HEALTH EDUCATION SYSTEMS INC (HESI) A2 EXAM • READING COMPREHENSION

Determine the author's purpose or tone

Master the analytical skill of identifying why a passage was written and the attitude conveyed through language choices.

Historical Context & Motivation

The study of authorial purpose and tone has roots stretching back to classical antiquity, when Aristotle's Rhetoric systematically categorized the persuasive strategies available to speakers and writers. Aristotle identified three rhetorical appeals — ethos, pathos, and logos — each of which depends heavily on an author's deliberate selection of tone and purpose. Over the millennia, scholars in rhetoric, hermeneutics, and literary criticism have refined frameworks for decoding the intentions embedded in any piece of writing. For graduate-level test takers preparing for the HESI A2, this skill is not merely academic; it is clinically relevant, because healthcare professionals must routinely evaluate the purpose and tone of research articles, patient-education materials, and institutional communications to determine credibility and appropriate application.

350 BCE
Aristotle's Rhetoric
Aristotle codifies the three persuasive appeals — ethos (credibility), pathos (emotion), and logos (logic) — establishing the foundational vocabulary for analyzing authorial intent and tone that persists in modern reading comprehension frameworks.
1938
Louise Rosenblatt's Transactional Theory
Rosenblatt introduces the concept that meaning emerges from the transaction between reader and text. Her distinction between efferent (information-seeking) and aesthetic reading becomes central to understanding purpose-driven analysis.
1956
Bloom's Taxonomy
Benjamin Bloom's classification of cognitive skills places analysis — including the identification of purpose and tone — as a higher-order thinking skill, influencing standardized test design for decades.
2001
HESI A2 Exam Development
The HESI A2 Reading Comprehension section formally incorporates questions on author's purpose and tone, recognizing that healthcare practitioners must critically evaluate written sources to ensure patient safety and evidence-based practice.

The central question this skill addresses is deceptively simple: Why did the author write this passage, and what attitude do they convey toward the subject? On the HESI A2, this question manifests in multiple forms — from straightforward identification of purpose to nuanced distinctions between closely related tones such as "cautious" versus "skeptical." Graduate admission candidates must develop a systematic approach that moves beyond intuition and toward evidence-based textual analysis, drawing on specific diction, syntax, and structural cues to support their conclusions.

Core Principles & Definitions

Before dissecting passages on the HESI A2, it is essential to establish precise definitions and distinguish between related but distinct concepts. Author's purpose refers to the overarching reason a text was composed — the communicative goal the writer seeks to accomplish. Tone refers to the author's attitude toward the subject matter, audience, or both, as revealed through specific language choices. While purpose addresses the "why" of a text, tone addresses the "how" — the emotional and intellectual register through which the purpose is executed. These two dimensions are deeply interrelated: an author whose purpose is to persuade may adopt an urgent, passionate tone, whereas an author whose purpose is to inform may adopt a neutral, measured tone.

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Author's Purpose

The fundamental reason a passage exists. The four primary purposes are to inform, persuade, entertain, or describe. HESI A2 passages frequently combine purposes, but one is always dominant.
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Tone

The author's attitude conveyed through word choice (diction), sentence structure (syntax), figurative language, and level of formality. Tone can range from objective and clinical to impassioned and sardonic.
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Diction

The specific words an author selects. Diction is the primary vehicle for tone — choosing "slaughtered" versus "euthanized" reveals fundamentally different attitudes toward the same event and signals persuasive versus clinical intent.
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Rhetorical Mode

The organizational strategy (narration, exposition, argumentation, description) that supports the author's purpose. Recognizing the mode helps confirm purpose — argumentation signals persuasion; exposition signals informing.
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Audience Awareness

The intended readership shapes both purpose and tone. A peer-reviewed journal article adopts a formal, evidence-driven tone for specialists, while a patient handout uses an accessible, reassuring tone for lay readers.
KEY TAKEAWAY
Think of purpose as the destination on a GPS and tone as the driving style. Two drivers may head to the same hospital (purpose: inform about a diagnosis), but one drives calmly and methodically (neutral, clinical tone) while the other accelerates aggressively with the horn blaring (urgent, alarming tone). The destination doesn't change, but the experience — and the effect on the passenger — is entirely different. On the HESI A2, you must identify both the destination and the driving style.

