NSG 121 HESI EXAM 1
Complete Study Guide: 150 Questions with Rationales & Memory Tricks
Explained Like You're Hearing It For The First Time
HOW TO USE THIS GUIDE
ANSWER = The correct answer to the question
WHY = The full rationale explaining why this is correct (and why others are wrong)
TRICK = An easy memory device, story, or pattern to remember forever
SECTION 1: THE NURSING PROCESS (ADPIE)
Q1. What does ADPIE stand for in the nursing process?
ANSWER Assessment, Diagnosis, Planning, Implementation, Evaluation
WHY ADPIE is the 5-step nursing process. Every single thing a nurse does follows these
steps in order. Assessment = gather data first. Diagnosis = identify the problem.
Planning = set goals. Implementation = do the care. Evaluation = did it work?
TRICK Say it like a word: 'AD-PIE.' Think of baking a pie — you Assess the ingredients,
Diagnose what's missing, Plan the recipe, Implement (bake it), then Evaluate how it
tastes!
Q2. Which step of the nursing process involves gathering subjective and objective data?
ANSWER Assessment
WHY Assessment is always the FIRST step. Before you can do anything else, you must
gather all information about the patient. You cannot diagnose, plan, or act without
data. This is like a detective collecting clues before solving the case.
TRICK Remember: Assessment = Always First. 'A' is the first letter of the alphabet AND the
first step of ADPIE. You wouldn't cook dinner without checking what food you have
first!
Q3. A patient tells you 'I have a sharp pain in my chest.' What type of data is this?
ANSWER Subjective data
WHY Subjective data = what the PATIENT tells you. It comes from the subject (the person).
Pain, nausea, dizziness, feelings — these are all subjective because only the patient
can feel them. You cannot measure someone else's feelings with a machine.
TRICK SUBjective = what the SUBject (patient) says. Think: 'S' = Stated by patient,
Symptoms, Self-reported. If the patient SAYS it, it's SUBJECTIVE!
Q4. A nurse measures a patient's blood pressure as 148/92. What type of data is this?
ANSWER Objective data
WHY Objective data = what you can OBSERVE, MEASURE, or TEST. Blood pressure,
, temperature, lab results, rashes you can see — all objective. The word 'objective'
means it doesn't depend on opinion; anyone with the right tool would get the same
measurement.
TRICK OBjective = OBservable. Think: 'O' = Others can see/measure it. A blood pressure cuff
gives you a number = Objective. If you can put a NUMBER on it or SEE it, it's
OBJECTIVE!
Q5. Which nursing diagnosis is the PRIORITY for a patient who is not breathing?
ANSWER Impaired Gas Exchange or Ineffective Airway Clearance
WHY In nursing, we use Maslow's Hierarchy of Needs to prioritize. Airway, Breathing,
Circulation (ABCs) are always top priority. A patient who cannot breathe will die in
minutes. All other problems become secondary when life is at immediate risk.
TRICK Remember the ABCs: Airway, Breathing, Circulation — always in this order. Think:
'You can't worry about anything else if you're DEAD.' Maslow says physiological
survival needs come first!
Q6. What is the difference between a nursing diagnosis and a medical diagnosis?
ANSWER A medical diagnosis identifies the disease (e.g., pneumonia). A nursing
diagnosis identifies the patient's RESPONSE to illness (e.g., Impaired Gas
Exchange).
WHY Doctors diagnose diseases. Nurses diagnose human responses to those diseases or
health problems. For example, a doctor says 'This patient has diabetes.' A nurse says
'This patient has Deficient Knowledge about managing diabetes.' Nurses focus on
what they can treat independently.
TRICK Think of it this way: Doctor = fixes the DISEASE. Nurse = fixes the PATIENT'S
REACTION to the disease. A doctor treats the fire; a nurse helps the person cope with
the smoke and burns!
Q7. During the Planning phase, what should nursing goals/outcomes be?
ANSWER SMART: Specific, Measurable, Achievable, Realistic, Time-bound — and patient-
centered
WHY Goals must be written so you can actually evaluate them later. Vague goals like
'patient will feel better' cannot be measured. A good goal: 'Patient will ambulate 50 feet
with assistance by discharge.' It's specific (50 feet), measurable (you can measure
distance), time-bound (by discharge).
TRICK Remember SMART goals: Specific, Measurable, Achievable, Realistic, Time-bound.
And always write goals about the PATIENT, not what the nurse will do. 'Patient
WILL...' not 'Nurse will teach...'
Q8. What happens during the Evaluation step of ADPIE?
ANSWER The nurse determines whether the patient goals/outcomes were MET,
PARTIALLY MET, or NOT MET, and revises the care plan accordingly.
WHY Evaluation is not the end — it's actually a loop back to assessment. If a goal wasn't
met, you reassess, re-diagnose, re-plan, and try again. Nursing care is a continuous
, cycle, not a straight line.
