1
HESI A2 Practice Exam Bank: 200+ Patient-Based
Reading Questions with Answers & Rationales
(2025 Update)
Table of Contents
Subtopic 1: Interpreting Patient Case Notes and Care Instructions ................................... 2
Subtopic 2: Analyzing Patient Education Materials and Discharge Instructions ................ 11
Subtopic 3: Inferring from Clinical Pathology and Lab Results ........................................ 20
Subtopic 4: Inferring from Patient Interviews and Symptom Descriptions ........................ 29
Subtopic 5: Drawing Conclusions from Medication Effects and Side Effects .................... 38
Subtopic 6: Drawing Conclusions from Health Promotion and Screening Data ................ 47
Subtopic 7: Interpreting Clinical Case Scenarios Involving Pediatric Patients................... 56
Subtopic 8: Interpreting Geriatric Patient Reports and Age-Related Conditions ............... 65
Subtopic 9: Drawing Conclusions from Emergency or Acute Care Scenarios ................... 74
Subtopic 10: Drawing Conclusions from Cultural, Ethical, or Psychosocial Patient Reports
.................................................................................................................................. 83
, 2
Subtopic 1: Interpreting Patient Case Notes and Care
Instructions
(Focus: Understanding and drawing logical conclusions from real-world documentation
like progress notes, discharge summaries, and instructions.)
Question 1
A patient’s chart reads: “Patient reports increasing shortness of breath over the past 3
days, especially when climbing stairs. Oxygen saturation is 89% on room air.”
What is the most reasonable conclusion?
A. The patient is recovering well from surgery.
B. The patient is experiencing hypoxia.
C. The patient has anxiety.
D. The patient is improving with rest.
Correct Answer: B
Rationale: Oxygen saturation below 90% suggests hypoxia. The symptom of shortness of
breath upon exertion supports this conclusion.
Question 2
The nurse reads the following in a patient's note: “Patient is A&Ox3. Pupils equal and
reactive to light. Follows commands.”
What can be concluded about the patient’s neurological status?
A. The patient is confused.
B. The patient has normal neurological function.
C. The patient is non-verbal.
D. The patient is unresponsive.
, 3
Correct Answer: B
Rationale: A&Ox3 (alert and oriented to person, place, and time) and reactive pupils
indicate normal neurological function.
Question 3
The discharge summary says: “Patient instructed to avoid weight-bearing activities for 6
weeks and attend outpatient PT twice weekly.”
What can be concluded about the patient's treatment plan?
A. The patient can return to work immediately.
B. The patient needs home health nursing.
C. The patient is recovering from an orthopedic procedure.
D. The patient is bedridden.
Correct Answer: C
Rationale: Avoiding weight-bearing activities and needing PT indicates a likely
musculoskeletal or orthopedic recovery.
Question 4
The medication administration record shows: “Lasix 40mg IV push every morning.”
What can be concluded about the patient’s condition?
A. The patient has hypotension.
B. The patient likely has fluid retention.
C. The patient is allergic to diuretics.
D. The patient needs nutritional support.
Correct Answer: B
, 4
Rationale: Lasix (furosemide) is a diuretic, used to treat fluid overload as seen in conditions
like heart failure.
Question 5
Charting reads: “Blood glucose before lunch: 280 mg/dL. Sliding scale insulin
administered.”
What conclusion can be drawn?
A. The patient has anemia.
B. The patient has hyperglycemia.
C. The patient’s blood sugar is stable.
D. The patient is fasting.
Correct Answer: B
Rationale: A glucose level of 280 mg/dL is above normal, indicating hyperglycemia.
Question 6
The nurse notes: “Patient refuses all oral intake since morning and complains of nausea.”
What should be concluded?
A. The patient is on a special diet.
B. The patient is at risk for dehydration.
C. The patient has completed their meal.
D. The patient is ready for discharge.
Correct Answer: B
Rationale: Refusing oral intake and nausea can lead to dehydration, especially if persistent.
