hesi a2 with critical thinking

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HESI A2 with Critical Thinking

Published Apr 9, 2012

Before taking this test I searched everywhere to try and find out what the critical thinking section would be like. I really couldn't find anything useful in easing my unease about that part of the test, so I thought I might post something to help others who take the HESI with the CT section.

The information I received with my CT scores follows:

This exam is a four-choice, multiple-choice test. All answers are correct. However, each choice reflects a different degree of critical thinking skills.

Scores range from 0-1000. The higher your score is, the better your ability to think critically within the discipline of nursing.

In addition to a total score on this exam you will receive scores on five sub-categories of critical thinking:

Problem Solving: These questions refer to the process of inquiry in which the nurse seeks multiple facts to remove obstacles or resolve patient care problems.

Biases and Ethical Dilemmas: These questions address ethical, legal, and moral issues, as well as biases nurses may have about patients and others.

Argument Analysis: These questions refer to situations in which the nurse seeks to resolve conflicts or disagreements by considering multiple points of view.

Analysis of Data: These questions address the need to interpret patient data correctly, and decide if further nursing action is required.

It says five sub-categories, but it only details four. Prioritization of patient care is not listed, but I think the title is very descriptive. Someone on another post suggested a practical nursing book, but I didn't have a chance to find one and study it. I scored 870 overall on the CT section. Can a nurse accept muffins as a thank you? I know that I myself would want to say thank you with baked goods, but I don't know if that's something that should be done. I also am not certain to what extent an off duty nurse should diagnose a stranger. It's obvious from my scores that I needed more knowledge regarding Analysis of Data and Argument Analysis.

(1) Analysis of Data 821

(2) Argument Analysis 800

(3) Prioritization of Care 916

(4) Problem Solving 868

(5) Resolution Biases/Ethical Dilemma 916

• + Join the Discussion

Thank you for this! I take mine tomorrow and I am super nervous about everything but especially the CT part! I have been searching high and low to find something about that portion! So thank you very much!

Hi. Thanks for posting this :)How many questions is the critical thinking section only? I read that's it is 25 questions... Was that true when you took it?If every choice is correct, do you get partial points for answers that would have been the "next best answer"? (hope that makes sense)I'm studying out of the Fundamentals book... For those who studied out of that book, are there sections I should focus on more?Do I need to know lab ranges?Thank you in advance...

I completed the hesi not sure where the critical score is i saw I made an 800 but now showing on my paper profile page is this separate . I dont see it listed only the personality ect which was listed last please help and ty :)

wow that was on my test too. i said direct to pharamacy about the diagnosing and share the muffins with the rest of the staff lol but im not sure. i received an 840 on that section

did u use any books to study for the critical thinking section katrinad and jshanice11

no i didn't use any books. the questions they ask you have to basically think if you was in that situation as a nurse and choose the best solution or action to take. it was kind of easy if you know the guidelines and do's and dont's of being a nurse.

I will be taking the Hesi exam next week. I just a had a quick question of any of y'all happen to know. Since all answers are correct and places you in a category of CT does this help or affect your final score? Thank you

Wow, I just took the CT exam, and I'm surprised that the questions (5 years after the original post) seem almost the same. I took the "muffins" (a box of chocolates on my exam) from a patients son, and shared them with the staff because it was a nice gesture, and to refuse seemed offensive. Regarding the question in the pharmacy (while off-duty), I chose to refuse to offer medical advice because I'm not a doctor. I also got the question about the patient defecating on themselves in the bed (chose to clean the patient first, and use towels underneath him until I could find clean sheets).

Honestly, there is no magical way to approach the questions. I just really tried to imagine myself in the situation, and decide what action I would take. For example, if I need to change bed linens for a patient, and the floor was out of linens, I would take them off of an unused bed. If I was in the middle of changing a dressing for a home health patient, and another patient called, I'd silence the call until I was done; however, if I was at dinner with friends, and I was on-call, I'd leave the table to take a call. If a patient just got a cast on their lower leg, and it became very painful, the first thing I'd check is their their toes to make sure there is adequate circulation. Really, all you need to do is think about what you'd do as a professional, and perhaps also think what you'd like a nurse to do for you if you were the patient. However, for the question about the guy who wanted to meet the nurse for coffee to discuss the physician, I chose to "explain professional boundries"--not everything the patient wants is acceptable :-). Overall, I scored 940, not the highest, but good enough. Good luck to all future HESI testers!

