My study guide for HESI -passed on first try! - page 3

I have done a lot of research on HESI through the internet and taught myself (through the HESI book, Saunders Questions, course reviews dealing specifically with critical thinking) how to answer questions and came up with this... Read More

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    This will be a quickie. I'm just going to make up a question on the fly and hope it makes sense and is factually accurate. You'd be surprised how hard it is to make up questions. If something is inaccurate let me know and I can fix the question or make it more clearer. This should apply to PRIORITY questions, what to do FIRST questions (i.e. Interventions) and Nursing Diagonsis questions (but not always...)

    Ok, the most life threatening disease or condition isn't always the right answer. At the same time picking Airway over breathing and circulation doesn't work either. It does work for a lot of things though! You need to make sure that the condition is APPROPRIATE to the question, you have high PRIORITY, and its RELEVANT as well. Let's take the ABCs for example.

    Airway, breathing, and circulation.
    Let's say you have a patient that is in the ER. Upon assessment you detect that he has severe lacerations and stab wounds on his thighs and legs. He is complaining of pain (duh), he is very pale and sweating and also has a weak pulse but is responding to questions and screaming about how the monsters will come and take him away. You are asked to determine what intervention takes priority?

    A- Maintain a patent airway.
    B- Sit the patient upright to help him breathe better.
    C- Tell the patient that there are no monsters.
    D- Type and crossmatch and give blood per MD order.

    So what can you get from the question?
    He's bleeding. He's been stabbed. He's pale probably from the blood loss and this can lead to shock. The pulse is weak so shock again added to the blood loss. The sweating also adds to this. He is RESPONDING to questions but his mental condition is probably shot. He's a mental patient. Probably schiz. The main problem is that he's going to bleed out.

    A-Airway - well, yes, it'd be nice if he could breathe. But think what good breathing will do when he bleeds out and dies. Well, at least he was breathing ok until he died right? Yes, its IMPORTANT. Then again, no where in the question do you get the idea that he can't breathe. Eventually if we can't stop the bleeding breathing will be a problem. So it's IMPORTANT but not really appropriate. Let's at least CHECK ALL THE ANSWERS.
    B-Breathing. Again, there is nothing that tells you that he can't breathe. It's would be good to have him breathe... also you might not need to sit him upright if you're gonna work on the leg. A better position might be indicated.
    C-Yeah, there are no monsters. But again, it would be APPROPRIATE (mental patient) and it is IMPORTANT (well kinda). but is it PRIORITY (not really)? The problem is the blood loss. you could argue that it'd be easier to treat him if he was calm, but that doesn't address the bleeding. You can really read too much into this one here just because he's a mental patient.
    D-This is what I would choose. It addresses the problem of the blood loss.
    Ok, so that was an easy question. But the thing that is important is that you go through some sort of process when you do a question that allows you to break it down and analyze everything. Priority questions and what intervention to do first questions are kinda hard. I can recall one book or another telling me what decision tree (kaplan) or choice diagram (one of the other books) to follow when I get one of these questions. Here's my solution:

    Break out your study questions and a piece of paper. Maybe even print them so you can write on it.

    1. Read the question once and write down what you can pull out of it but be careful not to read into the questions and come out with something that wasn't in the original question. When i went through my practice books I always UNDERLINED ALL THE KEYWORDS.
    2. READ all the answer choices.
    3. GO BACK to the answer choices and write why you think its RIGHT AND WRONG. i.e RATIONALES!
    4. Go BACK to the question
    5. Eliminate what answers you think are wrong based on what you wrote.
    6. Pick an answer. Based on what you wrote
    7. Make sure the answer you picked can be backed up by what you know.
    8. This should be the right one.

    It sounds like a long process and it is, but if you practice it a lot it becomes second nature.


    -Look up the right answer and compare your rationales with what the book says. If you got it right but for the wrong reason THIS IS BAD. You're gonna get it wrong somewhere down the road. You need to get the question right because you got the facts right. Likewise you should look at the answers you eliminated. If you got it eliminated for the wrong reason, you're gonna mess it up again.
    - You're gonna need to compare your thought patterns with your book study. Take those rationales you wrote down and compare to the disease process in your book. Maybe you taught yourself something incorrect or you forgot something very important. You need to do this with the incorrect rationales for the choices you eliminated too. Did you eliminate it for the right reason or did you just eliminate the right answer because you didn't know?
    -You'll start to notice patterns. (Hey I always eliminate the right answer first! or I always pick the wrong answer! etc). this will help you figure out what your thought patterns are.
    -When you practice one question may take like 5 minutes to do if you follow this. Combine that with how many questions you're doing....well....if it helps it helps, right?

    When you get really good you should be able to say why option A, B, and C are wrong and why and only why option D is correct. In effect you can already predict nearly word for word what the rationales are as they are printed in the book. I actually made one of my non nursing friends think I memorized an entire 2000 page Saunders book because I could predict not only why it was right, but why other thing were wrong.

    It's a skill that you need to practice.

    I though this was going to be shorter but oh well..

    Regarding decision trees, I don't think you need them if you can break down a question. You should be able to apply twenty different decision trees (i.e. do maslows first, then ABC, but not airway if this then that etc) or (i.e. check that this condition is not this then make sure its not food related and that you do that etc) to the same question and get the right answer every time otherwise its useless.

    The main reason people give decision trees is to help you think better. I think you think better when you can break down a question and its answers. Priority, Nursing Diagnosis, and what to do first become so much easier in my opinion.

    good luck
    Future ScorpioRN, alunchik, DIV-99, and 3 others like this.

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    Thank you Sisph. It is very helpful. I appreciate that you spent the time explaining the ABC. Jen
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    That was good information. I will apply that to the Hesi.
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    Thanks for all of the info! I agree with your tips. Some of my professors throughout nursing school gave us some of the same tips. I also took the Rutgers U. Review, but that focused on more content. The content review was good for me since I am more of an auditory/visual learner rather than reader. I also did about 1600 questions and I tried to always review the rationals, even on the questions I got right. Unfortunatly the HESI CD only allows you to review the questions that you got wrong, so I found myself taking notes during the test on topics that I wasn't sure of so that I could read up on it when I was done with the test.

    Of all of the practice quizzes and tests that I took, my average was only a 67.59% . I've read on some other posts that this rally wasn't that bad of a score. Hopefully I get more than an 850 on the HESI and pass the NCLEX.

    Anyway, I have my HESI tomorrow morning. Wish me luck!
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    Well, I took my HESI this week. When we got there our school said that they lowered the passing rate from 850 to 820. Thank god! I ended up getting an 846. I think someone was watching over me for this one. Now I can study for the NCLEX.
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    I don't understand the HESI
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    Is the HESI the same for incoming students? outgoing and in the programs? I am applying to nursing school and I am required to take the HESI before admissions. does this mean there is a particular HESI exam for incoming nursing students? I have two weeks to prepare. suggestions?
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    I just passed the Hesi with a 996!
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    u mean a 96? what is the highest score one can get? what did u use to study? was a lot of it common sense. great job and congrats!

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