Visual Explanation: Purpose & Tone Framework

This framework shows the two parallel analytical tracks you should run when reading any HESI A2 passage. Start by asking "Why was this written?" (left branch — purpose) and "What attitude is conveyed?" (right branch — tone). Then draw your evidence from four textual dimensions at the bottom: diction, syntax, organization, and supporting details.

The diagram above represents the analytical framework you should internalize before approaching any HESI A2 reading comprehension passage. Notice that purpose and tone are parallel but interconnected dimensions — a single passage can be analyzed through both lenses simultaneously. The four evidence sources at the bottom of the diagram are the concrete textual features you examine to support your conclusions. For example, when a passage about medication adherence uses words like "critical," "life-threatening," and "immediate," the diction signals an urgent tone, while the inclusion of statistical evidence and a call to action reveals a persuasive purpose. Developing the habit of consulting all four evidence channels ensures that your answer choices are grounded in textual support rather than subjective impression.

How It Works: The DOST Analysis Method

To systematize your approach on the HESI A2, employ the DOST method — an acronym standing for Diction, Organization, Syntax, and Thesis/Topic. This four-step process provides a repeatable, evidence-based protocol for determining both purpose and tone. Unlike intuitive reading, which may be influenced by the reader's own biases or emotional state, DOST grounds every conclusion in specific textual features. Graduate-level candidates benefit from this structured approach because HESI A2 answer choices are deliberately designed to include plausible distractors that feel correct but lack textual support.

Step 1 — Diction Analysis

Begin by scanning the passage for charged or marked vocabulary — words that carry strong connotative weight beyond their denotative meaning. In healthcare-related passages, notice whether the author uses clinical, neutral terminology ("adverse event," "contraindicated") or emotionally laden language ("tragedy," "devastating," "breakthrough"). The connotative charge of key terms serves as the single most reliable indicator of tone. A passage describing a new pharmaceutical intervention as a "promising advance" versus "an unproven compound" reveals fundamentally different attitudes despite referring to the same drug. Pay particular attention to adjectives, adverbs, and verbs of attribution (e.g., "claims" versus "demonstrates" versus "asserts").

Step 2 — Organization Analysis

Examine how the passage is structured. An informative passage typically follows a logical progression — general statement, supporting evidence, elaboration — without building toward a conclusion that advocates for a position. A persuasive passage, by contrast, often begins with a hook or problem statement, presents evidence selectively, and culminates in a recommendation or call to action. Descriptive passages emphasize sensory details and spatial or temporal organization, while entertaining passages may employ narrative arcs, dialogue, or humor. The macro-structure of the passage is a reliable proxy for purpose.

Step 3 — Syntax Analysis

Consider the length and complexity of sentences. Short, declarative sentences often convey urgency or emphasis. Long, subordinate-clause-heavy sentences suggest measured, academic analysis. The presence of rhetorical questions signals an attempt to engage the reader persuasively, while imperative constructions ("Consider..." "Note that...") indicate either instructional or persuasive intent. On the HESI A2, syntax is particularly useful for distinguishing between closely related tones — for instance, a passage that uses consistently short, punchy sentences with exclamatory constructions conveys an alarming or urgent tone rather than merely an informative one.

Step 4 — Thesis/Topic Analysis

Identify the passage's thesis or central topic sentence and ask whether it is a statement of fact, a statement of opinion, or a hybrid. A thesis that states "Influenza vaccination rates among healthcare workers remain below recommended levels" is factual and suggests an informative purpose. A thesis that states "Healthcare institutions must mandate influenza vaccination for all clinical staff" is argumentative and reveals a persuasive purpose. The thesis often contains the strongest clues about both purpose and tone because it represents the author's most distilled and intentional statement.

