BSN 246 HESI HEALTH ASSESSMENT V1 2026/2027 |
Nightingale College | GRADED A | Pass Guaranteed - A+
Graded
SECTION 1: Health History & Interview (Q1–Q12)
Q1: A 58-year-old patient presents to the clinic with complaints of chest pain. The nurse
begins the health history using the OLDCARTS mnemonic. After learning the pain is
substernal and pressure-like, what is the nurse's next priority assessment question?
A. "Have you tried any home remedies?"
B. "Does the pain radiate to your arm, jaw, or back?" [CORRECT]
C. "What is your family history of diabetes?"
D. "How many servings of vegetables do you eat daily?"
Correct Answer: B
Rationale: Radiation of chest pain to the arm, jaw, or back is a classic indicator of
cardiac ischemia and requires immediate assessment. While the other options are
relevant to a comprehensive history, determining radiation takes priority due to potential
acute coronary syndrome.
Q2: During a health interview, a 24-year-old college student admits to drinking alcohol
daily but becomes defensive when asked about quantity. The nurse recognizes the need
for further assessment. Which question should the nurse ask next?
A. "You shouldn't drink every day."
B. "Most people your age don't drink daily."
C. "Help me understand how much you typically drink in a week." [CORRECT]
D. "Do you realize alcohol is dangerous?"
Correct Answer: C
Rationale: Open-ended, non-judgmental questions encourage honest disclosure about
sensitive topics. Confrontational or leading responses shut down communication and
prevent accurate health history data collection.
,Q3: A nurse is assessing a patient with limited health literacy. Which technique best
promotes accurate data collection during the health history?
A. Use medical terminology to ensure precision
B. Provide written questionnaires only
C. Use the teach-back method and simple language [CORRECT]
D. Ask yes/no questions exclusively
Correct Answer: C
Rationale: The teach-back method confirms patient understanding by asking them to
explain information in their own words. Medical jargon and exclusive yes/no questions
limit comprehension and accuracy.
Q4: A nurse is conducting a cultural assessment with a patient recently immigrated
from Vietnam. Which question should the nurse ask first?
A. "Why don't you use Western medicine?"
B. "What cultural or traditional practices do you use to maintain health?" [CORRECT]
C. "Your English is good; do you really need an interpreter?"
D. "Don't you know herbal remedies can be dangerous?"
Correct Answer: B
Rationale: Culturally sensitive questions invite patients to share traditional health
practices without judgment. This approach builds trust and identifies potential
interactions with prescribed treatments.
Q5: In the emergency department, a patient presents with severe asthma exacerbation,
dyspnea, and inability to speak in full sentences. Which type of health history is most
appropriate for the nurse to obtain?
A. Comprehensive health history
B. Focused health history [CORRECT]
C. Family history only
D. Review of systems only
Correct Answer: B
Rationale: A focused health history targets the immediate presenting problem and
relevant history. In acute respiratory distress, a comprehensive history would delay
necessary interventions and is inappropriate.
,Q6: During a routine wellness visit, a nurse suspects intimate partner violence based on
the patient's evasive answers and patterned bruising. What is the nurse's next best
action?
A. Confront the partner in the waiting room
B. Ask the patient directly about safety in the home when alone [CORRECT]
C. Document suspicion and wait for the patient to volunteer information
D. Call law enforcement immediately without patient consent
Correct Answer: B
Rationale: Direct questioning about safety in a private setting allows the patient to
disclose violence when safe to do so. Immediate law enforcement contact without
consent violates patient autonomy unless imminent danger exists.
Q7: A patient with Type 2 diabetes states, "I know I should exercise, but I just can't seem
to start." Using motivational interviewing, which response by the nurse is most
appropriate?
A. "You need to exercise or you'll lose your legs."
B. "What barriers prevent you from starting an exercise routine?" [CORRECT]
C. "I'll write you a prescription for the gym."
D. "Your doctor will be disappointed if you don't exercise."
Correct Answer: B
Rationale: Motivational interviewing explores patient ambivalence by eliciting
self-motivating statements. Asking about barriers invites problem-solving and respects
patient autonomy.