Question 7
HESI A2 Practice Exam Bank: 200+ Patient-Based
Reading Questions with Answers & Rationales
(2025 Update)
Table of Contents
Subtopic 1: Interpreting Patient Case Notes and Care Instructions ................................... 2
Subtopic 2: Analyzing Patient Education Materials and Discharge Instructions ................ 11
Subtopic 3: Inferring from Clinical Pathology and Lab Results ........................................ 20
Subtopic 4: Inferring from Patient Interviews and Symptom Descriptions ........................ 29
Subtopic 5: Drawing Conclusions from Medication Effects and Side Effects .................... 38
Subtopic 6: Drawing Conclusions from Health Promotion and Screening Data ................ 47
Subtopic 7: Interpreting Clinical Case Scenarios Involving Pediatric Patients................... 56
Subtopic 8: Interpreting Geriatric Patient Reports and Age-Related Conditions ............... 65
Subtopic 9: Drawing Conclusions from Emergency or Acute Care Scenarios ................... 74
Subtopic 10: Drawing Conclusions from Cultural, Ethical, or Psychosocial Patient Reports
.................................................................................................................................. 83
, 2
Subtopic 1: Interpreting Patient Case Notes and Care
Instructions
(Focus: Understanding and drawing logical conclusions from real-world documentation
like progress notes, discharge summaries, and instructions.)
Question 1
A patient’s chart reads: “Patient reports increasing shortness of breath over the past 3
days, especially when climbing stairs. Oxygen saturation is 89% on room air.”
What is the most reasonable conclusion?
A. The patient is recovering well from surgery.
B. The patient is experiencing hypoxia.
C. The patient has anxiety.
D. The patient is improving with rest.
Correct Answer: B
Rationale: Oxygen saturation below 90% suggests hypoxia. The symptom of shortness of
breath upon exertion supports this conclusion.
Question 2
The nurse reads the following in a patient's note: “Patient is A&Ox3. Pupils equal and
reactive to light. Follows commands.”
What can be concluded about the patient’s neurological status?
A. The patient is confused.
B. The patient has normal neurological function.
C. The patient is non-verbal.
D. The patient is unresponsive.
, 3
Correct Answer: B
Rationale: A&Ox3 (alert and oriented to person, place, and time) and reactive pupils
indicate normal neurological function.
Question 3
The discharge summary says: “Patient instructed to avoid weight-bearing activities for 6
weeks and attend outpatient PT twice weekly.”
What can be concluded about the patient's treatment plan?
A. The patient can return to work immediately.
B. The patient needs home health nursing.
C. The patient is recovering from an orthopedic procedure.
D. The patient is bedridden.
Correct Answer: C
Rationale: Avoiding weight-bearing activities and needing PT indicates a likely
musculoskeletal or orthopedic recovery.
Question 4
The medication administration record shows: “Lasix 40mg IV push every morning.”
What can be concluded about the patient’s condition?
A. The patient has hypotension.
B. The patient likely has fluid retention.
C. The patient is allergic to diuretics.
D. The patient needs nutritional support.
Correct Answer: B
, 4
Rationale: Lasix (furosemide) is a diuretic, used to treat fluid overload as seen in conditions
like heart failure.
Question 5
Charting reads: “Blood glucose before lunch: 280 mg/dL. Sliding scale insulin
administered.”
What conclusion can be drawn?
A. The patient has anemia.
B. The patient has hyperglycemia.
C. The patient’s blood sugar is stable.
D. The patient is fasting.
Correct Answer: B
Rationale: A glucose level of 280 mg/dL is above normal, indicating hyperglycemia.
Question 6
The nurse notes: “Patient refuses all oral intake since morning and complains of nausea.”
What should be concluded?
A. The patient is on a special diet.
B. The patient is at risk for dehydration.
C. The patient has completed their meal.
D. The patient is ready for discharge.
Correct Answer: B
Rationale: Refusing oral intake and nausea can lead to dehydration, especially if persistent.
Question 7
