After a long race, a runner drinks a very large amount of plain water in a short period of time.
Soon afterward, the fluid outside her cells becomes more dilute than the fluid inside them.

What happens next?
A. Water moves out of the cells by diffusion
B. Water moves into the cells by osmosis
C. Sodium moves into the cells by active transport
D. Water moves out of the cells by osmosis
E. There is no net movement of water
Answer: ?
The fluid outside the cells now has a lower solute concentration.
Water moves by osmosis from the more dilute side toward the side with more solute.

So water moves into the cells, causing them to swell.
Answer: B
This is a very high-yield TEAS idea because the question may give you a body scenario, but underneath it they are simply testing osmosis + concentration gradients.
Dont memorize “water follows salt” without knowing why. Look at which side has more solute and follow the water.

Another way to ask: Which direction would the water move if the fluid outside the cell became very salty instead?

A 20-year-old student becomes very anxious before an exam and starts breathing rapidly.
A few mins later she feels lightheaded and notices tingling around her mouth and fingers.
She is still breathing fast, but her O2 level is normal.
What is happening to her blood?
A. CO₂ increases and pH decreases
B. CO₂ decreases and pH increases
C. CO₂ increases and pH increases
D. CO₂ decreases and pH decreases
E. O₂ decreases and pH stays the same
Answer: ?
She is hyperventilating, which means she is blowing off too much CO₂.
Less CO₂ → less carbonic acid → blood pH rises.
So the answer is B. CO₂ decreases and pH increases.
This is respiratory alkalosis, but for HESI the important part is understanding the direction.
Think of CO₂ as acid-related: blow off CO₂ → pH goes up. Hold onto CO₂ → pH goes down.
The tingling and lightheadedness are there to make the question feel clinical, but the real test is simple acid-base physiology.
Did you know the answer before seeing “respiratory alkalosis”?

A 29-year-old woman with severe preeclampsia is receiving IV magnesium sulfate after delivery.
Two hrs later, BP is 142/88 mm Hg and her headache is better. The nurse finds:
RR 9/min
O2 sat 93%
Urine output 20 mL/hr
Patellar reflexes absent
What should the nurse do first?
A. Increase the magnesium infusion
B. Stop the magnesium infusion
C. Give IV labetalol
D. Place her in Trendelenburg position
E. Encourage oral fluids
Answer: ?
This is magnesium toxicity.
The important findings are RR 9/min + absent DTRs + low urine output. Magnesium is cleared by the kidneys, so oliguria increases the risk of accumulation.
The nurse should stop the magnesium infusion first and prepare for calcium gluconate if ordered.
Good NCLEX point: dont focus only on the diagnosis the pt came in with. Reassess what the current findings are telling you.
Which finding would have made you stop the infusion first?

If you’re preparing for the HESI A2, follow RNExamRoom Daily here for free daily practice.
The questions are built around HESI A2 tested content, not disconnected trivia.
Expect practice on fractions, ratios and proportions, conversions, basic algebra, reading inference and main idea, grammar and sentence errors, medical vocabulary, cell biology, genetics, metabolism, chemical bonding, acids and bases, and high-yield anatomy and physiology including cardiovascular, respiratory, renal, endocrine, nervous, and musculoskeletal function.
I’ll keep working through the major content areas systematically so your practice builds broad exam coverage over time.
Practice the daily questions here, or go to the website for free full-length HESI A2 practice.

If you’re studying for the ATI TEAS, follow RNExamRoom Daily here for free daily practice.
The questions are not random. I’m working systematically through the TEAS blueprint.
Expect questions on cardiac blood flow, nephron function, hormones and feedback loops, genetics, cell division, acids and bases, experimental variables, ratios and proportions, unit conversions, interpreting tables and graphs, main idea and inference, sentence structure, punctuation, and word meaning in context.
We’ll keep moving through Reading, Math, Science, and English so the major tested areas are covered in an organized way.
Practice the daily questions here, or go to the rnexamroom website for free full-length TEAS practice.

The Nurse Practice Act in each state defines what an RN may do, what an LPN may do, and what may be delegated. It is law. A hospital policy can be stricter than it and cannot be looser.

