HESI A2 CRITICAL THINKING 2021

HESI A2

CRITICAL

THINKING

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Critical Thinking

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.

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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?

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 verify.

9. The Patients:

1. A 63-year-old with a burn on the left lower leg who is complaining of pain.

2. A 45-year-old with pneumonia, complaining of shortness of breath.

3. A 31-year-old with abdominal pain who has just vomited blood.

4. 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:

1. A 13-year-old female with a kidney infection who reports that there is “lots of

blood” in her urine.

2. An 18-year-old male with acute alcohol poisoning who is seeing “bugs on the

walls.”

3. A 21-year-old female with inflammatory bowel disease who has soaked a dressing

three hours after surgery.

4. 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?

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