GOOD ANN27, CAN YOU LEAVE ME AN EMAIL ADDRESS I THINK I HAVE SOME QUESTIONS I THINK YOU MIGHT BE ABLE TO HELP ME

anyone has any recommendation or source for critical thinking section?

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HESI A2 Critical Thinking more questions

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Hesi a2 critical thinking.

• The Patient: A 65-year- old male. The Situation: The family brings the patient to the emergency room because he just took an entire bottle of pills. The Question: What action should the nurse take first?

Answer – Determine the patient’s level of consciousness.

• The Patient: An 80 year-old male who has used continuous oxygen for the past three years. The Situation: While making a home visit, the wife tells the nurse that her husband was doing well on 2 litres of oxygen per minute until late last night when he developed severe shortness of breath on the way to the bathroom. The Question: What action should the nurse take first?

Answer – Assess the patient’s oxygen saturation by pulse oximeter.

• The Patient: A 41-year-old male. The Situation: The patient is complaining of severe stomach pain and states that he has been “vomiting all the time.” The Question: What should the nurse do first?

Answer – Administer a prescribed pain medication.

• The Patient: The wife of a wealthy owner of the town’s bank. The Situation: The patient and her husband arrive on the unit. While orienting the patient to the hospital room, the nurse notices that the patient has placed a large amount of cash and some expensive earrings in the drawer of the bedside table. The Question: What is the best action for the nurse to take?

Answer – Advise the patient to have her husband take the items home when he leaves.

• The Patient: A 45-year-old female who is 5’ 2” tall, weighs 200 pounds, and has smoked since age 21. The Situation: The patient comes to the clinic with a complaint of “leg pain.” The Question: It is most important for the nurse to obtain information about which previous occurrence?

Answer – A previous blood clot in the leg.

• The Patient: A 61-year-old female. The Situation: The patient has a fever of unknown origin. The nurse administered a fever-reducing medication 30 minutes ago. At this time there has been no decrease in the patient’s fever. The Question: What action would be best for the nurse to take?

Answer – Sponge the patient with cool water.

• The Patient: A 70-year-old male who is relatively healthy. The Situation: A liquid mediation is prescribed for this patient. The Question: Prior to administering the prescribed medication, what intervention has the highest priority?

Answer – Determine if the patient is allergic to the medication.

• The Patient: A fifty-eight-year-old female. The Situation: While the nurse is offering the patient her morning medications, she tells the nurse that she does not recall ever taking a pill that was pink-colored. The Question: What should the nurse do in response to this patient’s comment?

Answer – Withhold the mediation until the patient’s prescription is verify.

• A 63-year-old with a burn on the left lower leg who is complaining of pain.
• A 45-year-old with pneumonia, complaining of shortness of breath.
• A 31-year-old with abdominal pain who has just vomited blood.
• An 88-year-old who has right-sided paralysis and wants to be helped to the bathroom immediately. The Situation: The nurse is caring for these patients. The Question: Who should the nurse see first?

Answer – The 45-years old with pneumonia and shortness of breath.

• A 13-year-old female with a kidney infection who reports that there is “lots of blood” in her urine.
• An 18-year-old male with acute alcohol poisoning who is seeing “bugs on the walls.”
• A 21-year-old female with inflammatory bowel disease who has soaked a dressing three hours after surgery.
• A 25-year old male who is sobbing in his room after being told that he has testicular cancer. The Situation: The nurse is caring for these four patients. The Question: Who should the nurse see first?

The Question: What action would be best for the nurse to take?

Answer – Ask the patient about the frequency, timing and quality of her headaches.

