, BSN HESI 246 Health Assessment V1 Exam
Actual Exam – Nightingale College
Question 1
The nurse is performing a thoracic assessment on a client with chronic asthma and
hyperinflation of the lungs. Which finding should be expected for this client?
A) Pectus excavatum
B) Barrel chest
C) Kyphosis
D) Scoliosis
Answer: B
Rationale: A barrel chest is commonly observed in clients with chronic lung conditions such as
asthma due to hyperinflation of the lungs that increases the anteroposterior diameter of the
chest .
Question 2
Which technique should the nurse use to begin a head-to-toe assessment?
A) Palpate the scalp
B) Auscultate for bruits
C) Inspect the hair and skin
D) Percuss the frontal sinuses
Answer: C
Rationale: Inspection is always the first step in a physical assessment. By visually examining hair
and skin, the nurse gathers objective data such as texture, lesions, or discoloration before
moving on to palpation, percussion, or auscultation .
Question 3
While conducting an interview to obtain a health history, the nurse notices that the client
pauses frequently and looks at the nurse expectantly. Which response is best for the nurse to
provide?
,A) Ask rapid-fire questions to keep the conversation going
B) Offer the client a water break
C) Sit quietly to allow the client to respond comfortably
D) Encourage the client to continue speaking
Answer: C
Rationale: Allowing the client to take their time encourages open communication and helps
build trust, especially if they are feeling hesitant or uncomfortable. Silence is a therapeutic
communication technique that respects the client's need to process thoughts .
Question 4
The nurse is obtaining a health history for a client prior to a scheduled cholecystectomy. While
interviewing the client, which assessment technique should the nurse use when asking about
the client's use of illegal drugs and alcohol?
A) Ask about drug use in relation to the client's job
B) Inquire about general lifestyle habits
C) Ask specifically about alcohol, marijuana, cocaine, heroin, and amounts
D) Assess family history of substance use disorders
Answer: C
Rationale: Specific questions about types and amounts of substance use provide a clearer
understanding of the client's habits and potential risks that could affect surgical outcomes.
Question 5
A client has been diagnosed with bilateral lower lobe atelectasis. What percussion sound should
the nurse expect to hear when percussing over the client's lower lobes?
A) Resonant
B) Hyperresonant
C) Dull, thud-like
D) Tympanic
Answer: C
Rationale: Dullness is typically heard over areas of increased density such as consolidation or
atelectasis. The collapsed alveoli in atelectasis replace air with fluid or tissue, producing a thud-
like sound upon percussion .
, Question 6
While obtaining a health history, a male client reports occasional shortness of breath. His
respirations are regular and deep at 14 breaths/min. What is the nurse's best action?
A) Notify the provider
B) Apply supplemental oxygen
C) Ask the client to describe the episodes in more detail
D) Document the finding as normal
Answer: C
Rationale: Normal respiratory rate and depth suggest stability. Further subjective data is
required to identify triggers, duration, and severity before intervening.
Question 7
The nurse is assessing a healthy young adult during an annual physical examination. Which
assessment technique should the nurse implement when palpating the abdominal aorta?
A) Light palpation along the midline
B) Deep palpation above and to the left of the umbilicus
C) Percussion over the epigastrium
D) Auscultation before palpation
Answer: B
Rationale: Deep palpation allows the nurse to assess the size, pulsation, and possible
aneurysms of the abdominal aorta. It should be performed above and slightly left of the
umbilicus .
Question 8
A client is in the clinic for a yearly physical examination. Which action should the nurse take
when preparing to examine the client's abdomen?
A) Keep the room cool so the client is not perspiring
B) Ask the client to urinate before beginning the examination
C) Examine painful or tender areas first
D) Position the client supine with arms over the head
Answer: B
Actual Exam – Nightingale College
Question 1
The nurse is performing a thoracic assessment on a client with chronic asthma and
hyperinflation of the lungs. Which finding should be expected for this client?
A) Pectus excavatum
B) Barrel chest
C) Kyphosis
D) Scoliosis
Answer: B
Rationale: A barrel chest is commonly observed in clients with chronic lung conditions such as
asthma due to hyperinflation of the lungs that increases the anteroposterior diameter of the
chest .
Question 2
Which technique should the nurse use to begin a head-to-toe assessment?
A) Palpate the scalp
B) Auscultate for bruits
C) Inspect the hair and skin
D) Percuss the frontal sinuses
Answer: C
Rationale: Inspection is always the first step in a physical assessment. By visually examining hair
and skin, the nurse gathers objective data such as texture, lesions, or discoloration before
moving on to palpation, percussion, or auscultation .
Question 3
While conducting an interview to obtain a health history, the nurse notices that the client
pauses frequently and looks at the nurse expectantly. Which response is best for the nurse to
provide?
,A) Ask rapid-fire questions to keep the conversation going
B) Offer the client a water break
C) Sit quietly to allow the client to respond comfortably
D) Encourage the client to continue speaking
Answer: C
Rationale: Allowing the client to take their time encourages open communication and helps
build trust, especially if they are feeling hesitant or uncomfortable. Silence is a therapeutic
communication technique that respects the client's need to process thoughts .
Question 4
The nurse is obtaining a health history for a client prior to a scheduled cholecystectomy. While
interviewing the client, which assessment technique should the nurse use when asking about
the client's use of illegal drugs and alcohol?
A) Ask about drug use in relation to the client's job
B) Inquire about general lifestyle habits
C) Ask specifically about alcohol, marijuana, cocaine, heroin, and amounts
D) Assess family history of substance use disorders
Answer: C
Rationale: Specific questions about types and amounts of substance use provide a clearer
understanding of the client's habits and potential risks that could affect surgical outcomes.
Question 5
A client has been diagnosed with bilateral lower lobe atelectasis. What percussion sound should
the nurse expect to hear when percussing over the client's lower lobes?
A) Resonant
B) Hyperresonant
C) Dull, thud-like
D) Tympanic
Answer: C
Rationale: Dullness is typically heard over areas of increased density such as consolidation or
atelectasis. The collapsed alveoli in atelectasis replace air with fluid or tissue, producing a thud-
like sound upon percussion .
, Question 6
While obtaining a health history, a male client reports occasional shortness of breath. His
respirations are regular and deep at 14 breaths/min. What is the nurse's best action?
A) Notify the provider
B) Apply supplemental oxygen
C) Ask the client to describe the episodes in more detail
D) Document the finding as normal
Answer: C
Rationale: Normal respiratory rate and depth suggest stability. Further subjective data is
required to identify triggers, duration, and severity before intervening.
Question 7
The nurse is assessing a healthy young adult during an annual physical examination. Which
assessment technique should the nurse implement when palpating the abdominal aorta?
A) Light palpation along the midline
B) Deep palpation above and to the left of the umbilicus
C) Percussion over the epigastrium
D) Auscultation before palpation
Answer: B
Rationale: Deep palpation allows the nurse to assess the size, pulsation, and possible
aneurysms of the abdominal aorta. It should be performed above and slightly left of the
umbilicus .
Question 8
A client is in the clinic for a yearly physical examination. Which action should the nurse take
when preparing to examine the client's abdomen?
A) Keep the room cool so the client is not perspiring
B) Ask the client to urinate before beginning the examination
C) Examine painful or tender areas first
D) Position the client supine with arms over the head
Answer: B
