BSN 246 HESI Health Assessment Complete Exam Prep
Actual Exam 2026/2027 | Complete Exam-Style
Questions with Detailed Rationales | Pass Guaranteed –
A+ Graded
---
### SECTION 1: Health History, Interviewing, and General Survey (Questions 1-15)
**Q1:** A nurse is conducting a health history interview with a newly admitted patient. The patient
states, "I've been having chest pain for the past three days." Which response by the nurse best
demonstrates therapeutic communication?
A. "Chest pain can be serious. Have you called your doctor?"
B. "Tell me more about the chest pain you're experiencing." [CORRECT]
C. "Is the pain sharp or dull? Does it radiate?"
D. "You should have come to the emergency room sooner."
**Correct Answer:** B
**Rationale:** Correct because open-ended questions encourage the patient to provide detailed
information in their own words, establishing rapport and gathering comprehensive data. This
matches the therapeutic communication principle of using broad opening statements during the
working phase of the interview.
**Q2:** When using the OLDCARTS mnemonic to assess a patient's present illness, which
component addresses the severity of the symptom?
A. Onset
B. Location
C. Duration
D. Severity [CORRECT]
**Correct Answer:** D
**Rationale:** Correct because the "S" in OLDCARTS stands for Severity, which assesses how
intense the symptom is, typically using a 0-10 scale. This matches the systematic approach to
characterizing symptoms during the history of present illness.
**Q3:** A nurse is interviewing a patient who recently immigrated from Somalia and speaks limited
English. The patient's daughter offers to translate. What is the nurse's best action?
A. Accept the daughter's offer to facilitate communication
B. Use a professional medical interpreter [CORRECT]
C. Ask the patient to write responses
D. Proceed with basic yes/no questions only
**Correct Answer:** B
,**Rationale:** Correct because professional medical interpreters ensure accurate translation of
medical terminology and maintain confidentiality. This matches cultural competency standards and
prevents family members from filtering or altering information.
**Q4:** During the review of systems, a patient reports occasional headaches but denies associated
nausea, photophobia, or visual changes. Which documentation format best captures this finding?
A. "Headaches present without associated symptoms."
B. "Head: Occasional headaches. Denies nausea, photophobia, visual changes." [CORRECT]
C. "Neurological: Headaches negative for red flags."
D. "Patient has benign headaches."
**Correct Answer:** B
**Rationale:** Correct because documentation should include both positive findings and pertinent
negatives using a systematic format. This matches the review of systems documentation standard
that records what is present and what is denied.
**Q5:** A nurse is using motivational interviewing to help a patient reduce smoking. The patient
says, "I know smoking is bad, but I enjoy it too much to quit." Which response demonstrates the
technique of developing discrepancy?
A. "You need to quit smoking for your health."
B. "You enjoy smoking, yet you also know it's harmful. How do those two things fit together?"
[CORRECT]
C. "Have you tried nicotine patches?"
D. "Smoking causes lung cancer and heart disease."
**Correct Answer:** B
**Rationale:** Correct because developing discrepancy involves gently highlighting the gap between
current behavior and personal values or goals. This matches the motivational interviewing principle
of evoking the patient's own motivation for change rather than imposing external pressure.
**Q6:** When obtaining a past medical history, which question is most appropriate for gathering
information about childhood illnesses?
A. "Have you ever been hospitalized?"
B. "Did you have measles, mumps, chickenpox, or whooping cough as a child?" [CORRECT]
C. "Do you have any chronic diseases?"
D. "What surgeries have you had?"
**Correct Answer:** B
**Rationale:** Correct because specific questions about common childhood illnesses provide
complete data about immunization status and disease exposure. This matches the comprehensive
health history format that includes specific childhood disease inquiry.
**Q7:** A nurse documents a patient's health history using the SOAP format. Where would the nurse
record the patient's blood pressure of 142/88 mmHg?