💡 HESI A2 Strategy Note
On test day, you will not have time to perform a full DOST analysis on every question. Instead, practice enough that diction scanning becomes automatic — most purpose and tone questions can be resolved by analyzing three to five key words. Reserve the full DOST protocol for questions where your initial instinct leaves you choosing between two plausible answers.

Detailed Breakdown: Tone Classification

One of the greatest challenges on the HESI A2 is selecting the precise tone descriptor from answer choices that may include synonyms, near-synonyms, and subtle variations. The following taxonomy organizes the most commonly tested tones into families, enabling you to navigate from broad category to specific descriptor. Understanding this taxonomy prevents the common error of confusing related but distinct tones — for example, selecting "indifferent" when the correct answer is "objective," or choosing "critical" when "cautious" is more accurate.

The tone spectrum organizes commonly tested tones into five families ranging from negative (critical) through neutral to positive (enthusiastic). The signal words and phrases at the bottom provide concrete textual markers that anchor each tone family. When two answer choices fall within the same family (e.g., "skeptical" and "apprehensive"), use DOST analysis to determine which is more precisely supported by the passage.
Common purpose–tone pairings encountered on the HESI A2
PurposeSignal IndicatorsTypical Tone Pairings
To InformFactual statements, statistics, definitions, third-person perspective, absence of opinion markersObjective, matter-of-fact, neutral, clinical
To PersuadeOpinion statements, calls to action, rhetorical questions, loaded language, counterargument refutationUrgent, passionate, critical, concerned, persuasive
To EntertainNarrative elements, humor, dialogue, vivid imagery, first-person anecdotes, suspenseHumorous, lighthearted, whimsical, ironic, nostalgic
To DescribeSensory language, spatial/temporal organization, detailed imagery, figurative language, adjective densityVivid, reflective, appreciative, solemn, reverential

Worked Example: HESI A2–Style Passage Analysis

📄 Sample Passage
"Hand hygiene compliance among healthcare workers remains alarmingly low despite decades of evidence linking proper hand washing to reduced nosocomial infections. The Centers for Disease Control reports compliance rates as low as 40% in some hospital settings — a statistic that should trouble every clinician. While institutional barriers such as inadequate sink placement and time constraints undoubtedly contribute to the problem, the persistence of noncompliance suggests a deeper cultural issue that demands urgent intervention. Healthcare facilities must prioritize hand hygiene education, implement accountability measures, and invest in accessible hand-sanitizer stations if they hope to protect the patients entrusted to their care."

Question: What is the author's primary purpose, and what tone does the author convey?

DOST Analysis of the Hand-Hygiene Passage
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Step 1 — Diction AnalysisScan for charged vocabulary. The passage contains several connotatively loaded terms: "alarmingly low," "should trouble," "demands urgent intervention," "must prioritize," and "entrusted to their care." These words carry emotional weight and reveal an author who is not merely reporting facts but actively advocating for change. The phrase "alarmingly low" is particularly telling — an objective author would simply state the percentage without the adverb "alarmingly."
Diction is emotionally charged and advocacy-oriented → suggests persuasive purpose and urgent tone.
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Step 2 — Organization AnalysisThe passage follows a classic argumentative structure: it opens with a problem statement (low compliance), provides supporting evidence (CDC statistics), briefly acknowledges counterarguments (institutional barriers), and concludes with specific recommendations (education, accountability, infrastructure). This organizational pattern is characteristic of persuasive writing — note how the concession ("While institutional barriers...") is immediately followed by a pivot ("the persistence of noncompliance suggests...") that strengthens the argument rather than leaving the counterpoint unresolved.
Argumentative structure with concession-and-pivot → confirms persuasive purpose.
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Step 3 — Syntax AnalysisThe final sentence is an imperative construction with a conditional clause ("must prioritize... if they hope to protect..."), which is a hallmark of persuasive writing intended to compel action. The dash after "40%" creates a dramatic pause before the evaluative phrase "a statistic that should trouble every clinician," which functions syntactically as an amplifier — intensifying the emotional impact of the data. These syntactic choices create forward momentum and urgency.
Imperative constructions and dramatic pauses → tone is urgent and concerned.
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Step 4 — Thesis/Topic AnalysisThe implicit thesis can be reconstructed as: "Healthcare facilities must take aggressive action to improve hand hygiene compliance." This is clearly a statement of opinion and advocacy — the modal verb "must" signals obligation rather than description. No purely informative passage would conclude with a list of mandatory institutional changes. The thesis is prescriptive, not descriptive.
Final answer: Purpose = to persuade; Tone = urgent and concerned.

