, BSN HESI 246 Health Assessment V3 Exam
Actual Exam – Nightingale College
Question 1
A Muslim male client refuses to allow a female RN to auscultate his breath sounds. How should
the RN respond?
A) Explain that the exam is medically necessary
B) Proceed quickly with the assessment
C) Request a male nurse or healthcare provider
D) Ask a family member to remain present
Answer: C
Rationale: Modesty is a significant cultural value in Islam. Many Muslim clients prefer care from
same-sex healthcare providers, especially when physical exposure is involved. Respecting
cultural beliefs promotes trust and therapeutic communication. Requesting a male provider
ensures culturally competent care without delaying treatment .
Question 2
The RN is teaching a client who is being discharged after treatment of tuberculosis (TB). Which
cultural issues should the RN assess when preparing the client for discharge? (Select all that
apply.)
A) Native language
B) Education level
C) Type of lifestyle
D) Financial resources
E) Previous medical history
Answer: A, B, C, D
Rationale: Understanding language and education level ensures discharge instructions are clear.
Financial resources affect access to medications and follow-up care. Lifestyle factors impact
adherence to treatment regimens. Previous medical history is clinical, not cultural .
,Question 3
A client with progressive hearing loss appears distressed when the RN asks open-ended
questions about the health history. Which forms of communication should the RN use? (Select
all that apply.)
A) Face the client so the client can see the RN's mouth
B) Increase one's speech volume when interacting with the client
C) Repeat information to the client if misunderstood
D) Check if the client's hearing aids are working properly
E) Reduce environmental noise surrounding the client
Answer: A, D, E
Rationale: Facing the client allows for lip reading, checking hearing aids ensures proper
function, and reducing background noise improves hearing. Speaking clearly with enunciation
and in a regular tone is easier to understand than increasing volume. If a client shows signs of
confusion, rephrasing the question, instead of repeating, should be done to decrease client
anxiety and facilitate understanding .
Question 4
The RN is performing a mini-mental state examination (MMSE) for a client who is being
admitted to an assisted living community. Which communication techniques should the RN
implement to decrease anxiety in the client? (Select all that apply.)
A) Use simple sentences during the examination
B) Move to another question if the client seems confused
C) Reduce environmental detractors during the examination
D) Allow family to answer for the client to decrease frustration
E) Ask questions one at a time to decrease confusion
Answer: A, C, E
Rationale: Communication techniques for clients with cognitive impairments should be simple,
without environmental distractions, and direct. Using simple sentences, reducing environmental
noise, and asking one question at a time decreases confusion and anxiety .
Question 5
A client is switched from atenolol to enalapril. What teaching is most important?
, A) Monitor pulse daily
B) Take medication at bedtime
C) Rise slowly from sitting or lying
D) Report bruising immediately
Answer: C
Rationale: Enalapril is an ACE inhibitor that commonly causes orthostatic hypotension. Rising
slowly reduces dizziness and fall risk. Pulse monitoring is more critical with beta-blockers like
atenolol .
Question 6
The RN is conducting a health assessment interview with a client who is accompanied by a
family member. Which action by the RN is most appropriate?
A) Address all questions to the family member
B) Direct questions to the client while including the family member
C) Ask the family member to leave the room
D) Allow the family member to answer for the client
Answer: B
Rationale: The client is the primary source of information. Including the family member while
directing questions to the client respects autonomy and gathers accurate data .
Question 7
A client who recently immigrated from Vietnam presents for a routine physical. The client avoids
eye contact during the interview. What should the RN do?
A) Interpret this as a sign of dishonesty
B) Continue the interview while respecting cultural differences
C) Ask the client why they won't make eye contact
D) Terminate the interview
Answer: B
Rationale: In many Asian cultures, avoiding eye contact is a sign of respect, especially when
speaking with authority figures. Continuing the interview without drawing attention to the
behavior is most appropriate .
Actual Exam – Nightingale College
Question 1
A Muslim male client refuses to allow a female RN to auscultate his breath sounds. How should
the RN respond?
A) Explain that the exam is medically necessary
B) Proceed quickly with the assessment
C) Request a male nurse or healthcare provider
D) Ask a family member to remain present
Answer: C
Rationale: Modesty is a significant cultural value in Islam. Many Muslim clients prefer care from
same-sex healthcare providers, especially when physical exposure is involved. Respecting
cultural beliefs promotes trust and therapeutic communication. Requesting a male provider
ensures culturally competent care without delaying treatment .
Question 2
The RN is teaching a client who is being discharged after treatment of tuberculosis (TB). Which
cultural issues should the RN assess when preparing the client for discharge? (Select all that
apply.)
A) Native language
B) Education level
C) Type of lifestyle
D) Financial resources
E) Previous medical history
Answer: A, B, C, D
Rationale: Understanding language and education level ensures discharge instructions are clear.
Financial resources affect access to medications and follow-up care. Lifestyle factors impact
adherence to treatment regimens. Previous medical history is clinical, not cultural .
,Question 3
A client with progressive hearing loss appears distressed when the RN asks open-ended
questions about the health history. Which forms of communication should the RN use? (Select
all that apply.)
A) Face the client so the client can see the RN's mouth
B) Increase one's speech volume when interacting with the client
C) Repeat information to the client if misunderstood
D) Check if the client's hearing aids are working properly
E) Reduce environmental noise surrounding the client
Answer: A, D, E
Rationale: Facing the client allows for lip reading, checking hearing aids ensures proper
function, and reducing background noise improves hearing. Speaking clearly with enunciation
and in a regular tone is easier to understand than increasing volume. If a client shows signs of
confusion, rephrasing the question, instead of repeating, should be done to decrease client
anxiety and facilitate understanding .
Question 4
The RN is performing a mini-mental state examination (MMSE) for a client who is being
admitted to an assisted living community. Which communication techniques should the RN
implement to decrease anxiety in the client? (Select all that apply.)
A) Use simple sentences during the examination
B) Move to another question if the client seems confused
C) Reduce environmental detractors during the examination
D) Allow family to answer for the client to decrease frustration
E) Ask questions one at a time to decrease confusion
Answer: A, C, E
Rationale: Communication techniques for clients with cognitive impairments should be simple,
without environmental distractions, and direct. Using simple sentences, reducing environmental
noise, and asking one question at a time decreases confusion and anxiety .
Question 5
A client is switched from atenolol to enalapril. What teaching is most important?
, A) Monitor pulse daily
B) Take medication at bedtime
C) Rise slowly from sitting or lying
D) Report bruising immediately
Answer: C
Rationale: Enalapril is an ACE inhibitor that commonly causes orthostatic hypotension. Rising
slowly reduces dizziness and fall risk. Pulse monitoring is more critical with beta-blockers like
atenolol .
Question 6
The RN is conducting a health assessment interview with a client who is accompanied by a
family member. Which action by the RN is most appropriate?
A) Address all questions to the family member
B) Direct questions to the client while including the family member
C) Ask the family member to leave the room
D) Allow the family member to answer for the client
Answer: B
Rationale: The client is the primary source of information. Including the family member while
directing questions to the client respects autonomy and gathers accurate data .
Question 7
A client who recently immigrated from Vietnam presents for a routine physical. The client avoids
eye contact during the interview. What should the RN do?
A) Interpret this as a sign of dishonesty
B) Continue the interview while respecting cultural differences
C) Ask the client why they won't make eye contact
D) Terminate the interview
Answer: B
Rationale: In many Asian cultures, avoiding eye contact is a sign of respect, especially when
speaking with authority figures. Continuing the interview without drawing attention to the
behavior is most appropriate .
