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HESI A2 Reading comprehension: inference practice questions

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These are original practice items written to the HESI A2 blueprint (4 options, no penalty for wrong answers), not actual exam questions. Try each one before you open the answer.

What this topic covers

Reading comprehension: inference sits inside the Reading Comprehension section of the HESI A2. Our bank holds 55 verified items tagged to it, and the 4 below are a fixed sample so the page stays the same every time you open it. Each one shows the reasoning, not just the letter.

The topic tag comes from our own items rather than from a published syllabus, so treat it as a map of what we cover. For the official section breakdown see the HESI A2 page.

Reading comprehension: inference sample questions

Question 1

Passage: Despite repeated education about the importance of taking her diabetes medication daily, Mrs. Johnson has missed three doses this week. She tells the nurse that she sometimes forgets because her routine is disrupted when she visits her grandchildren. She also mentions that the pills are large and difficult to swallow.

Based on the passage, what is the most likely reason for Mrs. Johnson's medication noncompliance?

  1. A She does not understand the importance of the medication.
  2. B She intentionally refuses to take the medication.
  3. C She has multiple barriers including forgetfulness and difficulty swallowing.
  4. D She cannot afford the medication.
Show the answer and explanation

Correct answer: C

The passage provides two reasons: forgetfulness due to disrupted routine and difficulty swallowing large pills. Option B correctly infers multiple barriers. Option A is contradicted because she received education and understands importance. Option C is not supported (she forgets, not refuses). Option D is not mentioned.

Why the other options are wrong:
A: The passage states she received repeated education, so she likely understands the importance; the issue is forgetfulness and swallowing difficulty.
B: There is no evidence of intentional refusal; she reports forgetting and difficulty swallowing.
D: Cost is not mentioned in the passage; the barriers are forgetfulness and swallowing difficulty.

Question 2

Read the following passage and answer the question.

Passage: After the surgery, the patient was transferred to the recovery room. The nurse noted that the patient's blood pressure was 90/60 mmHg, which was lower than the preoperative baseline of 120/80 mmHg. The patient complained of dizziness.

Question: What can be inferred from the passage?

  1. A The nurse should call the doctor immediately.
  2. B The patient is experiencing hypotension.
  3. C The surgery was unsuccessful.
  4. D The patient will be discharged soon.
Show the answer and explanation

Correct answer: B

Inference is a logical conclusion based on evidence. The patient has low blood pressure (90/60) compared to baseline (120/80) and complains of dizziness, which are classic signs of hypotension. Option A is a reasonable inference. Option B cannot be inferred because low blood pressure after surgery is common and does not indicate failure. Option C is a possible action but not directly inferred from the given information; the passage does not suggest urgency. Option D is opposite; the patient is in recovery and not ready for discharge.

Why the other options are wrong:
A: While the nurse might need to report, the passage does not indicate an emergency or that calling the doctor is the immediate next step.
C: Low blood pressure after surgery is common and does not necessarily mean the surgery was unsuccessful; no evidence supports this inference.
D: The patient is in the recovery room with low blood pressure and dizziness, so discharge is not imminent.

Question 3

During a routine check, Nurse Patel noted that Mr. Garcia, a 72-year-old with congestive heart failure, had gained 3 pounds since yesterday and his ankles were more swollen. She also observed that he had been sleeping in his recliner instead of his bed for the past two nights. When she asked about his medication, Mr. Garcia admitted he had skipped his diuretic the last two days because he 'didn't want to run to the bathroom all night.' Nurse Patel documented the findings and notified the physician. Based on the passage, what can most reasonably be inferred about Mr. Garcia's condition?

  1. A The weight gain and increased swelling are likely related to his missed diuretic doses.
  2. B Mr. Garcia's preference for sleeping in the recliner indicates he is more comfortable there.
  3. C The physician will likely prescribe a stronger diuretic to address the fluid retention.
  4. D Mr. Garcia intentionally skipped his medication to avoid nighttime bathroom trips.
Show the answer and explanation

Correct answer: A

The correct inference is A. The passage states that Mr. Garcia has congestive heart failure, a condition where fluid retention is a key concern. He gained weight and had increased ankle swelling—both classic signs of fluid overload. He also admitted to skipping his diuretic for two days. From these details, it is reasonable to infer that his missed doses caused or worsened his fluid retention. This inference connects the observed symptoms to the patient's behavior without adding unsupported speculation.

Why the other options are wrong:
B: While the passage notes that Mr. Garcia slept in his recliner, it does not state that he did so because it was more comfortable. In fact, patients with heart failure often sleep in recliners due to orthopnea (shortness of breath when lying flat), so comfort is not the best inference. Moreover, the passage provides a clear reason for his behavior (avoiding bathroom trips) that is unrelated to comfort.
C: There is no evidence in the passage that the physician will prescribe a stronger diuretic. The physician may choose to educate Mr. Garcia on medication adherence, restart the same dose, or consider other interventions. This option is pure speculation and not a reasonable inference from the given information.
D: This option is explicitly stated in the passage: Mr. Garcia admitted he skipped his diuretic because he 'didn't want to run to the bathroom all night.' Therefore, it is not an inference but a direct statement. The question asks for what can be inferred, not what is directly told.

Question 4

Passage: "A study found that patients who received a detailed discharge instruction sheet had a 30% lower readmission rate compared to those who received only verbal instructions. However, the study also noted that patients with low health literacy did not benefit as much from the written sheet."

What can be inferred about patients with low health literacy?

  1. A They prefer verbal instructions.
  2. B They are more likely to be readmitted.
  3. C They should not receive written instructions.
  4. D They may need additional support to understand written instructions.
Show the answer and explanation

Correct answer: D

Since they did not benefit as much from the written sheet, it implies that they need extra help to comprehend it. Option A is not stated (preference unknown), option B is not directly inferred (the readmission rate was lower overall, but less benefit), and option D is too extreme.

Why the other options are wrong:
A: The passage does not mention patient preference, only that they did not benefit as much.
B: The study showed overall lower readmission, but low health literacy patients had less benefit; it does not say they are more likely to be readmitted than others.
C: The passage does not suggest eliminating written instructions; it implies a need for additional support.

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