Notice how each DOST step independently converges on the same conclusion. This convergence is what gives you confidence in your answer. If the steps had yielded conflicting signals — say, neutral diction but argumentative organization — you would need to weigh which evidence is stronger (typically diction and thesis carry the most weight on the HESI A2). On test day, if you can identify even two of the four DOST elements quickly, you will usually have sufficient evidence to select the correct answer with confidence.

Common Pitfalls & Strategies

Even well-prepared candidates make predictable errors on purpose and tone questions. The HESI A2 employs specific distractor patterns that exploit common cognitive biases. Understanding these patterns transforms potential traps into opportunities for elimination-based reasoning.

Five common HESI A2 pitfalls for purpose and tone questions
PitfallWhy It OccursStrategy to Avoid
Confusing topic with purposeA passage about hand hygiene tempts the answer "to discuss hand hygiene" — this describes the topic, not the purpose.Always answer with an action verb: "to persuade readers that..." not "to discuss..."
Projecting reader emotion onto authorIf a passage makes you feel angry, you may assume the author is angry — but the author may be calmly presenting facts that provoke anger in the reader.Focus on the author's word choices, not your emotional response. Ask "What does the diction show?" not "How do I feel?"
Selecting an extreme toneHESI A2 passages are typically drawn from healthcare contexts and rarely adopt extreme tones like "furious" or "ecstatic." Selecting such extremes is almost always incorrect.On the HESI A2, moderate tones (concerned, cautious, objective, hopeful) are far more common answers than extreme ones. Eliminate extremes first.
Ignoring the dominant purposeA passage may include some entertaining anecdotes within a primarily informative text. Selecting "entertain" ignores the hierarchy of purposes.Determine which purpose governs the passage as a whole. Secondary purposes support the dominant one — an anecdote may serve to engage the reader in service of an informative goal.
Confusing similar tones"Objective" and "indifferent" may seem synonymous, but objective implies professional neutrality while indifferent implies lack of concern — a crucial distinction in healthcare contexts.Use the tone spectrum to locate both options. Consider their connotations: would a healthcare professional be described as "indifferent" in a positive or negative sense? The nuance matters.
KEY TAKEAWAY
The relationship between common pitfalls and test design is analogous to the relationship between differential diagnosis and presenting symptoms in clinical practice. Just as a clinician must resist anchoring on the first plausible diagnosis and instead systematically consider the full differential, a test taker must resist anchoring on the first plausible answer and instead evaluate each option against textual evidence. The DOST method is your diagnostic protocol — it forces you to gather evidence from multiple sources before committing to a conclusion.

Connection to Advanced Reading Strategies

Mastering purpose and tone on the HESI A2 is a gateway to more sophisticated analytical reading skills that will serve you throughout graduate study and clinical practice. The ability to identify purpose and tone is foundational to critical appraisal of evidence — a core competency in evidence-based medicine. When reading a randomized controlled trial, for instance, you must evaluate whether the discussion section maintains the objective tone appropriate to scientific writing or whether the authors subtly shift to an advocacy-oriented tone that may overstate clinical significance. Similarly, understanding purpose helps you distinguish between primary research articles (purpose: to report findings), review articles (purpose: to synthesize), and editorials (purpose: to persuade).