A. Subjective
B. Objective [CORRECT]
C. Assessment
, D. Plan
**Correct Answer:** B
**Rationale:** Correct because measurable, observable data such as vital signs are documented in
the Objective section of SOAP notes. This matches the documentation format where objective data
includes physical examination findings and measurable assessments.
**Q8:** During the introductory phase of a health history interview, which action is most important
for the nurse to perform?
A. Begin asking questions about the chief complaint
B. Establish rapport and explain the purpose of the interview [CORRECT]
C. Review the patient's medical record thoroughly
D. Complete the physical examination first
**Correct Answer:** B
**Rationale:** Correct because the introductory phase focuses on building trust, establishing roles,
and setting expectations for the interview. This matches the three-phase interview structure where
rapport-building precedes data collection.
**Q9:** A nurse is assessing a patient's health literacy. The patient is unable to read the hospital's
informed consent form but states they understand the procedure. What is the nurse's best action?
A. Have the patient sign the form anyway
B. Provide the information verbally and use teach-back method [CORRECT]
C. Ask a family member to explain the form
D. Assume the patient understands and proceed
**Correct Answer:** B
**Rationale:** Correct because the teach-back method confirms understanding by having the patient
explain the information in their own words. This matches health literacy best practices that ensure
comprehension regardless of reading ability.
**Q10:** When documenting a patient's social history, which information is most important to
include regarding substance use?
A. Only current use patterns
B. Type, amount, frequency, and duration of all substances used [CORRECT]
C. Only illegal substances
D. Whether the patient considers themselves an addict
**Correct Answer:** B
**Rationale:** Correct because comprehensive substance use documentation includes type, amount,
frequency, and duration for all substances including alcohol, tobacco, and drugs. This matches the
social history component that quantifies use patterns for clinical significance.
**Q11:** A nurse is conducting a general survey and observes that a patient appears older than their
stated age, has poor hygiene, and demonstrates a flat affect. These findings suggest which potential
concern?
A. Normal aging process
B. Depression or self-neglect [CORRECT]
Actual Exam 2026/2027 | Complete Exam-Style
Questions with Detailed Rationales | Pass Guaranteed –
A+ Graded
---
### SECTION 1: Health History, Interviewing, and General Survey (Questions 1-15)
**Q1:** A nurse is conducting a health history interview with a newly admitted patient. The patient
states, "I've been having chest pain for the past three days." Which response by the nurse best
demonstrates therapeutic communication?
A. "Chest pain can be serious. Have you called your doctor?"
B. "Tell me more about the chest pain you're experiencing." [CORRECT]
C. "Is the pain sharp or dull? Does it radiate?"
D. "You should have come to the emergency room sooner."
**Correct Answer:** B
**Rationale:** Correct because open-ended questions encourage the patient to provide detailed
information in their own words, establishing rapport and gathering comprehensive data. This
matches the therapeutic communication principle of using broad opening statements during the
working phase of the interview.
**Q2:** When using the OLDCARTS mnemonic to assess a patient's present illness, which
component addresses the severity of the symptom?
A. Onset
B. Location
C. Duration
D. Severity [CORRECT]
**Correct Answer:** D
**Rationale:** Correct because the "S" in OLDCARTS stands for Severity, which assesses how
intense the symptom is, typically using a 0-10 scale. This matches the systematic approach to
characterizing symptoms during the history of present illness.
**Q3:** A nurse is interviewing a patient who recently immigrated from Somalia and speaks limited
English. The patient's daughter offers to translate. What is the nurse's best action?
A. Accept the daughter's offer to facilitate communication
B. Use a professional medical interpreter [CORRECT]
C. Ask the patient to write responses
D. Proceed with basic yes/no questions only
**Correct Answer:** B
,**Rationale:** Correct because professional medical interpreters ensure accurate translation of
medical terminology and maintain confidentiality. This matches cultural competency standards and
prevents family members from filtering or altering information.