Q8: A nurse is assessing an 82-year-old patient's functional status. Which assessment
tool best evaluates the patient's ability to manage medications, finances, and
transportation?
A. Katz Index of ADLs
B. Lawton IADL Scale [CORRECT]
C. Braden Scale
D. Glasgow Coma Scale
Correct Answer: B
Rationale: The Lawton Instrumental Activities of Daily Living (IADL) Scale assesses
complex tasks like medication management, finances, and transportation. The Katz
Index evaluates basic self-care activities only.
, Q9: When constructing a three-generation family genogram, which information is
essential to include?
A. Only living relatives
B. Age, health status, and cause of death for all first-degree relatives [CORRECT]
C. Only relatives with chronic diseases
D. Patient's friends and coworkers
Correct Answer: B
Rationale: Genograms document age, health conditions, and cause of death across
three generations to identify hereditary disease patterns. Excluding deceased relatives
or healthy family members creates an incomplete genetic risk assessment.
Q10: During the review of systems, a patient mentions occasional headaches but denies
associated symptoms. Which follow-up question best completes the OLDCARTS
assessment for this symptom?
A. "Do you prefer Tylenol or Advil?"
B. "What makes the headache better or worse?" [CORRECT]
C. "Have you had a CT scan?"
D. "Do your headaches occur in the morning?"
Correct Answer: B
Rationale: The "A" in OLDCARTS stands for aggravating/alleviating factors.
Understanding what worsens or improves headaches helps differentiate tension,
migraine, and secondary headache etiologies.
Q11: A nurse is providing health promotion teaching to a 50-year-old patient with no
chronic conditions. Which preventive screening recommendation is most appropriate?
A. Annual mammography starting at age 55
B. Colonoscopy beginning at age 45 [CORRECT]
C. PSA testing every 6 months
D. Bone density scan at age 50
Correct Answer: B
Rationale: Current USPSTF guidelines recommend colorectal cancer screening
beginning at age 45 for average-risk adults. Mammography typically begins at 40-50
depending on risk, and routine PSA is not universally recommended.
Q12: A patient arrives at the clinic with complaints of fever, sore throat, and a new rash.
Which action should the nurse prioritize during the health history interview?
Nightingale College | GRADED A | Pass Guaranteed - A+
Graded
SECTION 1: Health History & Interview (Q1–Q12)
Q1: A 58-year-old patient presents to the clinic with complaints of chest pain. The nurse
begins the health history using the OLDCARTS mnemonic. After learning the pain is
substernal and pressure-like, what is the nurse's next priority assessment question?
A. "Have you tried any home remedies?"
B. "Does the pain radiate to your arm, jaw, or back?" [CORRECT]
C. "What is your family history of diabetes?"
D. "How many servings of vegetables do you eat daily?"
Correct Answer: B
Rationale: Radiation of chest pain to the arm, jaw, or back is a classic indicator of
cardiac ischemia and requires immediate assessment. While the other options are
relevant to a comprehensive history, determining radiation takes priority due to potential
acute coronary syndrome.
Q2: During a health interview, a 24-year-old college student admits to drinking alcohol
daily but becomes defensive when asked about quantity. The nurse recognizes the need
for further assessment. Which question should the nurse ask next?
A. "You shouldn't drink every day."
B. "Most people your age don't drink daily."
C. "Help me understand how much you typically drink in a week." [CORRECT]
D. "Do you realize alcohol is dangerous?"
Correct Answer: C
Rationale: Open-ended, non-judgmental questions encourage honest disclosure about
sensitive topics. Confrontational or leading responses shut down communication and
prevent accurate health history data collection.
,Q3: A nurse is assessing a patient with limited health literacy. Which technique best
promotes accurate data collection during the health history?
A. Use medical terminology to ensure precision
B. Provide written questionnaires only
C. Use the teach-back method and simple language [CORRECT]
D. Ask yes/no questions exclusively
Correct Answer: C
Rationale: The teach-back method confirms patient understanding by asking them to
explain information in their own words. Medical jargon and exclusive yes/no questions
limit comprehension and accuracy.
Q4: A nurse is conducting a cultural assessment with a patient recently immigrated
from Vietnam. Which question should the nurse ask first?