How HESI A2 purpose-and-tone skills extend into graduate-level clinical reading
HESI A2 SkillGraduate-Level Extension
Identifying author's purpose (inform, persuade, entertain, describe)Classifying research publication types: primary research, systematic reviews, clinical guidelines, editorials, case reports
Detecting persuasive tone through dictionEvaluating spin in research reporting — identifying language that exaggerates findings or minimizes limitations
Distinguishing objective from biased toneAssessing risk of bias in clinical studies; evaluating pharmaceutical industry-funded research for promotional language
Recognizing audience-appropriate languageAdapting patient-education materials for health literacy levels; writing for interdisciplinary clinical teams

As you advance in your healthcare education, the skills developed here will become second nature. The DOST method, while initially a deliberate, step-by-step process, will eventually become an automatic cognitive lens through which you evaluate every piece of written communication you encounter — from journal articles and clinical protocols to insurance correspondence and patient advocacy documents. This integration of analytical reading into your professional practice is precisely the competency that the HESI A2 is designed to predict.

Practice Problems

PROBLEM 1CONCEPTUAL
A passage states: "Type 2 diabetes mellitus is a chronic metabolic disorder characterized by insulin resistance and relative insulin deficiency. It affects approximately 462 million people worldwide, with prevalence rates increasing in both developed and developing nations." What is the author's primary purpose, and what is the tone?
PROBLEM 2BASIC CALCULATION
Consider the following passage: "Every year, thousands of preventable medical errors claim the lives of patients who trusted the healthcare system to protect them. It is unconscionable that in the 21st century, communication failures between care teams continue to put vulnerable patients at risk. Hospitals must implement standardized handoff protocols immediately." Identify three specific diction choices that reveal the author's tone, and name that tone.
PROBLEM 3INTERMEDIATE
A passage reads: "While proponents of telemedicine argue that virtual visits expand access to underserved populations, the evidence supporting equivalent clinical outcomes remains limited. Several recent studies have reported diagnostic accuracy rates 12–18% lower in virtual consultations compared to in-person visits for dermatological conditions. Until more rigorous research establishes the boundaries of telemedicine's efficacy, healthcare systems should exercise caution in expanding virtual care to complex clinical presentations." Is the author's purpose to inform or to persuade? Justify your answer using at least two elements of the DOST method.
PROBLEM 4APPLIED
You are reviewing a patient-education brochure that reads: "Managing your blood pressure doesn't have to be overwhelming. Small changes — like adding a 20-minute walk to your daily routine, choosing fresh fruits over processed snacks, and taking your medication at the same time each day — can make a real difference. You have more control over your health than you might think, and your healthcare team is here to support you every step of the way." Identify the purpose and tone, and explain how the passage would differ if the purpose were changed to "inform" while keeping the topic the same.
PROBLEM 5CRITICAL THINKING
A passage reads: "The pharmaceutical industry has invested billions in developing novel antibiotic compounds, and yet the pipeline remains worrisomely thin. Meanwhile, antimicrobial resistance continues its relentless march, outpacing our capacity to develop countermeasures. Some researchers have turned to bacteriophage therapy — an approach abandoned decades ago but now enjoying a cautious renaissance. Whether this revival represents genuine scientific progress or merely the desperate recycling of old ideas remains an open question." Analyze this passage for mixed or ambiguous tone. Does the author maintain a single consistent tone, or does the tone shift? What purpose does the tonal complexity serve?

Lesson Summary

Determining the author's purpose requires identifying the dominant communicative goal — to inform, persuade, entertain, or describe — by examining the passage's thesis, organizational structure, and supporting evidence. Determining tone requires analyzing the author's attitude through diction (connotative word choice), syntax (sentence structure and length), and rhetorical mode (narration, exposition, argumentation, description). Use the DOST method (Diction, Organization, Syntax, Thesis) as a systematic protocol to ground your answers in textual evidence rather than subjective impression.

On the HESI A2, avoid the five common pitfalls: confusing topic with purpose, projecting your emotions onto the author, selecting extreme tones, ignoring the dominant purpose in multi-purpose passages, and conflating similar tones. Use the tone spectrum to locate answer choices on the negative-to-positive continuum, and remember that healthcare passages on the HESI A2 most commonly employ moderate tones — objective, concerned, cautious, encouraging — rather than extreme ones. These analytical reading skills transfer directly to graduate-level competencies in critical appraisal, evidence-based practice, and professional communication.

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