HESI HEALTH ASSESSMENT REAL FINAL
EXAM LATEST 2026 | TEST BANK REAL
EXAM | 100 QUESTIONS & DETAILED
ANSWERS
1. A 68-year-old male with a history of chronic hypertension presents to the clinic
complaining of sudden, exertional "faintness." Upon auscultation at the second right
intercostal space, you hear a harsh, crescendo-decrescendo systolic murmur that
radiates upward toward the carotid arteries. What is the most likely diagnosis?
A) Mitral Regurgitation
B) Aortic Stenosis
C) Aortic Regurgitation
D) Mitral Stenosis
B) Aortic Stenosis
Rationale: The location (Aortic area), timing (systole), and radiation to the neck are
classic for Aortic Stenosis, which often presents with syncope and exertional
lightheadedness.
2. During a pulmonary assessment of a patient suspected of having lobar pneumonia, you
perform vocal resonance tests. You find that when the patient whispers "one-two-
three," the words are heard clearly and loudly through the stethoscope over the right
lower lobe. This finding is documented as:
A) Negative Egophony
B) Positive Whispered Pectoriloquy
C) Bronchovesicular breath sounds
D) Normal Tactile Fremitus
B) Positive Whispered Pectoriloquy
Rationale: In air-filled lungs, whispers are muffled. When lung tissue is consolidated
(filled with fluid/solids), high-frequency sounds travel better, making the whisper distinct.
3. An 82-year-old female is admitted with suspected left-sided heart failure. During the
cardiac exam, you use the bell of your stethoscope at the apex while the patient is in
the left lateral decubitus position. You hear a low-pitched extra heart sound early in
diastole. How should this be documented?
, A) S4 heart sound
B) S3 heart sound
C) Pericardial friction rub
D) Mid-systolic click
B) S3 heart sound
Rationale: S3 (Ventricular Gallop) occurs in early diastole during rapid filling of a non-
compliant ventricle. In older adults, it is a hallmark sign of heart failure.
4. A 24-year-old female presents with acute periorbital pain, blurred vision, and reports
seeing "halos" around lights. On examination, you note a mid-dilated, fixed pupil and
a "steamy" cornea. What is the nurse's priority action?
A) Administer antibiotic eye drops.
B) Refer immediately to ophthalmology for suspected Acute Angle-Closure
Glaucoma.
C) Document the finding as a common migraine aura.
D) Perform a Snellen chart exam and reassess in 2 hours.
B) Refer immediately to ophthalmology for suspected Acute Angle-Closure
Glaucoma.
Rationale: This is a medical emergency. Rapidly increased intraocular pressure can
lead to permanent blindness if not treated within hours.
5. While assessing a patient with a 50-pack-year smoking history, you note a 1:1
anteroposterior-to-transverse diameter, hyperresonant percussion notes, and a
costal angle greater than 90 degrees. These findings are most consistent with:
A) Pneumothorax
B) COPD (Emphysema)
C) Atelectasis
D) Pleural Effusion
B) COPD (Emphysema)
Rationale: Chronic air trapping leads to a "barrel chest" (1:1 ratio) and hyperinflation,
which creates the hyperresonant sound and widened costal angle.
6. A patient presents with sudden-onset sharp chest pain and shortness of breath. On
palpation, you feel a crackling, popping sensation under the skin over the upper
chest and neck. This finding, known as crepitus, indicates:
A) Fluid in the pleural space.
B) Subcutaneous emphysema (air leaking into the tissues).
C) Severe muscle strain.
D) Consolidated pneumonia.
, B) Subcutaneous emphysema (air leaking into the tissues).
Rationale: Crepitus in the respiratory context occurs when air escapes the lungs and
enters the subcutaneous tissue, often following trauma or pneumothorax.
7. During an abdominal assessment on a patient with suspected appendicitis, the nurse
applies deep pressure to the Left Lower Quadrant and then releases it. The patient
reports sudden, sharp pain in the Right Lower Quadrant. This is known as:
A) Positive McBurney's sign.
B) Positive Rovsing's sign.
C) Positive Murphy's sign.
D) Positive Psoas sign.
B) Positive Rovsing's sign.
Rationale: Rovsing's sign is referred rebound tenderness; pressure on the left side
causes pain on the right, suggesting peritoneal irritation.
8. You are performing a neurological assessment on a patient who suffered a head injury.
You ask the patient to stick out their tongue, and you observe it deviating toward the
right side. This indicates a lesion of which cranial nerve?
A) CN IX (Glossopharyngeal)
B) CN XII (Hypoglossal)
C) CN X (Vagus)
D) CN VII (Facial)
B) CN XII (Hypoglossal)
Rationale: CN XII controls tongue movement. When damaged, the tongue
deviates toward the side of the lesion.
9. A patient is suspected of having a Deep Vein Thrombosis (DVT) in the left calf. Which
finding would most strongly support this diagnosis over other possibilities?
A) Bilateral 2+ pitting edema.
B) Unilateral calf swelling with a 3cm difference in circumference compared to the
other leg.
C) Cool, pale skin on the affected foot.
D) Faint pedal pulses in both feet.
B) Unilateral calf swelling with a 3cm difference in circumference compared to the
other leg.
Rationale: DVT is typically unilateral. A significant difference in calf circumference is a
major clinical indicator.
10. A nurse is assessing a 45-year-old female for a thyroid disorder. Which finding during
palpation of the thyroid gland would require immediate follow-up?