TRICK Think of Evaluation like a report card. Did the patient pass (met), partially pass
(partially met), or fail (not met)? If they fail, you go BACK to the beginning and try a
new approach. The nursing process is a CIRCLE, not a straight line!
SECTION 2: SUBJECTIVE vs. OBJECTIVE DATA
Q9. Which of the following is SUBJECTIVE data? A) Temperature of 101.2°F B) Patient states 'I
feel hot' C) Skin is flushed and warm D) Heart rate of 102
ANSWER B) Patient states 'I feel hot'
WHY Only option B is what the patient is SAYING. Options A, C, and D are all things the
nurse can measure or observe independently. The temperature is measured by a
thermometer (objective). Flushed skin is observed by the nurse (objective). Heart rate
is measured (objective). 'I feel hot' can only come from the patient.
TRICK Quick test: Can the NURSE independently verify it without asking the patient? YES =
Objective. NO = Subjective. 'I feel hot' — can a nurse feel what the patient feels? NO!
So it's subjective.
Q10. A patient's chart shows: 'Patient crying, states she is scared.' Which part is subjective?
ANSWER 'States she is scared' is subjective. 'Patient crying' is objective.
WHY This question tests whether you can identify BOTH types in one sentence. Crying is
something the nurse OBSERVES (objective). 'States she is scared' is what the patient
is SAYING (subjective). Many clinical situations contain both types of data
simultaneously.
TRICK Look for the word STATES, REPORTS, COMPLAINS OF, or DENIES — those signal
subjective data. What you can SEE, HEAR (like lung sounds), SMELL, TOUCH, or
MEASURE = objective!
SECTION 3: HEALTH HISTORY & INTERVIEWING
Q11. What is the purpose of a comprehensive health history?
ANSWER To collect complete subjective data about the patient's current health, past
medical history, family history, lifestyle, and psychosocial status to guide the
physical exam and care planning.
WHY The health history is like a complete life story of the patient's health. It helps you
understand the whole person, not just the current problem. It sets the foundation for
everything else in assessment. A thorough history can reveal patterns and risks you'd
miss otherwise.
TRICK Think of the health history as a PATIENT BIOGRAPHY. You want to know their whole
health story: past chapters (history), family background (family history), current
chapter (present illness), and daily life (lifestyle). Every detail matters!
Q12. What type of question would a nurse use to get a detailed description of a patient's pain?
, ANSWER Open-ended questions (e.g., 'Tell me about your pain' or 'How would you
describe it?')
WHY Open-ended questions cannot be answered with just 'yes' or 'no.' They invite the
patient to tell their story in their own words, which gives you more detailed and often
more accurate information. They show the patient you want to hear them, building trust
and rapport.
TRICK OPEN-ended = opens up the conversation. Think of a DOOR: open-ended questions
OPEN the door for the patient to talk. Closed-ended questions CLOSE the door
(yes/no only). For full details, OPEN the door!
Q13. Which question is CLOSED-ended?
ANSWER 'Do you smoke?' — this can be answered with just 'yes' or 'no'
WHY Closed-ended questions have a limited set of responses (yes/no, a specific number, a
specific choice). They are useful for getting specific facts quickly. However, relying
only on closed-ended questions means you may miss important details the patient
would have shared.
TRICK CLOSED = only a few answers possible. 'Do you smoke?' = Yes or No. A closed fist
only holds what's already in it — no room for more. But 'Tell me about your smoking'
OPENS the conversation!
Q14. What is SBAR communication and when is it used?
ANSWER SBAR = Situation, Background, Assessment, Recommendation. Used when
handing off patient care or reporting to a physician/provider.
WHY SBAR is a structured communication tool that prevents errors during care transitions.
Without structure, important information gets lost. SBAR ensures the listener gets all
critical information in a logical order. It's especially important when calling a doctor
about a deteriorating patient.
TRICK SBAR = 'S-B-A-R' like a SNACK BAR. S: What's happening NOW (Situation). B:
Patient's relevant history (Background). A: Your clinical judgment (Assessment). R:
What you need (Recommendation). 'SBAR saves lives!'
Q15. What is the BEST way to begin a health interview with a new patient?
ANSWER Introduce yourself, explain your role, ensure privacy, and ask open-ended
questions to establish rapport.
WHY The beginning of an interview sets the tone for the entire nurse-patient relationship.
Patients share more honestly when they feel safe and respected. Privacy is also a
legal and ethical obligation (HIPAA). Starting with 'What brings you here today?' is
ideal.
TRICK Think of meeting a new person: you shake hands, say your name, and find a private
place to talk. Same with patients! The interview is a professional relationship — start it
right. Privacy = trust = better information!