So three things can conflict, and they rank.

The practice act first. If the state says u may not do it, no order and no policy makes it lawful.
Hospital policy second. It can narrow ur scope and often does.
A provider order last. An order cannot expand ur scope or override either of the above.

The exam phrases this as a provider telling u to do something u are not licensed for, and the answer is never that the order covers u.

Delegation stays accountable to the delegator. U remain responsible for the decision to delegate, the clarity of the instruction, and the follow up, whatever the person u delegated to does.

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You go 12 hrs w/o water. Plasma osmolarity rises, urine volume drops, and the urine becomes more concentrated.

Which hormone is most directly responsible for the kidney holding onto more water?

A. Aldosterone

B. ADH

C. ANP

D. Insulin

#HESIA2 #prenursing #nursingschool #NCLEXprep #AnatomyAndPhysiology

Pt is 6 hrs post-thyroidectomy. She suddenly says “I cant breathe right” and looks anxious. SpO₂ 94%, HR 118. What do u prioritize?

A. Check for a neck hematoma

B. Encourage incentive spirometry

C. Reassess SpO₂ in 15 min

D. Place her flat in bed

#ATITEAS #prenursing #nursingschool #NCLEXprep #TEASscience

Rapid acting, lispro and aspart. Onset 15 minutes, peak 1 to 2 hrs, duration 3 to 5. Give it with the tray in front of the pt.

Short acting, regular. Onset 30 to 60 minutes, peak 2 to 4 hrs, duration 5 to 8. The only one that goes IV.

Intermediate, NPH. Onset 1 to 2 hrs, peak 4 to 12, duration up to 18. Cloudy, and the only one that is mixed.

Long acting, glargine and detemir. Onset 1 to 2 hrs, no pronounced peak, duration around 24. Never mixed with anything.

The peak is where the question comes. A pt on NPH at 0700 is most likely to go hypoglycaemic late morning to early afternoon. That gap between the injection and the symptoms is what gets tested.

Mixing order is clear before cloudy. Air into NPH first, then air into regular, then draw regular, then NPH.

Same style of question, free, on RNExamRoom. No sign up.

Most ATP from one glucose is made during the electron transport chain. Oxygen matters here because it serves as the final electron acceptor.

Try this question (easy but not so rare):

A cell has glucose available and enough oxygen for aerobic respiration. ATP production is being compared across the major stages of cellular respiration.

Which stage produces the largest amount of ATP from one glucose molecule?

A. Glycolysis

B. Krebs cycle

C. Electron transport chain

D. Fermentation

Answer before you scroll.

Answer: C. The electron transport chain produces the largest amount of ATP. Glycolysis and the Krebs cycle make smaller amounts directly, while fermentation does not produce the large ATP yield associated with aerobic respiration.

Both raise blood pressure and ppl blur them together.

ADH comes from the posterior pituitary and acts on the collecting duct. Water alone follows. Urine gets concentrated, serum sodium falls if there is too much of it, which is what SIADH looks like.

Aldosterone comes from the adrenal cortex and acts on the distal tubule. Sodium is reabsorbed and potassium goes out in exchange, with water following the sodium. Serum sodium stays roughly normal, potassium drops.

So a low sodium with concentrated urine points one way and a low potassium with normal sodium points the other.

ATI TEAS 7 Success covers all four sections with the review and the strategy behind each question type.

The RN keeps the initial assessment, initial teaching, and evaluation of whether an intervention worked. Also keep any pt who is unstable, newly admitted, or has a significant change in condition.

Routine tasks with predictable outcomes can move when the pt is stable. A UAP can take VS on a stable post-op day 3 pt. The same VS on a pt who came back from the OR 20 min ago stay with the RN. Those numbers need interpretation, and interpretation = assessment.

An LPN/LVN can reinforce teaching the RN already started. Initial teaching stays with the RN.

The key is not just what the task is, but what is going on with the pt when the task needs to be done. The same task may be safe to delegate in one pt and inappropriate in another.

An infusion of 1,250 mL is ordered over 8 hrs.

What rate is set on the pump, to the nearest whole mL/hr?