• The Patient: A 35-year-old female with a history of asthma. The Situation: The patient has been using a steroid inhaler because she is short of breath. However, she states that her shortness of breath is “no better.” The Question: What is the most important information for the nurse to obtain?

Answer – Method of using the inhaler.

• The Patient: An older confused male. The Situation: At 3 a. 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. 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 morphins whenever Nurse “B” is caring for him. Nurse “A” suspects that 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 toes 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”

• The Patient: A 35-year-old female. The Situation: The patient is admitted with a diagnosis of abdominal pain and diarrhea. The Question: Which action should the nurse take first?

Answer – Initiate Intravenous fluids.

• The Patient: A 51-year-old male. The Situation: The patient is pale, has dark circles under his eyes, and responds to questions with a soft, low voice. He tells the nurse that he has not slept well for months, but denies any type of pain. The Question: What information is most important for the nurse to obtain?

Answer – The existence of a significant life in the last year that has caused anxiety.

• The Patient: A 19-year-old male who has previously been healthy. The Situation: The patient complains that he is losing weight despite “eating all the time.” The Question: Considering this patient’s age and complaint, which diagnostic test is likely to provide the most important information?

Answer – A fingerstick for blood sugar level.

CRITICAL THINKING

• A client who is in hospice care complains of increasing amounts of pain. The healthcare

provider prescribes an analgesic every four hours as needed. Which action should the nurse

Give an around-the-clock schedule for administration of analgesics.

• The nurse is administering medications through a nasogastric tube (NGT) which is

connected to suction. After ensuring correct tube placement, what action should the nurse

Flush the tube with water.

• An elderly client with a fractured left hip is on strict bedrest. Which nursing measure is

essential to the client's nursing care?

Gently lift the client when moving into a desired position.

• When assessing a client with wrist restraints, the nurse observes that the fingers on the right

hand are blue. What action should the nurse implement first?

Loosen the right wrist restraint.

• The nurse is assessing the nutritional status of several clients. Which client has the greatest

nutritional need for additional intake of protein?

A lactating woman nursing her 3-day-old infant.

• A client is in the radiology department at 0900 when the prescription levofloxacin

(Levaquin) 500 mg IV q24h is scheduled to be administered. The client returns to the unit

at 1300. What is the best intervention for the nurse to implement?

Give the missed dose at 1300 and change the schedule to administer daily at 1300.

• While instructing a male client's wife in the performance of passive range-of-motion

exercises to his contracted shoulder, the nurse observes that she is holding his arm above

and below the elbow. What nursing action should the nurse implement?

Acknowledge that she is supporting the arm correctly.

• What is the most important reason for starting intravenous infusions in the upper

extremities rather than the lower extremities of adults?

A decreased flow rate could result in the formation of a thrombosis.

• The nurse observes an unlicensed assistive personnel (UAP) taking a client's blood pressure

with a cuff that is too small, but the blood pressure reading obtained is within the client's

usual range. What action is most important for the nurse to implement?

Reassess the client's blood pressure using a larger cuff.

• Twenty minutes after beginning a heat application, the client states that the heating pad no

longer feels warm enough. What is the best response by the nurse?

The body's receptors adapt over time as they are exposed to heat.

• A hospitalized male client is receiving nasogastric tube feedings via a small-bore tubeand

a continuous pump infusion. He reports that he had a bad bout of severe coughing a few

minutes ago, but feels fine now. What action is best for the nurse to take?

After clearing the tube with 30 ml of air, check the pH of fluid withdrawn from the tube.

• A male client being discharged with a prescription for the bronchodilator theophylline tells

the nurse that he understands he is to take three doses of the medication each day. Since,

at the time of discharge, timed-release capsules are not available, which dosing schedule

should the nurse advise the client to follow?

8 a., 4 p., and midnight.

• A client is to receive 10 mEq of KCl diluted in 250 ml of normal saline over 4 hours. At

what rate should the nurse set the client's intravenous infusion pump?

To calculate this problem correctly, remember that the dose of KCl is not used in the

calculation. 250 ml/4 hours = 63 ml/hour.