SECTION 4: THERAPEUTIC COMMUNICATION
Complete Study Guide: 150 Questions with Rationales & Memory Tricks
Explained Like You're Hearing It For The First Time
HOW TO USE THIS GUIDE
ANSWER = The correct answer to the question
WHY = The full rationale explaining why this is correct (and why others are wrong)
TRICK = An easy memory device, story, or pattern to remember forever
SECTION 1: THE NURSING PROCESS (ADPIE)
Q1. What does ADPIE stand for in the nursing process?
ANSWER Assessment, Diagnosis, Planning, Implementation, Evaluation
WHY ADPIE is the 5-step nursing process. Every single thing a nurse does follows these
steps in order. Assessment = gather data first. Diagnosis = identify the problem.
Planning = set goals. Implementation = do the care. Evaluation = did it work?
TRICK Say it like a word: 'AD-PIE.' Think of baking a pie — you Assess the ingredients,
Diagnose what's missing, Plan the recipe, Implement (bake it), then Evaluate how it
tastes!
Q2. Which step of the nursing process involves gathering subjective and objective data?
ANSWER Assessment
WHY Assessment is always the FIRST step. Before you can do anything else, you must
gather all information about the patient. You cannot diagnose, plan, or act without
data. This is like a detective collecting clues before solving the case.
TRICK Remember: Assessment = Always First. 'A' is the first letter of the alphabet AND the
first step of ADPIE. You wouldn't cook dinner without checking what food you have
first!
Q3. A patient tells you 'I have a sharp pain in my chest.' What type of data is this?
ANSWER Subjective data
WHY Subjective data = what the PATIENT tells you. It comes from the subject (the person).
Pain, nausea, dizziness, feelings — these are all subjective because only the patient
can feel them. You cannot measure someone else's feelings with a machine.
TRICK SUBjective = what the SUBject (patient) says. Think: 'S' = Stated by patient,
Symptoms, Self-reported. If the patient SAYS it, it's SUBJECTIVE!
Q4. A nurse measures a patient's blood pressure as 148/92. What type of data is this?
ANSWER Objective data
WHY Objective data = what you can OBSERVE, MEASURE, or TEST. Blood pressure,
, temperature, lab results, rashes you can see — all objective. The word 'objective'
means it doesn't depend on opinion; anyone with the right tool would get the same
measurement.
TRICK OBjective = OBservable. Think: 'O' = Others can see/measure it. A blood pressure cuff
gives you a number = Objective. If you can put a NUMBER on it or SEE it, it's
OBJECTIVE!
Q5. Which nursing diagnosis is the PRIORITY for a patient who is not breathing?
ANSWER Impaired Gas Exchange or Ineffective Airway Clearance
WHY In nursing, we use Maslow's Hierarchy of Needs to prioritize. Airway, Breathing,
Circulation (ABCs) are always top priority. A patient who cannot breathe will die in
minutes. All other problems become secondary when life is at immediate risk.
TRICK Remember the ABCs: Airway, Breathing, Circulation — always in this order. Think:
'You can't worry about anything else if you're DEAD.' Maslow says physiological
survival needs come first!
Q6. What is the difference between a nursing diagnosis and a medical diagnosis?
ANSWER A medical diagnosis identifies the disease (e.g., pneumonia). A nursing
diagnosis identifies the patient's RESPONSE to illness (e.g., Impaired Gas
Exchange).
WHY Doctors diagnose diseases. Nurses diagnose human responses to those diseases or
health problems. For example, a doctor says 'This patient has diabetes.' A nurse says
'This patient has Deficient Knowledge about managing diabetes.' Nurses focus on
what they can treat independently.
TRICK Think of it this way: Doctor = fixes the DISEASE. Nurse = fixes the PATIENT'S
REACTION to the disease. A doctor treats the fire; a nurse helps the person cope with
the smoke and burns!
Q7. During the Planning phase, what should nursing goals/outcomes be?
ANSWER SMART: Specific, Measurable, Achievable, Realistic, Time-bound — and patient-
centered
WHY Goals must be written so you can actually evaluate them later. Vague goals like
'patient will feel better' cannot be measured. A good goal: 'Patient will ambulate 50 feet
with assistance by discharge.' It's specific (50 feet), measurable (you can measure
distance), time-bound (by discharge).
TRICK Remember SMART goals: Specific, Measurable, Achievable, Realistic, Time-bound.
And always write goals about the PATIENT, not what the nurse will do. 'Patient
WILL...' not 'Nurse will teach...'
Q8. What happens during the Evaluation step of ADPIE?
ANSWER The nurse determines whether the patient goals/outcomes were MET,
PARTIALLY MET, or NOT MET, and revises the care plan accordingly.
WHY Evaluation is not the end — it's actually a loop back to assessment. If a goal wasn't
met, you reassess, re-diagnose, re-plan, and try again. Nursing care is a continuous
, cycle, not a straight line.