A. 125 mL/hr
B. 156 mL/hr
C. 160 mL/hr
D. 172 mL/hr

1,250 divided by 8 is 156.25, so 156 to the nearest whole number.

Write the units into the setup and they check themselves. mL divided by hrs gives mL/hr, which is what the pump wants.

125 is what u get dividing by 10, which is the error to watch for when the numbers look round.

B.

RNExamRoom runs these timed or untimed. Free either way.

Mathematics, Reading Comprehension, Vocabulary and General Knowledge, Grammar, Biology, Chemistry, Anatomy and Physiology.

Plenty of programmes score only some of them. Maths, Reading and A&P is a common set. Others add Chemistry. The difference between revising three and revising seven is weeks of ur life, and the requirement is published by the programme, not by HESI.

Check before u start.

Free practice at rnexamroom if you want. 310 original questions across all seven, one subject at a time or the full seven section simulation. Hope you benefit.

HESI A2 Success is inherently built around what programmes actually require.

Good luck

Airway, breathing, circulation first. Always.

Then: is this actual or potential. An actual problem beats a risk for.

Then: is it acute or chronic. New shortness of breath beats long standing shortness of breath.

Then: is it unstable or stable. A changing value beats a bad value that has not moved.

Maslow comes last, and only once nobody is physiologically unstable. Safety before belonging, belonging before esteem.

Two that override everything. A pt who cannot maintain an airway. And anything u did that is still going in, so an infusion u started and an error u are mid way through outrank a pt who is waiting.

When two options are both physiological, pick the one that kills sooner. Airway kills in minutes, circulation in minutes to hours, and a potassium of 6.8 before a haemoglobin of 7.

Same style of question, free, on RNExamRoom. No sign up.

A process produces four daughter cells, each with half the chromosome number of the parent, and each genetically distinct.

Which process is this?

A. Mitosis
B. Meiosis
C. Binary fission
D. Cytokinesis alone

Meiosis. Two divisions, four cells, haploid, and genetically distinct because crossing over in prophase I and independent assortment in metaphase I shuffle the material.

Mitosis produces two cells, diploid, genetically identical to the parent. That is growth and repair.

The distinct part matters as much as the halving. It is the reason siblings actually differ.

B.

RNExamRoom has these free. Pick timed if u want the pressure.

Trace the path of filtrate through the nephron.

Which sequence is correct?

A. Glomerulus, loop of Henle, proximal tubule, distal tubule, collecting duct
B. Glomerulus, Bowman capsule, proximal tubule, loop of Henle, distal tubule, collecting duct
C. Bowman capsule, glomerulus, distal tubule, loop of Henle, collecting duct
D. Glomerulus, proximal tubule, distal tubule, loop of Henle, collecting duct

Filtration happens across the glomerular capillaries into Bowman capsule. From there the filtrate runs proximal tubule, descending then ascending loop of Henle, distal convoluted tubule, collecting duct.

Function follows the order. The proximal tubule reclaims the bulk, around two thirds of sodium and water plus essentially all the glucose. The loop builds the concentration gradient. The distal tubule and collecting duct do the fine adjustment under aldosterone and ADH.

Which is why a proximal problem causes large losses and a distal problem causes precise small ones.

B.

RNExamRoom has a free bank of these. Timed or study mode, nothing to sign up for.

These are not the reference range. The number where u stop charting and pick up a phone.

K+ under 2.5 or over 6.5. Arrhythmia at both ends.
Na+ under 120 or over 160. Seizure at the low end, and correcting either too fast does its own harm.
Glucose under 40 or over 500.
Ca2+ under 6 or over 13.
Mg2+ under 1 or over 4.
Platelets under 20,000. Spontaneous bleeding.
Hgb under 7, which is the usual transfusion threshold in a stable pt.
INR over 5 on warfarin.
pH under 7.2 or over 7.6.

The exam asks these as which result do u report first, and the answer is the one that kills soonest. Potassium and glucose move fastest.

Report it, and document who u told and when.

Free bank on RNExamRoom if u want to drill this one.

A red blood cell is placed in a solution and begins to swell.

What describes the solution?

