenteritis who has a potassium (K+) level of 3.9 mEq/L.
The child diagnosed with cystic fibrosis who has a pulse oximeter reading of 90%.
, Correct Answer: 4
Rationale: A pulse oximeter reading of less than 93% is significant and indicates hypoxia, which
is life threatening; therefore, this child should be assessed first.
8. During an interview, a parent of a hospitalized child is sitting in an open position. As the
interviewer begins to discuss his son's treatment, however, he suddenly crosses his arms against
his chest and crosses his legs. This would suggest that the parent is:
A) just changing positions.
B) more comfortable in this position.
C) tired and needs a break from the interview.
D) uncomfortable talking about his son's treatment.
Correct Answer: D
Rationale: Note the person's position. An open position with the extension of large muscle
groups shows relaxation, physical comfort, and a willingness to share information. A closed
position with the arms and legs crossed tends to look defensive and anxious. Note any change in
posture. If a person in a relaxed position suddenly tenses, it suggests possible discomfort with the
new topic.
Page: 37
9. The nurse has received the a.m. shift report for clients on a pediatric unit. Which medication
should the nurse administer first?
The third dose of the aminoglycoside antibiotic to the child diagnosed with methicillin-resistant
Staphylococcus aureus (MRSA).
The IVP steroid methylprednisolone (Solu-Medrol) to the child diagnosed with asthma.
The sliding scale insulin to the child diagnosed with type 1 diabetes mellitus.
The stimulant methylphenidate (Ritalin) to a child diagnosed with attention deficit-hyperactivity
disorder (ADHD).
Correct Answer: 3
Rationale: Sliding scale insulin is ordered ac, which is before meals; therefore, this medication
must be administered first after receiving the a.m. shift report. Routine medications have a 1-
Actual Exam Questions and Correct
Answers
1. The nurse is working in the emergency department (ED) of a children's medical center. Which
client should the nurse assess first?
The 1-month-old infant who has developed colic and is crying.
The 2-year-old toddler who was bitten by another child at the day-care center.
The 6-year-old school-age child who was hit by a car while riding a bicycle.
The 14-year-old adolescent whose mother suspects her child is sexually active.
Correct Answer: 3
Rationale: The child hit by a car should be assessed first because he or she may have life-
threatening injuries that must be assessed and treated promptly.
2. In an interview, the nurse may find it necessary to take notes to aid his or her memory later.
Which statement is true regarding note-taking?
A) Note-taking may impede the nurse's observation of the patient's nonverbal behaviors.
B) Note-taking allows the patient to continue at his or her own pace as the nurse records what is
said.
C) Note-taking allows the nurse to shift attention away from the patient, resulting in an increased
comfort level.
D) Note-taking allows the nurse to break eye contact with the patient, which may increase his or
her level of comfort.
Correct Answer: A
Rationale: Note-taking may impede the nurse's observation of the patient's nonverbal behaviors.
Page: 31 Some use of history forms and note-taking may be unavoidable. But be aware that note-
taking during the interview has disadvantages. It breaks eye contact too often, and it shifts
,attention away from the patient, which diminishes his or her sense of importance. It also may
interrupt the patient's narrative flow, and it impedes the observation of the patient's nonverbal
behavior.
3. The 8-year-old client diagnosed with a vaso-occlusive sickle cell crisis is complaining of a
severe headache. Which intervention should the nurse implement first?
Administer 6 L of oxygen via nasal cannula.
Assess the client's neurological status.
Administer a narcotic analgesic by intravenous push (IVP).
Increase the client's intravenous (IV) rate.
Correct Answer: 2
Rationale: Because the client is complaining of a headache, the nurse should first rule out
cerebrovascular accident (CVA) by assessing the client's neurological status and then determine
whether it is a headache that can be treated with medication.
4. During an interview, the nurse states, "You mentioned shortness of breath. Tell me more about
that." Which verbal skill is used with this statement?
A) Reflection
B) Facilitation
C) Direct question
D) Open-ended question
Correct Answer: D
Rationale: The open-ended question asks for narrative information. It states the topic to be
discussed but only in general terms. The nurse should use it to begin the interview, to introduce a
new section of questions, and whenever the person introduces a new topic.
Page: 32
5. The 6-year-old client who has undergone abdominal surgery is attempting to make a pinwheel
spin by blowing on it with the nurse's assistance. The child starts crying because the pinwheel
won't spin. Which action should the nurse implement first?
,Praise the child for the attempt to make the pinwheel spin.
Notify the respiratory therapist to implement incentive spirometry.
Encourage the child to turn from side to side and cough.
Demonstrate how to make the pinwheel spin by blowing on it.
Correct Answer: 1
Rationale: The nurse should always praise the child for attempts at cooperation even if the child
did not accomplish what the nurse asked.
6. A nurse is taking complete health histories on all of the patients attending a wellness
workshop. On the history form, one of the written questions asks, "You don't smoke, drink, or
take drugs, do you?" This question is an example of:
A) talking too much.
B) using confrontation.
C) using biased or leading questions.
D) using blunt language to deal with distasteful topics.
Correct Answer: C
Rationale: This is an example of using leading or biased questions. Asking, "You don't smoke,
do you?" implies that one answer is "better" than another. If the person wants to please someone,
he or she is either forced to answer in a way corresponding to their implied values or is made to
feel guilty when admitting the other answer.
Page: 36
7. The nurse is caring for clients on the pediatric medical unit. Which client should the nurse
assess first?
The child diagnosed with type 1 diabetes who has a blood glucose level of 180 mg/dL.
The child diagnosed with pneumonia who is coughing and has a temperature of 100°F.
The child diagnosed with gastroenteritis who has a potassium (K+) level of 3.9 mEq/L.
The child diagnosed with cystic fibrosis who has a pulse oximeter reading of 90%.
, Correct Answer: 4
Rationale: A pulse oximeter reading of less than 93% is significant and indicates hypoxia, which
is life threatening; therefore, this child should be assessed first.
8. During an interview, a parent of a hospitalized child is sitting in an open position. As the
interviewer begins to discuss his son's treatment, however, he suddenly crosses his arms against
his chest and crosses his legs. This would suggest that the parent is:
A) just changing positions.
B) more comfortable in this position.
C) tired and needs a break from the interview.
D) uncomfortable talking about his son's treatment.
Correct Answer: D
Rationale: Note the person's position. An open position with the extension of large muscle
groups shows relaxation, physical comfort, and a willingness to share information. A closed
position with the arms and legs crossed tends to look defensive and anxious. Note any change in
posture. If a person in a relaxed position suddenly tenses, it suggests possible discomfort with the
new topic.
Page: 37
9. The nurse has received the a.m. shift report for clients on a pediatric unit. Which medication
should the nurse administer first?
The third dose of the aminoglycoside antibiotic to the child diagnosed with methicillin-resistant
Staphylococcus aureus (MRSA).
The IVP steroid methylprednisolone (Solu-Medrol) to the child diagnosed with asthma.
The sliding scale insulin to the child diagnosed with type 1 diabetes mellitus.
The stimulant methylphenidate (Ritalin) to a child diagnosed with attention deficit-hyperactivity
disorder (ADHD).
Correct Answer: 3
Rationale: Sliding scale insulin is ordered ac, which is before meals; therefore, this medication
must be administered first after receiving the a.m. shift report. Routine medications have a 1-