EXAM LATEST 2026 | TEST BANK REAL
EXAM | 100 QUESTIONS & DETAILED
ANSWERS
1. A 68-year-old male with a history of chronic hypertension presents to the clinic
complaining of sudden, exertional "faintness." Upon auscultation at the second right
intercostal space, you hear a harsh, crescendo-decrescendo systolic murmur that
radiates upward toward the carotid arteries. What is the most likely diagnosis?
A) Mitral Regurgitation
B) Aortic Stenosis
C) Aortic Regurgitation
D) Mitral Stenosis
B) Aortic Stenosis
Rationale: The location (Aortic area), timing (systole), and radiation to the neck are
classic for Aortic Stenosis, which often presents with syncope and exertional
lightheadedness.
2. During a pulmonary assessment of a patient suspected of having lobar pneumonia, you
perform vocal resonance tests. You find that when the patient whispers "one-two-
three," the words are heard clearly and loudly through the stethoscope over the right
lower lobe. This finding is documented as:
A) Negative Egophony
B) Positive Whispered Pectoriloquy
C) Bronchovesicular breath sounds
D) Normal Tactile Fremitus
B) Positive Whispered Pectoriloquy
Rationale: In air-filled lungs, whispers are muffled. When lung tissue is consolidated
(filled with fluid/solids), high-frequency sounds travel better, making the whisper distinct.
3. An 82-year-old female is admitted with suspected left-sided heart failure. During the
cardiac exam, you use the bell of your stethoscope at the apex while the patient is in
the left lateral decubitus position. You hear a low-pitched extra heart sound early in
diastole. How should this be documented?
, A) S4 heart sound
B) S3 heart sound
C) Pericardial friction rub
D) Mid-systolic click
B) S3 heart sound
Rationale: S3 (Ventricular Gallop) occurs in early diastole during rapid filling of a non-
compliant ventricle. In older adults, it is a hallmark sign of heart failure.
4. A 24-year-old female presents with acute periorbital pain, blurred vision, and reports
seeing "halos" around lights. On examination, you note a mid-dilated, fixed pupil and
a "steamy" cornea. What is the nurse's priority action?
A) Administer antibiotic eye drops.
B) Refer immediately to ophthalmology for suspected Acute Angle-Closure
Glaucoma.
C) Document the finding as a common migraine aura.
D) Perform a Snellen chart exam and reassess in 2 hours.
B) Refer immediately to ophthalmology for suspected Acute Angle-Closure
Glaucoma.
Rationale: This is a medical emergency. Rapidly increased intraocular pressure can
lead to permanent blindness if not treated within hours.
5. While assessing a patient with a 50-pack-year smoking history, you note a 1:1
anteroposterior-to-transverse diameter, hyperresonant percussion notes, and a
costal angle greater than 90 degrees. These findings are most consistent with:
A) Pneumothorax
B) COPD (Emphysema)
C) Atelectasis
D) Pleural Effusion
B) COPD (Emphysema)
Rationale: Chronic air trapping leads to a "barrel chest" (1:1 ratio) and hyperinflation,
which creates the hyperresonant sound and widened costal angle.
6. A patient presents with sudden-onset sharp chest pain and shortness of breath. On
palpation, you feel a crackling, popping sensation under the skin over the upper
chest and neck. This finding, known as crepitus, indicates:
A) Fluid in the pleural space.
B) Subcutaneous emphysema (air leaking into the tissues).
C) Severe muscle strain.
D) Consolidated pneumonia.
, B) Subcutaneous emphysema (air leaking into the tissues).
Rationale: Crepitus in the respiratory context occurs when air escapes the lungs and
enters the subcutaneous tissue, often following trauma or pneumothorax.
7. During an abdominal assessment on a patient with suspected appendicitis, the nurse
applies deep pressure to the Left Lower Quadrant and then releases it. The patient
reports sudden, sharp pain in the Right Lower Quadrant. This is known as:
A) Positive McBurney's sign.
B) Positive Rovsing's sign.
C) Positive Murphy's sign.
D) Positive Psoas sign.
B) Positive Rovsing's sign.
Rationale: Rovsing's sign is referred rebound tenderness; pressure on the left side
causes pain on the right, suggesting peritoneal irritation.
8. You are performing a neurological assessment on a patient who suffered a head injury.
You ask the patient to stick out their tongue, and you observe it deviating toward the
right side. This indicates a lesion of which cranial nerve?
A) CN IX (Glossopharyngeal)
B) CN XII (Hypoglossal)
C) CN X (Vagus)
D) CN VII (Facial)
B) CN XII (Hypoglossal)
Rationale: CN XII controls tongue movement. When damaged, the tongue
deviates toward the side of the lesion.
9. A patient is suspected of having a Deep Vein Thrombosis (DVT) in the left calf. Which
finding would most strongly support this diagnosis over other possibilities?
A) Bilateral 2+ pitting edema.
B) Unilateral calf swelling with a 3cm difference in circumference compared to the
other leg.
C) Cool, pale skin on the affected foot.
D) Faint pedal pulses in both feet.
B) Unilateral calf swelling with a 3cm difference in circumference compared to the
other leg.
Rationale: DVT is typically unilateral. A significant difference in calf circumference is a
major clinical indicator.
10. A nurse is assessing a 45-year-old female for a thyroid disorder. Which finding during
palpation of the thyroid gland would require immediate follow-up?