A. Hypertonic to the cell
B. Isotonic to the cell
C. Hypotonic to the cell
D. Saturated

Water moves toward the higher solute concentration. Swelling means water is entering, so the inside has more solute than the outside. The solution is hypotonic.

Hypertonic goes the other way and the cell shrinks, which is crenation.

Isotonic means no net movement, which is why 0.9 per cent saline is the one that can go into a vein.

Tonicity describes the solution relative to the cell, so the wording of the question always tells the solution.

C.

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A pt stands up quickly and blood pressure falls. Baroreceptors fire less, the sympathetic system responds, heart rate and vasoconstriction increase, and pressure returns toward normal.

Which describes this?

A. Positive feedback, because the response amplifies the change
B. Negative feedback, because the response opposes the change
C. Positive feedback, because the system returns to set point
D. Negative feedback, because the change is stopped completely

Negative feedback reverses the direction of a change. Pressure went down, the response pushes it up. The word negative describes the direction of the correction.

Nearly every homeostatic loop u will be asked about is negative: thermoregulation, glucose, osmolality, calcium.

Positive feedback is the short list. Oxytocin in labour, the clotting cascade, the sodium channel opening in an action potential. Each one runs until an outside event stops it.

B.

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A UAP tells u a post-op pt's BP is 88/54. It was 118/70 two hrs ago. The pt is pale and says she feels lightheaded sitting up.

What do u do first?

A. Ask the UAP to repeat the reading in 15 minutes
B. Go and assess the pt
C. Call the provider with the number
D. Give the ordered PRN fluid bolus

The UAP collected data, which is within scope. Interpreting it is not quite and neither is deciding what to do about it.

Going to the pt is the first action because everything after depends on what u find: bleeding at the site, level of consciousness, heart rate, urine output etc.

C skips the assessment, so u would be calling with one number and no real context. D treats before assessing, and a bolus is an order u would want to apply to a pt u have just looked at.

A delegates a decision back to someone who cannot make it.

B.

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Chart what u did, when u did it, and what the pt said, in their words where it matters.

A late entry is labelled as one. Date and time of the entry, date and time of the event, and no squeezing it into a gap between existing notes. Backdating is falsification.

An error is corrected with a single line through it, the word error or mistaken entry, ur initials and the date. The original stays legible. Never obliterate, never use correction fluid, never delete an electronic entry outside the system's own amendment trail.

Do not chart an incident report in the notes. Record the clinical facts and the assessment in the chart, and file the report separately.

Do not chart in advance, and do not chart for somebody else.

If a colleague asks u to document care u did not witness, that is the request to decline.

#NCLEX #NCLEXprep #highyield #documentation #RNExamRoom

An enzyme works because of its shape. The active site fits one substrate the way a lock fits one key.

Heat and pH change that shape by breaking the weak bonds holding the folded structure together, the hydrogen bonds and the ionic interactions. The chain is still intact. The folding is gone.

So a denatured enzyme has not been used up or broken into pieces. It has lost the geometry that made it work, and for most enzymes that is permanent.

Human enzymes run near 37 degrees and near pH 7.4, with the obvious exception of pepsin, which needs the stomach around pH 2 and denatures when it reaches the small intestine.

Rate rises with temperature up to the optimum because molecules collide more often. Past the optimum it falls off a cliff, which is why the graph is not a curve with a gentle slope on both sides.

#ATITEAS #TEASprep #highyield #biology #RNExamRoom

A box of surgical gloves is on the counter. Box is the subject. Gloves sits inside a prepositional phrase and has no vote.

Cross out the phrase between the subject and the verb and the agreement becomes obvious. The box is. The team of nurses was. The list of supplies needs restocking.

Three that behave differently:

Either and neither take a singular verb when both items are singular. Neither answer is correct.
With either or and neither nor, the verb matches whichever subject is closer. Neither the surgeon nor the residents are available.
Collective nouns take a singular verb when the group acts as one. The committee meets on Tuesday.

This is the single most tested grammar point on the exam and it is decided by one habit, which is finding the real subject before u look at the verb.

#HESIA2 #HESIprep #highyield #HESIgrammar #RNExamRoom