HESI A2 CRITICAL THINKING

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1. 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

2. 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.

3. 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.

4. 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.

5. 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.

6. 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.

7. 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?

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

8. 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 verified.

9. The Patients:

○ 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.

10. The Patients:

○ 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?

Answer: The 21-years old who is three hours postoperative and has a soaked dressing.

11. The Patients:

○ A 42-year-old with diabetes who is blind and is asking to get up and move to a chair.

○ An 88-year-old with lower body paralysis who wants to be turned in bed.

○ A 17-year-old with asthma who smokes and has been in the bathroom for 30 minutes.

○ A 55-year-old with cardiac disease who tells the nurse, "Get the TV fixed or I am leaving this

place."

The Situation: The nurse is caring for these four patients.

The Question: Which patient should the nurse see first?

Answer: The 17-year old with asthma who may be smoking in the bathroom.

12. The Patient: An elderly female accompanied by her middle-aged son.

The Situation: The patient is being discharged after a 15-day stay in the medical unit, and the son offers

the nurse a box of candy as a gesture of thanks for caring for his mother.

The Question: What should the nurse do in response to the offer of this gift?

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