TRICK Think of Evaluation like a report card. Did the patient pass (met), partially pass
(partially met), or fail (not met)? If they fail, you go BACK to the beginning and try a
new approach. The nursing process is a CIRCLE, not a straight line!
SECTION 2: SUBJECTIVE vs. OBJECTIVE DATA
Q9. Which of the following is SUBJECTIVE data? A) Temperature of 101.2°F B) Patient states 'I
feel hot' C) Skin is flushed and warm D) Heart rate of 102
ANSWER B) Patient states 'I feel hot'
WHY Only option B is what the patient is SAYING. Options A, C, and D are all things the
nurse can measure or observe independently. The temperature is measured by a
thermometer (objective). Flushed skin is observed by the nurse (objective). Heart rate
is measured (objective). 'I feel hot' can only come from the patient.
TRICK Quick test: Can the NURSE independently verify it without asking the patient? YES =
Objective. NO = Subjective. 'I feel hot' — can a nurse feel what the patient feels? NO!
So it's subjective.
Q10. A patient's chart shows: 'Patient crying, states she is scared.' Which part is subjective?
ANSWER 'States she is scared' is subjective. 'Patient crying' is objective.
WHY This question tests whether you can identify BOTH types in one sentence. Crying is
something the nurse OBSERVES (objective). 'States she is scared' is what the patient
is SAYING (subjective). Many clinical situations contain both types of data
simultaneously.
TRICK Look for the word STATES, REPORTS, COMPLAINS OF, or DENIES — those signal
subjective data. What you can SEE, HEAR (like lung sounds), SMELL, TOUCH, or
MEASURE = objective!
SECTION 3: HEALTH HISTORY & INTERVIEWING
Q11. What is the purpose of a comprehensive health history?
ANSWER To collect complete subjective data about the patient's current health, past
medical history, family history, lifestyle, and psychosocial status to guide the
physical exam and care planning.
WHY The health history is like a complete life story of the patient's health. It helps you
understand the whole person, not just the current problem. It sets the foundation for
everything else in assessment. A thorough history can reveal patterns and risks you'd
miss otherwise.
TRICK Think of the health history as a PATIENT BIOGRAPHY. You want to know their whole
health story: past chapters (history), family background (family history), current
chapter (present illness), and daily life (lifestyle). Every detail matters!
Q12. What type of question would a nurse use to get a detailed description of a patient's pain?
, ANSWER Open-ended questions (e.g., 'Tell me about your pain' or 'How would you
describe it?')
WHY Open-ended questions cannot be answered with just 'yes' or 'no.' They invite the
patient to tell their story in their own words, which gives you more detailed and often
more accurate information. They show the patient you want to hear them, building trust
and rapport.
TRICK OPEN-ended = opens up the conversation. Think of a DOOR: open-ended questions
OPEN the door for the patient to talk. Closed-ended questions CLOSE the door
(yes/no only). For full details, OPEN the door!
Q13. Which question is CLOSED-ended?
ANSWER 'Do you smoke?' — this can be answered with just 'yes' or 'no'
WHY Closed-ended questions have a limited set of responses (yes/no, a specific number, a
specific choice). They are useful for getting specific facts quickly. However, relying
only on closed-ended questions means you may miss important details the patient
would have shared.
TRICK CLOSED = only a few answers possible. 'Do you smoke?' = Yes or No. A closed fist
only holds what's already in it — no room for more. But 'Tell me about your smoking'
OPENS the conversation!
Q14. What is SBAR communication and when is it used?
ANSWER SBAR = Situation, Background, Assessment, Recommendation. Used when
handing off patient care or reporting to a physician/provider.
WHY SBAR is a structured communication tool that prevents errors during care transitions.
Without structure, important information gets lost. SBAR ensures the listener gets all
critical information in a logical order. It's especially important when calling a doctor
about a deteriorating patient.
TRICK SBAR = 'S-B-A-R' like a SNACK BAR. S: What's happening NOW (Situation). B:
Patient's relevant history (Background). A: Your clinical judgment (Assessment). R:
What you need (Recommendation). 'SBAR saves lives!'
Q15. What is the BEST way to begin a health interview with a new patient?
ANSWER Introduce yourself, explain your role, ensure privacy, and ask open-ended
questions to establish rapport.
WHY The beginning of an interview sets the tone for the entire nurse-patient relationship.
Patients share more honestly when they feel safe and respected. Privacy is also a
legal and ethical obligation (HIPAA). Starting with 'What brings you here today?' is
ideal.
TRICK Think of meeting a new person: you shake hands, say your name, and find a private
place to talk. Same with patients! The interview is a professional relationship — start it
right. Privacy = trust = better information!
SECTION 4: THERAPEUTIC COMMUNICATION