A. "Why don't you use Western medicine?"
B. "What cultural or traditional practices do you use to maintain health?" [CORRECT]
C. "Your English is good; do you really need an interpreter?"
D. "Don't you know herbal remedies can be dangerous?"
Correct Answer: B
Rationale: Culturally sensitive questions invite patients to share traditional health
practices without judgment. This approach builds trust and identifies potential
interactions with prescribed treatments.
Q5: In the emergency department, a patient presents with severe asthma exacerbation,
dyspnea, and inability to speak in full sentences. Which type of health history is most
appropriate for the nurse to obtain?
A. Comprehensive health history
B. Focused health history [CORRECT]
C. Family history only
D. Review of systems only
Correct Answer: B
Rationale: A focused health history targets the immediate presenting problem and
relevant history. In acute respiratory distress, a comprehensive history would delay
necessary interventions and is inappropriate.
,Q6: During a routine wellness visit, a nurse suspects intimate partner violence based on
the patient's evasive answers and patterned bruising. What is the nurse's next best
action?
A. Confront the partner in the waiting room
B. Ask the patient directly about safety in the home when alone [CORRECT]
C. Document suspicion and wait for the patient to volunteer information
D. Call law enforcement immediately without patient consent
Correct Answer: B
Rationale: Direct questioning about safety in a private setting allows the patient to
disclose violence when safe to do so. Immediate law enforcement contact without
consent violates patient autonomy unless imminent danger exists.
Q7: A patient with Type 2 diabetes states, "I know I should exercise, but I just can't seem
to start." Using motivational interviewing, which response by the nurse is most
appropriate?
A. "You need to exercise or you'll lose your legs."
B. "What barriers prevent you from starting an exercise routine?" [CORRECT]
C. "I'll write you a prescription for the gym."
D. "Your doctor will be disappointed if you don't exercise."
Correct Answer: B
Rationale: Motivational interviewing explores patient ambivalence by eliciting
self-motivating statements. Asking about barriers invites problem-solving and respects
patient autonomy.
Q8: A nurse is assessing an 82-year-old patient's functional status. Which assessment
tool best evaluates the patient's ability to manage medications, finances, and
transportation?
A. Katz Index of ADLs
B. Lawton IADL Scale [CORRECT]
C. Braden Scale
D. Glasgow Coma Scale
Correct Answer: B
Rationale: The Lawton Instrumental Activities of Daily Living (IADL) Scale assesses
complex tasks like medication management, finances, and transportation. The Katz
Index evaluates basic self-care activities only.
, Q9: When constructing a three-generation family genogram, which information is
essential to include?
A. Only living relatives
B. Age, health status, and cause of death for all first-degree relatives [CORRECT]
C. Only relatives with chronic diseases
D. Patient's friends and coworkers
Correct Answer: B
Rationale: Genograms document age, health conditions, and cause of death across
three generations to identify hereditary disease patterns. Excluding deceased relatives
or healthy family members creates an incomplete genetic risk assessment.
Q10: During the review of systems, a patient mentions occasional headaches but denies
associated symptoms. Which follow-up question best completes the OLDCARTS
assessment for this symptom?
A. "Do you prefer Tylenol or Advil?"
B. "What makes the headache better or worse?" [CORRECT]
C. "Have you had a CT scan?"
D. "Do your headaches occur in the morning?"
Correct Answer: B
Rationale: The "A" in OLDCARTS stands for aggravating/alleviating factors.
Understanding what worsens or improves headaches helps differentiate tension,
migraine, and secondary headache etiologies.
Q11: A nurse is providing health promotion teaching to a 50-year-old patient with no
chronic conditions. Which preventive screening recommendation is most appropriate?
A. Annual mammography starting at age 55
B. Colonoscopy beginning at age 45 [CORRECT]
C. PSA testing every 6 months
D. Bone density scan at age 50
Correct Answer: B
Rationale: Current USPSTF guidelines recommend colorectal cancer screening
beginning at age 45 for average-risk adults. Mammography typically begins at 40-50
depending on risk, and routine PSA is not universally recommended.
Q12: A patient arrives at the clinic with complaints of fever, sore throat, and a new rash.
Which action should the nurse prioritize during the health history interview?
