HESI A2 Critical Thinking 2024/2025 – 100% Verified Answers
with Expert Clinical Reasoning Explanations
Below are 80 unique multiple-choice questions for the HESI A2 Critical Thinking
section (versions V1–V3), focusing on ethical scenarios, patient safety, prioriti-
zation, and nursing judgment. Each question includes four answer choices, the
correct answer, and a clear rationale based on clinical reasoning principles. The
questions are designed to be realistic, non-repeating, and formatted for clean
PDF export.
Question 1: A nurse discovers that a patient’s IV medication was administered at the
wrong rate. What is the nurse’s first action?
A. Adjust the IV rate to the correct setting.
B. Assess the patient for adverse effects.
C. Document the error in the patient’s chart.
D. Notify the charge nurse about the error.
Correct Answer: B. Assess the patient for adverse effects.
Rationale: Patient safety is the priority. Assessing for adverse effects en-
sures immediate response to potential harm. Adjusting the rate, document-
ing, or notifying are necessary but secondary to stabilizing the patient.
Question 2: A patient with a history of seizures refuses their antiepileptic medication.
What should the nurse do first?
A. Document the refusal and continue care.
B. Educate the patient on the risks of refusal.
C. Notify the physician immediately.
D. Administer the medication covertly.
Correct Answer: B. Educate the patient on the risks of refusal.
Rationale: Education respects patient autonomy and may encourage com-
pliance. Documentation and notification are secondary, and administering
medication covertly is unethical and illegal.
Question 3: During a busy shift, a nurse notices a patient’s oxygen tubing is discon-
nected. What is the first action?
A. Reconnect the oxygen tubing.
B. Check the patient’s oxygen saturation.
C. Notify the respiratory therapist.
D. Document the incident in the chart.
Correct Answer: B. Check the patient’s oxygen saturation.
Rationale: Assessing the patient’s oxygen level determines the urgency of
the situation (ABCs). Reconnecting is important but follows assessment.
Notification and documentation are secondary.
1
, Question 4: A patient with a recent hip replacement reports sudden shortness of breath.
What should the nurse prioritize?
A. Administer pain medication as ordered.
B. Notify the physician immediately.
C. Encourage deep breathing exercises.
D. Document the patient’s complaint.
Correct Answer: B. Notify the physician immediately.
Rationale: Sudden shortness of breath may indicate a pulmonary embolism,
a life-threatening complication. Notification ensures rapid intervention.
Pain medication, breathing exercises, or documentation are less urgent.
Question 5: A nurse witnesses a colleague failing to wash their hands before patient
contact. What is the best action?
A. Report the colleague to the supervisor.
B. Remind the colleague to wash their hands.
C. Ignore the incident as a one-time error.
D. Document the incident in the colleague’s file.
Correct Answer: B. Remind the colleague to wash their hands.
Rationale: A direct, professional reminder promotes patient safety and
corrects the behavior without escalating. Reporting or documenting is pre-
mature, and ignoring risks infection.
Question 6: A patient with end-stage renal disease refuses dialysis. What is the nurse’s
best response?
A. Administer fluids to compensate.
B. Respect the refusal and inform the physician.
C. Convince the patient to reconsider.
D. Document the refusal and withhold care.
Correct Answer: B. Respect the refusal and inform the physician.
Rationale: Respecting autonomy is ethical; informing the physician en-
sures alternative care options are explored. Administering fluids is inad-
equate, convincing may pressure the patient, and withholding care is ne-
glectful.
Question 7: Three patients require attention: one with a temperature of 103°F, one with
a blood glucose of 50 mg/dL, and one with a dressing change. Which patient
should the nurse assess first?
A. The patient with high fever.
B. The patient with low blood glucose.
C. The patient needing a dressing change.
2
with Expert Clinical Reasoning Explanations
Below are 80 unique multiple-choice questions for the HESI A2 Critical Thinking
section (versions V1–V3), focusing on ethical scenarios, patient safety, prioriti-
zation, and nursing judgment. Each question includes four answer choices, the
correct answer, and a clear rationale based on clinical reasoning principles. The
questions are designed to be realistic, non-repeating, and formatted for clean
PDF export.
Question 1: A nurse discovers that a patient’s IV medication was administered at the
wrong rate. What is the nurse’s first action?
A. Adjust the IV rate to the correct setting.
B. Assess the patient for adverse effects.
C. Document the error in the patient’s chart.
D. Notify the charge nurse about the error.
Correct Answer: B. Assess the patient for adverse effects.
Rationale: Patient safety is the priority. Assessing for adverse effects en-
sures immediate response to potential harm. Adjusting the rate, document-
ing, or notifying are necessary but secondary to stabilizing the patient.
Question 2: A patient with a history of seizures refuses their antiepileptic medication.
What should the nurse do first?
A. Document the refusal and continue care.
B. Educate the patient on the risks of refusal.
C. Notify the physician immediately.
D. Administer the medication covertly.
Correct Answer: B. Educate the patient on the risks of refusal.
Rationale: Education respects patient autonomy and may encourage com-
pliance. Documentation and notification are secondary, and administering
medication covertly is unethical and illegal.
Question 3: During a busy shift, a nurse notices a patient’s oxygen tubing is discon-
nected. What is the first action?
A. Reconnect the oxygen tubing.
B. Check the patient’s oxygen saturation.
C. Notify the respiratory therapist.
D. Document the incident in the chart.
Correct Answer: B. Check the patient’s oxygen saturation.
Rationale: Assessing the patient’s oxygen level determines the urgency of
the situation (ABCs). Reconnecting is important but follows assessment.
Notification and documentation are secondary.
1
, Question 4: A patient with a recent hip replacement reports sudden shortness of breath.
What should the nurse prioritize?
A. Administer pain medication as ordered.
B. Notify the physician immediately.
C. Encourage deep breathing exercises.
D. Document the patient’s complaint.
Correct Answer: B. Notify the physician immediately.
Rationale: Sudden shortness of breath may indicate a pulmonary embolism,
a life-threatening complication. Notification ensures rapid intervention.
Pain medication, breathing exercises, or documentation are less urgent.
Question 5: A nurse witnesses a colleague failing to wash their hands before patient
contact. What is the best action?
A. Report the colleague to the supervisor.
B. Remind the colleague to wash their hands.
C. Ignore the incident as a one-time error.
D. Document the incident in the colleague’s file.
Correct Answer: B. Remind the colleague to wash their hands.
Rationale: A direct, professional reminder promotes patient safety and
corrects the behavior without escalating. Reporting or documenting is pre-
mature, and ignoring risks infection.
Question 6: A patient with end-stage renal disease refuses dialysis. What is the nurse’s
best response?
A. Administer fluids to compensate.
B. Respect the refusal and inform the physician.
C. Convince the patient to reconsider.
D. Document the refusal and withhold care.
Correct Answer: B. Respect the refusal and inform the physician.
Rationale: Respecting autonomy is ethical; informing the physician en-
sures alternative care options are explored. Administering fluids is inad-
equate, convincing may pressure the patient, and withholding care is ne-
glectful.
Question 7: Three patients require attention: one with a temperature of 103°F, one with
a blood glucose of 50 mg/dL, and one with a dressing change. Which patient
should the nurse assess first?
A. The patient with high fever.
B. The patient with low blood glucose.
C. The patient needing a dressing change.
2