**Q4:** During the review of systems, a patient reports occasional headaches but denies associated
nausea, photophobia, or visual changes. Which documentation format best captures this finding?
A. "Headaches present without associated symptoms."
B. "Head: Occasional headaches. Denies nausea, photophobia, visual changes." [CORRECT]
C. "Neurological: Headaches negative for red flags."
D. "Patient has benign headaches."
**Correct Answer:** B
**Rationale:** Correct because documentation should include both positive findings and pertinent
negatives using a systematic format. This matches the review of systems documentation standard
that records what is present and what is denied.
**Q5:** A nurse is using motivational interviewing to help a patient reduce smoking. The patient
says, "I know smoking is bad, but I enjoy it too much to quit." Which response demonstrates the
technique of developing discrepancy?
A. "You need to quit smoking for your health."
B. "You enjoy smoking, yet you also know it's harmful. How do those two things fit together?"
[CORRECT]
C. "Have you tried nicotine patches?"
D. "Smoking causes lung cancer and heart disease."
**Correct Answer:** B
**Rationale:** Correct because developing discrepancy involves gently highlighting the gap between
current behavior and personal values or goals. This matches the motivational interviewing principle
of evoking the patient's own motivation for change rather than imposing external pressure.
**Q6:** When obtaining a past medical history, which question is most appropriate for gathering
information about childhood illnesses?
A. "Have you ever been hospitalized?"
B. "Did you have measles, mumps, chickenpox, or whooping cough as a child?" [CORRECT]
C. "Do you have any chronic diseases?"
D. "What surgeries have you had?"
**Correct Answer:** B
**Rationale:** Correct because specific questions about common childhood illnesses provide
complete data about immunization status and disease exposure. This matches the comprehensive
health history format that includes specific childhood disease inquiry.
**Q7:** A nurse documents a patient's health history using the SOAP format. Where would the nurse
record the patient's blood pressure of 142/88 mmHg?
A. Subjective
B. Objective [CORRECT]
C. Assessment
, D. Plan
**Correct Answer:** B
**Rationale:** Correct because measurable, observable data such as vital signs are documented in
the Objective section of SOAP notes. This matches the documentation format where objective data
includes physical examination findings and measurable assessments.
**Q8:** During the introductory phase of a health history interview, which action is most important
for the nurse to perform?
A. Begin asking questions about the chief complaint
B. Establish rapport and explain the purpose of the interview [CORRECT]
C. Review the patient's medical record thoroughly
D. Complete the physical examination first
**Correct Answer:** B
**Rationale:** Correct because the introductory phase focuses on building trust, establishing roles,
and setting expectations for the interview. This matches the three-phase interview structure where
rapport-building precedes data collection.
**Q9:** A nurse is assessing a patient's health literacy. The patient is unable to read the hospital's
informed consent form but states they understand the procedure. What is the nurse's best action?
A. Have the patient sign the form anyway
B. Provide the information verbally and use teach-back method [CORRECT]
C. Ask a family member to explain the form
D. Assume the patient understands and proceed
**Correct Answer:** B
**Rationale:** Correct because the teach-back method confirms understanding by having the patient
explain the information in their own words. This matches health literacy best practices that ensure
comprehension regardless of reading ability.
**Q10:** When documenting a patient's social history, which information is most important to
include regarding substance use?
A. Only current use patterns
B. Type, amount, frequency, and duration of all substances used [CORRECT]
C. Only illegal substances
D. Whether the patient considers themselves an addict
**Correct Answer:** B
**Rationale:** Correct because comprehensive substance use documentation includes type, amount,
frequency, and duration for all substances including alcohol, tobacco, and drugs. This matches the
social history component that quantifies use patterns for clinical significance.
**Q11:** A nurse is conducting a general survey and observes that a patient appears older than their
stated age, has poor hygiene, and demonstrates a flat affect. These findings suggest which potential
concern?
A. Normal aging process
B. Depression or self-neglect [CORRECT]