• An obese male client discusses with the nurse his plans to begin a long-term weight loss

regimen. In addition to dietary changes, he plans to begin an intensive aerobic exercise

program 3 to 4 times a week and to take stress management classes. After praising the

client for his decision, which instruction is most important for the nurse to provide?

Be sure to have a complete physical examination before beginning your planned exercise

• The nurse is teaching a client proper use of an inhaler. When should the client administer

the inhaler-delivered medication to demonstrate correct use of the inhaler?

During the inhalation.

• Which action is most important for the nurse to implement when donning sterile gloves?

Keep gloved hands above the elbows.

• A client with chronic renal failure selects a scrambled egg for his breakfast. What action

should the nurse take?

Commend the client for selecting a high biologic value protein.

• A client who is 5' 5" tall and weighs 200 pounds is scheduled for surgery the next day.

What question is most important for the nurse to include during the preoperative

assessment?

What vitamin and mineral supplements do you take?

• During the initial morning assessment, a male client denies dysuria but reports that his

urine appears dark amber. Which intervention should the nurse implement?

Encourage additional oral intake of juices and water.

• Which intervention is most important for the nurse to implement for a male client who is

experiencing urinary retention?

Assess for bladder distention.

After completing an assessment and determining that a client has a problem, which action

should the nurse perform next?

Determine the etiology of the problem.

An elderly client who requires frequent monitoring fell and fractured a hip. Which nurse is

at greatest risk for a malpractice judgment?

The nurse who transferred the client to the chair when the fall occurred.

A postoperative client will need to perform daily dressing changes after discharge. Which

outcome statement best demonstrates the client's readiness to manage his wound care after

The client demonstrates the wound care procedure correctly.

When evaluating a client's plan of care, the nurse determines that a desired outcome was

not achieved. Which action will the nurse implement first?

Note which actions were not implemented.

When assisting an 82-year-old client to ambulate, it is important for the nurse to realize

that the center of gravity for an elderly person is the

Upper torso.

In developing a plan of care for a client with dementia, the nurse should remember that

confusion in the elderly

often follows relocation to new surroundings.

• An elderly male client who suffered a cerebral vascular accident is receiving tube feedings

via a gastrostomy tube. The nurse knows that the best position for this client during

administration of the feedings is

Fowler's.

• The nurse notices that the mother a 9-year-old Vietnamese child always looks at the floor

when she talks to the nurse. What action should the nurse take?

Continue asking the mother questions about the child.

• When conducting an admission assessment, the nurse should ask the client about the use

of complimentary healing practices. Which statement is accurate regarding the use of these

Many complimentary healing practices can be used in conjunction with conventional

• A young mother of three children complains of increased anxiety during her annual

physical exam. What information should the nurse obtain first?

Nutritional history.

• The nurse is completing a mental assessment for a client who is demonstrating slow thought

processes, personality changes, and emotional lability. Which area of the brain controls

these neuro--cognitive functions?

Frontal lobe.

• A male client tells the nurse that he does not know where he is or what year it is. What data

should the nurse document that is most accurate?

is disoriented to place and time.

• An African-American grandmother tells the nurse that her 4-year-old grandson is suffering

with "miseries." Based on this statement, which focused assessment should the nurse

Inquire about the source and type of pain.

• The nurse notices that the Hispanic parents of a toddler who returns from surgery offer the

child only the broth that comes on the clear liquid tray. Other liquids, including gelatin,

popsicles, and juices, remain untouched. What explanation is most appropriate for this

Hot remedies restore balance after surgery, which is considered a "cold" condition.

• During a physical assessment, a female client begins to cry. Which action is best for the

nurse to take?

Acknowledge the client's distress and tell her it is all right to cry.

• A female client asks the nurse to find someone who can translate into her native language

her concerns about a treatment. Which action should the nurse take?

Request and document the name of the certified translator.

• The nurse is teaching a client with numerous allergies how to avoid allergens. Which

instruction should be included in this teaching plan?

Avoid any types of sprays, powders, and perfumes.

• Multiple Choice

Topic : Pharmacology for Nurses

Subject : nursing - cte, this is a preview.

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